Medical Professionalisation

Question 1

1737

Answer 1

Edinburgh Medical Society formed

Question 2

What does Jewson argue?

Answer 2

The C18th patronage system made medicine a commodity - increasing the power of patients

Question 3

What does Waddington argue of the C18th?

Answer 3

Patronage and status mattered more than skill

Unificiation of training did not equal a unified profession, but began to create a professional idenitity

Question 4

Pre-1815 division

Answer 4

Apothecaries
Surgeons
Physicians
(though surgeon-apothecaries existed)
However this apparent division did not reflect reality - most served as general practitioners

Question 5

Who were the physicians ruled by pre-1815?

Answer 5

Royal College of Physicians founded 1518

Question 6

When was a membership exam introduced for the Royal College of Physicians?

Answer 6

1860

had been founded in 1518

Question 7

Who were surgeons ruled by pre-1815?

Answer 7

Barber-Surgeons Company 1745

became Royal College of Surgeons of London in 1800

Question 8

How did the Royal College of Surgeons of London assess membership?

Answer 8

Had to have completed an apprenticeship

Had to have attended at least one anatomy and one surgery lecture session

Question 9

How were apothecaries assessed pre-1815?

Answer 9

Society of Apocatheries in London established 1617

Oral examination and apprenticeships required

Question 10

How did King James distinguish apothecaries from grocers

Answer 10

Grocers were “unskilful” - unlike apothecaries

Question 11

What did the end of the Napoleonic Wars in 1815 cause?

Answer 11

Return of military surgeons - more competition

Question 12

What were the disadvantages of apprenticeships?

Answer 12

Variable training standards and length, not standardized curriculum

Question 13

What did Thomas Percival publish in the C18th

Answer 13

‘Medical Ethics’ - meant to negotiate interprofessional disputes

Question 14

Apothecaries Act 1815

Answer 14

Examinations introduced (though inefficient)
6 months hospital experience required
5 year apprenticeship made standard
Need to provide reference for moral character as well as education
License of the Society of Apothecaries needed to dispense
Compulsory attendance @ at least one lecture series
Aimed to privilege them over druggists?

Question 15

What was medical training generally by the mid-1840s?

Answer 15

Medical course generally 4 years

Apothecary course generally 3 years

Question 16

What did Justice Park argue in 1828?

Answer 16

That the Apothecaries Act was intended to keep the separation between the functions of surgeons, physicians, and apothecaries

Question 17

When was the British Medical Association founded?

Answer 17

1856

Question 18

When was the British Medical Act?

Answer 18

1858

Question 19

What did the 1858 Medical Act (Britain) do?

Answer 19

Established Register (publically available)
Arranged to publish Pharmacopeia (in Latin though - inaccessible except for educated)
Qualification regulation (NOT unification)
Disciplinary code established (problematic; restrictions undefined)
Sought to abolish geographic restrictions on practice (influence of geographic mobility?)
General Medical Council established

Question 20

What did the 1858 Medical Act (Britain) NOT do?

Answer 20

Make unqualified practice illegal - free market
Unify or standardize qualifications
Amalgamate/standardize universities and qualifications
Professional self-regulation remained

Question 21

What effects did the 1858 Act ahve?

Answer 21

Minimal growth in number of registered medical practitioners relative to population growth
Increased earnings and status of medical practitioners
Foucault: exemplified evolution of knowledge into power?

Question 22

How does Foucault’s theory of power relations apply to the standardization of medical practice?

Answer 22

Exemplifies the evolution of knowledge into a source of power

Question 23

What does Parry argue about the 1858 Medical Act?

Answer 23

Meant to create status and upward mobility for doctors, not protect patients or unify profession

Question 24

When did the Lancet argue that medics were not wealthy?

Answer 24

1830

Question 25

What did the rise of hospital medicine mean?

Answer 25

Charitable basis - reduction in free will and choice of the patient (especially by NHS)
By C19th, hospital training generally standard for medical men
Status of and trust in doctors rose (Waddington)

Question 26

What is an effect of increasing state liscensing?

Answer 26

Reducing professional competition

Question 27

What did Voltaire publish?

Answer 27

C18th satire against doctors

Question 28

What did new developments in the 1950s cause, according to Ivan Waddington?

Answer 28

Increased medical prestige

Question 29

What showed the 1960s/70s distrust of medicine?

Answer 29

Shows such as MAS*H, movies such as One Flew Over the Cuckoo’s Nest