Academic General Practice in the UK Medical Schools, 1948-2000

Academic General Practice in the UK Medical Schools, 1948-2000: A Short History

John Howie
Michael Whitfield
Copyright Date: 2011
Pages: 168
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  • Book Info
    Academic General Practice in the UK Medical Schools, 1948-2000
    Book Description:

    The first collective record of the evolution of general medical practice as an academic discipline over half a century.This anthology captures the stories of the early struggles to set up university departments between visionary supporters and traditionalist blockers as well as the steadily increasing successes aided by a dedicated funding system. The accounts are written where possible by the people involved in the early developments of their subject. These tales are of vision, commitment and resilience and are interesting both in their own right and for the more general lessons they tell us about the processes of creating institutional change within a modern democracy.* Demonstrates the radical shifts in the shape of medical education in the last two decades* Provides vivid personal accounts from early academic leaders* Includes comment on contemporary medical and educational developments

    eISBN: 978-0-7486-4374-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Table of Contents
    (pp. iii-v)
  3. Preface
    (pp. vi-vii)
    Frank Sullivan
  4. Acknowledgements
    (pp. viii-viii)
  5. Abbreviations
    (pp. ix-xi)
  6. Timeline
    (pp. xii-xiii)
  7. Introduction
    (pp. xiv-xvi)
    John Howie and Michael Whitfield

    In July 2007, the Heads of Departments group of SAPC invited those of their retired predecessors and founder members of AUTGP they could trace to join them for their annual get-together in an Indian restaurant in South Kensington. Anxious to repay their hospitality and recognising that many of our stories of the early struggles and setbacks along the road to where we were now had never been properly recorded and were in danger of being lost, our cluster of veterans agreed to write about the early developments of our respective departments. Four years on, this book is the result.


  8. Chapter 1 The University of Aberdeen
    (pp. 1-4)
    Lewis Ritchie and John Howie

    Aberdeen students in the pre-NHS era received an introduction to general practice during attachments to the Woolmanhill public dispensary as part of their public health teaching. Between 1948 and the creation of the GPTU in 1967, there was no formal teaching in general practice, although many students fixed up short attachments to north-east general practices on their own initiative during vacations.

    In 1967, with a grant from the Nuffield Provincial Hospitals Trust, the university decided to create the GPTU and advertised for a director at senior lecturer/reader level. Forty-four applications were received, the majority from senior north-east general practitioners without...

  9. Chapter 2 The University of Dundee
    (pp. 5-8)
    James Knox and Frank Sullivan

    Dundee is a small Scottish city with one of the smaller medical schools in the UK. Academic general practice has played an important role in its contribution to medical education and, increasingly, research.

    The University of Dundee began as a college of the University of St Andrews and became an independent institution in 1967. The senior faculty of its medical school soon realised it needed a department of general practice. On 1 April 1970, Dr James Knox left his practice in Edinburgh to become the inaugural professor of general practice.

    Originally based near the main university campus in the centre...

  10. Chapter 3 The University of Edinburgh
    (pp. 9-12)
    John Howie and David Weller

    During the second half of the eighteenth century, Andrew Duncan – then professor of medicine in the University of Edinburgh – proposed and constructed a public dispensary to provide care to the sick poor in the Old Town of Edinburgh and to instruct medical students. From 1890 attendance at one of several public dispensary practices became a compulsory part of the Edinburgh undergraduate curriculum.¹

    As in many UK medical schools, the development of the academic department owed much to the foresight and opportunism of senior academic public health/social medicine physicians. In Edinburgh, Professor Frank Crew recognised that the closure of...

  11. Chapter 4 The University of Glasgow
    (pp. 13-18)
    David Hannay and Graham Watt

    The origins of the department in Glasgow lay partly in community medicine and partly in the concerns of the SHHD to develop health centres. Community medicine was represented in Glasgow by the department of epidemiology and preventive medicine based at Ruchill Hospital. Its head, Professor Tom Anderson, was a moving spirit in promoting the concept of a health centre combining clinical care with teaching medicine in the community. As early as 1964, a working party from the west of Scotland faculty of the College of General Practitioners recommended setting up a department of general practice under the chair of medicine....

  12. Chapter 5 The Cardiff University School of Medicine
    (pp. 19-22)
    Nigel Stott and Chris Butler

    A medical school associated with Archie Cochrane’s MRC epidemiology research unit and Professor C.R. Lowe’s multidisciplinary university department of social and occupational medicine was ideally placed to develop academic general practice as an interface between biomedicine and community medicine. In 1968, Robert Harvard Davis, an Oxford graduate and general practitioner in Cardiff, was appointed to Professor Lowe’s department to establish an academic unit of general practice with teaching and research responsibilities. He established a presence in the department of social and occupational medicine and then negotiated with Cardiff City Council to co-fund the building of an academic health centre on...

  13. Chapter 6 Academic General Practice in Ireland
    (pp. 23-30)
    Tom O′Dowd, George Irwin, Philip Reilly, Andrew Murphy, Bill Shannon, Tom Fahey, Colin Bradley, Gerard Bury and Walter Cullen

    Two of the original twenty-nine departments of general practice which came to constitute the AUTGP were based in Ireland, one at Queen’s University Belfast (QUB) and the other at Trinity College Dublin (TCD). Over the years, cross-border collaboration led to the institution of the Association of University Departments of General Practice in Ireland (AUDGPI) in 1997. The ‘Ireland story’ presented in this chapter describes the early days of each department separately, followed by some reflections on how the partnership between them has now been formalised.

    In 1958, Professor John Pemberton, epidemiologist and founder of public health medicine, was appointed to...

  14. Chapter 7 The University of Birmingham
    (pp. 31-36)
    Michael Drury and Richard Hobbs

    During the 1950s a number of Birmingham practices began to offer an informal experience of general practice to students in their elective period. Some offered contacts in the evenings or at weekends to students who requested this. The Birmingham LMC was active in encouraging such experiences. In 1966 the Midland faculty of the then College of General Practitioners began to explore the possibility of establishing a formal post in the medical school and Michael Drury, who had recently returned from a Nuffield Fellowship, was offered a part-time post as a lecturer in the department of social medicine by Professor Thomas...

  15. Chapter 8 The University of Bristol
    (pp. 37-39)
    Michael Whitfield and Debbie Sharp

    The medical faculty of the University of Bristol was slow to accept that general practice has a role in teaching medical students and was the last of the pre-2000 medical schools in the UK to create an academic undergraduate post occupied by a general practitioner. The story behind this development is interesting and illustrates the way that tradition can be challenged and eventually altered.

    In the early 1960s, Bristol’s professor of public health and medical officer of health, Robert Wofinden, created a name for himself with the development of health centres. He saw this as a way of bringing together...

  16. Chapter 9 The University of Cambridge
    (pp. 40-46)
    Bob Berrington, John Perry, Nigel Oswald, Martin Roland, John Benson and Ann Louise Kinmonth

    Medicine has been studied in Cambridge since 1318, but it was not until the time of John Butterfield (Regius 1976–1987) and Keith Peters (Regius 1987–2005) that the foundation chairs of community medicine (1977) and general practice (1996) were established. Butterfield led the establishment of the school of clinical medicine (1976), and Peters the transformation of the school into a world leading centre for medical research.

    The path to realising the academic aspirations of general practice led uphill. The combined efforts of postgraduate general practice educators, the RHA, Royal Colleges and local practitioners took twenty years to establish a...

  17. Chapter 10 The University of Exeter
    (pp. 47-51)
    Denis Pereira Gray

    The University of Exeter established a department of general practice on 1 December 1973, just before a postgraduate university department of general practice was established in Denmark. This was the first postgraduate university department of general practice in the UK, modelled on the London postgraduate medical institutes. It was funded by the DHSS to develop vocational training for general practice. For almost a year, Denis Pereira Gray was alone with a half-time appointment as senior lecturer, the only academic general practice presence in the south-west region. Three more part-time senior lecturers, Keith Bolden, Michael Hall and Robert Jones, joined in...

  18. Chapter 11 The University of Leeds
    (pp. 52-57)
    John Wright and Conrad Harris

    Undergraduate teaching in general practice started life in the University of Leeds on 1 July 1974 as a division within the department of community medicine and general practice. The department was headed by Professor Gerald Richards, whose clear preference was that, in terms of educational and research policy, the new unit should have a considerable measure of autonomy.

    Though vigorously supported by the then Dean (Professor Derek Wood), the creation of such a unit was regarded with derision by a few of the influential senior faculty staff. Curricular time was, consequently, limited at first to a fortnight in the students’...

  19. Chapter 12 The University of Leicester
    (pp. 58-60)
    Robin Fraser

    Leicester was the last of the three new medical schools to be established in the twentieth century after Southampton and Nottingham. It accepted its first medical students in 1975. General practice was initially contained within the department of community health functioning as a semi-autonomous unit alongside epidemiology and biostatistics.

    Originally housed on the Leicester Royal Infirmary site, the unit moved to purpose-adapted premises at the Leicester General Hospital in 1992, shortly after becoming an independent department of general practice as a consequence of its widening activities and substantial increase in personnel. In 1995, reflecting its expansion beyond the boundaries of...

  20. Chapter 13 The University of Liverpool
    (pp. 61-63)
    Brian McGuinness, Ian Stanley and Christopher Dowrick

    In 1971, the first attempt to create a department of general practice in Liverpool centred on the Palacefields university practice in the then new town of Runcorn, under the directorship of Tony Hall-Turner, previously a general practice principal in Corby. Although modelled on the successful Guy’s Hospital development at Thamesmead in London, the Liverpool scheme differed significantly in receiving neither charitable funding nor any financial support from its own medical school, being expected – completely unrealistically – to fund its clinical and academic activities entirely from NHS practice income.

    Support from some senior academic staff within the medical school (notably...

  21. Chapter 14 The University of Manchester
    (pp. 64-69)
    David Metcalfe and Carl Whitehouse

    During the 1930s, John Ryle’s philosophy of ‘social medicine’ was developed. Its central tenet was that illness should be studied in relation to the patient’s occupational and social environment. These beliefs were held by Fraser Brockington, who became the Manchester professor of social and preventive medicine, and by Robert Platt, the professor of medicine. A social medicine ‘laboratory’ was required and the then Vice-Chancellor, John Stopford, set about finding one. A suitable building for an experimental health centre was found close to the university.

    Stopford secured grants from the Rockefeller and Nuffield foundations to buy Darbishire House for £17,500 in...

  22. Chapter 15 The University of Newcastle
    (pp. 70-74)
    John Walker and John Spencer

    The medical school in Newcastle had its origins in a series of lectures organised by a group of local practitioners beginning in 1832. Of the eight students enrolled, John Snow was to become the most distinguished, removing the handle of the Broad Street pump and becoming anaesthetist to Queen Victoria at the birth of two of her children in the 1850s. By 1834 the popularity of the lectures led to the foundation of the Newcastle College of Medicine which by 1851 had established a close connection with the developing University of Durham, allowing the College to award Durham degrees in...

  23. Chapter 16 The University of Nottingham
    (pp. 75-77)
    Idris Williams

    The University of Nottingham received its Charter in 1948, but it was some time before it had a medical school. By the late 1960s agreement was reached between the then Sheffield Regional Hospital Board and the university that there should be a university teaching hospital in Nottingham which allowed the university to proceed with the founding of a medical school. The first forty-eight students were admitted in September 1970 and the faculty was officially inaugurated in October 1970 by Sir Keith Joseph, the Secretary of State for Health and Social Services. Responsibility for general practice teaching was placed in the...

  24. Chapter 17 The University of Oxford
    (pp. 78-81)
    Godfrey Fowler

    The origins of the University of Oxford are said to be ‘lost in the mists of antiquity’. It is thought to date from the mid-twelfth century with the migration of students from Paris. ‘Physic’ was one of the early subjects studied, with a status approaching that of theology!

    Formal teaching of medical sciences to undergraduates did not start until the end of the nineteenth century, when chairs of anatomy and physiology were established. Clinical teaching was regarded by the university as a ‘trade’ and was left to the London teaching hospitals. An eventual change in this attitude was fortuitous, though...

  25. Chapter 18 The University of Sheffield
    (pp. 82-86)
    David Hannay and Nigel Mathers

    As in other medical schools, general practice emerged in Sheffield as a distinct academic discipline from under the umbrella of community medicine. In the 1950s and 1960s, final-year medical students had a two-day attachment for six weeks in general practice as part of the public health placement, organised by the then department of social medicine.

    In 1972, Eric Wilkes was appointed to the new chair of general practice within the department of community medicine headed by John Knowelden. There were several local applicants for the chair, but Eric Wilkes was a well-known local general practitioner in Baslow, who had recently...

  26. Chapter 19 The University of Southampton
    (pp. 87-91)
    George Freeman, John Bain and Tony Kendrick

    Southampton was one of the three new medical schools founded in the wake of the Todd report – the first new school in the UK since before the First World War (as we were constantly reminded). It prided itself on being different and set out to at least double the then very low proportion of clinical teaching in the community (achieving 7 per cent in the first decade). The foundation Dean, the epidemiologist Donald Acheson (later Sir Donald Acheson, CMO at the DHSS), had made his name in Oxford with his record linkage project. He brought with him an able...

  27. Chapter 20 The London Medical Schools
    (pp. 92-120)
    Colin Leonard, George Freeman, James Scobie, Marshall Marinker, Conrad Harris, Andy Haines, Brian Jarman, Robert Smith, Donald Craig, Roger Higgs, David Morrell, Roger Jones, Paul Julian, Gene Feder, Sally Hull, Sean Hilton, Margaret Lloyd, Chris Donovan and Michael Modell

    In 1967, all London medical schools were separate institutions based on their teaching hospitals, many of which had moved from their original central sites. Successive attempts at merger met resistance, but by 2000 there were just five undergraduate schools, all incorporated in large multi-faculty colleges with the exception of St George’s.

    In the north-west, Imperial College absorbed St Mary’s Hospital in 1989 and in 1997 also took in Charing Cross and Westminster Hospitals (already merged in 1983).

    Charing Cross Hospital medical school started in the mid-nineteenth century at the hospital building near The Strand, London. It was small, taking twenty...

  28. Chapter 21 The University of St Andrews
    (pp. 121-122)
    Cathy Jackson

    Although a ‘new department’, St Andrews, through James Mackenzie, can almost certainly lay claim to having had one of the first, if not the first, departments of academic general practice. In 1919, Sir James, who believed that general practice was the proper place for clinical research, managed to enlist the support and help of every general practitioner in the town in collaborating in clinical research. Following Mackenzie’s death his Institute suffered funding difficulties and eventually closed its doors in 1944.

    The rebirth of academic general practice at St Andrews occurred in 2008 with the appointment of Cathy Jackson to its...

  29. Appendix 1 Primary Care in the New Medical Schools
    (pp. 123-130)
    John Campbell, Helen Smith, Peter Campion, Amanda Howe, Robert Mckinley, Mary Hoptroff and Jeremy Dale
  30. Appendix 2 The SIFT/ACT Negotiations
    (pp. 131-134)
    John Howie
  31. Appendix 3 An Overview
    (pp. 135-142)
    John Howie
  32. Appendix 4 And Finally . . .
    (pp. 143-145)
    Helen Lester
  33. Index
    (pp. 146-152)