Surgeons on the move

The Company of Surgeons, a precursor to the Royal College of Surgeons in London (1800-1843) and the Royal College of Surgeons of England (1843- ), existed between 1745 and 1800. During the Company’s existence, over 2,400 men successfully passed surgical examinations, received diplomas, and became members of the Company. A diploma from the Company provided clear advantages for surgeons living in or wishing to set up practice within London as it qualified them to work within the city and a seven-mile radius.

But what advantages did a Company diploma offer surgeons who originated elsewhere? What motivated some men to travel extreme lengths to a city that they may not have remained in after qualification? These are some of the questions that arise upon a close examination of the “List of Members of the Company 1780-1800” book.

Above: Scans of pages from 1790 and 1791, exemplifying the diverse range of addresses. From “List of Members of the Company 1780-1800” (Archival Reference: COS/1/9).

Ambition, Opportunity, and Legitimacy

Many of the Company’s surgeons were incredibly mobile when it came to obtaining a surgical education. For example, Philip Syng Physick, the “Father of American Surgery”, travelled from Philadelphia to London in November 1788 and earned his Company diploma in February 1791. Physick studied and worked under the famed surgeon John Hunter before obtaining his diploma. After obtaining it, he travelled to Edinburgh to study medicine before returning to Philadelphia and becoming a professor of surgery at the University of Pennsylvania in 1803. According to his memoirist J. Randolph, Physick went to London for a better education than could be found in the United States:

The opportunities for the acquisition of profound medical knowledge offered by the schools and hospitals of this country, then in its infancy, were too limited to satisfy either his conscience or his ambition.

So it seems ambition drove Physick to London.

Above: “M0010198: Portrait of Philip Syng Physick (1768-1837)”. Public Domain Mark. Source: Wellcome Collection.

This motivation also likely influenced surgical students from within England, Wales, Scotland, and Ireland to travel to London and obtain a Company diploma. During the eighteenth century, national regulations of surgical education and surgical standards did not exist as we now know them. Within the British Isles, a surgical student could undertake an apprenticeship with a local surgeon and earn a certificate, or attend a local, private medical school. Surgical students did not need to move (or at least did not have to travel as far as London) to receive an education in surgery. According to the historian Alun Withey, many moved, at least temporarily, because they “desired or aspired to appear legitimate figures of authority on medicine” in order to access and keep a local, wealthy clientele that otherwise would have sought medical treatment in London. If a surgeon obtained a Company diploma before returning home, they carried an air of prestige and legitimacy that enabled them to make more money.

But why choose London over Dublin, Edinburgh, or Glasgow? Afterall, these cities had similar regulatory organisations to London’s Company. Again, ambition and opportunity likely influenced Irish and Scottish surgical students to move to London for a time. For example, during the Company’s existence, the Royal College of Surgeons in Ireland and the Royal College of Surgeons of Edinburgh could examine students to be surgeons’ mates or assistants within the British army and navy. However, to be a full surgeon in the British military, surgeons were required to have obtained a diploma from the London Company. According to the historian Helen Dingwall, Royal College of Surgeons of Edinburgh’s diploma holders were seen as less credible than Company diploma holders, due to the College’s difficulties standardizing examination and curriculum requirements in this period. If a surgeon earned an apparently more rigorous and acceptable Company diploma they could obtain a higher position in the military.

Final Thoughts

The “List of Members of the Company 1780-1800” book provides further evidence of surgeons on the move. These locations broadly include:

• Australia
• India
• West Indies
• East Indies
• Gibraltar
• Canada
• France
• Sweden
• Spain

The list also indicates those surgeons who were part of the Navy and Army.

More questions arise. What happened to these surgeons after obtaining their diplomas? Where did they set up practice? For those with connections to now former British colonies, did they serve civilian populations or only those in the army or navy? Similarly, what connection did some of these surgeons have to the slave trade or imperial wars against native populations?

A more in-depth dissection of some of the Company’s members who listed addresses abroad will likely shed great insight into how the Company contributed to the globalization of medicine and imperialism. Eighteenth century surgeons were clearly on the move in pursuit of ambition, opportunity, and legitimacy, but further research will allow these movements to be better placed within broader themes of history.

Further Reading

• Dingwall, Helen. A Famous and Flourishing Society: The History of the Royal College of Surgeons of Edinburgh, 1505-2005. Edinburgh; 2005.
• Lyons, J.B. “The Royal College of Surgeons in Ireland and Its Worthies” Dublin Historical Record. 1995; 48: 40-54.
• Morgan, Clifford. “Surgery and Surgeons in 18^th-Century London”. The Annals of the Royal College of Surgeons of England. 1968; 42: 1-37.
• Randolph, J. A Memoir on the Life and Character of Philip Syng Physick, M.D.. Philadelphia; 1839.
• Wall, Cecil. The History of the Surgeons’ Company. Plymouth; 1937.
• Warren, M.D. “Medical Education During the Eighteenth Century”. Postgraduate Medical Journal. 1951; 27: 304-311.
• Withey, Alun. “‘Persons That Live Remote from London’: Apothecaries and the Medical Marketplace in Seventeenth-and Eighteenth-Century Wales”. Bulletin of the History of Medicine. 2011; 85: 222-247.

Elizabeth Scheer, Museums Intern.