Friday, 28 October 2016

The 'Lady Students', Impropriety and the Mess Stallion

The University of Edinburgh has just welcomed its latest intake of medical students, a new wave of young faces eager to begin their medical careers. Around 60% of these new students are female, but when Sophia Jex-Blake applied to study medicine in 1869 she was denied - it was not considered practicable to make alternative arrangements for one lone woman. Undeterred, she advertised for more women to join her, and eventually gathered a group who would become known as the ‘Edinburgh Seven’. These seven began their medical education on 2nd November 1869.

All seven performed well in their first exams, with Edith Pechey topping the class and qualifying for a prestigious scholarship, but the staff had noticed a growing sense of unhappiness amongst the male students, and awarded it instead to one of them in an effort to quell this. As the events of 1870 would show, this was not particularly effective…

Then, as now, the time spent on wards was crucial for producing well-rounded doctors - as any medical practitioner will know, there is a big difference between learning the theories of diagnosis and treatment, and the reality of dealing with disease ‘in the flesh’. The female students wanted to be able to experience the wards alongside their male counterparts, and requested that they be allowed to join the clinical classes that were taught on the wards. To many of the male students, however, the idea of a female element in their midst was nothing less than horrifying, and a petition was presented to the Board of Management of the Royal Infirmary of Edinburgh (RIE) in protest. In total, five hundred and four students had signed the petition, with the petitioners being keen to point out that four hundred and ninety of those had been gathered in the first seven hours…

The issues hinged on the question of propriety. Was it proper for a lady to be present on a ward, where medical examinations were taking place? Would the men be able to comfortably discuss medical concerns in the presence of women? The petitions didn’t think so:

"many subjects of the gravest medical importance will be imperfectly treated, or omitted altogether" [LHB1/1/25]

The Board of Management was divided. It was decided that the opinions of the Physicians and Surgeons of the RIE should first be sought. In the meantime, Jex-Blake wrote to the Board. In a letter that sounds both begging and defiant, she suggests that only those physicians and surgeons who want to teach the ‘Lady Students’ would have to – “both as a matter of courtesy and because we shall already be provided with sufficient means of instruction”:

The infamous Surgeons Hall Riotoccurred two days later.

The matter remained unsettled for some time. Under pressure from some influential contributors, the Board were convinced that the female students should be allowed access, but the question remained of how to implement this without resorting to objectionable and improper mixed classes. This question continued for a number of months – in October 1872 opinions were sought from the medical and surgical staff, asking whether they were in favour of admitting the women at all, and if so, how they proposed this medical instruction could take place. The responses varied; while some were encouraging, many could not see their way clear to the women being present and involved in medical examinations:

"I am not prepared to give clinical instruction to mixed classes, on account of my own feeling of its impropriety and fear of evil results following" - letter to the Managers of the RIE from J Matthews Duncan, 31 Oct 1872

We’ll be sharing more of these letters over on our Twitter page over the course of the next week.

Eventually, the board agreed to allow women to attend classes on the wards, but these were held at different hours to the men’s’; they were only allowed to visit certain wards; they were permitted no access to post -mortems, surgical operations; and they were not allowed to work as clerks or dressers as this could lead to “inextricable confusion”:


A further example of women’s fight to be accepted by the medical society of Edinburgh can be seen in the minute book of the Medico-Chirurgical Society of Edinburgh (GD3). In 1892, Grace Cadell wrote to the Society requesting a form for membership. This appears to have prompted something of an urgent discussion amongst the members, and Grace soon received a letter informing her that “the Society has passed a law asserting that its membership shall be confined to Medical Practitioners of the male sex”.
 Although the number of women studying medicine had been growing steadily over the next thirty years, it was the outbreak of WWI in July 1914 that brought about a dramatic increase in the number of female students. Even with 373 female students studying in 1918/9, there was still no provision for the full instruction of women – mixed classes on medical wards began in 1927, but it wasn’t until 1933 that they were allowed access on surgical wards.

The barriers to the education of women weren’t always as regulatory, though. Women were granted the right to apply for residency placements (working as an appointed House Officer in a hospital) in the 1920s, but were not permitted to live in the Residency itself until the late 1940s. As the residency rules show, this was an environment very much geared towards its male inhabitants. I wonder how easily a woman would have fitted in with this bunch…
Rules of the Residency [LHB1/114/2]
The fight to be fully accepted in the medical community continued well into the 1950s. Both the Bruntsfield Hospital and the Elsie Inglis Memorial Maternity Hospital (EIMH) were closely associated with the idea of providing practical medical experience to young female doctors. Indeed, Bruntsfield Hospital took its name from Bruntsfield Lodge, Sophia Jex-Blake’s former home. In 1957, the resignation of a consultant physician at Deaconess and Longmore Hospital prompted the Regional Health Board to reconsider staffing arrangements across the Lothian area. A suggestion was put forward that a locum physician could work between EIMH, Bruntsfield Hospital & Deaconess Hospital – which could result in a male doctor working in the two women’s hospitals. This proposal was met with some anger. As Gertrude Herzfeld pointed out at a Board meeting on 9th November, “if a woman was not appointed, there would be no woman consultant physician in the Edinburgh Area to whom woman patients could be referred and there was a definite demand for the services of a woman consultant physician in the area”.
Others argued that allowing a man to take over such a role would “contravene, certainly the spirit, n and probably the terms of the trusts upon which these great hospitals were founded”, and Arthur Woodburn, MP for East Stirlingshire, suggested that “part of this trouble lies in the resistance of the male members of the medical profession to the entrance of female consultants into the higher grades of the profession”.

Instrumental in the campaign against this appointment was Helen Miller Lowe. Lowe was one of the first female chartered accountants in Scotland, and had a lifelong interest in the medical profession, acting as treasurer of both EIMH and Bruntsfield Hospital when they were transferred to the NHS. The GD34 collection contains correspondence, campaign papers, press cuttings and reports relating to the campaign she spearheaded. This garnered support from those both near to home and further afield (with some encouragement coming from a familiar name!)
The campaign was a successful one, with the RHB capitulating in Feb 1958 and agreeing that all of the vacant posts at the Brunts & EIMH be retained for women only.
 When considered in light of the history of the medical education, it seems no small feat that 60% of the current medical student intake are female. The collections that LHSA hold illuminate a small part of the fight for women’s place in medicine, and we’re pleased to be able to show them to a wider audience.

For more information, check out the Wikipedia pages on Women in Medicine

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