This month’s Fantastic Find is a selection of examination papers for obstetric and gynaecological practitioners which predate the Royal College of Obstetricians and Gynaecologists by over thirty years. The RCOG was only the third royal medical college to be established in England, but it is centuries younger than its predecessors: the Royal College of Physicians (which founded and gained royal charter in 1518) and The Royal College of Surgeons (formed in 1540 and gaining royal charter in 1800).
These two bodies, together with the Society of Apothecaries (established in 1617) and other British universities, regulated the medical education and the examination of physicians and surgeons including obstetricians, gynaecologists and midwives. In the late 19th century a studying gynaecologist in London would take examinations with both the RCP and the RCS to become qualified, becoming members or fellows of both colleges. But avenues for gaining a qualification in these medical specialities varied greatly depending on location.
In 1845 the Society of Apothecaries was the first organisation to establish midwifery examinations in England. The RCS and RCP later founded its own board of examinations which included midwifery as a subject. However, the examination of obstetric specialists was still overseen by physicians and surgeons.
Over time the RCP and the RCS began to invest more resources and time in their own immediate specialties and obstetrics and gynaecology beginning to lag behind as fields of study. The situation was worsened by the fact that obstetricians and gynaecologists at the time only represented a small minority of the General Medical Council. As a result opportunities for the advancement of the profession and the study of obstetrics, gynaecology and midwifery were few and far between.
In his history of the RCOG, obstetrician William Fletcher Shaw wrote that during this era ‘…the gynaecologist was merely a disappointed surgeon, without training in the branch he now practiced.’
This all changed in 1929 when Fletcher Shaw and William Blair Bell founded the Royal College of Obstetricians and Gynaecologists to provide a central, specialised means of entry into the profession and a recognition of the status of its practitioners.
The reasons for the establishment of an independent college for obstetricians and gynaecologists were four fold:
- To create a portal through which all studying obstetricians and gynaecologists were expected to pass through to become qualified
- To prevent obstetrics and gynaecology from begin separated as fields of study
- To bring together teachers of obstetrics and gynaecology to secure better facilities for teaching and examinations
- To represent and support all obstetricians and gynaecologists
Our archive holds a selection of written examination papers taken by gynaecology, midwifery and obstetric specialists before the foundation of the RCOG. The examination papers shown in this post were written and used by the RCP, RCS and other examining bodies. They demonstrate how obstetrics and midwifery were considered one of many branches of general medical and surgical training in the 19th century rather than a major speciality in its own right.
How many of these exam questions can you answer? And what do you think about the hypothetical scenarios raised in these papers? What do they tell us about the concerns of obstetric and midwifery specialists during the late-19th century?