KENNY
The Gordon-Taylor Memorial Lecture Metatropoi Aurai-The Winds of Change P. J. K E N N Y Sydney
THEREare duties which are difficult of fulfilment pertaining to every positon in life ; and there are duties attached to public professional life, from which no mati can assume to himself the right to shrink, with whatever diffidence and feeling of incapacity they may be undertaken. I n this duteous but self-mistrustful spirit I have ventured to accept, at the request of my colleagues in the Council of this College, this, in my estimation, highly honouralilc appointment-the requirements of which I must now proceed to carry out as best I can. These were the words of John Hilton in 1860, on the assumption of his duties at the Royal College of Surgeons of England. And so, in 1975, I wish to thank the Presidents of the Royal College of Surgeons of Australasia of England, and of Edinburgh, and the Senior Surgeon of the Middlesex Hospital, for their kindness in offering me this highly honourable appointment, which I undertake with diffidence and great feelings of incapacity. and which, self-mistrustful though I he, I must now proceed to carry odt as best I can. This occasion pays the laurel of tribute and the rosemary of remenil)rance to a nian who became a legend in his own lifetime. H e was a kindly nian. with a twinkle in his eye, who was a master surgeon. an inspiring teacher, and a humanitarian who loved his fellow men. A quirk of fate had him endure ten vears of active warfare. when vile enemies sought to
destroy him and the good things for which he stood, and eventually be killed on the roads of his native country. Williaiii Gordon Taylor was horn in Streatham, Tmndon, in 1878, nearly a century ago, and here may I correct our own Handbook which says that he was Iiorti in Scotlandhe was not. His Scottish mother, a Gordon,
As delivered at the Royal Australasian College
of Surgeons, Melbourne, February 27, 1975, hut in ptts abridged.
FIGURE I : T h e Fourth Dultc of Gordon, who
Address for reprints: 149 Macquarie St., Sydney
2ooo.
Ausr. N.Z. ,I.Sunr,., V ~ L45 . -No.
3, AUGUST,1975
was responsible for the formation of the Gordon Highlanders.
225
,_
I
111‘
\VINDS
OF
CIIAXGE
when widowed, took him back to her homeland, the land of the Gordon Highlanders, formed in 1794 under the Fourth Duke of Gordon, the “Cock of the North” (Figure I ) , whose principle recruiting officer was his wife “Bonnie Jean” (Figure 2 ) , who travelled on horseback from Buchan and Mar in the east, to Lochaber and Badenoch in the west, raising soldiers for the Regiment, with the customary King’s Shilling and in addition a kiss. As she was a noted heauty, there were plenty of recruits. Abercleen is the Regimental home, and here
KENNY so that his surgical career spanned 54 years.
It was indeed colourful and carpeted with many blooms. Trained in the hard school of casualty clearing station surgery, perhaps his greatest contribution in World W a r I was his proof of the error in the Surgeon-General’s dictum from the South African W a r that a man wounded in the abdomen had a better chance of living if left alone, hut was sure to die if subjected to an operation. Surely this is the greatest single advance i n the surgery of modern warfare.
FIGURE 2 : The raising of the Gordon Highlanders by Jean, Duchess of Gordon, in 1794.
Gordon-Taylor was educated in Robert Gordon’s School and received the School Gold Medal of the Classical Dux. Why he look up Medicine, even his former house-surgeons, Riches and Holrnes Sellors, did not know, but from his record, it must have been a true vocation. Windeyer hints that it may have heen an Aberdeen surgeon, Ogston, a contemporary of Lister, who inspired him. My researches however, reveal there were medical Gordons in Aberdeen from way back, for William Gordon was Mediciner (Tutor) at Kings College in 1636, and John Gordon, a physician, had a son James, who was Professor of Medicine at Marischal College in 1734, so that family tradition may have played a part. In 1906 he hecame a Fellow of the Royal College of Surgeons. H e died in 1960, 226
Here is the only picture (Figure 3 ) I can find of a casualty clearing station surgeon in World W a r I. It shows a Foundation Fellow of this College, Fay Maclure, somewhere in France. This was vastly different from such work in Hitler’s war, when forward operating teams were in surrounded fortresses like Tobruk, and subject to daily heavy air attack, or in the long steamy up-and-down trails like Kokoda or the Ramu and Markham valleys. There was an additional danger to medical personnel in the Western Desert. countered by a directive to stretcher bearers: “Don’t use loaded rifles as splints.” Here (Figure 4 ) is Tom Ackland operating at Soputa, north of Kokoda, and here (Figure 5 ) is another young surgeon,l who J. Loewenthal. .AUST. N.Z. J. SURG.,VOL.45 -NO. 3 , AUGUST,1975
KENNY
FIGURE 3: Fay Maclure, Foundation Fellow of the Royal Australasian College of Surgeons, operating in a casualty clearing station in France in the First World War.
Gordon-Taylor first came to this country in 1934 to conduct the second English Primary Fellowship Examination held in Melbourne. He must have been impressed by the Anzac surgeons he had met in the Kaiser’s war, for he rapidly became a firm friend, and set out to be of the utmost help to all from Anzac nations.
FIGURE 4 : T. H. Ackland operating in the Main Dressing Station, Soputa, north of Kokoda, while A. R. Wakefield gives the anzesthetic.
shall be nameless, but he gave the first GordonTaylor Lecture in this country, learning the hard way at Kaiapit near Shaggy Ridge in New Guinea. I have no pictures of Coates in Malaya or of D ~ i l l o por Fagan in the appalling slavery of the Burma Railway, hut their deeds are enshrined in our history. AUST. N.Z. J. S ~ J N G VOL. . , 45 -No,
3, AUGUST,1975
FIGURE 5 : Young Australian surgeon learning the hard way near Shaggy Ridge, New Guinea. 227
KENNY His kiiidness to our young inen was extraordinary, as if, far from the cold of Aberdeen, he had found a new glow in the Antipodes. W e elected him our fourth Honorary Fellow (Figure 6 ) , and the close links forged between us are reflected in our holding his portrait by Gmnn, a tribute by our own young Fellows, and his donation to us of the portrait of his wife, in our Gordon-Taylor Prize. and i n this Lecture,
A i i expert suI-geon-anatomist, it well may be that from his lofty seat among the immortals in a surgical Valhalla above, laden with richly deserved honours, he looks down with an amused bewilderment that we in this age have been so perturbed by the high failure rate in the Primary that we have lalioured to produce what we consider a more equitahle percentage of passes.
FIGURE 6 : Gordon-Taylor receiving the Honorary Fellowship of the Royal Australasian College of Snrgeons (left to right: W. A. Hailes, Surgeon-Captain Lambert Rogers, R.N.V.R., Sir Gordon Gordon-Taylor, Sir Victor Hurley, H. R. G. Poate, P.R.A.C.S.).
and in happy memories of a great and dear friend. His affection for things Australasian came out in his foreword to Rank and Wakefield’s “Surgery of Repair as Applied to Hand Injuries”, where he said : The thought readily comes to mind how much the surgery of repair already owes to those whose cradle rocked, or whose work has been wrought, in lands under the Southern Cross.
H e gave our 1947 Syme Oration entitled “The Debt of Surgical Science to Australasia”, and his opening remarks were: ‘
The selection of a subject €or this Syme Oration has been determined by my deep admiration, may I say, my deep affection, for the surgeons of AuTtralia and New Zealand.
H e relaxed with fine dinners, and with conversations. I can renieniber him at a large cocktail party at the University Club in Sydney, gleefully saying: “I like this-you meet so many people”. His knowledge of Greek and I.atin was profound. I have no Greek, I know some Latin, I have a smattering of Gaelic, and I doubt if I have m y of the Queen’s English, for when the President of the Royal College of Surgeons of GIasgow introduced me at a wonderful dinner I attended in 1970, among his remarks were the words. “I hope you’ll he ahle to understand his accent”.
KENNY And so, hecause this is to honour GordonTaylor, who loved Greek, I have taken as my text for this occasion ~ E T ~ T ~ O T &p,~-O L “The Winds of Change”. And I should like to make a few observations ahout exaniinations. and how we have changed, and with what results, and to pose a question or two for the future. I want to take you through the changes i n the assessment of a trainee surgeon froin way hack up to the present time, arid sec if the winds of change blow fair or ill. So let us look at each of the Surgical Colleges in turn, see some of their history, and ohserve how. through the years, they have assessed their would-he entrants. Tlie origins of Surgery are lost in antiquity, hut i n the Mitltlle Ages, gradually in the Western world, the healing art gravitated to tile monasteries. Tntleerl. four years after the Norman Conquest, the Archbishop of Canterhury referred to the ideal qualities of a snrgeon.’ Thc practice of surgery as a separate art away from that performed by the monks dates to a Palxi1 I3nll of Innocent 111 in 1219. rrrlcsia n h l i o i ~ r fu sangitine, which directed the monks hack to their spiritual duties, and accordingly surgery passed into the hands of a minor monastic order, from which origin arose the hnrhers. When in 1462 the Mistery of Rarllcrs of Tmntlon received the Charter from I‘dward TV, their activities were restricted to I)lootl lettino; and healing wounds. This, however, was a hase sort of surgery, for the barbers had been the priests’ assistants, and their deeds were frowned upon I)y the military surgeons. so that we find in early Norman times two Itotlies o f men. the surgeons and the barbers, e x h looselv gro:ipetl into a craft, guild, company or blistery. Tlie Guild of Surgeons, sinall i n nimi1)er. desired to raise standards and Taanfranc, 4rchhishop of Canterbury in 1070, said. “Jt is nccrssary that a Surgeon should have a tamperate and moderate disposition T h a t he should liavc well-formed hands, not inclined to tremble and with all his members trained to the capable fulfilment of thc wishes of his mind. H e should be well grounded in Natural Science, and should know not only medicine Init e\ery part of philosophy; should know logic well, so as to be able to understand what is written; to talk properly and to support what he has to say with good reasonsf”
protect the public. ,4s Paget said, the surgeons from whom we trace our descent were not harbers, and there is nothing discreditable in our pedigree.
ROYAL COLLEGEOF SURGEONS, ENCLANTI T h e history of this College can be summarized as follows : 1300-1540 Company of Barbers (Incorporated) Guild of Surgeons (not incorporated). I 540-1745 Company of Barber Surgeons. 1 7 ~ ~ - 1 8 0Company 0 of Surgeons. 1800-1843 Royal College of Surgeons, London, George 111. 1843 Royal College of Surgeons, England. T h e origin of the College dates back to about 1300. when the Guild of Surgeons was loosely affiliated with the Company of Barbers. I n 1415 the master surgeons objected to the inexperience of barbers, surely a courageoui act insofar as in 1491, only eight master surgeons practising no other craft existed in the City of London. Even as late as 1648. the Edinburgh harher surgeons consisted of only 16 members, of whom six were surgeons. T h e barbers were criticized for keeping their shops open on the Sabbath, and in 1511 the licensing of surgeons, by Act of Parliament, passed into the hands of the Bishop of 1,ondon and the Dean of S t Paul’s. T h e old monastic link persisted, but one man in history could break it. The momentous time came in 1540, when Henry V I I I gave to Thomas Vickerv the Charter which formed the Company of Barber Surgeons. and they proceeded to regulate the training by apprenticeship and to conduct examinations. Demonstrations of anatomy began on the bodies of executed criminals, so that in death they could expiate in some part their living critnes, and in 174s the surgeons used their scalpels to cut loose and hecotne the Company of Surgeons. Fifty-five years later they received a Royal Charter from George IT1 as the Royal College of Surgeons in London, which in 1843, under Queen Victoria, was amended to become the Royal College of Surgeons of England. I n the days of the harber surgeons, a seven-year apprenticeship was the usual train-
i ng. and there was no compulsory curriculum This was followed hy an examination coilductetl Ily the members of the Court of Examiners, ten in all, who were appointed for life When the Conipany of Surgeons came into heinq. there was war. and the only requirement\ were attendance at one course of anatoniy lectures, at one course of surgery lectures. antl at a hospital for one year. However. onc man friiled “seeming to know nothing of inrgery”. antl another for “being fuddled and not answering a question”. Talking of the oltler surgeons, Webh-Johnson in his Syme Oration quoted Kipling : “None too learned hnt nohly hold, into the fight went our fathers of old”. Tn ~ 8 0 0the Royal College of Surgeons in T,ontlon reaffirmed the Dower and life tenure of the ten Examiners. I n 1837, the candidate Found some relief in that he had to he tested 1~ three Examiners only, and not the whole ten. antl he could not he rejected without a written examinatinn. On the formation of the Rokal Cnllege of Surgeons of Encland, it was nyreed that anv new Examiners appointed should hold office during the lea sure of Council, usually five years. T h e old Examiners still clung fiercelv to their life tenure, and indeed one old man, Sir IVilliani Lawrence. a ~ ~ e84d vears. an Examiner for 27 years, died of :I stroke on the stens of the Colleqe on the W:LV to an examination Tt is not recorded which candidate had put a hex on him. 4 two-part examination appeared in r 8 & and a clinical comnonent in ~ 8 6 6 By 1862, :ir)m-etiticeship had virtuallv faded out T h e 2pothecnries .4ct had had its effect. and a five-vear curriculum was prescribed. T n 1867 the Primary, as we know it, began. Tn 1870 a Primarv Board of Examiners was institutrcl i n atltlition to the Final Court S o t1iinc.s had settled down, and a pattern was set. to he somewhat jolted when a failed candidate ‘is reccntlv as T W O fired six shnts from his rcvolwr i n the inner hall of the Collew This 1va.s onlv two vears after some had queried the Priiiiarv st2ndarrl 2s h e i w too hidi. 2nd wished t o iiiake it less tlifficlilt Tt was decided it was :in Honours esaniination and that there was no reason to alter it. Fifty vear.s later our own Collecc faced the same prohleni and came u p ith :I clifferent solution.
ROYALCOLLEGE01: S U R ~ ~ E O I
The Gordon-Taylor Memorial Lecture Metatropoi Aurai-The Winds of Change P. J. K E N N Y Sydney
THEREare duties which are difficult of fulfilment pertaining to every positon in life ; and there are duties attached to public professional life, from which no mati can assume to himself the right to shrink, with whatever diffidence and feeling of incapacity they may be undertaken. I n this duteous but self-mistrustful spirit I have ventured to accept, at the request of my colleagues in the Council of this College, this, in my estimation, highly honouralilc appointment-the requirements of which I must now proceed to carry out as best I can. These were the words of John Hilton in 1860, on the assumption of his duties at the Royal College of Surgeons of England. And so, in 1975, I wish to thank the Presidents of the Royal College of Surgeons of Australasia of England, and of Edinburgh, and the Senior Surgeon of the Middlesex Hospital, for their kindness in offering me this highly honourable appointment, which I undertake with diffidence and great feelings of incapacity. and which, self-mistrustful though I he, I must now proceed to carry odt as best I can. This occasion pays the laurel of tribute and the rosemary of remenil)rance to a nian who became a legend in his own lifetime. H e was a kindly nian. with a twinkle in his eye, who was a master surgeon. an inspiring teacher, and a humanitarian who loved his fellow men. A quirk of fate had him endure ten vears of active warfare. when vile enemies sought to
destroy him and the good things for which he stood, and eventually be killed on the roads of his native country. Williaiii Gordon Taylor was horn in Streatham, Tmndon, in 1878, nearly a century ago, and here may I correct our own Handbook which says that he was Iiorti in Scotlandhe was not. His Scottish mother, a Gordon,
As delivered at the Royal Australasian College
of Surgeons, Melbourne, February 27, 1975, hut in ptts abridged.
FIGURE I : T h e Fourth Dultc of Gordon, who
Address for reprints: 149 Macquarie St., Sydney
2ooo.
Ausr. N.Z. ,I.Sunr,., V ~ L45 . -No.
3, AUGUST,1975
was responsible for the formation of the Gordon Highlanders.
225
,_
I
111‘
\VINDS
OF
CIIAXGE
when widowed, took him back to her homeland, the land of the Gordon Highlanders, formed in 1794 under the Fourth Duke of Gordon, the “Cock of the North” (Figure I ) , whose principle recruiting officer was his wife “Bonnie Jean” (Figure 2 ) , who travelled on horseback from Buchan and Mar in the east, to Lochaber and Badenoch in the west, raising soldiers for the Regiment, with the customary King’s Shilling and in addition a kiss. As she was a noted heauty, there were plenty of recruits. Abercleen is the Regimental home, and here
KENNY so that his surgical career spanned 54 years.
It was indeed colourful and carpeted with many blooms. Trained in the hard school of casualty clearing station surgery, perhaps his greatest contribution in World W a r I was his proof of the error in the Surgeon-General’s dictum from the South African W a r that a man wounded in the abdomen had a better chance of living if left alone, hut was sure to die if subjected to an operation. Surely this is the greatest single advance i n the surgery of modern warfare.
FIGURE 2 : The raising of the Gordon Highlanders by Jean, Duchess of Gordon, in 1794.
Gordon-Taylor was educated in Robert Gordon’s School and received the School Gold Medal of the Classical Dux. Why he look up Medicine, even his former house-surgeons, Riches and Holrnes Sellors, did not know, but from his record, it must have been a true vocation. Windeyer hints that it may have heen an Aberdeen surgeon, Ogston, a contemporary of Lister, who inspired him. My researches however, reveal there were medical Gordons in Aberdeen from way back, for William Gordon was Mediciner (Tutor) at Kings College in 1636, and John Gordon, a physician, had a son James, who was Professor of Medicine at Marischal College in 1734, so that family tradition may have played a part. In 1906 he hecame a Fellow of the Royal College of Surgeons. H e died in 1960, 226
Here is the only picture (Figure 3 ) I can find of a casualty clearing station surgeon in World W a r I. It shows a Foundation Fellow of this College, Fay Maclure, somewhere in France. This was vastly different from such work in Hitler’s war, when forward operating teams were in surrounded fortresses like Tobruk, and subject to daily heavy air attack, or in the long steamy up-and-down trails like Kokoda or the Ramu and Markham valleys. There was an additional danger to medical personnel in the Western Desert. countered by a directive to stretcher bearers: “Don’t use loaded rifles as splints.” Here (Figure 4 ) is Tom Ackland operating at Soputa, north of Kokoda, and here (Figure 5 ) is another young surgeon,l who J. Loewenthal. .AUST. N.Z. J. SURG.,VOL.45 -NO. 3 , AUGUST,1975
KENNY
FIGURE 3: Fay Maclure, Foundation Fellow of the Royal Australasian College of Surgeons, operating in a casualty clearing station in France in the First World War.
Gordon-Taylor first came to this country in 1934 to conduct the second English Primary Fellowship Examination held in Melbourne. He must have been impressed by the Anzac surgeons he had met in the Kaiser’s war, for he rapidly became a firm friend, and set out to be of the utmost help to all from Anzac nations.
FIGURE 4 : T. H. Ackland operating in the Main Dressing Station, Soputa, north of Kokoda, while A. R. Wakefield gives the anzesthetic.
shall be nameless, but he gave the first GordonTaylor Lecture in this country, learning the hard way at Kaiapit near Shaggy Ridge in New Guinea. I have no pictures of Coates in Malaya or of D ~ i l l o por Fagan in the appalling slavery of the Burma Railway, hut their deeds are enshrined in our history. AUST. N.Z. J. S ~ J N G VOL. . , 45 -No,
3, AUGUST,1975
FIGURE 5 : Young Australian surgeon learning the hard way near Shaggy Ridge, New Guinea. 227
KENNY His kiiidness to our young inen was extraordinary, as if, far from the cold of Aberdeen, he had found a new glow in the Antipodes. W e elected him our fourth Honorary Fellow (Figure 6 ) , and the close links forged between us are reflected in our holding his portrait by Gmnn, a tribute by our own young Fellows, and his donation to us of the portrait of his wife, in our Gordon-Taylor Prize. and i n this Lecture,
A i i expert suI-geon-anatomist, it well may be that from his lofty seat among the immortals in a surgical Valhalla above, laden with richly deserved honours, he looks down with an amused bewilderment that we in this age have been so perturbed by the high failure rate in the Primary that we have lalioured to produce what we consider a more equitahle percentage of passes.
FIGURE 6 : Gordon-Taylor receiving the Honorary Fellowship of the Royal Australasian College of Snrgeons (left to right: W. A. Hailes, Surgeon-Captain Lambert Rogers, R.N.V.R., Sir Gordon Gordon-Taylor, Sir Victor Hurley, H. R. G. Poate, P.R.A.C.S.).
and in happy memories of a great and dear friend. His affection for things Australasian came out in his foreword to Rank and Wakefield’s “Surgery of Repair as Applied to Hand Injuries”, where he said : The thought readily comes to mind how much the surgery of repair already owes to those whose cradle rocked, or whose work has been wrought, in lands under the Southern Cross.
H e gave our 1947 Syme Oration entitled “The Debt of Surgical Science to Australasia”, and his opening remarks were: ‘
The selection of a subject €or this Syme Oration has been determined by my deep admiration, may I say, my deep affection, for the surgeons of AuTtralia and New Zealand.
H e relaxed with fine dinners, and with conversations. I can renieniber him at a large cocktail party at the University Club in Sydney, gleefully saying: “I like this-you meet so many people”. His knowledge of Greek and I.atin was profound. I have no Greek, I know some Latin, I have a smattering of Gaelic, and I doubt if I have m y of the Queen’s English, for when the President of the Royal College of Surgeons of GIasgow introduced me at a wonderful dinner I attended in 1970, among his remarks were the words. “I hope you’ll he ahle to understand his accent”.
KENNY And so, hecause this is to honour GordonTaylor, who loved Greek, I have taken as my text for this occasion ~ E T ~ T ~ O T &p,~-O L “The Winds of Change”. And I should like to make a few observations ahout exaniinations. and how we have changed, and with what results, and to pose a question or two for the future. I want to take you through the changes i n the assessment of a trainee surgeon froin way hack up to the present time, arid sec if the winds of change blow fair or ill. So let us look at each of the Surgical Colleges in turn, see some of their history, and ohserve how. through the years, they have assessed their would-he entrants. Tlie origins of Surgery are lost in antiquity, hut i n the Mitltlle Ages, gradually in the Western world, the healing art gravitated to tile monasteries. Tntleerl. four years after the Norman Conquest, the Archbishop of Canterhury referred to the ideal qualities of a snrgeon.’ Thc practice of surgery as a separate art away from that performed by the monks dates to a Palxi1 I3nll of Innocent 111 in 1219. rrrlcsia n h l i o i ~ r fu sangitine, which directed the monks hack to their spiritual duties, and accordingly surgery passed into the hands of a minor monastic order, from which origin arose the hnrhers. When in 1462 the Mistery of Rarllcrs of Tmntlon received the Charter from I‘dward TV, their activities were restricted to I)lootl lettino; and healing wounds. This, however, was a hase sort of surgery, for the barbers had been the priests’ assistants, and their deeds were frowned upon I)y the military surgeons. so that we find in early Norman times two Itotlies o f men. the surgeons and the barbers, e x h looselv gro:ipetl into a craft, guild, company or blistery. Tlie Guild of Surgeons, sinall i n nimi1)er. desired to raise standards and Taanfranc, 4rchhishop of Canterbury in 1070, said. “Jt is nccrssary that a Surgeon should have a tamperate and moderate disposition T h a t he should liavc well-formed hands, not inclined to tremble and with all his members trained to the capable fulfilment of thc wishes of his mind. H e should be well grounded in Natural Science, and should know not only medicine Init e\ery part of philosophy; should know logic well, so as to be able to understand what is written; to talk properly and to support what he has to say with good reasonsf”
protect the public. ,4s Paget said, the surgeons from whom we trace our descent were not harbers, and there is nothing discreditable in our pedigree.
ROYAL COLLEGEOF SURGEONS, ENCLANTI T h e history of this College can be summarized as follows : 1300-1540 Company of Barbers (Incorporated) Guild of Surgeons (not incorporated). I 540-1745 Company of Barber Surgeons. 1 7 ~ ~ - 1 8 0Company 0 of Surgeons. 1800-1843 Royal College of Surgeons, London, George 111. 1843 Royal College of Surgeons, England. T h e origin of the College dates back to about 1300. when the Guild of Surgeons was loosely affiliated with the Company of Barbers. I n 1415 the master surgeons objected to the inexperience of barbers, surely a courageoui act insofar as in 1491, only eight master surgeons practising no other craft existed in the City of London. Even as late as 1648. the Edinburgh harher surgeons consisted of only 16 members, of whom six were surgeons. T h e barbers were criticized for keeping their shops open on the Sabbath, and in 1511 the licensing of surgeons, by Act of Parliament, passed into the hands of the Bishop of 1,ondon and the Dean of S t Paul’s. T h e old monastic link persisted, but one man in history could break it. The momentous time came in 1540, when Henry V I I I gave to Thomas Vickerv the Charter which formed the Company of Barber Surgeons. and they proceeded to regulate the training by apprenticeship and to conduct examinations. Demonstrations of anatomy began on the bodies of executed criminals, so that in death they could expiate in some part their living critnes, and in 174s the surgeons used their scalpels to cut loose and hecotne the Company of Surgeons. Fifty-five years later they received a Royal Charter from George IT1 as the Royal College of Surgeons in London, which in 1843, under Queen Victoria, was amended to become the Royal College of Surgeons of England. I n the days of the harber surgeons, a seven-year apprenticeship was the usual train-
i ng. and there was no compulsory curriculum This was followed hy an examination coilductetl Ily the members of the Court of Examiners, ten in all, who were appointed for life When the Conipany of Surgeons came into heinq. there was war. and the only requirement\ were attendance at one course of anatoniy lectures, at one course of surgery lectures. antl at a hospital for one year. However. onc man friiled “seeming to know nothing of inrgery”. antl another for “being fuddled and not answering a question”. Talking of the oltler surgeons, Webh-Johnson in his Syme Oration quoted Kipling : “None too learned hnt nohly hold, into the fight went our fathers of old”. Tn ~ 8 0 0the Royal College of Surgeons in T,ontlon reaffirmed the Dower and life tenure of the ten Examiners. I n 1837, the candidate Found some relief in that he had to he tested 1~ three Examiners only, and not the whole ten. antl he could not he rejected without a written examinatinn. On the formation of the Rokal Cnllege of Surgeons of Encland, it was nyreed that anv new Examiners appointed should hold office during the lea sure of Council, usually five years. T h e old Examiners still clung fiercelv to their life tenure, and indeed one old man, Sir IVilliani Lawrence. a ~ ~ e84d vears. an Examiner for 27 years, died of :I stroke on the stens of the Colleqe on the W:LV to an examination Tt is not recorded which candidate had put a hex on him. 4 two-part examination appeared in r 8 & and a clinical comnonent in ~ 8 6 6 By 1862, :ir)m-etiticeship had virtuallv faded out T h e 2pothecnries .4ct had had its effect. and a five-vear curriculum was prescribed. T n 1867 the Primary, as we know it, began. Tn 1870 a Primarv Board of Examiners was institutrcl i n atltlition to the Final Court S o t1iinc.s had settled down, and a pattern was set. to he somewhat jolted when a failed candidate ‘is reccntlv as T W O fired six shnts from his rcvolwr i n the inner hall of the Collew This 1va.s onlv two vears after some had queried the Priiiiarv st2ndarrl 2s h e i w too hidi. 2nd wished t o iiiake it less tlifficlilt Tt was decided it was :in Honours esaniination and that there was no reason to alter it. Fifty vear.s later our own Collecc faced the same prohleni and came u p ith :I clifferent solution.
ROYALCOLLEGE01: S U R ~ ~ E O I
