The first record of medical students working within St Bartholomew's Hospital occurs in 1662, when the Governors gave orders that "young gentlemen or doctors or practitioners" should seek permission if they wished to be in attendance when the Hospital's Physicians were prescribing. The Surgeons also had pupils, and the first students often bound themselves to their teachers by means of an apprenticeship agreement. They received most of their education by attending in the wards and following Surgeons at their work, a practice which later became known as "walking the wards" of the Hospital. Physicians at that time would usually have learned their craft by means of a university degree, but with less opportunity for practical work. In 1734 the Governors for the first time gave consent for any of the Surgeons or Assistant Surgeons "to read lectures in anatomy in the dissecting-room of the Hospital", although permission was withdrawn in 1735. Hospital staff offered lectures to pupils privately before this time, often in their own homes, and continued to do so until the 1780s. In 1767 the Physicians and Surgeons again approached the Governors, who agreed to allow the reading of lectures in a room adjoining the operating theatre in the newly-built East Wing.
In 1791 the Governors agreed to the request of the surgeon John Abernethy for a purpose-built lecture theatre to be constructed within the Hospital. A theatre was built between Long Row and what was then Windmill Court, behind the West Wing, to the design of George Dance. It was variously known as the "Surgeons' Theatre", the "Medical Theatre" and the "Anatomical Theatre", and lectures were given there by Abernethy (on anatomy, physiology and surgery), John Latham (on medicine), Richard Powell (on chemistry) and others. The theatre was rebuilt, on the same site but with an enlarged capacity, in 1822. The efforts of Abernethy also persuaded the Governors to pass a resolution giving formal support to the provision of medical education within the Hospital. This recognition by the Governors and the rebuilding of the lecture theatre are generally regarded as marking the foundation of the Medical School in 1822. Further accommodation in Long Row was acquired by the School in the course of the nineteenth century. A theatre for chemical lectures was built at the southern end of Long Row, and in the 1830s a new museum and library were constructed, with a further theatre for lectures on materia medica and botany.
In Abernethy's time, and for some years afterwards, a student decided his own curriculum, attending lectures as he wished, besides walking the wards. If he preferred, he could choose to attend lectures at several different hospitals or private medical schools. At Bart's, as elsewhere, students paid no lecture fees to the Hospital, but could purchase admission tickets to as many individual courses as they wished to attend. Each lecturer sold tickets for his own courses. At the end of a course a certificate of attendance might be granted to those who had completed it. Certificates of "hospital practice" were also issued, to students who had attended regularly in the wards. After Abernethy's death in 1831 the School began to decline, as no member of the medical staff was prepared to take responsibility for administering it, or for offering guidance to the students in the development of their studies.
Until 1843 students had to arrange their own accommodation, but in that year the Governors founded a residential college to allow the students residence within the walls of the Hospital. The residential quarters occupied a row of houses on the west side of Duke Street (now called Little Britain). The first Warden of the College was James Paget, who had already distinguished himself by his discovery of the parasitic worm trichinella spiralis while still a student at the age of 21. As Warden, Paget soon found himself directing the studies not only of the residents, but also of those students who lived outside. Paget's dedication to this task quickly re-established the prestige of the School, and the Wardens became in effect the administrators of the School and the keepers of its accounts. In 1850 Paget was largely responsible for the welcome which Bart's extended to Elizabeth Blackwell, who had just become the first qualified female medical practitioner. From May 1850 until July 1851 she was the first, and only, female student in the Medical School at St Bartholomew's. After her departure, however, a more conservative outlook prevailed and for many years any suggestion that female students should be admitted to Bart's was met with strenuous resistance. Women students continued to be prohibited until 1947.
Until 1892 the regulations of the Royal College of Physicians and Royal College of Surgeons required four years' study for a professional qualification, of which only thirty months had to be spent at a hospital medical school. After 1892 five years' study became the norm. By 1900 the winter sessions at St Bartholomew's offered lectures, classes and demonstrations in the different branches of medicine, surgery, anatomy and physiology, biology, chemistry, pathology and bacteriology. The summer session provided tuition in forensic, ophthalmic and psychological medicine, materia medica and pharmacology, midwifery and public health. The fee for five years of study was 150 guineas, if paid in one sum on entrance, or 160 guineas if paid in four annual instalments. As early as 1839 the teaching at the Medical School had been recognised by the University of London in admitting candidates for medical degrees. In 1900 the School became one of the constituent colleges of the University, but it remained a voluntary association of teachers in the hospital with no legal status of its own until after the First World War. A new post of Dean was created in 1904. In 1919 Medical and Surgical Professorial Units were established, in anticipation of a formal alteration to the status of the School. The Units aimed to bridge the gap between training, practical medicine and surgery, and the academic world of scientific research. It was a condition of University recognition that the Units were provided with their own research laboratories. The School and the Hospital were formally separated in 1921, when the School was incorporated with a new title, the Medical College of St Bartholomew's Hospital in the City of London.
In 1933-1934 the Medical College purchased the site of the former Merchant Taylors' School in Charterhouse Square. This acquisition enabled it to re-house the pre-clinical departments, which were previously in cramped quarters on the west side of Giltspur Street. In the Second World War, however, the college suffered badly. Most of the buildings on the Charterhouse Square site were damaged or destroyed, and on the Smithfield site the buildings in Long Row were also wrecked. At the outbreak of war pre-clinical students were evacuated to Queen's College, Cambridge, while clinical teaching was divided between St Bartholomew's and its two evacuation sites, Hill End Hospital at St Alban's and Friern Hospital, New Southgate. The pre-clinical school returned to London in 1946, but the rebuilding of the Charterhouse Square site was not completed until 1963. The Robin Brook Centre for Medical Education was opened in June 1980. In the 1960s the College acquired its first regular peacetime teaching facilities outside Bart's when seventy general medical beds were made available to it at St Leonard's Hospital. After the establishment of the City and Hackney Health District in 1974 it became possible for all students to receive part of their training at several other hospitals within the District.
Following the recommendations of the Royal Commission on Medical Education in 1968, a close association with the London Hospital Medical College was developed, and a number of joint academic departments were established. At the same time, a link with Queen Mary College (later Queen Mary and Westfield) was begun, with the aim that eventually students would take their two-year pre-clinical course at Queen Mary College before going on to study at St Bartholomew's or the Royal London. In 1989 the pre-clinical teaching of the London Hospital Medical College merged with that of St Bartholomew's Hospital Medical School as the Central and East London Confederation (CELC). It was re-sited at the Basic Medical Sciences Building at Queen Mary & Westfield College, Mile End, and the first intake of students entered the new pre-clinical school in 1990. Following the recommendations of the Tomlinson Report (1992) and the governmental response to it (Making London Better, 1993), the medical colleges of the Royal London Hospital and St Bartholomew's Hospital were united with Queen Mary & Westfield College in December 1995. The medical school is now known as Barts and The London School of Medicine and Dentistry, and is part of Queen Mary, University of London.
