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The earliest resident appointment for students of Guy's Hospital Medical School was the Lying-in Charity, which was established in 1833, when 'resident accoucheurs' were appointed. In 1849 three senior pupils were appointed 'resident obstetric clerks' and were provided with board and accommodation in one of the houses in Maze Pond. They were required to be ready at all times to assist the pupils who attended the deliveries in the district.
The first house surgeon at Guy's Hospital was appointed in 1856 and was required to be a member of the Royal College of Surgeons. He held office for six months, was resident in the hospital and in the absence of the Surgeons and Assistant Surgeons was responsible for the whole surgical side of the hospital. From 1857 the House Surgeon was required to keep a journal 'entering therein everything which occurs by day or by night within the Hospital' and present it to the Treasurer every morning. In 1865 a non-resident Assistant House Surgeon was appointed, and from 1878 he too was given board and residence at the hospital and assigned duties in the wards. Another Assistant House was appointed to share the work in Outpatients, but was not resident at the hospital.
The first resident House Physician was appointed in 1865 to assist the Resident Apothecary in the care of patients in the wards, and assist in the Outpatient Department for three days a week. In 1866 the outpatient work was assigned to an Assistant House Physician who was not resident. In 1873 a second resident House Physician was appointed. On the opening of the Residential College for students in 1890 the number of resident appointments increased and a resident assistant was appointed for each member of staff.
In 1846 it was made obligatory for all students of Guy's Hospital Medical School to report cases. In 1836 Guy's Society for Clinical Reports was established by pupils. The influence of Thomas Addison was instrumental in the development of regular case reporting and the establishment of the Clincal Report Society at Guy's Hospital. He insisted on a higher standard of work from his clinical clerks and by 1828 had established a regular method of case taking.