Student Work: Collective Identity, Belonging, and the American Medical School
Keynote paper given at the symposium, ‘Medical training, student experience and the transmission of knowledge, c.1800-2014’, organised by Laura Kelly at CHOMI, UCD, October 2014
Professor John Harley Warner’s paper examines identity and identity formation among American medical students from the middle of the nineteenth century and into the 1920s. His aim is to rethink the place the medical school occupied in shaping and conferring collective identity drawing especially on the short, hand-written, highly mannered these
s that most colleges required for graduation. Continuing this focus on collective identity he turns to one site within the medical school – the dissecting room – and the genre of photographic group portraiture that students cultivated there; a depiction and production of student work that enriches and challenges our understanding of medical student culture.
The starting point for his talk is a particular problem in the historiography of American medical education. The American case was peculiar and Warner begins by mapping how the mid-nineteenth century American medical school is portrayed in the regnant historiography. By all accounts this was the profession’s low point. The American medical marketplace had become the freest and most open in the western world. Like other professions, medicine was a target for popular animosity against all groups claiming special privilege. In the face of radical democratic protest against putative monopolies, state legislatures revoked virtually all medical licensing laws. A medical degree wasn’t required to practice as a physician or to be considered as a fully fledged member of the profession.
But if you wanted a medical degree, you could easily attain one by attending three months of didactic lectures taken twice, submitting a thesis, undergoing a very brief oral examination and paying fees. The proliferation of proprietary medical schools, often of low standards, greatly increased the production of sometimes poorly trained practitioners leading to overcrowding and divisive competition in the medical marketplace. Alternative healers – homeopaths, hydopaths, botanics – attacked the pretensions and therapies of orthodox self-styled regular physicians, and competed successfully for paying patients. With good reason regular physicians believed that the power and prestige of their profession was declining and that medical schools bore a lot of the blame. This was a profession in crisis.
For more than a hundred years that’s how the story of medical education in nineteenth century America has been told. It’s a true story, yet this telling of it is also ahistorical in its distorting selectivity. Criticism of schools at the time had less to do with the education received there than with the overproduction of medical degrees.