University of St Andrews School of Medicine

The University of St Andrews School of Medicine (formerly the Bute Medical School) is the school of medicine at the University of St Andrews in St Andrews, Fife, Scotland and the oldest medical school in Scotland.

University of St Andrews School of Medicine
Former names
Bute Medical School
TypeMedical school
Established1413
Parent institution
University of St Andrews
DeanDavid Crossman
Administrative staff
54
Students464[1]
Location
St Andrews
,
Fife
,
Scotland
Colours
                             
Websitemedicine.st-andrews.ac.uk

The medical school offers two programs to students, the BSc (Hons) in Medicine program teaches medical students for the first three years of their training, with students completing this training, earning their MB ChB/MBBS at various partner medical schools in the UK in a pre-arranged fashion. The school also offers a 4 year graduate entry medical program in combination with the University of Dundee, awarding a joint MB ChB from the University of St Andrews and Dundee.

The school is associated with 1 Nobel Prize and 2 Victoria Cross winners. Famous alumni include small pox vaccine pioneer Edward Jenner, revolutionary journalist Jean-Paul Marat, and inventor of beta blockers and H2 receptor antagonists, Nobel Prize in Medicine winner Sir James Black.

History

The early medical school

Medicine was the third subject to be taught at the University of St Andrews, at St Salvator's College and later the United College of St Salvator and St Leonard. Bishop Kennedy founded St Salvator's College in 1450, confirmed by a Papal Bull in 1458.

From the 17th to the 19th centuries, medical degrees from St Andrews were awarded by an early version of distance learning. The university awarded the degree of MD to individuals who were usually already established in medical practice, the first being conferred in 1696. This degree was awarded on the basis of a testimonial written by a supervisor, and a fee was paid to the university. The whole process was conducted through the post, and the candidate did not have to visit the university. Recipients of the MD at this time include the French Revolutionary, Jean-Paul Marat (1743–1793), who obtained his MD in 1775 for an essay on gonorrhea, and Edward Jenner (1749–1823), who developed the first smallpox vaccine, and was awarded the MD in 1792.

In 1721, Chancellor of the University, James Brydges, 1st Duke of Chandos established the Chandos Chair of Medicine and Anatomy, to fund the appointment of a Professor of Medicine and Anatomy at the university, and Thomas Simson was appointed as the first Chandos Professor. The Chandos Chair still exists, although it has now become a chair of physiology.

In the early 19th century, examinations were introduced. Students had to visit St Andrews to sit them, but there was no teaching at the university.

The founding of the Bute Medical School

In 1897, as Rector of the University of St Andrews, the 3rd Marquess of Bute, in addition to his provident restorations of other university buildings, initiated the construction of the current Bute Medical Buildings, south of St Mary's College, completed in 1899. The buildings, much added to and modified, especially after a gift from Andrew Carnegie, built labs to the north (now the Carnegie Building). These provided for the establishment of a regular medical school, which both taught and examined medical students. The 3rd Marquess of Bute also provided for the establishment of a new chair of medicine—the Bute Chair of Medicine.

Bute Medical Building

The St Andrews-Dundee course

In 1898, University College Dundee - which had been created in 1891 - became affiliated to the University of St Andrews,[2] and it was this that enabled a full undergraduate medical degree to be offered by St Andrews, as the City of Dundee had a large population and contained several hospitals where students could receive clinical teaching. Together, the Bute Medical School and clinical facilities at University College Dundee formed a conjoint medical school.

Medical students could either undertake their pre-clinical teaching at the Bute Medical School in St Andrews or go straight to Dundee for their pre-clinical years, and then the two groups combined to complete their clinical training in Dundee. Students were awarded the degree of MB ChB by the University of St Andrews.

In 1954, University College Dundee changed its name to Queen's College, but remained part of the University of St Andrews.

In August 1967, following recommendations by the Robbins Report, the Universities (Scotland) Act 1966 came into force. This separated Queen's College from the University of St Andrews, and granted independent university status to the new University of Dundee.

In a great many respects, the medical school at the University of Dundee is the direct inheritor of the medical traditions of St Andrews University. The same can be said of the Dundee dental school.

As the clinical part of the medical school (along with other parts of the University of St Andrews, including the Law and Engineering Faculties) had been completely based in Dundee, this left St Andrews with no clinical medical school or teaching hospital in which medical students could receive clinical training. The Universities (Scotland) Act 1966 also removed the University of St Andrews's right to award undergraduate and postgraduate degrees in medicine, including the MBChB and MD. However, in more recent times the right to award the MD (St Andrews) has been restored.

In order to continue to be able to offer access to a medical degree, St Andrews established a new link with the English Victoria University of Manchester in 1970, which was at that time seeking to enlarge its medical school. Students completed a three-year BSc in medical science at St Andrews, and could optionally complete an extra intercalated year for the award of BSc Hons at St Andrews, before completing their clinical training at the University of Manchester, with the final MBChB awarded by Manchester.

Between 2002–2006 there was also the ‘option’ (mostly allocated on a compulsory basis) of completing clinical training at Keele University Medical School in Stoke-on-Trent, and annually around twenty St Andrews graduates went to Keele University. This option no longer exists for students.

Recent history

Major changes to the curriculum were made in 2000 with increased emphasis on psychology and cellular biology, with the introduction of a two-year course in cellular and molecular medicine and a three-year course in behavioural sciences. Further curriculum changes took place in 2004, with a reduction in the amount of teaching but the introduction of a research project into the final year, allowing for an honours degree to be attained after three years' study, and therefore since September 2005, the Bute Medical School has offered a Bachelor of Science with honours in Medicine (BSc Hons Medicine).

Admissions

St Andrews is one of a few schools in the UK to use the multiple mini interview, an interview system first developed by McMaster University Medical School which exposes applicants to several interviews of shorter time, exposing the applicant to more interviewers and reducing the chance that one bad or good interview determines the applicants success at gaining admissions.

Courses

Medical degree programme

The BSc (Hons) programme is three years long; on graduating from St Andrews, students will progress to one of the University's partner medical schools in Scotland or England for a further  three years. Applicants who are ‘overseas’ for fee purposes will progress to the Medical School at the University of Manchester.

At the end of the six year programme, students will have completed their training as a doctor and graduate with MBChB/MBBS.[3]

First year

In the first year of the course, the modules provide a scientific foundation for clinical practice. Students also commence communication and clinical skills training, alongside patient interaction, which continues throughout all three years.  [4]

Second year

The Honours programme, which runs through both second and third year, focuses in detail upon the normal function and dysfunction of specific physiological systems. Students attend a range of community based clinical placements.[4]

Third year

In third year, the first semester focuses on complex integrative physiological systems (central nervous system and endocrine organs). Semester 2 is focused on a significant student-selected Honours research project, as well as the application of medicine and developing clinical skills. Students participate in secondary care based clinical placements.

Scottish Graduate Entry Medicine (ScotGEM)

ScotGEM is an intensive four-year graduate entry medicine programme run by the universities of St Andrews and Dundee in collaboration with four health boards: NHS Fife, Tayside, Highland and Dumfries and Galloway.

The course is led for first and second year by the University of St Andrews and in third and fourth year by the University of Dundee. The course focuses on rural medicine and healthcare improvement with students living and studying in rural areas from second year onwards.[5]

The course undertook its first cohort of students in 2019 with the intention of graduating students in September 2022 and awarding a joint degree from the University of St Andrews and the University of Dundee.[6]

Postgraduate

In 2002 the Scottish Parliament passed the University of St Andrews (Postgraduate Medical Degrees) Act 2002 which re-instated the university's right to award the postgraduate research degree of Medicinae Doctor (MD) to students who have completed two years of full-time or up to 5 years of part-time research, which had been removed by the Universities (Scotland) Act 1966.[7][8] The first MD since 1967 was awarded in 2004.

Facilities and buildings
New Medical School

The University of St Andrews’ new Medical and Biological Sciences Building brings together the medical school (relocated from the Bute Building), biologists, physicists and chemists, while also linking to the School of Physics and Astronomy via a first-floor bridge—making it one of the first medical schools in the UK to fully integrate research facilities across the sciences.

The School, which has been built at a cost of £45m, contains research laboratory space, as well as teaching facilities and a lecture theatre.[9]

Medical Societies

Over recent years, many medical societies have been developed, alongside the historical Bute Medical Society, to help incorporate the clinical aspects into the course—one which was traditionally science-based only. These societies include Surgical, Clinical and Preventative medical societies.

The Bute Medical Society
Bute Medical School Scarf

The Bute Medical Society was founded in 1915, by its first president Margaret Shirlaw, with the support of Miss Mildred Clark, Calum McCrimmon, Clive Mackie Whyte, Cecily Thistlewaite, Mary Ellison and W.G. Robertson. The initial aim of the society was to hold clinically oriented lectures that the students could attend voluntarily. This tradition still continues today with the society's bimonthly 'cheese and wine' evening. As an independent, non-profit organisation it is still run entirely by medical students, supported by some sponsorship.[10] Fundraising events held throughout the year also enable the Society to contribute to charities.

Surgical Society

In 2009, a small group of students set up the University's first surgical interest society. Since then, a multitude of lectures, skills workshops and anatomy revision tutorials have been run by the society and it continues to grow in size. The Robert Walmsley Lecture was created in 2011 as a yearly event held in the old Bute Buildings to commemorate this previous setting of the teaching of medicine in St Andrews; the inaugural lecture was delivered by David Sinclair.

Research areas

Research at the school is grouped into four main areas:[11]

  • Cellular medicine
  • Education
  • Infection and global health
  • Population and behavioural science

Research Institutes
  • WHO Collaborating Centre for International Child & Adolescent Health Policy
  • Child and Adolescent Health Research Unit (CAHRU)
  • Scottish Healthcare Associated Infection Prevention Institute

Academic dress

St Andrews undergraduate medical students are members of the United College of St Salvator and St Leonard, and as such wear the scarlet gown with burgundy velvet collar for official academic occasions. They graduate as a BSc or BSc (Hons) and so wear a black gown with a fuchsia hood trimmed with white fur. On graduation from Manchester they are entitled to wear a black gown with scarlet hood trimmed with white fur, and black cap.

When postgraduate students graduate with the MD degree, they wear a black gown with a crimson hood with a white lining, alternatively they may wear a crimson gown.

Alumni

Medical students at the University of St Andrews have included:

Name Class year Notability Reference(s)
John Arbuthnot MD 1696 Physician in ordinary to Queen Anne, member of the Scriblerus Club, inventor of the figure of John Bull
Robert Whytt MA 1730, MD 1737 President of the Royal College of Physicians in Edinburgh, wrote book on diseases of the nervous system
William Wright MD 1763 President of the London Royal School of Medicine, Physician in Chief of Jamaica, the genus Wrightia (Apocynaceae) are named after him
Andrew Duncan MA 1762, MD 1769 President of the Royal Medical Society and the Royal College of Physicians in Edinburgh, First physician to the King in Scotland, founder of the Harveian Society, founder of the first lunatic asylum in Edinburgh, Professor of Theory of Medicine at University of Edinburgh
Jean-Paul Marat MD 1775 Radical pro-revolutionary journalist during the French Revolution
Busick Harwood MD 1790 Professor of Anatomy at University of Cambridge
Edward Jenner MD 1792 Discovered the smallpox vaccine
Alexander Berry 1798 Established the first European settlement in New South Wales, Australia
Richard Poole MD 1805 Editor of the New Edinburgh Review, the Phrenological Journal and Encyclopædia Edinensis
Duncan McNeill, 1st Baron Colonsay MD 1809 Lord President of the Court of Session of Scotland, MP for Argyllshire
George William Balfour MD 1845 Honorary Physician in Ordinary to King Edward VII in Scotland.
Anthony Brownless MD 1846 Founder of the University of Melbourne Medical School
Samuel Cockburn MD 1848 Scottish physician, outspoken defender of homeopathy
Anthony Dickson Home MD 1848 Scottish physician, Surgeon General of the British Army, recipient of the Victoria Cross
Benjamin Ward Richardson MD 1854 British physician, introduced over 14 anesthetics including methylene bichloride, invented the double valve mouthpiece for administration of chloroform
Thomas Egerton Hale MD 1855 Scottish physician, Surgeon Major of the British Army, recipient of the Victoria Cross
Douglas Argyll Robertson MD 1857 Scottish ophthalmologist, described the Argyll Robertson pupil a sign of neurosyphilis
Joseph Bancroft MD 1859 surgeon and parasitologist, discovered filariasis, made advances in leprosy
Pulney Andy MD 1860 Became the first Indian to receive a British medical degree and established the National Church of India in Madras. [12]
George Turner Orton MD 1860 Liberal-Conservative MP of Canada for Wellington Centre
John Young Bown MD 1863 Liberal-Conservative MP of Canada for Brant North
Stewart Duke-Elder BSc 1919, MA (Hons) 1919, MB ChB 1923, MD 1925, DSc 1927, LLD (Hon) 1950 Surgeon Oculist to King Edward VIII, King George VI and Queen Elizabeth II, Brigadier General in the Royal Army Medical Corps, author of the widely used textbooks Textbook of Ophthalmology and System of Ophthalmology, Founder of the Institute of Ophthalmology in London and the Faculty of Ophthalmologists, Hospitaller of the St John Ophthalmic Hospital, President of the International Council of Ophthalmology
Andrew Logan MB ChB 1929 Surgeon who pioneered the mechanical dilation of the mitral valve to treat mitral stenosis
John Forfar BSc 1938, MB ChB 1941, MD 1958 Pediatrician and author of the Forfar and Arneil's Textbook of Paediatrics, awarded the Military Cross for service during the Second World War
Sir Douglas Black MB ChB 1943 Author of the Black Report; former President of the Royal College of Physicians
Walter Perry MB ChB 1943, MD 1948, DSc 1958 Dean of Medicine of the University of Edinburgh Medical School, First Vice-Chancellor of the Open University, Life Peer of the House of Lords
Sir James Black MB ChB 1946 Inventor of Propanolol; Developer of Cimetidine and Ranitidine; Nobel Prize in Medicine winner; Chancellor of the University of Dundee
Lord Patel MB ChB 1964 Chancellor of the University of Dundee
Michael Henderson MB ChB 1969 Chief Medical Officer of the University of Mississippi Medical Center, Chair of Surgery at the Cleveland Clinic Lerner College of Medicine [13]
Lewis Moonie, Baron Moonie MB ChB 1970 Labour Co-operative MP for Kirkcaldy from 1987 to 2005
Alexander Burns Wallace PhD 1973 Plastic surgeon, co-founder and President of the British Association of Plastic Surgeons, founding editor of the British Journal of Plastic Surgery, developed the Wallace rule of nines, a method of determining the proportion of body affected by burns
Gordon Ritchie MB ChB Progressive Conservative MP of Canada for Dauphin
Kim Fox MB ChB Diana Princess of Wales Chair in Cardiovascular Medicine and Science at the Royal Brompton Hospital, Head of the National Heart and Lung Institute at Imperial College School of Medicine, Editor in Chief of the European Heart Journal and President of the European Society of Cardiology
John Garrow MD, PhD Chairman of HealthWatch, editor of the European Journal of Clinical Nutrition
Nancy K. Conn MB ChB 1945 Bacteriologist known for preventing a typhoid outbreak in Edinburgh in 1970. [14]

Faculty

List includes faculty who were not also graduates of the medical school

Name Department Notability Reference
William Scheves Archdeacon and Royal Cleric Scottish physician, Physician to James III of Scotland [15]
John Reid Chandos Chair of Medicine and Anatomy 1841-1849, FRCP 1836 Scottish physician, described the function of the glossopharyngeal nerve and vagus nerve. He also proved the heart had a double innervation through the vagus and sympathetic nerves
Percy Theodore Herring Chandos Chair of Medicine and Anatomy 1908-1948, FRSE 1916 Scottish physician, discovered herring bodies
Richard G. Morris Lecturer 1977-1986, FRS 1997, CBE 2007 British neuroscientist, developed the Morris water navigation task

The Bute Chair

The Bute Chair was established by John Crichton-Stuart, 3rd Marquess of Bute in 1898.

Holders of the Bute Chair are known as Bute Professors and include:

  • 1901–1914 James Musgrove
  • 1914–1942 David Waterston (died in office)
  • Inter Regnum due to war
  • 1946–1973 Robert Walmsley
  • 1973–1996 David Brynmor Thomas
  • 2003–2014 Robert Hugh MacDougall
  • 2014-present David Christopher Crossman

Sir James Black Chair of Medicine

In 2010 the Bute Medical School of the University of St Andrews, where Black had studied his initial degree in medicine, unveiled that an honorary 'Sir James Black Chair of Medicine' would be created. This post remained unfilled for the remainder of the academic year 2009–2010. In September 2010 the first Chair of Medicine at the ancient University was given to Professor Stephen H Gillespie MD, DSc, FRCP (Edin), FRC Path, leaving his post as Professor of Medical Microbiology at UCL.

The John Reid Chair of Pathology

In 2012 the Bute Medical School of the University of St Andrews, appointed Prof. David Harrison to the John Reid Chair of Pathology, leaving his previous post as the Head of Division of Pathology in the University of Edinburgh. He remains an Honorary Consultant Pathologist in Lothian University Hospitals Division and Director of the Breakthrough Research Unit, Edinburgh.

Ann Gloag Chair of Global Health Implementation

The current holder of this chair appointed in 2013 is Prof. Will Stones

See also

References
  1. "UCAS stats". Retrieved 29 January 2013.
  2. Herring, P. T. (1948). "Prof. E. Waymouth Reid, F.R.S". Nature. 161 (4094): 591–592. Bibcode:1948Natur.161..591H. doi:10.1038/161591a0. ISSN 0028-0836.
  3. "Medicine BSc A100 - Subjects - University of St Andrews". www.st-andrews.ac.uk. Retrieved 2020-08-06.
  4. "Medicine BSc A100 - Subjects - University of St Andrews". www.st-andrews.ac.uk. Retrieved 2020-08-06.
  5. "ScotGEM MBChB - Subjects - University of St Andrews". www.st-andrews.ac.uk. Retrieved 2020-08-06.
  6. "Doctors of the future - gov.scot". www.gov.scot. Retrieved 2020-08-06.
  7. "Policy Memorandum | University of St. Andrews (Postgraduate Medical Degrees) Bill (SP Bill 51)" (PDF). parliament.scot. Scottish Parliament. 17 April 2002. Retrieved 29 April 2017.
  8. Scottish Parliament. University of St. Andrews (Postgraduate Medical Degrees) Act 2002 as amended (see also enacted form), from legislation.gov.uk.
  9. "St Andrews University medical school in £8m pledge wait". BBC News. 17 February 2010. Retrieved 2 July 2014.
  10. "Philosophy". www.butemedicalsociety.co.uk. Retrieved 5 December 2015.
  11. "Research - School of Medicine - University of St Andrews".
  12. "Medical News". The Lancet. Elsevier. 76 (1936): 346–348. 6 October 1860. doi:10.1016/s0140-6736(02)57082-3. Retrieved 20 February 2011.
  13. Cummins, Ruth. "New CMO: A leader in patient quality outcomes". University of Mississippi Medical Center. UMMC. Retrieved 28 April 2015.
  14. "Dundee Courier". British Newspaper Archive. 22 June 1945. Retrieved 27 August 2020.
  15. Shepherd, J. A. (1972). "Medical Teaching in St. Andrews University 1413-1972". BMJ. 3 (5817): 38–41. doi:10.1136/bmj.3.5817.38. PMC 1788514. PMID 4557032.
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