Some years ago a tourist shown the shopping Galleria in Milan asked the guide why the ceiling paintings illustrating the world’s continents did not include Australia. The guide explained that Australia had yet to be invented. She was clearly misinformed in that the British had established the penal colony at Botany Bay some one hundred years earlier, in 1770. But its states developed gradually and became the Commonwealth of Australia on 1 January 1901.

During the first half of the twentieth century, Australia remained a backwater of the British Empire. In 1948 it had a population of seven million people, hailing almost entirely from the British Isles. Twice in that time, it sent its sons overseas to fight Germany and its allies. In the 1950s, young men who had never been abroad would tell you unequivocally that Australia was the best country in the world, supposed to have the highest standard of living, the best beaches and the best beer, and the most beautiful girls in the world.

After World War Two, Australia’s leaders realized that its population was much too small for the size of the continent. They instituted an immigration policy that, at its peak, would take in half a million people per year, more in proportion than even the United States at the peak of its immigration policy. The immigrants were received with open arms, and many were naturalized within three to five years. By 2024, the population had risen to 27.7 million.

The country soon changed dramatically. In 1950 Sydney had one mediocre hotel, the Australian, one bad Italian restaurant, the Fiorentina, another bad multiethnic one, the Swiss Home, and many Chinese “chop-sui” ones. With the arrival of the Italians, the ever-present milk bars became espresso bars. Pizza arrived around 1954, and television around 1955. Its opera house was almost ten years under construction because letters to the Sydney Morning Herald said it would be better to have another cricket ground. Even in the 1960s, academic professors complained that it took six weeks to receive scientific journals from Europe. It was a far cry from the modern city of today, with its famous opera house, its many modern hotels, its view from the seashore, its many skyscrapers, and all the benefits in communication brought by the computer age, the internet, and international travel.

So what was it like to attend medical school in 1950? In Sydney’s state, New South Wales, according to a charter promulgated by Queen Victoria, tertiary education was virtually free. The university campus was splendid, its buildings and lawns like those of the “home country.” In 1950 over 300 students had been admitted to “med one”, including many older people who had returned from the war and were now allowed to have a free education. Raucous and not respectful of anybody, they once turned up sitting in the front row with umbrellas unfurled because the lectures of the physics professor were like rain. On campus, the students had to run from the physics to the biochemistry building to secure a front seat, as sitting further back would have made the lecturer’s Highland accent incomprehensible.

Most of the professors had come from Scotland during the Depression and had been in their position for twenty years. Most had written a book that was compulsory for the students to buy. In medicine, the professor announced to the assembled class that he was retiring, burst into tears, and then stayed on for another year. In chemistry, first-year students in the auditorium would yell and throw paper airplanes if the experiments demonstrated by the lecturer on the front desk went awry. The students at entry were mostly eighteen to nineteen years old. The professors lectured from the same old notes for at least ten years. Department chairmen in biochemistry, anatomy, and physics rarely, if ever, taught. First-year students had to learn botany, the difference between a monocotyledon and a dicotyledon, between the xylem and phloem. In zoology they had to learn the parts of the cockroach and dissected stingrays and oxen eyes. Preclinical departments had one or two readers (senior lecturers) and relied much on volunteer private practice surgeons to help the students dissect and find the anatomical structures they were looking for. One department chairman could be observed stopping on his way to lunch to chat with whomever he met and not return to his office until about two pm. In the clinical years, the teaching was done mainly by senior residents. The clinical services in the teaching hospitals were overseen by practicing attending physicians who came once or twice a week to supervise the junior staff.

At the beginning of overall clinical orientation in the first year, students were greeted by the dean, who told them to look to the right and then to the left and understand that only one out of three would graduate. The students worked hard and, as medical graduates, were generally well-trained and competent. Until about 1965, they mostly deferred marriage until after internship and then went into general practice, often in country towns. Some saved enough money to get higher degrees in England and surgical experience by working in the large hospitals in the provinces. Very few went to America. In the 1950s, Australia was producing competent primary care doctors at minimal cost but also some great scientists. It also rivaled the United States by often winning the Davis Cup.