London’s hospitals have played a key part in medical history. The earliest ones were not medical schools, but religious or charitable institutions established to serve the poor, infirm, and pilgrims. St. Bartholomew’s Hospital, founded in 1123 by Rahere, an Augustinian monk and former courtier of King Henry, was one of these early establishments, followed by St. Thomas’ Hospital, originally the Priory of St. Mary Overie in Southwark. The dissolution of the monasteries under Henry VIII would have resulted in the extinction of these facilities were it not that London’s rapidly expanding population created urgent demands that could not be ignored. Hospitals survived under secular governance, their growth supported by the founding of the Royal College of Physicians in 1518 and the Company of Barber-Surgeons in 1540. Inevitably, these hospitals also became venues for medical education where students were taught by London’s prominent physicians. The students followed them on rounds, attended their lectures, and worked as dressers and ward clerks under their supervision.
In the early 1700s, the London hospitals began to establish formal teaching medical schools. St. Bartholomew’s and St. Thomas’ Hospital were first to do so. Guy’s Hospital, endowed by Sir Thomas Guy, and St. Thomas’ Hospital became closely linked in 1721 to form one of the earliest joint teaching hospitals. It was there that John Keats attended and completed a five-year apprenticeship before registering as a medical student in 1815. In 1825 a dispute between the surgeon Sir Astley Cooper and the physician Sir William Lawrence led to the separation of these two medical schools. It would be nearly two centuries before they were reunited.
Other teaching hospitals also emerged to serve London’s expanding poor population. The London Hospital opened in 1740 in Whitechapel; the Middlesex Infirmary on Windmill Street in 1745; and St. George’s Hospital at Hyde Park Corner in 1733. The rise of clinical pathology and forensic medicine later produced influential figures such as Henry Gray, whose Gray’s Anatomy became one of the most enduring medical textbooks ever written.
In 1834 University College Hospital (UCH) was founded in Bloomsbury as part of the University of London, and as a secular and non-denominational institution, it attracted students who were excluded from Oxford and Cambridge due to religious reasons. The Royal Free Hospital, founded in 1828 by surgeon William Marsden, became the first hospital in London to admit women to its medical student program (1874). St. Mary’s Hospital was established in 1851 and quickly became a leading teaching medical school, where Alexander Fleming discovered penicillin in 1928. The rise of specialization gave an impetus to the establishment of Moorfields Eye Hospital (1805), the Royal Brompton Hospital for lung diseases (1841), and Great Ormond Street Hospital for Children (1852).
During the Victorian era, London’s teaching hospitals grew in size and reputation as advances in anesthesia, bacteriology, and surgery transformed medical care. Associated with these schools were Thomas Sydenham, who emphasized clinical observation; John Hunter, the great surgeon-anatomist; Joseph Lister, who championed antisepsis; and Florence Nightingale, who revolutionized nursing practice.
The establishment of the National Health Service in 1948 brought about profound restructuring. Already during the period of 1960–1980 many smaller or district hospitals closed their doors or merged with the larger teaching medical schools, and subsequently these were further consolidated into NHS trusts. The famous medical schools of the past are no more or have been merged, the London Hospital school with St. Bartholomew’s, the Royal Free and St Mary’s with the University of London, etc. But their work continues as in the past, an indestructible tripod of education, research, and patient care.