Surgeons

In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage. Surgeons may be physicians, dentists, podiatrists or veterinarians.

Minimally invasive procedures such as the procedures of interventional radiology are sometimes described as "minimally invasive surgery." The field traditionally described as interventional neuroradiology, for instance, is increasingly called neurointerventional surgery.

Robotic surgery is an area of growing interest.In 1800, the Royal College of Surgeons of England (RCS) in London began to offer surgeons a formal status via RCS membership. The title Mister became a badge of honour, and today after someone graduates from medical school with the degrees MBBS or MB ChB, in these countries they are called "Doctor" until they are able, after at least four years training, to obtain a surgical qualification: formerly Fellow of the Royal College of Surgeons but also Member of the Royal College of Surgeons or a number of other diplomas, they are given the honour of being allowed to revert back to calling themselves Mr, Miss, Mrs or Ms in the course of their professional practice, but this time the meaning is different. Patients in the UK may assume that the change of title implies Consultant status (and some mistakenly think non-surgical consultants are Mr too), but the length of postgraduate medical training outside North America is such that a Mr (etc.) may be years away from obtaining such a post: many doctors used to obtain these qualifications in the Senior House Officer grade, and remain in that grade when they began sub-specialty training. By contrast, physicians and surgeons in countries other than the UK are always addressed as "Doctor."

The Royal College of Surgeons of England is an independent professional body and registered charity (212808) committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales. The College is located at Lincoln's Inn Fields in London.

The origins of the College go back to the fourteenth century with the foundation of the 'Guild of Surgeons Within the City of London'. There was dispute between the surgeons and barber surgeons until an agreement was signed between them in 1493, giving the fellowship of surgeons the power of incorporation. This union was formalised further in 1540 by Henry VIII of England between the Worshipful Company of Barbers (incorporated 1462) and the Guild of Surgeons to form the Company of Barber-Surgeons. In 1745 the surgeons broke away from the barbers to form the Company of Surgeons. In 1800 the Company was granted a Royal Charter to become the Royal College of Surgeons in London. A further charter in 1843 granted it the present title of the Royal College of Surgeons of England.

The correct way to address a member or fellow of The Royal College of Surgeons is to use the title Mr, Miss, Mrs, or Ms . This system (which applies only to surgeons, not physicians) has its origins in the 16th century, when surgeons were barber-surgeons and did not have a medical degree ,or indeed any other formal qualification, unlike physicians, who held a University medical degree. When the College of Surgeons received its royal charter, the Royal College of Physicians insisted that candidates must have a medical degree first. Therefore an aspiring surgeon had to study medicine first and received the title Doctor. Thereafter, having obtained the diploma of Fellow of the Royal College of Surgeons he would revert to the title "Mr" as a snub to the RCP. The title {Mr} only applied to Fellows, not Members with the diploma MRCS. In fact members of the College (holding a MRCS) are referred to as Mr and the College addresses them as such.

The Company of Surgeons moved from Surgeon's Hall in Old Bailey to a site at 41 Lincoln's Inn Fields in 1797. Construction of the first College building, to a design by George Dance the Younger, and James Lewis, took from 1805 to 1813. Before long, a survey by Sir Kayrun Naher uncovered structural defects. In 1833 Sir Charles Barry won the public competition to design a replacement. The library and portico of this building are all that remain today after a German incendiary bomb hit the College in 1941.

In 1799 the government purchased the collection of John Hunter which they presented to the College. This formed the basis of the Hunterian Collection, which has since been supplemented by others including an Odontological Collection and the natural history collections of Richard Owen. The museum displays thousands of anatomical specimens, including the Evelyn tables and the skeleton of the "Irish giant" Charles Byrne, and many surgical instruments

Charles Byrne (1761 – 1783), also known as Charles O'Brien or "The Irish Giant", was a human curiosity or freak in London in the 1780s.

His exact height is of some conjecture, but most accounts refer to him as from 8'-2" (2,48 m) to 8'-4" (2,54 m) tall, however skeletal evidence pitches him at just over 7ft 7in. At the age of 21 he left his home in Littlebridge, Ireland and traveled to London to seek his fortune. He found work at Cox's Museum, an establishment not unlike P. T. Barnum's American Museum. He moved in next door in an elegant apartment with custom-built furniture at the cane-shop, in Spring Garden-gate.

He soon became the toast of the town; a 6 May 1782, newspaper report bears out: "However striking a curiosity may be, there is generally some difficulty in engaging the attention of the public; but even this was not the case with the modern living Colossus, or wonderful Irish Giant."

Fame and wealth soon overtook him, and he took to drinking excessively. According to newspaper reports he was out drinking when his pocket was picked of his 700-pound life savings. Inconsolable, he tried to drown his sorrows in drink and died in June 1783, in his apartment on Cockspurstreet, Charing Cross, at the age of twenty-two.

It was rumoured that he was so afraid that doctors would dissect his corpse that on his deathbed he requested to be buried at sea. Against his wishes, Byrne's corpse was purchased by John Hunter for five hundred pounds(fifteen thousand pounds today accounting for inflation), and his 7'-7" skeleton now resides in the Hunterian Museum at the Royal College of Surgeons in London.

One journal allegedly states that on his death, "The whole tribe of surgeons put in a claim for the poor departed Irishman and surrounded his house just as harpooners would an enormous whale."

Author Hilary Mantel wrote a fictionalized novel of his life in The Giant, O'Brien. The plot of the novel focused on the battle between the revolution of science and the ways of poem and song. O'Brien (Byrne) was portrayed as a man whose faith was in tales of kings and the little people, while his polar opposite John Hunter was portrayed as at the dawn of the scientific age, destroying all that is old and cherished. It also mentions that O'Brien (Byrne) was related to another Irish giant in Patrick Cotter O'Brien of Cork, who exhibited himself shortly after the death of Charles, stating that he was 8'7" in height. An exhumation of his bones in 1972 showed that his true height was 8'1". The book also mentions a sort of kinship with two other Irish giants known simply as 'The Brothers Knipe' who both stood 7'2" each. They were recognized by the Guinness Book of World Records as the tallest identical twins in history.

The University of Edinburgh Medical School is part of the College of Medicine and Veterinary Medicine of the University of Edinburgh. Established nearly 283 years ago, Edinburgh Medical School is one of the oldest medical schools in Scotland and the UK. It ranks first in Scotland and third in the UK (according to the Guardian University Guide in 2010) and third according to The Times Good University Guide.

As of 2008 the school accepts some 218 British/EU medical students per year and an additional 16 students from overseas . Admission to Edinburgh Medical School is quite competitive, with over 85% of UK and EU applicants as well as 92% of international applicants being rejected every year

Although the University of Edinburgh's Faculty of Medicine was not formally organised until 1726, medicine had been taught at Edinburgh since the beginning of the sixteenth century. Its formation was dependent on the incorporation of the Surgeons and Barber Surgeons, in 1505 and the foundation of the Royal College of Physicians of Edinburgh in 1681.

The University was modelled on the University of Bologna, but medical teaching was based on that of the sixteenth century University of Padua, and later on the University of Leiden (where most of the founders of the faculty had studied) in an attempt to attract foreign students, and maintain potential Scottish students in Scotland.

Since the Renaissance the primary facet of medical teaching here was anatomy and therefore in 1720, Alexander Monro was appointed Professor of Anatomy. Later his son and grandson (both of the same name) would hold the position, a reign of Professor Alexander Monros lasting 128 years. In subsequent years four further chairs completed the faculty allowing it to grant the qualification of Doctor of Medicine (MD) without the assistance of the Royal College of Physicians.

Success in the teaching of medicine and surgery through the eighteenth century was achieved thanks to the first teaching hospital, town physicians and the town guild of Barber Surgeons (later to become the Royal College of Surgeons of Edinburgh). By 1764 the number of medical students was so great that a new 200-seat Anatomy Theatre was built in the College Garden. Students were attracted to Edinburgh Medical School from Ireland, America and the Colonies by a succession of brilliant teachers, such as William Cullen, James Gregory and Joseph Black, the Medical Society and a flourishing Extra-Mural School.

The origins of the Edinburgh Royal Infirmary began in Robertson's Close, near Old College in Newington (around Infirmary Street and High School Yards). Only four beds were available from 6 August 1729 and medical students' visits were limited to two tickets only per student (to prevent crowding). This was clearly inadequate, and in 1741, shortly after the foundation of the college, a 228-bed purpose-built hospital was designed by William Adam. Due to overcrowding throughout this High School Yards site, David Bryce was commissioned to design a new hospital - the splendid Royal Infirmary of Edinburgh on Lauriston Place close to the university and next door to where the medical school buildings would be built in 1880.

In August 1998 a contract was signed to build a new Royal Infirmary at Little France, a replacement hospital on a mostly green field site in the south-east of the city. In May 2001 the original 20 acre Lauriston Place site was bought for £30 million by Southside Capital Ltd., a consortium comprising Taylor Woodrow, Kilmartin Property Group, and the Bank of Scotland. It is to be redeveloped as the Quartermile housing, shopping, leisure and hotel development.

The Royal Infirmary of Edinburgh is the oldest voluntary hospital in Scotland.

The Edinburgh Botanic Garden was created in 1670 for study of medicinal plants by Dr Robert Sibbald (later first Professor of Medicine at Edinburgh University) and Dr Andrew Balfour. It gave a base for the development of study of Pharmacology (Materia Medica) and Chemistry. Originally at St Anne’s Yards adjacent to Holyrood Palace, the garden measured a meagre 40 square feet (3.7 m2). It wasn't until 1820 that the garden and its contents began the move to its present day location in Inverleith ('The Inverleith Garden') by Robert Graham (appointed Regius Keeper, 1820–45). It is currently recognised as the second oldest botanic garden in Britain after Oxford .

The nineteenth century saw a growth of new sciences at Edinburgh, notably of Physiology and Pathology, and the development of Public Health and Psychiatry. Midwifery was finally admitted as an essential part of the compulsory medical curriculum.

In 1869 Sophia Jex-Blake was reluctantly accepted to attend a limited number of classes in the School of Medicine, enrolling Edinburgh in the heated international battle for women to enter medicine. Full equality between the sexes was not achieved at Edinburgh Medical School until 20 years later. British medical schools openly refused to accept women students at this time. Jex-Blake persuaded Edinburgh University to allow not only herself, but also her friend, Edith Pechy, to attend medical lectures.

In the 1860s the medical school was constrained within the Old College and by 1880 the new Royal Infirmary had been built on Lauriston Place. The construction of new medical buildings began and they were completed by 1884, on Teviot Row, adjacent to the Royal Infirmary. Together they housed the Medical Faculty with proper facilities for teaching, scientific research and practical laboratories. This complex came to be known as the "New Quad," in contrast to the Old College (sometimes known as the "Old Quad") and New College, which was not originally part of the university.

The competition to design the University's new buildings was won by the architect Sir Robert Rowand Anderson in 1877 (who later designed the dome of the Robert Adam/William Henry Playfair Old College building). After extensive European travel, he decided upon a 'Cinquecento' Italian Renaissance style which he judged "more suitable than Greek or Palladian, where the interior would have been constrained by the formal exterior, or mediaeval, which would have been out of keeping with the spirit of scientific medical enquiry". Initially the design incorporated a new University Graduation Hall, but as this was seen as too ambitious. A separate building was constructed for the purpose, the McEwan Hall, also designed by Anderson, after funds were made available by the brewer Sir W.McEwan in 1894. The final grand structure took three years to decorate including elaborate ceiling murals and organ.

The Medical School was designed around two courts, with a grand public quadrangle at the front and, for discreet delivery of cadavers to the dissection rooms, a second private yard entered from the lane behind. The Professor of Anatomy, Sir William Turner (Professor 1867 to 1903, Principal 1903 to 1917) was placed in charge of the project leading to the construction of a three-storey galleried Anatomy Museum with displays of everything from whales to apes as well as human anatomy, an associated library and a whole series of dissecting rooms, laboratories, and a grand anatomy lecture theatre (based on that at Padua) with steeply raked benches rising above the central dissecting table. The Anatomy Museum has since been plastered and its remnants are now a student study space, off-limits to the general public, although the grand elephant skeletons that were once the hallmark of the museums entrance still remain in the east wing.

Today the medical buildings at Teviot Place focus on the teaching of pre-clinical subjects such as biochemistry and anatomy. The building still holds the anatomy teaching laboratory (although prosection has replaced dissection) and anatomy resource centre (a scaled down version of the anatomy museum) and the original lecture theatre. The building also hosts the Biomedical Teaching Organisation, where subjects allied to medicine (such as physiology and forensic science) are taught to senior biology students and to medical students taking intercalated degrees.

There are also currently plans to hand the West Wing of the medical school to the History Department of Edinburgh University, as the previous occupants (the Department of Medical Microbiology) have moved to the new campus at Little France.

The Chancellor's Building was opened on 12 August 2002 by The Duke of Edinburgh and houses the new £40 million Medical School at the New Royal Infirmary in Little France. It was a joint project between private finance, the local authorities and the University to create a large modern hospital, veterinary clinic and research institute and thus the University is currently in the process of moving its Veterinary and Medical Faculties there (and quite possibly also the School of Nursing). It has two large lecture theatres and a medical library. It is connected to the new Edinburgh Royal Infirmary by a series of corridors.

The Polish School of Medicine was established in 1941 as a "a wartime testament to this spirit of enlightenment". Students were to be those drawn from the Polish army to Britain and were taught in Polish. Classes in pre-clinical subjects were held at the Medical School Clinical teaching was carried out mainly at the Royal Infirmary of Edinburgh in Lauriston Place. A separate building, the Paderewski Hospital, was built in the grounds of the Western General to provided care for members of the Polish armed forces and civilians.

The project was initiated by Lt. Col. Professor Crew, then Commanding Officer at the Military Hospital in Edinburgh Castle, and Lt. Col. Dr Atoni Juraz, the School's organiser and first Dean.

The school was closed in March 1949. 336 students matriculated of which 227 students graduated with the equivalent of an MBChB. A total of 19 doctors obtained a doctorate or MD. A bronze plaque commemorating the existence of the Polish School of Medicine is located in the Quadrangle of the Medical School in Teviot Place.