Review of Laura Kelly, Irish Medical Education and Student Culture c.1850-1950 (Liverpool University Press: Reappraisals in Irish History, 2017, 2020).

There is no doubt about it, but the medical world between 1850 and 1950 was predominantly bourgeois and male, inextricably embedded in a network that championed those more ‘noble’ masculine traits and upward social mobility. During these one hundred years, medicine became less of a trade and more of a profession, which imposed its own privileged ‘take’ on life in all its guises. Women joined the profession, most significantly from the 1880s onwards. Their testimonies of operating in an environment dominated by traits of ‘nobility’ and ‘masculinity’ are astutely woven into Irish Medical Education and Student Culture c.1850-1950 by Laura Kelly, a valuable narrative and the first comprehensive history of all aspects of the life of the medical student on the island of Ireland in one defining century.

Kelly reminds us that the experiences of medical students of the past have been neglected in the historiography of medical education, in favour of providers, practitioners and academics. It is this shortcoming that she addresses from an Irish perspective seeking, as she says in her introduction, ‘to reinstate the student’s voice in the history of medical education in Ireland and to improve our understanding of the history of the Irish medical profession’ (p. 3). Kelly does this moreover, from what she describes as a ‘bottom-up view’, utilising newspaper articles, student magazines, doctors’ memoirs and most significantly, oral history accounts from those who experienced student life in the 1940s and 1950s. 

This is a wide and ambitious sweep embracing academic, cultural, social, and religious aspects of being a medical student in Ireland between 1850 and 1950. From an academic perspective it is interesting to note that once women became established members of the medical student body, they report, particularly in the first half of the twentieth century, that they were, relatively speaking, treated fairly by tutors and professors. Interestingly, compared to their counterparts in the United Kingdom, Irish colleges were regarded as open-minded in their accommodation of female medical students, although patronisingly referred to as ‘lady medicals’ (pp 173-174). It is apparent that even though a sense of fairness was felt, it was tempered by the many doors that were closed to women in the profession.  Indeed, Kelly relates an incident from 1896 where the outraged young men in the Royal College of Surgeons opposed the appointment of a woman as Senior Examiner in Midwifery and requested a gentleman be appointed instead (p. 36). 

More recently, in the twentieth century, a study of the student press at the University of Liverpool between 1944 and 1979 by Sarah Jane Aiston, showed that women students tended to be stereotyped in a negative manner up until as late as 1959, described through the usual tropes of physical attractiveness and a desire to find a husband (pp. 177-178). This unfortunate tendency is also evidenced in the Snakes Alive magazine of Queen’s College Belfast. In 1953 the magazine published an article by a student who wondered at the low number of female medical students in third year compared with the far greater number in fifth year, ‘5^th Year contains about three dozen of the pests – sorry pets’. He observed this interesting downward trend as going in the right direction, defending his position by claiming that ‘only a small proportion are suited for the profession anyway’ (p. 232). 

Students identified with peers and created networks through extracurricular activities which served to maintain this hegemonic masculinity: ‘this identity construction, through various rites of passage, and social and educational activities, aimed to preserve Irish medicine as a masculine sphere’ (p. 138). The collective team sport of rugby was the preferred activity to engender discipline and camaraderie, especially important for those wishing to embark on a career in surgery, which was regarded as a male preserve (p. 160).

Kelly alludes to the commonplace image of the heroic doctor given in introductory addresses to medical students in the nineteenth century, addresses specifically tailored to encourage ‘manly’ ideals. (p. 62). The predominant masculine image was one of strength and composure with the ability to make difficult decisions in a fearless manner. Notwithstanding these heroic attributes, the (arguably) brave work of female missionary doctors in the nineteenth century were not, Kelly reminds us, mentioned in introductory addresses to medical students (p. 63).

Kelly refers to a 1905 article in Q.C.B. remarking that working as a doctor or surgeon ‘would result in a loss of womanliness for the female doctor’ (p. 179). Lamentably, Oliver St John Gogarty, in his autobiography, It isn’t this time of year at all! An unpremeditated autobiography, describes two of his female medical school classmates as ‘breastless, defeminised, with dry hair’ (p. 181). But Kelly notes that some female medical students complied with patriarchy by actively supporting the football matches and male-led rag week events – perhaps their only way, within the social strictures of this time, of partaking in and benefiting from some form of camaraderie, an esprit de corps that was otherwise denied them. ‘In this way,’ says Kelly, ‘female medical students could be said to have been complying with patriarchy through emphasised femininity’. Indeed, such appreciation for this faithful support is applauded in the editorial of a 1925 edition of T.C.D: a college miscellany. (p. 182). Examples of this maintenance of masculine hegemony in medical schools is sharply highlighted throughout Kelly’s book in behaviours that might not readily spring to mind, for example, smoking in the dissecting room, pranks and hi-jinks in the lecture theatres – all things that engendered camaraderie among male students.

From women having to play catch-up because they had not studied chemistry or physics at school (p. 211), to students being assigned gender appropriate cadavers in the dissection room (p. 189), and so much more, Irish Medical Education and Student Culture c.1850-1950 is an intriguing and comprehensive study that must be read by anyone who is interested in the history of education and its impact on gender roles and expectations.

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Berni Dwan broadcasts about literature and history on Near FM 90.3. Her podcast series The A to Z of Historical Blunders: mistakes in history that should never be repeated can be heard on http://nearfm.ie/podcast/?cat=10362 and her podcast series Oldfilibuster’s Rhyme and Reason can be heard on http://nearfm.ie/podcast/?cat=18892.