Why it's time to celebrate Edinburgh's medical school, the oldest in the English-speaking world

Three centuries of medical education is worth marking, and a public events programme will unfold throughout the year. There will be community connection projects, a team examining digital frontiers in healthcare, a medical school tartan and a strand looking at the global impact of the medical school across its three centuries.

This will include a series of public lectures by students and experts, focussed on what we can learn from our history. The first of these, entitled A Deep History of Health and Healing in Edinburgh, will take place today, led by architect Malcolm Fraser and architectural historian Harriet Blakeman.

It will explore the intersection of health with place; with how environmental conditions like fresh air, sunshine and shelter have an influence on recovery. Fraser and Blakeman will explore how these principles have (or haven’t) been expressed in our Edinburgh hospitals across the centuries – even before the establishment of Edinburgh’s Royal Infirmary on Infirmary Street in 1729 (three years after the medical faculty).

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Mob sacks Blackfriars Friary

The earliest city hospitals were, by custom, religious tradition, and necessity, located outside the filth and squalor of the Old Town. The first was in the Blackfriars Friary (the approach to which is still remembered in the naming of Blackfriars Street), whose ministering Dominican order emphasised a duty of care to the townsfolk.

In 1558, with the dissolution of the monasteries, Blackfriars was sacked by the mob. It is no coincidence that the town’s secular High School (on what became High School Yards), and medical institutions like the first infirmary were established there.

There was also the Church of the Holy Trinity, founded by the shores of the Nor Loch. This was the one of several sites occupied by Edinburgh’s Botanical Garden over the centuries; a plaque to commemorate its position stands overlooking Waverley Station’s platform seven.

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Preceding any of the city’s health education institutions and a full 17 miles away in the Lammermuir Hills was the House of the Holy Trinity at Soutra. The reason for its site remains something of a mystery – not only is it a day’s journey on foot from Edinburgh, it's miles from anywhere and was the highest hospital in Britain, on a road frequently impassable for snow.

We might see an argument for the bracing qualities of cold air – but consider that this must have coincided with the ascetic, monkish admiration for austerity, to seek healing in the teeth of the winds.

‘The best-planned hospital in Britain’

Both speakers will touch on the many factors that have influenced how and why we have built our hospitals over the centuries – taking in changes in medical innovation, social transformation, and developments in the way that such projects have been financed.

Beyond the infirmaries, it’ll touch on the 1850s surgical hospital at High School Yards (now Edinburgh University’s Department of Geography), as well as the convalescent hospitals of the city, and the Western General Hospital (which grew out of St Cuthbert’s workhouse for the poor).

The siting of hospitals to aid health by means of sunshine, natural ventilation and a view of nature found its greatest expression in the 19th century after the Crimean War, including the principles of the (Florence) Nightingale Wards of the old Royal Infirmary – now Edinburgh’s Futures Institute – which opened in 1879 alongside a purpose-built Medical School at Teviot Place. At the time it was described as “probably the best-planned hospital in Britain”.

It is remarkable that, in a city sloping north to the Forth, most of its hospitals, including the Royal Infirmary of Edinburgh, the Astley Ainslie, Murrayfield, the Elsie Inglis and the Princess Margaret Rose, were sited on south-facing slopes, with views south to hills, parks and trees. Recent research has confirmed these simple facts: that sunshine, fresh air and a view of nature aids recovery.

A duty of society

The 20th century saw enormous pressures brought to bear on the Victorian infirmary, to expand but also to change with the times. The introduction of the NHS in 1948 saw a revolution in hospital design, and there was hope that the Infirmary could be rebuilt piece by piece on its existing site.

Blakeman will give the broader view of how Edinburgh’s health and healing institutions changed in context with other developments across Scotland, and unpack the reasons for the Infirmary’s move to Little France.

The way that a society chooses to care for its sick and infirm members says something about that society, as does the way that we train our doctors. This year is an opportunity to reflect and transform the future vision of Edinburgh Medical School.

The events aim to build a sense of belonging with the community, as well as share gratitude – the medical school couldn’t exist without the support of the people of Edinburgh. And, as the title of the commemorative poetry pamphlet puts it, in the words of one of our student poets Maria-Ariadna Ghiuta: “We are just getting started.”

Harriet Blakeman is an academic architectural historian who maintains the site: historic-hospitals.com. Malcolm Fraser is an Edinburgh architect whose work spans award-winning homes, cultural renewal, and the care and renewal of historic buildings and towns. Gavin Francis is a GP who co-leads part of the Edinburgh Medical School 300 project.

Tonight’s public talk is fully booked, but a waiting list, and information on other events, can be found at: 300 years of medicine | College of Medicine and Vet Medicine.