368:(Licence in Medicine and Surgery of the Society of Apothecaries). The TQ had been created out of a concern felt by the Scottish medical colleges that they might lose their status as licensing bodies in favour of the universities and the London Colleges. The universities from the outset regarded the TQ as inferior to their examinations. In 1870, Edinburgh University told Parliament that it had a ‘fully equipped medical school which was operating to higher standards than any of the other award bodies’. Most doctors who had qualified with the TQ pursued a career in general practice rather than a hospital speciality, and many felt that there was discrimination against them entering hospital medicine as they had what was regarded by many as an 'inferior qualification'.
400:(UEB) which had been set up to by the GMC to oversee non-university medical qualifications. Candidates now sat the same examination, held in turn by each of the three licensing bodies. At the same examination diet they sat written, oral and clinical examinations and, if successful, were awarded the qualification of the centre where they sat. Candidates who sat in Edinburgh were still awarded the Triple Qualification. Inspections by the GMC from 1998 reported doubts about whether successful candidates had the 'breadth and depth of knowledge, the clinical skills and the professional attitudes and values expected by the GMC of UK-qualified doctors'. They concluded that the examination was not fit for purpose and recommended its abolition.
286:
changed with time to take account of advances in medicine and medical education. They came to include anaesthetics, paediatrics, psychiatry, ophthalmology, diseases of the ear, nose and throat, forensic medicine, and venereal disease. From 1968 international graduates from approved medical schools could be admitted directly to the final examination. In 1975 the GMC set up the
Temporary Registration Assessment Board (TRAB), which conducted its own structured examination for international medical graduates, which included an assessment of English language skills. TQ candidates were required to pass this before being granted temporary GMC registration. From 1978 this became
217:
134:
385:
the Royal
Colleges closed in 1948. Yet the Colleges continued to offer the TQ qualification. In the 1950s many candidates were British students whose studies had been interrupted by war service, while from the early 1960s the vast majority of candidates were international medical graduates or medical students. From 1979 the GMC required prospective international candidates for the TQ to sit and pass the PLAB examination.
372:
Cambridge
University medical students who had failed university exams immediately sat and passed the Apothecaries examination, further strengthening the view that non-university exams were set at a lower standard. The view that the three non-university medical qualifications constituted an inappropriate and easy "back door into medicine" was regularly voiced in the medical press.
317:
gain entry to university medical schools. In the latter years of the 19th century, this included women whose entry to
British university medical schools began in 1892. Between 1884 and 1909, 7% of those qualifying with the TQ qualification were women, a higher percentage than qualified from university medical schools at that time. Among the women to qualify with the TQ were
345:, won the Nobel Prize for the discovery of insulin. Kosterlitz qualified with the Triple Qualification in 1938, and eventually became Professor of Pharmacology at Aberdeen University in 1968. He went on to discover endorphins and was elected a Fellow of the Royal Society who awarded him their prestigious gold medal.
384:
The
Goodenough report (1944) concluded that "...the extra-mural schools of a lower standard than other schools in the country" and recommended that all undergraduate medical education and qualification in the UK should be administered by universities. As a result, the Edinburgh School of Medicine of
285:
The examinations were very similar to those taken in university medical schools. Basic sciences and basic anatomy were examined at the end of the first year, anatomy, physiology and materia medica at the end of the second year with clinical examinations being taken in the final year. The examinations
316:
Scottish qualification regulations were simpler than those in
England. The examination therefore proved to be a popular route to British medical practice for international medical graduates whose degrees were not recognised in the UK, for refugee doctors or aspiring doctors and for those unable to
276:
In addition to the above, many candidates took voluntary additional courses which included sanitary science, histology, botany, psychiatry, dermatology, ophthalmic surgery, diseases of the ear, nose and throat and therapeutics. These regulations were rigorously enforced and exceptions were rarely
371:
Until the 1960s many university medical students would take the TQ or the
Conjoint final exams as practice for university finals or as a fall back in case of failure in finals. It was common for those who did fail university final to then sit the TQ, conjoint or LMSSA. In 1982, seven out of ten
146:
The TQ examination regulations required candidates to present proof of having attended approved lectures and approved clinical teaching placements. In
Edinburgh and Glasgow private anatomy schools and small private medical schools had been a key feature of medical education since the late 18th
96:(GMC) and practise medicine in the United Kingdom. It was a route used by international medical graduates and those unable to gain entry to university medical schools, which included women in the late 19th century and refugee medical students and doctors throughout the 20th century.
375:
Despite being regarded as an inferior qualification and in the face of repeated unfavourable GMC inspections, there was pressure on the GMC for its retention, on the grounds that it offered international graduates, and in particular refugee doctors, a
British medical qualification.
309:
The total number of candidates obtaining the TQ qualification between 1894 and 1993 has been calculated to be 10,246, of whom 9.3% were women. The pass rate has been estimated at 48% in 1890-99 down to 21% in the last examination to be administered by the TQ board in 1993.
205:, founded in 1895. This school of medicine had a charter, a board of governors from the three colleges and provided a comprehensive lecture course equivalent to that of a university medical school, and became the principle teaching institution in Edinburgh for TQ students.
113:
and the
Medical Register, and began the process of standardising medical education, qualification and registration. The Medical Act (Amendment Act) of 1886 required qualification in both medicine and surgery for entry to the Medical Register and the three Scottish
108:
medical practitioners in the British Isles could acquire their qualifications from a number of institutions including universities, medical and surgical colleges and from the Apothecaries' Halls in London and Dublin. The 1858 Act established the
332:
Between 1933 and 1938, some 25% of the successful candidates were of European Jewish origin, a reflection of Nazi persecution. Some of these Jewish refugees who qualified with the TQ went on to academic careers in the UK, like
388:
Freedom of movement of workers within the European Union from 1973 began the process of EU qualified medical practitioners practising in the UK without any examination. This was eventually enshrined in UK law by European
403:
The final diet of the TQ examination was held in 1993. In 2000 the GMC decided that all UEB candidates should be assessed by universities. The last LMSSA diploma was awarded in 2003 and the UEB was dissolved in 2007.
396:
A GMC inspection in 1985 found the TQ examination 'old-fashioned' and from 1994 the Triple and the Conjoint examinations, together with the LMSSA were combined and came under the aegis of the
277:
granted. Doctors who had qualified elsewhere in the world, often with years of experience were still required to complete the clinical elements and in many cases the basic science elements.
202:
555:
349:
975:
976:""I am a refugee of Nazi oppression": The Scottish Royal Medical Colleges and Medical Refugees | Library & Special Collections The Royal College of Surgeons of Edinburgh"
89:
313:
Many of the candidates came from countries of the former British Empire, many came from Europe and others from Russia, China, Japan, South America and the United States.
322:
833:
1408:
958:
1403:
929:. Borowski, E. J. (Ephraim J.), Granat, Leah., Scottish Council of Jewish Communities. (2nd ed.). Glasgow: Scottish Council of Jewish Communities. p. 27.
834:"The Archive of the Extramural School of Medicine of the Royal Colleges of Edinburgh | Library & Special Collections The Royal College of Surgeons of Edinburgh"
287:
118:
set up a combined medical and surgical qualification called the Triple Qualification (TQ). This was approved by the GMC in 1884, and in the same year the
178:
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85:
198:
182:
190:
81:
909:
119:
755:
123:
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Candidates for the TQ were first required to pass a preliminary entrance examination or show evidence of an approved university degree.
297:
LRCPE, LRCSE & LRCPSG after their names and could apply for provisional registration with the GMC. After completion of one year of
788:
647:
596:
365:
1388:
1374:
934:
155:
583:
The shaping of the medical profession : the history of the Royal College of Physicians and Surgeons of Glasgow, 1858-1999
201:. One of the effects of the GMC regulation was the consolidation of most of the extramural schools in Edinburgh into a formal
298:
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154:
Medical School and the Glasgow Royal Infirmary School of Medicine, which in 1888 became St Mungo's Medical School. The
338:
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1413:
162:
110:
93:
137:
Anderson's College Medical School, Glasgow, showing the tower and the plaque with the College name engraved
397:
1090:
Edinburgh University Library (EUL) Da31.5, Minutes of the Senatus Academicus, 24 June 1870, 14 June 1872.
872:
216:
133:
115:
151:
364:
Throughout its lifetime, controversy was never far away from the TQ, the conjoint examination and the
1308:
693:
Lawrence, Christopher (2006). "The shaping of things to come: Scottish medical education 1700–1939".
390:
294:
1272:
1262:
Goodenough W. Report of the Inter-Departmental Committee on Medical Education . London: HMSO; 1944.
952:
726:
780:
505:"The Triple Qualification examination of the Scottish medical and surgical colleges, 1884-1993"
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Candidates who successfully completed the course and passed the examinations could place the
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In Edinburgh many university lecturers and professors also gave extramural classes including
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Extramural medical education in Edinburgh, and the School of Medicine of the Royal Colleges
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Scotland's Jews : a guide to the history and community of the Jews in Scotland
326:
318:
194:
423:"The Politics of Professionalization: MPs, Medical Men, and the 1858 Medical Act"
181:, established in 1841. Two medical schools for women latterly formed part of the
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Sophia Jex-Blake : a woman pioneer in nineteenth century medical reform
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541:
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456:
1249:
1208:"GMC must not recommend abolition of United Examining Board's examination"
1192:
1135:
901:
Beyond the Factory Gates: Asbestos and Health in Twentieth Century America
1044:
873:"TRAB/PLAB candidate numbers, pass rates and IMG registrations 1975-1997"
127:
158:
Medical School for Women merged with the University of Glasgow in 1892.
642:. Edinburgh: Royal College of Surgeons of Edinburgh. pp. 73–117.
92:
between 1884 and 1993. Successful candidates could register with the
329:. who became the second woman to register as a doctor in Australia.
356:(Zimbabwe) in 1965, many of the candidates came from that country.
132:
1381:
Medical teaching in Edinburgh during the 18th and 19th centuries
1295:
Royal College of Surgeons of Edinburgh, TQ minutes, 7 March 1986
640:
Medical teaching in Edinburgh during the 18th and 19th centuries
177:. The first school to offer lectures on a range of subjects was
147:
century. These were known collectively as extramural schools.
220:
The former School of Medicine of the Edinburgh Royal Colleges
224:
They were then required to complete a curriculum as follows:
512:
The Journal of the Royal College of Physicians of Edinburgh
337:, who fled from Berlin to Aberdeen where he worked with
622:
The History of the Royal College of Surgeons of England
633:
631:
1383:. Edinburgh: Royal College of Surgeons of Edinburgh.
682:. Edinburgh: E. & S. Livingstone. pp. 15–28.
203:
School of Medicine of the Royal Colleges of Edinburgh
80:) was a medical qualification awarded jointly by the
1029:"European Refugee Physicians in Scotland, 1933-1945"
90:
Royal College) of Physicians and Surgeons of Glasgow
250:
Pathological anatomy or general pathology, 3 months
62:
47:
32:
24:
1367:Storming the citadel: The rise of the woman doctor
268:Midwifery/diseases of women and children, 3 months
126:set up a similar joint qualification known as the
288:the Professional and Linguistic Assessments Board
301:posts, they could apply for full registration.
579:Hull, Andrew; Geyer-Kordesch, Johanna (1999).
193:(which closed in the late 1890s), and in 1889
817:Shadow of swords: A biography of Elsie Inglis
262:Principles and practice of surgery, 6 months
8:
957:: CS1 maint: multiple names: authors list (
750:. Amberley Publishing Limited. p. 135.
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1001:"Berne, Dagmar | The Dictionary of Sydney"
624:. London: Anthony Blond. pp. 146–156.
253:Practical midwifery, at least 6 deliveries
232:Practical anatomy, two courses of 6 months
18:
1239:
1182:
1151:"LMSSA: a back door entry into medicine?"
1125:
1102:"LMSSA: A back door entry into medicine?"
819:. London: Michael Joseph. pp. 54–60.
523:
446:
238:Practical/analytical chemistry, 3 months
215:
86:Royal College of Physicians of Edinburgh
1409:Medical education in the United Kingdom
413:
199:Edinburgh College of Medicine for Women
197:and her father John Inglis founded the
1404:Academic degrees of the United Kingdom
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350:unilateral declaration of independence
191:Edinburgh School of Medicine for Women
82:Royal College of Surgeons of Edinburgh
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1067:"Obituary: Professor Hans Kosterlitz"
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120:Royal College of Physicians of London
7:
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587:. London: Hambledon Press. pp.
124:Royal College of Surgeons of England
1309:"Education: United Examining Board"
1342:Worshipful Society of Apothecaries
556:"Medical Act (Amendment Act) 1886"
503:Dingwall, H. M. (September 2010).
14:
857:RCSEd TQ archive 1980 ref6/1/11/2
707:10.1111/j.1365-2929.2006.02393.x
1419:1884 establishments in Scotland
271:Medical jurisprudence, 3 months
241:Dispensary attendance, 3 months
779:. London: Routledge. pp.
299:pre-registration house officer
256:Practice of medicine, 6 months
183:extramural school in Edinburgh
1:
1206:Gibberd, F. B. (2 May 1998).
925:E., Collins, Kenneth (2008).
244:Practical pharmacy, 3 months
1149:Wakeford, R. (1987-04-04).
321:, who went on to found the
259:Clinical medicine, 9 months
1435:
1224:10.1136/bmj.316.7141.1386a
1100:Wakeford, Richard (1987).
1033:Social History of Medicine
1027:Collins, K. (2009-12-01).
904:. Continuum. p. 198.
323:Scottish Women's Hospitals
265:Clinical surgery, 9 months
150:In Glasgow these included
815:Lawrence, Margot (1971).
771:Roberts, Shirley (1993).
744:Michael, Meighan (2013).
678:Guthrie, Douglas (1965).
439:10.1017/s0025727300003306
1167:10.1136/bmj.294.6576.890
1118:10.1136/bmj.294.6576.890
341:, who had, jointly with
247:Materia medica, 3 months
1379:Kaufman, M. H. (2003).
1316:General Medical Council
1106:British Medical Journal
898:Bartrip, Peter (2006).
421:Roberts, M J D (2009).
111:General Medical Council
94:General Medical Council
88:and the Faculty (later
1273:"European legislation"
1155:Br Med J (Clin Res Ed)
1005:dictionaryofsydney.org
638:Kaufman, M.H. (2003).
620:Cope, Zachary (1959).
525:10.4997/jrcpe.2010.317
398:United Examining Board
221:
156:Queen Margaret College
138:
116:medical royal colleges
1369:. London: Constable.
219:
142:Teaching and training
136:
16:Medical qualification
1365:Bell, E. M. (1953).
391:Directive 2005/36/EC
74:Triple Qualification
20:Triple Qualification
980:library.rcsed.ac.uk
838:library.rcsed.ac.uk
235:Chemistry, 6 months
21:
1045:10.1093/shm/hkp059
222:
152:Anderson’s College
139:
106:Medical Act (1858)
1161:(6576): 890–891.
911:978-0-8264-8836-7
877:What do they know
747:Glasgow A History
695:Medical Education
354:Southern Rhodesia
343:Frederick Banting
229:Anatomy, 6 months
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879:. 3 April 2014
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