A recent review of the history of teaching hospitals in England1 served as a reminder of the early similarities in the structure of medical education in that country and the United States. In both cases, the initial widespread impetus to institutionalize medical education focused largely on the hospital rather than on the university.
In England and its American colonies, hospitals were established as institutions primarily concerned with the care of the sick in the latter half of the eighteenth century. At that time, medical practitioners throughout the English-speaking world largely acquired their medical knowledge through indentured service as apprentices. This system was extended early into the wards of the "new" hospitals, and improvement resulted from the inevitable exposure of the apprentice to more than one master.
Apprenticeships, within and without the hospitals, had the great disadvantage of providing little if any instruction in the fundamental medical sciences. Anatomy was
THE BEGINNINGS OF MODERN MEDICAL EDUCATION IN THE UNITED STATES AND ENGLAND. JAMA. 1960;174(11):1527. doi:10.1001/jama.1960.03030110155015