The Royal College of Physicians of London 500th Anniversary

Conflict with other bodies

Shortly after the parliamentary act of 1523, the College believed that it was the regulator of the medical profession. This brought the College into conflict with the Society of Apothecaries, the Barber-Surgeons (Company of Barber-Surgeons from 1540) and the irregular practitioners. The Company of Barber-Surgeons broke ties with the College with the formation of the Royal College of Surgeons in 1800. The conflict eventually resolved with the publication of the Apothecaries Act of 1815 which united the physicians, surgeons and apothecaries, albeit temporarily, against the reforms of the control of the medical profession.1-3

Internal dispute

Initially, full voting fellowship of the College required a degree from Oxford or Cambridge Universities and to study there you had to be an Anglican (Church of England). As a result, many good doctors were excluded. Following a bitter internal dispute lasting from 1767 until 1835 candidates from other universities were finally admitted to the fellowship.1,3

College examinations

Conscious of the importance to maintaining high standards of medical practice, the College attached significant importance to its examinations. They were held in Latin. In 1859, the first membership examination was held which included written papers on anatomy, the practice of medicine, public health and psychological medicine. In the same year, licentiates of the College were allowed to become members without examination, hence becoming eligible for election to the fellowship. In 1880s, the RCP and the Royal College of Surgeons set up the Conjoint Board and the first diploma of Licentiate of the Royal College of Physicians and Membership of the Royal College of Surgeons of England (LRCP, MRCS) degree was awarded in 1885.4

Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP (UK))

In 1963, the examination underwent major changes. A multiple choice paper for the Part 1 examination was first introduced by London in 1963, and the new Part 2 would consist of written papers, clinical tests, and an oral examination. In 1969, another significant development happened when a new MRCP (UK) Part 1 examination run by the 3 Colleges (London, Edinburgh and Glasgow) was introduced to maintain standards across the UK. A new joint Examining Board with representatives from each of the 3 Colleges was established. A common Part 2 examination, requiring candidates to demonstrate their grasp of clinical knowledge, problem solving abilities, clinical skills and attitudes, was introduced soon after. Practical Assessments of Clinical Examination Skills was introduced in 2001.

Women and the college5

During the first 391 years of the RCP’s history, women were excluded from membership. The first female member was admitted in 1909, when a Bye-Law was passed allowing women to sit the examination and the first female licentiate in 1910. After another Bye-Law change in 1928, Helen Mackay, was the first female fellow to be elected in 1934. During her fellowship, she was instrumental in changing medical attitudes towards infant feeding, and became an authority on anemia in children caused by diet.

Dame Margaret Turner-Warwick (1925-2017), a respiratory physician, the first female president was elected in 1989. The current president, Jane Dacre, a rheumatologist and educationalist, is the third woman president.

Excellence in medical care

The RCP works with its members, patients, hospitals and policymakers to ensure that patients receive high quality evidence based medical care. This is carried out by promoting best practice, auditing and accrediting clinical services, raising the standard of healthcare records, and developing cost effective evidence-based guidelines.

In the early seventeenth century, the College published its register of drug formulae, the London Pharmacopoeia. In 1869, the RCP published The Nomenclature of Diseases and listed English terms for diseases with their Latin and other languages equivalents. The Nomenclature remained a standard manual of nosology until the early 1960s. The RCP moved into public health in 1962 when it published its report on Smoking and Health. Many more reports followed since then. Since 1965, the Advanced Medicine Conference has been published annually. The Journal of the RCP London was first published in October 1966 and in 1994, it changed to a bimonthly frequency. The title was changed to Clinical Medicine in 2001.

The National Guidelines Centre is hosted by the RCP and is a globally acknowledged clinical guideline development organisation and is commissioned by the National Institute of Health and Care Excellence to produce evidence based guidelines.

Royal College of Physicians Global

Today, the College has grown to a membership of over 34,000, comprising physician associates, medical students, doctors in training, consultants and more from more than 80 countries. The RCP has a truly global network, with 18% of our members based outside the UK. The College has 559 members and fellows in the Middle East and 169 in North Africa.

The Hans Sloane Fellowship was set up in 1986 to promote and expand the international work of the College. The first Hans Sloane Fellow was Sir John Badenoch (1920-1996). The current Hans Sloane Fellow and director of the international office is the eighth.

Examples of our international work include: clinical skills workshops and educational courses in countries in Africa, Indian subcontinent, the Middle East and South East Asia, guideline development in the Middle East, supporting the East, Central and Southern Africa College of physicians should be physicians and the Medical Training Initiative (MTI). The MTI enables junior doctors from all over the world to work and train in the UK, giving National Health Service hospitals a high-quality and longer-term alternative to using locums to fill rota gaps. This scheme is an example of a mutually beneficial partnership. Nearly 300 international medical graduates are currently working in the UK through the RCP’s MTI scheme, which is now in its seventh year.

Royal College of Physicians North

The RCP working in partnership with Liverpool City Council officially opened RCP North on 10 October 2017, as the first phase of a development of a major centre for clinical excellence in Liverpool. RCP North will be a hub providing medical training, examinations, conference facilities, quality improvement programme and research. Similar hubs are planned in India and in one the Arabian Gulf countries.

Royal College of Physicians 5 year strategy

Over the next 5 years, the College activities and resources will be centred on delivering 5 strategic aims: improving care for patients, developing physicians throughout their careers, leading and supporting its members, shaping the future of health and healthcare and investing in the College future and build on its heritage.

The RCP is focused on delivering world leading clinical improvement work, medical education, membership experience, continued emphasis on public health and policy, and investing in the heritage of the College whilst modernising the College business practices to ensure we are here for the next 500 years. The principle here being; with great leadership comes great responsibility.

The RCP success is a reflection of its fellows’ belief in quality and high standard of medical care, equality and diversity. It has moved from being an exclusive institution to a globally inclusive medical college. As King Henry VIII intended, the purpose of the College in the 21st century is still to play a leading role in the delivery of high quality patient care, by setting standards for medical practice and promoting clinical excellence all over the world.