University of St Andrews School of Medicine

Coordinates: 56°20′17″N 2°47′38″W / 56.338°N 2.794°W

University of St Andrews School of Medicine

Type	Medical school
Established	1413
Dean	Prof. David Crossman
Deputy Head of School	Prof. Simon Guild
Administrative staff	54
Students	464[1]
Location	St Andrews, Fife, Scotland
Colours
Affiliations	University of St Andrews
Website	medicine.st-andrews.ac.uk

The University of St Andrews School of Medicine (formerly the Bute Medical School) is the school of medicine at the University of St Andrews in St Andrews, Fife, Scotland and the oldest medical school in Scotland.

The School of Medicine was ranked 8th in the UK by the Times Good University Guide Subject Tables 2013, 2014 and 2015. Admission is very competitive, with an acceptance rate of 17.2% in 2012-13. The yield rate, also known as the matriculation rate is 68% for the 2012-13 admissions year. According to the Guardian University Guide 2013, St Andrews requires the 6th highest entry grades in the UK. The medical school teaches pre-clinical medicine with students completing clinical teaching at different medical schools in the UK.

The school is associated with 1 Nobel Prize and 2 Victoria Cross winners. Famous alumni include small pox vaccine pioneer Edward Jenner and inventor of beta blockers and H2 receptor antagonists, Nobel Prize in Medicine winner Sir James Black.

History

The early medical school

Medicine was the third subject to be taught at the University of St Andrews, at St Salvator's College and later the United College of St Salvator and St Leonard. Bishop Kennedy founded St Salvator's College in 1450, confirmed by a Papal Bull in 1458.

From the 17th to the 19th centuries, medical degrees from St Andrews were awarded by an early version of distance learning. The university awarded the degree of MD to individuals who were usually already established in medical practice, the first being conferred in 1696. This degree was awarded on the basis of a testimonial written by a supervisor, and a fee was paid to the university. The whole process was conducted through the post, and the candidate did not have to visit the university. Recipients of the MD at this time include the French Revolutionary, Jean-Paul Marat (1743–1793), who obtained his MD in 1775 for an essay on gonorrhea, and Edward Jenner (1749–1823), who developed the first smallpox vaccine, and was awarded the MD in 1792.

In 1721, whilst Chancellor of the University, James Brydges, 1st Duke of Chandos established the Chandos Chair of Medicine and Anatomy, to fund the appointment of a Professor of Medicine and Anatomy at the university, and Thomas Simson was appointed as the first Chandos Professor. The Chandos Chair still exists, although it has now become a chair of physiology.

In the early 19th century, examinations were introduced. Students had to visit St Andrews to sit them, but there was no teaching at the university.

The founding of the Bute Medical School

In 1897, as Rector of the University of St Andrews, the 3rd Marquess of Bute, in addition to his provident restorations of other university buildings, initiated the construction of the current Bute Medical Buildings, south of St Mary's College, completed in 1899. The buildings, much added to and modified, especially after a gift from Andrew Carnegie, built labs to the north (now the Carnegie Building). These provided for the establishment of a regular medical school, which both taught and examined medical students. The 3rd Marquess of Bute also provided for the establishment of a new chair of medicine—the Bute Chair of Medicine.

Bute Medical Building

The St Andrews-Dundee course

In 1898, the University of St Andrews created the University College Dundee. Together, the Bute Medical School and clinical facilities at University College Dundee formed a conjoint medical school. Medical students could either undertake their pre-clinical teaching at the Bute Medical School in St Andrews or go straight to Dundee for their pre-clinical years, and then the two groups combined to complete their clinical training in Dundee. Students were awarded the degree of MB ChB by the University of St Andrews.

In 1954, University College Dundee changed its name to Queen's College, but remained part of the University of St Andrews.

In August 1967, following recommendations by the Robbins Report, the Universities (Scotland) Act 1966 came into force. This granted independent university status to the University of Dundee, separating Queen's College from the University of St Andrews. In many respects, the medical school at the University of Dundee inherited the medical traditions of St Andrews University.

As the clinical medical school (along with other parts of the University of St Andrews including the Law faculty) had been based in Dundee, this left St Andrews with no clinical medical school or teaching hospital. The Universities (Scotland) Act 1966 also removed the University of St Andrews's right to award undergraduate and postgraduate degrees in medicine, including the MB ChB and MD. However, the right to award the MD (St Andrews) has since been restored.

The link with Manchester Medical School

In order to continue to be able to teach medicine, St Andrews therefore established a new link with the English Victoria University of Manchester, in 1970 which was at that time seeking to enlarge its medical school. Students completed a three-year BSc in medical science at St Andrews, and could optionally complete an extra intercalated year for the award of BSc Hons at St Andrews, before completing their clinical training at the University of Manchester, with the final MB ChB awarded by Manchester.

For a brief period there was the option of completing clinical training at Keele University Medical School in Stoke-on-Trent, and around twenty St Andrews graduates each year between 2002–2006 have gone to Keele University. This option no longer exists.

Recent history

Major changes to the curriculum were made in 2000 with increased emphasis on psychology and cellular biology, with the introduction of a two-year course in cellular and molecular medicine and a three-year course in behavioural sciences. Further curriculum changes took place in 2004, with a reduction in the amount of teaching but the introduction of a research project into the final year, allowing for an honours degree to be attained after three years' study, and therefore since September 2005, the Bute Medical School has offered a Bachelor of Science with honours in Medical Science (BSc Hons Med Sci).

Admissions

St Andrews is one of a few schools in the UK to use the multiple mini interview, an interview system first developed by McMaster University Medical School which exposes applicants to several interviews of shorter time, exposing the applicant to more interviewers and reducing the chance that one bad or good interview determines the applicants success at gaining admissions.

Course structure

Phase 1 — Pre-Clinical Years

Teaching methods include lectures and practical classes, utilising self-directed learning and case-based learning. Examination methods include multiple-choice questions, short answers, and essays in written exams and OSCEs (Objective Structured Clinical Exam). A research project is also required for completion of the honours degree—normally undertaken in third year of study. The University is noted as being one of the few medical schools in the UK to award an honours classification (1st, upper 2nd, lower 2nd, 3rd) to its BSc (Hons) Degree in Medicine.

A further three years' study is required to receive a Bachelor of Medicine, Bachelor of Surgery (MB, ChB), and requires training at a university that supports a clinical course—this extra training is known as phase 2. The course therefore takes an extra year in comparison to other Scottish universities.

Phase 2 — Clinical Years

In 2004, Sir Kenneth Calman's report into medical education recommended that medical graduates from St Andrews should remain in Scotland to complete their clinical medical education, and arising out of this, discussions about a link with University of Edinburgh have taken place.^[2][3]

The Board for Academic Medicine under Sir David Carter was established and tasked with, amongst other things, the implementation of these plans. Sir David Carter, Hugh MacDougall (Dean of Medicine) and Simon Guild (Director of Teaching, Deputy Head of School) surveyed the capacity of other medical schools to accept St Andrews medical students.

For the 2012 cohort it is expected that the students who are allocated a "Scottish Route" place will be divided as follows:

• 27 students—University of Glasgow Medical School,
• 18 students—University of Edinburgh Medical School,
• 8 students—University of Dundee Medical School,
• 7 students—University of Aberdeen School of Medicine.

This began with a phased introduction of the students starting their St Andrews careers in 2007, with 55 progressing to the Scottish medical schools.

A remainder of 80 students would continue to go to the University of Manchester or Barts and The London School of Medicine and Dentistry. Students choosing Manchester will be allocated to one of its four teaching hospitals. Every student accepted to St Andrews is guaranteed a place for their clinical years at one of the 4 Scottish schools, Manchester or Barts.

Each year, a group of students apply to complete their studies at the University of Cambridge. Spaces are limited and are allocated based on the student's academic and extracurricular achievements prior to application and an interview held in February.

Students with an interest in academic medicine sometimes choose to pursue an MRes or PhD prior to continuing to a clinical school.

Postgraduate

In 2002 the Scottish Parliament passed the University of St Andrews (Postgraduate Medical Degrees) Act 2002 which re-instated the university's right to award the postgraduate research degree of Medicinae Doctor (MD) to students who have completed two years of full-time or up to 5 years of part-time research, which had been removed by the Universities (Scotland) Act 1966. The first MD since 1967 was awarded in 2004.

Facilities and buildings

New Medical School

The University of St Andrews’ new Medical and Biological Sciences Building brings together the medical school (relocated from the Bute Building), biologists, physicists and chemists, while also linking to the School of Physics and Astronomy via a first-floor bridge—making it one of the first medical schools in the UK to fully integrate research facilities across the sciences.

The School, which has been built at a cost of £45m, contains state-of-the-art research laboratory space, as well as modern teaching facilities and a large lecture theatre.^[4] The new building allows for extensive inter-disciplinary medical research and is unique in the fact that it is physically linked to the Faculty of Science buildings.

Opening the building on Friday 12 November 2010, the First Minister Alex Salmond said:^[5]

“The University of St Andrews has a long, proud tradition in educational excellence and this £45 million state-of-the-art facility will bring together students across all science disciplines to create a rich collaborative environment. "Scotland’s scientists and researchers have made an immense contribution to shaping the modern world and this new facility will strengthen this reputation. It will not only attract new undergraduates to the University, educating our next generation of doctors, but will establish a hub for the creation of new medical research and breakthroughs. “This new building will be one of the first UK medical schools where research facilities are integrated across the sciences and this opening demonstrates how Scotland's oldest University remains at the forefront of innovation.”

The First Minister marked the occasion by unveiling a commemorative, meagre stump in the building’s courtyard. He was joined by Chancellor Sir Menzies Campbell MP, Principal and Vice Chancellor Louise Richardson, Master of the United College Neville Richardson, Dean of Medicine and Head of the School of Medicine Hugh MacDougall, and Acting Head of the School of Biology Mike Ritchie.

Medical Societies

Over recent years, many medical societies have been developed, alongside the historical Bute Medical Society, to help incorporate the clinical aspects into the course—one which was traditionally science based only. These societies include Surgical, Clinical and a Medsin group.

The Bute Medical Society

Bute Medical School Scarf

The Bute Medical Society was founded in 1915, by its first president Margaret Shirlaw, with the support of Miss Mildred Clark, Calum McCrimmon, Clive Mackie Whyte, Cecily Thistlewaite, Mary Ellison and W.G. Robertson. The initial aim of the society was to hold clinically oriented lectures that the students could attend voluntarily. This tradition still continues today with the society's bimonthly 'cheese and wine' evening. As an independent, non-profit organisation it is still run entirely by medical students, supported by some sponsorship.^[6] Fundraising events held throughout the year also enable the Society to contribute to charities.

Medsin

Medsin is a network of students with an interest in health, with branches at universities across the UK. Medsin's Activities aim to promote health as well as to act upon and educate students about health inequalities in our local and global communities. In St Andrews therefore, Medsin acts as an umbrella society, supporting new start-up projects.

Projects include StopAids Campaign, Teddy Bear Hospital, Climate Change Awareness, and the Global Health Education Project (GHEP)

Malawi and The Global Health Education Project (GHEP)

Global Health Education Project

The Global Health Education Project (GHEP) is an initiative set up within the School of Medicine at the University of St Andrews, independently by young, full-time medical students who collectively have interests in improving healthcare and education of medicine across the world.

In 2008 the society was partially established with the aims of developing such interests, raising awareness of global health, and tackling issues that may hinder improvements in both education and deliverance of healthcare across the developing world.

Currently the project is heavily involved in establishing an exchange programme with the Malawian College of Medicine, taking full advantage of the University's long history in the country. Endorsed by the University of St Andrews, the Scottish SNP Government and Members of Parliament in the UK, the project has grown rapidly since its founding in 2008, and has now more than 200 members and an active committee.

Ten students have visited the Malawian College of Medicine in July 2011 as part of a GHEP group, forming part also of the first ever University of St Andrews medical exchange.

The relationship between the University of St Andrews and the Malawian College of Medicine is over twenty years old.^[7] The College was founded upon the basis of previous medical training at St Andrews and many of the graduates of Medicine and of Health Care Management now hold the highest clinical and governmental positions in Malawi.

A Memorandum of Understanding between the Bute Medical School staff and the College of Medicine was signed in March 2008, which outlines a collaboration between the two institutions over curriculum reform, curriculum support through improved infrastructure and IT resources and research networking and support. GHEP is however an entirely student run programme.

Other project activities include the running of Global Health Education Workshops/Module, which 2010 attracted more than 200 students, staff and visitors from the world of medicine and further afield. Titles covered included climate change, overpopulation, epidemics and elimination and the concept of good aid.

Surgical Society

In 2009, a small group of students set up the University's first surgical interest society. Since then, a multitude of lectures, skills workshops and anatomy revision tutorials have been run by the society and it continues to grow in size. The Robert Walmsley Lecture was created in 2011 as a yearly event held in the old Bute Buildings to commemorate this previous setting of the teaching of medicine in St Andrews; the inaugural lecture was delivered by David Sinclair.

Research

Research at the school is grouped into three main areas: People and Populations, Molecular Medicine and Medical Photonics. Much of the research is interdisciplinary especially in medical photonics where close links with the School of Physics exist. There are groups involved in child health and development, cell signaling, cancer, neurobiology, infection, cell biology and molecular psychiatry.

Research Institutes:

• WHO Collaborating Centre for International Child & Adolescent Health Policy
• Child and Adolescent Health Research Unit (CAHRU)
• Scottish Healthcare Associated Infection Prevention Institute

Academic dress

St Andrews undergraduate medical students are members of the United College of St Salvator and St Leonard, and as such wear the scarlet gown with burgundy velvet collar for official academic occasions. They graduate as a BSc or BSc (Hons) and so wear a black gown with a fuchsia hood trimmed with white fur. On graduation from Manchester they are entitled to wear a black gown with scarlet hood trimmed with white fur, and black cap.

When postgraduate students graduate with the MD degree, they wear a black gown with a crimson hood with a white lining, alternatively they may wear a crimson gown.

Alumni

Medical students at the University of St Andrews have included:

Name	Class year	Notability	Reference(s)
John Arbuthnot	MD 1696	Physician in ordinary to Queen Anne, member of the Scriblerus Club, inventor of the figure of John Bull
Robert Whytt	MA 1730, MD 1737	President of the Royal College of Physicians in Edinburgh, wrote book on diseases of the nervous system
William Wright	MD 1763	President of the London Royal School of Medicine, Physician in Chief of Jamaica, the genus Wrightia (Apocynaceae) are named after him
Andrew Duncan	MA 1762, MD 1769	President of the Royal Medical Society and the Royal College of Physicians in Edinburgh, First physician to the King in Scotland, founder of the Harveian Society, founder of the first lunatic asylum in Edinburgh, Professor of Theory of Medicine at University of Edinburgh
Jean-Paul Marat	MD 1775	Radical pro-revolutionary journalist during the French Revolution
Busick Harwood	MD 1790	Professor of Anatomy at University of Cambridge
Edward Jenner	MD 1792	Discovered the smallpox vaccine
Alexander Berry	1798	Established the first European settlement in New South Wales, Australia
Richard Poole	MD 1805	Editor of the New Edinburgh Review, the Phrenological Journal and Encyclopædia Edinensis
Duncan McNeill, 1st Baron Colonsay	MD 1809	Lord President of the Court of Session of Scotland, MP for Argyllshire
George William Balfour	MD 1845	Honorary Physician in Ordinary to King Edward VII in Scotland.
Anthony Brownless	MD 1846	Founder of the University of Melbourne Medical School
Samuel Cockburn	MD 1848	Scottish physician, outspoken defender of homeopathy
Anthony Dickson Home	MD 1848	Scottish physician, Surgeon General of the British Army, recipient of the Victoria Cross	[8]
Benjamin Ward Richardson	MD 1854	British physician, introduced over 14 anesthetics including methylene bichloride, invented the double valve mouthpiece for administration of chloroform	[8]
Thomas Egerton Hale	MD 1855	Scottish physician, Surgeon Major of the British Army, recipient of the Victoria Cross
Douglas Argyll Robertson	MD 1857	Scottish ophthalmologist, described the Argyll Robertson pupil a sign of neurosyphilis
Joseph Bancroft	MD 1859	surgeon and parasitologist, discovered filariasis, made advances in leprosy
Pulney Andy	MD 1860	Became the first Indian to receive a British medical degree and established the National Church of India in Madras.	[9]
George Turner Orton	MD 1860	Liberal-Conservative MP of Canada for Wellington Centre
John Young Bown	MD 1863	Liberal-Conservative MP of Canada for Brant North
Stewart Duke-Elder	BSc 1919, MA (Hons) 1919, MB ChB 1923, MD 1925, DSc 1927, LLD (Hon) 1950	Surgeon Oculist to King Edward VIII, King George VI and Queen Elizabeth II, Brigadier General in the Royal Army Medical Corps, author of the widely used textbooks Textbook of Ophthalmology and System of Ophthalmology, Founder of the Institute of Ophthalmology in London and the Faculty of Ophthalmologists, Hospitaller of the St John Ophthalmic Hospital, President of the International Council of Ophthalmology
John Forfar	BSc 1938, MB ChB 1941, MD 1958	Pediatrician and author of the Forfar and Arneil's Textbook of Paediatrics, awarded the Military Cross for service during the Second World War
Sir Douglas Black	MB ChB 1943	Author of the Black Report; former President of the Royal College of Physicians
Walter Perry	MB ChB 1943, MD 1948, DSc 1958	Dean of Medicine of the University of Edinburgh Medical School, First Vice-Chancellor of the Open University, Life Peer of the House of Lords
Sir James Black	MB ChB 1946	Inventor of Propanolol; Developer of Cimetidine and Ranitidine; Nobel Prize in Medicine winner; Chancellor of the University of Dundee
Lord Patel	MB ChB 1964	Chancellor of the University of Dundee
Michael Henderson	MB ChB 1969	Chief Medical Officer of the University of Mississippi Medical Center, Chair of Surgery at the Cleveland Clinic Lerner College of Medicine	[10]
Lewis Moonie, Baron Moonie	MB ChB 1970	Labour Co-operative MP for Kirkcaldy from 1987 to 2005
Alexander Burns Wallace	PhD 1973	Plastic surgeon, co-founder and President of the British Association of Plastic Surgeons, founding editor of the British Journal of Plastic Surgery, developed the Wallace rule of nines, a method of determining the proportion of body affected by burns
Gordon Ritchie	MB ChB	Progressive Conservative MP of Canada for Dauphin
Kim Fox	MB ChB	Diana Princess of Wales Chair in Cardiovascular Medicine and Science at the Royal Brompton Hospital, Head of the National Heart and Lung Institute at Imperial College School of Medicine, Editor in Chief of the European Heart Journal and President of the European Society of Cardiology
John Garrow	MD, PhD	Chairman of HealthWatch, editor of the European Journal of Clinical Nutrition

Faculty

List includes faculty who were not also graduates of the medical school

Name	Department	Notability	Reference
William Scheves	Archdeacon and Royal Cleric	Scottish physician, Physician to James III of Scotland	[11]
John Reid	Chandos Chair of Medicine and Anatomy 1841-1849, FRCP 1836	Scottish physician, described the function of the glossopharyngeal nerve and vagus nerve. He also proved the heart had a double innervation through the vagus and sympathetic nerves
Percy Theodore Herring	Chandos Chair of Medicine and Anatomy 1908-1948, FRSE 1916	Scottish physician, discovered herring bodies
Richard G. Morris	Lecturer 1977-1986, FRS 1997, CBE 2007	British neuroscientist, developed the Morris water navigation task

The Bute Chair

The Bute Chair was established by John Crichton-Stuart, 3rd Marquess of Bute in 1898.

Holders of the Bute Chair are known as Bute Professors and include:

• 1901–1914 James Musgrove
• 1914–1946 David Waterston
• 1946–1973 Robert Walmsley
• 1973–1996 David Brynmor Thomas
• 2003–2014 Robert Hugh MacDougall
• 2014-present David Christopher Crossman

Sir James Black Chair of Medicine

In 2010 the Bute Medical School of the University of St Andrews, where Black had studied his initial degree in medicine, unveiled that an honorary 'Sir James Black Chair of Medicine' would be created. This post remained unfilled for the reminder of the academic year 2009–2010. In September 2010 the first Chair of Medicine at the ancient University was given to Professor Stephen H Gillespie MD, DSc, FRCP (Edin), FRC Path, leaving his post as Professor of Medical Microbiology at UCL.

The John Reid Chair of Pathology

In 2012 the Bute Medical School of the University of St Andrews, appointed Prof. David Harrison to the John Reid Chair of Pathology, leaving his previous post as the Head of Division of Pathology in the University of Edinburgh. He remains an Honorary Consultant Pathologist in Lothian University Hospitals Division and Director of the Breakthrough Research Unit, Edinburgh.

Ann Gloag Chair of Global Health Implementation

The current holder of this chair appointed in 2013 is Prof. Will Stones

See also

• Chandos Chair of Medicine and Anatomy

References

1. "UCAS stats". Retrieved 29 January 2013.
2. "New era for medical education". Scottish Government. 29 June 2005. Retrieved 2 July 2014.
3. "Medical student placements announced". Scottish Government. 7 September 2006. Retrieved 2 July 2014.
4. "St Andrews University medical school in £8m pledge wait". BBC News. 17 February 2010. Retrieved 2 July 2014.
5. "Gateway to medical discovery". Scottish Government. 12 November 2010. Retrieved 2 July 2014.
6. "Philosophy". www.butemedicalsociety.co.uk. Retrieved 5 December 2015.
7. "Malawi & St Andrews". University of St Andrews. Retrieved 2 July 2014.
8. "Anthony Dickson Home". Retrieved 15 November 2013.
9. "Medical News". The Lancet (Elsevier) 76: 346–348. 6 October 1860. doi:10.1016/s0140-6736(02)57082-3. Retrieved 20 February 2011.
10. Cummins, Ruth. "New CMO: A leader in patient quality outcomes". University of Mississippi Medical Center. UMMC. Retrieved 28 April 2015.
11. Shepherd, J. A. (1972). "Medical Teaching in St. Andrews University 1413-1972" (PDF). BMJ 3: 38–41. doi:10.1136/bmj.3.5817.38. PMC 1788514. PMID 4557032.

External links

• Official website
• Map