HUNTERIAN SCHOOL OF MEDICINE

Age 23. In October 1836, John Snow arrived in to London to start his formal medical education.  Snow decided to walk the entire distance from York to London, but not by direct route.  He went first to Wales, then to the west of central England, on to Bath to visit his uncle Charles Empson, before proceeding to London.  He enrolled for a year in the Hunterian School of Medicine (shown here) located on Great Windmill Street in the South of the Soho region where he would later investigate the cholera outbreak associated with the Broad Street pump.  The school was privately run and was also know as the Windmill Street School or the Great Windmill Street School.  

The Hunterian provided lectures, demonstrations and dissections and once the initial fee was paid, permitted entry to future lectures or courses without charge.  The school was within walking distance of several of London's teaching hospitals, but was primarily affiliated with Middlesex Hospital.  Shortly after John Snow completed his year of education, the privately-funded Hunterian Medical School ceased to exist.   

During this time John Snow rented an inexpensive room at 11 Bateman's Buildings, a narrow alleyway several blocks North of the Hunterian Medical School and just South of Soho square.

WESTMINSTER HOSPITAL

Age 24.   Starting in October 1837, Snow began attending medical and surgical practices at the  Westminster Hospital, thereby gaining experience in a hospital setting.  The hospital was nearly a mile to the south of his home on Bateman's Buildings, to which he walked most days.  At the same time he regularly attended meetings of the Westminster Medical Society. The hospital had been reconstructed and enlarged in 1834, and had an excellent reputation in surgery. 

At the end of this time he gained enough experience from his three apprenticeships (see early history), the year at the Hunterian School of Medicine, and time at the Westminster Hospital to take his practitioner licensing examination.  

Age 25. In May 1838, Snow passed his examination to become a Member of the Royal College of Surgeons of England (MRCS), permitting him to practice general medicine. He ranked 7th among the 114 candidates who passed the examination. Snow also passed his Licentiate of the Society of Apothecaries (LSA) in October 1838, ranking 8th on a list of 10, allowing him to prepare and sell drugs and other medicines.  Finally after many years of study and work, he was certified as a general practitioner, ready to establish a private medical practice. 

He moved out of his student apartment to 54 Frith Street, further South of Soho Square, where he set up a surgery and general practice, remaining there until 1852.  He also became a member of the Westminster Medical Society and during the next five years, regularly addressed the organization on such varied topics as alcoholism, mechanics of respiration, deformities of the chest and spine in children, salivation due to mercury and lead, and the effects of anemia.

UNIVERSITY OF LONDON

Age 30.  Apparently being a licensed general practitioner was not enough for John Snow. Instead he wanted a more academic medical education, one that would allow him to obtain an academic post, and be certified as a physician, being able to attend a wider array of patients, including those in the upper classes. The University of London was created in 1826 and opened a medical school and hospital in 1836-37.  It demanded proof of basic education before a student could begin to read for its degrees.  The Hunterian School of Medicine was a recognized institution, so many of his courses were accepted for credit tranfer.  Snow attended the University of London for several years, and in November 1843 when he was 30 years old, received the Bachelor of Medicine (MB) degree.  A year later in December 1844, he obtained the Doctorate of Medicine (or MD), also from the University of London. 

ALDERSGATE STREET MEDICAL SCHOOL

Age 33.  In 1846, a position as lecturer in forensic medicine opened at the Aldersgate School of Medicine, a private medical school on Aldersgate Street in central London.  He remained at the school as Lecturer from 1846 to 1849 when the institution closed for lack of funding.

Age 36.  His final academic advancement came in June 1850 when he passed the examination to become a Licentiate of the Royal College of Physicians (LRCP) of London.  The LRCP contained the most elite of the medical profession. 

In the mid-1800s, neither the MB and MD from the University of London nor the LRCP was necessary to practice general medicine.  Instead, Snow's obtained these degrees and the additional certification because of his intense interest in medicine, a desire for wealthier more discerning patients, and his fascination with the unknown and the power of research to illuminate and enlighten.  The outcome of his education and experiences would soon become apparent in anesthesiology and epidemiology, two professions that honor his many intellectual contributions. 

Sources:  

Brown PE. Anesthesia and Analgesia 43(6), 1964.

Ellis RH. Medical History (Supp 14), 1994.

Keys TE. J History of Medicine 1(4), 549-66, 1946.

Richardson, BW in Snow on Cholera, Hafner Pub. Co., 1965.

Rivett G. Development of London Hospital System, 1986.

Sakula A. J Medical Biography 3: 160, 1995. 

Shephard DAE. John Snow: Anaesthetist to a Queen and Epidemiologist to a Nation: A biography. 1995.

Snow SJ. Journal of Medical Biography 8(2), 71-77, 2000.

Thornton LA. Anaesthesia 5(3): 129-135, 1950. 

Vinten-Johansen P et al. Cholera, Chloroform, and the Science of Medicine: A Life of John Snow, 2003.

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