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History of the Royal College of Physicians

Discover the story of the RCP and its role in the development of medical practice over five centuries.

Founded in 1518 by a Royal Charter from King Henry VIII, the Royal College of Physicians of London is the oldest medical college in England, often playing a pivotal role in raising standards and shaping public health. See our Timeline for a closer look at some of the key moments in the college’s history.

Founding the RCP

In the 1500s medical practice in England was poorly regulated. Many ‘physicians’ were working with no formal training or knowledge, and almost certainly killed as many patients as they cured. The leading physicians of the early 16th century wanted the power to grant licenses to those with actual qualifications and to punish unqualified practitioners and those engaging in malpractice.

A small group of physicians led by the scholar Thomas Linacre persuaded King Henry VIII to establish a college of physicians on 23 September 1518 with the above purpose. An Act of Parliament extended its powers from London to the whole of England in 1523.

Originally called the College of Physicians. it was only with the restoration of the monarchy in the late 1600s, that the RCP started referring to itself consistently as ‘royal’. But from the very beginning its members found their patients from the highest levels of society.

Examinations

The first president, Thomas Linacre, wanted to found an academic body for physicians rather than a trade guild of the kind which regulated surgeons and apothecaries. Physicians were to be the educated elite of the medical world. A degree would usually be required to gain a licence. Candidates took an oral examination to demonstrate that they were ‘groundedly learned’ (classically educated) in a range of subjects. In addition, fellowship (full voting membership) required a degree from Oxford or Cambridge.

Struggle and conflict

From the start the RCP was involved in battles with other medical bodies in the struggle to control medical licensing in London. It did actively engage in licensing practitioners and punishing those involved in ‘malapraxa’, especially in the 16th and 17th centuries. But until the 19th century there were usually fewer than 60 fellows at any one time and under 100 licentiates (Licensed to practice and paying an annual fee).

There were internal disputes as well. In 1767 a bitter dispute with the licentiates was caused by the fellowship’s refusal to admit candidates for fellowship from non-Oxbridge universities. The affair famously resulted in angry licentiates storming the building during a committee meeting. But it was not until 1835 that candidates from all universities became eligible for fellowship.

Equal rights – women at the RCP

Women in the medical profession struggled to find strong representation until the societal changes of the late 19th and 20th centuries. During the first four centuries of the RCP’s history, women were excluded from being licensed or becoming members.

The barrier was breached in 1909, when a bylaw was passed allowing women to take examinations. The first female member was admitted the same year and the first female licentiate in 1910. After a further bylaw change in 1928, the first female fellow, Helen Mackay, was elected in 1934. During her fellowship, she changed global medical attitudes towards infant feeding, and became an authority on anaemia of dietetic origin in childhood.

Dame Margaret Turner-Warwick became the first female president, elected in 1989. She was one of the world’s leading thoracic physicians and contributed greatly to discussions around professionalism and integrated care.

Achievements

  • Public health - The RCP has been concerned with public health and preventive medicine. The college opened the first public dispensary in England in 1698, providing medicine free of charge to the poor. A report on the hazards of industrial work was published in 1627 and another on the dangers of excessive gin-drinking in 1726. .
  • Medical literature - The RCP also made important contributions to medical literature. It issued advice on threats such as plague and cholera. The publication of the London Phamacopoeia in 1618 created the first standard list of medicines and their ingredients published in England. This publication regulated the composition of medicines until 1864. The 1869 publication Nomenclature of Diseases created an international standard for the classification of diseases which lasted until the 20th century.
  • Medical reforms - In the 19th century RCP expertise was relied upon by successive governments as long-overdue medical reforms were introduced, most importantly the Medical Act of 1858. In recent times, RCP support was crucial to the establishment of the National Health Service in 1945. The landmark report Smoking and Health of 1962 was a turning point in post-war health policy and heralded a new era of public engagement for the RCP.

Benefactors

Members have always given generously, not just of their time, but also their own collections and wealth. Over the centuries the RCP has accumulated a large number of trusts, given and bequeathed by past fellows, members and their families. Some to them founded research programmes or supported RCP activities and services. Many of these endowed lectures which are still active today. 

You can find out more about our charitable aims here, alternatively if you wish to donate directly to the RCP museum and archive collections you can find out how on our website.

Inspiring physicians

All physicians linked to the RCP from 1518 to the 1820s are celebrated in our obituary service, compiled by the harveian librarian of the time, William Munk. It was originally called Munk’s Roll in honour of its creator. Since the 1820s, this fascinating series has focussed on past fellows (voting members). Modern entries are usually written by colleagues, peers and family members. Find out more about our past members and their lives in Inspiring physicians.