In the year 1878, I took my degree of Doctor of Medicine of the University of London…
And so begins one of the most popular stories of all time. This is Dr. John Watson, of course, and our troubles of gender-swapping him and remaining true to canon seem to begin with the 4th word of the entire Holmes saga.
But as we have discovered in our previous post, by 1876, British women had gained the right to sit any medical exam for which they were qualified—IF the credentialing body decided to allow it. And as we saw, the King and Queen’s College of Physicians in Ireland did just that in 1877, just a year before Dr. Watson’s vaunted achievement. So yes, there were degreed and licensed women doctors in Britain by 1878.
But what about this particular qualification?
What, precisely, is a Doctor of Medicine degree in this time period? And what was the University of London? And most importantly, could a woman Dr. Watson have taken this degree, in this year, from this institution?
That’s exactly what we are about to find out.
First off, we need to understand what our woman Watson’s educational path would have looked like.
Educating girls was becoming a bigger priority in Britain by the mid-1800’s. Assuming that Watson was born in 1852, as a lot of Holmesian scholars estimate, she may have attended a local primary school from ages 6-11. She would have learned to read and write, maybe some basic math, but most of her schooling would probably have been focused on “domestic skills” like embroidery and cooking.
But let’s say she showed some remarkable academic talent and had supportive, middle-class parents. She might have been able to attend a “ladies’ college” from age 11-18. (This is not a college as my American readers will think of. It would be more like middle school and high school.) Here, she would have been studied foreign languages, mathematics, science, literature, as well as the expected litany of domestic arts.
This is the sort of education that trailblazing women doctors like Sophie Jex-Blake received early on. Some of these ladies’ colleges were quite radical in their approach and thinking for the time period. It’s not at all a stretch to think that if our Watson showed interest in the sciences and math that her teachers would have encouraged her and her parents to allow her to advance to further study when she completed her time there, around 1870.
But progressing to a university to study medicine would have required money, especially since her only options by the early 1870’s would have been in Europe or the United States. Watson’s family was probably not poor, but likely not super wealthy either. Perhaps they were well-off enough to pay for her to study in Europe, or maybe there was a wealthy relative who funded her studies.
We don’t know for sure where canon Dr. Watson went to medical school, but it was likely the school associated with St. Barts Hospital in London. He would have attended lectures at the school and then done further hands-on training at the hospital.
This is the first point where we are forced to slide away from canon Watson. Interestingly, Elizabeth Blackwell studied privately at Barts in 1850, thanks to a professor there who was sympathetic to women’s education. But in the 1860’s, when another female student wished to do the same, the male students reacted by circulating a petition against allowing her to attend lectures. They also caused such an uproar anytime she set foot in a lecture hall that she was forced out after only a year and never gained her medical education.
After that, Barts Hospital did not allow women anywhere near its hallowed, dick-infested halls until 1947, and that was only because the school was being forced to become coeducational by the University of London. (Hold on—we’ll get to the U of L shortly.)
So, with Barts being a misogynistic shit-hole clear up to half-way through the 20th century, where could our Watson have studied instead?
She could have gone to Paris or Zurich or the United States. There were even one or two universities in Germany that were starting to open to women. But a lot of women medical students in the early 1870’s went to Zurich, which had a stellar reputation and where they had been welcome since about 1865 to attend lectures and study right alongside men. So we’ll say that’s where our Watson went.
In the timeline for my story, I decided that it takes her some time to figure out what she wants to do and how to make it happen. So she doesn’t start studying in Zurich until 1872, funded by a conveniently-rich and supportive uncle.
The course of study for a medical student in Zurich would have included lectures, dissection, and a final thesis that would have to be defended orally in front of the medical faculty and an auditorium full of onlookers. I’m unclear how long this would take—the first woman to earn her medical degree there only took two years to do it, but I’ve also read that it might have taken 5-6 years to complete the course of study and the thesis.
In my timeline, Watson makes quick work of it and graduates in three years, in 1875. Her degree would have been an MD from the University of Zurich, but the equivalent degree in Britain at the time was the Bachelor of Medicine, or MB.
The Zurich coursework included attending lectures and watching demonstrations, dissection, and writing the thesis. The exam was an oral one based on the student’s thesis. But there was no clinical work offered.
Gaining clinical experience was one of the biggest challenges for women doctors, right up there with getting their degrees. So what would our Watson’s options be?
Pretty limited, unfortunately. There was nowhere in Britain quite yet that would allow her any kind of supervised clinical practice. She may have been able to practice midwifery in France or Germany, but her best option would be to go to America where there were teaching hospitals in Boston and Philadelphia specifically set up for women doctors and medical students.
So let’s say she goes to the Women’s Hospital of Philadelphia for what we now would call a residency. She stays for two years and then returns home for Plot Reasons I Cannot Say Because Spoilers.
By this time it is 1877. Much has changed in Britain since she left for Zurich and then America. The London School of Medicine for Women (LSMW) was founded in 1874, and in 1876, Parliament passed a bill allowing any medical degree-granting institution to offer credentialing exams to women. The King and Queen’s College of Physicians in Ireland opened exams to women in 1877 as well, which means our Watson could take that exam and become a registered doctor a whole year ahead of schedule. Perhaps she does. As I said previously, her Zurich MD would probably have been equivalent to a British MB, which is all she would need to qualify to sit the exam and become licensed in Britain. Certainly several of her Zurich classmates did exactly that when Ireland opened its arms (and exams) to them.
But we want to get back on canon, so regardless of any other qualifications, we need her to get that Doctor of Medicine degree from the University of London, in 1878.
First of all, we need to understand what the University of London was at the time. Without getting too detailed about it, you can think of it as basically an umbrella institution that offered exams and awarded degrees but didn’t have classes of its own. The purpose of the university was, in part, to maintain a consistent exam protocol across all colleges in the UK and British territories, as well as to offer a secular alternative to Cambridge and Oxford, both of which required students to be Anglican in order to attend.
After the Medical Act of 1876 that permitted institutions to let women sit their exams, the University of London was asked to let women sit exams for medical degrees. No surprise by this time, but the medical students and graduates threw an enormous temper tantrum about it, which delayed matters until 1878. But in May of that year, the change to the university’s charter was complete. Women could sit for exams at the University of London.
But there are still a few more logistical hurdles for our Watson.
First—and this one might be where I’m doing a wee bit of hand-waving—the university’s requirements for granting medical degrees seems to be pretty intent on the student attending one of the university’s affiliated medical schools. Most of these schools, including Barts, were in London.
The LSMW was added to that list in October of 1878. In 1877, they formed a partnership with the Royal Free Hospital that allowed their students to gain clinical practice there. This was crucial for qualifying for an MB through the University of London. Our Watson could easily have practiced there, maybe even doing some demonstrations as a qualified, licensed doctor, while still gaining additional, valuable experience for herself.
The MD exam was offered the 4th Monday in November. So far, so good. The LSMW was approved as part of the university in October. Watson could just squeak in that way if she was otherwise prepared for the exam.
But the requirements of the University of London’s Doctor of Medicine degree (which, by the way, was a kind of specialist or honors degree, beyond the typical MD or MB required to practice medicine) may not have allowed Watson to sit the exam, even if she was affiliated with the LSMW by that time. The list of requirements I found (from 1876) say the following:
1) You have to have gotten your MB from the University (meaning, I assume, one of the affiliated medical schools in London).
2) You have to have done clinical work at one of the affiliated medical schools’ hospitals and/or otherwise practiced as a doctor for a combination of 3-5 years. Some of this time could be knocked off if you scored high enough on your MB exams.
I can make the math work for #2, especially if we say that of course our Watson scored in the first division on her MB exam. But I’m not sure about #1—would Watson have been allowed to sit the MD exam when her initial degree came from Switzerland via Ireland? I don’t know for sure. It seems that Edinburgh University in Scotland had some sort of arrangement with the University of London where doctors with MBs from Edinburgh could sit for the MD London. But I can’t find any evidence of any other such reciprocal agreements.
However, considering Sir Arthur Conan Doyle’s own hand-waving and discrepancies, I’m willing to say fuck it—it could have been possible. (LET ME HAVE THIS ONE SMALL THING!) If so, our Watson would have been in for the most grueling test of her life. The MD London was notorious for being absurdly difficult, to the point where the male students were perpetually bitching about it. (And failing it!)
No LSMW students took it in the first several years after 1878. One doctor, Helen Prideaux, came very close in 1885. After winning a gold medal in 1881 in anatomy and earning her MB and BS with top honors in 1884, she became the first woman in Britain, to gain a hospital post in direct competition with men. She was on the verge of taking the MD exam in 1885 when she contracted diphtheria and died at the age of 27.
I have not yet found out who actually was the first woman to take her Doctor of Medicine of the University of London. But in our fictional version of events, it’s very plausible that our Dr. Watson could have done it in 1878, as per ACD canon.
Next time, we’re going to leave Watson for awhile and turn our attention to female Holmes’ possible education. It’s not quite as intricate, but there are some fascinating possibilities!
(Photo Credit: The London School of Medicine, Physiology Laboratory. Women students at work, 1899. Wellcome Collection.)