How to teach doctors

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1870s, 1880s, 1890s, clinical education, hospitals, medicine

Millen Coughtrey (1848-1908), the first professor of Otago’s Medical School. Photograph courtesy of Hocken Collections, University of Otago, S06-092.

Otago’s first medical professor, Millen Coughtrey, was not short of an opinion or two. Lancashire-born and Edinburgh-educated, he was appointed to the chair of anatomy and physiology in 1874, but resigned two years later after a disagreement with the university over his right to continue in private medical practice. Coughtrey stayed on in Dunedin and was a respected physician and participant in numerous community activities; he opened a private hospital at St Clair in the 1890s.

Two major published speeches by Coughtrey suggest he was an entertaining presenter. “I love plain speaking, wherever it is desirable, and I shall, therefore, not hesitate to point out whatever may seem to me to be defects and errors in the present means and methods of conducting the practice of medicine, and of preparation for that practice.” So he declared early in his Introductory address in the Faculty of Medicine of Otago University, given in May 1875 at the gathering “to cut the first sod of medical education in this Colony”. Twelve years later, the university invited Coughtrey back to deliver the graduation address; William Christie was awarded Otago’s first medical degree at this historic event, and it was also the occasion when Frederick Fitchett was awarded New Zealand’s first LL.D.

As well as more general discussion of university education, in his 1887 speech Coughtrey reflected on the history of the Otago Medical School and made suggestions for improvement. These ranged from the division of the heavy workload of anatomy and physiology into two professorial chairs (that finally happened in 1905) to the fostering of original research. Some of his most intriguing comments related to clinical education. More needed to be done, he said, in the way of “systematic instruction by the bedside in the hospital”; he was concerned that the public did not really understand this. “The presence of medical students in the hospital does not necessarily involve that the patients should be tortured, that the unfortunate sufferers should be percussed out of one disease into another.” On the contrary, claimed Coughtrey, medical students made the hospital a better place: they provided a “wholesome check” on senior staff, who did not want to perform badly under their gaze; under careful supervision they contributed to medical care, promoting “the early recovery of every ailing inmate”; and they lessened the workload of the nursing staff “by doing the practical dressing of patients’ wounds.” Coughtrey’s opinion of nurses of this period was scathing: “With some exceptions the nursing in New Zealand hospitals is simply execrable”.

Arranging adequate clinical experience for medical students is a perennial challenge, but it was probably never more difficult at Otago than in the nineteenth century. Medical students may have been few, but hospitals were also small and training opportunities there limited. Public hospitals were yet to become centres of technology, open to all; instead they were the last resort of the ailing poor, with admission severely means tested. Most people paid to receive private healthcare – including surgery – in their own homes. Dunedin Hospital had particular problems, and an 1890 Royal Commission thoroughly condemned conditions there.

Thankfully things have moved on considerably since the 1890s, in part due to the advocacy of Otago Medical School staff like Coughtrey who campaigned for improved hospital services for the public and better clinical education opportunities for their students. If you are asked to consent to the involvement of a medical student in your care, remember you are not only helping with their education, but may also be contributing to the betterment of health services!

Guinea pigs at Studholme

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1910s, 1930s, 1940s, 1950s, 1960s, food, home science, St Anne's, St Helens, Studholme

The original Studholme House (later known as Lower Studholme), on the corner of Leith and Union streets, c.1951. Photograph courtesy of Sadie Andrews.

Studholme, one of Otago’s older residential colleges, has seen many changes in its 99-year history. Today’s residents may be surprised to learn that their predecessors served as captive experimental subjects for Otago students learning about institutional administration – indeed that is one of the reasons Studholme was set up in the first place. The college had its beginnings when the university purchased two joined houses on the corner of Leith and Union streets (where Unicol stands today), converting them into the first home science hostel, opened in 1915. It was named after Colonel John Studholme, the Canterbury landowner and philanthropist who funded the chair in home science. Winifred Boys-Smith, who became the first Professor of Home Science in 1911, would no longer have to teach the practical aspects of the course, notably laundry work, in her own home. As early regulations for the home science course explained, “all Diploma Students must take the course in Practical House-management provided at the Home Science Hostel.”

Upper Studholme House in the snow, c.1950. Photograph courtesy of Sadie Andrews.

Until the 1960s, all Studholme residents were home science students, and all home science students from out of town lived at Studholme. The original premises soon became too small for the expanding School of Home Science, and the university bought further houses to provide more accommodation. The most important was a large house at 127 Clyde Street, which remains in use as the west wing of Studholme today. It opened in 1930 as ‘Upper Studholme’, and the original hostel was christened ‘Lower Studholme’. By the 1950s, home science students were spread between Upper and Lower Studholme, St Helens (the former maternity hospital in Regent Road, lent by the government to the university since 1939), St Anne’s (a former private hospital at 305 Leith Street, next to Lower Studholme, purchased by the university in the 1940s), and various other smaller houses and flats. Lower Studholme was becoming old and decrepit, but deemed uneconomic to repair. The bedrooms had to be abandoned in 1951 after they partially collapsed. Sadie Andrews, who lived there in 1951, comments that she had a lucky escape – the students had already departed at the end of the year when the roof collapsed onto their beds. The kitchen and dining room remained in use for some years. In 1961, after about thirty years of planning and fundraising, a large new custom-designed block was finally opened in the grounds of Upper Studholme. That spelled the end of Studholme’s days as a residence purely for home science students – there was now room for other women students too.

Home science students in the front garden of St Anne’s, with Allen Hall in the background, 1951. Left to right – Connie Matthewson, Nona Collis, Shirley Wilson, Prue Corkhill. Unidentified sunbathing legs on the left. Photograph courtesy of Sadie Andrews.

Nancy Carr (nee Deal), who later returned to the Faculty of Home Science as a lecturer, has fond memories of her years at Studholme in the 1950s. Residents had breakfast in their various different locations, but ate their dinner together in the Lower Studholme dining room. Students specialising in dietetics were most involved in running the institution, but all the home science students were rostered on to assist with dinners. Nancy recalls being assigned to prepare that southern delicacy, swedes, as a newcomer from the north – she peeled the unfamiliar vegetable far too thinly! A bigger challenge came with a month-long block course in household management. Students worked in pairs to plan, shop for and prepare three meals a day on a limited budget, this time using the foods department kitchen. The dinners were served to invited guests, frequently university staff and students. Most appreciated the invitation – despite the strict budget, the meals were pretty good.

Nona Collis on the front steps of St Helens, c.1951. Photograph courtesy of Sadie Andrews.

These days, Studholme provides accommodation for nearly 200 students, both male and female. About a quarter of them have rooms in six houses adjacent to the main block, but all residents share the main communal meals and activities. Long gone are the years of shared rooms – Sadie Andrews shared with four other women as a first year student at Upper Studholme in 1950, while more senior residents had the luxury of just one roommate! Long gone, too, are the days when Studholme was an exclusively home science domain and a place of experiential learning for future homemakers and managers of residential institutions. Do you have any memories to share of being a home science guinea pig or of practising your skills on other residents?

Summer school

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2000s, 2010s, summer school, university extension, Wellington

Summer school, from the cover of the 2009 prospectus.

Happy new year! The Dunedin campus came back to life last week as summer school began, so this seems a good moment to look back at the short history of the summer semester, now in its 14th year.

For many decades the University of Otago offered various special courses over the summer, but with a few exceptions these did not give credit towards university qualifications. Most were continuing education programmes, run by the Department of University Extension, which offered a wide variety of opportunities for learning over the summer. People came to Dunedin from near and far for short intensive courses on everything from creative writing to a seniors’ course on the living environment. Bridging and promotional courses were also offered over summer, as remains the case today, with JumpStart Physics and Hands-On Science bringing many people to campus. Beyond Dunedin, the University of Otago, Wellington, established a Public Health Summer School in 1997. This popular programme continues to offer short intensive continuing education courses on numerous public health topics.

This was all very commendable, but did not help students who would like to use the long summer break to complete more of their course. Perhaps they wanted to repeat a paper they had failed, or meet a prerequisite needed so they could change their major, or just to spread their workload more through the year. By 1999 the University of Otago was the only New Zealand university without a summer school offering papers for credit. This clearly put it at a disadvantage in the contest for new students; what is more, some Otago students attended summer schools at other universities to further their learning, showing a clear demand for such a service. The Vice-Chancellor set up a committee to investigate extending Otago’s teaching year. It quickly ruled out the idea of three equal teaching semesters and became the Summer School Working Party. Its final report, in February 2000, recommended that a summer school be introduced, with the first two or three years as a trial. Associate Professor Merv Smith, who had for many years chaired one of Otago’s largest departments, biochemistry, was appointed to the new key position of Director of Summer School.

In January 2001, 700 students arrived on campus to study the 23 papers on offer at Otago’s first formal summer school. This was more students than anybody had hoped for; the programme was a roaring success from the start. After a second successful year, with over 1000 enrolments, the trial was over and summer school was confirmed as a permanent fixture on the Otago calendar. By 2010 summer school enrolments had grown to 2639, but the university had to cap numbers at a lower level the following year to avoid carrying more students than it received government funding for.

Effective writing, computer programming, criminal justice, introductory economics and introductory business management featured among the most popular papers in the early years of summer school. Alongside such bread and butter offerings, some departments quickly recognised that summer school provided an opportunity to provide quirkier courses which might attract new students who would come to do a paper or two just for personal interest. Visiting lecturers – sometimes from overseas – could be appointed to teach a special paper, offering opportunities for some very creative curriculum choices. The only course which might be considered a little out of the routine in 2001 was a second year paper on wine tourism, but soon it had been joined by a wide range of other papers offered only at summer school. Some courses have related to current political issues or to popular culture: theology, money and markets; governing the global environment; the vampire on screen; and the fantasy worlds of CS Lewis, Philip Pullman and JK Rowling, to take four recent examples. Others have introduced completely new subjects into the Otago curriculum: disabilities studies; Arabic language; and, one of the most popular papers of recent summers, forensic biology.

My best wishes to everybody involved in summer school in 2014. You might appreciate some advice given by Vice-Chancellor Graeme Fogelberg in the prospectus for Otago’s first summer school: “Perhaps you will also take some time away from your desks to enjoy Dunedin and its environs at a time when the days are longer and warmer than those during our normal semester programmes.” This summer hasn’t been notable for its warm temperatures as yet, but there are still those magnificent long southern evenings to enjoy!