The time it took to grow up: from Society to Royal College

David J Wilkinson

St. Bartholomew’s Hospital, London, UK

With the successful introduction of modern anaesthesia into the UK in December of 1846 there was no infrastructure for the new speciality at all. Often not even provided by medical practitioners, anaesthesia was just a new therapeutic measure that required little in the way of training or professional development.

John Snow planted the seeds of a scientific base for the subject and started to report the results of his investigations at medical meetings. His prolific production of books and papers began to indicate that there might be more to the subject than had first been realised. His investigative mantle was taken over by Joseph Clover in London after his early death in 1858 and more physicians started to spend greater parts of their time providing anaesthesia. Those who were skilled did well.

In 1893 Joseph Silk suggested that a Society of Anaesthetists be founded and this soon became a vibrant Society which held regular meetings, published proceedings and started to seriously influence the status and development of our speciality. They lobbied for and were granted the need for anaesthesia to become a integral part of a medical student's curriculum. With the formation of the Royal Society of Medicine (RSM) in 1907, this sub-specialty group integrated into the wider body and became the Anaesthetic Section of the RSM in 1908. This was the main meeting place for all anaesthetists in the UK for the next 50 years. It was here that science, administration and political matters were discussed by all the leaders of the speciality.

In 1914 the Scottish Society of Anaesthetists was formed in Edinburgh and continues to this day, claiming , with some justification, to be the oldest anaesthesia society in the world.

However in the early 1930s it was felt that a more specialist society was needed in the UK which could try to lobby on behalf of anaesthetists on matters relating to pay, status and regulations. Henry Featherstone founded the Association of Anaesthetists of Great Britain and Ireland (AAGBI) in 1932 and immediately started to lobby for the creation of a post graduate examination in anaesthesia. The Diploma of Anaesthesia (DA) was administered by the Conjoint Board starting in November 1935 and the possession of this qualification became the standard measure of a 'proper' anaesthetist.

With the formation of a National Health Service in 1948, thanks to persistent lobbying by the then Presidents of the AAGBI and the Royal College of Surgeons in England, anaesthesia became an equal consultant speciality with all others. The DA was extended to become a two-part examination in the same year and this was administered by a new Faculty of Anaesthetists created within the Royal College of Surgeons of England at the same time.

With the increasing development within the speciality over the coming decades so the three basic bodies, the RSM Anaesthetic Section, the AAGBI and the Faculty of Anaesthetists, continued to develop. Anaesthetists often belonged to Councils of each group either at the same time or with rapid succession! Friction between the AAGBI and Faculty came and went and there was considerable overlap between the functions of the three groups.

In 1988 after prolonged lobbying by the AAGBI, the Faculty of Anaesthetists became a College within the Royal College of Surgeons and after a further 4 years a natural progression was the formation of a separate Royal College of Anaesthetists.
This evolution of a Society into a Royal College has not meant that the formative organisations have ceased to exist and in many ways each is now stronger than at any other time. It is likely that further developments will occur to take into consideration changes within the speciality and profession.