Learning how to practice medicine in early modern Europe involved years spent training as an apprentice for the great majority of practitioners, especially surgeons, apothecaries, and midwives. Only a small proportion of practitioners, mainly physicians, would study academic medicine at a university. Indeed, it was not until the twentieth century that university education came to dominate all branches of medical training. By that point, many of the pedagogical features of apprenticeship had been absorbed into the process of hospital training.
Apprenticeship was a legally binding agreement (the indenture) between an experienced practitioner, the master, to teach an unskilled youth, the apprentice, their trade in exchange for their service for a period of years. During the term of their indentures, apprentices were often paid no wages, except for the value of the board and lodging they received as they lived with their master. Apprentices were usually between 14 and 17 years old when they began – the same age as farm servants and university entrants. The length of terms varied across Europe, with seven years the legal minimum in England from 1563, and shorter contracts more common elsewhere. In Haarlem, in the Netherlands, for example, surgeons’ apprentices served a minimum of five years.
Apprenticeships were long, and not all were completed: a substantial minority ended early, with apprentices leaving their masters before the end of their term of service. In some cases, these ex-apprentices would move away from the place where they had trained to set themselves up independently. For others, movement was linked to gaining access to a wider set of skills, by working for a different master, sometimes in a different location.
Valuable skills – like those required for medicine – were in demand, and medical apprentices’ families often paid a substantial fee to the master. In eighteenth-century London, apprentice apothecaries paid an average of £73 to their master, six times the annual earnings of an unskilled labourer. In some European towns and cities, medical work was governed through guilds, associations with the ability to regulate and control access to their craft or trade. When their master was a member of a guild, completing an apprenticeship usually gave their former apprentice the right to join a guild in their own right, and gained them the privilege of working freely in the town or city.
This system of training was widespread and operated with only minor differences across Europe, and in many other parts of the world. While it was normally connected to guilds in places where they were active, apprenticeship did not depend on guilds. Rural medical practitioners and those operating outside of guilds trained apprentices in just the same way. Apprenticeship was also used by both male and female medical practitioners, although in some places guilds limited occupations by gender. The popularity of apprenticeship reflects its effectiveness at solving the problem of how to give skilled workers an incentive to pass on their knowledge to members of the next generation. It also facilitated occupational and geographical mobility. Apprentices in larger cities were often migrants, who were moving to enter occupations that were frequently different to their father’s: apprenticeship contracts provided the security for their transition into a new place and trade.
Apprentices mostly learned their craft by watching and copying their master. Over time, they would begin to operate more independently, taking on specific roles or tasks, and they might work with more than one master during their term, broadening their experience. For surgeons’ apprentices, for example, their apprenticeship might involve some time working autonomously as a surgeon on a ship. Although apothecaries were lambasted by critics such as Christopher Merrett in his Short View of the Frauds and Abuses committed by Apothecaries for their ignorance of medical theory, academic learning might play a part in training. Both surgeons’ and apothecaries’ apprentices were required to be literate in London, and the latter had to master the Latin pharmacopoeia. Antwerp required surgeons’ and apothecaries’ apprentices to follow lecture courses for several years at the Medical College established in 1620s and sit its examination if they were to practice in the city. In some places, but far from all, the end of apprenticeship involved a final exam. In London, unusually, apothecaries’ apprentices were examined by members of the College of Physicians, while Barber Surgeons were examined by the senior members of their guild. But this should not be taken as evidence that this was akin to a modern academic qualification. The durable core of apprenticeship in medical practice remained centred in learning by observing and doing.
Further Readings
Cavallo, Sandra. Artisans of the Body in Early Modern Italy : Identities, Families and Masculinities. Manchester: Manchester University Press, 2007.
De Munck, Bert. "Corpses, Live Models, and Nature: Assessing Skills and Knowledge before the Industrial Revolution (Case: Antwerp)." Technology and Culture 51, no. 2 (2010): 332-56.
Pelling, Margaret. "Managing Uncertainty and Privatising Apprenticeship: Status and Relationships in English Medicine, 1500–1900." Social History of Medicine: The Journal of the Society for the Social History of Medicine 32, no. 1 (2019): 34-56.
Prak, Maarten, and Patrick Wallis, eds. Apprenticeship in Early Modern Europe. Cambridge: Cambridge University Press, 2019.