Following a publication on Irish women and medicine in 2015, Laura Kelly has published a new study on Irish medical students and the unique challenges they faced at the turn of the twentieth century: Irish Medical Education and Student Culture, 1850–1950. While a good deal of scholarship examines the lives of doctors, only recently have historians focused on the medical student, and Kelly finds good value in discussing the Irish student experience within the context of British medicine. Ireland had much to contribute to the United Kingdom's medical educational system, and Dublin was central—surpassed only by London in choice of medical schools.

In the 1850s, efforts began to professionalize the medical establishment and to regulate medical education in Britain and Ireland. In 1858, the formation of the General Medical Council of Medical Registration and Education sought to separate the qualified from the unqualified. It regulated medical education and imposed on students an onerous year-long apprenticeship prior to their studies. The council's rules also helped to create a hierarchy of the hospital physician over the general practitioner. Into the mid-twentieth century, Ireland's medical schools continued to present unique challenges, and Irish medical students consequently sometimes looked elsewhere for their education.

Kelly shows that while the British medical student had his path to school and hospital clearly set, Irish students had much greater choice. However, this resulted in Irish institutions competing for much-needed student fees. In Ireland, medical school choice included Trinity College Dublin (1592), the Royal College of Surgeons (1784), and the Queen's College's established in Galway, Cork, and Belfast in 1849, though the Roman Catholic Church dismissed all of them as “godless” and forbade Catholics from attending. Political pressure resulted, and in 1854, the Catholic University (changed in 1881 to University College Dublin) opened. Students also frequently chose to attend Scottish institutions, which, similar to Irish institutions, were also more inclined to accept women.

In the mid-nineteenth century, Ireland, like Scotland and England, had high numbers of medical students, but Kelly tells of how Irish schools struggled to maintain standards. For the Irish, the liberality of choice and failure to govern student activity led to abuses. For example, in a practice known as sham certificates, students paid tuition, did not attend the course, but nevertheless took the course's final exam. Nevertheless, Kelly argues, greater freedom of choice provided medical students with greater influence on decisions made by fee-dependent schools, and students were not silent when unhappy. In addition to actual street protest over policy, faculty appointments, or poor instruction, students also revealed their discontent in personal writings, student newspapers, and direct contact with the school's administration. The quality of Irish medical schools was not as rigorous as that of their English and Scottish counterparts, so student discontent was often legitimate. What is less evident, given the cost of living outside of Ireland, is Kelly's argument that significant numbers of students voted with their feet.

Next, Kelly moves to the Irish student image. Due to choice, the apprenticeship model, and the system's permissiveness, some Irish medical students had more time to invest in extra-curricular activities. Left to their own devices, students, including many from rural Ireland, found themselves tempted by the offerings of larger towns—particularly Dublin. Medical students, whether deservedly or not, were notorious for bad behavior, which, as Kelly notes, also reinforced the masculine traits that the doctor was to exhibit. And, as the nineteenth century turned into the twentieth and Europe edged toward war, the expected masculine and martial nature of the medical man intensified.

In short, medical schools were not immune to the Victorian and Edwardian eras’ social expectations of gender, and Kelly demonstrates that medical schools were very much boys’ clubs. In addition to the importance of sport, even at the cost of academic progress for some of the best athletes, schools emphasized the heroic and manly nature of the medical man. Kelly's evidence shows that while increasing numbers of women found themselves accepted into Irish medical schools and classrooms, they were not invited into many of the clubs; socially, women were generally shunned. Not helped by the (albeit small) number of nuns and future missionaries attending medical school (another interesting topic for historians to pursue further), female students sat separately and were written and spoken of in masculinized terms into the twentieth century.

Through Kelly's use of oral interviews, newspapers, student writings, manuscripts, diaries, and medical school records, Irish Medical Education and Student Culture provides important insight into Ireland's rich medical history. Kelly delivers a wealth of evidence for the slowly changing and imperfectly improving world of the Irish medical student. Student reasons for attending medical school were, as they are today, various. However, what also comes through in Kelly's research is that Ireland's medical schools reflected the island's deep-seated sectarian troubles, and here Kelly might further develop her argument. It is clear that students experienced strong religious and social pressure to choose schools and work in hospitals of their respective religion. Sectarianism was well on display by students and schools. While students, most of whom were middle- and upper class, did not write or speak of each other in the same dogmatic language that can be found in newspapers, religious archives, or philanthropic records that dealt with the poor, it would be interesting for Kelly to expand her discussion of how Ireland's religious authorities deeply affected, if not outright controlled, medical student choice of school and hospital.

To broaden our understanding of Irish and British medical systems, Laura Kelly advocates that historians delve further into the medical student's educational and cultural life. By the twentieth century, Ireland's medical schools, responding to both domestic and international medical assessments, sought, with imperfect success, to provide students a quality education. Sadly, though not surprisingly, many of these future doctors would never practice in Ireland as they, like rest of the country, were subject to the economic forces that resulted in decades of chronic emigration.