Semmelweis University, Faculty of Medicine

About The University
Founded in 1769, Semmelweis University is the oldest medical school in Hungary. The faculty became an independent medical school after the Second World War and developed into a university that teaches medicine, dentistry, pharmacy, health sciences, health management, and physical education and sport sciences.

The University is named after Ignac Semmelweis (1818-1865), the revolutionary obstetrician who discovered the cause of puerperal fever in the 1840s, and is therefore also known as "the savior of mothers".

Today, Semmelweis University is widely recognized as one of Europe's leading centers of medicine and health sciences, combining innovation and a time-tested tradition in three main areas: education, research and health care.

The University is a truly international community, embracing over 11,000 students from 60 nations over five continents. Its six faculties offer a wide range of courses from undergraduate to doctorate level in three languages: Hungarian, English and German. Foreign students account for about 20 percent of the total community.

Semmelweis University is the largest health care institution in Hungary with over 9,000 employees covering approximately six percent of the health care needs of the country's population.

With an over 240-year-old tradition of academic excellence, Semmelweis University ranks among the most prestigious Hungarian research institutions, where more than 1,300 staff members in over 80 departments are involved in R&D activities.

A Brief History
The University is named after Ignac Semmelweis (1818-1865), the revolutionary gynecologist who discovered the cause of puerperal fever in the 1840s. The "Saviour of Mothers" also served as Director of the Medical Faculty's Gynecology Clinic.

The University's forerunner was founded in 1769, when Empress Maria Theresa launched health care reforms throughout the Hapsburg Empire. In the 19th century, the Faculty of Medicine set up a unified medical education system and built a wide range of new departments to cater for, what was then, over 1000 students. The Faculty became an independent medical school after the Second World War, at which time the Dentistry and Pharmacy faculties were also incorporated.

The University's name was changed to Semmelweis University of Medicine on the 200th anniversary of the founding of its Faculty of Medicine.

Now known as Semmelweis University (Universitas de Semmelweis Nominata in Latin), its current structure results from the merger in 2000 of Semmelweis Medical University, the Hungarian University of Physical Education and the Haynal Imre University of Health Sciences.

Detailed History of the University
Foundation of the Medical Faculty of Nagyszombat, 1769
The University of Nagyszombat was founded in 1635 by Peter Pazmany, Archbishop of Esztergom. The University was expanded to include a medical department as part of a monarchical health care reform introduced by the Empress Maria Theresa. Although medical training in Hungary can be traced back to the Middle Ages, its activity remained dormant for several centuries. Formal education was not put on the agenda until the 18th Century, although the Schola Medicinalis, advocated by Karoly Eszterhazy, bishop of Eger, was a prelude to that.

The concept of a medical faculty in Nagyszombat (devised by Gerhardt van Swieten, a physician-in-ordinary to the Queen) was based on the reformed Medical Faculty of Vienna. Its formation was brought about by Maria Theresa's decree of November 7, 1769 - also considered to be the foundation date of Semmelweis University.

A separate building, designed by Franz Anton Hillebrandt and completed in May of 1772, was constructed to accommodate the new faculty. Medical instruction was already underway in 1770, initially with five departments: Physiology and Pharmacology (Prandt), Anatomy (Trnka), Surgery (Plenck), Botany and Chemistry (Winterl), and General Pathology (Shoretich).

The University's Move to Buda and Pest
On July, 17, 1769, the University was elevated to the status of a "royal institute". In 1777, it was relocated to Buda and it was in this same year that the first Ratio Educationis imposed structural changes within the University. The University Council, or, Senate, replaced the so-called Consistorium (a representative of the state since 1767), although its membership remained practically identical.

The annually elected magistratus academicus, whose function was primarily ceremonial in nature, was further maintained. At the same time, a chairman and a director general were appointed to manage the institution, while the faculties were headed by faculty directors (chairmen). When Emperor Joseph II resigned his office a couple of years later, in 1786, his functions were delegated to the deans. This was the first instance of professorial appointment being regulated: the senate made a proposal based on the opinion of the faculty and the monarch appointed the elected instructors via a procuratorial council.

On 25 March 1780, Empress Maria Theresa issued the so-called Diploma Inaugurale (known as the Magna Charta of the University) specifying the legal status and financial framework of the University and imposing general regulations.

The successor to the Empress, Emperor Joseph II, was also interested in the development of the University and, after making some personal visits, he decided to relocate the institution to Pest in 1784. The Medical Faculty found accommodation at the former Jesuit friary located on the corner of Hatvani (now Kossuth Lajos) and (now Semmelweis) streets.

These frequent moves interfered with the educational process, as financial resources went primarily to building needs. Nevertheless, the rapidly evolving city of Pest provided more and wealthier patients, and the number of beds now available at the clinic rose to 16.

Within a short time, the cloister proved too small to accomodate the newly-formed departments (the Department of Theoretical Medicine and Natural History in 1784, the Department of Veterinary Medicine in 1787, Department of State Medicine and Special Therapeutics in 1793, Department of Theoretical Surgery in 1808, Department of Obstetrics in 1812, and Department of Ophthalmology in 1817) as well as the increasing number of students.

Practical training was significantly encumbered by the fact that, unlike in most countries, the clinics were located in the faculty building as opposed to city hospitals, leaving no opportunity for the regular rotation of patients demonstrated on for classes. Although the Faculty made several attempts to include the St. Rochus Hospital in its expansion plans, these attempts repeatedly failed due to the magistratus's resistance. Nonethless, a new, practical approach to training would be introduced after the 1820s.

Initially, the length of the medical training (based on Van Swieten's model) had not been regulated. The first decree to do so, introduced in 1774, stated that medical training should last for a period of five years. In 1786 ,this was shortened to four years.

As a result of stricter examination rules inducted by Joseph II, medical diplomas were now recognized abroad as well - at the universities of Vienna, Prague, Krakow and Pest. In 1804, Vienna withdrew from this system and demanded it be given special privileges.

Courses in surgery and civil surgery lasted for two years, while those in pharmaceutics went for one year. Midwifery courses were short and held on a semesterly basis. From 1787 on, they were accompanied by classes in veterinary medicine.

The First Decades of the 19th Century: Icy Floods and State Medicine
The University's vital period at the end of the century was replaced by the retrograde era of Francis I. This was reflected in the second Ration Educationis issued in 1806, which called for centralization and the elimination of academic freedoms. The second Ratio Educationis dealt more thoroughly with the Medical Faculty than the previous one had. It specified curricula and the duties of the professors in detail, modernized the order of studies and final examinations, and increased the length of study to five years. The chairman, representing the will of the government (praeses universitatis) and his assistant, the vice-chairman (vice-praeses) and chancellor of the university, was now given a decisive role in the University's management. The magistratus (the rector, deans and seniors), on the other hand, now had very limited rights.

Around 1810, the faculty director position was reinstalled despite the fact that the Medical Faculty was professionally supervised by the national head physician. As medical training counted as neutral territory from the French revolutionary ideas feared by the monarchist government, significant scientific activities and major development would only be performed at the Medical Faculty beginning in the 19th century.

Nevertheless, despite numerous efforts to the contrary, training conditions gradually worsened after the 1830s due to increasing demands and overcrowding. The situation was also aggravated by the icy flood of 1838 - to such an extent that even the Parliament had to intervene in the Medical Faculty's affairs.

It was under such conditions that professors were forced to keep up with the rapid development and specialization of international medical science. State medicine became an independent department at the University of Pest in 1893 (ahead of Vienna) and, considering the circumstances of the time, this is quite a remarkable achievement. Smallpox vaccination was introduced to Hungary in 1799, and in 1824 a Vaccination Institute, headed by Ferenc Gebhardt, was founded within the Medical Faculty.

One of the most important natural scientists of the age, Pal Kitaibel, was also a professor of the Faculty. The Pathological Institute founded by Lajos Aranyi in 1844 was one of the very first institutions of its kind in the world. At the beginning of 1847, just a couple of months after the first trial at the Massachusetts Hospital, Janos Balassa, in Pest, successfully performed anesthesia with ether. Nevertheless, certain modern trends of the age such as ontology, the diagnose-free system of Brown, and the irritation theory of Broussais, had no influence on the Medical Faculty. Physical diagnostics, on the other hand, was hugely popular within the Faculty, especially with Pal Bugat, Frigyes Eckstein, Ignac Sauer, Agoston Schopf-Merei and Ignac Stahly. The Faculty played a determinant role in controlling major epidemics (typhus, yellow fever, smallpox, and cholera in 1831 and in 1848-1849).

Establishment of Hungarian-Language Instruction
The language of instruction for medical and surgical courses had been Latin; education in the national language was not put on the agenda until the end of the 18th century. In 1830, a new law permitted the use of Hungarian and, three years later, Ferenc Flor published his Hungarian dissertation - the very first scientific work to appear in the national language. In 1844, Hungarian became the official language of instruction. However, despite the professors' dedication to their country, the Medical Faculty regarded the change with reservation. This was due in part to the fact that several students, and sometimes even professors, did not understand the language, as well as the deficiency of Hungarian medical terminology at the time.

Pal Bugat was the one to undertake this neologistic task, and many of his terms are used to this very day. Although lower level training courses such as surgical mastery, midwifery, and veterinary medicine had been held in several non-Latin languages (e.g. Hungarian, German, and Slovakian) from the very beginning, Hungarian didn't become the official language of instruction until 1848.

Aftermath of the Revolution and the War of Independence in 1848/1849
In the Code of April 1848, a separate article (XIX/1848) dealing with the University finally declared its independence and the liberal principle of academic freedom. The majority of professors and students actively participated in events involving the fight for freedom. This show of resistance (after initial capitulation) on the part of the instructors brought severe consequences: many of the professors were jailed (e.g. Balassa) or forced into hiding (e.g. Bugat) or emigration (e.g. Schopf-Merei, who went on to found a children's hospital in Manchester).

Professors were forced to defend themselves and could retain their jobs only upon proof of loyalty to the throne. Harassment by authorities became an everyday occurrence. The Faculty was filled with new teachers loyal to the Emperor, but these were often lacking in competence. During this so-called absolutist period, education and administration were performed in German. The curriculum of 1848 was replaced by the Viennese version of 1833, which was based on the "conformetur" principle. However, some modernization did manage to take place. In 1850, the graduation certificate issued by secondary schools was introduced and the faculty director post was eliminated.

Although 9 departments had training programs, the surgical master courses gradually disappeared. Finally, education was suspended at the University of Pest, just as it had been in Lemberg, Olmutz and Salzburg. By 1872, even the craft union was dissolved, and, as far as language was concerned, progress occurred only after the Court experienced major failures in foreign policy. In 1859, a delegation of students went to Vienna to negotiate the reinstitution of the Hungarian language. In 1860, the University of Pest was also granted the right to the autonomous appointment of deans.

Following the October Diploma, main subjects were taught in Hungarian while others could be taught in the language requested (German, Slovakian, or Latin). Instruction in the Hungarian language was rehabilitated only after the Compromise of 1867, by Act XLIX/1868. By this time, professors who did not know Hungarian (such as the Czech Jan Nepomuk Czermak, whose colleagues tried in vain to convince him to stay) had left the University.

The Integration of Medical Training and the Establishment of the Center.
Standardized medical education was introduced in 1872. As a result, a single medical diploma - the "Doctor of Universal Medical Sciences" - was issued from 1878 on. University regulations of 1875 introduced new and universal types of medical exams, granted autonomy and new academic freedom. After 1881, the starting and ending dates of the academic year were changed: instead of beginning in November and ending in August, it now began in September and finished in June.

In addition to its poor equipment, the Faculty's other major problem was still the lack of space. Although clinics had finally been moved from the Ujvilag (now Semmelweis) street facility in 1848, relief was only temporary as they were transferred back after the revolution's defeat.

The number of students considerably increased - from around four or five hundred in the 1860s to more than a thousand by the 1880s. It was in the 1860s that the first student societies began to emerge, beginning with an assistance association in 1862 and progressing to a culture club five years later.

The problem of admitting women into the University occurred at the end of the century, with the Medical Faculty generally opposing the idea. The first Hungarian lady doctor, Vilma Hugonnay, would have to wait seventeen years to have the diploma she had obtained in Zurich in 1879 recognized. Although a decree of 1895 allowed women to study liberal arts as well as to participate in medical and pharmaceutical training and practice, real breakthrough in this field came only after the world war.

World War I and the Tragedy of Trianon
During World War I, the majority of students and professors were enlisted in the army. Half of all hospital beds (which quickly increased to two thousand) were reserved for the wounded. The shift to a wartime economy, as well as the economic depletion of the Monarchy itself, drastically cut back on educational funding.

The University was no exception. The war drained the University of practically all of its student life. After the capitulation, however, there was a great "dumping" in this regard. Compared to the year preceding the outbreak of the war, two times the number of medical students (6,526) wished to attend university, to finish their interrupted studies. The continuous waves of revolutions from 1918 to 1919 only added to the confusion. The University was placed under strong central management and significant amount of restructuring occurred. Staff was replaced: professors considered to be rightists were suspended. Later on, when the Faculty Council declared the events following October 31, 1918 to be "ex lex", new replacements were performed and attestation procedures were introduced.

Several professors were removed from the Faculty - the excellent ophthalmologist Emil Grosz, for example, and the founder of nuclear medicine, Gyorgy Hevesy, who was later to receive the Nobel Prize abroad. Excess numbers of students and revolutionary experiences resulted in the Act XXV/1920, also known as the "Act of Numerus Clausus", sharply restricting university admission requirements. This new system was intended to both generally decrease the number of students in higher education and to limit the number of Jewish students.

The latter, especially, had a significant effect on the Medical Faculty as the medical profession had always attracted a large number of Jewish youth; in this regard the law encouraged protectionism. At the same time, the Faculty tried to prevent the admission of women. Although a decree of 1924 theoretically opened secular higher education to them, very few of them attended the Medical Faculty. Post-war economic depression, further aggravated by the severe loss of territories, created financial problems never before experienced by the University. The purchase of western literature became more and more of a challenge.

The University in the Interwar Period: the Great Depression and International Achievements
The situation was just beginning to improve when the Great Depression of 1929 hit and funds for education and health care once again became scarce. Even doctors were to experience unemployment. The University staff underwent a reduction of more than ten percent, investments were stopped, and one-fourth of the hospital beds had to be left empty for financial reasons. Contrary to the international trend, the number of students had also dropped significantly (from 1,729 in the 1925/1926 academic year to 1,234 in 1930/1931). In 1922, a long-awaited medical school reform with an emphasis on the joint training of researchers and medical practitioners was implemented.

The length of the study time increased from five to six years, final examinations were split up into four phases, and the number of lectureships offered was also increased. Later on, the system of final examination was further modified but these changes wouldn't be introduced until 1943. In 1936, the classification of diplomas underwent a change - it was at this time that the diploma qualifications of today (rite, cum laude, summa cum laude, etc.) - were created.

And much later down the line, the training of pharmacists would also be reformed: the program would be increased from two to four years and the length of internship would be decreased from two years to one year. Prior experience at a pharmacy was no longer a prerequisite for acceptance into the program. With a high school diploma anyone could enter the University. The Medical Faculty operated internationally recognized schools during the interwar period as well. One of them, run by , whose father had founded it, boasted achievements such as the development of exam methodology on the kidney and the quarantining of tuberculosis.

Years of World War II
Apart from military service and the medical care of the wounded, World War II did not disturb Faculty life. As the front line advanced, the majority of the teaching staff was mobilized and the University had to be evacuated. Clinics were relocated to Visegrad, Fot, various villas in Buda, and to sanatoriums, and the Faculty itself had to be evacuated to Germany.

Resistance at the Medical Faculty, however, led to the partial failure of the action; about 600 students and some professors were sent to Halle while the clinics and their equipment remained in the country. The Faculty was heavily hit by the siege of Budapest - facilities were severely damaged (particularly four clinics) and much equipment was destroyed. The total damage amounted to approximately thirteen million gold Pengő (the currency in 1938).

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Semmelweis University