This article was automatically translated from the original Turkish version.
Modern medical education in the Ottoman Empire is generally considered to have begun on March 14, 1827, with the establishment of the Tıphane-i Amire in the Vezneciler Tulumbacıbaşı Konağı. Prior to this, medical education as provided in Medical Madrasa was based on the method of students reading and internalizing foundational texts under the supervision of teachers. Students would present each completed book to their instructors, answer questions about its content, and receive certification of mastery upon demonstrating sufficient competence, thereby completing the curriculum. Practical training needs were met in hospitals.
When modernized medical education was introduced in 1827, instruction continued for a time to follow the traditional medrese method. The only change was in the textbooks used. Previously, texts by Ibn Sina, Al-Zahrawi, and Ali ibn Abbas had been taught in the Medical Medrese; now, books on modern physiology, anatomy, and pharmacology were adopted. However, sufficient translations of these new medical texts into Ottoman Turkish had not yet been produced, so they were taught in their original languages. Consequently, it became essential for both instructors and students to be proficient in these languages. Before beginning their core medical studies, students received instruction in French and Italian. Medical education continued as in the medrese, with students presenting books they had read and internalized to their instructors for evaluation.
Medical Education in the Ottoman Empire (Generated by Artificial Intelligence)
The Ottoman State soon realized that modernization of medical education could not be achieved merely by introducing new medical textbooks and continuing the medrese method of instruction. As a result, foreign consultants were brought in to redesign the medical school building and curriculum to meet the requirements of modern medical education. In 1838, under the leadership of Charles Ambroise Bernard, invited from Vienna, medical education began in the Galata Sarayı, which was transformed into a modern school building equipped with an anatomy theater, museums, and laboratories—necessities for practical training. Bernard also restructured the medical curriculum, shifting toward a system with more intensive practical instruction.
Following a major fire in Beyoğlu, the medical school was forced to vacate its fully equipped building in 1849 and continued instruction until 1866 in the Humbarahane Kışlası. New museums and laboratories were established there. Recognizing the importance of keeping students and instructors informed about contemporary scientific developments, the first Turkish medical journal was published during this period. Moreover, for the first time, students voiced demands that medical education, which had long been conducted in French, should be delivered in Turkish. However, this transition was not feasible under the conditions of the time.
Due to a major cholera outbreak in 1865, the Humbarahane Kışlası, where the medical school was located, was converted into a hospital for infectious diseases, forcing education to be temporarily relocated to a rented building. In 1866, it was decided to move the medical school to the Demirkapı Kışlası. The necessary practical training facilities were established there as well. However, students frequently complained that insufficient experiments were conducted in chemistry and physics laboratories, almost no cadavers were available for the anatomy theater, and instructors at the seririyat hospital did not provide systematic practical training. Furthermore, during this period, the medical school became entangled in political power struggles and effectively lost its educational function.
Sultan Abdülhamid II was a ruler who placed great importance on medical education. To halt the negative trajectory of the medical school, he decided to seek expert advice and was prepared to take all necessary steps to elevate medical education to the highest contemporary standards. First, in 1893, following a major cholera outbreak in Istanbul, he commissioned Chantemesse, a French expert invited to advise on cholera control, to prepare a report on medical education. Chantemesse recommended that the school building be restructured and that greater emphasis be placed on practical training in the curriculum. He also advised establishing modern laboratories and acquiring the necessary equipment.
Another consultant sought by Sultan Abdülhamid II was Margery, who was serving as an inspector at the Yıldız Sarayı Hospital at the time. At the Sultan’s request, Margery conducted an investigation at Mekteb-i Tıbbiye and submitted a report outlining the necessary reforms. According to Margery, practical training at Tıbbiye was inadequate. Both Chantemesse and Margery highlighted another critical issue: students were not gaining sufficient clinical experience through adequate patient observation at the school’s teaching hospital.
In 1898, Sultan Abdülhamid II sought expert advice for the third time regarding the modernization of medical education. He commissioned Dr. Robert Rieder, a German consultant appointed to the Gülhane Askeri Tatbikat Mektebi, to prepare a report on the medical curriculum to be delivered in the new medical school building then under construction in Haydarpaşa. In his subsequent report, Rieder summarized the deficiencies of the existing medical education system under four main headings. First, he emphasized that medical education lacked a systematic and logical course structure. He stressed that students must sequentially study basic medical sciences, then pre-clinical courses, and finally gain clinical experience.
According to Rieder, another problem was that basic medical science courses were insufficiently represented in the curriculum, while subjects such as zoology, botany, and mineralogy consumed excessive lecture hours. Rieder argued that anatomy instruction needed to be significantly expanded. Although deficiencies could be partially mitigated through wax models, colored posters, and organ specimens preserved in solutions, none of these could replace the experience of dissecting an actual human body. Students must personally perform dissections, locate muscles and nerves, and determine the spatial relationships of organs. Only by internalizing these images could students recall them during the stressful moments of complex surgery, where precise incisions were critical. This could only be achieved through sufficient exposure to cadaver dissection.
Another issue identified by Rieder in the existing curriculum was that peripheral clinical disciplines received more emphasis than core clinical fields. Rieder emphasized that instruction should progress from general to specific. He argued that it was impossible to make a physician an expert in every medical field within two or three years. Therefore, greater priority must be given to core clinical disciplines, ensuring that essential areas were thoroughly mastered rather than superficially covering all fields.
According to Rieder, the most critical problem in medical education was the disproportionate emphasis on theoretical instruction over practical training. Under the current program at Mekteb-i Tıbbiye, students spent only three hours per week visiting internal medicine and surgical clinics, yet they received four hours of theoretical instruction in these subjects every week for two years. Rieder argued that in the new curriculum, more time should be allocated to clinical instruction, because instructors in clinical settings naturally provided theoretical knowledge while explaining patients’ conditions. Medicine, above all, was an applied science, and therefore medical students needed more practical training than theoretical instruction. He viewed rote memorization through loud reading of texts as self-deception and a waste of time.
Medical Education in the Ottoman Empire (Generated by Artificial Intelligence)
After the proclamation of the Second Constitutional Monarchy, renewed reform of medical education became a priority, and this time expert advice was sought from Dr. Wieting, director of the Gülhane Seririyat Hastanesi. In his report, Wieting also emphasized the need to increase practical training. He stressed that the seven hours allocated daily to education should not be entirely filled with theoretical lectures, and that students should be divided into small groups to receive practical instruction.
Throughout all consultations undertaken during the Ottoman period to modernize medical education, attention was consistently drawn to the excessive focus on theoretical instruction and the inadequacy of practical training. In the Republican era, the establishment of numerous medical faculties in recent years, as part of the ongoing effort to achieve high-quality medical education, is a valuable step. However, many faculties still face persistent problems, including curricula dominated by theoretical lectures throughout the day, insufficient access to cadavers for dissection, and inadequate opportunities to apply fundamental clinical skills before entering clinical rotations. Today, given evolving preferences in learning methodologies, it is of great importance that medical education programs focus on transforming knowledge into practical skills, moving beyond the traditional lecturer-listener model and adopting alternative teaching methods.