Evaluation of the Wellcome Trust History of Medicine Programme

As part of an ongoing process of policy development in the Wellcome Trust History of Medicine Programme, the Trust undertook a review in 2000 of the history of medicine in the UK. The review explored its development and current status, and considered the role of the Trust in this area. In the course of carrying out the review, many people with history of medicine interests from both the UK and abroad were consulted. The findings of this review are reported in a published report, 'Evaluation of the Wellcome Trust History of Medicine Programme'.

Download the report [PDF 330KB].

Executive summary

This report describes an evaluation of the Wellcome Trust History of Medicine Programme. This evaluation was intended to answer three main questions:

1. What is the state of the history of medicine in the UK and how has it developed during the period of Trust funding, from around 1960 onwards?

2. Are the overall size, shape and funding structures of the Wellcome Trust's History of Medicine Programme satisfactory?

3. What impact has the history of medicine had on the study of history in general, the general public, health policy development and medical practice?

Main findings

We sought evidence from written questionnaires; personal interviews in the UK, continental Europe, the USA and Canada; a bibliometric study; and a workshop with members of the history of medicine community. Our main findings are as follows:

1. Over the last 30 years, the history of medicine has become a flourishing academic discipline in the UK, and is considered to be a leader in the international history of medicine community.

2. In particular, it is associated with the development of social approaches in the field, and innovative use of methodology and concepts from a variety of disciplines. A tendency to concentrate on UK issues and a lack of exploitation of international sources for comparative material were identified as potential weaknesses in the current field.

3. The diverse academic backgrounds of researchers and the broad-ranging nature of research interests are considered to contribute to the vibrancy of the UK discipline.

4. The integration of the history of medicine into the mainstream UK university system has been a key achievement of the last 30 years. It has taken root in a variety of locations, from independent units encompassing a large number of scholars, to individual positions in history and other departments. The geographical spread of the subject across the UK is considered to be important, particularly for regional research and dissemination.

5. Research in the field tends to be carried out individually by scholars, but there is a strong emphasis on maintaining close contact with other historians of medicine. This is considered to be particularly important for nurturing a good research and training environment, and is strongly supported by history of medicine students.

6. In spite of its growing presence in UK universities, a key problem facing the field - as indeed for other fields - remains one of long-term career stability. While overall the Trust's funding in the field is thought to be good, particular questions arise about the balance between its various schemes. In the short term, there are concerns about the lack of secure opportunities available to researchers at mid-career level and there is widespread support for the resumption of the University Award scheme. In the long term, it is feared that insufficient numbers of PhD students are being trained to maintain the present size of the field. A coherent strategy on careers needs to ensure that both the levels of funding are right at each stage, and that gaps between them are filled.

7. The administration of the Trust's Programme was praised for its friendliness and efficiency, but some refinement and clarification of procedures are needed, particularly in terms of detailed dissemination of policies. There is considerable enthusiasm in the field for greater involvement and consultation in the policy process.

8. In terms of its wider impact, the history of medicine in the UK has had a significant influence on general history, and has, in turn, derived much benefit from being seen primarily as a historical discipline. Its close links to the history of science are thought to be of continued importance, and the dynamic between the two subjects needs to be considered in the context of the funding scope of the Trust Programme.

9. Interactions between medicine and the history of medicine, and communication of research to wider audiences appear to be the smallest areas of activity, in part owing to the research emphasis that funding schemes have imposed on the discipline, both in Trust reviews and the Research Assessment Exercise (RAE).

10. Unlike the situation in other areas of Europe and North America, history of medicine in the UK is not primarily associated with medical schools and, although there are some mutually advantageous links, there are areas for improvement. Teaching of the history of medicine to medical students was highly praised where it did occur, and there is much potential for its expansion, if issues of time and resources can be addressed.

11. Some types of dissemination to wider audiences have been very successful, including television programmes, popular books and exhibitions. The Trust could play a much bigger role in supporting these activities, by making provision for them in its awards and by taking account of them in evaluation procedures. The History of Medicine Programme has the potential to overlap with other areas of Trust interest, in its public understanding of science activities and also in cross-panel interdisciplinary projects in more contemporary areas of the discipline. As well as continuing and building on the intellectual leadership that the UK field now possesses, there is much scope for the Trust to play a greater role in encouraging the larger academic and public interest that such research excellence in the history of medicine has fostered.