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Hospitals in Canada were initially places which cared for the poor as those with higher socioeconomic status were cared for at home. In Quebec during the 18th century, a series of charitable institutions, many set up by Catholic religious orders, provided such care.[1]
The first medical schools were established in Lower Canada in the 1820s. These included the Montreal Medical Institution, which is the McGill University Faculty of Medicine today. In the mid-1870s, Sir William Osler changed the face of medical school instruction with the introduction of the hands-on approach. The College of Physicians and Surgeons of Upper Canada was established in 1839, and in 1869, it was permanently incorporated. In 1834, William Kelly, a surgeon with the Royal Navy, introduced the idea of preventing the spread of disease via sanitation measures following epidemics of cholera. In 1892, Dr. William Osler wrote the landmark text The Principles and Practice of Medicine, which dominated medical instruction in the West for the following half century. Around this time, a movement began that called for the improved healthcare for the poor, focusing mainly on sanitation and hygiene. This period saw important advances including the provision of safe drinking water to most of the population, public baths and beaches, and municipal garbage services to remove waste from the city. During this period, medical care was severely lacking for the poor and minorities such as First Nations.[2]