Early medical education in Liverpool centred around the institution of examinations for surgeons who had to be carried on ships engaged in the African Trade under an Act of 1788; the system of apprenticeship operated at Liverpool Infirmary and at the Dispensary (founded in 1778); and the medical and scientific courses which were held at the recently founded Royal Institution from 1816 onwards.
However, medical education laboured under a number of difficulties amongst which was the demand of the College of Surgeons in London that Anatomy and one course of Surgery should be attended in London for its Diploma. The Anatomy Act of 1832 eased the situation and in 1834 a School of Medicine and Surgery was established at the Royal Institution and shortly afterwards recognised by the Society of Apocatheries and the Royal College of Surgeons although the latter still required some months' training at a London hospital. Clinical instruction was provided at the Infirmary in Brownlow Street and the Northern Hospital.
The Infirmary transferred to Brownlow Street in 1824; the Lunatic Asylum also transferred to an adjacent site on Brownlow Hill in 1830. It was clearly preferable that the Medical School should be more closely associated with the Infirmary: following negotiations with the Infirmary the latter granted a site on the north-west corner of the Asylum for building a Medical School, to which the Medical School at the Royal Institution was transferred in 1844. This building was sufficient accommodation until the 1870s when student numbers on occasion topped the hundred mark. The Infirmary granted more land and extensions were erected 1872-1874, including a new museum, the only part of the old medical school which now survives.
The Medical School had to rely on the generosity of the public and the fees of its students to support it, and it was to obtain some endowment for new teaching posts that the Council of the School approached the Association for Promotion of Higher Education in Liverpool. The School's Council and the Association formed a Joint Committee which presented a requisition to the Mayor in 1878 asking him to summon a town's meeting to discuss the establishment of a University College. The end result was that the Crown incorporated University College, Liverpool in 1881, the College being initially housed in the disused Asylum; one of the reasons why the College was established here was its proximity to the Medical School. The Medical School retained its autonomy, although co-operating with the new College until 1884, in which year it became the Medical Faculty of the College which itself became an integral part of the Victoria University. The Victoria University had been granted an extension of its privileges whereby it could grant degrees in Medicine as well as in Arts and Science and the Medical Faculty established at Owen's College, Manchester, possessed greater advantages of position, equipment and endowment. The Royal Infirmary School of Medicine felt that their School would not be able to hold its own against the Manchester School once students at the latter could take resident Victoria degrees whilst the Liverpool School could continue only to train for non-resident London degrees or for the preliminary stages of medical degrees conferred by Scottish Universities. The only escape from this position appeared to be in the admission of the Infirmary School, as a constituent part of University College, into the Victoria University.
In the Letters Patent establishing University College in 1881 the latter was enabled to co-operate with the Infirmary School of Medicine. The Medical School, while retaining its name and constitution and separate government, could act as the new College Medical Faculty and could be represented on the new College's Senate. No provision was in fact made in these Letters Patent for the organisation of separate faculties apart from these provisions relating to the Medical School. The nucleus of the new Faculty of Medicine consisted of the professors and independent lecturers in charge of particular subjects. The Faculty's meetings were to be presided over by an annually elected chairman who need not necessarily be a member of the professoriate; however, the Principal of University College acted as Chairman when present although it was only upon rare occasions after the 1890s that he attended. The Chairman was not to hold office for more than one year in succession. The Dean of the Faculty was to be elected annually and be elegable for re-election, and was to act as Secretary and Treasurer to the Faculty, and present to each Annual Meeting a report to the Medical Department. In addition the Chairman or Dean could suspend any student from attendance until the Principal or Senate considered the case, and Assistant Lecturers, Demonstrators and other Assistants were to be appointed and dismissed by the Faculty or subject to the faculty's approval by the Council or a Professor or Lecturer.
The Constitution of the Faculty of Medicine, which was agreed upon in 1883, shortly before the formal amalgamation, was to have considerable influence upon the constitution of the other faculties. The first serious attempt to organise the College's work on a faculty basis outside the Medical School was made in 1895 when Senate set up a Committee to consider the advisability of establishing faculties. The result was the establishment of the Faculty of Arts in 1896 whose constitution was based to a considerable extent on that of the Medical Faculty, providing for an annually elected chairman (who could be the Principal of the College) as well as a dean.