Why graduates of Bidloo’s school had to sit an exam in the navy

In 1712, Stepan Blazhenev and Ivan Belyayev, graduates of Nicolaas Bidloo’s Moscow Hospital School, had to sit another examination in St Petersburg after their final examination in Moscow, before entering service with the Baltic Fleet. The naval commission judged their knowledge inadequate; following their mentor’s complaint to Admiral General Fyodor Apraksin, both were nevertheless granted the rank of assistant medical practitioner and allowed to practise. The surviving evidence does not establish whether their failure resulted from poor training, the examiners’ prejudice or a combination of the two.

Bidloo wrote to Peter I about the content of the training and defended his students, while researchers give only a brief account of the naval commission’s assessment, without the questions put to each graduate or their answers. These accounts allow us to trace the dispute, but not the examination itself.

Why was a school opened at Moscow Hospital?

Peter I ordered the construction of a hospital to treat the sick and train medical personnel. His decree of 25 May 1706 designated a site beyond the Yauza River, opposite the German Quarter, and envisaged an intake of 50 students. The hospital began admitting patients in November 1707, and a school opened alongside it. It was headed by the Dutch physician Nicolaas Bidloo. The historian V. S. Delvig gives these dates and the contents of the decree in his study of the history of Moscow Hospital.

The state needed medical practitioners for the army and navy. Russian military units had received medical care before Bidloo: historians of military medicine point to the school attached to the Apothecary Chancellery, which had operated since the mid-17th century. Moscow Hospital’s innovation was to establish a lasting combination of hospital care and formal teaching within a single institution. Students observed treatment on the wards and worked alongside medical staff, rather than learning their craft solely under an individual mentor.

Moscow Hospital was an institution of the Monastery Chancellery, which funded its construction, medicines and salaries. Its wards admitted servicemen and people of other ranks, while its school trained personnel for the army and navy. This arrangement explains why graduates of the Moscow institution came under Admiral Apraksin’s authority and were assessed by naval medical practitioners. The institution’s history on the Burdenko Hospital website confirms that it began admitting patients on 21 November 1707, Old Style, and that the school opened at the same time.

The first building was wooden. The traveller Cornelis de Bruijn described a ward divided into two sections, with an anatomy room between them. By his count, each half contained seven double beds, nine single beds in the middle and another ten double beds in the well-lit area. Upstairs were rooms for the physician, apothecary and surgeon; the pharmacy occupied three rooms, one reserved for herbs. Delvig cites this eyewitness account. It shows that the school was integrated into the hospital’s daily work: anatomy, nursing care and the preparation of medicines took place side by side, although the description of the building alone tells us nothing about each student’s progress.

In a report to the tsar, Bidloo summarised the hospital’s work in 1708–1712: it had admitted 1996 patients, of whom 1026, he stated, had been cured of serious and longstanding illnesses, while 142 remained at the time of writing. These figures convey the scale of the daily practical experience available to students. They cannot be treated as a modern measure of treatment effectiveness: there is no information about a consistent method of record-keeping, the severity of all cases or the criteria for recovery. These patients provided the students with continuous clinical experience.

Moscow Hospital’s patients were not limited to military personnel. A report from the Monastery Chancellery to the Senate Chancellery, cited by Delvig, mentions dragoons, soldiers and people of other ranks referred for treatment by various institutions. Students worked with patients, but the document does not link particular cases to Blazhenev or Belyayev. The range of patients helps us understand the conditions in which they trained, rather than assess the skills of these two graduates.

What were future medical practitioners taught?

The curriculum combined anatomy, surgery, internal medicine and ‘materia medica’ — knowledge of medicinal substances. According to Delvig’s account, students attended patient examinations, ward rounds and operations in the morning, helping with dressings and nursing care; classroom lessons followed. An anatomical theatre was used for practical training, and in 1710 Bidloo compiled a handwritten surgical manual. Working with patients and studying the structure of the body formed part of a single programme of training.

The school trained medical practitioners and assistant medical practitioners for practical service, without awarding the university degree of Doctor of Medicine. The names of these ranks matter in this episode: after Bidloo’s intervention, the two graduates were specifically granted the rank of assistant medical practitioner and the right to practise. Their training in Moscow and their subsequent naval appointments were separate administrative processes.

A day of clinical training involved more than observing Bidloo. According to V. G. Abashin’s research, all the hospital’s medical staff took part in teaching: the chief physician gave lectures and led ward rounds, while his colleagues demonstrated dressings, nursing care and operations. The 1710 staffing schedule, cited by Delvig, provided for one physician, one medical practitioner, an apothecary, an assistant apothecary and an assistant medical practitioner, alongside 50 student places. Medical staff combined treatment with teaching, and the range of practical cases depended on the patients admitted to the hospital. The studies consulted do not say which operations Blazhenev and Belyayev personally performed before graduating.

Abashin clarifies how teaching duties were allocated: when the senior physician was absent, lectures and ward rounds were led by the medical practitioner, and later by the chief medical practitioner. Subsequently, the school’s graduate Fyodor Bogdanov spent almost thirty years showing students how to apply bandages. He completed his training in 1715, after Blazhenev and Belyayev’s dispute in St Petersburg. This later example shows that former students became teachers themselves, but does not identify the mentors of the two men who sat the examination.

Surgery was the main focus of the training. Anatomy was studied using illustrations, a skeleton and specimens; classes also took place in the dissection room. In his handwritten ‘Manual for Students of Surgery in the Anatomical Theatre’, Bidloo set out in 1710 the methods a future medical practitioner would need. Abashin lists sections in the manuscript on wounds, fractures, dislocations and amputations. Mirsky’s study in a journal of medical history emphasises the equal importance of theory and practice in the school’s founding vision.

A review of the published Russian translation of the ‘Manual’ reveals what Bidloo himself meant by ‘surgery’. The manuscript’s four parts covered general principles, operations by region of the body, the treatment of diseases and indexes. In describing procedures, the author discussed indications, contraindications, instruments, dressing materials and medicines. The review in the ‘Kazan Medical Journal’ shows that Bidloo’s curriculum cannot be reduced to the ability to apply a bandage: he taught students to choose an appropriate method of treatment and explain it.

Compiled in 1710, the ‘Manual’ was not a printed textbook available to every student. Students took notes from dictation, while Bidloo’s work itself was written in Latin. A Russian translation was not published until 1979; the hospital’s history states that the manuscript is held in the library of the Military Medical Academy. The existence of this teaching text therefore reveals the curriculum’s content and ambition, but does not prove that every graduate mastered all its chapters equally well.

Abashin counts 129 chapters and eight indexes in the ‘Manual’. Its scale shows the breadth of Bidloo’s vision, but cannot replace evidence of how an individual graduate answered examination questions. The excerpts published by researchers contain no list of the tasks set or procedures performed by Blazhenev and Belyayev.

Medicines were covered in a separate part of the curriculum. The hospital had a pharmacy, and in 1710 an apothecary’s garden and a botanical garden were established to grow medicinal plants. According to Delvig, this subject was taught by the apothecaries Christian Eichler and later Ivan Maak. Working with plants did not amount to knowing every medicinal preparation: students needed to identify raw ingredients and understand how remedies were prepared and used. This is why the commission’s later criticism concerning ‘medicines’ deserves separate consideration, rather than being lost amid praise for surgical skills.

Latin was needed to study medical texts, and Bidloo sought recruits with language training at the Slavic-Greek-Latin Academy and religious schools. Delvig lists students from the lower clergy and the children of soldiers and Cossacks; for some newcomers, mastering Latin presented an additional challenge. Bidloo had not recruited fully trained doctors. The length of study depended on when a student enrolled and when he became capable of passing the examination; Delvig also records training that lasted many years. The 50 places specified in the decree therefore cannot be read as a promise to produce 50 medical practitioners every year. The five-year interval between the school’s opening and the dispatch of trained specialists is explained by the gradual admission of students and the lengthy course of study.

The considerable gap between intake and the first graduating class is evident in Bidloo’s own report. Of the 50 students admitted in different years, 33 remained by 1712; six had died, eight had run away, the fate of another two was recorded as ‘taken into the school by decree’, and one had been sent to serve as a soldier. The document reveals the difficulty of retaining students, but does not justify treating every escape as a rejection of the teaching because of its quality. We have the final figures and Bidloo’s explanation; the report does not examine the motives of each person who left.

Which of the first graduates went to serve with the Baltic Fleet?

Stepan Blazhenev and Ivan Belyayev were among the hospital school’s first graduates. Delvig records their appointments to the Baltic Fleet. A study by I. V. Karpenko, made available by Sechenov University, confirms that two members of the first graduating class went to serve with the navy, and that subsequent cohorts also joined its medical service.

Simonenko, Abashin and Alexandrov compared extracts from archival documents from 1712. An entry dated 19 May 1712 names Stefan Blazhennoy, Yegor Shchukin and Ivan Belyayev. Another register from the same day names Yegor Zhukov instead of Shchukin. The researchers believe these refer to a single graduate whose surname appears in two forms. This is a matter of comparing documentary evidence, rather than adding two more people to the list.

The extracts published by Simonenko and his co-authors state that on 19 May the students were sent to St Petersburg ‘to the Senate Chancellery’. The May register does not contain the June assessment of their knowledge. The graduates’ transfer by official order, Blazhenev and Belyayev’s assignment to the navy and their second examination should be read as successive events, rather than as a single record of fully qualified naval medical practitioners.

The same publication explains the count of ‘three or four’. The May list contains three students. Ivan Orlov graduated later and was sent to Arkhangelsk Governorate on 18 December 1712 to treat recruits. Counting only the May graduating class gives three; counting the whole of 1712 gives four. Blazhenev and Belyayev went to St Petersburg for the examination described here, so the difference between the monthly and annual counts does not change who sat it.

Subsequent postings show that the school’s ties with the Baltic Fleet continued after the two graduates’ failure. According to documents cited by Abashin, six students graduated on 28 April 1713 and twelve on 12 March 1714. Karpenko notes that all six graduates of 1713 were sent to serve as assistant medical practitioners with the Baltic Fleet; the next group was assigned there too. This evidence does not allow us to revise the commission’s assessment of 1712 retrospectively, but helps us gauge the scale of the school’s work across its first three graduating classes.

Why did a diploma from the Moscow school not mark the end of the assessment?

The graduation examination at the hospital school in Moscow was not the final assessment Blazhenev and Belyaev faced before entering naval service. In St Petersburg, four foreign physicians examined them again, according to Delvig. The naval authorities assessed graduates already assigned to them through their own examining board; there is no evidence that this procedure was compulsory for every medical practitioner who arrived.

The Moscow assessment preceded their appointment. The authors of a study in the Bulletin of the Russian Military Medical Academy describe the graduation examination as a public assessment held whenever a group of students was ready. Bidloo kept students in training until he was confident they could work independently, even though he received payment for every physician or assistant physician who graduated. Blazhenev and Belyaev thus arrived in St Petersburg after graduating in Moscow, where their training had already been assessed.

The navy needed medical personnel, and its medical service already had its own leadership. The study by Simonenko and colleagues cites an order of 1707 requiring the physician Yan Goviy to supervise naval physicians, students and patients, and to report to Apraksin. N. V. Milasheva, V. A. Ovchinnikov and A. I. Samoylov found the names of 27 students attached to the naval medical service in St Petersburg in archival lists for 1710. They also cite a decree of 1713 that again placed the naval infirmary, physicians and students under Goviy's supervision. The newcomers from Moscow entered an established organisation in which the allocation of duties and recognition of rank depended on the Admiralty authorities. This separate administration helps explain why the Moscow certificate did not complete the appointment process for these graduates.

The arrangements involved both money and service rank. According to the archival information presented by Abashin, the Senate ordered that Blazhenev and Belyaev receive relocation allowances funded by the Monastery Chancellery, which maintained the Moscow hospital. Funding the move and recognising their qualifications remained separate matters: the naval board could assess the new arrivals after the state had already decided to send them to St Petersburg. A second examination was therefore consistent with their official assignment; the dispute arose at the next stage, when they sought permission to practise.

The St Petersburg examining board did not work at the Moscow school and represented the naval medical community. The date of its assessment, its membership and its brief conclusion, reproduced by researchers, are known; the publications available do not contain a complete set of questions and answers. It cannot be stated with certainty that such an examination was formally compulsory for everyone assigned to the navy, but there are also no grounds for treating it as entirely fictitious. What is firmly established is that Blazhenev and Belyaev were examined and that the result was disputed.

What did the St Petersburg examination reveal?

On 12 June 1712, the St Petersburg examining board judged Blazhenev's and Belyaev's knowledge insufficient. The researchers Simonenko, Abashin and Alexandrov quote its brief conclusion; Delvig writes that the graduates effectively failed the examination. In February of the same year, Bidloo had recommended his best students to Peter I, praising their knowledge of diseases and treatment. The school head's letter preceded graduation, while the St Petersburg physicians were judging two specific individuals.

According to the publication by Simonenko and colleagues, four foreign physicians served on the board, one of them in absentia. The source does not explain how the absent physician assessed the graduates. Its conclusion therefore cannot be treated as the result of four physicians personally observing their work.

The physicians tested several areas of knowledge. Simonenko, Abashin and Alexandrov quote the assessment: ‘they knew little anatomy and theory, and nothing of practice or medicines’. At the same time, the examiners allowed that the young men could improve their surgical skills. This twofold assessment matters more than the word ‘failure’: it recorded the weaknesses the board had identified while leaving open the prospect of professional development.

The comment about medicines is particularly interesting in light of the Moscow hospital's facilities. It had a pharmacy and a medicinal garden, and staff apothecaries taught ‘materia medica’. The curriculum confirms that this subject was taught, but tells us nothing about how Blazhenev and Belyaev actually answered questions about medicines. The pharmacy's operation does not refute the examiners' comments about the two graduates; equally, their assessment does not establish the quality of the Moscow course as a whole.

The question of practical skills is equally nuanced. Bidloo described wound dressing and patient treatment, and researchers confirm the school's surgical focus. Yet taking part in ward rounds and watching an operation are not the same as independently performing a complex procedure. The available extracts do not reveal which practical tasks Blazhenev and Belyaev demonstrated to the examiners. The curriculum and the board's brief conclusion therefore do not provide a complete picture of each graduate's skills.

Bidloo's report to Peter dates from February 1712, before the June examination. In it, the doctor did more than praise his students: he noted that the hospital housed between one hundred and two hundred patients each day and that students were learning to dress wounds. S. M. Solovyov reproduced this text in ‘History of Russia from the Earliest Times’. This account is valuable because it was written before the dispute in St Petersburg; at the same time, Bidloo was addressing the tsar as the head of a school with an interest in securing confidence in his work.

The most significant limitation of the St Petersburg evidence is the absence of a published full record of the examination with each candidate's answers. We have the date, the board's membership and fragments of its conclusion in researchers' works. It is therefore impossible to establish whether the two graduates answered equally well, what tasks each examiner set, or why the absent member agreed with the assessment. These gaps prevent us from either upholding or overturning the examination result with the precision of a modern independent review.

Bidloo observed the students' work in the hospital while also bearing responsibility for his school's reputation. His report therefore describes their daily training, but does not provide an independent assessment of Blazhenev's and Belyaev's knowledge in the June examination.

Can the examining board's bias be proved?

Bias on the part of the four St Petersburg examiners cannot be proved: Bidloo's complaint is known, but there is no full record of the examination. In a letter to Peter I quoted by Delvig, the school head complained that foreign surgeons were obstructing the training of Russian students and expressed concern that graduates would be kept in the position of servants. The complaint explains Bidloo's position, but does not reveal the motives of each board member.

The context supports a cautious interpretation: foreign specialists held a substantial proportion of medical posts, and the arrival of graduates from the new school changed established recruitment and promotion practices. Historians A. A. Budko and N. Yu. Brinyuk describe this reliance on foreign specialists in an article on military medicine under Peter I. However, a general conflict of interest tells us nothing about the specific incorrect answers Blazhenev and Belyaev may have given. The likelihood of bias and the possibility of genuine gaps in knowledge are not mutually exclusive.

Bidloo himself was Dutch and a graduate of Leiden University: a physician's origins alone did not determine his position in the dispute over the Moscow school. He argued with some physicians already serving in the navy over his students' admission to practice. His complaint describes a professional dispute; it cannot establish whether each of the board's conclusions was fair.

Evidence concerning the third graduating class helps test the idea that foreign physicians held a common position. Abashin reports that these students' knowledge was assessed by a board that included Chief Physician Robert Erskine, Dr Georgy Dimaki and Staff Physician Yagoviy; the board judged their training ‘very good indeed’. This was a different group and a different assessment, so the positive outcome does not negate Blazhenev's and Belyaev's failure. It does, however, prevent us from portraying all foreign medical authorities as opponents of Bidloo's graduates.

The surviving evidence for the two assessments also differs in quality. For 1712, the authors of the study of naval medicine reproduce a brief negative assessment of the two candidates; according to Abashin, Bidloo's appeal of 1715 was accompanied by a certificate confirming that students from the third graduating class had passed their examination. The boards assessed different groups at different times. The later certificate supported Bidloo's argument about the fate of graduates in general, but did not constitute a review of Blazhenev's and Belyaev's individual answers.

The documents confirm the differing assessments and the school head's complaint. The inference of professional rivalry rests on his words, so it cannot be extended to the motives of each of the four examiners. At the same time, the board's brief negative conclusion remains a fact that the complaint alone does not overturn.

How did Blazhenev and Belyaev eventually enter service?

Bidloo appealed to Admiral-General Fyodor Matveyevich Apraksin, after which both graduates were accepted into the Baltic Fleet. Delvig reports this, citing an earlier study by M. F. Zlotnikov on the Moscow school's graduating classes. The appeal to the commander shows that the dispute had gone beyond a routine academic assessment: the issue was whether men trained in Moscow would be allowed to enter active service.

According to Abashin's more detailed account, Bidloo submitted a complaint to Apraksin on 27 June 1712 — fifteen days after the second examination. The doctor accused the admiral's subordinates of unfair treatment and defended his students' right to practise their profession. These dates link Bidloo's action specifically to the case of the first two graduates; his complaint cannot be applied to the events involving the third graduating class two years later.

Following the intervention, both were granted the rank of assistant physician and permission to practise. Simonenko and colleagues quote the wording ‘freedom to practise’. This is more specific than the vague statement that ‘they were accepted into service’: it concerned recognition of their professional status and the right to use the skills they had trained to acquire. The rank they received should be distinguished from a doctorate in medicine and should not be treated as evidence that they were deemed to have passed the second examination.

Less is known about Stepan Blazhenev's career than about the other graduate's service. Researchers of naval medicine note that in 1718 Ivan served in Nikita Repnin's division and under Mikhail Golitsyn, in 1720 he was transferred to Azov as regimental physician of the Troitsky Regiment, and in 1724 he worked with naval personnel in Novaya Ladoga. This does not prove that his answers in June 1712 were faultless; it shows that failure in one examination did not end his medical service.

When was the Senate's decision made?

The date of the general decision to protect graduates is unclear. Delvig dates the Senate resolution to 18 March 1714. E. R. Iskhakov and S. G. Aksenov, in an article on medical legislation under Peter I date the tsar's resolution to the same day in 1715; Abashin also gives 1715 as the year of the Senate ruling. Without comparing the journal entry and the resolution, it is impossible to say with confidence that these accounts refer to the same record or to establish an undisputed date.

Both proposed dates fall after the examination on 12 June and Bidloo’s complaint of 27 June 1712. However, a connection between the later ruling and the individual case of Blazhenev and Belyaev cannot be established solely on the basis of a shared subject: the texts also discuss the position of other graduates of the school. The June dispute and the broader defence of surgeons trained by Bidloo should therefore be considered separately.

The Senate’s resolution must be distinguished from the complaint of 1712. By the time measures were taken to protect the graduates as a whole, the school had produced further cohorts, and the dispute over the status of Russian surgeons had extended beyond the fate of Blazhenev and Belyaev. In Abashin’s account, the ruling protected the honour and career advancement of the practitioners trained by Bidloo. The decision concerned the school’s graduates as a whole, rather than just the two men who sat the examination in June 1712.

The resolution also included a financial provision: according to Abashin, Bidloo was promised one hundred roubles for every pupil who mastered surgery and passed an assessment. This promise linked the head of the school’s remuneration to the graduation of pupils who had passed the required assessment. It does not prove that Blazhenev and Belyaev received the highest mark in the St Petersburg examination; the Senate’s decision addressed a broader issue than their individual case.

What does this story tell us about the Moscow Hospital School?

By 1712, Bidloo’s school was already able to send graduates into service, but its diploma did not yet guarantee a smooth entry into the navy’s established medical community. The strength of the Moscow training lay in its combination of clinical practice, anatomy and surgery; the weakness of the early system of professional recognition was a young practitioner’s dependence on the judgement of colleagues at a new posting. The St Petersburg episode reveals the tension between these two circumstances more precisely than the general description of the institution as the ‘first medical school’.

Following Bidloo’s complaint, Blazhenev and Belyaev were granted the rank of assistant surgeon, and Belyaev remained in service until at least 1724. This documented career path of one graduate confirms that the setback in St Petersburg did not end his medical career. The studies consulted provide less information about Blazhenev’s subsequent service, so Belyaev’s biography cannot be assumed to apply to him.

Following these early efforts, the Moscow model was adopted elsewhere: Delvig and Karpenko note that in 1733 work began to establish schools modelled on it at the army and admiralty hospitals in St Petersburg and at the hospital in Kronstadt. This continuity shows that the approach to training survived the dispute of 1712. Information about these later institutions does not allow us to assess Blazhenev’s and Belyaev’s answers in the St Petersburg examination.

The meaning of the phrase ‘first medical school’ needs to be clarified. Before the Moscow hospital was established, pupils were trained under the Apothecary Chancery; historians of military medicine date this initiative to 1654. Bidloo’s hospital school stood out for its regular teaching and clinical work within a permanent hospital. This institutional innovation is highlighted in the Burdenko Hospital’s historical overview. Bidloo’s school sought recognition in a field where other methods of training and established medical posts already existed.

In Lefortovo, beyond the Yauza River, pupils learnt medicine in the wards of a working hospital. The route of the ‘Window to Europe’ tour of the German Quarter runs from Baumanskaya metro station to Gospitalny Val and helps place the site of the early hospital in the context of the district’s other institutions from Peter the Great’s era. The programme does not include entry to the historic interiors.

Sources

1. V. S. Delvig. The Place and Role of Moscow Hospital in the History of Medical Reform in Russia, 1707–1735.
2. I. V. Karpenko. The Institutionalisation of Military Medical Education in Russia, 1654–1936.
3. A. A. Budko, N. Yu. Brinyuk. Peter I’s Contribution to the Development of Russian Military Medicine
4. E. R. Iskhakov, S. G. Aksenov. State and Legal Regulation of Healthcare during the Reign of Peter I
5. V. B. Simonenko, V. G. Abashin, A. S. Alexandrov. The First Naval Physicians of the Imperial Russian Navy
6. V. G. Abashin. Dr Nikolai Bidloo — the First Head of Moscow Hospital and the Hospital School
7. N. N. Burdenko Main Military Clinical Hospital. History of the Hospital
8. S. M. Solovyov. History of Russia from the Earliest Times. Volume 16
9. M. B. Mirsky. Moscow Hospital School
10. Bulletin of the Russian Military Medical Academy. A Study of Early Hospital Schools, 2018
11. Kazan Medical Journal. Review of N. L. Bidloo’s Instructions for Students of Surgery in the Anatomical Theatre
12. Radius Tour Bureau. ‘Window to Europe’ Tour
13. N. V. Milasheva, D. V. Ovchinnikov, V. O. Samoylov. Robert Erskine — the First Chief Physician and Founder of Military Medicine and Military Medical Education in Russia