The merger of the medical schools of four London teaching hospitals with the Imperial College of Science, Technology and Medicine will create one of the biggest academic medical institutions in the country with more than 1,000 students and 300 staff.
However, the new Imperial College Medical School will also mark the end of an era for the training of doctors in London as portrayed by the tribally loyal, mascot-waving, rugby playing medics in the fictional Doctor in the House classics.
Medical students fear the new hi-tech "multi-faculty institution" will kill the historic culture and traditions of medical education and extra-curricula activities which are unique to the London teaching hospitals.
At the same time science and engineering students and staff at Imperial College fear the new emphasis on medicine could down-grade their international reputation for pure scientific endeavour, research and technological developments.
But the Government's plans for the wider reorganisation of hospitals in London mean the rationalisation of the medical schools is inevitable. And in future all the medical schools will be merged into four larger University of London institutions.
Last month the governing bodies of three medical institutions in west London agreed in principle to merge with Imperial College - these are the the Royal Postgraduate Medical School at the Hammersmith hospital,Charing Cross and Westminster Medical School, and the National Heart and Lung Institute at the Royal Brompton hospital. St Mary's hospital Medical School merged with Imperial College in 1988 but still retained most teaching.
A site for the new college has been earmarked in the heart of the Imperial College campus and, assuming the Government agrees funding, building work would start this summer with the first student intake in September 1998. It will be the academic hub of pre-clinical teaching for undergraduate medical students from St Mary's and Charing Cross and Westminster for their first two years, and be the centre for bio-medical sciences and research. The students will return to hospitals for clinical training for three years.
The teaching of postgraduate students from the Royal Postgraduate Medical School and the National Heart And Lung Institute will stay at the respective hospitals but there will be more joint use of facilities with Imperial College. Discussions to join theenterprise are continuing with the Institute for Cancer Research, at the Royal Marsden hospital.
Sir Ronald Oxburgh, Rector of Imperial College, is confident of government funding. About £25m would be needed from the Higher Education Funding Council for England and about £25m from the Department of Health with the Board of Imperial College finding about £10m. He said the funding council had been "very supportive" and was expected to make a final decision soon.
Sir Ronald told the Independent there had been much heart searching by all the institutions, which would inevitably lose some independence. But, he said, "the next generation of doctors will have to be educated in a way that they are not afraid of technology. Medical technology is burgeoning and doctors will have to be comfortable with it".
Professor Brian Jarman, of the department of general practice at St Mary's, agreed. "The scientific discipline of thought will be very helpful in medicine, especially when making decisions on how to evaluate the effectiveness of treatments and ration limited resources."
Many students are bitterly opposed. In a recent letter to the University of London medical faculty committee the students representative wrote: "Students choose to study medicine in London based on excellent academic standards and the extensive range of extra curricula activities available. It is vital to ensure the survival of the established tradition of medical student life in London."
Marc Swan, former president of St Mary's Medical School Students Union, now chairman of the University of London Medical Students Group, said: "As our medical schools merge into multi-faculty institutions college authorities seem intent on steamrolleringthe special needs and interests of medics with seemingly little regard for our unique history and rich traditions of academic and extra curricula excellence. We are in grave danger of losing the ability of London to attract the very best students . . .''
Professor Peter Richards, Dean of St Mary's Medical School, is also rueful about the changes. "The traditional loyalties to individual medical schools will inevitably decline. There will be an institutional ethos cost and the merger will cause shockwavesat Imperial College, but on balance there is enormous potential."