In the 18th and early 19th centuries, the St Andrews MD was awarded on the basis of testimonials from other physicians. Edward Jenner (1749–1823, MD 1792), creator of the smallpox vaccine, is perhaps the most famous St Andrews alumnus to receive an MD by recommendation.

From the 1830s, candidates could also receive an MD by examination, provided they had sufficient proof of medical training and education. This became a popular way for non-European practitioners to gain accreditation in Britain.

In 1856, Rustomjee Byramjee (1833–1913) became the first graduate of St Andrews from a non-European background.

Born in India, Byramjee passed his MD examination at St Andrews in 1856. He joined the Indian Medical Service as assistant surgeon in 1857. He was one of only three Indians admitted to the Indian Medical Service during the East India Company’s rule, and the only stationed in Bombay. He served as superintendent of vaccinations in the Northern Circle and became Surgeon-Major in 1873.

In 1858, William Broughton Davies (1833–1906) became the first west African to qualify as a medical doctor in Britain.

Born in Sierra Leone, Davies was recruited by the War Office to study medicine and serve in the colonial armed forces. After taking courses at King’s College London, he passed his MD examination at St Andrews in 1858. He served in the African Medical Service for the remainder of his career and was appointed Surgeon-Major in 1875.

Rustomjee Byramjee’s and William Broughton Davies’ name in the minutes of Senatus Academicus, reporting the examinations and confirmation of degrees (UYUY452/17), and their signatures in register of medical candidates for examination (UYUY355/2). Courtesy of University of St Andrews Libraries and Museums.

The new offer of the MBChB degree from 1897 displaced the MD as the primary degree for medical practice.

Byramjee and Davies represent the diversity of MD alumni, however, their medical education in Britain was directly correlated to serving under a repressive colonial regime.