Banting then pursued more surgical training at the Hospital for Sick Children in Toronto in 1919-1920. He was in a position similar to the position that George Minot had at MGH in Boston, immediately after graduating from Harvard Medical School. Although George Minot’s responsibilities were more general and Fred’s responsibilities were focused on surgery. The position was limited to one year when his training would end, a new man would take over, and he would move on to a permanent position.
At the Hospital for Sick Children, he performed hundreds of operations and assisted on even more. Since it was a children’s hospital his surgeries tended to be typical of that age group: removing tonsils was probably the most frequent surgery, but he also repaired cleft palates, removed appendices, and treated birth deformities. The hospital was a hotbed of surgical activity and many bright young surgeons had passed through the training program.
Fred was excited to begin a career as an innovative surgeon. A century before, surgery was considered a craft more than a profession; it was performed by the same man who cut hair. However, with the modernization of medicine, surgery became a profession and required knowledge of physiology and anatomy. Surgeons were inventing new procedures all the time, and Fred envisioned a career as one of these new innovative surgeons. He thought that after the training period ended, he would secure a position as a staff surgeon at Children’s Hospital and work to that goal.
However, in the summer of 1920 when his training period ended, there were no opportunities at Children’s Hospital or any of the other Toronto Hospitals. Fred had no one to arrange a position for him. His family had no connections. He was on his own.
For comparison, when George Minot’s training ended at MGH, he had Dr Edsall, the head of MGH, write a letter of introduction for him to Dr. William Thayer, a leading physician in Baltimore at Johns Hopkins University. When Dr Thayer got the letter, it was not the first he heard of a Minot. He already knew George’s father, who was a prominent physician in Boston and George’s cousin, Charles Minot Sedgwick who was a Professor at Harvard Medical School.
George Minot had the connections because he was born with them. His family was full of physicians and professors. Fred Banting did not. He was a farm boy, his family were all farmers who never finished high school. Without these connections, Fred’s dreams of becoming a leading surgeon and inventing new surgical techniques came crashing down.
Instead of working as a pioneering surgeon at a big city hospital, he moved to London Ontario and opened a solo general practitioner’s office. His practice suffered from his lack of professional connections. He didn’t know any other physicians in London who could refer patients to him. Professional rules in effect at the time prohibited advertising. He simply put up a sign signifying a physician’s office, unlocked the door, and waited.