During the second half of the 18th century demands as to the competence and expertise of regional medical staff, both physicians and surgeons increased. A broad range of activities alongside a high degree of responsibility, which they shouldered, came hand in hand with growing demands for their professional development. In the second half of the 18th century, similar to other medical personnel, a standardised curriculum for study and expertise was established for regional health officers, also. Thus, increasing and clearly defined requirements in terms of knowledge and ability had transformed the profile of a suitable medical candidate. These changes are, understandably, evident in the different patterns of expertise shown down through several generations, which can be wholly and comprehensively documented. The idea of 'a modern profession' is further demonstrated by the fact that as early as the beginning of the 19th century salaries became standardised and from the 1780s regional medical personnel were entitled to similarly 'standardised' pensions, whose levels corresponded to the number of years of service. Even though their salaries undoubtedly lagged behind the salaries of other higher officials of the regional government for a long time to come, these posts were, without doubt, highly sought and prestigious, which is also shown in the ever increasing numbers of candidates for posts on regional public health boards. Particular attention was especially paid to public competition for posts of regional medical personnel. The Faculty's expert recommendation for someone as suitable for a post was matched against the view of the Land Committee, which paid for medical personnel; in addition, the opinion of the Land protomedicus was also important (and it seems that the opinion of the Governor's Office was not ignored either, yet its role cannot be, at present, fully understood on the basis of original documents researched). Although, it was possible to grant some exceptions in terms of required competences at the beginning (for example, allowing the required certification to be gained later), after 1800, when the numbers of competent candidates for these civil service posts increased, these exceptions became rarer. However, the link to the region continued to play a significant role. The posts of regional physicians from Joseph II's era were occupied by men who were relatively young, aged 30-40, thus on average 5-10 years after their graduation (in some exceptional cases, positions were even given to candidates who were junior in terms of service, about three years after the completion of their studies). Unless they failed in their duties, they usually remained in office until their retirement, or - as with the majority of them - until their death. Although the post of a regional physician/surgeon represented the peak of a career in its own right, some regional medical personnel considered it more beneficial and prestigious to be transferred to the municipal health board in the capital city of Prague. However, there were only a few who succeeded in culminating their career in a goal higher than that - namely, acquiring a professorial position at the university, or even becoming head of the Czech medical administration - a protomedicus. In any case, we might perhaps claim that in the last decades of the 18th century and at the threshold of the 19th century regional physicians and surgeons did confirm their status as a real 'new elite' amongst medical personnel: being equipped with new authority, competences and obligations, they carried on their shoulders a growing responsibility for the medical and sanitary situation in their entire region. In addition, they gradually became integrated in the state administration, indeed, civil servants in a regional office.
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