1. GCSE History Master class Medicine Paper

2. Time = 1 hour 15 mins
Q1 = 8 marks
Q2 = 6 marks
Q3 = 8 marks
Q4 & Q5 = 12 marks each
Q6 & Q7 =16 marks each

3. the beliefs about the causes of disease?
1) Study sources A and B below.
What do Sources A and B show about the changes in
the beliefs about the causes of disease?
Explain your answer using Sources A and B and your
own knowledge. (8 marks)
Source A – Flagellants whipping Source B – Hand wash at
themselves so they wouldn’t entrance of a 21st century
catch the Black Death hospital ward.

4. Level 1 (1- 2 marks) – Simple statements
Level 2 (3 – 6 marks) - Developed statements
Statements made about change with support based on detail from the sources and/or own knowledge.
Maximum of 4 marks if only use sources or own knowledge.
Level 3 (7 – 8 marks) - Analysis
Inferences are made about the nature or extent of change based on the use of both sources and own knowledge.

5. Question Two (6 marks)
The boxes below show two different time periods.
Choose one and describe the key features of medical training during the period.
The Later Middle The nineteenth
Ages Century.

6. Mark scheme Level 1 – (1 – 3 marks) General answer.
Limited or very little details included.
Level 2 – (4 – 6 marks) Key features described.
Precise and relevant details with links to key features.

7. Medical Training - Activity
Pick which time period you want to do in your pairs.
Think – on your own – 2 mins
Pair – discuss together – 2 mins
Share – discuss as a group / table – 2 mins.
Feedback to rest of class

8. Medical training in later Middle Ages
Qualifications needed to be a doctor
In C12th specific courses on medicine available
In C13th doctors had to prove they had several years of medical study before being allowed to practice
Medical training at medical schools eg Salerno or at Padua university, lasting 10 years before introduction of specific medical degree
Doctors practiced on the job with an experienced doctor, like an apprenticeship.

9. Medical Training in the C19th.
Theory-based training from books, usually written by doctors and done at a university.
Some practical work and observations done in teaching hospitals.
Use of microscopes and labs later on to understand more about illnesses.
Students carried out own dissections to learn more about human anatomy.
Proper training for nurses after work of Florence Nightingale eg keeping hospital wards and patients wounds clean.

10. Question 3 –How useful is this cartoon to a historian who is investigating the fight against infectious diseases in the C19th? Use Source C and your own knowledge to explain your answer. (8 marks)
A cartoon showing
Koch in the 1880s
slaying the TB germ,
from a school
textbook.

11. Level 1 – (1 – 2 marks) Judgement based on simple criteria.
Level 2 – (3 – 6 marks) Judgement based on the usefulness of the source because of the content OR the provenance (where it comes from).
Maximum of 4 marks if answer is based only on the source or on own knowledge.
Level 3 – (7 - 8 marks) Judgement based on the usefulness of the source because of the content AND the provenance (where it comes from).
Use both the source AND your own knowledge.

12. Content:
Useful - shows Robert Koch defeating the TB germ (shown as a ‘dragon’ and him as St. George), 2nd step towards finding cures.
1st step = proving germs float in air/cause diseases (Pasteur) OK used
Picture shows the equipment he used to do this eg microscope in his hand instead of a sword; he looks like an ordinary doctor (no elaborate clothing/armour); investigation used to identify germ – tested against your own knowledge.
Not useful as only shows 1 germ being identified, not any others and hasn’t yet produced any cures for infectious diseases. OK used
Provenance:
Useful – a cartoon but visual to show Koch as a hero, he is the slayer of the TB germ just like St. George slaying the dragon, showing people’s ideas that this breakthrough was very significant
Produced in a textbook on medicine – fully researched, factual, symbolism in cartoon chosen deliberately
Produced at the time (TB germ identified in 1878).

13. Question 4 (12 marks)
Why did it take so long for penicillin to be produced in Britain on a large scale?
You may use the following in your answer:
Alexander Fleming
Howard Florey and Ernst Chain
You must include information of your own.

14. Mark Scheme Level 1 (1 – 4 marks) Simple generalised comments
Level 2 (5 – 8 marks) Developed statements with relevant support from own knowledge
Level 3 (9 – 12 marks) Clear focus on the question with relevant support from own knowledge

15. Level 2 (5 – 8 marks) Developed statements with relevant support from own knowledge
Student offers relevant detail mainly describing the work of Fleming or of Florey and Chain.
EG Describes Fleming’s discovery of penicillin or the work of Florey and Chain
OR Describes the failure of Fleming’s attempt to get funding and the availability of government funding during WW2

16. Level 3 (9 – 12 marks) Clear focus on the question with relevant support from own knowledge
The response shows understanding of the focus of the question and deploys sufficient accurate and relevant material to support the points the student makes.
EG Explains why Fleming did not develop penicillin and the factors inhibiting its mass production.
AND Explains the factors leading to Florey and Chain’s success by giving the combination of factors which made it possible for penicillin to be mass produced during WW2.

17. Question 5 – 12 marks
Why have science and technology been so important in improving medical understanding of illness since 1850?
You may use the following in your answer:
Louis Pasteur published his Germ Theory in 1861
Crick and Watson discovered the structure of DNA in 1953
You must include information of your own.

18. Activity
Step 1 - Match up the discoveries since 1850 with the correct discoverer.
Step 2 – Draw a timeline on the sugar paper from 1850 to 1960.
Step 3 - Place these onto the timeline in the correct chronological order.
Step 4 – Write down the scientific/technological advances which helped each discovery. You can use the list of examples given.
Step 5 – Give a few sentences of explanation of how these examples have helped improve medical understanding of illness.

19. Level 1 (1 – 4 marks) Simple generalised comments
Level 2 (5 – 8 marks) Developed statements with relevant support from own knowledge
Level 3 (9 – 12 marks) Clear focus on the question with relevant support from own knowledge

20. Level 2 (5 – 8 marks) Developed statements with relevant support from own knowledge
Student offers relevant detail about an example of science /technology linked to medicine
Eg describes Pasteur’s work on the germ theory and relates it to medicine in general terms.
Germ theory explained as a scientific development, disproving the theory of spontaneous generation, and so improving scientific understanding of the cause of disease. Improvements in microscopes in the work of
Pasteur and Koch in identifying individual microbes and in Franklin’s photograph of the DNA double helix.

21. Level 3 (9 – 12 marks) Clear focus on the question with relevant support from own knowledge
The response shows understanding of the focus of the question and deploys sufficient accurate and relevant material to support the points the student makes.
Answer shows how scientific /technological advances since 1850 have improved understanding of illness.
Eg Pasteur’s work leading to the identification of different
germs for specific diseases; X Rays/CAT/MRI/ ultrasound scans helping to identify internal problems not just broken bones; improvements in microscopes leading to work by Koch or Crick and Watson; DNA discovery leading to a better understanding of genetic illness.

22. medicine and public health’. How far do you agree with this
6 – ‘The Roman withdrawal from Britain was a turning point in
medicine and public health’. How far do you agree with this
statement? Explain your answer. (16 marks)
Step 1 – What is meant by a ‘turning point?’
Step 2 – Key terms of ‘stagnation’, ‘progression’, ‘regression’.
Step 3 – List the main ideas about public health, care of the sick and the ideas
about the causes and cures of diseases in both Roman times and Medieval times.
You can create a table like the one below.
Causes
Cures
Public Health
Care of the Sick
Roman times
Medieval times
Stagnation?
Progression?
Regression?

23. Step 4 - Colour code those that show stagnation, progression and regression.
Step 5 – Assess whether or not each section is a turning point (these will be your main paragraphs and should refer back to the question each time).
Step 6 – Overall assessment of a ‘turning point’ based on your analysis.
NB There is a sample answer to this question on the school website – June 2012 ‘Turning point’.

24. Describes the decay of public health structures;
Level 2 (5 -8 marks) - Statements are developed with support from material which is mostly relevant and accurate.
Answer offers information about the Roman contribution to medicine and public health and/or information about medicine in the Middle Ages/Medieval period.
E.G. describes treatment during Roman and /or the Middle Ages/Medieval period – Theory of Opposites, herbal or folk remedies;
Describes the decay of public health structures;
Describes medical knowledge and training.
Peg at 6 answers which only cover Galen’s ideas

25. Level 3 ( marks) - Answer shows understanding of the focus of the question and deploys sufficient accurate and relevant material to support the points made.
Answer identifies and explains examples of change and/or
continuity in order to analyse the effects of the Roman
withdrawal.
E.G. explains continuity in treatment based on Galen’s theories was because medical training was based on Galen;
Shows the collapse of some aspects of public health / medicine;
Shows change in the people or institutions providing care and treatment.

26. Level 4 (13 – 16 marks) A sustained analysis is supported by precisely selected and accurate material and with sharply focused development of points made. The answer as a whole will focus well on the question.
Answer evaluates nature/extent of change (agrees that it was a turning point) and continuity (disagrees that it was a turning point) in order to reach a judgement.
E.G. answer will cover a range of material on both change and continuity in order to weigh the significance of the Roman withdrawal.
Reserve top of level for answers covering both medicine and public health.

27. Able students could identify elements of continuity in medicine which led them to evaluate the extent to which the Roman withdrawal was an overall turning point. In most cases the opinion was that there was a decline in the infrastructure of public health, but continuity and stagnation in medicine through the preservation of Galen’s texts, or even progress in some areas and therefore the Roman withdrawal was not completely a turning point. It was interesting to see that a small number of candidates queried the allegedly high standard of Roman public health and pointed out that the standard of public health in villas was not typical of the general standard, or that public baths often contained unhealthy bacteria – this was then used to challenge the idea of decline and turning point in public health. Other points used to good effect were that Roman hospitals were only for the army, not the public; that the Church developed organised training and care during the Middle Ages; that hygiene in monasteries and the use of medieval stewes meant that cleanliness did not decline completely; that people living in villages were largely unaffected by the Roman withdrawal; and that responsibility for care within the home passed from the father to the mother.
Change = RED Continuity = GREEN (From the Examiner’s Report)

28. Question 7
“Discoveries made during the Renaissance made little practical difference to medical treatments between 1500 and 1750.” How far do you agree with this statement? (16 marks)
Medical treatments
William Harvey

29. Describes the discoveries made by Vesalius and Harvey
Level 2 (5 -8 marks) - Statements are developed with support from material which is mostly relevant and accurate.
Describes the discoveries made by Vesalius and Harvey
Describes new developments such as a better understanding of human anatomy
Describes the improvements in technology eg printing press, microscopes
Describes the treatments and medical training available, based on the work of Galen and the continued importance of the theory of the 4 humours.

30. Level 3 ( marks) - Answer shows understanding of the focus of the question and deploys sufficient accurate and relevant material to support the points made.
Explains how the discoveries related to developments in anatomical/physiological knowledge and not the understanding of illnesses or treatments
Explains that the influence of the Church on education and medical training meant it only used Galen’s ideas and doctors/medical students weren’t encouraged to deviate from accepted practice

31. Medical knowledge advanced but not important until years later
Level 4 (13 – 16 marks) A sustained analysis is supported by precisely selected and accurate material and with sharply focused development of points made. The answer as a whole will focus well on the question.
Explains that the discoveries were both a breakthrough and a ‘dead end’
Limited or no impact on medical treatments as discoveries didn’t help anyone get better
Needed work of Pasteur and germs for advances in causes of disease and then cures
Medical knowledge advanced but not important until years later
Evaluates importance of proving Galen wrong

32. Questions 6 and 7 – key features
Evaluates nature (type) and extent of change.
Focus on question throughout.
Detailed knowledge
Clearly structured, giving a balanced argument, both sides needed.
Range of examples.

33. There are sample answers to Qs 6 and 7 on the website, along with other sample answers to 16 mark questions.

34. WHERE TO GO FOR EXAM INFO
Your own notes (exercise books, revision notes)
VTLE (My Courses – GCSE Medicine) here you will find a copy of the textbook, videos, power points, mindmaps, revision sheets and quizzes.
Student Shared area – Departments –History – GCSE
History website – GCSE – Medicine – here you will find sample answers to past questions, including the ‘mock’ exam in January, knowledge tests (with answers to test yourself) and podcasts.
history.ossettacademy .com