Two important developments, improved standards in the medical profession and the development of nursing as a profession, influenced health care in the nineteenth century.

In the 18th century, the community depended on military and naval surgeons who did some private practice. In the 19th century, the government introduced a number of statutes to standardize medical practice. In 1795, a statute to Regulate the Practice of Physic and Surgery was introduced in Upper Canada. Two examiners were appointed to determine an applicant's fitness to practice. In 1818, the Medical Board of Upper Canada was established. The Board included five examiners who met every three months to examine candidates with appropriate educational credentials and experience with a community physician. Finally, in 1866, the College of Physicians and Surgeons of Ontario was established. The Council of the College was given the authority to license medical practitioners and to regulate medical education.

At the beginning of the nineteenth century, medical education was either obtained overseas or as an apprentice to an established physician. The first medical school was opened in Toronto at Kings College in 1843. A medical faculty was established by Queen's College in 1854 with a close relationship to the hospital. A faculty member served as the daily visiting surgeon and supervised the senior students whose curriculum included 12 months of hospital practice. Although the organization varied, the Royal College of Physicians and Surgeons of Kingston was responsible for medical education between 1866 and 1880 and a separate medical school for women in Kingston operated from 1883 to 1895, medical education was a major commitment at Queen's and the Kingston General Hospital.

Religious orders for centuries had provided nursing services for the destitute and the sick. Anglican communities such as the Oxford Movement in the United Kingdom provided nursing for the sick poor. By 1864, 26 Sisterhoods were training and supplying nurses to hospitals. However frequent conflicts arose between the Sisters and the hospitals regarding nursing accountability.

There were no secular nursing training programs when Florence Nightingale with 38 nurses demonstrated the importance of nursing in the maintenance of sanitation and the prevention of suffering and ill health during the Crimean War. The Nightingale Fund established in 1856 in recognition of these services developed a relationship with the nursing training program at St. Thomas Hospital in London. Although this program had limited success, the principles advocated by Florence Nightingale were widely admired and contributed in a major way to the changing attitudes toward and the standards of practice of nursing.

The role and need for nursing services was highlighted during the American Civil War. There were 600,000 deaths, 200,000 due to casualties and 400,000 due to disease. The Army Medical Service was in its infancy but necessity required the rapid development of both general and field hospitals. In 1861, hundreds of woman responded to the call for volunteers. Initially, these women had no experience and little training. However the nurses changed the atmosphere in the hospitals creating order and contributing to sanitation, nutrition and systematic treatment. By the end of the Civil War, nursing was recognized as a respectable profession for women.

Hospitals began to open nursing schools. In 1885, Dr. Fenwick recommended to the Board that a nursing school should be established at the Kingston General Hospital. He said: "it is only those who have had the services of a thoroughly trained nurse during a severe illness that can appreciate their value and how suffering can be mitigated and even life prolonged."

The nursing school began in 1886, providing a two-year training program leading to a diploma.

The increasing number of well-trained professionals were a major factor leading to improved standards of care and to the introduction of new methods of diagnosis and treatment in the hospital.

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