Prior to 1820, to meet the requirements of London's College of Surgeons, students would spend time in London and select courses of instruction in surgery by teachers at Guy's Hospital, St Thomas' - together known as London's Borough Hospitals - and as well as attend anatomy classes at private institutions such as William Hunter's anatomy school, attached for a time to Middlesex Hospital. Although at this time some students of surgery had already acquired the M.D. (or its equivalent) qualification, it was not until the 1830s that students of surgery were required to have obtained a medical degree at a university before commencing studies for membership of the Royal College of Surgeons. By the 1830s, medical schools in London at the University of London, St George's Hospital and King's College, London had been established and the influence of the private schools was diminished.