In early colonial Australia, medical apprenticeship was a primary pathway to practising medicine. Those chosen entered the world of medicine not through lecture halls and university campuses, but through a hands-on, mentor-based system of learning. Unlike today's structured medical degrees, a would-be doctor in 1800s Australia typically trained under the guidance of an established practitioner with access to a hospital system. The apprentice would assist with patients, learn surgical techniques by observation, dispense drugs and read the few medical texts (if any) available.

The absence of consistent medical regulation in the colonies created a space in which professional legitimacy was negotiable. Reputation and experience meant everything. Apprentices often lived with their mentors, sharing meals and house calls, and gradually absorbing the skills required through daily immersion. Women were almost entirely excluded from the profession at the time, so it usually fell to young men, often still teenagers, with access to family money to cover the costs of being mentored.

Training could last anywhere between three to seven years and include several years studying overseas at one of the teaching hospitals in the United Kingdom or Europe. There was no set curriculum, but apprentices could expect to learn basic anatomy, wound care and surgery, midwifery, pharmacology, and perhaps some public health through dealing with outbreaks of disease. Learning was informal and highly variable, with quality teaching dependent on the mentor's expertise, resources, and commitment.

Frederick Milford was the first medical apprentice at the Sydney Infirmary (later Sydney Hospital), attending as a pupil from 1849 to 1852. He was only 18 when apprenticed to surgeon Charles Nathan. The long winded indentures of apprenticeship are short on the finer details - there is no context provided as to the hours, subjects taught, or access to resources. Indeed, the official recognition of students at Sydney Infirmary was not finalised until the annual meeting held on 14th of January, 1851. At this meeting the directors passed a resolution to the effect that every physician or surgeon of the Infirmary "shall be required to admit to his hospital practice all pupils who shall have been previously enrolled by the Weekly Committee as hospital medical and surgical pupils". The relationship between Nathan and his student was clearly mutually beneficial. In 1852, Milford became the first apprentice of the Sydney Infirmary to travel to Europe to continue his medical studies. He carried with him the first official certificates signed by the President and members of the Hospital Board, to be presented to the College of Surgeons and other bodies in Europe (now held in the History of Medicine Library). The Infirmary recognised this as the seed of future medical training in Sydney:

"The establishment therefore of a Medical School, for the education of colonial youth, may be anticipated at no very distant period."

- Annual report, 1853

Although the Infirmary had been in discussions with the University of Sydney since 1859 about establishing a Medical School, no progress was made in the short term. After a successful period of study in London and Heidelberg however, Milford returned to Australia with many certificates of qualifications, to take up a position at St. Vincents. He was notable for his active building of medical journalism through the New South Wales Medical Gazette and the Australasian Medical Gazette. In the first edition of New South Wales Medical Gazette he addressed the subject of medical qualifications:

It is not generally known, even amongst the profession that anyone who chooses to do so may practice medicine in New South Wales...There is absolutely no law that will prevent a man, who is to-day employed in the useful occupation of a cab-driver, to-morrow undertaking to remedy "all the ills that flesh is heir to," and assuming whatever titles he pleases...New South Wales stands almost alone in thus neglecting the interests of her population.

By the second half of the 19th century, as colonial governments established medical boards and medical schools opened to students, the apprenticeship model began to decline. The structure of medical education was gradually established, with the opening of the Medical School at Melbourne University in 1862, and the commencement of teaching at Sydney University Medical School in 1883.