Draft:Max Elstein (born 1932)

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Max Elstein (born 1932) is a South African-born British obstetrician, gynaecologist, and Emeritus Professor of Obstetrics, Gynaecology and Reproductive Health Care at the University of Manchester. An important figure in medical education, reproductive health care and medical ethics, Elstein has made substantial contributions to research in contraceptive developments and infertility over a career spanning more than five decades. He also donated his extensive medical library which includes 220 publications he authored, to the University of Manchester.

Early life and education

Elstein was born in Cape Town, South Africa. He studied medicine at the University of Cape Town, qualifying with an MB ChB in 1955. After graduation, he held professorial junior posts in Groote Schuur Hospital and affiliated hospitals. From 1958 to 1961, Elstein worked in general practice in Stellenbosch, with a special interest in obstetrics and gynaecology. In 1961, he emigrated to the United Kingdom with his wife, the artist Cecile Elstein, seeking to escape the apartheid regime.

Medical and academic career

Elstein’s postgraduate training in the UK included appointments at Queen Charlotte’s Maternity Hospital, Hammersmith Hospital, and Charing Cross Hospital. Between 1964 and 1970, he held posts as registrar, lecturer, and research fellow from the Royal College of Obstetricians and Gynaecologists. During this time, his research covered hormonal contraception, cervical mucus, and intrauterine contraceptive devices. He was awarded an MD from the University of Cape Town in 1969 for his research on cervical mucus.

In 1970, Elstein was appointed Senior Lecturer in Human Reproduction and Obstetrics at the newly established Southampton Medical School at the University of Southampton. He played a key role in shaping the progressive medical curriculum, teaching sexuality and notably introducing early medical contact in obstetrics. The medical school’s teaching programme extended throughout the Wessex region. Elstein set up a collaborative research programme in reproductive biochemistry and contraceptive development connecting Portsmouth and Cardiff University, which later became international. He was promoted to Reader in 1976.

In 1977, Elstein was appointed Professor of Obstetrics and Gynaecology at the University of Manchester, later adding Reproductive Healthcare to his title. His clinical commitments were based in South Manchester at Withington Hospital and, later, at St Mary’s Hospital.

He held this post until 1995, during which time he also led the integration of academic departments of Obstetrics and Gynaecology at St Mary’s Hospital and the University Hospital of South Manchester (1993–1995), forming a single Department of Obstetrics, Gynaecology and Reproductive Health Care at Central Manchester Healthcare Trust. His teaching and clinical work focused on reconstructive surgery (including microsurgery), reproductive endocrinology, contraceptive provision, and infertility. He played a formative role in introducing interdisciplinary teaching on medical ethics, human sexuality, and reproductive health.

Throughout his career, Elstein served on committees of the Department of Health, the Royal College of Obstetricians and Gynaecologists, FIGO, IPPF, MDU, and local medical committees. He also served as an expert medical witness in litigation cases concerning obstetrics and contraception, including intrauterine contraceptive devices (IUDs).

From 1995 to 2000, Elstein served as Executive Director of the Institute of Medicine, Law and Bioethics (IMLAB), a collaborative initiative involving five North West universities: Manchester, Liverpool, Lancaster, Central Lancashire, and Keele. He continued as Chairman of the IMLAB Council.

From approximately 1998 until 2023, Elstein served as a lay member on the evolving programme of welfare and ethics of animals in research, collaborating with the RSPCA. This work became part of the Animal Welfare and Ethics Review Body (AWERB).

Research and publications

Elstein’s research interests have included hormonal contraceptive development, spermicidal research, infertility, endometriosis, endometrial function, pelvic blood flow, and patient safety in obstetric care. He has published over 220 scientific papers and co-edited influential texts, including contributions to Sexual Medicine.

Works include:

• "Clinics in Obstetrics and Gynaecology"^[1] editor. Education in sexuality in the medical curriculum" (August 1980), Vol. 7, No. 2, jointly with K.J. Dennis
• "Bacteriological colonisation of the uterine cavity: role of tailed intrauterine contraceptive device^[2]" (BMJ, 1981, 282:1189–1191), jointly with R.A. Shaw, B.G.A. Purrier, and P.J. Watt
• "IUCD Liability^[3]" (1982), British Journal of Obstetrics and Gynaecology, Supplement, Vol. 4, p. 1117
• "Teaching of Medical Ethics^[4]" (1990), Medical Education, Vol. 24, p. 531, jointly with J. Harris
• "Undergraduate education and recruitment in obstetrics and gynaecology^[5]" (1991), European Journal of Obstetrics & Gynaecology and Reproductive Biology, Vol. 41, pp. 37–42
• "Training in Family Planning^[6]" (1993), British Medical Bulletin, Vol. 49, pp. 237–244
• "Managing miscarriage medically^[7]" (1993), BMJ, Vol. 306, p. 876, jointly with P. Macrow
• "Consensus paper: Low dose contraceptive formulations – Is further reduction in steroid dosage justified?^[8]" (1994), Advances in Contraception, Vol. 10, pp. 1–4
• "Profile of a young people's advice clinic in reproductive health 1985–1993" (1994), BMJ, Vol. 309, pp. 786–788^[9], jointly with E.C. Williams and R.J.E. Kirkman
• "Standards of Education in Obstetrics and Gynaecology: Report of the Committee of Education of Obstetrics and Gynaecology and Human Reproduction^[10]" (1995), International Journal of Gynaecology and Obstetrics, Vol. 50, pp. 85–95
• "Rethinking sexual health clinics^[11]" (1995), BMJ, Vol. 310, pp. 342–343, jointly with Y.F. Stedman

Awards and recognition

• Research Prize, Board of Governors, Queen Charlotte's and Chelsea Hospital (1962)
• Cuthbert Crichton Memorial Lecture, University of Cape Town (1993)
• Herbert Thomas Ortho Pharmaceutical Lectureship, American Fertility Society (1994)
• Honorary Fellowship, Faculty of Family Planning and Reproductive Health Care, Royal College of Obstetricians and Gynaecologists (1995)
• Award for Special Contribution to Reproductive Medicine, 10th World Congress of Human Reproduction and 25th Anniversary of the Academy of Human Reproduction, Salvador, Brazil (1999)

Personal life

Elstein and his wife Cecile, a sculptor and environmental artist, settled in Manchester in 1977. They became active in the city’s cultural and intellectual life, supporting institutions such as the Whitworth Art Gallery, the Manchester Luncheon Club, and the Manchester Literary and Philosophical Society. For twelve years during retirement, Elstein organised annual symposia on medical ethics at the Menorah Synagogue. He enjoys classical music, gardening, and is a devoted father, grandfather, and great-grandfather.

References

1. Elstein, Max; Dennis, KJ (1980). "Education in sexuality in the medical curriculum". Clinical Obstetrics and Gynecology. 2 (2): 183–91. PMID 7002408.
2. Elstein, Max; Watt, PJ; Purrier, BG; Sparks, RA (1981). "Bacteriological colonisation of uterine cavity: role of tailed intrauterine contraceptive device". British Medical Journal. 282 (6271): 1189–1191. doi:10.1136/bmj.282.6271.1189. PMC 1505233. PMID 6788128 – via BMJ.
3. Elstein, Max (1982). "IUCD liability". British Journal of Obstetrics and Gynaecology, Suppliment. 4 (Suppl 4): 11–19. doi:10.1111/j.1471-0528.1982.tb15065.x. PMID 7150526 – via Wiley.
4. Elstein, Max; Harris, J (1990). "Teaching of medical ethics". Medical Education. 4 (6): 531–534. doi:10.1111/j.1365-2923.1990.tb02670.x. PMID 2266890.
5. Elstein, Max (1991). "Undergraduate education and recruitment in obstetrics and gynaecology". European Journal of Obstetrics & Gynecology and Reproductive Biology. 41 (1): 37–42. doi:10.1016/0028-2243(91)90317-E. PMID 1748225 – via Science Direct.
6. Elstein, Max (1993). "Training in family planning". British Medical Bulletin. 49 (1): 237–244. doi:10.1093/oxfordjournals.bmb.a072601. PMID 8324612 – via Oxford Academic.
7. Elstein, Max; Macrow, P (1993). "Managing miscarriage medically". British Medical Journal. 306 (6882): 876. doi:10.1136/bmj.306.6882.876. PMC 1677357. PMID 8490409.
8. Elstein, Max (1994). "Low dose contraceptive formulations: is further reduction in steroid dosage justified?". Advances in Contraception. 10 (1): 1–4. doi:10.1007/BF01986523. PMID 8030448.
9. Elstein, Max; Kirkman, RJ; Williams, EC (1994). "Profile of young people's advice clinic in reproductive health, 1988-93". British Medical Journal. 309 (6957): 786–788. doi:10.1136/bmj.309.6957.786. PMC 2541028. PMID 7950570.
10. Elstein, Max (1995). "Standards of education in obstetrics and gynecology Report of the Committee on Education in Obstetrics and Gynecology and Human Reproduction". International Journal of Gynaecology and Obstetrics. 50 (1): 85–95. doi:10.1016/0020-7292(95)90003-9. PMID 7556869 – via Wiley.
11. Elstein, Max; Stedman, Yvonne (1995). "Rethinking sexual health clinics: providing them under one roof would be an improvement". British Medical Journal. 310 (6976): 342–345. doi:10.1136/bmj.310.6976.342. PMC 2548756. PMID 7866202 – via JSTOR.