AbstractThe period until 1745 found the Viennese medical system languishing far behind advances made in other major European centers. This chaotic situation was reversed by the foresight and breadth of vision of the Empress Maria Theresa, who initiated considerable reform in Austria by actively recruiting the best minds of the time to reduce the intellectual and technologic differences. Her ability to entice one of Boerhaave's most eminent pupils, Gerard van Swieten, to leave Leiden for Vienna, particularly benefited the Vienna Medical School. In 1745 van Swieten assumed responsibility for reconfiguration of the patronage and nepotism‐ridden medical system of the Austro‐Hungarian Empire. As a first task, he swiftly expunged the influence of the Jesuits and other religious orders from medicine and established formal training and examinations, transforming the medical discipline into a meritocracy. Excelling as a physician and an innovative teacher, he also established a close personal relationship with the Empress and became her medical confidante. To a large part, the success of this first great Viennese medical school was owed to de Haen, who left Leiden to implement Boerhaave's method of clinical teaching. As a result of these innovations and with considerable support from the Empress, the University of Vienna, particularly its medical school, within a few decades achieved recognition throughout Europe as a seat of learning and scholarship. Van Swieten would not be remembered today if his contribution had been only scholarly or scientific achievements. He propelled Austrian medicine to a level commensurate with that of other European states of the day by 27 years of dedicated and industrious service.