At the start of the twentieth century there were four medical colleges (at Calcutta, Madras, Bombay and Lahore) in then undivided India, and 22 medical schools called the Temple Medical schools. The one in Patna was established in 1874. These schools were named after Sir Richard Temple who joined the Bengal Civil Services in 1846 and went on to become Lieutenant-Governor of Bengal and later Governor of Bombay. To commemorate the 1921 visit of prince of Wales (later king Edward VIII, who then abdicated) to Patna, it was decided to upgrade the medical school to a college and so it was renamed Prince of Wales Medical college when it opened formally in 1927.

 

At the same time the government was thinking of building a new medical school in North Bihar. The choice would have been Muzzaffarpur but for the fact that Maharaja Rameshwar Singh of Darbhanga had made the single largest donation of five lakh rupees plus a part of his property, Darbhanga House, in patna for the medical college. During British rule, Darbhanga was the largest and best run zamindari and yet its rulers (considered a royal family by the people of Mithila) were also great supporters of the Independence movement, public works, arts and crafts, education and industry. Many universities such as the ones in Banaras, Calcutta, Allahabad, Aligarh and Patna benefited from generous donations by them. 

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