[4] Stephen and Smith attached one caveat to their generous contribution to the City of Montreal: the hospital's land and its buildings must only ever be used for healing.

[5] The founders intended the Royal Vic "to be for the use of the sick and ailing without distinction of race or creed," and when it opened in 1893 it was hailed as the "finest and most perfectly equipped (hospital) on the great American continent".

[7] Over the years, the philanthropy and business acumen of many of the residents of the Golden Square Mile - the prominent members of Montreal's English speaking community - brought the hospital global recognition as a major centre of healthcare and learning.

[8] The hospital was previously housed in a building complex at 687 Pine Avenue on the slope of Mount Royal in the borough of Ville-Marie.

McGill University has unveiled an idea to repurpose the hospital for academic purposes, but also add community and green space.,[9][10] a project that opposes the wishes of the founders, lords Strathcona and Stephen.

Constructed of Montreal limestone, the original Royal Vic is distinguished by its crenelated structures and romantic turrets framing generous sun porches at the corners of its imposing medical and surgical wards.

From a medical perspective, his design of the Royal Vic was influenced by the ideas of Florence Nightingale as a Pavilion Hospital, in which the separation and isolation of both patients and diseases were thought to discourage the spread of infection.

It was designated a National Historic Site in 1997 in recognition of the important role the building played in the training and professionalism of nurses in Canada.