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An onscreen prologue reads: "This motion picture is a story of individual characterizations and is in no way intended as a reflection on the great medical profession which has done so much towards beating back those forces of nature that retard the physical progress of the human race." According to information contained in the file on the film in the BFI Library, the film was released in Great Britain on March 6, 1939 with a length of 9,970 ft. and a running time of 111 min. Among the differences between the original A. J. Cronin novel and the film, two are significant: first, in the book "Christine Manson" is killed after being hit by a car, whereas in the film, it is "Denny" who is hit by a car; second, in the book the bungled operation is performed on one of "Andrew's" lower-class patients, but in the film the bungled operation causes the death of "Denny." Modern sources note that the novel contained some autobiographical aspects of Cronin's life. Cronin was a Scottish-born physician who practiced medicine in a mining town in Wales, then moved to London and established himself as a prominent physician before beginning his successful writing career.
The Citadel was the second M-G-M-British production. According to a Hollywood Reporter news item on February 10, 1938, English actress Elizabeth Allan was cast as the female lead. A Film Daily news item on March 31, 1938 noted that because Margaret Sullavan was replacing Rosalind Russell in the lead of The Shopworn Angel (see below), that Russell was now available to appear in The Citadel. A April 30, 1938 Hollywood Reporter news item announced that Allan was suing M-G-M-British for breach of contract after she was removed from the picture. Allan had been under contract to M-G-M for three years when she decided to leave the United States and return to her native England. According to a news item in Hollywood Reporter on January 9, 1937, when Allan left M-G-M the studio agreed to have her "on call" for two films a year. This May have been the basis of her suit, about which no additional information been located.
Robert Donat was borrowed from Alexander Korda for his role in the film, and by terms of the agreement between Korda and M-G-M, the film was shot at Denham Studios instead of Pinewood, which was initially to be the production site. According to another Hollywood Reporter news item, Frederick Y. Smith, a former English film editor, was to be the only technician going from Hollywood to England for the film, but only Charles Frend is credited as film editor in other contemporary sources, and Smith's participation in the picture has not been confirmed. A Motion Picture Daily news item includes actor Eliot Makeham in the cast, but his appearance in the released film has not been confirmed. Russell was the only American actor to be sent to England for the picture.
According to informaion in the Howard Dietz Collection at the AMPAS Library The Citadel cost $1,012 and grossed $2,598,000. The picture was nominated for several Academy Awards, including Best Picture, Best Director for King Vidor, Best Screenplay for Ian Dalrymple, Elizabeth Hill and Frank Wead. The National Board of Review named the film Best Picture, Donat Best Actor, and Ralph Richardson Best Supporting Actor; New York Times named the picture one of the Ten Best of the Year; and Film Daily Year Book named the picture number eight on its list of the Ten Best Pictures of 1938. Other adaptations of the Cronin novel include a 1950 television drama and a 1983 two-part BBC television drama, starring Ben Cross. The BBC drama, which was broadcast over Public Television in the United States, adhered more faithfully to the original novel than previous productions.