In America all surgeons are doctors, holding an MD degree and passing state licensure exams, with surgeons usually
passing additional qualifications (I presume). But in England I understand that this isn’t always so, or it didn’t used to be. In other words, you could have surgeons who were not doctors, and were addressed by the title Mr.
How does or did this system work? How are non-doctor surgeons trained and certified, and are there or were there also doctor-surgeons?
I’ll start the ball rolling, but this is just off the top of my head.
After medical school (long and arduous), many people go into general practice. They are called Doctor and are known as GP’s (from general practice).
Other graduates join hospitals. Junior doctors work frighteningly long hours there for little money (a sort of apprenticeship). Politicians often say they’ll do something to ease the load … but you know politicians :rolleyes: ).
Once qualified, the next steps are fuzzy in my mind. I know there are (at least) surgeons, consultants and registrars. I think consultants are near the top of the tree and are called Mr.
These people also specialise (e.g. ear, nose + throat).
Surgeons in the UK are also qualified doctors but they do not use the title of “doctor”. This is used only by physicians. Surgeons take the title “Mr” or “Miss”, as do dentists and vets.
The MD is a higher degree in this country, roughly equivalent to a PhD. The basic qualifications to practice medicine are Bachelor of Medicine and Bachelor of Surgery (MB BCh), which is what you get when you graduate from medical school.
FWIW, the career path is as follows:
Five or six years’ university/medical school (age 18-24 or 25)
One year as a Junior House Officer, which must include at least four months each of medicine and surgery (usually six months of each).
Everybody in hospital medicine below the grade of Consultant works about 70-80 hours per week, some of which is remunerated at a rate little higher then the minimum wage.
A minimum two years as a Senior House Officer (SHO), during which they usually rotate through about six different specialisms, after which they can take exams to gain membership of the Royal College of Physicians, Royal College of Surgeons or one of the other Royal Colleges (e.g. Psychiatry, Obs. & Gynae.). I believe that it is at this point that the surgeons go back to being “Mr” or “Miss”.
Membership of a Royal College entitles you to apply for a Specialist Registrar post in your chosen specislism, which should in theory lead to a Consultant post after four or five years.
General Practitioners (family doctors) generally leave the hospital system after the SHO stage, aged about 28-30)
By the way, this reminds me of something else I’ve never been sure of:
Psychiatry is a medical specialism in the UK: you have to qualify as a doctor before you can become a psychiatrist. I believe that this may not be the case in the US: you can become a psychiatrist without going through medical school, etc. Is this correct?
No, it is not correct. A psychiatrist in the US is a doctor of medicine. Psychiatry is his speciality, just as a doctro can specialize in any of the othe fields: internist, cardiologist, orthopedist, etc.
However, psychologists are not medical doctors, but must have a Ph.D. to be authorized to sign off on evaluations. There are psychologists who have only master degrees, but they are quite limited in what they can do (legally).
IIRC, Psychiatry is a medical field here in the US. In order to be a psychiatrist you must be a licensed MD. A psychiatrist can prescribe meds.
A psychologist need not be a licensed MD. My SO is a psychologist, but is not an MD (she is a “Dr.” but that’s because she has her PhD. She is also licensed, but not as an MD). A psychologist cannot prescribe meds.
To make it even more confusing, in the U.S. psychologists who have earned the title “doctor” can also had D.Ed. or Psy.D degrees. In theory, I guess they could also have a D.S.W. (doctorate of social work), but I’ve never actually heard of a D.S.W. program - all my friends (pshrinks or non-pshrinks) have M.S.W.'s.
I believe that only Ph.D psychologists are rightfully called clinical psychologists.
Sua
Thanks. Sounds like basically the same situation as in the UK.
Regarding the OP, the distinction is a vestige of the separate origins of the two jobs. A physician was originally someone with a university degree in medicine. As such, he was a gentleman and merely gave advice to his clients. Any medicine he prescribed had to be obtained from an apothecary, who ranked as a tradesman. A surgeon was someone who amputated limbs, a skill which did not require much education of any sort. Surgeons were definitely not gentlemen. It was only with the advances in surgical technique in the nineteenth century that surgeons’ social status rose and their job became a fully-fledged profession. One result of that process was the introduction of the requirement that prospective surgeons qualify in medicine first. Their title ‘Mr’ reflects the older usage.