Doctor_of_medicine

Doctor of Medicine (M.D. or MD, from the Latin Medicinae Doctor meaning "Teacher of Medicine,") is an academic degree for medical doctors.

How the term MD is applied varies between countries - it is a first professional degree (medical diploma) in some countries, for example in the USA and Canada, while in some countries it is a relatively rare higher doctoral academic research degree resembling a PhD, for example in the United Kingdom and Australia.CF Hawkins, "Write the MD Thesis" in "How To Do It" London: British Medical Association 2nd ed. 1985 ISBN 0-7279-0186-9. In the UK and countries following the British model, the equivalent of the American MD degree is the MBChB or MBBS (meaning "Bachelor of Medicine and Bachelor of Surgery" - see later).

History of the medical degree

According to Sir John Bagot Glubb and Syed Farid Alatas, the first medical schools to issue academic degrees and diplomas were the Bimaristan teaching hospitals of the medieval Islamic world. The first of these institutions was opened in Baghdad during the time of Harun al-Rashid. They then appeared in Egypt from 872 and then in Islamic Spain, Persia and the Maghreb thereafter. Physicians and surgeons at these hospital-universities gave lectures on Islamic medicine to medical students and then a medical diploma or degree was issued to students who were qualified to be practicing physicians.Sir John Bagot Glubb (cf. Dr. A. Zahoor (1999), Quotations on Islamic Civilization)Alatas, Syed Farid, "From Jami`ah to University: Multiculturalism and Christian–Muslim Dialogue", Current Sociology 54 (1): 112-32

According to Douglas Guthrie,Douglas Guthrie, A History of Medicine. London: Thomas Nelson 1945, p. 107 who bases his account on L Thorndike,L Thorndike, History of Magic and Experimental Science. New York 1934 - 41, Vol. 2 of 6 medical men were first called "Doctor" at the Medical School of Salerno. He states that that the Emperor Frederick II decreed in 1221 that no one should practice medicine until he had been publicly examined and approved by the masters of Salerno. The course lasted 5 years, and to start one had to be 21 years old and show proof of legitimacy and of three years study of logic. The course was followed by a year of supervised practice. After the laureation ceremony the practitioners could call themselves "magister" or "doctor."

United States and Canada

Physician education and training in the United States

Stages Pre-medical Med school Sub-internship Internship Residency Fellowship Board certification Continuing medical education Types Allopathic Osteopathic Comparison Degrees Doctor of Medicine Doctor of Osteopathic Medicine MD/PhD or DO/PhD Exams MCAT COMLEX Step 1, 2CE, 2PE, 3 USMLE Step 1, 2CK, 2CS, 3 Regulatory bodies Association of American Medical Colleges American Association of Colleges of Osteopathic Medicine National Resident Matching Program National Matching Service Accreditation Council for Graduate Medical Education Liaison Committee on Medical Education Commission on Osteopathic College Accreditation Accreditation Council for Continuing Medical Education American Osteopathic Association American Medical Association Student groups American Medical Student Association Alpha Omega Alpha Sigma Sigma Phi Lists Medical schools Specialty colleges

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The M.B. or Bachelor of Medicine was the first type of medical degree to be granted in the United States and Canada. The first medical schools that granted the M.B. degree were UPenn, Harvard, Toronto, Maryland, and Columbia. These first few North American medical schools that were established were (for the most part) founded by physicians and surgeons who had been trained in England and Scotland where basic medical education culminated with the M.B. qualification and later the Bachelor of Medicine and Bachelor of Surgery (MBBS or MBChB) after surgery (or latin chirurgiae) became less the practice of barbers technicians and more the mainstay of general medical education. This degree is the oldest and the most traditional medical degree held by physicians and surgeons. North American Medical schools however began granting the M.D. title rather than the more traditional M.B. mostly throughout the 1800s.

Sometimes, holders of the MD or MBBS degrees are referred to as "allopathic physicians"Physicians and Surgeons. Occupational Outlook Handbook. Bureau of Labor Statistics. U.S. Dept of Labor. [1] or graduates of allopathic schools of medicinePhysician Education, Licensure, and Certification. American Medical Association.[2], although some claim this term is pejorative.Atwood KC (2004). "Naturopathy, pseudoscience, and medicine: myths and fallacies vs truth". MedGenMed : Medscape general medicine 6 (1): 33. PMID 15208545. Retrieved on 2007-08-17. ^{[neutrality disputed]}Students earning an M.D. degree are trained in accredited schools of medicinePhysician Education, Licensure, and Certification. American Medical Association.[3] which are overseen by the Association of American Medical Colleges and the Liaison Committee on Medical Education, both independent boards of the American Medical Association, the AMA.

Admissions to medical schools in the United States are competitive, with 17,800 of the approximately 47,000 applicants matriculating to a medical school. Before graduating from a medical school and achieving the degree of Medical Doctor, students have to pass the United States Medical Licensing Examination (USMLE) Step 1 and to take (but not necessarily pass) both the Clinical Knowledge and Clinical Skills parts of Step 2. The M.D. degree is typically earned in four years. Following the awarding of the M.D., physicians who wish to practice in the United States are required to complete at least one internship year (PGY-1) and pass the USMLE Step 3. Most, in order to receive Board Eligible or Board Accredited status in a specialty of medicine such as general surgery or internal medicine, then undergo additional specialized training in the form of a residency. Those who wish to further specialize in areas such as cardiology or interventional radiology then complete a fellowship. Depending upon the physician\'s chosen field, residencies and fellowships involve an additional three to eight years of training after obtaining the M.D. This can be lengthened with additional research years, which can last one, two, or more years.

In Canada, the M.D. is the basic medical degree required to practice medicine. At McGill University in Montreal, M.D. C.M. (Medicinae Doctor et Chirurgiae Magister) degrees are awarded.

Even though the M.D. is a first professional degree and not a doctorate of research (ie. PhD), many holders of the M.D. degree conduct clinical and basic scientific research and publish in peer-reviewed journals during training and after graduation. Some M.D.s choose a research career and receive funding from the NIH as well as other sources such as the Howard Hughes Medical Institute. A few even go on to become Nobel Laureates.[4]

Equivalent Degrees

• The Bachelor of Medicine and Bachelor of Surgery degrees (MB BS or MB ChB, and several variants) are medical qualifications that are entirely equivalent to the North American MD degree.
• The Scandinavian Candidatus medicinae or Candidata medicinae degrees (Cand.med.) are equivalent to the North American MD degree as determined by U.S. state medical boards.
• In all 50 of the United States, and some Canadian provinces, the osteopathic medical degree (D.O.) is identical to the training requirements and practice rights of the M.D. degree.Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Kurt J. Isselbacher, Eds. Chapter 10. Complementary and Alternative Medicine Harrison\'s Principles of Internal Medicine, 16th Edition. 2005. McGraw Hill.

Further information: Comparison of the M.D. and D.O. degrees and Canadian practice rights of U.S. trained D.O.s

• In Mexico as well as most Latin American countries, schools of medicine award the "Titulo de Medico Cirujano" degree after 6 years of study. The Mexican "Titulo" is equivalent to the North American M.D. degree according to the ECFMG. The medical curriculum in Mexico follows the European model of medical education which includes 4 years of study covering the basic and clinical sciences, an undergraduate rotating internship year, and a year of social service providing primary care to an underserved population. Physicians holding the Mexican "Titulo" degree who practice medicine in the USA or Canada use the designation "M.D." aftern their name.

Philippines

Formal Medical Education in the Philippines was introduced by Spain at the Royal and Pontifical University of Santo Tomas, granting the Doctor of Medicine and Surgery degree. Under American rule from 1898 - 1946, the Philippine government adopted all aspects of the American educational system. As a result, all accredited medical schools in the Philippines are mandated by law to award an MD (Doctor of Medicine) degree to their graduates, similar to the United States. Entry into medical programs of study generally require a prior undergraduate baccalaureate degree in addition to fulfilling other premedical requirements. Students then complete at least four years of full-time medical education plus a required 1 year of clinical internship before sitting the national Physician\'s Licensure Examinations to become fully licensed general practitioners. In most cases, this means at least nine years of full-time coursework after high school to become a primary physcian. The University of the Philippines College of Medicine offers a seven year Integrated Arts and Medicine Curriculum for high school graduates obtaining the highest marks in the University of the Philippines College Admissions Tests. This accelerated program is not unlike similar six or seven year "straight M.D." and "straight Ph.D." programs in North American Universities.

Additional qualifications in Medical (Family and Community Medicine, Internal Medicine, Pediatrics, Psychiatry, Anesthesia) and Surgical (General Surgery, Ophthalmology, Otorhinolaryngology Head and Neck Surgery, Orthopedic Surgery, Obstetrics and Gynecology)Specializations require completion of accredited Residency Training Programs in tertiary teaching hospitals for an additional three to five years before sitting a specialty board examination which usually includes written, oral and practical portions. Successful examinees are inducted as Diplomates of their respective Specialty Boards and are entitled to practice their field of specialization. Further sub-specialization can be earned by completing Clinical Fellowship training in one to four additional years. Examples of subspecializations are Hospice and Palliative care, Endocrinology, Cardiology, Pulmonology, Gastroenterology, Pediatric Anesthesiology, Thoracic and Cardiovascular Surgery, Plastic Surgery, Glaucoma, Retina, Rhinology and Paranasal Sinus Surgery, Otology Neurotology and Skull-base Surgery, Perinatology. Altogther, it takes thirteen (medical subspecialties) to twenty-one years (surgical subspecialties)of full time study and training after high school to start practice as a subspecialist.

United Kingdom, Ireland and some Commonwealth countries

In the United Kingdom and Ireland (and many Commonwealth countries) the MD is a postgraduate research degree in medicine. At some universities, this takes the form of a first doctorate, analogous to the PhD, awarded upon submission of a thesis and a successful viva. The thesis may consist of new research undertaken on a full- or part-time basis under the supervision of a senior academic, or a portfolio of previously-published work (see, for example, [5]).

At some other universities (especially older institutions such as Oxford and Cambridge) the MD is a higher doctorate awarded upon submission of a portfolio of published work representing a substantial contribution to medical research.page 60.

In the case where the MD is awarded (either as a first or higher doctorate) for previously-published research, the candidate is usually required to be either a graduate or a full-time member of staff, of several (typically seven to ten) years\' standing of the university in question (see, for example, [6]).

The entry-level professional degree in these countries for the practice of medicine is that of Bachelor of Medicine and Bachelor of Surgery (MBBS or MBChB). This degree typically requires between four and six years of study and clinical training, and is equivalent to the North American MD.

Other postgraduate clinical degrees

There is also a similar advanced professional degree to the postgraduate MD: the Master of Surgery (usually ChM or MS, but MCh in Ireland, Wales and at Oxford and MChir at Cambridge).

In Ireland, where the basic medical qualification includes a degree in obstetrics, there is a similar higher degree of Master of the Art of Obstetrics (MAO).

India and Pakistan

In India, an M.D. is a higher postgraduate degree awarded by many medical colleges to medical graduates,holding the MBBS degree, after three years of study and passing an examination which includes both theory and practical, in a pre-clinical or clinical subject of a non-surgical nature. The original research element is not as prominent here, as this is primarily a clinical qualification resembling the professional doctorates of the USA. In surgery,orthopedics and gynaecology the equivalent degree is Master of Surgery (M.S). After obtaining post graduate degree that is MD/MS one can go for further superspecialisation in Mediac and surgical subjects. This requires three years of hard training and study and then passing an exam both theory and practical and the degree awarded is DM(Doctor of Medicine,superspeciality) eg DM in Cardiology, Neurology,Nephrology,Gastroenterology etc. For surgical superspecialities degree awarded is Mch, eg Mch in Cardiac surgery, Neurosurgery etc.

In Pakistan an MBBS is awarded as the basic medical qualification after completing five/six years of study. Tough entry tests are passed successfully before entering in to a medical college. Medical colleges and foreign medical qualifications are supervised by the Pakistan Medical and Dental Council (PMDC). Specialized degrees are awarded by the Pakistan College of Physicians and Surgeons.

References

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