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The Doctor of Medicine (MD, from the Latin Medicinæ Doctor meaning "Teacher of Medicine") is a doctoral degree for physicians (medical doctors). The degree is granted by medical schools.

It is a first professional degree (qualifying degree) in some countries, including the United States and Canada, although training is entered after obtaining at least 90 credit hours of university level work (see second entry degree). In other countries, such as United Kingdom and Australia, the MD is a higher doctoral academic research degree resembling a PhD.^[1] In Britain and many Commonwealth nations, the qualifying medical degree is instead the Bachelor of Science in Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS, BMBS, BM BCh or MBChB).

[edit] History of the medical degree

According to Sir John Bagot Glubb, Syed Farid Alatas, and S. M. Imamuddin, the first medical schools to issue academic degrees and diplomas were the teaching Bimaristan (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.^[2]^[3]^[4]

According to Douglas Guthrie,^[5] who bases his account on L Thorndike,^[6] medical men were first called "Doctor" at the Medical School of Salerno. He states 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."

[edit] Academic degrees for physicians by country

[edit] United States and Canada

The MB or Bachelor of Medicine was also the first type of medical degree to be granted in the United States and Canada. The first medical schools that granted the MB degree were Penn, Columbia, Harvard, Maryland, and Toronto. 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. University medical education in England culminated with the MB qualification, and in Scotland the MD, until from the mid-19th century the public bodies who regulated medical practice at the time required practitioners in Scotland as well as England to hold the two the dual Bachelor of Medicine and Bachelor of Surgery degrees (MB BS/MBChB/MB BChir/BM BCh etc). North American Medical schools switched to the tradition of the Ancient universities of Scotland and began granting the MD title rather than the MB mostly throughout the 1800s. The Columbia University College of Physicians and Surgeons in New York (which at the time was referred to as King's College of Medicine) was the first American University to grant the MD degree instead of the MB.^[7]

Within the United States, MDs are awarded by LCME-accredited medical schools.^[8].^[9]^[10] The Liaison Committee on Medical Education is an independent body sponsored by the Association of American Medical Colleges and the American Medical Association, the AMA.

Admissions to medical schools in the United States is highly competitive, with 17,800 of the approximately 47,000 applicants matriculating to any medical school. Before entering medical school students must complete a four year undergraduate degree (usually in science) and take the Medical College Admission Test (MCAT). 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 MD degree is typically earned in four years. Following the awarding of the MD, 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. 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 MD. This can be lengthened with additional research years, which can last one, two, or more years.

In Canada, the MD is the basic medical degree required to practice medicine. At McGill University in Montreal, M.D., C.M. (Medicinae Doctor et Chirurgiae Magister or a Doctor of Medicine and Master of Surgery sometimes also written MDCM) degrees are awarded.

Even though the MD is a first professional degree and not a doctorate of research (ie. PhD), many holders of the MD degree conduct clinical and basic scientific research and publish in peer-reviewed journals during training and after graduation. Medical Scientist Training Programs (MSTPs) are offered at many universities which are a combined medical degree and PhD. Some MDs 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.^[11]

[edit] 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, with much less supervision (in the UK) than for a PhD, or a portfolio of previously-published work.^[12]

In order to be eligible to apply for an MD degree from a UK or Commonwealth University on must hold either an MBBS, MBChB, or an equivalent US-MD degree and must usually have at least 5-years of postgraduate experience.

At some other universities (especially older institutions such as Oxford and Cambridge) the MD is a higher doctorate (similar to a DSc) awarded upon submission of a portfolio of published work representing a substantial contribution to medical research.^[1]

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 years' standing of the university in question.^[13]

The University of Buckingham,^[14] the only private university in Great Britain, has announced an Indian-style two year full-time taught course for a "Clinical MD" in internal medicine. This is designed for non-European Union graduates, who are no longer to be allowed to take accredited training posts in UK hospitals. This degree will be awarded first in 2010. The entry-level first professional degree in these countries for the practice of medicine is that of Bachelor of Medicine and Bachelor of Surgery (MBBS, MB, MB BCh BAO, BMBS, MBBChir, or MBChB). This degree typically requires between four and six years of study and clinical training, and is equivalent to the North American MD degree.

The University of Melbourne^[15] in Australia has announced plans to introduce the Doctor of Medicine (MD) in 2011 as their first professional degree in medicine for graduates of the Bachelor of Biomedicine or a Bachelor of Science degree. The university will become the first in Australia to leave the Bachelor of Medicine and Bachelor of Surgery (MBBS) and offer the MD as a first professional degree in medicine rather than as a research degree.

[edit] Argentina, India and Pakistan

In Argentina the medical degree of Medic (Título de Médico)^[16] are equivalent to the North American M. D. Degree with 6 year of intensive theoric studies followed by three years of the Residencia as a Mayor Especialidad in a particular empiric field, compounded of internships, social services and sporadic research. Only by holding a Medical Title and having been achieved the Residency stage the postgraduate student might applied for the Doctor degree through a Doctorate in Medicine program approved by the National Commission for University Evaluation and Accreditation^[17].

In India, an MD is a higher postgraduate degree awarded by many medical colleges to medical graduates holding the MBBS degree {MBBS degree course has a duration of five and a half years}, 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, orthopaedics and gynaecology the equivalent degree is Master of Surgery (MS). DNB (Diplomate of the National Board) is considered equivalent to MD and MS. This can be obtained by passing an exam conducted by national board of examinations (usually in the month of June) after completing 3 years post MBBS training in hospitals recognised by the board. After obtaining the first post graduate degree, that is MD/MS/DNB, one can go for further specialisation in medical or surgical fields. This requires three years of hard training and study and then passing an examination, both theory and practical, and the degree awarded is DM (Doctorate in Medicine, superspeciality) eg DM in Cardiology, Neurology, Nephrology, Gastroenterology etc. For surgical subspecialities the degree awarded is MCh, eg MCh (Cardiac Surgery), MCh (Neurosurgery) etc.The DM or MCh degrees are equivalent to the Fellowship training in the US and are considered "post-doctoral" degrees in India, similar to the PhD.

In Pakistan equivalent degree is MBBS (bachelors of medicine and bachelors of surgery). MBBS is awarded as the basic medical qualification after completing five years of study. This comprises two years of basic science subjects which include anatomy, physiology, and biochemistry, with a particular emphasis on human anatomy. Subsequently, there are three years of clinical internship and courses on medicine surgery and pharmacology. Finally, the student is required to work for one year under a professor, before one is awarded Degree of MBBS with license to practice. For specialization, one has to pass Fellow of College of Physicians & Surgeons Pakistan (FCPS) exam-1 in field in of specialization and obtain an internship in the field for 3–6 years. Next, one can take the FCPS exam part 2, which includes intensive practical exams. Upon successful completion a fellow of the relevant specialty is awarded. 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.

[edit] Equivalent degrees in other countries

The Bachelor of Medicine and Bachelor of Surgery degrees (MB BS or MB ChB, and several variants).
The American osteopathic medical degree (DO) has identical training requirements and practice rights as the MD degree within North America.^[18] (See Comparison of MD and DO in the United States.)
In Italy, the title of "Dottore in Medicina e Chirurgia" (literally "Doctor in Medicine and Surgery") is awarded on graduation; physicians then simply use the title "Dott." or "Dr." before their name.
In Germany physicians obtain the degree "Dr. med., Doktor der Medizin".
The Czech and Slovak title doktor medicíny, or MUDr. (Medicinae Universae doctor).
In Poland the title of lekarz
The Danish and Norwegian Candidatus medicinae or Candidata medicinae degrees (Cand.med.)
In Mexico as well as most Latin American countries, schools of medicine award the "Titulo de Medico Cirujano y Partero" degree.
In Nepal, an MBBS degree is awarded.

[edit] 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).

In East Africa, the medical schools in Kenya, Tanzania and Uganda award the degree of Master of Medicine (MMed) degree in both surgical and medical specialty disciplines following a three year period of instruction.

[edit] References

^ ^a ^b CF Hawkins, "Write the MD Thesis" in "How To Do It" London: British Medical Association 2nd ed. 1985 ISBN 0-7279-0186-9
^ Sir John Bagot Glubb (cf. Dr. A. Zahoor (1999), Quotations on Islamic Civilization)
^ Alatas, Syed Farid (2006), "From Jami`ah to University: Multiculturalism and Christian–Muslim Dialogue", Current Sociology 54 (1): 112–32, doi:10.1177/0011392106058837
^ Imamuddin, S. M. (1981), Muslim Spain 711-1492 A.D., Brill Publishers, p. 169, ISBN 9004061312
^ Douglas Guthrie, A History of Medicine. London: Thomas Nelson 1945, p. 107
^ L Thorndike, History of Magic and Experimental Science. New York 1934 - 41, Vol. 2 of 6
^ http://www.columbia.edu/about_columbia/history.html
^ Physician Education, Licensure, and Certification. American Medical Association.
^ Registering with the NRMP. National Residency Matching Program. Accessed 15 March 2008.
^ Whorton, James. Counterculture Healing: A Brief History of Alternative Medicine in America. 4 November 2003. WGBH Educational Foundation. accessed 25 December 2007.
^ http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-professional-studies.html
^ See, for example, http://www.otago.ac.nz/courses/qualifications/md.html
^ See, for example, http://www.uq.edu.au/study/program.html?acad_prog=7504
^ http://www.buckingham.ac.uk
^ http://www.unimelb.edu.au
^ CONEAU Comisión Nacional de Evaluación y Acreditación Universitaria.
^ National Commission for University Evaluation and Accreditation
^ 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.

[hawkins-0] CF Hawkins, "Write the MD Thesis" in "How To Do It" London: British Medical Association 2nd ed. 1985 ISBN 0-7279-0186-9

[1] Sir John Bagot Glubb (cf. Dr. A. Zahoor (1999), Quotations on Islamic Civilization)

[Alatas-2] Alatas, Syed Farid (2006), "From Jami`ah to University: Multiculturalism and Christian–Muslim Dialogue", Current Sociology 54 (1): 112–32, doi:10.1177/0011392106058837

[3] Imamuddin, S. M. (1981), Muslim Spain 711-1492 A.D., Brill Publishers, p. 169, ISBN 9004061312

[4] Douglas Guthrie, A History of Medicine. London: Thomas Nelson 1945, p. 107

[5] L Thorndike, History of Magic and Experimental Science. New York 1934 - 41, Vol. 2 of 6

[6] ttp://www.columbia.edu/about_columbia/history.html

[7] Physician Education, Licensure, and Certification. American Medical Association.

[NRMP-8] Registering with the NRMP. National Residency Matching Program. Accessed 15 March 2008.

[Whorton-9] Whorton, James. Counterculture Healing: A Brief History of Alternative Medicine in America. 4 November 2003. WGBH Educational Foundation. accessed 25 December 2007.

[10] ttp://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-professional-studies.html

[11] See, for example, http://www.otago.ac.nz/courses/qualifications/md.html

[12] See, for example, http://www.uq.edu.au/study/program.html?acad_prog=7504

[13] ttp://www.buckingham.ac.uk

[14] ttp://www.unimelb.edu.au

[15] CONEAU Comisión Nacional de Evaluación y Acreditación Universitaria.

[16] National Commission for University Evaluation and Accreditation

[17] 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.

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