Doctor of Medicine

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Doctor of Medicine (M.D. or MD, from the Latin Medicinae Doctor meaning "Teacher of Medicine,") is an academic degree for medical doctors. It varies between countries, from being a first professional degree (medical diploma), to being a relatively rare higher doctoral academic research degree (usually if granted outside of the US and Canada).[1].

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According to Douglas Guthrie,[2], who bases his account on L Thorndike,[3] 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."

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"[4] or graduates of allopathic schools of medicine[5], although some claim this term is pejorative.[6][neutrality disputed]Students earning an M.D. degree are trained in accredited schools of medicine[7] 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 less than one half of the approximately 35,000 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 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]

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

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 all its graduates, which is similar to that of the United States. Most medical students enrolled in MD programs must have a bachelor's degree in any subject of their choice in addition to fulfilling all premedical requirements. Students then apply to medical schools where they attend four years to complete their medical education plus a required 1 year of clinical rotation in a public hospital and 2 years of additional clinical rotation to become a fully licensed general practitioner. In all, it takes 4 years of undergraduate plus 4 years of medical proper to attain an MD in addition to mandatory 3 years of clinical rotation to become a primary care physician.

In the United Kingdom and many other Commonwealth countries, the M.D., as in some but not all European countries, is a higher doctoral degree reserved for those who have contributed significantly to the academic study of medicine or surgery[9]. An M.D. typically involves part- or full-time research in a pre-clinical or clinical subject, followed by the submission and defence of a thesis.

Alternately, the M.D. may be a degree granted to medical graduates of the same institution after a body of previously published research is submitted. This would normally be a series of publications on a single topic. This may be considered equivalent to a Ph.D. (e.g., [5]).

Some universities will grant an M.D. by published research to medical graduates from elsewhere who have some other degree from them, such as an M.A. (in the case of Oxford or Cambridge), an MSc or a Ph.D. e.g., [6]).

In India, an M.D. is a higher degree awarded by many medical colleges to M.B. B.S. graduates after two or three years of study and examination 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 U.S.A. In surgery and gynaecology the equivalent degree is Master of Surgery or M.S. A few institutions confer a higher doctorate (abbreviated D.M.) after study and training in a subspecialty, e.g. cardiology, or in fields such as neurosurgery a higher mastership (M.Ch.).

They may follow the same research learning pathway as the first two years of a Ph.D., allowing clinical fellows to pursue combinations of laboratory and clinical-based research under the supervision of senior clinical and research members of the School. Given good progress (at an unspecified instiution) and by adding a further year, students can convert to a Ph.D. programme[citation needed].

There is also a similar advanced professional degree to the postgraduate M.D., the Master of Surgery (usually Ch.M. or M.S., but M.Ch. in Ireland, Wales and Oxford and M.Chir. at Cambridge), which is obtained after an M.B., Ch.B. or M.B., B.S.

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 (M.A.O.)

The entry-level professional degree in these countries for the practice of medicine is that of Bachelor of Medicine and Bachelor of Surgery (M.B., B.S. or M.B., Ch.B.) (which is equal to the "North American MD"), requiring typically four to six years of studies and training at university.

The four-year courses are "graduate-entry" and can only be entered with a previously completed bachelors degree, which in the case of the UK can be in any subject. In India there has for a long time been a dual intake to the standard-length medical course, with most students entering after Pre-Degree College, and the rest after a B.Sc. degree in a pre-medical subject.

  1. ^ Hawkins, CF "Write the MD Thesis" in "How To Do It" London: British Medical Association 2nd ed. 1985 ISBN 0-7279-0186-9
  2. ^ Douglas Guthrie, A History of Medicine. London: Thomas Nelson 1945, p. 107
  3. ^ L Thorndike, History of Magic and Experimental Science. New York 1934 - 41, Vol. 2 of 6
  4. ^ Physicians and Surgeons. Occupational Outlook Handbook. Bureau of Labor Statistics. U.S. Dept of Labor. [1]
  5. ^ Physician Education, Licensure, and Certification. American Medical Association.[2]
  6. ^ 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. 
  7. ^ Physician Education, Licensure, and Certification. American Medical Association.[3]
  8. ^ 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.
  9. ^ Hawkins op cit p 60
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