Doctor of Medicine (abbreviated M.D., from the Latin Medicinae Doctor) is a medical degree, the meaning of which varies between different jurisdictions. In the United States, and some other countries, the M.D. denotes a professional degree. This generally arose because many in 18th-century medical professions trained in Scotland, which used the M.D. degree nomenclature. In England, however, Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) was used and eventually in the 19th century became the standard in Scotland too. Thus, in the United Kingdom, Ireland and other countries, the M.D. is a research doctorate, honorary doctorate or applied clinical degree restricted to those who already hold a professional degree (Bachelor's/Master's/Doctoral) in medicine. In those countries, the equivalent professional degree to the North American, and some others' usage of M.D. is still typically titled Bachelor of Medicine, Bachelor of Surgery.^[1]

History

The first medical degrees were awarded by the Schola Medica Salernitana around the year 1000, including to women such as Trota of Salerno.^[2][3] The degrees received legal sanction in 1137 by Roger II of Sicily and in 1231 by Emperor Federico II, in the Constitution of Melfi.^[4] In the titles XLIV-LXXXIX of the third book of the Constitutions of 1231, it was established that the activity of a physician (medicus) could only be carried out by physicians holding a medical degree, the Licentia Medendi (license to practice medicine), by the Schola Medica Salernitana (the only school in the kingdom authorized to award degrees in medicine).^[2][5] This degree was awarded after a curriculum composed of three years of study of logic, five years of medical studies, an examination of a commission composed of the professors of the university, a one-year apprenticeship with an expert doctor, and a final examination before the commissioners of the Royal Curia and the Provincial Curias.^[5]

In 1703, the University of Glasgow's first medical graduate, Samuel Benion, was issued with the academic degree of Doctor of Medicine.^[6]

University medical education in England culminated with the MB qualification, and in Scotland the M.D., until in 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 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 M.D. title rather than the MB beginning in the late 18th century. 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 M.D. degree instead of the MB.^[7]

Early medical schools in North America that granted the Doctor of Medicine degrees were Columbia, Penn, Harvard, Maryland, and McGill.^[8] 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.

In most countries having a Doctor of Medicine degree does not mean that the individual will be allowed to practice medicine. Typically a physician must go through a year of general medical education in a hospital as an intern and then a residency for at least three years in a specific field of medicine and then take some form of licensing examination in their jurisdiction.

A feminine form, "Doctress of Medicine" or Medicinae Doctrix, was also used by the New England Female Medical College in Boston in the 1860s.^[9][10][11]

By country

Professional degrees

Afghanistan

In Afghanistan, medical education begins after high school. No pre-medicine courses or bachelor's degree is required. Eligibility is determined through the rank applicants obtain in the public university entrance exam held every year throughout the country. Entry to medical school is competitive, and only students with the highest ranks are accepted into medical programs. The primary medical degree is completed in 7 years. According to the new medical curriculum (from 2016), during the 12th semester, medical students must complete research on a medical topic and provide a thesis as part of their training. Students have also a one-year compulsory internship which has to be completed in a teaching hospital. Medical graduates are awarded a certificate in general medicine, regarded as "MD" and validated by the "Ministry of Higher Education of Afghanistan". All physicians are to obtain licensing and a medical council registration number from the "Ministry of Public Health" before they officially begin to practice. They may subsequently specialize in a specific medical field at medical schools offering the necessary qualifications. After graduation, students may complete residency.

The MD specification: Before the civil wars in Afghanistan, medical education used to be taught by foreign professors or Afghan professors who studied medical education abroad. The Kabul medical institute certified the students as "Master of Medicine". After the civil wars, medical education changed extensively, and the MD certification has been reduced to "Medicine Bachelor".

Argentina

In Argentina, the First Degree of Physician or Physician Diplomate (Spanish: Título de Médico)^[12] is equivalent to the North American MD Degree with six years of intensive studies followed by usually three or four years of residency as a major specialty in a particular empiric field, consisting of internships, social services and sporadic research. Only by holding a Medical Title can the postgraduate student apply for the Doctor degree through a doctorate in medicine program approved by the National Commission for University Evaluation and Accreditation ^[es].^[12]

Australia

Historically, Australian medical schools have followed the British tradition by conferring the degrees of Bachelor of Medicine and Bachelor of Surgery (MBBS) to its graduates whilst reserving the title of Doctor of Medicine (MD) for their research training degree, analogous to the PhD, or for their higher or honorary doctorates. Although the majority of Australian MBBS degrees have been graduate programs since the 1990s, under the previous Australian Qualifications Framework (AQF) they remained categorized as Level 7 Bachelor's degrees together with other undergraduate programs.

The latest version of the AQF includes the new category of Level 9 Master's (Extended) degrees which permits the use of the term 'Doctor' in the styling of the degree title of relevant professional programs. As a result, various Australian medical schools have replaced their MBBS degrees with the MD to resolve the previous anomalous nomenclature. With the introduction of the Master's level MD, universities have also renamed their previous medical research doctorates. The University of Melbourne was the first to introduce the MD in 2011 as a basic medical degree, and has renamed its research degree to Doctor of Medical Science (DMedSc).^[13]

Australian National University offers a Doctor of Medicine and Surgery (MChD, abbreviated from Medicinae ac Chirurgiae Doctoranda) which is also a 4-year extended master's degree that qualifies graduates to be medical practitioners or work as surgeons.^[14]

Austria

In Austria, medical studies (medicine or dentistry) take six years full-time. In medicine, the first two years comprise basic fields of medicine such as anatomy, biology, chemistry, physics, physiology, etc., the next three years consist of all medical fields in the narrower sense with frequent bedside training and medical traineeships while the sixth and last year is dedicated solely to working in a clinic. After this, a specific six-year training (e.g. in internal medicine, paediatrics, ENT, pathology) or four year (GP) can be started; without this training, working with patients is forbidden. There is no central placement test for said specialist training, only a board-registered spot as a resident/registrar is needed. As with all other studies in Austria, there is no tuition but compulsory students' insurance (approx €38 per year). A specific entrance exam (MedAT, Medizin-Aufnahmetest, medicine acceptance test) has to be taken but is open only once a year in summer; a fee of €110 has to be paid. In 2019, 16443 persons registered for the MedAT and 12960 took the test.^[15] 1.680 university places for both medicine and dentistry are offered each year with 95% of all places for EU citizens and 75% for applicants with an Austrian higher education entrance qualification/GCE A-levels. Many Germans who are denied studying in their home country try to study medicine in Austria; hence this quota was introduced and approved by the EU as most of them leave upon graduation.^[16]

The title of "Doktor" is granted to physicians (Dr. med. univ., Doctor medicinae universae, Dr. der gesamten Heilkunde = Dr. "of the entire art of healing") and dentists (Dr. med. dent., Doctor medicinae dentinae), who do not possess doctorate degrees, but Master's level 6 year-training, similar to the American MD or DDS.^[17] although they have to write a diploma thesis of approx. 50–100 pages. In former days the same title was connected to an official doctorate degree in connection with an older study regulation.^{[18][circular reference][19][20]} The law has been changed in 2002. Some of which are published in peer-reviewed journals while others are not. A post-graduate research doctorate (Dr. scient. med., Dr. scientiae medicinae, or PhD) can be obtained after a three years post-graduate study at a medical university.

All doctors may be addressed as "Doktor ______", and the title is usually contracted to "Dr. ______". In many everyday-day settings in Austria, also outside the clinic, it is common to address medical doctors solely as "Herr/Frau Doktor" (Mr./Ms./Mrs. doctor) without any specific family name (especially in rural areas and small villages, and by older people), and they are often viewed as the "real doctors". Among themselves, MDs do not use "doctor" as an appellation but just "Herr Kollege/Frau Kollegin" (Mr./Ms/Mrs. = "dear" colleague). Consistent use of "Doktor" when addressing another medical doctor is seen as confrontative and mockery.

Belgium

In Belgium, the medical degree awarded after six years of study is called "Docteur en Médecine" in the French-speaking part of the country and "Master in de geneeskunde" in Flanders. Physicians would then have to register with the Ordre des Médecins to practice medicine in the country. Physicians would then either have to do a three-year internship to become a general practitioner or up to 6 years to specialize.

Bosnia and Herzegovina

In Bosnia and Herzegovina, the title of "doktor medicine" (abbreviated "dr. med.") is awarded upon completion of six years of study at a Faculty of Medicine ("medicinski fakultet") immediately after high school.

Botswana

In Botswana, the seven-year medical studies only begin after the completion of senior secondary education and obtaining enough points to qualify for admittance to the University of Botswana. Students pursuing science based or STEM careers i.e. medicine are admitted to a two-year Bsc course where they'll be taught chemistry, Physics and Biology. Students who obtained extremely good grades at the end of this course are cherry picked to further their studies at the School of Medicine (A faculty of the university) if they wish to pursue a medical career. Standards are very high and admittance is strict with only about 50 students out of three to five thousand being able to qualify for medical studies.

Here, the students specialise, and choose which medical careers they're going for. After doing so, students are placed in their respective classes; learning, studying and practicing their choice of medicine. Furthermore, it is in this school that they pursue an MBBS degree (Bachelor of Medicine Bachelor of Surgery) for five years.

In these five years, the first two follow an integrated problem based learning approach. The last three years are clinically structured, providing an opportunity to practice in medical institutions and communities. An equivalent to residencies and internships in the medical western world.

After completion of their internships. They graduate and are honoured with an MBBS degree and a medical practitioner license. Those that wish to further their studies can do so in order to pursue PhDs and master's degrees in medicine.

Bulgaria

At the end of the six-year medical programs from Bulgarian medical schools, medical students are awarded the academic degree Master/Magister in Medicine and the professional title Physician – Doctor of Medicine (MD / MA ).^[21][22]

Cambodia

After six years of general medical education (a foundation year plus five years), all students will graduate with a Bachelor of Medical Sciences (BMedSc, Khmer: បរិញ្ញាប័ត្រ វិទ្យាសាស្រ្តវេជ្ជសាស្ត្រ), equivalent to Bachelor of Science, Bachelor of Surgery (MBBS). This degree does not allow graduates to work independently as a physician, but it is possible for those who wish to continue to master's degrees in other fields relating to medical sciences such as public health, epidemiology, biomedical science, and nutrition.

Medical graduates, who wish to be fully qualified as physicians or specialists must follow the process as below:

• General Practitioner's (GP) course of eight years (BMedSc plus a two-year internship). Clinical rotation during the internship is modulated within four main disciplines (general medicine, surgery, gynecology, and pediatrics). The medical certification awarded is Diploma of Doctor of Medicine (MD, Khmer: បណ្ឌិតវេជ្ជសាស្ត្រ ឬ វេជ្ជបណ្ឌិត) – equivalent to a master's degree .
• After graduating with BMedSc; any students who wish to enter a 'Residency Training Program', are required to sit for an Residency Entrance Exam. The duration of the programs takes four years after either BMedSc or MD (BMedSc or MD plus four years of specialization). Once the graduates have successfully defended their practical thesis, they are awarded the Diploma of Specialized Doctor (MD with specialization, Khmer: សញ្ញាប័ត្រ៖ វេជ្ជបណ្ឌិតឯកទេស, lit. 'Professional Doctorate').

All medical graduates must complete a 'Thesis Defense' and pass the National Exit Exam (Khmer: ប្រឡងចេញថ្នាក់ជាតិក្នុងវិស័យសុខាភិបាល) to become either GPs or medical or surgical specialists. Last but importantly, those GPs or MDs have to register their name in the Cambodian Medical Committee (CMC) to receive the license to see patients, and pay for the registration every year.

Canada

In Canada, the M.D. is the degree required to practise medicine. Similar to the United States, students in Canada from English-speaking provinces must complete four years of a bachelor's degree, then write the MCAT at which point they move into the typical four year medical school curriculum. As a practical matter, nearly all successful applicants have completed one or more degrees before admission to a Canadian medical school, although despite this it is, along with other first professional degrees, the Canadian M.D. is considered to be a bachelor's degree-level qualification.^[23][24]

The notable exception is the French-speaking province of Quebec, where their special CEGEP post-secondary institutions do not grant a bachelor's degree, but instead College Education Diplomas (DECs). Students typically enroll in a two-year Science Program such as Health Science, Pure & Applied, or Environmental (latter exclusive to CEGEP Dawson College) which lead into the Med-P qualifying year at Mcgill University or l'Université de Montréal, after which students complete the four-year curriculum similar to other provinces. Other Quebec universities such as the Université Laval and Université de Sherbrooke admit students possessing a DEC directly into the four-year program. This in total means the path to graduation from medical school is one to two years shorter for Quebec students (six or seven as opposed to eight).

Another exception is the availability of a 3-year medical school curriculum, offered at two medical schools in Canada, the McMaster University Medical School and the University of Calgary.

McGill University Faculty of Medicine is the only medical school in Canada that continues to award the M.D., C.M. degrees (abbreviated M.D.C.M.). M.D.C.M. is from the Latin Medicinae Doctorem et Chirurgiae Magistrum meaning "Doctor of Medicine and Master of Surgery".

Upon graduation, students enter into a residency phase of training. Prior to obtaining an independent practicing license from a provincial regulatory body, students must complete the Medical Council of Canada Qualifying Examination to obtain the Licentiate of the Medical Council of Canada (LMCC) qualification.^[25] and complete the specialty certifying exam from their respective college, the Royal College of Physicians and Surgeons of Canada for specialists and the College of Family Physicians of Canada for family physicians.

Chile

In Chile, medical education begins after graduating high-school, in public or private universities, which select candidates based on a national entrance exams (former University Selection Test, now in transition to a new selection test). Public universities and private universities cost around US$8,000–12,000 a year. In almost every university the career lasts for 7 years, the first two being basic sciences, then three years of preclinical studies, and ending with two years of supervised clinical practice (internship, or "internado") both at hospitals and ambulatory centers. Upon graduation, students obtain the professional title "Médico Cirujano", equivalent to Doctor of Medicine (MD). After graduation every new physician must take the EUNACOM ^[es] (National Exam of Medical Knowledge), which gives the ability to practise medicine in public establishments of primary or hospital care. The title enables the graduate to practice as a General Practitioner, and many of them may follow specialization studies in clinical or non-clinical fields. There is a national program of accreditation, mandatory to every Medicine School. In Chile, physicians receive the courtesy denomination of Doctor followed by their family name, even though in an academic environment the medical title is not accepted as an equivalent to PhDs; regardless, at community and family level, and in day-to-day activities, they are often viewed as "real doctors".

China

In China, many prestigious research universities such as Peking Union Medical College, Peking University Health Science Center, and Shanghai Jiao Tong University offer the eight-year Doctor of Medicine program. In the meantime, the majority of primary medical training comes in the form of a 5-year Bachelor of Medicine degree, which includes 2.5 years of basic science and biomedical science training and 2.5 years of clerkship training. Graduates from such programs are eligible to sit for Medical Doctor License Examination in China providing they are working as resident physicians in a hospital. Many of the young doctors do seek further training by entering a three-year Master of Medicine (clinical track) program or five-year Doctor of Medicine (clinical track). Some take a job/promotion after the three-year program and work for a number of years and then take on another three years of training to get the ultimate Doctor of Medicine degree.^[26]

Croatia

In Croatia, the title of "doktor medicine" (abbreviated "dr. med.") is awarded to candidates who successfully completed six years of study in medicine and defended their graduate thesis (student's original research in clinical / preclinical medicine or life sciences). The title is legally awarded only upon the successful thesis exam (thesis defence) in the presence of a board of senior researchers and candidate's research mentor. It is not equivalent to "doktor znanosti" degree ("doctor scientiae", abbreviated "dr.sc."), which is equivalent to PhD.

Cuba

In Cuba, the title of "Doctor en Medicina" (Doctor of Medicine) is awarded upon completion of six years of study at a University of Medical Sciences after high school. Medicine was one of the four foundational careers of the first Cuban university named Real y Pontificia Universidad de San Jeronimo de La Habana (current University of Havana) founded in 1728.

Czech Republic

In the Czech Republic, students are awarded the title MUDr. (medicinae universae doctor in Latin) upon successfully passing set of State Examinations after six years of medical school composed of theoretical and clinical training.

Dominican Republic

In the Dominican Republic, it is known as "Doctor en Medicina" (Doctor in Medicine). In 1511 the Spanish Catholic church founded the first university of the Americas in Santo Domingo present capital of modern-day Dominican Republic and name it Universidad Santo Tomas de Aquino (today Universidad Autonoma de Santo Domingo). In 1630 this university graduated the first medical doctors of the Americas and amongst the graduates some Native Americans included.

Ecuador

In Ecuador, medical school begins after graduating high-school. There are two options; applying to public or private universities. Both private and public university select their candidates based on entrance exams. Public universities are free while private universities cost around US$6,000–12,000 a year. In most universities, the career lasts for six years. After graduating, students obtain a degree of "médico" or "médico cirujano", depending which one is offered by each university. Both degrees are equivalent to doctor of medicine (MD).

Egypt

In Egypt, the primary medical degree is Bachelor of Medicine and Surgery (MBBCh.), which is obtained after completion of six years of medical education and one year National Compulsory Internship Program. The Degree Doctor of Medicine (MD) is the highest academic medical degree in Egypt. It is a research degree obtained after the primary medical qualification (MBBCh.) and a master's degree in a certain specialty in medicine. It usually requires coursework, clinical training and a thesis. The degree Doctor of Medicine allows for promotion to the level of "Consultant Physician" in a specific medical specialty.

Estonia

In Estonia, there is only one university, The University of Tartu, with programs in medicine and dentistry. The program in medicine lasts for six years, including a one-year clinical internship, and students are awarded Doctor of Medicine (MD) upon graduation. The degree is academically equivalent to a master's degree. After that, one can work either as a general practitioner or enter a residency program to become a specialized doctor. Residency usually lasts, depending on the field, three to five years, with surgical residencies usually being the longest (5 years).

France

After graduating from high school with a Baccalaureat, any student can register at a university of medicine (there are about 30 of them throughout the country). Until 2018, at the end of the first year, an internal ranking examination took place at each of these universities in order to implement the numerus clausus. This ranking examination and the numerus clausus has since been abolished. First year consists primarily of theoretical classes such as biophysics and biochemistry, anatomy, ethics or histology. Passing first year is generally considered very challenging, requiring hard and continuous work. Each student can only try twice. For example, prior to its 2019 merger with Paris Diderot University, the Université René Descartes welcomed about 2,000 students in the first year and only 300 after numerus clausus.

The second and third year are usually quite theoretical although the teachings are often accompanied by placements in the field (e.g., internships as nurses or in the emergency room, depending on the university).

During their fourth, fifth and sixth years, medical students get a special status called "externe" (In some universities, such as Pierre et Marie Curie, the externe status is given beginning in the third year). They work as interns every morning at the hospital plus a few night shifts a month and study in the afternoon. Each internship lasts between three and four months and takes place in a different department. Med students get five weeks off a year.

At the end of the sixth year, they need to pass a national ranking exam, which will determine their specialty. The first student gets to choose first, then the second, etcetera. Usually, students work hard during the fifth and sixth years in order to train properly for the national ranking exam. During these years, actual practice at the hospital and in conjunction with some theoretical courses are meant to balance the training. Such externs' average wage stands between 100 and 300 euros a month.

After taking those ranking exams, students can start as residents in the specialty they have been able to pick. That is the point from which they also start getting paid.

Towards the end of the medical program, French medical students are provided with more responsibilities and are required to defend a thesis; however, unlike a PhD thesis, no original research is actually necessary to write an MD thesis. At the conclusion of the thesis defense, French medical students receive a State Diploma of Doctor of Medicine (MD, French: diplôme d'Etat de docteur en médecine). Every new doctor must then proceed to a Diploma of Specialised Studies (DES, French: diplôme d'Etudes spécialisées) to mark their specialty. Some students may also receive a Diploma of Complementary Specialized Studies (DESC, French: diplôme d'Etudes spécialisées complémentaires).^[27]

Georgiaedit

In Georgia, medical universities in Georgia offer a six-year curriculum leading to award Doctor of Medicine (MD) "Physician" "Medical Doctor (MD), a European medical degree which is valid throughout the world. Some of the reputed medical universities include Batumi State University,^[28][29] Tbilisi State Medical University, Akaki Tsereteli State University, Ilia State University and University of Georgia^[30]

Germanyedit

After at least six years of medical school, the students graduate with a final federal medical exam (Dritter Abschnitt der ärztlichen Prüfung). Graduates receive their license to practice medicine and the professional title of physician (Arzt). About 60% of them additionally obtain the academic degree Doctor of Medicine (Dr. med.).^[31] The European Research Council ruled in 2010 that a medical doctorate alone is not considered equivalent to a PhD research degree for the purpose of selection for ERC Starting Grants, requiring additional evidence (e.g., proof of an appointment that requires doctoral equivalency, such as a post-doctoral fellowship) for the overall training to be considered equivalent to a PhD.^[32]

Guyanaedit

In Guyana, Doctor of Medicine (MD) degree is awarded after the completion of four years or five years of study. Texila American University, Green Heart University, American International School of Medicine, Alexander American University, Lincoln American University provides medicine programs.

Hungaryedit

Zdroj:https://en.wikipedia.org?pojem=Doctor_of_Medicine
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