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Bachelor of Medicine and Surgery
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Bachelor of Medicine, Bachelor of Surgery, or in Latin Medicinae Baccalaureus, Baccalaureus Chirurgiae (abbreviated in various ways, viz. MB BChir, BM BCh, MB BCh, MB ChB, BM BS, MBBS, M.B.B.S. etc.), are the two first professional degrees awarded upon graduation from medical school in medicine and surgery by universities in various countries that follow the tradition of the United Kingdom.
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Bachelor of Medicine, Bachelor of Surgery, or in Latin Medicinae Baccalaureus, Baccalaureus Chirurgiae (abbreviated in various ways, viz. MB BChir, BM BCh, MB BCh, MB ChB, BM BS, MBBS, M.B.B.S. etc.), are the two first professional degrees awarded upon graduation from medical school in medicine and surgery by universities in various countries that follow the tradition of the United Kingdom. The naming suggests that they are two separate degrees; however, in practice, they are usually treated as one and awarded together.
History and nature
The degrees of Bachelor of Medicine and Bachelor of Surgery are currently awarded in various forms in institutions in Australia, Bangladesh, Barbados, the Republic of China, Egypt, Fiji, Ghana, Guyana, Hong Kong, India, Iraq, the Republic of Ireland, Jamaica, Jordan, Kenya, Kuwait, Libya, Malawi, Malaysia, Mauritius, Mexico, Myanmar, Nepal, New Zealand, Nigeria, Pakistan, Papua New Guinea, Samoa, Saudi Arabia, Sierra Leone, Singapore, South Africa, Sri Lanka, Sudan, Tanzania, Trinidad and Tobago, the United Arab Emirates, the United Kingdom, Zambia and Zimbabwe.
Historically, Bachelor of Medicine was also the primary medical degree conferred by institutions in the United States and Canada, such as the Pennsylvania, Harvard, Toronto, Maryland, and Columbia. Several early North American medical schools were (for the most part) founded by physicians and surgeons who had trained in England and Scotland. University medical education in England culminated with the Bachelor of Medicine qualification, and in Scotland the Doctor of Medicine, until from the mid-19th century when the public bodies that 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. Throughout the 1800s, North American medical schools switched to the tradition of the Ancient universities of Scotland and began conferring Doctor of Medicine rather than Bachelor of Medicine, the first institution to make such a switch being King's College (now Columbia University) in New York.
In the countries that award bachelors' degrees in medicine, however, Doctor of Medicine denotes a holder of a higher doctorate and is reserved for medical practitioners who undertake research and submit a thesis in the field of medicine. Nevertheless, those holding Bachelor of Medicine, Bachelor of Surgery are usually referred to by the courtesy title of "Doctor" and use the prefix "Dr".
Despite their styling as two degrees, Bachelor of Medicine and Bachelor of Surgery are usually conferred together. At some institutions, such as Oxford and Cambridge, it was possible in the past to be awarded the two degrees in different years.
In many countries, the degrees are awarded after an undergraduate course lasting five or six years. In some cases, a graduate in another discipline may subsequently enter a special graduate-entry medical course, reduced in duration to account for relevant material covered or learning skills acquired during the first degree. In some cases the old first year courses (for six year degrees) in the basic sciences of physics, chemistry and biology have been abolished, and that standard has to be reached by means of school examinations before entry. However, in most countries a newly-graduated Bachelor of Medicine and Surgery must spend a specified period in internship before they can obtain full qualification as a medical practitioner.
Naming
The specific names and abbreviations given to these degrees depend on the particular institution, awarding body or country, and vary widely; this is mostly for reasons of tradition rather than to indicate any particular difference between the relative levels of the degrees, and they are considered equivalent.
If the awarding body titles the degrees in Latin, the degrees are commonly named Medicinae Baccalaureus, Chirugiae Baccalaureus, Medicinae Baccalaureus et Chirurgiae Baccalaureus, or Baccalaureus in Medicina et in Chirurgia, abbreviated as MB ChB, MB BCh or otherwise. If titled in English, they are named Bachelor of Medicine, Bachelor of Surgery, Bachelor of Medicine and Bachelor of Surgery, or Bachelor of Medicine and Surgery, usually abbreviated as MB BS, and rarely as BM BS, even though most MB BS-awarding institutions do not use Latin to name their degrees.
Below are described the specific names used, arranged by country.
Australia
MB BS are conferred by most Australian medical schools. The graduate-entry Flinders medical school confers BM BS. The University of Newcastle confers BMed; although no degree in surgery is formally awarded by Newcastle, this degree is equivalent to the MB BS, and students may go on to a career in surgery the same as any other graduates in medicine and surgery.
Egypt
All medical schools in Egypt award MB BCh.
England
Various abbreviations are used for these degrees in England:
- MB ChB are used at the universities of Birmingham, Bristol, Edinburgh, Leeds, Leicester, Liverpool, Keele, Manchester, Sheffield, and Warwick.
- MB BS are used at the University of East Anglia, Hull York Medical School, Imperial College London, the University of London (comprising of the UCL Medical School, St. George's, University of London, King's College London Medical School, and St. Bartholomew's and the London Medical School), and Newcastle University.
- BM BCh are used at the University of Oxford.
- BM BS are used at the University of Nottingham, Peninsula College of Medicine and Dentistry, and Brighton Sussex Medical School
- BM is awarded at the University of Southampton. Although no degree in surgery is formally awarded by Southampton, this degree is equivalent to the MB ChB, and students may go on to a career in surgery the same as any other graduates in medicine and surgery.
- MB BChir are awarded by the University of Cambridge.
At the Universities of Oxford and Cambridge, the preclinical course leads to an additional Bachelor of Arts degree (upgradable after three or four years to Master of Arts), after which most students used to go elsewhere (but usually to one of the London teaching hospitals) to complete clinical training. They could then take the degrees of their new university: they used to have the options of returning to their old university to take the clinical examinations, or taking one of the old non-university qualifying examinations.
The English Triple Conjoint Diploma diplomas: LRCP, LRCS, LMSSA were non-university qualifying examinations in medicine and surgery awarded jointly by the Royal College of Physicians of London, Royal College of Surgeons of England and Society of Apothecaries through the United Examining Board from 1994 until 1999, when the General Medical Council withdrew permission. Prior to 1994, the English Conjoint diploma of LRCP, MRCS was awarded for 110 years, and the LMSSA was a distinct and sometimes less-esteemed qualification. These diplomas slowly became less popular among British medical students, but as recently as 1938 only a half of them qualified with university degrees.The diplomas came to be taken mostly by those who had already qualified in medicine overseas.
Guyana
The University of Guyana awards MB BS. Other "offshore" United-States-linked schools in the country award the North American MD, but these are not recognized in Guyana itself.
Hong Kong
The awarding of qualifications in Hong Kong has continued to follow the British tradition despite the handover of the territory's sovereignty from the hands of the United Kingdom to the People's Republic of China on 30 June 1997.
The dual degree is awarded as:
India
Medical colleges in India award MB BS. Licenciate qualifications in medicine and surgery, LMS or LMP, were also formerly awarded after a shorter course, originally at a "medical school" rather than a "medical college".
In addition, the College of Physicians and Surgeons of Bombay formerly awarded a licentiate at LMS level, a membership (MCPS) at MB BS level and a fellowship (FCPS) at MD level and the State Medical Faculty of West Bengal (previously of Bengal) similarly gave licentiates and memberships on an external basis.
Iraq
All medical schools in Iraq award MB ChB.
Ireland
The University of Limerick awards BM BS. The other medical schools in both the Republic of Ireland and Northern Ireland—namely Queen's University Belfast, University of Dublin (Trinity College), some constituent institutions of the National University of Ireland (University College Dublin, University College Cork and National University of Ireland, Galway), and the Royal College of Surgeons in Ireland—award the degrees of MB BCh BAO. The letters BAO stand for Baccalaureus in Arte Obstetricia (Bachelor of Obstetrics), a degree unique to Ireland which the Irish universities added in the 19th century as the legislation at the time insisted on a final examination in obstetrics. This third degree is an anachronism which is not registerable with the Irish Medical Council nor the British General Medical Council (GMC).
LRCPI LRCSI, or simply LRCP&SI, denotes a holder of the historical non-university qualifying licenciates awarded jointly by the Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland to students of the RCSI's medical school under the Irish Conjoint Scheme. Unlike the corresponding licentiates awarded by the Royal Colleges in Scotland and England (which were external qualifications), these qualifications are still registerable with the Irish Medical Council, but not with the British GMC. Students at RCSI still receive these licenciates but now also receive the degrees MB BCh BAO, due to RCSI's status as a recognised college of the National University of Ireland. The RCSI students also received a Licence in Midwifery (LM) from each college, in the same way that the Irish universities granted BAO degrees, so their qualifications were sometimes expressed as L & LM, RCPI, L & LM, RCSI or more misleadingly as LLM, RCP&SI.
LAH formerly denoted a licentiate of the now-defunct Apothecaries' Hall, Dublin, and is no longer awarded.
Kenya
The national universities with medical faculties in Kenya, namely the University of Nairobi, Kenyatta University and Moi University, award MB ChB.
Malaysia
The University of Malaya and Universiti Teknologi MARA both award MB BS. Other public universities such as Universiti Kebangsaan Malaysia, Universiti Sains Malaysia, Universiti Putra Malaysia, Universiti Malaysia Sabah and Universiti Malaysia Sarawak, however, follow the North American model and style their degrees as Doctor of Medicine. However, it is questionable whether such degrees are academically equivalent to the US award, since the latter universities usually require entrants to have a four year bachelor degree before entry into a professional medical degree.
Mexico
Most medical schools last for 5 or 6 years, which include 1 or 2 years of internship in public and/or private hospitals. After those years of school, every medical student is required to complete one year working in rural places. This year is referred to as "social service." During this year the student may practice medicine although the title can not be awarded until this year has been completed. After the social service year the student receives the title of "Physician and Surgeon" (or Doctor).
Myanmar
All four medical schools in Myanmar award MB BS.
Nepal
All 12 medical schools in Nepal award MB BS.
New Zealand
The two New Zealand medical schools, Auckland and Otago, style their degrees as MB ChB.
Pakistan
All medical schools in Pakistan award the MB BS degree after completion of an undergraduate medical education.
Scotland
All medical schools in Scotland (Aberdeen, Glasgow, Edinburgh and Dundee) award MB ChB.
The University of St Andrews's Bute Medical School awarded MB ChB until the early 1970s, but since the incorporation of its clinical medical school into the University of Dundee, St Andrews now only awards a pre-clinical BSc or BSc (Hons), and students go elsewhere to finish their clinical training, usually to the University of Manchester where they are awarded an MB ChB after a further three years' study.
The Scottish Triple Conjoint Diploma of LRCPE, LRCSE, LRCPSG (earlier LRCPE, LRCSE, LRFPSG) is an old non-university qualifying examination in medicine and surgery awarded jointly by the Royal College of Physicians of Edinburgh, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, previously through a Conjoint Board and from 1994 through the United Examining Board. These qualifications are still registrable with the GMC, but permission to award them was withdrawn by the Privy Council of the UK in 1999.
South Africa
The University of Pretoria, University of Cape Town, University of the Free State, University of Stellenbosch, University of KwaZulu-Natal and MEDUNSA all award MB ChB, whereas the University of the Witwatersrand styles its degree as MB BCh.
Singapore
The Yong Loo Lin School of Medicine at the National University of Singapore confers MB BS. The American Duke University also has a medical programme based in Singapore, but it follows the North-American model of styling its degree Doctor of Medicine.
Sri Lanka
The University of Colombo, University of Peredeniya, University of Kelaniya (Ragama), University of Ruhuna and University of Jaffna all award MB BS.
Wales
All medical schools in Wales award MB BCh.
West Indies
All constituent countries of the University of the West Indies (UWI) confer MB BS, due to the historical affiliation of UWI to the University of London.
Other medical schools in the West Indies however follow the American system leading to the 'MD' qualification.
Classification
Medical degrees differ from other undergraduate degrees in that they are professional qualifications which lead holders to enter a particular career upon receipt. This is not the case with most other undergraduate degrees, with the exception of qualifications in pharmacy, dentistry, veterinary medicine and qualifying law degrees, so whilst the Bachelor of Medicine and Bachelor of Surgery are undergraduate or graduate degrees (depending on the institution), they are perhaps more accurately conceptualised as a so-called first professional degree.
Bachelor of Medicine, Bachelor of Surgery are usually awarded as general/ordinary degrees, not as honours degrees, and as such the graduate is not classified as for honours degrees in other subjects. However, at many institutions (for example the University of Manchester in England and the University of Dundee in Scotland) it is possible for the degrees to be awarded with Honours (i.e. MB ChB (Hons)) or with Commendation, if the board of examiners recognises exceptional performance throughout the degree course. Very few of these are awarded.
More often, it is possible to study one subject for an extra year for an intercalated honours degree. This is usually a Bachelor of Science (BSc), Bachelor of Medical Science (BMedSci), Bachelor of Medical Biology (BMedBiol) or similar: at Oxford and Cambridge in England and Dublin in Ireland Bachelor of Arts degrees are awarded. At a few universities most medical students obtain an ordinary degree in science as well: when the University of Edinburgh had a six year course, the third year was followed by award of an ordinary BSc(MedSci). In Australia, The University of Melbourne in Australia offers an Arts Degree (BA) to a medical student on the completion of two extra years of undergraduate study, and Monash University offers a Law degree (LLB); if the optional Law degree is undertaken, on completion of their degree the student may choose to do a one-year internship at a hospital and become a doctor, or spend one year doing articles to practise thereafter as a lawyer. At the University of Nottingham in England all medical students on the five year course obtain a Bachelor of Medical Sciences (BMedSci) degree without an extra intercalated year. The Royal College of Surgeons in Ireland along with certain National University of Ireland medical schools offers a BMedSci qualification on completion of a thesis based on 2-3 months of summer research; only students achieving honours in their preclinical courses are eligible to receive the degree. At Imperial College London certain medical students are able to extend their intercalated year to an extra three years, thus temporarily exiting the MBBS course to complete a PhD. Upon completion of the PhD, the student is required to sit the remaining 2 years of the medicine course in order to receive his/her MBBS degeee.
Progression
Medical school graduates are only entitled to use the courtesy title "Doctor" upon registration as a medical practitioner with the relevant regulatory body in their respective country.
Medical graduates are also eligible to sit various postgraduate examinations, including examinations for membership and fellowship of professional institutions (such as Membership of the Royal College of Surgeons), postgraduate Masters degrees (such as a Master of Surgery or Master of Obstetrics) and a postgraduate doctorate in medicine (eg Doctor of Medicine, if earned in Ireland, the UK or Commonwealth nations), and board certification examinations.
See also
Footnotes
Notations
- (PHY-993) Use of the M. D. Title: The Wisconsin Medical Society: 1) defends the use of the M.D. title by physicians who graduated with an M.B.B.S. and are licensed to practice medicine in Wisconsin. (HOD,0495)
http://www.cmb.ac.lk/academic/medicine/index.htm
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