Conjoint
Encyclopedia
The conjoint was a basic medical qualification in the United Kingdom
administered by the United Examining Board
. It is now no longer awarded. The Conjoint Board was superseded in 1994 by the United Examining Board
, which lost its permission to hold qualifying medical examinations after 1999.
Medical education at the London
Teaching Hospital
s began some centuries before there was a university in London to award medical degrees. Those who had taken BAs
at Oxford
or Cambridge
, or occasionally started their pre-clinical education at universities further afield, could return there to take medical examinations, but it was open to most to take the examinations of the London medical corporations.
As the early 19th century law restricting medical employment in the British military to those who had qualifications in both medicine and surgery was taken to require diplomas from different organisations, it became customary to take both the Licence of the Society of Apothecaries (LSA) and the Membership of the Royal College of Surgeons of England
(MRCS).
These corporations diverged: the Society of Apothecaries added surgery to their examination, to grant a Licence in Medicine and Surgery (LMSSA) as a complete qualification. The surgeons then teamed up with the Royal College of Physicians of London who paired their Licentiate diploma (LRCP) with the MRCS to create the English Conjoint Diploma in 1884.
The London LRCP had previously been a means for bachelors or licentiates in medicine from Oxford and Cambridge (and a few MDs from elsewhere) to qualify to practice in London as physicians (i.e internal medicine specialists, as distinct from surgeons or apothecaries). The old LRCP also allowed the holder by custom to be addressed as "doctor" without holding a university doctorate: this privilege became generalised in the 19th century to all licentiates and bachelors of medicine.
The nomenclature of the diplomas may have contributed to the nearly-obsolete practice of general practitioners styling themselves as "Physician and Surgeon": previously they were mostly regarded as Apothecaries.
(There were also Scottish and Irish conjoint qualifications: the former became known as the Triple Qualification.)
In the 19th century the new University of London
Bachelor of Medicine and Bachelor of Surgery degrees were regarded as more academic than the Royal Colleges' diplomas, so many people qualified and started practice with the Conjoint before taking the M.B. and B.S. a year or two later. This paralleled the practice in some European countries of taking a state medical examination separately from or instead of a university degree. In the English provincial cities, some medical schools developed separately from the new Redbrick universities, so the Conjoint diplomas were at first usually taken.
Armed forces officer cadet
s would be promoted from second lieutenant
to lieutenant
on qualifying, which included the conjoint qualification. The difference in pay between the times of the two exams would more than pay for the entry fee, and also seniority in the officer corps would be enhanced by those few months.
The conjoint diploma of the London Royal Colleges (Royal College of Surgeons of England
and Royal College of Physicians of London) was more reputable in its day, but after World War II it was regarded as a practice exam before university
finals. It provided a safety net, in that medical student
s unsure whether they would pass or fail would have two chances if they took both.
By far the greatest use of the Conjoint and similar qualifications in recent years was as a means for foreign medical graduates to obtain British qualifications, which eased their problems of obtaining registration and employment in the U.K., and also made it easier to go on to work in third countries.
The scheme of examinations included a notional full set of pre-clinical subjects (anatomy, physiology, pharmacology, pathology, etc) from which those who had university passes or another final medical qualification would be exempted: but fees might still have to be paid.
The closure of this portal, along with the recent recategorisation of junior doctors from student to worker status for immigration purposes, may hasten the changeover of the National Health Service
's dependence from Third World
medical graduates to European Union
doctors, who may not be asked to submit to further examination.
These subtleties of the British system of medical qualifications were rarely known to patients, who may have been more impressed to see "MB BS MRCS LRCP" on a brass plate than "MD FRCP"
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
administered by the United Examining Board
United Examining Board
The United Examining Board was formed in 1993 to administer non-university qualifying examinations in medicine and surgery. The diplomas offered by the United Examining Board were registerable with the General Medical Council in order to register as a medical practitioner in the United Kingdom,...
. It is now no longer awarded. The Conjoint Board was superseded in 1994 by the United Examining Board
United Examining Board
The United Examining Board was formed in 1993 to administer non-university qualifying examinations in medicine and surgery. The diplomas offered by the United Examining Board were registerable with the General Medical Council in order to register as a medical practitioner in the United Kingdom,...
, which lost its permission to hold qualifying medical examinations after 1999.
Medical education at the London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
Teaching Hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...
s began some centuries before there was a university in London to award medical degrees. Those who had taken BAs
Bachelor of Arts
A Bachelor of Arts , from the Latin artium baccalaureus, is a bachelor's degree awarded for an undergraduate course or program in either the liberal arts, the sciences, or both...
at Oxford
University of Oxford
The University of Oxford is a university located in Oxford, United Kingdom. It is the second-oldest surviving university in the world and the oldest in the English-speaking world. Although its exact date of foundation is unclear, there is evidence of teaching as far back as 1096...
or Cambridge
University of Cambridge
The University of Cambridge is a public research university located in Cambridge, United Kingdom. It is the second-oldest university in both the United Kingdom and the English-speaking world , and the seventh-oldest globally...
, or occasionally started their pre-clinical education at universities further afield, could return there to take medical examinations, but it was open to most to take the examinations of the London medical corporations.
As the early 19th century law restricting medical employment in the British military to those who had qualifications in both medicine and surgery was taken to require diplomas from different organisations, it became customary to take both the Licence of the Society of Apothecaries (LSA) and the Membership of the Royal College of Surgeons of England
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...
(MRCS).
These corporations diverged: the Society of Apothecaries added surgery to their examination, to grant a Licence in Medicine and Surgery (LMSSA) as a complete qualification. The surgeons then teamed up with the Royal College of Physicians of London who paired their Licentiate diploma (LRCP) with the MRCS to create the English Conjoint Diploma in 1884.
The London LRCP had previously been a means for bachelors or licentiates in medicine from Oxford and Cambridge (and a few MDs from elsewhere) to qualify to practice in London as physicians (i.e internal medicine specialists, as distinct from surgeons or apothecaries). The old LRCP also allowed the holder by custom to be addressed as "doctor" without holding a university doctorate: this privilege became generalised in the 19th century to all licentiates and bachelors of medicine.
The nomenclature of the diplomas may have contributed to the nearly-obsolete practice of general practitioners styling themselves as "Physician and Surgeon": previously they were mostly regarded as Apothecaries.
(There were also Scottish and Irish conjoint qualifications: the former became known as the Triple Qualification.)
In the 19th century the new University of London
University of London
-20th century:Shortly after 6 Burlington Gardens was vacated, the University went through a period of rapid expansion. Bedford College, Royal Holloway and the London School of Economics all joined in 1900, Regent's Park College, which had affiliated in 1841 became an official divinity school of the...
Bachelor of Medicine and Bachelor of Surgery degrees were regarded as more academic than the Royal Colleges' diplomas, so many people qualified and started practice with the Conjoint before taking the M.B. and B.S. a year or two later. This paralleled the practice in some European countries of taking a state medical examination separately from or instead of a university degree. In the English provincial cities, some medical schools developed separately from the new Redbrick universities, so the Conjoint diplomas were at first usually taken.
Armed forces officer cadet
Officer Cadet
Officer cadet is a rank held by military and merchant navy cadets during their training to become commissioned officers and merchant navy officers, respectively. The term officer trainee is used interchangeably in some countries...
s would be promoted from second lieutenant
Second Lieutenant
Second lieutenant is a junior commissioned officer military rank in many armed forces.- United Kingdom and Commonwealth :The rank second lieutenant was introduced throughout the British Army in 1871 to replace the rank of ensign , although it had long been used in the Royal Artillery, Royal...
to lieutenant
Lieutenant
A lieutenant is a junior commissioned officer in many nations' armed forces. Typically, the rank of lieutenant in naval usage, while still a junior officer rank, is senior to the army rank...
on qualifying, which included the conjoint qualification. The difference in pay between the times of the two exams would more than pay for the entry fee, and also seniority in the officer corps would be enhanced by those few months.
The conjoint diploma of the London Royal Colleges (Royal College of Surgeons of England
Royal College of Surgeons of England
The Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...
and Royal College of Physicians of London) was more reputable in its day, but after World War II it was regarded as a practice exam before university
University
A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...
finals. It provided a safety net, in that medical student
Medical Student
Medical Student may refer to:*Someone studying at medical school*Medical Student Newspaper, a UK publication...
s unsure whether they would pass or fail would have two chances if they took both.
By far the greatest use of the Conjoint and similar qualifications in recent years was as a means for foreign medical graduates to obtain British qualifications, which eased their problems of obtaining registration and employment in the U.K., and also made it easier to go on to work in third countries.
The scheme of examinations included a notional full set of pre-clinical subjects (anatomy, physiology, pharmacology, pathology, etc) from which those who had university passes or another final medical qualification would be exempted: but fees might still have to be paid.
The closure of this portal, along with the recent recategorisation of junior doctors from student to worker status for immigration purposes, may hasten the changeover of the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
's dependence from Third World
Third World
The term Third World arose during the Cold War to define countries that remained non-aligned with either capitalism and NATO , or communism and the Soviet Union...
medical graduates to European Union
European Union
The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...
doctors, who may not be asked to submit to further examination.
These subtleties of the British system of medical qualifications were rarely known to patients, who may have been more impressed to see "MB BS MRCS LRCP" on a brass plate than "MD FRCP"