Bachelor of Medicine and Surgery

Bachelor of Medicine and Bachelor of Surgery, or in Latin Medicinae Baccalaureus et Baccalaureus Chirurgiae (abbreviated MB BChir, BM BCh, MB BCh, MB ChB, BM BS, MB BS, etc.), are the two degrees awarded upon graduation from medical school currently in medicine and surgery, by universities in Australia, Bangladesh, Barbados, the Republic of China, Egypt, Fiji, Ghana, Guyana, Hong Kong, India, Iraq, the Republic of Ireland, Jamaica, Jordan, Kuwait, Libya, Malawi, Malaysia, Mauritius, 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.[1]

The naming suggests that they are two separate degrees; however, in practice, they are usually treated as one. (At Oxford and Cambridge in the past it was possible to be awarded the two degrees in different years, but usually they are treated as one degree.[2])

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, 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. 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/MB ChB/MB BChir/BM BCh/MB 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. Columbia University 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.[3]

Those holding the degree(s) and practising medicine are usually referred to as "Doctor" and use the prefix "Dr".

The degrees are often used as the Commonwealth equivalent of what is known elsewhere as the degree of Doctor of Medicine (MD).

In countries that award bachelors' degrees in medicine, however, the MD refers to a Higher Doctorate more similar to a PhD, and is reserved for medical practitioners who do research and submit a thesis in the field of medicine.

The MB BS, MB ChB, BM BCh, MB BCh, BMed, MB BChir, MD, MDCM, BM BS, Dr.MuD, Dr.med, (etc) are all considered equivalent first degrees in medicine.

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Naming

See also: Surgeon#Surgeon titles

The specific names and abbreviations given to these degrees vary from country to country and from one institution or awarding body to the next; this is mostly for reasons of tradition rather than to indicate any significant difference between the relative levels of the degrees. The Latin names are usually given as Medicinae Baccalaureus, Chirugiae Baccalaureus or Baccalaureus in Medicina et in Chirurgia, abbreviated as MB ChB, MB BCh or otherwise; the English versions are Bachelor of Medicine, Bachelor of Surgery or Bachelor of Medicine and Surgery, usually abbreviated as MB BS, and rarely as BM BS, even though most MBBS-awarding institutions do not use Latin on their diplomas.

The following is a list of the specific names used, arranged by country.

Australia

MB BS are conferred by most Australian medical schools (undergraduate and graduate-entry).

The graduate-entry Flinders medical school confers BM BS.

The University of Newcastle offers the five-year undergraduate degree 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.

Bangladesh

All 50 medical colleges in Bangladesh (14 public and the rest private) award MBBS. Dhaka medical college, Sir Salimullah Medical College, Z.H. Sikder Woman's Medical College, Mymensingh Medical College are the top graded one.

Egypt

All medical schools (faculties) in Egypt- both government owned and private - award MB BCh, which is given by the awarding university and accepted by the Egyptian Medical syndicate. The duration of the course for the degree is six years and a one year internship/house-job (pre-registration houseofficer) is required before receiving the degree or receiving licence to practice.

England

Various abbreviations are used for these degrees in England:

At Oxford and Cambridge universities the preclinical course leads to a 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 its 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.[4]The diplomas came to be taken mostly by those who had already qualified in medicine overseas.

Guyana

MBBS degree is awarded by University of Guyana. There are other "offshore" schools in the country, but the MD awarded in these schools is 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 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.

The course is of four and half years of training (1 year preclinical and rest clinical) followed by a year of internship that includes a compulsory 3 months (1 month for mumbai municipal colleges) post in rural area.

Iraq

All medical schools in Iraq award M.B Ch.B.

Ireland

The University of Limerick awards BM BS, on completion of its new four-year graduate-entry programme. All 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 three degrees of MB BCh BAO. The letters BAO stand for Baccalaureus in Arte Obstetricia (Bachelor of the Obstetric Art), a degree unique to Ireland which the Irish universities began to award in the 19th century after legislation insisted on a final examination in obstetrics; this third degree, however, is not registerable with the British General Medical Council (GMC) or the Irish Medical Council.

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. 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.

The traditional route of pursuing a medical degree in Kenya requires one to have high marks in KCSE, a national exam administered at the conclusion of high school. In recent years however, students who can pay their own tuition and those from other countries have been accepted into these programs. It is hoped that these new regulations shall promote the number of locally trained doctors as many are leaving the country in a phenomenon that has been regarded by others as a brain drain.

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, follows 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 US universities usually require entrants to have a four year bachelor degree before entry into a professional medical degree. There is an increasing number of private medical schools in Malaysia, offering either full programs (with the whole course completed within Malaysia) or joint programs (where part of the course is completed at an overseas institution). The entrance into the medical faculty in the public universities is very competitive, and often causes controversy and tension among students and their respective parents nationwide.

Myanmar

All four medical schools in Myanmar award MB BS. The duration of the MB BS course in Myanmar is five years plus one year residency in rural areas or in big cities depending on the school transcript.

Nepal

All 12 medical schools in Nepal award MB BS. The duration of the MB BS course in Nepal is four and half years plus a one year internship/house-job is required for those graduates who wish to practice in Nepal. Graduates who wish to practice outside of Nepal are not required to complete the one year house-job/internship in Nepal. Those graduates can carry out one year compulsory internship in any recognized hospital outside Nepal.

New Zealand

The two New Zealand medical schools, Auckland and Otago, style their degrees as MB ChB. The New Zealand MB ChB degrees take at least 6 years after commencing university study depending upon graduate or undergraduate entry.

Pakistan

All medical schools in Pakistan award the MB BS degree, which is given by the awarding university and accepted by the Pakistan Medical and Dental Council. The duration of the course for the degree is five years and a one year internship/house-job is required for those graduates who wish to practice in Pakistan. Graduates who wish to practice outside of Pakistan are not required to complete the one year house-job/internship.

Scotland

All medical schools in Scotland (Aberdeen, Glasgow, Edinburgh and Dundee) award MB ChB.

The University of St Andrews awarded MB ChB until the early 1970s, but since the incorporation of the clinical medical school into the University of Dundee (the former Queens College St Andrews), the University of 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. All South African medical degrees are awarded under the auspices of the Health Professions Council of South Africa and take at least 6 years to complete.

Singapore

The Yong Loo Lin School of Medicine at the National University of Singapore confers MB BS.

Duke University also has a medical program based in Singapore and offers the MD degree.[5]

Sri Lanka

MB BS is offered only by the government universities. The University of Colombo, University of Peredeniya, University of Kelaniya (Ragama), University of Ruhuna and University of Jaffna each has a medical faculty. The course lasts 6 years. Students are chosen on a merit basis from local advanced level examination from the biological sciences stream. Students have to complete 1 year of internship before they are awarded the medical council registration which is needed to practice medicine in Sri Lanka.

Tanzania

All four public and private medical schools (University of Dar es Salaam - Muhimbili, Bugando, HKMU, and KCMCollege) offer MD degree after completion of five year of studies, followed by one year of internship. The entrance to Medical School is usually after completion of A-level studies, especially within study combinations of PCB and CBG.

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.

Classification of degrees

In the UK, the degree can be taken after an undergraduate course lasting five years, or in some cases, a graduate in another discipline, such as physiology or pharmacology, may subsequently enter a medical course which has been reduced to 4-years in duration to take into account relevant material covered during the first degree. UK medical schools are setting up four-year courses for older candidates who already have a degree, not necessarily in a biological subject. The old first year courses (for six year degrees) in physics, chemistry and biology have mostly been abolished, and that standard has to be reached by means of school examinations before entry.

A UK medical degree leads to Provisional Registration with the General Medical Council which allows employment as a Pre-Registration House Officer. One year of satisfactory practice leads to Full Registration. These House Officer posts have recently been replaced by a broader two year programme of work and training as a Foundation House Officer which is similar to the former American internship year.

Medical degrees differ from other undergraduate degrees in that they are professional qualifications which entitle bearers to enter a particular career upon receipt. This is not the case with most other undergraduate degrees, with the exception of pharmacy, dentistry, veterinary medicine and the new "Qualifying Law Degrees", so whilst the MBBS and MBChB are undergraduate/graduate degrees, they are perhaps more accurately conceptualised as a so-called 'First Professional' degree.

The MBBS or MBChB is usually awarded as a general/ordinary degree, not as an honours degree, and as such the graduate is not graded 1st class, 2:1 etc. as for honours degrees in other subjects.

However, at many institutions (for example the University of Manchester and University of Dundee) 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 BSc, BMedSci, BMedBiol or similar: at Oxford, Cambridge and Dublin it is a BA. 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 (Med Sci). In Australia, The University of Melbourne 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 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 other 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.

Progression

Medical school graduates are only entitled to use the title "Doctor" upon registration as a medical professional 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 the Art of Obstetrics) and a postgraduate doctorate in medicine (eg MD if earned in the UK or Commonwealth nations), and board certification examinations.

See also

References

Footnotes

Notations

http://www.cmb.ac.lk/academic/medicine/index.htm