Doctor of Medicine

Doctor of Medicine (MD or DM), or in Latin: Medicinae Doctor, meaning "Teacher of Medicine", is a terminal degree for physicians and surgeons. In countries that follow the tradition of ancient Scotland, it is a first professional graduate degree awarded upon graduation from medical school.It is most commonly used in the United States.^[1] In countries that follow the tradition of the United Kingdom, the title of the equivalent medical degree is instead styled as Bachelor of Medicine, Bachelor of Surgery.^[2] In those countries, the MD may either be: (1) a research doctorate, akin to the Doctor of Philosophy (PhD); (2) an advanced clinical coursework degree, akin to the Master of Surgery; or (3) an honorary or higher doctorate reserved for medical graduates.

History of the medical degree

According to Sir John Bagot Glubb, Syed Faride and S. M. Imamuddin, the first medical schools to issue academic degrees and diplomas were the teaching Bimaristan (Hospitals) of the medieval Islamic world. The first of these institutions was opened in Baghdad during the time of Harun al-Rashid. They then appeared in Egypt from 872 and then in Islamic Spain, Persia and the Maghreb thereafter. Physicians and surgeons at these hospital-universities gave lectures on Medicine to medical students and then a medical diploma or degree was issued to students who were qualified to be practicing physicians.

Academic degrees for physicians by country

United States and Canada

The initial medical schools that granted the MD (Doctor of Medicine) degree were Columbia, Penn, Harvard, Maryland, and McGill.^[3] 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 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.^[4]

In the United States, MDs are awarded by medical schools as Professional Doctorate^[5][6][7] and is accredited by the Liaison Committee on Medical Education (LCME), an independent body sponsored by the Association of American Medical Colleges and the American Medical Association (AMA).^[8][9]

Admission to medical schools in the United States is highly competitive, with about 17,800 out of approximately 47,000 applicants receiving at least one acceptance to any medical school in recent application years. Before entering medical school, many schools require that students must complete a four-year undergraduate degree and take the Medical College Admission Test (MCAT); however, some medical schools require only a certain amount of undergraduate coursework (but not degree completion) before the start of the medical curriculum.^[10] Before graduating from a medical school and achieving the Doctor of Medicine degree, most schools require their students to take 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. In order to receive Board Eligible or Board Accredited status in a specialty of medicine such as general surgery or internal medicine, they 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.

The Doctor of Osteopathic Medicine or D.O. degree is the only other legal and professional equivalent to the M.D. degree in the United States and Canada.^[11] The differences between the M.D. and the D.O. degrees lie in the distinctive osteopathic philosophy and osteopathic manipulative treatment (OMT).

In Canada, the M.D. is the basic medical degree required to practice medicine. McGill University Faculty of Medicine is the only medical school in Canada that continues to award the M.D., C.M. degrees (abbreviated MDCM). MDCM 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 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) qualifications.

Research physicians

Even though the MD and DO are first professional degrees and not doctorates of research (i.e., a PhD), many holders of the MD or DO degree conduct clinical and basic scientific research and publish in peer-reviewed journals during training and after graduation; an academic physician whose work emphasizes basic research is called a physician-scientist. Combined medical and research training is offered through programs granting MD-PhD or DO-PhD degrees. The National Institutes of Health (NIH) through its Medical Scientist Training Program funds MD-PhD training programs at many universities. Some MDs and DOs 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.^[12] The United States Department of Education and the National Science Foundation do not include the M.D. or other professional doctorates among the degrees that are equivalent to research doctorates.^[13][14]

UK, Ireland and some Commonwealth countries

The entry-level first professional degree in these countries for the practice of medicine is that of Bachelor of Medicine and Bachelor of Surgery (MBBS, MB, MB BCh BAO, BMBS, MBBChir, or MBChB). This degree typically requires between four and six years of study and clinical training, and is equivalent to the North American MD degree. Due to the UK code for higher education, first degrees in medicine comprise an integrated programme of study and professional practice spanning several levels. These degrees may retain, for historical reasons, "Bachelor of Medicine, Bachelor of Surgery" and are abbreviated to MBChB or MBBS.^[15]

In the UK, Ireland and many Commonwealth countries, the M.D. is a postgraduate research degree in medicine. At some universities, this takes the form of a first doctorate, analogous to the Ph.D., awarded upon submission of a thesis and a successful viva. The thesis may consist of new research undertaken on a full- or part-time basis, with much less supervision (in the UK) than for a Ph.D., or a portfolio of previously published work.^[16]

In order to be eligible to apply for an M.D. degree from a UK or Commonwealth University one must hold either an MBBS, MBChB, or an equivalent US-MD degree and must usually have at least 5-years of postgraduate experience. Therefore, graduates from the MBBS or MBChB degrees do not hold doctorates; however, physicians holding these degrees are referred to as 'Doctor' as they are fully licensed as medical practitioners. In some commonwealth nations these interns are designated as House Officers.

At some other universities (especially older institutions, such as Oxford, Dublin, Cambridge and St Andrews), the MD is a higher doctorate (similar to a DSc) awarded upon submission of a portfolio of published work representing a substantial contribution to medical research.^[17] The University of Cambridge is proposing to introduce a new degree of Med.Sc.D. (more akin to the ScD degree) awarded on the basis of a career's contribution to the science or art of medicine, rather than a thesis, for which a candidate may be awarded the M.D. degree.^[18]

In the case where the MD is awarded (either as a first or higher doctorate) for previously published research, the candidate is usually required to be either a graduate or a full-time member of staff, of several years' standing of the university in question.^[19]

Denmark

In Denmark, basic medical education and training is available at four universities: The University of Copenhagen, Aarhus University, The University of Southern Denmark and Aalborg University. The duration of basic medical education and training is six years and the course leads to the degree of Candidate of Medicine (rated equally to master's degree). Students are qualified as Medical Doctor (M.D.) after swearing the Hippocratic Oath upon graduation.^[20]

Medical school is usually followed by a year of residency called basic clinical training (Danish: Klinisk basisuddannelse or just KBU) which upon completion grants the right to practice medicine without supervision.

France

Medical studies in France are organised as follows:

Right 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). At the end of first year, an internal ranking examination takes place in each of these universities in order to implement the numerus clausus. First year consists mainly of theoretical classes such as biophysics and biochemistry, anatomy, ethics or histology. Passing first year is commonly considered as challenging and requires hard and continuous work. Each student can only try twice. For example, the Université René Descartes welcomes about 2000 students in first year and only 300 after numerus clausus.

The second and third year are usually mainly 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 4th, 5th and 6th years, medical students get a special status called 'Externe' (In some universities, such as Pierre et Marie Curie, the 'Externe' status is given starting in the 3rd 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 3 and 4 months and takes place in a different department. Med students get 5 weeks off a year.

At the end of sixth year, they need to pass a national ranking exam, which will determine their specialty. Indeed, the first student gets to choose first, then the second et cetera. Usually students work pretty hard during 5th and 6th years in order to train properly for the national ranking exam. During these years, actual practice at the hospital and some theoretical courses are meant to balance the training. Such externs' average wage stands between 100 and 300 euros a month.

After that 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 a MD thesis. At the conclusion of the thesis defense, French medical students receive a State Diploma of Doctor of Medicine (MD) or diplôme d'Etat de docteur en médecine. Every new doctor must then proceed to a Diploma of Specialised Studies (Diplôme d'Etudes Spécialisées or DES) to mark their specialty. Some students may also receive a Diploma of Complementary Specialized Studies (Diplôme d'Etudes Spécialisées Complémentaires or DESC).^[21]

Germany

In Germany, admission to medical schools is currently administered jointly by the Stiftung für Hochschulzulassung (SfH), a centralized federal organization, and the universities themselves. The most important criterion for admission is the Numerus clausus, the final GPA scored by the applicant on the Abitur (highest secondary school diploma). However, in light of the recent gain in influence of medical schools in regards to applicant selection, additional criteria are being used to select students for admission. These criteria vary among medical faculties and the final Abitur GPA is always a core indicator and strongly influences admission. Admission remains highly competitive. A very small number of slots per semester are reserved for selected applicants which already hold a university degree (Zweitstudium) and for medical officer candidates (Sanitätsoffizieranwärter).

The first two years of medical school consist of the so-called pre-clinical classes. During this time, the students are instructed in the basic sciences (e.g. physics, chemistry, biology, anatomy, physiology, biochemistry, etc.) and must pass a federal medical exam (Erster Abschnitt der ärztlichen Prüfung), administered nationally. Upon completion, the students advance to the clinical stage, where they receive three years of training and education in the clinical subjects (e.g., internal medicine, surgery, obstetrics and gynecology, pediatrics, pharmacology, pathology, etc.). The last year of medical school consists of the so-called "practical year" (Praktisches Jahr, PJ). Students are required to spend three four-month clerkships, two of them in a hospital (internal medicine and surgery) as well as one elective, which can be one of the other clinical subjects (e. g. family medicine, anesthesiology, neurology, pediatrics, radiology etc.).

After at least six years of medical school, the students graduate with a final federal medical exam (Zweiter Abschnitt der ärztlichen Prüfung). Graduates receive their license to practice medicine and the professional title of physician (Arzt). The academic degree Doctor of Medicine (Dr. med.) is technically a research doctorate degree, though it is roughly equivalent to a master's degree in Anglo-Saxon countries.^[22] It is awarded if the graduate has, in addition, successfully completed a scientific study and dissertation. Many medical students opt to perform their thesis during their studies at medical school, but are only allowed to finish the dissertation process after their studies. If physicians wish to open up a doctor's practice, they are required to further complete residency in order to fulfill the federal requirements of becoming Facharzt (specialized in a certain field of medicine such as internal medicine, surgery, pediatrics etc.).

There are 36 medical faculties in Germany.

Netherlands and Belgium

In the Netherlands and Belgium, medical students receive 6 years of university education prior to their graduation.

In the Netherlands, students receive three years of preclinical training, followed by three years of clinical training (co-assistentschappen, or co-schappen for short) in hospitals. At one medical faculty, that of Utrecht University, clinical training already begins in the third year of medical school. After 6 years, students graduate as Basisartsen (comparable to Doctors of Medicine). As a result of the Bologna process, medical students in the Netherlands now receive a bachelor's degree after three years in medical school and a master's degree upon graduation. Prospective students can apply for medical education directly after finishing the highest level of secondary school, vwo; previous undergraduate education is not a precondition for admittance.

The Belgian medical education is much more based on theoretical knowledge than the Dutch system. In the first 3 years, which are very theoretical and lead to a university bachelor degree, general scientific courses are taken such as chemistry, biophysics, physiology, biostatistics, anatomy, virology, etc. To enter the bachelor course in Flanders, prospective students have to pass an exam, as a result of the numerus clausus.

After the bachelor courses, students are allowed to enter the 'master in medicine' courses, which consist of 3 years of theoretical and clinical study. In general, the first 2 master years are very theoretical and teach the students in human pathology, diseases, pharmacology. The third year is a year full of internships in a wide range of specialities in different clinics. The seventh, final year serves as a kind of 'pre-specialization' year in which the students are specifically trained in the specialty they wish to pursue after medical school. This contrasts with the Dutch approach, in which graduates are literally 'basic doctors' (basisartsen) who have yet to decide on a specialty.

South Korea

In South Korea, there is a Medical Doctor (MD) license.

The medical educations in South Korea (Republic of Korea) are 6 or 4 years in duration, 6-year courses starting right after high schools, and 4-year course starting after 4-year's university education(To start 4-year course, the student needs bachelor's degree). The first 2 years in the 6-year system is composed of basic sciences and liberal art courses.

Sweden

Medical education in Sweden begins with a five-and-a-half-year undergraduate university program leading to the degree "Master of Science in Medicine" (Swedish: Läkarexamen) . Following this, the National Board of Health and Welfare requires a minimum of 18 months of clinical internship (Swedish: Allmäntjänstgöring) before granting a medical license to be fully qualified as Medical Doctor (MD).^[23]

This internship consists of surgery (3–6 months), internal medicine (3–6 months), psychiatry (three months) and family medicine (six months). Upon receiving a license to practice, a physician is able to apply for a post to start specialist training. There are currently 52 recognized medical specialties in Sweden. The specialist training has a duration of minimum five years, which upon completion grants formal qualification as a specialist.

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 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 categorised 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).^[24]

Malaysia

In Malaysia, M.D. are awarded by both private and public universities, mostly are trained as a 5 years course, however with the establishment of Perdana University, it became the first university in Malaysia to provide a 4-year graduate entry course. Example of universities in Malaysia offering M.D. are University Sains Malaysia, National University of Malaysia, University Putra Malaysia, UCSI University, etc..

Argentina

In Argentina the First Degree of Physician or Physician Diplomate (Título de Médico)^[25] is equivalent to the North American M. D. 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.^[26]

India

The MBBS (Bachelor of Medicine/Bachelor of Surgery) degree represents the first (graduation) level of training required to be licensed as a physicians, and the MS or MD degree is a higher postgraduate degree, representative of specialty training. The equivalent training in the US or Canada would be completion of a medical (post-graduate) degree. Eligibility for the MS or MD course is restricted to medical graduates holding the MBBS degree. The MBBS course is for five and a half years, and training is obtained in medical disciplines (e.g.: Internal Medicine, Radiology, Pathology, etc.). After three years of study and the successful completion of an examination, which includes both theoretical and practical elements, in a pre-clinical or clinical subject of a non-surgical nature the candidate receives MD degree, whereas in a pre-clinical or clinical subject of a surgical nature, i.e. anatomy, general surgery, orthopaedics and gynaecology, the candidate receives the equivalent degree Master of Surgery (MS).

The research element is not very prominent in India, as this is primarily a clinical qualification resembling the professional doctorates of the USA. In general surgery, orthopaedics and gynaecology and in a pre-clinical subject like anatomy the equivalent degree is Master of Surgery (MS).

A second alternate qualification, termed DNB [Diplomate of National Board], is considered equivalent to the MD and MS degrees. This can be obtained by passing the exam conducted by the National Board of Examinations after completing 3 years of post-MBBS residency training in teaching hospitals recognised by the board. The College of Physicians & Surgeons of Bombay, India (Established 1912) also awards higher postgraduate degrees in clinical and pre-clinical specialties, called FCPS; it involves three years of study and the successful completion of an examination, which includes both theoretical and practical elements, and a research thesis and a viva. The FCPS is representative of specialty clinical training, and equivalent to MD/MS/DNB in India, or PhD or Professional Doctorates in other parts of the world. Till 2007, the Government of India and the Medical Council of India recognised the FCPS qualification - since then, this is being done by State Medical Councils.

After obtaining the first postgraduate degree, that is MD/MS/FCPS/DNB, one can go for further specialisation in medical or surgical fields. This involves a highly competitive entrance examination. Course has three years of additional training and study and then after passing an examination, both theory and practical, the degree awarded is DM (Doctor of Medicine), like DM in Cardiology, Neurology, Nephrology, Gastroenterology, NeuroRadiology, Critical Care, Pulmonology, Hematology, Medical Oncology, Cardioanaesthesia,Clinical Pharmacology and Neuroanaesthesia. For surgical superspecialities the degree awarded is MCh (Magister Chirurgiae), like MCh in Cardiac Thoracic and Vascular Surgery, Neurosurgery, Gastrosurgery, Urology, Plastic Surgery, Pediatric Surgery etc. DM and Mch are Doctorate degrees. A third alternate qualification is DNB (superspecialties), offered by National Board of Examinations, like DNB in Cardiology, Neurology, Cardiac Surgery, Neurosurgery.

The DM and MCh degrees are super-specialties and are very high ranked/prestigious.

Following DM or Mch, one can further go for a third postdoctorate degree that is, postdoctoral fellowship programs of one-year duration in specific subspecialities like Cardiac Electrophysiology, Invasive cardiology, Pediatric cardiology, Epilepsy, stroke, electroencephalography, movement disorders, neuromuscular disorders, cerebrovascular surgery, skull base surgery, pediatric cardiac surgery etc. offered by prestigious government institutes.

Iran

In Iran, Medical education begins after high school. No pre-med course or BSc degree is required. The eligibility is determined through the rank applicants obtain in the public university entrance exam being held every year throughout the country. The entry to medical school is competitive and only students with the highest rank are accepted into medical program. The primary medical degree is completed in 7-7.5 years. Medical graduates are awarded a certificate in general medicine, called "Professional Doctorate in Medicine" validated by the "Ministry of health and Medical Education of Iran". All physicians will obtain licence and medical council registration number from the "Medical Council of Iran" before they officially begin to practice. They may subsequently specialize in a specific medical field at medical schools offering the necessary qualifications.

Israel

There are five university medical schools in Israel, including the Technion in Haifa, Ben Gurion University in Be'er Sheva, Tel Aviv University, the Hebrew University in Jerusalem and the Medical school of the Bar-Ilan University in Safed. They all follow the European 6-year model except Bar-Ilan University who has a four-year program similar to the US system.^[27] However, as of 2009, Tel Aviv University has introduced a four-year program similar to the US system for students with a bachelor's degree in certain biological sciences. The entrance requirements of the various schools of medicine are very strict. Israeli students require a high school Baccalaureate average above 100 and psychometric examination grade over 740. The demand for medical education is strong and growing and there is a lack of doctors in Israel. The Technion Medical School, Ben Gurion University, and Tel Aviv University Sackler Faculty of Medicine^[28] offer 4-year MD programs for American students who have American college degrees and have taken the MCAT interested in completing rigorous medical education in Israel before returning to the US or Canada. The degree of Doctor of Medicine (MD) is legally considered to be equivalent to master's degree due to Israeli Educational System .^[29]

Pakistan

In Pakistan, the equivalent degree is MBBS (Bachelor of Medicine and Bachelor of Surgery). The MBBS is awarded as the basic medical qualification after completing five years of study. This comprises two years of basic science subjects including anatomy, physiology, and biochemistry, with a particular emphasis on human anatomy. Subsequently, there are three years of clinical internship and courses on medicine surgery and pharmacology. Finally, the student is required to work for one year under a professor, before one is awarded the degree of MBBS with license to practice. So the total duration of the MBBS degree is six years in Pakistan. For specialization, one has to pass the Fellow of College of Physicians & Surgeons Pakistan (FCPS) exam part 1 in the field in of specialization and obtain an internship in the field for three to six years. Next, one can take the FCPS exam part 2, which includes intensive practical exams. Upon successful completion, a fellow of the relevant specialty is awarded. Medical Universities are awarding MD/MS/MDS of four to six years' duration on successful completion of residency program in a university hospital. These are terminal qualifications and similar to the FRCS/MRCP. Tough entry tests are passed successfully before entering into a medical college. Medical colleges and foreign medical qualifications are supervised by the Pakistan Medical and Dental Council (PMDC). Specialized degrees are awarded by the Pakistan College of Physicians and Surgeons. In basic medical sciences such as Anatomy, Physiology, Biochemistry, Pathology etc., the research postgraduate degree awarded by many universities is M.Phil, which has a mandatory prerequisite of a minimum of two years of Demonstratorship in relevant subjects in a recognized Medical College. The M.Phil course is two to four years and is a research postgraduate degree, containing submission and defence of a research thesis in basic sciences similar to the MD program in India. Including two years of a mandatory training period as demonstratorship, the total M.Phil duration in Pakistan for a six-year MBBS degree holder thus becomes 4 to 6 years. Many universities in conjunction with tertiary hospitals offer coursework towards the MD and MS degrees as well. In certain known universities of Pakistan like Dow Medical College ^[30] is now being offered a complete blend of all the subjects at modular level. Not just anatomy, physiology and biochemistry is being taught; pathology, community med, behavioral sciences, research, pharmacology, orthopedics, clinical faculty, neurology faculty etc. weigh very high in some modules during the first two years of MBBS. Also, the craze of getting an MD is at peak nowadays because of the integrated curriculum. They are having pathophysiological and pharmacological dynasties of medicine at the same ground.

Philippines

The Dominicans, under the Spanish Government, established the oldest Medical School in the Philippines in 1871, known as the Faculty of Medicine and Surgery (at that time was one with the University of Santo Tomas Faculty of Pharmacy, also considered the oldest pharmacy school in the Philippines) of the Pontifical and Royal University of Santo Tomas in Intramuros, Manila.

Medical education in the Philippines became widespread under the American administration. The Americans, led by the insular government's Secretary of the Interior, Dean Worcester, built the University of the Philippines College of Medicine and Surgery in 1905. By 1909, nursing instruction was also begun at the Philippine Normal School.

At present there are a number of medical schools in the Philippines, notable examples include the University of the Philippines College of Medicine, Our Lady of Fatima University, Far Eastern University – Nicanor Reyes Medical Foundation, Saint Louis University International School of Medicine, De La Salle Health Sciences Institute, University of Santo Tomas Faculty of Medicine and Surgery, Pamantasan ng Lungsod ng Maynila, UERMMMC College of Medicine, St. Luke's College of Medicine–William H. Quasha Memorial, Cebu Doctors' University, Cebu Institute of Medicine, Mindanao State University College of Medicine, Southwestern University, West Visayas State University in Iloilo City, Davao Medical School Foundation in Davao City, Xavier University – Ateneo de Cagayan, Dr. Jose P. Rizal School of Medicine in Cagayan de Oro, Virgen Milagrosa University Foundation in San Carlos, Pangasinan, and University of Northern Philippines in Vigan.

In 1994, the Zamboanga Medical School Foundation was founded. Currently, it is now known as the Ateneo de Zamboanga University School of Medicine. It is an innovative medical school which patterned its curriculum from the College of Medicine in the University of New Mexico and the University of Calgary in Canada yet, evolving it to be suitable and unique to the Philippine setting. It is the only medical school in the Philippines offering a 5-year program integrating degrees of Doctor of Medicine and Master of Public Health.

On 2007, the Ateneo School of Medicine and Public Health was established. It is the first medical school in the country to offer a double degree program leading to the degrees Doctor of Medicine and Masters in Business Administration.

Any college graduate may apply for medical school given that they satisfy the requirements set by the institutions. There is also a test known as the National Medical Admission Test or NMAT. Scores are given on a percentile basis and a high ranking is a must to enter the top medical schools in the country.

In most institutions, medical education lasts for four years. Basic subjects are taken up in the first and second years, while clinical sciences are studied in the second and third years. In their fourth year, students rotate in the various hospital departments, spending up to two months each in the fields of internal medicine, surgery, obstetrics and gynecology, and pediatrics, and several weeks in the other specialties. After this, students graduate with a Doctorate in Medicine (MD) and apply for postgraduate internship (PGI) in an accredited hospital of their choice. After PGI, the student is eligible to take the Medical Licensure Examination. Passing the examinations confers the right to practice medicine as well as to apply in a Residency Training Program.

Romania

Romanian medical schools lasts for 6 years (including clinical practice) and concludes with a final licensing examination (licența), which is based on the dissertation of the student's original research. The degree awarded is that of Doctor-medic (Medical Doctor), abbreviated as "MD", or more commonly "Dr."^[31]

Sri Lanka

In Sri Lanka, MBBS degree is the degree to be held for one to be licensed as a physicians by the Sri Lanka Medical Council. MD degree is a higher postgraduate degree and in Sri Lanka awarded by the Postgraduate Institute of Medicine after completion of a postgraduate course and examinations. The MD degree in Sri Lanka is representative of specialty training in clinical, para clinical and preventive medicine (e.g., General Medicine, Cardiology, Nephrology, Oncology, para clinical such as microbiology, haematology and preventive such as Community Medicne .). Entry for the MD course open only for medical graduates holding the MBBS degree (with a duration of five and a half years), and training is obtained in medical disciplines that are non-surgical in nature (e.g., Internal Medicine, Radiology, Pathology, etc.). After three or four years of study and the successful completion of an examination with written as well as cases and viva examinations, the MD degree in the respective field of Study is awarded. In Community medicine and Medical Administration, part I examination consists of a theoretical exam while the degree is cofered after completion of a thesis as n PhD. This thesis has to be completed within a period of five years. After successfully defending the academic thesis, MD degree is conferred to the candidate, The MD degree holder is certified as a Board certified specialist by the respective board of study of the Postgraduate Institute of Medicine after he/she undergoes 2–4 years of local and foreign training depending on the specialty/subspecialty selected.

In Ayurveda, Bachelor of Ayurveda, Medicine and Surgery B.A.M.S in Unani, Bachelor of Unani Medicine and Surgery BUMS in Sidha, Bachelor of Sidha Medicine and Surgery BSMS are the basic qualification for practicing Ayurveda, Unani,&Sidha. The B.A.M.S, B.U.M.S, and B.S.M.S are 6-year degree (including internship) courses accepted by the University Grants Commission (Sri Lanka). M.D (Ayu)(Ayurveda vachaspati) can be done after B.A.M.S, as a speciality, and it takes 3 years (including submission of a thesis) to complete the course. Ayurveda M.D (Ayu) (Ayurveda vachaspati) is a master's degree accepted by University Grants Commission (Sri Lanka), after completion of MPhil can follow PhD level programmes in Sri Lanka.

Taiwan

The medical education in Taiwan is usually 7 years (6-year learning plus 1-year internship) in duration, starting right after high schools. The first 2 years in the 7-year system is composed of basic sciences and liberal art courses. Doctor-patient classes are emphasized, and most schools require compulsory amounts of volunteer hours. Clinical sciences are compressed into a two-year program in the 3rd and 4th years. The duration of clerkships and internships varies from school to school, but all of them end at the 7th grade. Taiwan’s medical education began in 1897 and is over 100 years old now. Students graduate with a Doctor of Medicine (MD) degree. Starting from the year 2013, incoming students will have a 6+2 year curriculum, in which the first 6 years are oriented similarly as before and the last two years are Post Graduate Years; this change aims to increase primary care capabilities of medical school graduates.^[32]

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 (Duke-NUS Graduate Medical School), but it follows the North-American model of styling its degree Doctor of Medicine (MD) at master's degree level.^[33]

Thailand

The Thai medical education is 6 years system, consisting of 1 year in basic-science, 2 years in pre-clinical training, and 3 years for clinical training. Upon graduation, all medical students must pass national medical licensing examinations and a university-based comprehensive test. After medical school, newly graduated doctor are under contract to spend a year of internship and 2 years of tenure in rural areas before they are eligible for any other residency positions or specialized training. The students will receive Doctor of Medicine (MD) degree. However the degree is equivalent to master's degree in Thailand.

Tunisia

In Tunisia, education is free for all Tunisian citizens and for foreigners who have scholarships. The oldest Medical school is a faculty of the University of Tunis. There are four medicine faculties situated in the major cities of Tunis, Sfax, Sousse and Monastir. Admission is bound to the success and score in the baccalaureate examination. Admission score threshold is very high, based on competition among all applicants throughout the nation. Medical school curriculum consists of five years. The first two years are medical theory, containing all basic sciences related to medicine, and the last three years consists of clinical issues related to all medical specialties. During these last three years, the student gets the status of "Externe". The student has to attend at the university hospital every day, rotating around all wards. Every period is followed by a clinical exam regarding the student's knowledge in that particular specialty. After those five years, there are two years on internship, in which the student is a physician but under the supervision of the chief doctor; the student rotates over the major and most essential specialties during period of four months each. After that, student has the choice of either passing the residency national exam or extending his internship for another year, after which he gains the status of family physician. The residency program consists of four to five years in the specialty he qualifies, depending on his score in the national residency examination under the rule of highest score chooses first. Whether the student chooses to be a family doctor or a specialist, he has to write a doctoral thesis, which he will be defending in front of a jury, after which he gains his degree of Doctor of Medicine (MD).

Cambodia

After 6 years of general medical education (a foundation year + 5 years), all students will graduate with Bachelor of Medical Sciences (BMedSc) បរិញ្ញាប័ត្រ វិទ្យាសាស្រ្តវេជ្ជសាស្ត្រ. This degree does not allow graduates to work independently as 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, Nutrition...

Medical graduates, who wish to be fully qualified as physician must do as below:

• General Practitioner's (GP) course is of 8 years ( BMedSc + 2-year internship). Clinical rotation in the internship is modulated within 4 main disciplines (general medicine, surgery, gynecology, pediatrics). The medical degree awarded is Doctor of Medicine (MD) សញ្ញាប័ត្រ វេជ្ជបណ្ឌិត (equivalent to master's degree).

• After graduating with BMedSc; students, who wish to enter Specialist Training Programs, are required to sit for a rigorous Contesting Entrance Exam. It lasts 9 to 10 years from the beginning of medical school (BMedSc + 3– 4 years of specialization) that will lead to conferment of the degree of (after thesis defense) Doctor of Medicine with Specialization (MD-DES) វេជ្ជបណ្ឌិតឯកទេស which is officially rated as "Professional Doctorate".

All Medical graduates must complete Thesis Defense and pass the National Licensing Exam ប្រឡងអជ្ញាប័ណ្ណជាតិ to become either GPs or Medical/Surgical Specialists.

Equivalent degrees in other countries

• In Kosovo , there are Medicine High schools when students from elementary school choose the medicine high-school and its 3 years when they finish the 3 years they practice 4 months and then after the promotion they can be a nurse or they can go ahead to medicine faculities in Pristina and the education there is around 6 years including practice.

• In Russia, medical Universities in Russia offer a 6-year curriculum leading to award Doctor of Medicine (MD) "Physician".

• In Ukraine, medical Universities in Ukraine offer a 6-year curriculum leading to award Doctor of Medicine (MD) "Physician"

• 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.

• In Guyana, Doctor of Medicine (MD) degree is awarded after the completion of 4 years or 5 years of study. Texila American University, Green heart university, American International School of Medicine provides Medicine programs

• In Bangladesh, the basic medical degree is the MBBS. After completing the intermediate level of education (12 years) the candidate must undergo 5 years of medical training in any medical college to achieve the MBBS degree. After obtaining the degree, the candidate needs to undergo one year of internship to obtain BMDC (Bangladesh medical and dental council) accreditation in order to practice in the country.

• In Italy, the title of "Dottore in Medicina e Chirurgia" (literally "Doctor in Medicine and Surgery") is awarded after completion of a Master's course in Medicine and Surgery (lasting six years) in a University. After obtaining this degree, graduates have to pass a state examination (called "abilitazione") through which they acquire the right to work as a medical doctor. All Doctors then should enroll to a specialization school for a specific medical field.
• In Georgia, medical Universities in Georgia offer a 6-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 Tbilisi state Medical University and Petre Shotadze Tbilisi Medical Academy^[34]
• The Czech and Slovak title MUDr. (Medicinae Universae doctor or doktor medicíny) is a professional doctorate granted upon completion of six years pregraduate Master's study at medical schools. The postgraduate academic research degree in medicine is a PhD degree.
• In Poland the title of lekarz (physician, medic) or "lek." is granted after completing a 6-year Master's medical program (although students apply to it directly after graduating high school).^[35] In contrast, a higher doctoral academic research degree in medicine resembling a PhD is named "dr n. med." or doktor nauk medycznych (Doctor of Medical Sciences). Specialization is valued similarly to a specialization in the English system and is a pre-requisite for a "dr. n. med." which is usually defined within the same field.
• The Danish and Norwegian Candidatus medicinae or Candidata medicinae degrees (cand. med.) is awarded after completing a six-year medical programme, to which students apply directly upon finishing secondary school. The programme usually includes a small thesis. However, the cand. med. degree must not be confused with the previous Danish and Norwegian Dr. Med. degree, which is a separate degree from the Ph.D. and represents a higher degree of medical research experience. It typically consists of at least 5–6 original publications.
• In Mexico and Perú, schools of medicine award the "Título de Médico Cirujano" degree after completing either six or seven years of study. This curriculum includes a rotating internship year and a year of social service providing care to an underserved community.
• In Nepal, a MBBS degree is awarded. This is an undergraduate level degree, which is awarded after completion of four and half years of medical school followed by one year of clinical internship. Most medical schools also offer postgraduate M.D and M.S. degrees, which requires three years of further training. Post-doctorate D.M. and M.Ch. terminal degrees are awarded by a few elite institutions after three more years of super-speciality training.
• In Greece, after a six-year study, a medical student acquires his medical degree and the right to use "Δρ.", (Dr.) before his name. This is considered equivalent to the M.D. title.
• In mainland China, some medical schools award MBBS to foreign students while all medical schools award Bachelor of Medicine to nationals. MD is a higher academic research degree.
• In Colombia, the medicine faculties of the universities awards the title of "Medico Cirujano" after taking 10 semesters of studies on "all clinic and surgery discipline a two semester on internship. After receiving the degree there is a mandatory year "obliged social work" were the doctors practice as GP in the countryside. Residency programs last between 3–4 years depends on the specialty.
• In Sudan the awarded degree in most of the medical schools is, Bachelor of Medicine and Basic Surgery (MBBS). In schools that are based on the English system of medical teaching, the degree is granted after six years of studying. As for the schools that are adopting the American system, they grant their students the degree of MBBS in only five years.
• In Turkey, the title of "Tıp Doktoru" (literally "Doctor of Medicine")is awarded upon completion of six years continuous study started with five years university education include three years basic sciences, two years clinical courses followed by one year of internship in university hospitals.
• In Indonesia, the title of "dokter" (dr.) is awarded after a Medical student received their Bachelor in Medicine (Sarjana Kedokteran; S. Ked) after 3-3.5 years of study (at least) and 1.5–2 years of clinical course in university hospitals. After a medical student finished those five years of study and take Hippocrates Oath, The title of Dokter (dr.) is entitled before their name. Then they need to take Ujian Kompetensi Dokter Indonesia (UKDI, test to get license to practice medicine as general practitioner) then take a year-long internship course in primary health care clinics (also known as Puskesmas) or primary hospitals all over the country to practice as general practitioner under supervision of senior doctors. Those who wished to further their study into specialties can take graduate course of medicine of their preference and will be entitled with "Specialist of ..." after their name (e.g.: Sp.A for Spesialis Anak = Pediatrician). graduate course of medicine is equal with residency program which is required the candidates to study for four years and hospital internship. (Note: dr. (dokter) is used for medical graduates, while Dr. (Doktor) is used for PhD holders..
• In Serbia and Croatia, the title of "doktor medicine" (abbreviated "dr. med.") is awarded upon completion of six years of study at a Faculty of Medicine ("medicinski fakultet") directly after high school.
• In Slovenia, the title of "doktor medicine" (abbreviated "dr. med.") is awarded upon completion of six years of study at one of the two Slovenian Faculties of Medicine ("medicinska fakulteta") in Ljubljana or Maribor. Studying at these faculties is only possible if the student has finished a Gymnasium/Grammar School ("gimnazija") with a general dimploma called "splošna matura".
• In Japan, “Doctor of Medicine (MD)” is awarded from the government, after graduating a medical university or college with 6-year curriculum and passing the national examination.
• In Portugal, to practice Medicine, a Masters in Medicine (awarded after a 6-year Integrated Masters Program in Medicine) is mandatory. Before the 2007 Bologna Process, the same course was only a Licentiate Degree. After the 6-year program, students must go through the Specialty Exam (which is not an evaluation), and then a year of Medical Internship. When the internship ends, the students are placed in their choice of Medical Specialty, according to their ranking in the formentioned Specialty Exam. Only when each student finishes the Medical Internship and the first year of their Specialty, will they be allowed to practice Medicine without supervision. Entry to the Integrated Masters Program in Medicine is done directly after High School, based on the student's grade - each year there are about 1500 new Medical Students in Portugal, in 8 different Medical Schools.

Other postgraduate clinical degrees

There is also a similar advanced professional degree to the postgraduate MD: the Master of Surgery (usually ChM or MS, but MCh in Scotland, Ireland, Wales and at Oxford and MChir at Cambridge). The equivalence of these degrees, but their differing names, prevents the need for surgeons (addressed as Mr. in the UK) having to revert to the title Dr., which they once held as new MBBS graduates.

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 (MAO). A Master of Midwifery was formerly examined by the Worshipful Society of Apothecaries of London (hence MMSA) but fell into abeyance in the 1960s; in this case the term Master referred not to a university degree but rather a professional rank that is common among craft guilds.

In East Africa, the medical schools in Kenya, Tanzania and Uganda award the degree of Master of Medicine (MMed) degree in both surgical and medical specialty disciplines following a three-year period of instruction.

In West Africa, the West African College of Physicians and the West African College of Surgeons award the Fellowship of the West African College of Physicians (FWACP) and the Fellowship of the West African College of Surgeons (FWACS) in medical and surgical disciplines respectively after a minimum of four-year residency training period.

References

Levels of academic degree First-tier Associate degree Foundation degree Higher National Diploma Second-tier Bachelor's degree Honours degree Diplom Specialist degree Engineer's degree Third-tier Master's degree Magister degree Fourth-tier Doctorate Magister degree Candidate of Sciences Doctor of Letters Higher doctorate Habilitation Tenure Professorial degree Graduate certificate Licentiate First professional degree Terminal degree Honorary degree

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Medical education in the United States Stages Pre-medical Medical school Clerkship Sub-internship Internship Residency Fellowship Board certification Licensure Continuing medical education Pathways Medicine (MD) Osteopathic Medicine (DO) International medical graduate Degrees Doctor of Medicine Doctor of Osteopathic Medicine MD-PhD Comparison Exams MCAT USMLE Step 1 2CK 2CS 3 COMLEX Level 1 2CE 2PE 3 Regulatory bodies Association of American Medical Colleges American Association of Colleges of Osteopathic Medicine National Resident Matching Program National Matching Service Accreditation Council for Graduate Medical Education Liaison Committee on Medical Education Commission on Osteopathic College Accreditation Accreditation Council for Continuing Medical Education American Osteopathic Association American Medical Association Lists Medical schools Specialty colleges Reformers Abraham Flexner William Osler William Stewart Halsted Andrew Taylor Still