Bachelor of Medicine, Bachelor of Surgery

Bachelor of Medicine, Bachelor of Surgery, or in Latin: Medicinae Baccalaureus, Baccalaureus Chirurgiae (abbreviated in many ways, e.g. MBBS, MBChB, MBBCh, MB BChir (Cantab), BM BCh (Oxon), BMBS), are the two first professional degrees in medicine and surgery awarded upon graduation from medical school by universities in countries that follow the tradition of the United Kingdom. The historical degree nomenclature suggests that they are two separate undergraduate degrees; however, in practice, they are usually treated as one and conferred together, and may also be awarded at graduate-level medical schools. In countries that follow the system in the United States, the equivalent medical degree is awarded as Doctor of Medicine (MD).[1]

History and nature

The degree is currently awarded in institutions in Australia, Bahrain, Bangladesh, Barbados, Botswana, China, Egypt, Fiji, Gambia, Ghana, Guyana, Hong Kong, India, Iraq, Ireland, Jamaica, Jordan, Kenya, Kuwait, Lebanon, Libya, Malawi, Malaysia, Mauritius, Myanmar, Nepal, New Zealand, Nigeria, Pakistan, Papua New Guinea, Samoa, Saint Kitts and Nevis, Saudi Arabia, Sierra Leone, Singapore, South Africa, Sri Lanka, Sudan, Tanzania, Trinidad and Tobago, Uganda, Ukraine, the United Arab Emirates, the United Kingdom, Vanatu, Zambia and Zimbabwe.[2]

Historically, Bachelor of Medicine was also the primary medical degree conferred by institutions in the United States and Canada, such as University of Pennsylvania, Harvard, University of Toronto, University of 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. In the mid-19th century the public bodies that regulated medical practice required practitioners in Scotland and England to hold the dual Bachelor of Medicine and Bachelor of Surgery degrees. Throughout the 19th century, 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 was King's College (now Columbia University) in New York City.[3]

In the countries that award bachelor's 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.", whether or not they also hold a PhD or DSc. In theory the right to the use of the title "Doctor" is conferred on the medical graduate when he or she is registered as a medical practitioner by the relevant professional body, not by the possession of the MBBS degrees.[4] The reason is found in a parallel tradition for those who are post-graduate specialists in Surgery; on acceptance into a College of Surgeons, they stop styling themselves "Doctor" and revert to "Mister" (Mr), "Miss", "Muz" (Ms.) or "Missus" (Mrs). This curious situation, where an elevation in professional rank is signified by dropping the title of Doctor, came about because historically a "surgeon" was an ordinary worker, usually a barber, not trained in medicine but performing dissections and surgery under the direction of a gowned academic who was the actual "doctor".

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 to be awarded the degrees in different years.

In many countries, the degrees are awarded after an undergraduate course lasting five or six years. For example, most Chinese universities offering medical degrees provide undergraduate courses lasting six years.[5] 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: that standard has to be reached by 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 registration as a licensed medical practitioner.

Recently, courses have been established in the Commonwealth country Australia that award the title MD (see Australia).

Naming

The names and abbreviations given to these degrees depend on the institution, awarding body or country, and vary widely. This is mostly for reasons of tradition rather than to indicate any difference between the relative levels of the degrees. They are considered equivalent.

If the awarding body titles the degrees in Latin, the degrees are commonly named Medicinae Baccalaureus, Chirurgiae 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 sometimes 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

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, some 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).[6]

Bahrain

The Medical University of Bahrain or RCSI-Bahrain is a constituent university of the Royal College of Surgeons in Ireland (RCSI) and awards its graduates the MB BCh BAO, the same degree awarded to graduates at RCSI.

Bangladesh

All medical schools in Bangladesh award MBBS.

University Degree Previous degree Duration Level
University of Dhaka MBBS A- Level 6 years (incl. 1 year intern) Undergraduate
BSMMU MD,[7] MS MBBS 5 years Postgraduate

China

In China, medical graduates are traditionally awarded a Bachelor of Medicine (BMED) for a course of study lasting five or six years. However, as of 2011, 49 universities (including its frequently top-ranked medical schools) have been authorised by the government to award the MBBS degree as an equivalent to the BMed. The 2014–15 list is not published by Ministry of Education.[8] The universities listed in 2011 were:

Egypt

All Egyptian medical schools, public and private, award an MB BCh as the basic medical degree after completion of 6 academic years followed by a full year of obligatory clinical rotations.

Ghana

All Ghanaian medical schools award an MBChB as the basic medical degree after 6 academic years. These medical schools are Kwame Nkrumah University of Science and Technology,[9] University of Ghana, University for Development Studies and University of Cape Coast.

Guyana

The University of Guyana awards MB BS. Other "offshore" United-States-linked schools in the country award the North American MD, such as Texila American University.

Hong Kong

The awarding of qualifications in Hong Kong follows the British tradition. The dual degree is awarded as:

India

Medical colleges in India, accredited by the Medical Council of India, all title the degrees as MBBS. A medical college offers graduate degree Bachelor of Medicine and Bachelor of Surgery (MBBS). Only institutions offering MBBS course in its curriculum are referred to as a Medical Colleges. The college may teach Post Graduate as well as Paramedical courses. The admission to government MBBS programs is highly competitive because of high subsidy and extensive hands-on experience.

The MBBS course starts with the basic pre and para-clinical subjects such as biochemistry, physiology, anatomy, microbiology, pathology and pharmacology. The students simultaneously obtain hands-on training in the wards and out-patient departments, where they interact with real patients for five years. The curriculum aims to inculcate standard protocols of history taking, examination, differential diagnosis and complete patient Management. The student is taught to determine what investigations will be useful for a patient and what are the best treatment options. The curriculum also contains a thorough practical knowledge and practice of performing standard clinical procedures. The course also contains a 12-month-long internship, in which an intern is rotated across various specialties. Besides standard clinical care, one also gets a thorough experience of ward management, staff management, and thorough counselling skills.

The degree awarded is "Bachelor of Medicine and Bachelor of Surgery". The minimum requirements for the MBBS course are 50% marks in physics, chemistry, biology and English in the '10+2' examinations. For reserved category students, the requirement is 40%. MBBS admissions are not centralised. The admission requirements differ across universities. Generally, students who attain higher marks in the qualifying examinations and in the Medical Entrance examinations conducted by various agencies are accepted onto the MBBS course.The government is planning to come up with new medical colleges in 58 districts of India. The new colleges will add 5,800 more MBBS seats in the country.

Entrance examinations are conducted by the following agencies:

Indonesia

In Indonesia, graduating students are awarded the degree of S.Ked (Sarjana Kedokteran / Bachelor of Medicine). At this point, the graduate is not yet a doctor, but he or she may choose to work directly as a scientist or other non-clinician professions (usually health-related). However, most S.Ked graduates will pursue the conventional path, which is to enroll in the clerkship program for another 1.5 up to 2 years.

Iraq

All medical schools in Iraq award MB ChB.

Ireland

The medical schools in both the Republic of Ireland and Northern Ireland – Queen's University Belfast, the 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). The only exception is the newly established University of Limerick graduate entry school of medicine which awards BM BS for Bachelor of Medicine and Bachelor of Surgery.

At the University of Dublin the preclinical course leads to an additional Bachelor of Arts (BA) degree (upgradable after three or four years to Master of Arts); as originally after this most students used to go elsewhere to complete clinical training.

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 licences 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 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 of Ireland, and is no longer awarded.

Jordan

The Bachelor of Medicine and Surgery (MBBS) degree is awarded in Jordan by:

Kenya

The national universities with medical faculties in Kenya, namely University of Nairobi, Moi University, Kenyatta University, Egerton University, Maseno University and Kenya Methodist University award MB ChB.

Mount Kenya University and Egerton University also award the four-year BSc. Clinical Medicine degree in addition to the five-year MBChB.

Libya

There are three major public medical universities in Libya, University of Tripoli (Tripoli), University of Benghazi (formerly Garyounis) (Benghazi), and University of Alzaweyah. The schools award the MBBCh.

The Libyan International Medical University is an accredited private medical university that awards an MBChB to its graduates.

Malaysia

The MBBS is awarded by five public and 14 private universities:

Public

Private

Mexico

In Mexico, the National Autonomous University of Mexico,[10] the National Polytechnic Institute,[11] the Metropolitan Autonomous University,[12] among others, grant the title of "Médico cirujano" (Physician-surgeon) after five years of post-high school education, plus one year of internship and one year of social service.

Myanmar

All five medical schools (UM1, UM 2, DSMA, UMM, UMMG) in Myanmar award MB BS.

Nepal

There are 18 medical schools in Nepal that award the MBBS degree. Nepal Medical Council (NMC) is the regulatory board that gives recognition to medical institutions for providing formal studies in medical science and training.

Kathmandu University (KU) and affiliated colleges

Tribhuvan University (TU) and affiliated colleges

Medical schools not affiliated to universities or having their own board

National Academy of Medical Sciences (NAMS), Kathmandu is an NMC-recognized medical college that has post-graduate residency (MD/MS) training programs but does not award MBBS degree.

New Zealand

The two New Zealand medical schools, Auckland and Otago, style their degrees as "MBChB" and "MB ChB" respectively.

Pakistan

In Pakistan, a medical school is more often referred to as a medical college. A medical college is affiliated with a university as a department which usually has a separate campus. Currently, there is a total of 94 medical colleges in Pakistan, 39 of which are public and 55 private. All but two colleges are listed in International Medical Education Directory.

All medical colleges and universities are regulated by the respective provincial department of health. They, however, have to be recognised after meeting criteria set by a central regulatory authority called Pakistan Medical and Dental Council (PMDC). Entrance into the medical colleges is based on merit under the guidelines of PMDC. Both the academic performance at the HSC (grades 11–12) and an entrance test like MCAT are taken into consideration for the eligibility to enter most of the medical colleges.

Saudi Arabia

Medical schools in Saudi Arabia award the MBBS.

Singapore

The Yong Loo Lin School of Medicine at the National University of Singapore and the Lee Kong Chian School of Medicine at Nanyang Technological University confer MB BS. The American Duke University 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.[13]

Somalia

Amoud University, Benadir University and Hargeisa University award the MB ChB, East Africa University awards MMBS.[14]

South Africa

The University of Pretoria, University of Cape Town, University of the Free State, University of Stellenbosch, University of KwaZulu-Natal, Walter Sisulu University and MEDUNSA all award MBChB, whereas the University of the Witwatersrand styles its degree as MBBCh.

South Sudan

The University of Juba, University of Bahr El-Ghazal and Upper Nile University in South Sudan awards the MBBS degree after the successful completion of six academic years.

Sri Lanka

In 1942, the University of Ceylon was established through legislation and the MBBS degree was recognised for registration of doctors in place of the Licentiate in Medicine and Surgery (LMS).[15]

Sudan

All Sudanese medical schools award the MBBS.

Syria

The higher education in Syria provides training to a Diploma, Bachelor, Master, and Doctorate levels (see European Education, Audiovisual and Culture Executive Agency on Higher Education: Syria.[16]

Uganda

The five universities in Uganda that have medical schools that teach undergraduate courses, namely Makerere University, Mbarara University, Gulu University, Kampala International University and Busitema University, all award the MBChB degree, after five years of study.

United Kingdom

England, Wales and Northern Ireland

While first degrees in medicine typically meet the expectations of the descriptor for higher education qualification at "level 7 (the UK master's degree)", these degrees usually retain, for historical reasons, "Bachelor of Medicine, Bachelor of Surgery" and are abbreviated to MBChB or MBBS.[17]

Varied abbreviations are used for these degrees in these areas:

At the universities of Oxford and Cambridge, the preclinical course leads to an additional Bachelor of Arts (BA), 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. Most students at Oxford and Cambridge now remain in place to take their clinical training.

The Conjoint diplomas LRCP MRCS 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. Before 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.[18] The diplomas came to be taken mostly by those who had already qualified in medicine overseas.

Scotland

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

The University of St Andrews School of Medicine 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 to a Partner Medical School (Aberdeen, Dundee, Edinburgh, Glasgow, or 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.

United States

Wisconsin

The Wisconsin Medical Society defends the use of the MD title by physicians who graduated with an MBBS and are licensed to practice medicine in Wisconsin.[19]

Vietnam

There are many medical schools in Vietnam, such Hanoi Medical University, the Vietnam University of Traditional Medicine, and the University of Ortondo-Stomatology. Most of them require six years to receive a Doctor of Medicine degree.

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. The three physical campuses are Mona in Jamaica, St. Augustine in Trinidad and Tobago, Cave Hill in Barbados with each campus having a Medical Faculty. The University of Guyana (UG) also confers "MB BS" to their medical school graduates. There are other medical schools in the West Indies, but these follow the North-American system leading to MD.

Zambia

All schools in Zambia that award the MBChB degree:

Government sponsored medical schools:

Private sponsored medical schools:

Zimbabwe

The University of Zimbabwe College of Health Sciences awards the MBChB degree, while the National University of Science and Technology awards the MBBS degree.

Classification

Medical degrees differ from other undergraduate degrees in that they are professional qualifications that lead holders to enter a particular career upon receipt. This is not the case with most other undergraduate 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. Other professions whose qualifications follow a similar pattern include:

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 Birmingham, University of Sheffield, University of Liverpool, University of Leicester and 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 the 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 and the University of Southampton, both in England, all medical students on the five-year course obtain a Bachelor of Medical Sciences (BMedSci) degree without an extra intercalated year. At Imperial College London and University 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 to receive his/her MBBS degree. The University of the West Indies, Mona in Kingston, Jamaica automatically awards a Bachelor of Medical Sciences (BMedSci) degree to all students who have successfully completed three years of their MBBS programme.[20]

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 eligible to sit postgraduate examinations, including examinations for membership and fellowship of professional institutions. Among the latter are the Membership of the Royal College of Surgeons, postgraduate master's degrees (such as a Master of Surgery or Master of Medicine), and a postgraduate doctorate in medicine (such as Doctor of Medicine or Doctor of Science, if earned in Ireland, the UK or Commonwealth nations, and board certification examinations).

See also

References

  1. ↑ O'Connor, Bridget N. (October 2011). "Perspectives on professional doctorate education in the United States" (pdf). Work Based Learning e-Journal. Middlesex University. 2 (1). Retrieved 8 April 2015.
  2. ↑ "ECFMC 2017 guide: Reference Guide for Medical Education Credentials". www.ecfmg.org. Educational Commission for Foreign Medical Graduates. Retrieved 25 June 2017.
  3. ↑ "Columbia University: About Columbia".
  4. ↑ Bowden, K.M. (1965) Forensic Medicine, Jacaranda Press, p. 23
  5. ↑ "Study MBBS in China".
  6. ↑ "Doctor of Medicine (MD)". University of Melbourne. 15 January 2014. Retrieved 5 July 2014.
  7. ↑ http://www.bsmmu.edu.bd/?page=menu&content=139020387254 List of Program offered by BSMMU
  8. ↑ Ministry of Education Notice (PRC)
  9. ↑ About Kwame Nkrumah University
  10. ↑ http://oferta.unam.mx/carreras/37/medicina
  11. ↑ http://www.esm.ipn.mx/OfertaEducativa/Paginas/Plan-de-Estudios.aspx
  12. ↑ http://www.uam.mx/licenciaturas/index.html
  13. ↑ "Duke-NUS Graduate Medical School Singapore".
  14. ↑ "Medical schools in Somalia". helpforafricanstudents.org. Retrieved 14 November 2016.
  15. ↑ "About us". Sri Lanka Medical Council. Retrieved 5 October 2016.
  16. ↑ "Education, Audiovisual and Culture Executive Agency on Higher Education in Syria" (PDF). Retrieved 21 February 2015.
  17. ↑ The UK quality code for higher education
  18. ↑ Walker, R Milnes (1965). Medical Education in Britain. London: Nuffield Provincial Hospitals Trust.
  19. ↑ (PHY-993) (HOD,0495) Wisconsin Medical Society PDF
  20. ↑ Regulations of the University of West Indies Regarding The MBBS dEGREE
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