To become a surgeon in the UK, you need to finish medical school first. Then, you can “join the paid two-year foundation programme where you’ll work in six placements in different settings,” the NHS says.
“After your foundation programme, you can apply for paid specialty training to become a general surgeon, which will take a minimum of eight years.”
After all that training, you’d think you’d at least get to call yourself a doctor, right? Well, in the UK and Ireland, many don’t ― the formal title for doctors in those parts of the world is “Mr, Miss, Mrs,” or “Ms.”
Why?
Like lots of baffling things about the UK and Ireland, it comes down to tradition (and possibly a little bit of snobbery).
The British Medical Journal (BMJ) says that the “curious” tradition, which it calls “a mystery to doctors in other countries as well as to the British public,” dates back to before 1800.
Back then, physicians were usually “gentlemen” who possessed a formal Medical Degree (MD) from an accredited university. But surgeons didn’t usually have one and often took apprenticeships rather than studying, after which they were tested and awarded a diploma if they passed.
That meant surgeons stayed “Mr” while physicians were “MD”s. But over time, especially with the addition of London’s “voluntary” hospitals, surgeons proved their skill and mettle.
Honorary surgeon at St Bartholomew’s Hospital John Abernethy wrote in 1812, “There was a time when surgeons were considered as mere appendages of physicians, the mere operators to be put in motion by their directors: but times have changed and surgeons are changed too... and in consequence have got a kind of information which puts them on a par with others of the profession.”
Surgeons have long needed a medical degree and then some. So why keep the name?
Well, partly tradition.
But also, as the BMJ explains, “Surgeons had become so pleased with themselves that being addressed as Mr ceased to be a put-down and became a badge of honour and distinction. Although surgeons in 1730 had no right to be called Dr, hospital surgeons in 1830 had no wish to be.”
In other words, surgeons began to see their distinction from physicians as an honour. And now, as The Royal College of Surgeons points out, “in effect a person starts as Mr/Miss/Ms/Mrs, becomes a Dr and then goes back to being a Mr/Miss/Ms/Mrs again.”
After a complicated turn of events, which saw lots of arguments about who did and didn’t get to call themselves Mr and Dr, there is now only one medical Mr/Ms/Miss/Mrs per eight Drs.