If you’ve ever met a surgeon whose door has a sign that proudly states “Mr So-and-so” or “Ms So-and-so”, you’re not witnessing a typo. You’re seeing one of medicine’s oldest traditions in action. It’s a quirk that confuses many members of the public, but it is rooted in a surprisingly dramatic history.
WORDS LIM TECK CHOON
IN THE BEGINNING
Back in the early days of medicine, before the 1800s, physicians and surgeons in what we know as the United Kingdom (UK) today started out as two very different professions.
Physicians
- These were the scholars.
- They studied, wrote, theorized, and attended universities, earning degrees and the honorific title “Doctor”.
Surgeons
- They were seen more as craftsman or tradesman, never attended any university.
- Instead, surgeons often performed tasks of a barber as well as crude early forms of services from lancing boils to amputations.
- The earliest formal organization was the Company of Barber-Surgeons, established in 1540 by King Henry VIII, thus combining barbers and surgeons into one single profession.
- Hence, they were addressed as “Mister” — most barber-surgeons were males back then.
THE RISE OF THE SURGEONS
Things changed over the 18th and 19th centuries, as surgical colleges began to form.
- In 1745, surgeons separated from the barbers to form the Company of Surgeons.
- This group gained a royal charter in 1800 and became known as the Royal College of Surgeons.
- This is that starting point of formal surgical regulation and education as a specialty distinct from general medicine and barbering.
The establishment of the Royal College of Surgeons formalized surgical training, introducing apprenticeships and structured exams that surgeons had to pass to earn fellowship of the college (FRCS).
- Over time, advances were made, such as anesthesia and antiseptic techniques, which expanded the scope and complexity of surgeries.
- Spurred by this, the College raised its educational standards, transitioning from apprenticeship systems to more formalized curricula and competency assessments that eventually became the foundation of surgical education today.
Thus, the surgical colleges evolved over centuries into respected institutions that emphasized practical surgical skills, rigorous examinations, and continuing medical education.
A Parallel to Medical Education
- While this was going on, medical schools taught physicians university-based scientific medicine, which was slightly different from the surgical colleges.
- The surgical colleges instead maintained exam-based certification and hands-on training.
This dual development explains why surgeons in these regions adopted distinct titles like “Mr”, “Mrs”, or “Ms” even after becoming medical doctors, reflecting their separate tradition and specialized training through the surgical colleges.
AN HONOURIFIC DESIGNATION
Today, some medical establishments still address surgeons as “Mr”, “Mrs”, or “Ms”, especially in the United Kingdom and some Commonwealth countries like Malaysia.
- This is because such designations are actually a badge of honour that symbolizes the mastery of the person over the medical arts of surgery.
- It shows that the person has completed the necessary rigorous and even tough training to become a qualified surgeon.
- It is also a reminder of the history of surgery, which had risen from its humble roots to become a much respected and important medical profession today.
So, the next time you meet Mrs Tan, Consultant Surgeon, keep in mind that she hasn’t lost the right to use the title of “Doctor”.
She earned it, but she has decided to give it back to instead honour the history and legacy of surgery as a profession.
| This article is part of our series on issues and developments affecting the Malaysian medical landscape. |
Reference: Loudon, I. (2000). Why are (male) surgeons still addressed as Mr?. BMJ, 321(7276), 1589–1591. https://doi.org/10.1136/bmj.321.7276.1589
