Another Successful Summer in Prague

Prague Selective Group Photo in White CoatsWith high ranking officials addressing the medical students in Prague this summer, the seventh annual Prague Selective was more outstanding than ever. The Czech minister of health, Dr. Jozef Kubinyi, led a two-hour discussion one afternoon during the three-week selective, and the U.S. Ambassador to the Czech Republic, William J. Cabaniss, talked to the students adding to the prominence of the program.

The Prague Selective, the most popular selective in the School of Medicine, brings medical students from St. George’s University and other U.S. medical schools to Prague for three weeks of medical training in the Czech Republic. The students spend three weeks in hospitals in Prague under the tutelage of the local faculty and physicians.

The goals of the Prague Selective, which was founded and is directed by Dr. Martin Stransky, SGU ’83, are: to introduce the student to clinical medicine through actual observation of various patient care settings; to introduce the student to the thinking process that clinicians use when examining patients; to introduce the student to medical care in a Central European country emerging from communist rule; and to develop and foster contacts, both locally and internationally.

Instructed by local university faculty and physicians, the students rotate each morning through hospitals, both teaching and non-teaching. “The hospitals are fantastic,” Dr. Stransky said. “The students are exposed to real clinical situations and are able to scrub into surgeries and see babies in outpatient clinics.” Two afternoons a week the students attend lectures and informal seminars, where they hear from various medical professionals and learn “how to think in medicine.”

During the selective the students learned and were exposed to many different healthcare models. In addition to learning about the Czech Republic’s system, they explored the way healthcare works in the U.S., Canada, the U.K., and Germany. The students are engaged in lively debate about the pros and cons of socialized medicine vs. a capitalist, market-focused society.

Prague Selective Doctors in SurgeryAt the end of the program a pass-fail, oral and written exam is administered. Upon successful completion the students receive two credits for the selective. The Prague Selective is registered in the International Health Medical Education Consortium catalog as a SGUSOM course. “It’s great for St. George’s to have such a program under their registration and have students from U.S. medical schools attend and receive credit,” Dr. Stransky commented.

70 medical students were enrolled in the selective this year, 45 of whom were from St. George’s University. The other students came from U.S. medical schools, including Albert Einstein, George Washington University, UCLA, St. Louis, SUNY Upstate, and SUNY Downstate.

To date more than 500 students have attended the selective, which is the largest program of its type. The concept for the program began in 1997 when Dr. Stransky was visiting St. George’s as a lecturer. Some students approached him and asked to shadow him in Prague for a few weeks to learn about medicine in the Czech Republic and to visit the city. From there St. George’s University decided to formalize the program and the Prague Selective became official. Dr. Stransky has since developed the program into a unique experience enjoyed and embraced by students worldwide.

Dr. Stransky’s impressive medical background at Yale University, in the Czech Republic, and at St. George’s University have enabled the Prague Selective to grow into what is today with hopes of expansion in the future.

For more information on the Prague Selective, visit sgusom.hyperlink.cz and for more information on Dr. Martin Stransky, and to contact him, visit www.narodni.cz.

Published on 10/06/2004

Save

Save

Philip Finlay Leaves University to Join Family in U.S.

Philip Finlay Side PortraitAfter serving St. George’s University as a faculty member for the past 11 years, Dr. Philip Finlay regretfully resigned from his post as Associate Professor of Medicine and Director of Medical Education at the Clinical Teaching Unit in December 2003 in order to join his family in the United States. Dr. Finlay, a Grenadian by birth, has been connected to the University since he enrolled in the School of Medicine as a student in 1979.

“The University will miss him greatly,” said Dr. Paddy Ross, Dean of Clinical Studies in the Caribbean. “Dr. Finlay is a person of immense integrity. A born teacher, he is incredibly conscientious and people enjoyed his teaching sessions.”

Growing up in Grenada, Dr. Finlay was always intrigued by medicine. After earning his undergraduate degree from the University of the West Indies, he returned to Grenada and was accepted to St. George’s University School of Medicine. Overcoming financial obstacles, he received a government scholarship and began his studies. “This was the best thing that happened to me,” Dr. Finlay said. “St. George’s has enabled me to live two lives – as a teacher and as a doctor.”

After graduating with an MD degree in 1983, Dr. Finlay interned at the General Hospital in Grenada. He then did his residency in Internal Medicine and a fellowship in Infectious Disease at the University of Miami/ Jackson Memorial Hospital. After completing his postgraduate training abroad, Dr. Finlay returned to Grenada in 1992 and joined the faculty of St. George’s and became Director of Medical Education at the General Hospital.

Dr. Finlay was instrumental in the organization of the internship program at the General Hospital in Grenada and the training of the young doctors. When Dr. Finlay was interning at the Hospital in the early 80’s, the internship program had not been formally organized. When he joined the faculty, he made this one of his goals; and he succeeded. Today, about ten interns per year work in the Hospital for one year before beginning their residencies.
Being a part of the University for so long, Dr. Finlay witnessed the many changes and improvements that have made the University what it is today. “There have been huge changes within the University and it’s amazing to see what it has become,” Dr. Finlay commented. “The administration has made a serious commitment to quality from day one and they’re continuing to make the school better and better.”

In addition to the work he has done for the University, Dr. Finlay is a well recognized physician in the Grenadian and Caribbean professional communities and beyond. As Director of the National Infectious Disease Control Unit in Grenada’s Ministry of Health from 2002 to 2003, Dr. Finlay worked closely with other stakeholders to formulate a national plan to manage HIV/AIDS in Grenada. He liaised with the Clinton Foundation to start an HIV Clinic, which became a reality in March 2003 and provides free treatment and medication for all HIV/AIDS patients. He served the Grenada Medical Association for many years and is a member of the American College of Physicians, the American Medical Association, and an associate member of the Infectious Diseases Society of America.

Dr. Finlay has joined his wife and family in the United States, where they have been since 2001. He is currently working in the Central Texas Veterans Health Care System.

“I hope that some sort of relationship can continue so that I am never too far from St. George’s University,” Dr. Finlay said. “I always want to have an association with the school. Hopefully I’ll return as a visiting professor soon.”

Published on 10/06/2004

Save

New Chair of Medicine Named

Dr Jacobs PortraitWith the appointment a new Chair of Medicine, St. George’s University has again demonstrated its effort and commitment to ensuring excellence in education and positive growth into the 21st century.

Fred M. Jacobs, M.D., J.D., F.A.C.P., was named Chair of the Department of Medicine in the School of Medicine, effective July 1, 2004. Dr. Jacobs, who serves on the Board of Trustees and is a Professor of Medicine and Jurisprudence at the University, has been affiliated with St. George’s since 1980.

As Chair of Medicine, Dr. Jacobs will be responsible for the internal medicine education at all clinical centers and affiliated hospitals. “I want to assure that the curriculum is presented in a comprehensive and coherent manner, and that the students and faculty are fulfilling their obligations.” Dr. Jacobs said “I want to make sure that each program is presented in the context of the medical environment of the 21st Century, to see that regulations are being followed and that there is an emphasis on social, economic and ethical issues that are so important in today’s practice of medicine. Medicine today is the best it has ever been in terms of technology, pharmacology and the enormous advances in medical care. Certainly, I recognize that the practice of medicine exists in a challenging environment.”

Dr. Jacobs’ extensive professional career has prepared him well for this new role. He received his MD Degree from the University of Miami School of Medicine where he was elected to the Alpha Omega Alpha Honor Society. He trained in internal medicine at Maimonides Medical Center and Mt. Sinai Hospital in New York City and completed a pulmonary research fellowship at the University of California, San Francisco Medical Center and a Chief Residency in pulmonary disease at Kings County Hospital Center in New York. He is Board Certified in both Internal Medicine and Pulmonary Disease. He is a Fellow of the American College of Physicians, the American College of Chest Physicians and the American College of Legal Medicine.

In 1969, he joined the staff at Saint Barnabas Medical Center in New Jersey where he has been Chief of Pulmonary Disease, Medical Director of the Intensive Care Unit and was elected President of the Medical Staff in 1987. Subsequently, he became Senior Vice President for Medical Affairs at Saint Barnabas, and later, Executive Vice President for Medical Affairs for the Saint Barnabas Health Care System.

Dr. Jacobs has also held many faculty positions, including Clinical Associate Professor of Medicine at the University of Medicine and Dentistry of New Jersey, New Jersey Medical School. In 1990, Dr. Jacobs graduated from Rutgers University School of Law in Newark, New Jersey and is admitted to the Bar of the States of New Jersey and Florida.

Dr. Jacobs was appointed to the New Jersey State Board of Medical Examiners by then Governor Thomas Kean in 1989 and was reappointed by Governor James Florio in 1993. He served as President of the Board from 1993 to 1995.

Dr. Jacobs’ two children have both attended St. George’s University, and his wife, Miriam, is Associate Director of the Office of Career Guidance.

A more detailed biography of Dr. Jacobs can be found on our website.

Published on 10/06/2004

Save

A Global Perspective: Exploring the World of International Medical Education

After more than a decade on the air, ER still ranks as one of the most popular dramas in TV history. Not surprisingly, more than a few MDs have come to appreciate the intricate “medspeak,” highly realistic plots, and multidimensional characters like Dr. Carter, Dr. Kovac, Dr. Benton and Dr. Corday. But what can a TV show possibly tell us about the state of the American medical community and medical education? It might seem like a minor point at first, but one casting note is worth pointing out, if only for the symbolism: Many viewers will note that several U.S.-trained doctors have checked in and out of County General Hospital. Meanwhile Dr. Corday, the highly driven British surgeon, is still in residence and currently serving as the assistant chief of surgery. From that perspective, ER’s “MD makeover” symbolizes some interesting institutional developments in the American medical community: You could argue that Dr. Corday, an international medical graduate (IMG) who is passionately committed to her craft and her patients, represents what many believe is the future of the U.S. medical community. Increasingly, leading experts believe that a broad, international medical background is critical to the future well-being of the country’s patients, hospitals, and medical system.

From SARS, Bioterrorism, and AIDS to increased use of technology, rising healthcare cost/inequities, and doctor/nurse shortages, Medicine is being transformed as never before. The patient population today is vastly differentiated, diversified, and more empowered (via the Internet), signaling a new change in the patient-doctor relationship. Subsequently, there is an increased need for highly skilled doctors who embody the “global perspective” – a keen appreciation of the socio-economic/cultural factors that impact Medicine coupled with superior core skills and a talent for patient care – and not just the traditional and increasingly outdated view of medical practice. As a group, IMGs already fill some of the most critical positions in GP and specialty medicine. This is clearly a big shift from just thirty years ago. Back then, U.S. medical school applicants did not even consider international schools and IMGs were rarely considered for top residency posts. Today, thousands of American-born IMGs play a vital “vanguard” role in the U.S. medical community, and bring a critically important global perspective to medical practice. Subsequently, it is increasingly common for an American med student to enroll at a “foreign” (Caribbean, European, Australian) school, complete his or her clinicals in far-off locations, such as Prague, and return to practice in New York. So what is it that initiated this trend and why is it important for aspiring doctors to explore the world of international medical education? To answer this question fully, it’s important to look at the challenges transforming the American medical community, examine the evolution of medical education and provide some insight into the IMG experience.

Understanding the Challenges

In the United States, the medical community faces multiple challenges ranging from socio-economic factors to fundamental institutional changes. American doctors face an increasingly diversified patient population coupled with unique, demographic-based needs (minority/emigrant health), chronic health problems, high-risk behavior, environmental health hazards, increasing age/racial diversity of population and growing socio-economic disparities in healthcare. Most critically, predicted physician shortages are threatening to impede the very delivery of healthcare to some of the country’s most isolated constituencies: rural and urban communities. U.S. medical schools have been churning out 15,000 to 16,000 graduates, according to the Department of Health and Human Services, but census data show the population has increased 24 percent, from more than 226 million to more than 281 million people. While 972,000 physicians are projected for 2020, more than 1 million are needed. And a recent report by the Health Resources and Services Administration shows a current ratio of one worker for every 637 persons, a decrease from the 1970s’ ratio of 1:457. More critically, the number of physicians as a percentage of the student body in schools of public health plunged from 61 percent of all students in 1946 to 11 percent in 1979. The impending crisis might be considered catastrophic were it not for an emergent group of IMGs who are stepping into the void and filling a very critical need. In addition to filling the preexisting gaps in hospitals and clinics, IMGs also play a vital role in caring for – otherwise overlooked – racial/ethnic communities with very specific needs. In this respect, IMGs are integral to the future well-being of the nation’s patients and healthcare system. Not surprisingly, the AMA has focused its efforts on minimizing work delays for non-American IMGs, publicizing the need for enhanced minority representation, collaborating with public and private sectors to ensure adequate physician supply, among other measures. But before we examine the IMG experience directly, it is important to understand the system that is responsible for developing this new breed of doctor.

The Evolution of Medical Education

Given the physician glut and the preexisting challenges facing the U.S. medical community, especially socio-economic/cultural factors, many experts now advocate new strategies for capacity building. Some believe that a broad, international medical experience is vital if doctors are to meet these challenges effectively. It is against this background that international medical education (combining the best global learning practices) evolved outside the United States. As noted in a 2001 report titled Health Policies for the 21st Century: Challenges and Recommendations for the U.S. Department of Health and Human Services, the U.S. medical community has directed funds away from physician training and toward research, technology, and construction of healthcare facilities. Meanwhile, U.S.-based medical schools have continued to focus on technology and biomedical research. As a result, “[the] the major federal investments in capacity building for health have not systematically funded the public health infrastructure.”

Given this situation, perhaps it was inevitable that “foreign” medical schools would emerge to meet some of the challenges in American healthcare. In taking a training-focused approach to medical education and employing innovative curricula, many of these schools not only pioneer international medical education, but produce an entirely new breed of MDs who embody the global perspective and a uniquely “hybrid” view of Medicine. One school that has led the way is Grenada-based St. George’s University.

Founded in 1976 to anticipate global healthcare challenges, the University has since evolved from a Medical School to an international center of education, adding a School of Medicine and a School of Arts & Sciences. The University created the first truly global curriculum, drawing on the best of U.S. and U.K. medical systems. It is this tradition of commitment to academic leadership that has drawn Nobel Prize winners to St. George’s academic board, and professors and visiting scholars from the most prestigious institutions in the world, including Harvard University, London School of Hygiene and Tropical Health, and the Rockefeller Institute. In fact, the School of Medicine has a strong and stable faculty of 800 members, with full-time professors with an average tenure of ten years. It also has a network of prestigious clinical training affiliations with well-established U.S. and U.K. institutions.

With more than 5,000 graduates practicing – in different specialties and sub-specialties – worldwide, St. George’s has developed a well-earned reputation for excellence in the lecture hall, as well as in the operating room. Students score on parity with U.S. counterparts on standardized examinations and sometimes even exceed them, as they did in 2001. American observers like Dr. Daniel Ricciardi, Director of Medical Education at Long Island College Hospital, Brooklyn, NY, are quick to acknowledge that IMGs from schools like St. George’s are necessary for the well-being of an American medical community that is over-reliant on technology.

“In most instances throughout the U.S., [doctors] don’t really touch a patient anymore. [Basically], we’ve lost the compassion,” said Dr. Ricciardi. “But the beauty of St. George’s University is that it gives [medical students] a little bit more of an insight into the compassion.”

The IMG Experience

Currently, there are thousands of IMGs practicing across the United States, and the numbers are set to increase, especially as students begin to consider all of their options. Nearly 25 percent of physicians in U.S. allopathic training programs in 2002-2003 were IMGs, and the percentage of DOs continues to increase to meet specific needs (source: AMA). For example, the rising number of residents conversant in Spanish readily meets the needs of this fast-growing minority group. Of course, the day-to-day experience is no different from their U.S.-educated counterparts. In fact, many are trailblazing a path for others to follow. One remarkable example is that of Dr. Reginald Abraham. A 1990 graduate of St. George’s University, Dr. Abraham exemplifies the University’s international heritage and commitment to a broad medical education.

A Sri Lankan born in Malaysia and schooled in Canada, Dr. Abraham had always been a world traveler. So when it came time for him to pursue a career in medicine, St. George’s University was the perfect fit. The diverse community, global perspective on medicine, and world of opportunities inspired him to take the international experience even further. For Dr. Abraham, that meant clinical rotations in England and New York, a surgical residency at Yale University, and a Fellowship in Cardiothoracic Surgery at New York Medical College. Now a specialist in minimally invasive heart surgery and off-pump coronary artery surgery, he is one of California’s top surgeons, a strong advocate of St. George’s unique medical training regimen, and uniquely attuned to the new challenges facing the American medical community.

“The world, and the medical world in particular, have changed dramatically,” noted Dr. Abraham. “Increasingly, people of different cultures are making America their new home. So it’s vitally important that American doctors have the knowledge base and the adaptability needed to appreciate different cultural nuances, as well as relate to people of different cultures. The more broad-based an education you have, the more capable a physician you’ll become.”

Abraham, who credits St. George’s with providing him with “a very cosmopolitan and enriching experience,” proves just how important it is for American-based MDs to possess that increasingly key advantage: an international background. Of course, this is not restricted to the United States alone. Many of Abraham’s classmates represent the promise outlined in St. George’s “Think Beyond” tagline. The emphasis on “learn here, practice anywhere” has enabled thousands of doctors practicing outside the U.S. to achieve an equal level of professional excellence and personal fulfillment. One notable example is Dr. Angela Huang, a Taiwanese doctor currently practicing in her homeland. After moving to the United States, she went on to pursue her undergraduate degree in biochemistry from the University of Minnesota. She sought out St. George’s because it made for the best fit … but she also benefited from the broad and diverse educational experience. For example, while most students choose to do their clinical training in the U.S., she chose to do her rotations in England, where she had the chance to experience yet another culture. After graduation from St. George’s, Dr. Huang decided to return to Taiwan, where she completed her residency in internal medicine at Cheng-Hsin Rehabilitation Center and went on to pursue a pulmonary medicine fellowship.

A Global Perspective

There has never been a more critical time in the history of the U.S. medical community, and healthcare reform – the primary catalyst for change (above and beyond education) – is once again a key subject in this year’s presidential elections. With new challenges transforming the very institution of Medicine, hospitals and patients alike need doctors who understand and anticipate their unique needs. Experts now tout the increasingly important balance between excellent healthcare delivery and cultural awareness in the patient-doctor relationship, noting the singular importance of “foreign” medical schools like St. George’s University. For prospective MDs, the bottom line is this: While ER’s Dr. Corday represents the new image of the IMG on-screen, real-world practitioners like Dr. Abraham bring a new level of excellence, expertise, and leadership to the U.S. medical community, inspiring many more to follow in their globe-trotting footsteps.

Published on 08/11/2004

Conservation Medicine

Dr. Alonso Aguirre, Executive Director of Conservation Medicine with the Wildlife Trust, will conduct a seminar at St. George’s on Monday, April 5 at 5pm in the Bourne Hall. Dr. Aguirre is one of the founders of Conservation Medicine – an emerging medical discipline that joins the expertise of veterinary medicine and human medicine in the service of ecosystem health. At a time of damaged and collapsing habitats around the world where biodiversity loss now threatens the ecological infrastructure of human populations, conservation medicine offers considerable global relevancy. In the truest medical tradition, this discipline seeks to diagnose the proximate and ultimate causes of health decline at the ecosystem level and to implement corrective policies that will reclaim and safeguard the variety of environments supporting human and animal life. This exciting new medical specialty promises to expand the capabilities of both physicians and veterinarians in addressing increasingly pressing environmental and societal concerns in virtually every part of the world today.

Published on 04/05/2004

Kingstown Medical College Celebrates 25 Years of Academic Excellence

The Kingstown Medical College, a long time affiliate of St. George’s University School of Medicine, kicked off a week long celebration of its 25th Anniversary on February 14th 2004. The Kingstown Medical College was founded in January, 1979 and since its inception, has provided outstanding preclinical training for St. George’s University medical students during their fifth and sixth term.

SGU’s medical students spend a critical period of their medical training at KMC in a semester whose curriculum bridges knowledge from the basic sciences to the clinical program. Their program includes frequent visits to the Milton Cato Memorial Hospital where students obtain clinical experience in core rotations and certain specialties.

KMC’s 25th Anniversary celebration was launched by a Cardiology Symposium chaired by His Excellency, Sir Frederick N. Ballantyne, followed by a luncheon reception attended by faculty, staff, alumni, and distinguished guests of Kingstown Medical College and St. George’s University. A Celebratory Program in the KMC Lecture Hall was moderated by the Dean of KMC, Dr. Ed Johnson, who introduced the principle speakers.

The keynote speakers, Drs. Mary Jeanne Kreek and Richard Roberts, both of the Cornell and Rockefeller Universities, have been long time lecturers at KMC. Dr. Frederick Ballantyne, Governor General of St. Vincent and one of the School’s first champions back in 1978 and Dr. Charles R Modica, Chancellor of St. George’s University, gave somewhat different, but equally entertaining early histories of KMC. Rosalind Ambrose, MD (SGU, 1983) Director of Medical Education at the Milton Cato Memorial Hospital, spoke of her experiences as an early student at the University. In addition, Dr. Douglas Slater, Minister of Health and the Environment SVG; The Honorable Vincent Beache, Acting Prime Minister for SVG., also spoke at the Celebratory Program. Eloquent closing remarks were offered by Dr. Jack Cush, SGU graduate and Chair of the Academic Board and member of the Board of Trustees.

The celebration culminated in an evening reception, hosted by Sir Fredrick and Lady Sally Ann Ballantyne, at Government House. Toasts were offered by Sir Frederick, Chancellor Modica, and Dean Johnson. The successes of KMC and SGU graduates was noted and special tribute was paid to the 21 Vincentian graduates who are now practicing in Saint Vincent, many of whom serve as Clinical Faculty at the Milton Cato Memorial Hospital.

Additional events during the “Celebration Week” included a “Handing over of the Keys” ceremony on Tuesday the 17th. The keys were presented in recognition of the renovations performed on the Calliaqua Clinic by KMC staff members. The Clinic, a training site for KMC in the early 1980’s, was remodeled to provide better patient care and to again provide a clinical training site for KMC’s students. On Thursday, February 19th, Dr. Timothy Providence, the Director of the Cato Memorial Hospital and Dr. Frederick Ballantyne, the Governor General, officially thanked SGU and KMC for the donation of 5 Automated External Defibrillators, which were obtained through the dedicated efforts of Rosann Hansford, RN, Deputy Director, Cardiology Unit of University Health Services at SGU and Dr. Henry Halperin, ACLS visiting instructor from John’s Hopkins University.

The week’s activities closed with a dinner party for the employees of KMC on Saturday evening February 21st. On this occasion employees with 10 or more years service at KMC were awarded a certificate of appreciation and given gifts to note their contribution, with a special acknowledgement of those with 25 years of service. The Administration, faculty and staff of KMC extended their sincere appreciation to all of the members of the Vincentian Government and community, SGU graduates and Grenada visitors who participated in these festivities.

Published on 02/27/2004

Surgeon Titles: Dr. vs. Mr.

As Originally Published in The eZine “Education Update

While surgeons carry the appellation “Dr.” in the USA and other parts of the world, in the UK they are referred to as “Mr.” How has this anomaly arisen? Academically, in order to be called “Dr.” one must hold a doctoral degree (the highest academic degree in any field of knowledge), such as Doctor of Medicine, M.D., or Doctor of any other discipline. In the USA, an M.D. is a licensing qualification to practice medicine, whereas in Britain, an M.D. is a postgraduate thesis degree. In order to practice medicine in Britain, students must attain a Bachelor of Medicine and a Bachelor of Surgery degree (MB and BS). Therefore they are not, in the strictest sense, “doctors.” However, once graduated in Britain, all graduates are referred to as Doctor, as are consultant and trainee physicians and other specialists––all except surgeons.

The word “doctor” is derived from the Latin doctor-oris, meaning teacher or instructor, and in Middle English (c. 1150-1500) it became used for any learned man or medical practitioner. The title “Mr.” is a 16th century English variant of Master, derived from the Latin Magister, which means master or teacher. Following the fall of the Roman Empire, most surgery in Europe was performed in monasteries by monks and their assistants, the barbers. As well as cutting hair and shaving, barbers helped with blood-letting.

The Medieval Universities were founded to teach subjects, including medicine, which had no place in the ecclesiastical curriculum. Salerno was one of the first medical schools and was established by the middle of the 11th century. Courses were initially available to physicians and surgeons, but not to apothecaries.

In 1123 CE, Pope Calistas II decreed that monks must not shed blood, and it was this ruling that resulted in the teaching of surgeons being forbidden in church-dominated universities. Surgeons, therefore, served an apprenticeship, whilst physicians spent four years at university, leading to a Bachelor of Medicine degree and a possible further thesis leading to a Doctorate. The Pope’s ruling also resulted in a great boost to the barbers, who now performed dental extractions and fracture treatments as well as blood-letting. Because of their increased role, they became known as the barber-surgeons, and monks then administered only to the spiritual needs of patients.

At this time, true surgeons also developed. They were more skilled than the barber-surgeons, but were apprenticed and not university trained, and therefore could not style themselves as “doctors.”

In 1493 English surgeons decided to enter a working agreement with the barber-surgeons, and this association was given Royal assent in 1540 when Henry VIII, by Act of Parliament, united the two groups under the name of “Masters, Governors of the Mystery and Commonalty of Barbers and Surgery of London.” From this time, by Royal edict the barbers could only perform barbery and extraction of teeth, and the surgeons had to refrain from cutting hair and shaving people! King Henry VIII gave each member of this newly formed group the right to be addressed as “Master,” and in time “Master” was pronounced “Mr.” So when a British Surgeon is addressed as “Mr.” he is actually being honoured, as in reality he is being called “Master.” Female surgeons are called Miss, Ms. or Mrs.

The association of surgeons and barber-surgeons lasted until 1745, when the surgeons petitioned the English parliament for a separation that lasts to this day. The barber-surgeons are now represented by the Benevolent Barbers’ City Livery Company.

By Mr. Rodney Croft

Published on 01/05/2004