Master of Surgery

The Master of Surgery is an advanced qualification in surgery. It is most commonly abbreviated Ch.M. or M.S., as well as M.Ch. and M.Chir. from its Latin name, Magister Chirurgiae or the English form of Master of Surgery.

A typical taught program lasts between 1 and 3 years depending on mode of attendance. The possession of a medical degree is a prerequisite. There is also a similar Masters degree in Obstetrics (MAO) in Ireland.

Several kinds of Surgical Mastership

Master of Surgery degrees are awarded by universities in the Commonwealth of Nations and a few other countries that used to be in the British Empire. There are/were several different kinds of this degree:

1.(a) An initial qualification in medicine. The University of Glasgow School of Medicine introduced a C.M. degree early in the nineteenth century, following a shortened version of the curriculum for the M.D., the normal initial qualification for those few who took a degree in medicine. This infringed the rights of the Faculty of Physicians and Surgeons of Glasgow (now the Royal College of Physicians and Surgeons of Glasgow) and was discontinued after prolonged litigation.

1.(b) When the British Universities replaced the M.D. as an initial medical qualification in the middle of the nineteenth century, they awarded instead paired degrees of Bachelor of Medicine and Master of Surgery: usually M.B., C.M.

1.(c) Late in the nineteenth century, Bachelor of Surgery degrees (usually Ch.B.) began to be awarded with the M.B., and the mastership became a higher degree, usually abbreviated Ch.M.: but M.S. in London, where the first degree was M.B.,B.S. Only McGill University in Canada still gives an initial qualification of Master of Surgery as part of its M.D., C.M.

2.(a) In the British system, the ChM became like the MD: universities held examinations, generally limited to their own graduates, and also asked for a dissertation or thesis, which in the early days might have been a commentary on a medical text or on a set of case reports, rather than the substantial experimental work that would be expected nowadays. Candidates would be expected to have surgical experience. There would be no full-time course.

2.(b) In Britain most universities have stopped holding written and clinical examinations for the Ch.M., as they have done for the M.D. also in the post-war era. Only Oxford and Cambridge still have a (Part One) examination before submission of the thesis and oral examination on the same for the degrees which they abbreviate as M.Ch. and M.Chir. respectively.

The regulations ^[1] may ask for surgical experience and a thesis topic that is not purely medical, but otherwise there is little to distinguish the ChM from the MD, especially if the research is done on animals. Some British universities have stopped giving ChMs altogether: e.g. the University of Birmingham in 1974^[2], so that only MDs are awarded. As with the MD, in recent years many British universities have opened the exam to graduates of other universities working in their area. The ChM became a purely research degree when it became normal for trainee surgeons to take the F.R.C.S. examination of one or other Royal College of Surgeons in basic sciences and clinical subjects.

As with the M.D., candidates who are part of a university-based research group might well choose nowadays to register for a PhD instead.

2.(c) Indian universities have taken the opposite route, of setting up three year courses as well as examinations for M.S. in general surgery or gynaecology (etc.), on the same pattern as the modern Indian M.D. Candidates would have clinical experience before taking a competitive entrance exam to join the programme. This kind of degree certifies clinical skill as well as academic knowledge.

3. (a) More specialised examinations appeared much later. For many years the University of Liverpool has had courses and examinations for M.Ch.Orth.^[3] in orthopaedics and M.Ch.Otol. in ear, nose and throat surgery, and in the 1980s there was also a Mastership in Gynaecology and Obstetrics^[4], but the other British universities have not followed suit. They are unlikely to do so now as the old fellowship examinations that used to be taken by surgical trainees have been replaced by membership examinations (M.R.C.S.), which are followed a few years later by the new fellowship examinations in subspecialties. Instead there are increasing numbers of Master of Science (M.Sc.) courses in clinical subjects.

3.(b) A few Indian medical schools have developed courses for second masterships in surgical sub specialties, leading to the M.Ch., on the same pattern as the second doctorate (D.M.) in medical specialties.Here the M Ch qualification is akin to fellowships in specialized branches of surgery, such as cardiac surgery, Neurosurgery, Urology, etc., which are awarded after a further 3 year training course, that follows the standard MS (General Surgery) 3 year specialty training. The MS General surgery is similar to the surgical residency program, followed by the M Ch,which is similar to a specialty fellowship program.

3.(c) University of Seychelles American Institute of Medicine ^[5] offers a distance learning program to earn their M.Ch.(Orthopaedics) or M.Ch.(Orth)^[6]: this requires a medical degree, a postgraduate qualification in orthopaedics and four years surgical experience. The on-line course has assessments after each of five monthly modules, followed by a dissertation, two days of lectures held in India, the UK or Persian Gulf and one day of assessment, for 225,000 Indian Rupees. It is not recognised anywhere and there are no students studying in the main university.

References

1. ^ Hawkins, CF "Write the MD Thesis" in "How To Do It" London: British Medical Association 2nd edition 1985 ISBN 0-7279-0186-9
2. ^ Hawkins op cit p 60
3. ^ Shah Alam Khan "Degree of Master of Surgery (Orthopaedics), MChOrth" British Medical Journal Career Focus (2007) 334
4. ^ Williams, John "Mastership in Ob/Gyn" BMJ Career Focus Online 8 September 2001
5. ^ University of Seychelles - American Institute of Medicine
6. ^ MCh-Orth Certification Programme By Boolean Education & USAIM

See also

• Doctor of Medicine
• Medical education