In English-speaking countries, the title “Doctor” can refer either to a medical practitioner (clinician) or to a person who holds a research doctorate, such as a PhD (Doctor of Philosophy), which is the highest academic degree that a university can confer. Strictly speaking, most medical degrees, such as the MBBS (Bachelor of Medicine, Bachelor of Surgery) or the MD in the United States, are professional degrees, not research doctorates. They are academically closer to a Bachelor’s or Master’s level qualification, rather than to a doctorate in the scholarly sense.
From a purely academic perspective, therefore, a medical doctor is not a “doctor” in the same way that a PhD holder is. The title “Doctor” for physicians originated historically as a courtesy or honorific address, first given by society and patients, and only later adopted by medical practitioners themselves. Over time, clinicians began to routinely call themselves “doctors,” and the title became institutionalized.
This naturally raises the question:
Why do medical practitioners call themselves “Doctor” when the degree they hold is not a doctorate in the academic sense?
To answer this, we must understand the original meaning and historical development of the word “doctor.”
The Original Meaning of “Doctor”
The word “doctor” originates from the Latin verb docēre, meaning “to teach.” In its original and most literal sense, a doctor is simply “a teacher.”
In the Middle Ages (12th–14th centuries), the title “Doctor” referred to a learned scholar who had earned a formal license to teach (licentia docendi) at a university. The earliest doctors were not physicians, but theologians, known as Doctors of the Church, who were qualified to interpret and teach religious doctrine. Later, the title expanded to scholars in law, and eventually to medicine.
Thus, historically, the word “Doctor” was entirely academic, not clinical.
Why Medical Practitioners Use the Title “Doctor”
Although most modern medical degrees are professional rather than academic doctorates, the title “Doctor” became attached to physicians through a mixture of social prestige, public perception, and professional branding.
In the 18th century, particularly in Scotland, medical schools began addressing their graduates as “Doctor” to distinguish university-trained physicians from apprentice-trained surgeons and apothecaries. By the 19th century, the general public had begun using “doctor” as a synonym for “physician,” and medical practitioners gladly adopted the title because it conferred status, authority, and trust.
In the United Kingdom, the Royal College of Physicians formally recognized the use of “Doctor” as a courtesy title for licensed physicians in 1838, regardless of the academic level of their degrees.
In the United States, medical schools went even further by naming the professional degree “Doctor of Medicine (MD)”, which sounds like a doctorate, even though it remains fundamentally a vocational professional degree, not a research doctorate like a PhD.
The Fundamental Difference: PhD vs MD / MBBS
The essential difference lies in purpose and function:
A PhD (Doctor of Philosophy) is a research doctorate. It focuses on the creation of new knowledge, requiring original research, a substantial thesis, and a formal defense.
whereas, an MD or MBBS is a professional or vocational degree. It focuses on the application of existing knowledge to diagnose, treat, and care for patients.
In short:
PhD = discovery of knowledge.
MD/MBBS = application of knowledge.
Why Surgeons Are Called “Mr.” Instead of “Dr.”
In countries such as the UK, Ireland, Australia, and New Zealand, surgeons traditionally revert from “Dr.” to “Mr.”, “Ms.”, “Mrs.” or “Miss.” This peculiar practice is a historical badge of honor rooted in professional rivalry.
Historically, physicians were university-educated scholars and held academic degrees, so they were called “Doctor.” Surgeons, however, were originally craftsmen, trained through apprenticeships, not universities. Many began as barber-surgeons, performing amputations and bloodletting with the same tools used for cutting hair.
Because surgeons lacked university degrees, physicians looked down on them and denied them the title “Doctor.” In response, surgeons eventually embraced “Mr.” as a symbol of elite professional identity, turning an insult into a badge of pride.
Today, this is purely symbolic. All surgeons must first qualify as medical doctors. After passing prestigious examinations such as those of the Royal College of Surgeons, they revert to “Mr.” or “Ms.” as a sign of seniority and specialization.
Personally, I regard this tradition as largely vanity and professional ego, rather than genuine humility.
Academic vs Professional Culture
In universities and research institutes, especially those with strong scientific traditions, medical practitioners are often called “clinicians”, not “doctors,” unless they also hold a PhD. This is not a demotion, but a functional distinction:
Clinicians treat patients.
Scientists (PhDs) generate new knowledge.
This distinction becomes evident in research output. It is striking that most Nobel Prizes in Medicine or Physiology have gone not to clinicians, but to biomedical scientists, who uncover the fundamental mechanisms of disease, diagnostics, and therapies.
This reality is uncomfortable for many in medicine. The Nobel Prize is named after medicine, yet most recipients are not practicing doctors. Clinicians apply knowledge; scientists create it.
The UK MD vs the US MD
In the UK, the MD (Doctor of Medicine) is not an entry-level medical degree. It is a higher research doctorate, often more prestigious than a PhD in clinical medicine.
To earn a UK MD, a doctor must:
Conduct original clinical research.
Write a substantial thesis (60,000–80,000 words).
Defend it in a viva voce.
By contrast, the American MD is simply the basic medical qualification.
Thus, paradoxically:
UK MD = academic doctorate.
US MD = professional degree.
Dentists and Veterinarians
Dentists and veterinarians followed similar historical paths:
Dentists were allowed to use “Doctor” in the UK in 1995 as a courtesy title. Veterinarians were granted the same in 2015.
In both cases, the title is professional, not academic.
The "Legality" Guardrail
Technically, in most countries, the title "Doctor" is not a protected term in the way "Architect" or "Physiotherapist" might be. However, "Medical Practitioner" is protected.
Tables of "Doctorate" Types
Category | Degree Type | Nature of "Doctor" Title |
PhD / DPhil | Academic Doctorate | Academic Title (Earned through original research) |
MD (UK/Aus) | Higher Doctorate | Academic Title (Earned through clinical research) |
MBBS / MD (US) | Professional Doctorate | Courtesy Title (By virtue of license/tradition) |
BDS / DDS (Dentist) | Professional Degree | Courtesy Title (By virtue of license/tradition) |
BVSc / DVM (Vet) | Professional Degree | Courtesy Title (By virtue of license/tradition) |
Chinese Perspective on Titles
In Chinese:
A medical doctor is 医生 (yīshēng)., whereas a PhD holder is 博士 (bóshì).
These are distinct terms. A 博士 is explicitly an academic authority, while 医生 is a professional healer.
Interestingly, Chinese culture places the title after the surname (e.g., 王博士), reflecting humility, not self-importance in very rich Chinese cultures.
In Chinese society, a PhD is far more prestigious than a medical doctor, because it represents the pinnacle of intellectual achievement.
Humility and the Obsession with Titles
I personally call myself simply “lin ru wu” (林如武), without any title.
Life is extremely brief. I have written and explained this here:
https://scientificlogic.blogspot.com/2025/12/the-brevity-of-human-life.html
None of us can carry, wealth, power, social status, professional titles, to the grave.
As Jesus warned:
“What does it profit a man to gain the whole world, but lose his soul?”
(Matthew 16:26; Mark 8:36)
So why must we be so obsessed with titles? since none of us can carry any wealth, power, positions, social status or titles to the grave - so why must we lose our souls in the next world?
All human titles, whether Doctor, Professor, Sir, Datuk, are temporary illusions. The only title that ultimately matters is who we are before God.
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Let me rewrite this article in another way here:
In English-speaking countries, the title "doctor" can either mean a medical doctor or a clinician, which is a basic bachelor's degree in medicine - MBBS, or a PhD which is the highest degree a university can confer. All bachelor's degrees, including even a Master's degree, whichever the field of studies are not a doctorate degree. and hence a medical doctor is not considered a 'doctor' in that sense. The title for a medical doctor is actually a polite or a courtesy address given by patients, and not that medical doctors are eligible for it. Subsequently clinicians started calling themselves as 'doctors’
So why is a medical doctor calling themselves a doctor when the degree they hold is just a Bachelor's degree and not a doctorate degree like a PhD. What is the original meaning of the word "doctor". Let me explain the history behind this.
The term "doctor" has a history rooted in education rather than medicine, and its use by medical professionals today is a result of historical social shifts and courtesy titles.
The original meaning of Doctor merely means The Teacher. The word "doctor" originates from the Latin verb docēre, which means "to teach".
In the Middle Ages (roughly 12th–14th centuries), the original usage of a "doctor" meant a learned teacher or a high-level scholar who had earned a "license to teach" (licentia docendi) at a university.
The title was initially reserved for theologians (Doctors of the Church) who were qualified to teach religious doctrine. It later expanded to include other university experts in law and eventually medicine.
So why do medical doctors use the title?
Whie most medical degrees today (like the MBBS) are academically at a Bachelor's or Master's level, the title "Doctor" became standard through a mix of public perception and professional branding. Let me clarify
In the 18th century, medical schools, particularly in Scotland, began addressing their graduates as "Doctor" as a mark of respect and to distinguish university-trained physicians from apprentice-trained surgeons and apothecaries.
By the 19th century, the general public began using "doctor" as a synonym for "physician." Medical practitioners happily adopted the prestigious title because it lent them credibility
In the UK, the Royal College of Physicians officially recognized the use of "Doctor" as a courtesy title for all licensed physicians in 1838, regardless of their degree level.
In the United States, medical schools eventually renamed their degree to "Medical Doctor" (MD) so that it sounds like a doctorate degree with this common usage, even though it remained a professional training degree at Bachelor’s level rather than a research doctorate like a PhD.
So what is the diffrence? A PhD (Doctor of Philosophy) focuses on creating new knowledge through original research and a thesis, whereas an MD / MBBS (Medical Doctor) focuses on practicing and applying knowledge to treat patients.
What about surgeons who are higher than medical doctors? Why surgeons in countries like the UK often prefer to be called "Mr." or "Ms." instead of "Doctor"? Why are surgeons addressed as Mr. or Miss instead of retaining their doctor title?
In certain countries (like the UK, Ireland, Australia, and New Zealand), surgeons revert to the titles "Mr.", "Miss", "Mrs.", or "Ms." as a badge of honor rooted in historical professional rivalries.
The tradition stems from a period when physicians and surgeons had completely different educational paths. Historically, physicians were university-educated scholars who studied theory. Because they held university degrees, they were entitled to the title "Doctor", whereas
surgeons were "craftsmen". Surgery was once considered a manual trade rather than a scholarly one. Surgeons often began as barber-surgeons, who performed amputations and bloodletting using the same sharp tools they used to cut hair. They were trained through apprenticeships rather than university programs and received a diploma instead of a degree. I should say it was just the "Badge of Honor". Because they lacked university degrees, physicians looked down on surgeons and did not allow them to use the title "Doctor". In a move of professional pride, surgeons eventually turned the "Mister" title into a mark of distinction to separate themselves from "mere" physicians. To me, this is all vanity and unnecessary pride - complete lack of professional humility. It is just ego to me.
Today, all surgeons must first qualify as medical doctors (earning the title "Dr.") before undergoing years of specialized surgical training.
Once a doctor passes the difficult exams to become a member of a professional body, such as the Royal College of Surgeons, they "revert" to being called Mr. or Ms..
It is a sign of seniorit for surgeons. In these medical systems, a surgeon being called "Mr. Lee or Mr Tan in a hospital often signals that the individual is a senior specialist or consultant, whereas "Dr. Ong might be a junior doctor or a non-surgical specialist.
This tradition is almost entirely absent in the United States and Canada, where surgeons always retain the title "Doctor".
However, in a university, academia or in a research center where I am more familiar and comfortable they may be medical doctors and PhD doctors working together as a team. In such an academic environment we do not address our medical colleagues as doctors but we always call them as clinicians, except and unless they hold a PhD degree as well, which is the pinnacle of scholarly achievements. We too like to separate the clinicians from the research scientists who normally have both a medical degree as well as a PhD.
In an academic or research setting, the distinction between a "Doctor" and a "Clinician" highlights this difference between academic achievement and professional licensing. Whereas the MD or MBBS is a professional doctor’s or vocational degree focused on the application of existing knowledge. In academia, "Doctor" technically denotes a research-based doctorate.
In research teams, medical doctors are often called clinicians to specify their role, namely they provide treatment and healthcare to patients, while PhD scientists handle the laboratory or theoretical research. This is a functional description, not a demotion. It is unfortunate most of the Nobel Prize in medicine or in physiology since the 1900’s goes not to medical doctors but to the scientists who made inroads into medical discoveries rather than to the clinicians who do routine clinical work. See this paper here published by clinicians themselves who are all Fellows of the the Royal Society of Medicine, London.
This is a disaster for medical doctors because the Nobel Prize in medicine or in Physiology is meant for them to win as the world’s most prestigious and glamorous of all prizes. But almost all of them went to the biomedical scientists instead who made most of the medical discoveries from causes of disease, diagnostics, treatment and prevention for the medical doctors who merely apply them in their practice.
Let me now explain the academic vs. professional titles
In the US Department of Education and most global qualification frameworks consider the PhD (Doctor of Philosophy) as the highest academic degree because it requires the creation of original knowledge through research.
Medical doctors almost always like to be addressed as "Doctor," but the authority for this title varies. In most countries, once a medical graduate registers with a licensing body (like the Singapore Medical Council or the Malaysian Medical Council), they are entitled to use the title "Dr." as a professional designation.
But for the patient and the public for those with an MBBS (Bachelor's) or an MD , "Dr." is often a courtesy title given by them as a tradition. In contrast, for a PhD, "Dr." is a permanent academic title earned by completing a research doctorate.
What about surgeons who are higher than a general medical doctor? Why are they addressed as Mr. or Miss instead of retaining their doctor title?
In certain countries (like the UK, Ireland, Australia, and New Zealand), surgeons revert to the titles
"Mr.", "Miss", "Mrs.", or "Ms." as a badge of honor rooted in historical professional rivalries.
The tradition stems from a period when physicians and surgeons had completely different educational paths. Historically, physicians were university-educated scholars who studied theory. Because they held university degrees, they were entitled to the title "Doctor".
Surgeons historically are "craftsmen". Surgery was once considered a manual trade rather than a scholarly one. Surgeons often began as barber-surgeons, who performed amputations and blood-letting using the same sharp tools they used to cut hair. They were trained through apprenticeships rather than university programs and received a diploma instead of a degree.
The "Badge of Honor" I should say. Because they lacked university degrees, physicians looked down on surgeons and did not allow them to use the title "Doctor". In a move of professional pride, surgeons eventually turned the "Mister" title into a mark of distinction to separate themselves from "mere" physicians.
To me, all these are mere pride, and not humility and professional integrity . Jesus, who is the greatest of all physicians since the creation of this world has never called Himself as “Dr. Jesus” There is a very huge divine difference in humility between Him as the Son of God, and us with our ego and self-pride.
Modern Practice
Today, all surgeons must first qualify as medical doctors (earning the title "Dr.") before undergoing years of specialized surgical training. Once a doctor passes the difficult exams to become a member of a professional body, such as the Royal College of Surgeons, they "revert" to being called Mr. or Ms. It is a sign of seniority and specialization. In these medical systems, being called "Mr. Lee" or Mr Lim (examples) in a hospital often signals that the individual is a senior specialist or consultant, whereas "Dr. Ong (example) might be a junior doctor or a non-surgical specialist.
This tradition is almost entirely absent in the United States and Canada, where surgeons always retain the title "Doctor".
Collaborative Roles
In modern research, the "pinnacle" is often seen as the MD-PhD (Physician-Scientist), an individual who holds both degrees and can bridge the gap between "bench" research and "bedside" care.
In the UK and many Commonwealth systems, there is a fascinating distinction between the "MD" and the "PhD," as well as how other medical professions navigate the "Doctor" title.
In the UK a PhD degree in medicine is the highest accolade for a medical doctor. A PhD-level research requirement that medical doctors in the UK are exceedingly tough to get or to earn. In the UK a Doctorate in Medicine (MD) is much higher and far more prestigious than an MBBS or its lower equivalent (MD) in the United States. Let me clarify this.
The UK "MD" vs. the PhD
In the UK, the MD (Doctor of Medicine) is actually a Higher Research Doctorate, which is distinct from the American "MD" (which is an entry-level medical degree).
To earn an MD in the UK, a medical doctor who already holds an MBBS must
conduct original extensive clinical research, usually over 2 to 3 years of full-time study (or longer part-time).
He must write a substantial thesis (typically 60,000–80,000 words) that demonstrates an original contribution to medical knowledge. The medical doctor must undergo a viva voce (an oral defense) in front of a panel of experts, just like a PhD candidate.
While a PhD can be in any subject (from physics to poetry), the MD (Res) is specifically focused on clinical or "bench-to-bedside" research. In the academic hierarchy, a PhD is often considered more rigorous in terms of basic science, while the UK, an MD is the pinnacle of clinical academic achievement.
In an academic, university or research setting where I am more familiar normally we do not address our medical colleagues as ‘doctors’. We merely call them as clinicians unless they also have a PhD. As scientists and clinicians we clearly want to make this distinction between a "PhD doctor" and a "clinician"
Academic vs. Professional Titles:
In the US Department of Education and most global qualification frameworks consider the PhD (Doctor of Philosophy) as the highest academic degree because it requires the creation of original knowledge through research. Whereas the MD or MBBS is a professional degree or vocational degree focused on the application of existing knowledge. In academia, "Doctor" technically denotes a research-based doctorate. In research teams, medical doctors are often called clinicians to specify their role. They provide treatment and healthcare service to patients while PhD scientists handle the laboratory or theoretical research. This is a functional description, not a demotion.
In most countries, once a medical graduate registers with a licensing body (like the Singapore Medical Council or the Malaysian Medical Council), they are entitled to use the title "Dr." as a professional designation. For those with an MBBS (Bachelor's), "Dr." is often a courtesy title granted by professional tradition. In contrast, for a PhD, "Dr." is a permanent academic title earned by completing a research doctorate.
What about dentists who also like to use the "doctor" title?
Historically, dentists were addressed as "Mr." or "Ms." because their training was considered a branch of surgery (the "manual trade" mentioned earlier). However, this has changed recently due to global standardization:
In the UK, the General Dental Council (GDC) changed its guidelines in 1995 to allow dentists to use the title "Doctor" as a ”courtesy” title.
A dentist can call themselves "Doctor" as long as they do not imply they hold a PhD if they don't, or imply they are a registered medical practitioner (physician). Most are encouraged to sign off as Dr. [Name] (Dentist) to avoid public confusion.
Veterinarians too like to be called a "doctor"
Veterinarians have followed a very similar path to dentists, but even more recently in 2015, the Royal College of Veterinary Surgeons (RCVS) officially sanctioned the use of the "Doctor" title for vets in the UK. Before 2015, UK vets were "Mr." or "Ms." (holding a BVSc or BVMS degree). The RCVS allowed the title change because the public already perceived the rigor of veterinary medicine to be on par with human medicine. Like medical doctors, most vets do not hold a research doctorate (PhD). Their use of "Doctor" is purely a professional “courtesy” title they gave for themselves
Tables of "Doctorate" Types
Category | Degree Type | Nature of "Doctor" Title |
PhD / DPhil | Academic Doctorate | Academic Title (Earned through original research) |
MD (UK/Aus) | Higher Doctorate | Academic Title (Earned through clinical research) |
MBBS / MD (US) | Professional Doctorate | Courtesy Title (By virtue of license/tradition) |
BDS / DDS (Dentist) | Professional Degree | Courtesy Title (By virtue of license/tradition) |
BVSc / DVM (Vet) | Professional Degree | Courtesy Title (By virtue of license/tradition) |
The "Legality" Guardrail
Technically, in most countries, the title "Doctor" is not a protected term in the way "Architect" or "Physiotherapist" might be. However, "Medical Practitioner" is protected.
The Rule of Thumb is, anyone can call themselves a "Doctor" (even a "Doctor of Style"), but it becomes a legal offense (fraud) the moment they use that title to lead someone to believe they are a licensed physician or a surgeon to perform medical acts without a license.
But a medical doctor in Chinese is commonly called 医生 (yī shēng), which is the standard term used for modern medical practitioners. Another common, slightly more colloquial term is 大夫 (dài fu).
A PhD holder in Chinese is called 博士 (bóshì). This term functions both as the name of the degree and as an honorific title, often placed after a surname (e.g., Wang Bóshì, or 王博士) to indicate academic expertise, distinguishing them from medical doctors (医生, yīshēng).
In Chinese the title for both, whether medical or PhD, is placed after the surname - a hallmark of humility in very rich Chinese culture, and not before the surname as in English-speaking countries.
For the Chinese a PhD holder is much more honorific than a medical doctor because a PhD is the pinnacle of academic and scholarly achievement whereas medical Dr is just a polite title given by patients and by the doctors themselves, but not by the university or by other academicians who normally call medical doctors as clinicians as I have already explained
I call myself a plain lin ru wu in Chinese as in my blog without any title.
Life is extremely brief for all of us in this world as I have already explained here.
https://scientificlogic.blogspot.com/2025/12/the-brevity-of-human-life.html
So why must we be so obsessed with titles? since none of us can carry any wealth, power, position, social status or titles to the grave - so why must we lose our souls in the next world?
In Matthew 16:26 and Mark 8:36, it clearly warns us - “what does it profit a man to gain the whole world, but loses his soul”? It signifies that gaining all earthly riches, power, and pleasure is worthless if one loses their soul or forfeits eternal life. It is a rhetorical question emphasizing that the human soul has higher value than all material possessions and titles combined.
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