“Dr” or “Mr”? And the origins of Barber Surgeons

You may have noticed that many surgeons use the title “Mr” rather than “Dr”, even though all surgeons are qualified medical doctors with specialist training. But have you ever wondered why that is the case?

The origin of “Mr” dates back hundreds of years when surgeons weren’t medical doctors. In Middle Ages Europe doctors acted much the way physicians do today: they would consult with patients and prescribe various treatments and medicines, but they would rarely perform any surgical procedures. Barbers originally became popular due to the requirement of Catholic monks to maintain their traditional baldness (called a tonsure), therefore many monasteries would train or hire a barber who would then go on to perform minor surgical procedures such as teeth pulling once he had mastered the use of a blade with the simple act of shaving hair.

France was one country in which doctors could perform surgical procedures, but there were two levels of student doctor with only ‘long-robed’ academics permitted a licence to operate. The ‘short-robed’ doctors were bitter with this arrangement and secretly began an agreement with the Parisian barber surgeons: the doctors would teach the barbers human anatomy to improve their surgical skills, and in return the barbers swore an allegiance to the short-robes. The barber surgeons’ skills increased during times of war and conflict to include procedures such as limb amputation and even performing surgery on internal body organs.

In England, surgeons were distinct to doctors (physicians) as they were typically trained by an apprenticeship, whereas physicians were taught academically. As such, there was a hierarchy in which physicians were higher in the English class system than their non-academic counterparts. In 1540 the Fellowship of Surgeons merged with the Company of Barbers to form the Company of Barber-Surgeons. As the barber surgeons were not doctors, the physicians did not permit them to use the honorific title “Dr”, and therefore were only allowed to call themselves “Mr”, being that they were all male. The physicians continued to harass the barber surgeons, and in 1745 the surgeons and the Barber’s Company disbanded, with the surgeons forming the Company of Surgeons. This became the Royal College of Surgeons in London following recognition by Royal Charter, and then later the Royal College of Surgeons of England. Other Royal Colleges now exist in other British colonies, including the Royal Australasian College of Surgeons here in Australia and New Zealand.

For many years, surgeons affiliated with the Royal College of Surgeons of the United Kingdom and the various British colonies would continue to call themselves Mr after obtaining specialist surgeon qualifications. This is despite having already obtained the title of Dr following graduation from medical school. The reason many surgeons call themselves Mr is therefore one of tradition, and dates to the time when surgeons were not academically trained and not allowed to use Dr as a title. Even though surgeons have been medically trained for a long time now these traditions persist – in fact, it's been suggested that some surgeons have politely declined the offer of being called Dr after centuries of being denied the ability, perhaps in an act of defiance!

These traditions are slowly being phased out. Last year the Royal Australasian College of Surgeons announced that they were phasing out gendered titles for surgeons in an order to avoid confusion and to help generate equality within the profession. Surgeons are doctors, and a great deal of surgeons are also female, therefore the use of “Mr” really is outdated and should be discontinued although its history is certainly fascinating. Finally, surgeons certainly are no longer barbers, and you would not ask your surgeon for a haircut. Neurosurgeons in particular are awful hairdressers: most cranial operations require shaving the hair beforehand, but we typically only shave the hair where the skin incision will be, and this creates all sorts of whacky hairstyles the type of which you would not ask your barber for!

For more information about the history of Barber Surgeons there is an excellent Wikipedia article which can be found here.