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I wonder whether we can stop referring to DOCTOR John H. Watson (MBBS, according to his CV in TBB) as a surgeon? (True, Dr JH Watson in ACD!canon is an MD, and did the "course prescribed for surgeons in the army", but as an MD and not a MRCS - Member of the Royal College of Surgeons -  what I have to say here still applies.)

He is not a surgeon. You know how I know? Not from anything complicated like freeze-framing his CV in TBB. It's a simple deduction.

He's DR J H Watson.

Due to an historic separation between the Royal College of Surgeons and the Royal College of Physicians, although surgeons have to train as doctors, they are not *called* "doctor" in England. A surgeon is Mr/Ms/Miss/Mrs, possibly Professor if s/he's connected to a teaching hospital and possibly "Sir" if knighted (or "Dame" if honoured and female), possibly even a Lord/Lady.

But never is a licentiate of the Royal College of Surgeons called Doctor.

Addendum: having actually freeze-framed his CV in TBB, I see that Dr Watson has an MBBS degree - Bachelor of Medicine, Bachelor of Surgery - an interest in surgery and an ability to perform some minor operations.

This does not make him a surgeon

As it says at the top of the CV, he is interested in *further training*. It will take at least four years of further study/training - beyond his medical degree - for him to obtain a surgical qualification and become an *actual* surgeon, licensed by the Royal College of Surgeons and entitled to revert to being a Mister.

On another note entirely, according to the same CV he's supposed to be two years younger than I am, since he left Grammar School (11+ education that requires passing an examination - called the eleven-plus funnily enough - but is free to attend) in 1999, at 18 (presumably, since he went straight on to his BSc and MBBS studies). I find that more than a little bizarre.

ETA (2) - re-posted from f'locked comment exchange withlindentreeisle 

his CV says he's "seeking further training and experience in accident and emergency medicine while working towards a career in laporoscopic and bloodless surgery"

OTOH I'm not too sure how reliable we should find that CV. It is, after all, just a prop. In the first place there's the age thing: according to that CV he left school (at 18) in 1999 (I mis-read the start-date last time) which would make him only 29 in Season One. I don't see it. :( Secondly, it details 6 A*s at GCSE (exams taken at 16) but gives no information about his A-levels (exams taken at 18). Thirdly it gives his university as King's College London. The teaching hospital associated with King's College, is, funnily enough, King's College Hospital (London SE5), with some posts being available at Guys and St Thomas's, but not Bart's since it has it's own facility.

If he had been "trained at Bart's" his CV would list Queen Mary, University of London as the university and Bart's and the London School of Medicine and Dentistry as his teaching hospital. Although he could, conceivably, have done some of his post-graduate training/qualifications as a house officer/junior doctor at Bart's, again, however, this information is missing from his CV.

Finally, the top line of his "Educational Qualifications" merely says "Medical School/University Attended Qualification(s) Obtained From 2004 To 2006" - ifit were not for the dates, I'd think that was intended to be a header for the following information, but he got his MBBS in 2004 (five years study, which is right) so it sounds more like he commenced further study but they couldn't be bothered to detail what!

From his Employment History we know he did one year's in-house post-graduate training, as a PRHO (Pre-registration - i.e. before he was allowed to register with the General Medical Council as a practitioner - House Officer) in General Surgery and Medicine, and a six month rotation as Senior House Officer (SHO) in Trauma and Orthopaedics (again surgical, since his supervisor is "Mr Taylor"). However, any postgraduate exams he took during those years are not detailed and there is no evidence that he received any further qualification to his MBBS, suggesting he did not complete further training or progress to registrar status (next step up).

Instead, it looks like he joined RAMC, though there are - again - no details of any further training or qualifications he received there. It's like his training progression stopped in 2004 - he didn't even get MRCP/MRCS status, . (I wonder if that's deliberate - if maybe he wasn't good enough to go on to make surgeon?) Hmmm. So much for being "A bit over-qualified" for a GP.

So many writers are so keen to make him a skilled surgeon etc people keep describing his "competent surgeon's hands" etc... and just, he isn't. Although I wonder how many Americans were thrown by him saying to Sherlock in the next scene, "I went to see about a job at that surgery"?

In Britain, a surgery is what you call the doctor's office/clinic.


Comments

( 27 comments — Leave a comment )
fanbot
Oct. 19th, 2011 01:57 pm (UTC)
Very interesting.

Poor prop makers. With HDTV they can no longer put random words on pages. :)

I have a question: What would his military rank be? Just "Doctor"? Where does doctor fit in the scale of rankings? (I need this for a fic I am planning.)
natsuko1978
Oct. 19th, 2011 02:15 pm (UTC)
Please note that I am no expert on the British military. Have you tried military_beta?

But we can assume from his mug in ASiP that he was in the RAMC - Royal Army Medical Corps - http://www.army.mod.uk/army-medical-services/5319.aspx

The Corps functions as its own Unit, and as you can see from the website, there are Officer and Soldier career paths within it.

Rank works pretty much the same as it does for other Units/Brigades (Ranks - http://www.army.mod.uk/structure/23155.aspx) with an Army medic on the Officer path required to undertake training at the Royal Military Academy, Sandhurst. As a Doctor - presumably trained and qualified before he joined up - John would probably have served as a Medical Officer (http://www.army.mod.uk/army-medical-services/ramc/15836.aspx) and it is generally (fanon?) agreed that he was a Captain.

As a Captain he would not have retained his military title or uniform after he received his medical discharge. (The lowest rank to keep their use of a military title after leaving the Army is Major.)
fanbot
Oct. 19th, 2011 02:27 pm (UTC)
Thank you so very much.
natsuko1978
Oct. 20th, 2011 04:43 am (UTC)
Welcome!
natsuko1978
Oct. 23rd, 2011 01:22 pm (UTC)
NB - please see the comment below. While we know that the show stuffed up on some matters of John's CV etc (so you may be able to handwave) apparently you have to apply to join the RAMC, you have to apply in the first year of your MBBS or other degree.
mrs_tilford
Oct. 19th, 2011 02:15 pm (UTC)
This information about Watson's medical career is fascinating! I was aware there's a difference between Dr./Mr. (old Mills & Boon novels), but now I know exactly what it is.

I'm not a Brit, and I take a lot of what I read without question (except for things like the names of floors in a building - grrr). Thanks so much for your explanations.

Edited at 2011-10-19 02:18 pm (UTC)
natsuko1978
Oct. 19th, 2011 04:50 pm (UTC)
Happy to help.
smiley_nat
Oct. 19th, 2011 04:32 pm (UTC)
I learned Dr. vs Mr. from Law & Order: UK, the episode about kidney thieves. It's nice to get some more information on why, though.
natsuko1978
Oct. 19th, 2011 04:50 pm (UTC)
If you really want to know why: when the RCS - then the Royal College of BARBER Surgeons - was first set up, there was more prestige (and more qualifications required) in being a Physician - so physicians were Doctors and surgeons were just plain Mister (back then they were all male).

As time went by and being a surgeon became more prestigious/qualified, with our peculiarly British adherence to tradition, they decided to stay as Misters, but to implement it as a badge of rank.

Strange, but true!
mirabile_dictu
Oct. 20th, 2011 02:09 am (UTC)
Thanks so much for writing these posts! I really appreciate them, and find the information fascinating.
natsuko1978
Oct. 20th, 2011 04:40 am (UTC)
TBH it makes a nice change to *know* things without the hours of frustrating research required by SGA/SG-1. So I figured I ought to make the UK version of the resource I'd love to have in my US fandoms.
gloeden
Oct. 20th, 2011 02:24 am (UTC)
Interesting.
The "Dr." vs. "Mr." thing alone puts him in a different light for me. And, actually, makes him more canon, in a way.
Also for a long time I'd wondered why there wasn't more emphasis on how his injury had changed the course of his life in a major way. It seemed a big odd hole to have a surgeon rendered suddenly useless because of his hands not being trustworthy anymore, but no sense that he felt the loss. Even in fic, I'd wondered why it was so rarely touched on.
Now, I think, from a series sense anyway, that he didn't feel the loss so keenly because the loss wasn't there. He isn't the surgeon I thought he was. Something competent, but not what had been implied in fic especially.
natsuko1978
Oct. 20th, 2011 04:43 am (UTC)
We-ell, if his BBC canon CV is to be trusted, he *wanted* to be a surgeon, so he has lost his intended career path.

But he got a whole new Sherlock-focussed career instead, so I guess there's compensation. :D

Hmm... interesting point about the fic, though... Hmmm, what can I do with that?
stupidmuse_hate
Oct. 20th, 2011 07:30 am (UTC)
I wrote more deeply on John in the army several months ago and I had to research what sort of school he would have attended and etc. so I totally agree with you about them fubar-ing what uni he would have had to attend to also train at st. barts.

but what I found pretty interesting was that here in the U.S. your bachelor's degree only counts for pre-med and you have to get a masters to actually become a doctor, while in Britain you can become qualified as a GP in three years. But what I wanted to bring up was that to get into the RAMC, you have to apply in your very first year of uni. As soon as possible, they advise. You start training for that sort of thing while you're still in school, and that's the only way to be a 'field surgeon' or 'field medic' in the RAMC. If you don't apply for the RAMC whilst earning your medical degree, the only job you can have is as a technician of some sort, not an actual doctor position (it's really very interesting).

I really enjoyed reading what you wrote! :)
natsuko1978
Oct. 23rd, 2011 01:45 pm (UTC)
Interesting. Most of my knowledge of the army comes from relatives who were in it during WWII or Nation Service in the 40s and 50s - where, obviously, if you had a medical qualification, you could be conscripted into the RAMC to use it.

Presumably one can join *other* medical corps/services if you were already qualified and wanted a change of direction - say you wanted to join up because we were now at war?

If we assume that John is the same age as Martin Freeman (as opposed to the age/details on his CV) and *career* military in the RAMC, presumably he would also be likely to be of higher ran than Captain, too. Probably a major.

Hmm. Interesting.

Though now in the UK, GP training actually requires a four to six year undergraduate medical degree (MBBS; MD; etc) and then a minimum of five years post-graduate placement training - two years as a Foundation Doctor and three years on a GP Speciality Training Programme. (Prior to 2005, a GP required a medical degree and then a minimum of four years' post-graduate in-post training: one year as PRHO, two years as SHO and one year as a GP Registrar.)

If your A-levels aren't good enough for entry to a medical degree, you can do a three-year BSc in one of the Biological Sciences and subsequently, if your degree is good enough, enter MBBS etc as a graduate student. That takes even longer, however. (3 years + 4 years + 5 years in-post post-graduate training.)

I'm not sure where you got the idea one can be a GP in three years.
arbitrary_fic
Jun. 19th, 2012 06:57 am (UTC)
As a note, from my research I gather that the RAMC limitation only applies if you are looking to have them pay your way during med school (medical cadetship). I don't think it prevents you from signing up if you are already a full-fledged doctor.
impulsereader
Jun. 15th, 2012 05:26 pm (UTC)
Ha - well this sort of answers my earlier question about John's age and cv in your view.

While I do think most americans take the fact that he works in a surgery and run with that - which is - well, silly. I also think it's flipping hilarious that other fic writers put something like two thousand times more effort into research and execution than the prop team which is paid to produce John's cv.

Well, as I said in my previous response I add ten years to the dates on his cv and that quite happily brings him up to Martin's age in my mind.

I am interested in what doctorish sorts of pursuits John is actually qualified to perform. I do want to show him doctoring, and that made me think - well, what sorts of injuries can I inflict which he can take care of without sending anyone off to A&E.
natsuko1978
Jun. 15th, 2012 06:18 pm (UTC)
As a (locum) GP in a general surgery, John is more likely to perform examinations and write prescriptions (on the computer!) than to actually *treat* things. Looking at tonsils and ear infections and things and refering people to hospital where necessary. If wounds need re-dressing, or blood samples need taking, ears syringing etc you are most likely to be sent to the Practice Nurse. All very boring - hence Sarah's comments to him in Banker. :)

If you do send people to Casualty - please note that Bart's does not have an A&E department, only a Minor Injuries Unit for the Smithfield Meat Market. (That blue, white and red sign at Bart's entrance, seen in some placement shots, actually announces this fact.)

Which is NOT to say that John won't keep supplies at home for patching himself and Sherlock up when necessary. Only they are unlikely to be prescription meds (such as antibiotics), because meds are not kept at the surgery. He might be able to go into the surgery and print Sherlock out a prescription when necessary, though. And you never know what Mycroft might be able to supply.

John will have spent some time on Trauma and A&E wards as either a trainee or a junior doctor. So he will know what to do. And it's fic... a certain freedom is a given. Except for identifying him as a surgeon when he clearly ISN'T. lol
arbitrary_fic
Jun. 19th, 2012 06:41 am (UTC)
Hahahah, I hadn't caught the bit about his age! He does look a bit old to pull off 29, though I could see early 30s. Hey, not everybody is lucky enough to look like a spring chicken. ^_^

Yeah, I came across the Doctor/Mister thing too, and discovered what it meant. But seeing as they half-assed everything else with his background, might as well throw that on the pile for potential fudging. :D

Still. I think I favor him as a doctor with a specialty in emergency medicine. It makes the most sense, and...my inner ACD fangirl still insists that he's a doctor (though it'd be rather kickass if he were indeed an MD...and it'd be another way to explain the odd gap between his education, rank, and apparent age, if you don't buy that he's 29).
natsuko1978
Jun. 19th, 2012 06:53 am (UTC)
Well according to the "offical" blog and the newspaper articles in Scandal John's 37. I guess it's a case of take your pick... Nice to see BBC canon being just as consistent as ACD! :D

Most of the doctors at my local GP surgery have MBBS plus subsequent qualifications, just as an FYI/BTW.

It should also be recognised that not all the work of the RAMC will be trauma/surgery. Soldiers get infections, flu, colds, tonsillitis etc etc too, even (especially, given the effect of stress on the immune system??) on the front lines in Afghanistan.

I too prefer John as a doctor rather than a surgeon proper. It makes more sense of him going into private practice in ACD rather than rejoining a London *hospital*, you know? (Even in the 1880s, London had several. Bart's, the London, Guy's, St Thomas's, etc...)

And it also makes sense of the shoulder injury/hand tremor not ruining his life/career and being a Major Thing (TM).

(And thanks for reading!)
arbitrary_fic
Jun. 19th, 2012 07:05 am (UTC)
Most of the doctors at my local GP surgery have MBBS plus subsequent qualifications, just as an FYI/BTW.

Makes sense. That's the same in the States. There's just so much to know as a doctor that you can't expect to be solid on everything you'll need just from your core training.

Hee, yeah, I've done a lot of research on medical personnel in Afghanistan, and there's taking care of war injuries, but also all the usual crud--twisted ankles, viruses, food poisoning. And military doctors do a certain amount of treating the local populace too, depending on where they're stationed (which, considering the utterly abysmal situation for medical care in Afghanistan, apparently is, um, interesting). But given John's apparent interest in A&E medicine, and the list of conditions that he can apparently perform surgery for despite not being a surgeon, having an emergency medicine background would make sense (and reconcile a bit of that 'trauma medicine' stuff on his resume, if you want to preserve any of it at all). And it'd hardly prevent him from treating the flu. :)

Besides, I like the possibility of him having been a MEDEVAC physician. ^_^ Now that is cool!

And it also makes sense of the shoulder injury/hand tremor not ruining his life/career and being a Major Thing (TM).

Also a good point. There wasn't exactly any angsting over how HIS CAREER WAS OVER, was there? You'd think that would've been mentioned. ^_^
natsuko1978
Jun. 19th, 2012 07:41 am (UTC)
With the MBBS comment, I meant "rather than/instead of an MD and subsequent", sorry. :)

As I said, you've done a lot more research than I have and I salute you. :D It's really very useful. I pretty much looked at the fact that he's a doctor not a mister, working as a locum GP in London and decided that my experience of being a patient would do for anything I want to write. (But then I don't plan on any "John Watson: The War Years" fics, not at the moment, anyway!)

I agree with you though: trauma/emergency medicine makes a lot of sense for the John we know. He likes his adrenaline and everything needing to happen *now*. Sitting in a surgery feeling for swollen glands and looking into throats and ears would soon drive him barmy without the excitement of Sherlock's cases. :D (And from Series 2, it looks as if John's working fulltime with/for Sherlock.)

arbitrary_fic
Jun. 19th, 2012 05:18 pm (UTC)
Heh! Oh, I was thinking additional certifications and training. Yeah, I know the MD is an advanced degree in the UK. Not like the US, where earning it is part of the process. Which is why I said it'd be pretty cool if John did have one. ^_^ (I can't help it! I'm a natural academic. Education is sexy. ^_^)

Hah! Yeah, the "John Watson: the War Years" is exactly it. I'm not some pure paragon of research; I've got a fic to write. ^_^

Now you mention it, that's an interesting thing. John doesn't really seem to be any hurry to work as a doctor now that he's back in the country, does he? He got a job as a locum because he needed rent money. But once he convinces Sherlock to start taking fees, he seems perfectly happy to drop it and be a detective's assistant full time.

It seems kind of odd to me, considering the amount of time, money and effort he must've put into becoming a doctor. But then maybe he's had enough of it. Or the pace is too slow for him. Or it might bring back bad memories (the hand and leg may not be PTSD, but the nightmares sure were).
zellieh
Sep. 15th, 2012 01:12 pm (UTC)
Hey, I just spotted your comment upthread about liking the idea of John with a speciality in emergency medicine, and I'd C&P my comment from downthread here:

I've had this discussion with someone else who was writing a Sherlock AU, and if you want to update this post, this link might help:

http://en.wikipedia.org/wiki/British_Association_for_Immediate_Care

BASICs provide doctors and nurses to work alongside paramedics, and they get called in by the local ambulance service to handle big emergencies, large gatherings, or complex cases. Getting involved with BASICs is one way that John could get involved in emergency medicine (and some emergency surgery) and generally do more interesting things than just being a GP. He'd also be able to fit it in around being a locum. (And he might well ride a motorbike around London to get to cases. ::g::)

We decided it was just what the author wanted for that story, and it was a pity it wasn't better known, or the author would've chosen it from the start instead of having to go back and re-write large chunks of story. I'm not sure of they did re-write in the end.

Sooo, there's a way for you to have your emergency medicine Watson, as well as your GP Watson, all at once! (And possibly in motorbike leathers, if you like that sort of thing. ::g::)
prettyarbitrary
Sep. 15th, 2012 04:49 pm (UTC)
Ohhhhhhh, that is hot. You're right, people should know! I don't think it'll help for the purposes of this AU I'm working on now, but...it sort of makes me want to start writing another one where he's in on this because da-yum.

(PS: Sorry about the multi-post, natsuko. I didn't realize I wasn't logged in.)
wellingtongoose
Sep. 1st, 2012 06:07 pm (UTC)
Hi,

I was wondering if you're still interested in John Watson's medical career.

I've written a couple of metas on the subject of John's medical career. Part 1 explaining why he has to be a GP and not a surgeon might be interesting to you

http://wellingtongoose.livejournal.com/7505.html

There's also a part 2 and 3 if you're interested in how an army GP is able fight on the front lines (they really aren't allowed anywhere near combat)
zellieh
Sep. 15th, 2012 01:08 pm (UTC)
I've had this discussion with someone else who was writing a Sherlock AU, and if you want to update this post, this link might help:

http://en.wikipedia.org/wiki/British_Association_for_Immediate_Care

BASICs provide doctors and nurses to work alongside paramedics, and they get called in by the local ambulance service to handle big emergencies, large gatherings, or complex cases. Getting involved with BASICs is one way that John could get involved in emergency medicine (and some emergency surgery) and generally do more interesting things than just being a GP. He'd also be able to fit it in around being a locum. (And he might well ride a motorbike around London to get to cases. ::g::)

We decided it was just what the author wanted for that story, and it was a pity it wasn't better known, or the author would've chosen it from the start instead of having to go back and re-write large chunks of story. I'm not sure of they did re-write in the end.
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