Several interesting points were made by Asfour and Winter in their letter1 in response to the 2016 CMAJ News article by Roger Collier on who is entitled to be called a doctor.2 Although the Latin root of the word “doctor” does indeed have the meaning of teacher, the same root is used to refer to a person who is learned or skilled.3 It cannot be realistically stated that a physician would not meet this definition.
The authors correctly point out that medical school is considered undergraduate education; however, no physician can practise solely with this degree. The physician offices in which they enter and then so blithely remark that only they are “the real” doctors, are operated by persons who have completed a residency, which, in Canada, is a course of studies and supervised training at a university.
Interestingly, one of the authors of the letter appears to hold a PhD in engineering, which a recent report4 showed is the academic field where those with PhDs are least likely to become professors. It seems strange to try to take sole ownership for a term describing a teacher when most individuals in some fields with that designation do not actually have teaching as a part of their professional practice.
In contrast, the CanMEDS framework,5 which “identifies and describes the abilities physicians require to effectively meet the health care needs of the people they serve” has a key role of “Scholar.” This is defined as “a lifelong commitment to excellence in practice through continuous learning and by teaching others, ….” In addition, the Hippocratic oath explicitly states that it is the role of the physician to teach (“that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art …”).6 This teaching role is essential to the training of physicians who are instructed, mentored and supervised by other physicians through every step of their training.
Perhaps of greatest importance, however, is that the meanings of words change over time. Sometimes this is through legal interventions, such as the modification of the definition of marriage in Canada to include nonheterosexual unions, whereas, at other times, this change may be the result of a shift in cultural understanding. For example, if someone were to yell on an airplane, “Is there a doctor on board?”, it would be understood implicitly that there is a medical emergency, not an urgent need for teaching.
I do agree with the authors that a careful evaluation of the definition of doctor should be undertaken. This term should be carefully regulated to avoid misconceptions and confusion, especially when the health and well-being of the public is at stake, regardless of the historic origins of the term.
Footnotes
Competing interests: None declared.