From hair to heart and lungs – a history of surgeons

KUALA LUMPUR: Some 1,000 years ago, all surgeons were barbers. Yes, you read that right.

During wars in the United Kingdom, barbers who were skilled with razors treated wounded soldiers in need of surgery or amputation.

They stood apart from physicians, who were taught at universities. Barbers learned their skills in barber shops and battlefields.

Today, all surgeons must first obtain a medical degree, so they are doctors too. But some surgeons uphold their history of being distinct from physicians, which is why surgeons often prefer the honorifics “Mr”, “Miss” or “Mrs” instead of “Dr”.

Between 1400s and 1500s, those barber-surgeons received royal charters to form the Royal College of Surgeons (RCS) and now there are four – in Edinburgh, England, Glasgow and Ireland.

Their postgraduate certifications are recognised by hospitals nearly all over the world.

The RCS of Edinburgh (RCSEd), which recently sent a four-page letter to Health Minister Datuk Seri Dr Dzulkefly Ahmad expressing concern that one of its postgraduate qualifications for heart and lung (cardiothoracic) surgeons were not recognised, has had direct working relationships with the Health Ministry for over two decades.

The college’s president Professor Rowan W Parks, in his letter, wrote that RCSEd was involved in the training of cardiothoracic surgeons here at least since 2000 when one of its surgeons, Pala Rajesh, was invited by Institut Jantung Negara (IJN) to start up video-assisted thoracoscopic surgery there.

“The RCSEd was also invited by the ministry, Academy of Medicine of Malaysia (AMM) and the Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) to help develop a national training programme in cardiothoracic surgery for the country,” Prof Parks added.

This led to the parallel pathway programme (PPP) in 2016, which allowed the ministry to directly train its medical officers to be heart and lung surgeons.

Prof Parks pointed out that RCSEd made frequent visits between 2018 and 2022 -- except during the pandemic -- to check on all the accredited training centres to make sure the PPP was well conducted at selected hospitals nationwide.

Prof Parks said on successfully passing the examination, candidates were awarded the Fellowship of the Royal College of Surgeons of Edinburgh (FRCSEd) in Cardiothoracic Surgery, which qualifies them to practise even in the UK.

Last month, The Star reported that four surgeons who earned the FRCSEd could not become full surgeons because their qualification was not locally recognised.