Who should use the title ‘surgeon’?

As many members know, while the use of the title ‘specialist surgeon’ is restricted in Australia, the use of ‘surgeon’ itself is not protected or restricted. Last year, the Australian Health Practitioner Regulation Agency (Ahpra) wrote to the Royal Australasian College of Surgeons (RACS) expressing the following view.

Enforcement of use of the title ‘surgeon’ is complex as the term ‘surgeon’, with other descriptors, is used commonly to describe medical practitioners who, as part of their usual practice, perform surgical procedures of varying invasiveness. This reflects the common definition of surgery, as well as the fact that the basic medical qualification is generally a ‘bachelor or doctor of medicine and surgery’.

This means there is little to prevent any medical practitioner from referring to themselves as a ‘cosmetic surgeon’, or other similar titles. Meanwhile, using ‘surgeon’ in combination with other words that imply a person is registered in a particular surgical field of specialty practice (i.e. one of the nine RACS specialties), is prohibited when the person using the term is not registered in that specialty.

However, there is some movement on this issue happening at a government level. Not long before their focus turned to the COVID-19 pandemic, Australian health ministers announced they would undertake ‘consultation on which medical practitioners should be able to use the title “surgeon”’. With this process in mind, RACS decided to reconsider the issue, and in February endorsed a new position on who should be able to use ‘surgeon’ in their title in Australia.

It must be recognised that Australian governments do not seek to protect medical titles in order to protect the interests or prestige of practitioners; they do so with the aim of ensuring Australians have access to a safe and competent registered health workforce.

The RACS position is that those who are not specialist surgeons should be restricted from using ‘surgeon’ in their titles, except if they are a member of a medical profession which has a significant surgical training component in its curricula. (Such professions include specialist medical practitioners in obstetrics and gynaecology and ophthalmology.) According to the RACS position, these medical practitioners would be able to use ‘surgeon’ in combination with relevant ‘qualifier’ or ‘descriptor’ words that accurately describe their scope of practice. This would allow titles such as ‘ophthalmic surgeon’.

General practitioners in areas of need, where other medical specialists are less accessible, and when they have attained their qualifications via Australian Medical College accredited courses including a surgical component, would also be able to use ‘surgeon’ in their title. This would only be in combination with the words ‘GP’ or ‘general practitioner’, allowing the titles ‘GP surgeon’ or ‘general practitioner surgeon’.

This position is one that cannot be construed as RACS restricting the title to RACS Fellows. Its focus on surgical training means the position is primarily about patient safety. Allowing GPs with relevant training in underserved areas to use the term acknowledges the need to ensure equitable access.

With this new position confirmed, RACS will be engaging with Australian governments as their focus widens beyond COVID-19.

The detail of RACS’ position can be found on the RACS website at surgeons.org/ about-racs/position-papers.

Academic gown donation

RACS would like to thank Mrs Sue Armstrong for the generous donation of Mr W. L. H. Armstrong’s academic gown to the College, and Mr Kenneth MacGowan FRACS for the generous donation of his academic gown to the College.

RACS preserves academic gowns for use by Convocating Fellows and at graduation ceremonies at the College. If you no longer have use for your gown, RACS would be grateful to add to our reserve. We can acknowledge your donation and place your name on the gown if you approve.

To donate your gown, please contact the Conference and Events Department +61 3 9249 1248. Alternatively you could mail the gown to Ms Ally Chen c/o Conferences and Events Department, Royal Australasian College of Surgeons, 250-290 Spring St, EAST MELBOURNE, VIC 3002.