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==Training== In Canada, Australia, New Zealand, and the United States general surgery is a five to seven year [[resident (medicine)|residency]] and follows completion of [[medical school]], either [[Doctor of Medicine|MD, MBBS, MBChB]], or [[Doctor of Osteopathic Medicine|DO]] degrees. In Australia and New Zealand, a residency leads to eligibility for Fellowship of the [[Royal Australasian College of Surgeons]]. In Canada, residency leads to eligibility for certification by and Fellowship of the [[Royal College of Physicians and Surgeons of Canada]], while in the United States, completion of a residency in general surgery leads to eligibility for board certification by the [[American Board of Surgery]] or the [[American Osteopathic Board of Surgery]] which is also required upon completion of training for a general surgeon to have operating privileges at most hospitals in the United States. In the [[United Kingdom]], surgical trainees may apply to enter training after five years of medical school and two years of the [[Foundation Programme]]. During the two year core surgical training programme ("phase 1"), doctors are required to sit the Membership of the [[Royal College of Surgeons]] (MRCS) examination. On award of the MRCS by one of the four surgical colleges, surgeons may hold the title '[[Mr.|Mister]]' or '[[Miss]]/[[Ms.]]/[[Mrs]]' rather than doctor. This tradition dates back hundreds of years in the United Kingdom from when only physicians attended medical school and surgeons did not, but were rather associated with [[barber]]s in the [[Barber surgeon|Barber Surgeon's]] Guild. The tradition is also present in many [[Commonwealth of Nations|Commonwealth]] countries including [[New Zealand]] and some states of [[Australia]]. After completion of phase 1 training, trainees may apply for a nationally awarded Higher Surgical Training (HST) programme, which lasts six years and is now divided into two further phases (phases 2 and 3). Trainees are expected to declare a sub-specialty before the end of phase 2, and training during phase 3 focuses on that sub-specialty. Before the end of HST, the examination for [[Fellowship of the Royal Colleges of Surgeons|Fellowship of the Royal College of Surgeons]] (FRCS) must be taken in general surgery plus the subspeciality. Upon completion of training, the surgeon will be eligible for entry on the [[General Medical Council|GMC]] Specialist Register. They may then apply to work both in the [[National Health Service|NHS]] and independent sector as a consultant surgeon, although many trainees complete further fellowships.<ref>{{Cite web |last=sitecore\gwright@rcseng.ac.uk |title=Surgery Entry Requirements and Training |url=https://www.rcseng.ac.uk/careers-in-surgery/careers-support/what-is-surgery-like-as-a-career/entry-requirements-and-training/ |access-date=2024-03-14 |website=Royal College of Surgeons |language=en}}</ref> The implementation of the European Working Time Directive limited UK surgical residents to an average 48-hour working week.<ref>{{cite journal |author=Fitzgerald JEF|author2=Caesar B |title=The European working time directive: A practical review for surgical trainees |journal=International Journal of Surgery |volume=10 |issue=8 |pages=399β403 |date=2012 |pmid=22925631 |doi=10.1016/j.ijsu.2012.08.007|doi-access=free }}</ref>
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