In the spirit of all the hoopla over the wedding of Prince William and Kate Middleton, I thought it might be time to demystify certain letters you’ll often see after a doctor’s name on a business card. The custom of letters representing “fellowship” in medical societies is English, after all, and dates back more than five centuries.

FRCP: This implies that the doctor is a “Fellow of the Royal College of Physicians.” Fellowship in all of these societies is an


Royal Wave

honorific, reflecting good standing in the profession and a degree of professional accomplishment. The Royal Colleges (Physicans, and Surgeons [below]) were “chartered” (actually given “cognizance,” but why split hairs?) under King Henry VIII as long ago as 1492. That was a big year for other reasons, too.

FRCS: A doctor with those initials after his or her name is a “Fellow of the Royal College of Surgeons.” The history of surgery is intertwined with barbers. Thus in the 16th and 17th centuries, your doctor would have been part of the “Company of Barber-Surgeons.” Barber-Surgeons administered leeches for bloodletting, extracted teeth, and performed other medicinal practices in addition to taking care of hair and beards. Barbers and Surgeons have dramatically different roles here in the 21st century, enabled by new understanding in the fields of anatomy, pathophysiology, radiology, and coiffeurology.

Turning stateside, we have our own traditions that have parroted our longer-historied brethren across the pond.

FACP: Such a doctor is a “Fellow of the American College of Physicians.” The ACP is the largest single specialty organization (Internists) in the U.S; its membership is second only to the AMA (which is comprised of doctors from ALL specialties). The ACP is an infant, having only been incorporated in 1915. Can you say big anniversary party in a few years? It’ll probably be as well covered as that wedding….NOT!

FACS: By now, you’ve figured out the pattern. A doctor with FACS after his or her name is a “Fellow of the American College of Surgeons.” The ACS is headquartered in fancy digs in downtown Chicago. It started in 1913, a couple of years before the ACP. According to their website, a surgeon can only become a fellow after they “…have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College.”

In other words, when your doctor’s card has any of these initials after the MD, they have a special seal of approval. Maybe not as flashy as Kate’s dress, but pretty impressive nonetheless.