I’ve been having this 3:30 am (EST) insomnia for about the last two months, so I often pull the laptop up and survey the blogosphere in the still of the night. A simple look at the Last 24 Hours at ScienceBlogs and elsewhere in the blogosphere tells me that some knuckleheads in the mainstream press have taken issue with Dr Jill Biden, doctor of education, using the honorific, “Dr.”
Keep in mind that the article in question comes from the L.A. Times – the very same paper that graces my e-mail account weekly humping their fishwrapper’s science and environment coverage. I did just look up some of these articles and while some folks are referred to as Senator or General, professionals who earned PhDs carry no honorific.
My dear colleagues below have done a collectively admirable job on addressing the historical use of “doctor” for PhDs, even before physicians used the term “medical doctor.” (However, I do believe that while physicians in Great Britain use “Dr,” it is more honorable to use “Mr” if one is a surgeon.)
But because my pharmaceutical and herbal medicine work causes me to straddle different worlds, here are my two contributions to raise more ire regarding who should or shouldn’t be using the honorific, “Dr”:
N.D. – Doctor of Naturopathy
Pharm.D. – Doctor of Pharmacy
Doctor of Naturopathy
There are five colleges of naturopathy in North America, if you count the correspondence school, and they generally offer a pretty reasonable first two years of what might be considered medical school. Naturopaths then learn a lot of nutrition, a good bit of herbal medicine, but throw in homeopathy for good measure. For some reason, though, naturopaths act in the most anti-medical ways possible, such as in opposing vaccination. Just over a dozen US states license naturopaths but take a look at the “Natural Health” section of your local newspaper. Note that the ND requires no thesis or dissertation. But residencies and other experiential learning are usually required. Invariably, naturopaths refer to themselves as “Dr.”
Doctor of Pharmacy
I know I’ll draw trouble from questioning the use of “Dr” by my Pharm.D. colleagues. The Doctor of Pharmacy degree became the entry-level degree for pharmacists in the last 1980s and early 1990s with the idea that pharmacy services added significant value, especially clinically, to medical care and the avoidance of medical errors. Previously, the B.S. in pharmacy was the entry degree, requiring two years of an undergraduate basic science foundation followed by two years of progressively applied pharmacotherapeutics that included unpaid experiential rotations in four or five diverse pharmacy settings.
Now, the PharmD is a 2 + 4 program such that even your newly-minted community retail pharmacist must have a PharmD. It also allowed pharmacy schools to charge a doctoral level tuition for those four years instead of the undergrad tuition for the three years of the old five-year B.S. Community PharmDs rarely request the honorific “Dr” but academic and clinical PharmDs do as a matter of routine practice. Note that the PharmD requires no thesis or dissertation. But residencies and other experiential learning are usually required. Most of my slightly elder PhD colleagues who were at the table when the PharmD was being debated as the required entry-level degree felt that the title of M.S. in Pharmacy would have been more appropriate.
A Career Aside
A few months ago, a reader studying undergraduate biochemistry asked me what I might do if I did my training again. I never got around to a formal response (sorry!) but after watching my students over the last 15 years, I might have been just as happy with a PharmD that had a clinical pharmacology emphasis.
The pharmacy degree allows you great geographical freedom, unlike an academic position, tied only to places with hospitals or retail pharmacies, the latter of which can provide four offerings of employment at a single road intersection. The starting pay is about that of an average PhD associate-to-full professor ($80,000 – $100,000 USD) and if you can stand insurance paperwork and some of the reality vs. academic stuff described by The Angry Pharmacist and The Angrier Pharmacist, it makes for a pretty darn good life.
My former students: they live in the mountains, at the beach, the magnificient desert Southwest, in quiet rural woods, and bustling metropolis. Many use the career less for professional satisfaction and more as a vehicle for their other activities, like marathons and triathlons, professional stained glass crafting, mountain climbing, music, etc. Moreover, pharmacy is incredibly friendly for the parent who wishes to spend more time with the family as part-time wages are not much lower than full-time rates – about $40-50 USD per hour.
One of my favorite moments as a professor was standing outside an Aspen, Colorado pharmacy on a brilliant, hot but characteristically dry summer day waiting for my former student to get off to go enjoy a fermented beverage. An older gentleman came by and my student brought him outside and introduced me to him as, “the guy who made this life possible for me,” his hand sweeping across the sky and mountains of the Roaring Fork Valley. I may be a professor, but my student gets to live in Aspen – moreover, he’s married to another one of my students even more charming and beautiful than he.
And, by the way, he got in before the PharmD became mandatory.
One Final Aside – to newly-minted PharmDs, courtesy of the wisdom of The Angry Pharmacist:
Respect your elders – Waltzing in with your fancy PharmD and showing up all of the BS’s with 30+ years of experience is a good way to piss people off. Be humble towards people who have been practicing pharmacy for longer than you have been alive. You may know more book-learned material than they do, but they know what does and doesn’t fly with the patients and doctors. You can’t teach experience, remember that.
But now back to my original thesis before I try to go back to sleep:
Question: Should individuals earning the N.D. or Pharm.D. be permitted to use the title of “Dr.?”
Links to commentary on the Dr Jill Biden coverage:
GrrlScientist – Living the Scientific Life
Mike Dunford – The Questionable Authority
Chad Orzel – Uncertain Principles
Dr Dr Janet D Stemwedel/Free-Ride – Adventures in Ethics and Science
*with apologies to the late Robert Palmer.