 From the Middle Ages, physicians such as Cuningham were required to embark on formal university training to gain a degree in medicine before they could practice.Possession of this doctorate entitled them to call themselves Doctor of Medicine.Until the mid-19th century surgeons didn't have to obtain a university degree, but served an apprenticeship to a surgeon and took an examination, conducted in London by the Company of Barber-Surgeons until 1745 and after 1800 by the Royal College of Surgeons.