Letter to the Editor

Comments on P. W. J. Bartrip's article "Irving John Selikoff and the Strange Case of the Missing Medical Degrees" (Vol. 58, January 2003, 3-33).

To the Editor:

Bartrip's title hints at an expose, in the sense that something discreditable has been unearthed, a theme that is pursued further in the text in the form: "Questions are raised about how he attained such high professional recognition given his very modest educational attainments. Reflections are offered about whether asbestos regulation and litigation might have been different if Selikoff's evasions had come to light before now."¹

To which I would contend:

(a) That there was no "strange case of missing degrees";

(b) That Selikoff's educational attainments were far from "modest";

(c) That he achieved high professional recognition by being found worthy by his peers;

(d) That Bartrip's "discoveries" are far from new; industry's efficient intelligence service got there first;

(e) That the "revelations" about Selikoff's education and training were exploited at the time by industry protégés, but proved ineffectual in influencing the processes of asbestos regulation and litigation.

The "Missing Degrees"

I know of no occasion of Selikoff claiming to have received a British Doctorate. Confusion may arise from the relationship between the British and American Doctorates of Medicine. Essentially, the American M.D. is the basic qualification with which a physician graduates. The British M.D. (or D.M. according to the awarding university) is a postgraduate degree, usually awarded after the conduct of research that leads to a substantial advance in knowledge. The basic British qualification may take the form of a degree (Bachelor) granted by a university, or of a diploma granted by certain institutions. Selikoff was awarded the diplomas granted by the Royal Faculty of Physicians and Surgeons of Glasgow, the Royal College of Physicians Edinburgh, and the Royal

College of Surgeons Edinburgh (abbreviated as the Triple Qualification and further as the TQ). It was instituted in 1884 following the report of the Royal Commission on the Medical Act of 1858. The Medical Act of 1886 reinforced the arrangements agreed between the three Colleges and approved by the General Medical Council. It was for a long time the only avenue for women who wanted to qualify as medical practitioners, and in the 1920s and 1930s was taken by large numbers of Jewish people who were excluded from universities in the United States and elsewhere.² While some deemed it the equivalent of the M.B., Ch.B. holders of the TQ were looked down on by some, although either qualification admitted recipients to the British Medical Register.³ In England, the same snobbery applied to holders of the Conjoint Diplomas awarded by the Royal College of Physicians (London) and the Royal College of Surgeons (England).

The Commissioner of Education had discretion, with the approval of the Board of Regents of the University of the State of New York, to accept an application for the endorsement of such a medical license obtained abroad as equivalent to its M.D. Thus an American student in Australia at the same time as Selikoff, who qualified with the degree M.B., B.S.(Melbourne), before starting out in private practice checked with his Medical Society, who informed him that as he was licensed by the State of New York to practice Medicine and Surgery, he could properly call himself M.D.⁴

The medical and surgical diplomas issued by the Royal Colleges, by individual colleges, and by Societies of Apothecaries, have a history in their own right. They offered the opportunity for the candidate to take examinations in smaller modules than did university degrees, and were popular with graduate biochemists and physiologists requiring a medical qualification to improve their research and career prospects, as they facilitated the intercalation of clinical studies with research. As they could be taken earlier than a degree, they appealed to the penurious. Some went...