The correct way to address a member or fellow of The Royal College of Surgeons is to use the title Mr, Miss, Mrs, Ms, or Mx (not Dr). This system (which applies only to surgeons, not physicians) has its origins in the 16th century, when surgeons were barber-surgeons and did not have a medical degree (or indeed any formal qualification), unlike physicians, who, by the 18th century, held a university medical degree and could thus be referred to as "Doctor". By the time the College of Surgeons received its Royal Charter in 1800, the Royal College of Physicians were insisting that candidates for membership for the college of Surgeons must have a medical degree first. Therefore, the ensuing years saw aspiring surgeons having to study medicine first and hence receive the title Doctor. Thereafter, having obtained the diploma of Member or Fellow of the Royal College of Surgeons he would revert to the title "Mr" as a snub to the RCP. Nowadays the title "Mr" is used by Members of the College who have passed the diploma MRCS examination and the College addresses Members as "Mr" or "Ms".