It is a professional doctorate / first professional degree (qualifying degree) in some countries, including the United States and Canada. Students need to have completed 90 to 120 credit hours of university level work (see second entry degree) and in most cases should already have a Bachelors Degree.
In other countries, such as the United Kingdom and Germany, the Doctor of Medicine is an advanced academic research degree similar to a PhD or a higher doctorate. In Britain, Ireland, and many Commonwealth nations, the qualifying medical degree is the Bachelor of Science in Medicine, Bachelor of Medicine, Bachelor of Surgery (MBBS, BMBS, BM BCh, BM, MB BCh BAO, or MB ChB) and is the same as the M.D. degree in the U.S. system.
In these countries it is illegal to prescribe scrips (prescriptions) and perform operations without the basic degree; also usual is the membership of appropriate medical and/or surgical societies. The societies (such as the British Medical Association) act as a kind of sophisticated trades union for doctors. In the British system, the General Medical Council has legal authority for the medical register of doctors licensed to practice medicine. They can and do hold tribunals to decide whether doctors accused of misdeeds should be struck off the medical register. Therefore, to practice it is necessary not only to hold the medical degree(s), but also to be on the register.