In English, there have been many synonyms for physician, both old and new, with some semantic variation. The noun phrase medical practitioner is perhaps the most widely understood and neutral synonym. Medical practitioner is lengthy but inclusive: it covers both medical specialists and general practitioners (family physician, family practitioner), and historically would include physicians (in the narrow sense), surgeons or apothecaries. In England, apothecaries historically included those who now would be called general practitioners and pharmacists.
In some jurisdictions, specialty training is begun immediately following completion of entry-level training, or even before. In other jurisdictions, junior medical doctors must undertake generalist (un-streamed) training for one or more years before commencing specialization. Hence, depending on jurisdiction, a specialist physician (internist) often does not achieve recognition as a specialist until twelve or more years after commencing basic medical training â five to eight years at university to obtain a basic medical qualification, and up to another six years to become a specialist.
