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Doctor of Medicine (MD, from the Latin Medicinæ Doctor meaning "Teacher of Medicine") is a doctoral degree for physicians granted by medical schools. It is a professional doctorate / first professional degree (qualifying degree) in some countries, including the United States and Canada, although training is entered after obtaining from 90 to 120 credit hours of university level work (see second entry degree) and in most cases after having obtained a Bachelors Degree. In other countries, such as India, the United Kingdom, Germany, and Sri Lanka, the MD is an advanced academic research degree more similar to a PhD. In India, Britain, Ireland, and many Commonwealth nations, the medical degree is instead the MBBS i.e., Bachelor of Medicine, Bachelor of Surgery (MBChB, BM BCh, MB BCh, MBBS, BMBS, BMed, BM) and is equivalent to the MD and DO degrees in the U.S. system.

History of the medical degree[link]

According to Sir John Bagot Glubb, Syed Faride and S. M. Imamuddin, the first medical schools to issue academic degrees and diplomas were the teaching Bimaristan (Hospitals) of the medieval Islamic world. The first of these institutions was opened in Baghdad during the time of Harun al-Rashid. They then appeared in Egypt from 872 and then in Islamic Spain, Persia and the Maghreb thereafter. Physicians and surgeons at these hospital-universities gave lectures on Medicine to medical students and then a medical diploma or degree was issued to students who were qualified to be practicing physicians.^[1][2][3]

According to Douglas Guthrie,^[4] who bases his account on L Thorndike,^[5] medical men were first called "Doctor" at the Medical School of Salerno. He states that the Emperor Frederick II decreed in 1221 that no one should practice medicine until he had been publicly examined and approved by the masters of Salerno. The course lasted 5 years, and to start one had to be 21 years old and show proof of legitimacy and of three years study of logic. The course was followed by a year of supervised practice. After the laureation ceremony the practitioners could call themselves "magister" or "doctor."

Academic degrees for physicians by country[link]

United States and Canada[link]

The first medical schools that granted the MD degree were Columbia, Penn, Harvard, Maryland, and McGill.^[6] These first few North American medical schools that were established were (for the most part) founded by physicians and surgeons who had been trained in England and Scotland. University medical education in England culminated with the MB qualification, and in Scotland the MD, until in the mid-19th century the public bodies who regulated medical practice at the time required practitioners in Scotland as well as England to hold the dual Bachelor of Medicine and Bachelor of Surgery degrees (MB BS/MBChB/MB BChir/BM BCh etc.). North American Medical schools switched to the tradition of the Ancient universities of Scotland and began granting the M.D. title rather than the MB beginning in the late 18th century. The Columbia University College of Physicians and Surgeons in New York (which at the time was referred to as King's College of Medicine) was the first American University to grant the MD degree instead of the MB.^[7]

In the United States, MDs are awarded by medical schools accredited by the Liaison Committee on Medical Education (LCME), an independent body sponsored by the Association of American Medical Colleges and the American Medical Association (AMA).^[8][9]

Admission to medical schools in the United States is highly competitive, with about 17,800 out of approximately 47,000 applicants receiving at least one acceptance to any medical school in recent application years. Before entering medical school, students must complete a four year undergraduate degree and take the Medical College Admission Test (MCAT). Before graduating from a medical school and achieving the degree of Medical Doctor, most schools require their students to take the United States Medical Licensing Examination (USMLE) Step 1 and both the Clinical Knowledge and Clinical Skills parts of Step 2. The M.D. degree is typically earned in four years. Following the awarding of the MD, physicians who wish to practice in the United States are required to complete at least one internship year (PGY-1) and pass the USMLE Step 3. In order to receive Board Eligible or Board Accredited status in a specialty of medicine such as general surgery or internal medicine, then undergo additional specialized training in the form of a residency. Those who wish to further specialize in areas such as cardiology or interventional radiology then complete a fellowship. Depending upon the physician's chosen field, residencies and fellowships involve an additional three to eight years of training after obtaining the M.D. This can be lengthened with additional research years, which can last one, two, or more years. The Doctor of Osteopathic Medicine or D.O. degree is the only other legal and professional equivalent to the M.D. degree in the United States and some parts of Canada. The differences between the M.D. and the D.O. degrees lie in the distinctive osteopathic philosophy and osteopathic manipulative treatment (OMT). In Canada, the M.D. is the basic medical degree required to practice medicine. McGill University Faculty of Medicine is the only medical school in Canada to award M.D., C.M. degrees (abbreviated MDCM). MDCM is from the Latin "Doctorem Medicinae et Chirurgiae Magistrum" meaning "Doctor of Medicine and Master of Surgery".

Research physicians[link]

Even though the M.D. and D.O. are first professional degrees and not doctorates of research (i.e., a Ph.D.), many holders of the M.D. or D.O. degree conduct clinical and basic scientific research and publish in peer-reviewed journals during training and after graduation. Combined medical and research training is offered through programs granting MD/PhD or DO/PhD degrees. The National Institutes of Health through its Medical Scientist Training Program funds MD/PhD training programs at many universities. Some MDs and DOs choose a research career and receive funding from the NIH as well as other sources such as the Howard Hughes Medical Institute. A few even go on to become Nobel Laureates.^[10] The United States Department of Education and the National Science Foundation do not include the M.D. or other professional doctorates among the degrees that are equivalent to research doctorates.^[11][12]

UK, Ireland and some Commonwealth countries[link]

In the UK, Ireland and many Commonwealth countries, the MD is a postgraduate research degree in medicine. At some universities, this takes the form of a first doctorate, analogous to the PhD, awarded upon submission of a thesis and a successful viva. The thesis may consist of new research undertaken on a full- or part-time basis, with much less supervision (in the UK) than for a PhD, or a portfolio of previously published work.^[13]

In order to be eligible to apply for an MD degree from a UK or Commonwealth University one must hold either an MBBS, MBChB, or an equivalent US-MD degree and must usually have at least 5-years of postgraduate experience. Therefore graduates from the MBBS or MBChB degrees do not hold doctorates, however physicians holding these degrees are referred to as 'Doctor' as they are fully licensed as primary care physicians upon the completion of mandatory clinical internship minimum of one full year after graduating from the medical college. In some commonwealth nations these interns are designated as as House surgeons. Total duration to obtain MBBS degree is about 6 years that includes 5 years of course work and minimum one year of Compulsory rotating clinical internship.

At some other universities (especially older institutions such as Oxford, Cambridge and St Andrews) the MD is a higher doctorate (similar to a DSc) awarded upon submission of a portfolio of published work representing a substantial contribution to medical research.^[14]

In the case where the MD is awarded (either as a first or higher doctorate) for previously published research, the candidate is usually required to be either a graduate or a full-time member of staff, of several years' standing of the university in question.^[15]

The entry-level first professional degree in these countries for the practice of medicine is that of Bachelor of Medicine and Bachelor of Surgery (MBBS, MB, MB BCh BAO, BMBS, MBBChir, or MBChB). This degree typically requires between four and six years of study and clinical training, and is equivalent to the North American MD degree.

The University of Melbourne^[16] in Australia introduced the North American MD degree in 2011 for graduates of the Bachelor of Biomedicine and Bachelor of Science New Generation degrees. The university is the first in Australia to leave the Bachelor of Medicine and Bachelor of Surgery (MBBS) and offer the Doctor of Medicine (MD) as a first professional degree in medicine rather than as a research degree. The first cohort of MD students from the university will graduate in 2014, one year after the last graduating cohort of MBBS students. The University of Melbourne renamed its previous research MD degree to Doctor of Medical Science (DMedSc), which will distinguish the new MD graduates from the doctors who obtain the research degree.

The University of Western Australia from 2014 will begin a similar 4 year post graduate course with graduates qualifying with an MD rather than the MBBS as it stood up until 2011.

The University of Queensland is planning on also introducing the MD to replace the current Bachelor of Medicine and Bachelor of Surgery.^[17]

Argentina[link]

In Argentina the First Degree of Physician or Medic Title (Título de Médico)^[18] is equivalent to the North American M. D. Degree with 6 year of intensive studies followed by usually three or four years of the residency as a major specialty in a particular empiric field, compounded of internships, social services and sporadic research. Only by holding a Medical Title the postgraduate student might apply for the Doctor degree through a Doctorate in Medicine program approved by the National Commission for University Evaluation and Accreditation.^[19]

India[link]

The MBBS degree represents the first (graduation) level of training required to be licensed as a physicians, and the MS OR MD degree is a higher postgraduate degree, representative of specialty training. The equivalent training in the US or Canada would be completion of a medical (post-graduate) degree. Eligibility for the MS or MD course is restricted to medical graduates holding the MBBS degree. The MBBS course is for five and a half years, and training is obtained in medical disciplines (e.g.: Internal Medicine, Radiology, Pathology, etc.). After three years of study and the successful completion of an examination, which includes both theoretical and practical elements, in a pre-clinical or clinical subject of a non-surgical nature the candidate receives MD degree, were as in a pre-clinical or clinical subject of a surgical nature i.e,anatomy ,general surgery, orthopaedics and gynaecology the candidate receives the equivalent degree Master of Surgery (MS).

The research element is not prominent in India, as this is primarily a clinical qualification resembling the professional doctorates of the USA. In general surgery, orthopaedics and gynaecology and in a pre-clinical subject like anatomy the equivalent degree is Master of Surgery (MS).

A third qualification, termed DNB [Diplomate of National Board], is considered equivalent to the MD and MS degrees. This can be obtained by passing the exam conducted by the National Board of Examinations after completing 3 years of post-MBBS residency training in teaching hospitals recognised by the board.

After obtaining the first postgraduate degree, that is MD/MS/DNB, one can go for further specialisation in medical or surgical fields. This requires three years of additional training and study and then passing an examination, both theory and practical, and the degree awarded is DM (Doctor of Medicine), like DM in Cardiology, Neurology, Nephrology, Gastroenterology, etc. For surgical subspecialities the degree awarded is MCh (Magister Chirurgiae), like MCh in Cardiac thoracicSurgery, Neurosurgery, etc. A third qualification in subspecialities is DNB (superspecialties), offered by National Board of Examinations, like DNB in Cardiology, Neurology, Cardiac Surgery, Neurosurgery, etc.

The MCh degrees are for super-specialties in medicine and are very high ranked/prestigious.

In Ayurveda, B.A.M.S in Unani, Bachelor of Unani Medicine and Surgery BUMS in Sidha BSMS in homoeo B.H.M.S are the basic qualification for practicing Ayurveda,Unani,Homoeo&Sidha. The B.A.M.S, B.U.M.S, B.S.M.S and B.H.M.S are 6 year degree (including internship called house surgeoncy) course after 12 years of formal education at a C.C.I.M approved colleges. M.D has to be done after B.A.M.S, B.U.M.S, B.S.M.S or B.H.M.S in a speciality, and it takes 3 years (including submission of a thesis) to complete the course. In Acupuncture Diploma in Acupuncture D Acu is the basement course for Bachelor of Acupuncture B Acu (three years). MD Acu is the post graduate(Master)degree in Acupuncture(two years after B Acu).

Pakistan[link]

In Pakistan equivalent degree is MBBS (bachelors of medicine and bachelors of surgery). MBBS is awarded as the basic medical qualification after completing five years of study. This comprises two years of basic science subjects including anatomy, physiology, and biochemistry, with a particular emphasis on human anatomy. Subsequently, there are three years of clinical internship and courses on medicine surgery and pharmacology. Finally, the student is required to work for one year under a professor, before one is awarded Degree of MBBS with license to practice. For specialization, one has to pass Fellow of College of Physicians & Surgeons Pakistan (FCPS) exam-1 in field in of specialization and obtain an internship in the field for 3–6 years. Next, one can take the FCPS exam part 2, which includes intensive practical exams. Upon successful completion a fellow of the relevant specialty is awarded. Tough entry tests are passed successfully before entering in to a medical college. Medical colleges and foreign medical qualifications are supervised by the Pakistan Medical and Dental Council (PMDC). Specialized degrees are awarded by the Pakistan College of Physicians and Surgeons. In basic medical sciences such as Anatomy, Physiology, Biochemistry, Pathology etc. the research postgraduate degree awarded by many universities is M.Phil., which has a pre-requirement of at least two years of Demonstratorship in relevant subject in a recognized Medical College. The Mphil course is 2–4 years and is a research postgraduate degree, containing submission and defence of research thesis in basic sciences similar to MD degree program in India. Many universities in conjunction with tertiary hospitals offer coursework MD and MS degrees as well.

Romania[link]

Romanian medical school lasts for 6 years including clinical practice and concludes with a final licensing examination (licenta). The degree awarded is Doctor-medic (Medical Doctor) abbreviated as MD.^[20]

Sri Lanka[link]

In Sri Lanka, MBBS degree is the degree to be held for one to be licensed as a physicians by the Sri Lanka Medical Council. MD degree is a higher postgraduate degree and in Sri Lanka awarded by the Postgraduate Institute of Medicine after completion of a postgraduate course and examinations. The MD degree in Sri Lanka is representative of specialty training in clinical, para clinical and preventive medicine (e.g., General Medicine, Cardiology, Nephrology, Oncology, para clincal such as microbiology, haematology and preventive such as Community Medicne .). Entry for the MD course open only for medical graduates holding the MBBS degree (with a duration of five and a half years), and training is obtained in medical disciplines that are non-surgical in nature (e.g., Internal Medicine, Radiology, Pathology, etc.). After three or four years of study and the successful completion of an examination with written as well as cases and viva examinations, the MD degree in the respective field of Study is awarded. In Community medicine and Medical Administration, part I examination consists of a theoretical exam while the degree is cofered after completion of a thesis as n PhD. This thesis has to be completed within a period of five years. After successfully defending the academic thesis, MD degree is conferred to the candidate,The MD degree holder is certified as a Board certified specialist by the respective board of study of the Postgraduate Institute of Medicine after he/she undergoes 2–4 years of local and foreign training depending on the specialty/subspecialty selected .

Equivalent degrees in other countries[link]

• In the Dominican Republic it is known as "DOCTOR EN MEDICINA" (DOCTOR IN MEDICINE). In 1511 the Spanish Catholic church founded the first university of the Americas in Santo Domingo present capital of modern day Dominican Republic and name it UNIVERSIDAD SANTO TOMAS DE AQUINO (today UNIVERSIDAD AUTONOMA DE SANTO DOMINGO). In 1630 this university graduated the first medical doctors of the Americas and amongst the graduates some Native Americans included.

• The Bachelor of Medicine and Bachelor of Surgery degrees (MB BS or MB ChB, and several variants).
• In Italy, the title of "Dottore in Medicina e Chirurgia" (literally "Doctor in Medicine and Surgery") is awarded by a preventive selection ("test a numero chiuso"): only 10% of the students that pass this test have to complete 6 years of medical school and have to pass a final state examination (called "abilitazione") to acquire the right to work as a physician; finally they can use the title "Dott." or "Dr." before the name. All Doctors then must sign theirself to a schools of specialization (literally "scuole di specializzazione") that, after the winning of the competition in the field that each doctors choose, last 4 years at least.
• In Germany students having completed 6 years of medical school and two rigorous state examinations acquire the right to work as a physician but no definite title. To obtain the degree "Dr. med., doctor medicinæ; Dr. med. dent., doctor medicinæ dentariæ; Dr. med. vet., doctor medicinæ veterinariæ" writing a dissertation/thesis is required. It is estimated that 70% of all graduates will eventually complete a dissertation, which is perceived to be important for career promotion and to attract patients.
• The Czech and Slovak title MUDr. (Medicinae Universae doctor or doktor medicíny) is a professional doctorate granted upon completion of six years pregraduate Master's study at medical schools. The postgraduate academic research degree in medicine is a PhD degree.
• In Poland the title of lekarz (physician, medic) or "lek." (previously lekarz medycyny or "lek. med.") is granted after completing a 6-year Master's medical program (although students apply to it directly after graduating high school).^[21][21] In contrast, a higher doctoral academic research degree in medicine resembling a PhD is named "dr n. med." or doktor nauk medycznych (Doctor of Medical Sciences). Specialization is valued similarly to a specialization in the English system and is a pre-requisite for a "dr. n. med." which is usually defined within the same field.
• The Danish and Norwegian Candidatus medicinae or Candidata medicinae degrees (cand.med.) is awarded after completing a 6-year medical programme, to which students apply directely upon finishing secondary school. The programme usually includes a small thesis. However, the cand.med. degree must not be confused with the previous Danish and Norwegian dr.med. degree, which is equivalent to the current post-graduate PhD.
• In Mexico, schools of medicine award the "Titulo de Medico Cirujano" degree after completing either 6 or 7 years of study. This curriculum includes a rotating internship year and a year of social service providing care to an underserved community.
• In Nepal, a MBBS degree is awarded.
• In Greece, after a six-year study, a medical student acquires his medical degree and the right to use "Δρ.", (Dr.) before his name. This is considered equivalent to the M.D. title.
• In Iran the professional degree in Medicine or MD is awarded upon completion of seven years continuous study started with 5.5 years university education include 2.5 years basic sciences,1 year pathophysiology and 2 years clinical courses followed by one & half year of internship in accredited hospitals plus thesis.
• In mainland China, some medical schools award MBBS to foreign students while all medical schools award Bachelor of Medicine to nationals. MD is a higher academic research degree.
• In Colombia, the medicine faculties of the universities awards the title of "Medico Cirujano" after taking 10 semesters of studies on "all clinic and surgery disciplines an 2 semester on internship. After receiving the degree there is a mandatory year "obliged social work" were the doctors practice as GP in the countryside. Residency programs last between 3-4 years depends on the specialty.
• In Sudan the awarded degree in most of the medical schools is, Bachelor of Medicine and Basic Surgery (MBBS).In schools that are based on the English system of medical teaching, the degree is granted after 6 years of studying. As for the schools that are adopting the American system, they grant their students the degree of MBBS in only 5 years.
• In Turkey, the title of "Tıp Doktoru" (literally "Doctor of Medicine") is awarded upon completion of six years continuous study started with 5 years university education include 3 years basic sciences, 2 years clinical courses followed by one year of internship in university hospitals.
• In the Netherlands, the title 'Arts' (Dutch, meaning 'physician') is awarded after six years of study, and most patients address the physician as 'Dokter'. Most Dutch universities have divided the medical study in four years theory and two years practical experience. Exception are the universities of Maastricht and Utrecht. At Utrecht the program consists of two and a half year of theory, two and a half year specialty-dedicated theory blocks, a clinical rotation in that specialty, and one year continuous practical experience.
• In Indonesia, the title of "dokter" (dr.) is awarded after a Medical student received their Bachelor in Medicine (Sarjana Kedokteran; S.Ked) after 3-3,5 years of study (at least) and 1,5 – 2 years of clinical course in university hospitals. After a medical student finished those 5 years of study and take Hippocrates Oath, The title of Dokter (Dr.) is entitled before their name. Then they need to take Ujian Kompetensi Dokter Indonesia (UKDI, test to get license to practice medicine as general practitioner) then take a year long internship course in primary health care clinics (also known as Puskesmas) or primary hospitals all over the country to practice as general practitioner under supervision of senior doctors. Those who wished to further their study into specialties can take graduate course of medicine of their preference and will be entitled with "Specialist of ..." after their name (e.g.: Sp.A for Spesialis Anak = Pediatrician). graduate course of medicine is equal with residency program which is required the candidates to study for 4 years and hospital internship. (Note: dr. (dokter) is used for medical graduates, while Dr. (Doktor) is used for PhD holders.)

Other postgraduate clinical degrees[link]

There is also a similar advanced professional degree to the postgraduate MD: the Master of Surgery (usually ChM or MS, but MCh in Scotland, Ireland, Wales and at Oxford and MChir at Cambridge). The equivalence of these degrees, but their differing names, prevents the need for surgeons (addressed as Mr. in the UK) having to revert to the title Dr., which they once held as new MBBS graduates.

In Ireland, where the basic medical qualification includes a degree in obstetrics, there is a similar higher degree of Master of the Art of Obstetrics (MAO). A Master of Midwifery was formerly examined by the Worshipful Society of Apothecaries of London (hence MMSA) but fell into abeyance in the 1960s; in this case the term Master referred not to a university degree but rather a professional rank that is common among craft guilds.

In East Africa, the medical schools in Kenya, Tanzania and Uganda award the degree of Master of Medicine (MMed) degree in both surgical and medical specialty disciplines following a three year period of instruction.

In West Africa, the West African College of Physicians and the West African College of Surgeons award the Fellowship of the West African College of Physicians (FWACP) and the Fellowship of the West African College of Surgeons (FWACS) in medical and surgical disciplines respectively after a minimum of four year residency training period.

References[link]

http://www.ucl.ac.uk/medicalschool/undergraduate/mbbs-programme/prospectus/medicalschoolprospectus2012.pdf

Further reading[link]

• Biabangardi, Zinab; Baradaran (2006). JCEHP 26 (3). 

A Doll's House
Original manuscript cover page, 1879
Written by	Henrik Ibsen
Characters	Nora Torvald Helmer Krogstad Mrs. Linde Dr. Rank Children Anne-Marie
Mute	Nora's Father
Date premiered	21 December 1879 (1879-12-21)
Place premiered	Royal Theatre in Copenhagen, Denmark
Original language	Norwegian
Subject	The feminist awakening of a good middle-class wife and mother.
Genre	Naturalistic / realistic problem play Modern tragedy
Setting	The home of the Helmer family in an unspecified Norwegian town or city, circa 1879.
IBDB profile
IOBDB profile

A Doll's House (Norwegian: Et dukkehjem; also translated as A Doll House) is a three-act play in prose by the playwright Henrik Ibsen.^[1] It premièred at the Royal Theatre in Copenhagen, Denmark, on 21 December 1879, having been published earlier that month.^[2]

The play was controversial when first published, as it is sharply critical of 19th century marriage norms.^[3] Michael Meyer argues that the play's theme is not women's rights, but rather "the need of every individual to find out the kind of person he or she really is and to strive to become that person."^[4] In a speech given to the Norwegian Women's Rights League in 1898, Ibsen insisted that he "must disclaim the honor of having consciously worked for the women's rights movement," since he wrote "without any conscious thought of making propaganda," his task having been "the description of humanity."^[5] The Swedish playwright August Strindberg attacked the play in his volume of short stories Getting Married (1884).^[6]

UNESCO inscribed Ibsen's autographed manuscripts of A Doll's House on the Memory of the World Register in 2001, in recognition of their historical value.^[7]

Synopsis[link]

Act one[link]

A Doll's House opens as Nora Helmer returns from Christmas shopping. Her husband Torvald comes out of his study to banter with her. They discuss how their finances will improve now that Torvald has a new job as the vice president of the bank. Torvald expresses his horror of debt. Nora behaves childishly and he enjoys treating her like a child to be instructed and indulged.

Soon an old friend of Nora's, Christine Linde, arrives. She is a childless widow who is moving back to the city. Her husband left her no money, so she has tried different kinds of work, and now hopes to find some work that is not too strenuous. Nora confides to Christine that she once secretly borrowed money from a disgraced lawyer, Nils Krogstad, to save Torvald's life when he was very ill, but she has not told him in order to protect his pride. She told everyone that the money came from her father, who died at about the same time. She has been repaying the debt from her housekeeping budget, and also from some work she got copying papers by hand, which she did secretly in her room, and took pride in her ability to earn money "as if she were a man." Torvald's new job promises to finally liberate her from this debt.

Nora asks Torvald to give Christine a position as a secretary in the bank, and he agrees, as she has experience in bookkeeping. They leave the house together.

Krogstad arrives and tells Nora that he is worried he will be fired. He asks her to help him keep his job and says that he will fight desperately to keep it. Nora is reluctant to commit to helping him, so Krogstad reveals that he knows she committed forgery on the bond she signed for her loan from him. As a woman, she needed an adult male co-signer, so she said she would have her father do so. However the signature is dated three days after his death, which suggests that it is a forgery. Nora admits that she did forge the signature, so as to spare her dying father further worry about her (she was pregnant, poor, and had a seriously ill husband). Krogstad explains that the forgery betrayed his trust and is also a serious crime. If he told others about it, her reputation would be ruined, as was his after a similar "indiscretion," even though he was never prosecuted. He implies that what he did was in order to provide for his sick wife, who later died.

Act two[link]

Christine arrives to help Nora repair a dress for a costume party she and Torvald are going to the next day. Then Torvald comes home from the bank and Nora pleads with him to reinstate Krogstad at the bank. She claims she is worried that Krogstad will publish libelous articles about Torvald and ruin his career. Torvald dismisses her fears and explains that although Krogstad is a good worker and seems to have turned his life around, he insists on firing him because Krogstad is not deferential enough to him in front of other bank personnel. Torvald goes into his study to do some work.

Next Dr. Rank, a family friend, arrives. Nora talks about asking him for a favor. Then he reveals that he has entered the terminal stage of tuberculosis of the spine (a contemporary euphemism for congenital syphilis),^[8] and that he has always been secretly in love with her. Nora tries to deny the first revelation and make light of it, but she is more disturbed by the second. She tries clumsily to tell him that she is not in love with him, but loves him dearly as a friend.

Desperate after being fired by Torvald, Krogstad arrives at the house. Nora gets Dr. Rank to go in to Torvald's study, so he does not see Krogstad. When Krogstad comes in he declares he no longer cares about the remaining balance of Nora's loan, but that he will preserve the associated bond in order to blackmail Torvald into not only keeping him employed, but giving him a promotion. Nora explains that she has done her best to persuade her husband, but he refuses to change his mind. Krogstad informs Nora that he has written a letter detailing her crime (forging her father's signature of surety on the bond) and puts it in Torvald's mailbox, which is locked.

Nora tells Christine of her predicament. Christine says that she and Krogstad were in love before she married, and promises that she will try to convince him to relent.

Torvald comes in and tries to check his mail, but Nora distracts him by begging him to help her with the dance she has been rehearsing for the costume party, as she is so anxious about performing. She dances so badly and acts so worried that Torvald agrees to spend the whole evening coaching her. When the others go in to dinner, Nora stays behind for a few minutes and contemplates suicide to save her husband from the shame of the revelation of her crime, and more importantly to pre-empt any gallant gesture on his part to save her reputation.

Act three[link]

Christine tells Krogstad that she only married her husband because she had no other means to support her sick mother and young siblings, and that she has returned to offer him her love again. She believes that he would not have stooped to unethical behavior if he had not been devastated by her abandonment and in dire financial straits. Krogstad is moved and offers to take back his letter to Torvald. However, Christine decides that Torvald should know the truth for the sake of his and Nora's marriage.

After literally dragging Nora home from the party, Torvald goes to check his mail, but is interrupted by Dr. Rank, who has followed them. Dr. Rank chats for a while so as to convey obliquely to Nora that this is a final goodbye, as he has determined that his death is near, but in general terms so that Torvald does not suspect what he is referring to. Dr. Rank leaves, and Torvald retrieves his letters. As he reads them Nora steels herself to take her life. Torvald confronts her with Krogstad's letter. Enraged, he declares that he is now completely in Krogstad's power—he must yield to Krogstad's demands and keep quiet about the whole affair. He berates Nora, calling her a dishonest and immoral woman and telling her she is unfit to raise their children. He says that from now on their marriage will be only a matter of appearances.

A maid enters, delivering a letter to Nora. Krogstad has returned the incriminating papers, saying that he regrets his actions. Torvald exults that he is saved as he burns the papers. He takes back his harsh words to his wife and tells her that he forgives her. Nora realizes that her husband is not the strong and gallant man she thought he was, and that he truly loves himself more than he does her.

Torvald explains that when a man has forgiven his wife it makes him love her all the more since it reminds him that she is totally dependent on him, like a child. He dismisses Nora's agonized choice made against her conscience for the sake of his health and her years of secret efforts to free them from the ensuing obligations and danger of loss of reputation, while preserving his peace of mind, as a mere mistake that she made owing to her foolishness, one of her most endearing feminine traits.

Nora tells Torvald that she is leaving him to live alone so she can find out who she is and what she believes and decide what to do with her life. She says she has been treated like a doll to play with, first by her father and then by him. Concerned for the family reputation, Torvald insists that she fulfill her duty as a wife and mother, but Nora says that her first duties are to herself, and she cannot be a good mother or wife without learning to be more than a plaything. She reveals that she had expected that he would want to sacrifice his reputation for hers, and that she had planned to kill herself to prevent him from doing so. She now realizes that Torvald is not at all the kind of person she had believed him to be, and that their marriage has been based on mutual fantasies and misunderstanding.

Torvald is unable to comprehend Nora's point of view, since it contradicts all that he had been taught about the female mind throughout his life. Furthermore, he is so narcissistic that it would be impossible for him to bear to understand how he appears to her, as selfish, hypocritical and more concerned with public reputation than with actual morality. Nora leaves her keys and wedding ring and as Torvald breaks down and begins to cry, baffled by what has happened, Nora leaves the house, slamming the door behind herself.

Alternative ending[link]

It was felt by Ibsen's German agent that the original ending would not play well in German theatres; therefore, for the play's German debut, Ibsen was forced to write an alternative ending for it to be considered acceptable.^[9] In this ending, Nora is led to her children after having argued with Torvald. Seeing them, she collapses, and the curtain is brought down. Ibsen later called the ending a disgrace to the original play and referred to it as a 'barbaric outrage'.^[9]

Writing process and publication[link]

Ibsen started thinking about the play around May 1878, although he did not begin its first draft until a year later, having reflected on the themes and characters in the intervening period (he visualised its protagonist, Nora, for instance, as having approached him one day wearing "a blue woolen dress").^[10] He outlined his conception of the play as a "modern tragedy" in a note written in Rome on 19 October 1878.^[11] "A woman cannot be herself in modern society," he argues, since it is "an exclusively male society, with laws made by men and with prosecutors and judges who assess feminine conduct from a masculine standpoint."^[12]

Ibsen sent a fair copy of the completed play to his publisher on 15 September 1879.^[13] It was first published in Copenhagen on 4 December 1879, in an edition of 8,000 copies that sold out within a month; a second edition of 3,000 copies followed on 4 January 1880 and a third edition of 2,500 was issued on 8 March.^[14]

Real-life basis[link]

A Doll's House was based on the life of Laura Kieler (maiden name Laura Smith Petersen). She was a good friend of Ibsen. Much that happened between Nora and Torvald happened to Laura and her husband, Victor, with the most important exception being the forged signature that was the basis of Nora's loan. In real life, when Victor found out about Laura's secret loan, he divorced her and had her committed to an asylum. Two years later, she returned to her husband and children at his urging, and she went on to become a well-known Danish author, living to the age of 83. In the play, Nora left Torvald with head held high, though facing an uncertain future given the limitations women faced in the society of the time. Ibsen wrote A Doll's House at the point when Laura Kieler had been committed to the asylum, and the fate of this friend of the family shook him deeply, perhaps also because Laura had asked him to intervene at a crucial point in the scandal, which he did not feel able or willing to do. Instead, he turned this life situation into an aesthetically shaped, successful drama. Kieler eventually rebounded from the shame of the scandal and had her own successful writing career while remaining discontent with sole recognition as "Ibsen's Nora" years afterwards.^[15]

Production history[link]

A Doll's House received its world première on 21 December 1879 at the Royal Theatre in Copenhagen, Denmark, with Betty Hennings as Nora and Emil Poulsen as Torvald.^[16] Writing for the Norwegen newspaper Folkets Avis, the critic Erik Bøgh admired Ibsen's originality and technical mastery: "Not a single declamatory phrase, no high dramatics, no drop of blood, not even a tear."^[17] Every performance of its run was sold out.^[18] Another production opened at the Royal Theatre in Stockholm, Sweden, on 8 January 1880, while productions in Christiania (with Johanne Juell as Nora and Arnoldus Reimers as Torvald) and Bergen followed shortly after.^[19]

In Germany, the actress Hedwig Niemann-Raabe refused to perform the play as written, declaring that "I would never leave my children!"^[18] Since the playwright's wishes were not protected by copyright, Ibsen decided to avoid the danger of being re-written by a lesser dramatist by committing what he called a "barbaric outrage" on his play himself and giving it an alternative ending in which Nora did not leave.^[20] A production of this version opened in Flensburg in February 1880.^[21] This version was also played in Hamburg, Dresden, Hanover, and Berlin, although, in the wake of protests and a lack of success, Niemann-Raabe eventually restored the original ending.^[21] Another production of the original version, some rehearsals of which Ibsen attended, opened on 3 March 1880 at the Residenz Theatre in Munich.^[21]

In Great Britain, the only way in which the play was initially allowed to be given in London was in an adapted form made by Henry Arthur Jones and Henry Herman and called Breaking a Butterfly. This adaptation was produced at the Princess Theatre, 3 March 1884. The first British production of the play in its regular form opened on 7 June 1889 at the Novelty Theatre, starring Janet Achurch as Nora and Charles Carrington as Torvald.^[22][23][24] Achurch played Nora again for a 7-day run in 1897. Soon after its London première, Achurch brought the play to Australia in 1889.^[25]

The play was first seen in America when, during 1883, in Louisville, Kentucky, Helena Modjeska acted Nora.^[23] The play made its Broadway première at the Palmer's Theatre on 21 December 1889, starring Beatrice Cameron as Nora Helmer.^[26]

It was first performed in France in 1894.^[19]

Other productions in the United States include one in 1902 starring Minnie Maddern Fiske and a 1997 production starring Janet McTeer (in a critically acclaimed performance) at the Belasco Theater, which received three Tony Awards and the Drama Desk Award for Outstanding Revival of a Play.

A new translation by Zinnie Harris at the Donmar Warehouse, starring Gillian Anderson, Toby Stephens, Anton Lesser, Tara FitzGerald and Christopher Eccleston opened in May 2009.^[27]

Criticism[link]

This section may contain original research. Please improve it by verifying the claims made and adding references. Statements consisting only of original research may be removed. More details may be available on the talk page. (February 2011)

A Doll's House criticises the traditional roles of men and women in 19th-century marriage.^[28] To many 19th-century Europeans, this was scandalous. Nothing was considered more holy than the covenant of marriage, and to portray it in such a way was completely unacceptable;^[29] however, a few more open-minded critics such as the Irish playwright George Bernard Shaw found Ibsen's willingness to examine society without prejudice exhilarating.^[30] In Germany, the production's lead actress refused to play the part of Nora unless Ibsen changed the ending, which, under pressure, he eventually did.^[28] In the alternative ending, Nora gives her husband another chance after he reminds her of her responsibility to their children. This ending proved unpopular and Ibsen later regretted his decision on the matter. Virtually all productions today, however, use the original ending, as do nearly all of the film versions of this play, including Dariush Mehrjui's Sara (the Argentine version, made in 1943 and starring Delia Garcés, does not; it also modernizes the story, setting it in the early 1940s).

Because of the radical departure from traditional behavior and theatrical convention involved in Nora's leaving home, her act of slamming the door as she leaves has come to represent the play itself.^[31][32] One critic noted, "That slammed door reverberated across the roof of the world."^[33]

Adaptations[link]

A Doll's House has been adapted for several film releases including two in 1973: one directed by Joseph Losey, starring Jane Fonda, David Warner and Trevor Howard; and one directed by Patrick Garland with stars Claire Bloom, Anthony Hopkins, and Ralph Richardson. In 1993, David Thacker directed, with stars Juliet Stevenson, Trevor Eve and David Calder. Dariush Mehrjui's 1993 film Sara is based on A Doll's House, with the plot transferred to Iran with Sara, played by Niki Karimi, is the Nora of Ibsen's play.

A version for American television was made in 1959, directed by George Schaefer and starring Julie Harris, Christopher Plummer, Hume Cronyn, Eileen Heckart and Jason Robards. A 1974 West German television adaptation, titled Nora Helmer was directed by Rainer Werner Fassbinder and starred Margit Carstensen in the title role. A 1938 US radio production starred Joan Crawford as Nora and Basil Rathbone as Torvald. A later US radio version by the Theatre Guild in 1947 featured Rathbone with Wendy Hiller and Catherine Rowan, his co-star from a contemporary Broadway production.

References[link]

Sources[link]

• Brockett, Oscar G. and Franklin J. Hildy. 2003. History of the Theatre. Ninth edition, International edition. Boston: Allyn and Bacon. ISBN 978-0-205-41050-7.
• Dukore, Bernard F., ed. 1974. Dramatic Theory and Criticism: Greeks to Grotowski. Florence, KY: Heinle & Heinle. ISBN 978-0-03-091152-1.
• Innes, Christopher, ed. 2000. A Sourcebook on Naturalist Theatre. London and New York: Routledge. ISBN 978-0-415-15229-7.
• Meyer, Michael. 1967. Ibsen. Harmondsworth: Penguin, 1974. ISBN 978-0-14-021772-8.
• Moi, Toril. 2006. Henrik Ibsen and the Birth of Modernism: Art, Theater, Philosophy. Oxford and New York: Oxford UP. ISBN 978-0-19-920259-1.
• Simon, John (15 July 1991). "Baptism by Fire Island". New York) 24 (27): 55. 
• Törnqvist, Egil. 1995. Ibsen, A Doll's House. Plays in Performance ser. Cambridge: Cambridge UP. ISBN 978-0-521-47866-3.
• Worthen, W. B. 2004. The Wadsworth Anthology of Drama, 6e. Wadsworth: Cengage Learning. 666-691.

Further reading[link]

• Ibsen, Henrick (trans McLeish). A Doll's House, Nick Hern Books, London, 1994
• Unwin, Stephen. Ibsen's A Doll's House (Page to Stage Study Guide) Nick Hern Books, London, 1997
• William L. Urban. "Parallels in A Doll's House." Festschrift in Honor of Charles Speel. Ed. by Thomas J. Sienkewicz and James E. Betts. Monmouth College, Monmouth, Illinois, 1997.

External links[link]

Wikisource has original text related to this article: A Doll's House

Wikimedia Commons has media related to: A Doll's House

• A Doll's House at the Internet Broadway Database
• A Doll's House at the Internet Movie Database
• A Doll’s House: A Study Guide
• A Doll's House at Project Gutenberg
• A Doll's House at Project Gutenberg (alternate edition)
• The Social Significance of the Modern Drama, a book by Emma Goldman, contains a chapter on A Doll's House.