In Japan, some individuals trained as dentists (DDS: Doctor of Dental Surgery) have been substantially involved in pathological diagnosis within the field of medicine, not just in dental or oral specialties. Even more concerning, some of them have been listed as co-authors in English-language academic papers with the title “MD: Medical Doctor,” despite holding no legal medical license.

These false credentials created the impression that they were fully licensed physicians — and this perception has spread, quietly and unchallenged, into the international medical literature. Some of these individuals have even contributed to WHO classification books, where academic titles are not specified, further deepening the confusion.

Why does this matter?

• Because pathological diagnosis forms the basis for cancer treatment decisions.

• Because the trustworthiness of global medical publishing depends on correct author credentials.

• Because patients deserve to know not just what the diagnosis is — but who made it, and whether that person was truly qualified.

 This isn’t just about one person.
It’s a reflection of systemic ambiguity in Japan’s healthcare and academic systems — where rules are vague, responsibility is blurred, and institutional silence often wins over transparency.

This project does not seek to blame individual dentists, but to clarify the structural and institutional conditions that have allowed role ambiguity to persist.

NOTE:
The term “MD” in this book follows the U.S. definition—referring to a licensed graduate of a medical school. Usage may vary by country, but here, “MD” does not include dentists (DDS) or other non-physician degrees.

Like a silent figure in the shadows—a medical ninja—a shadow MD is a non-physician who ends up being widely seen as a real medical doctor, without ever clearly claiming to be one.  In many settings, they are essentially treated as one. It often starts with just a few academic papers listing title “MD” as their degree. After that, even without credentials in later publications, the illusion sticks.
This quiet assumption of medical authority is rarely questioned—especially in academic publishing, where credentials often go unchecked.

This occurs because only a small fraction of scientific journals require academic degrees to be listed.

※ In this book, shadow MD is defined in a narrow, research-based way to explore structural issues in academic medicine.
But outside the lab, you might have seen someone like this:
They talk like they understand every medical detail. They give advice at the bar.
Maybe they once said, “Well, I’m basically a doctor.”
Were they? Or were they just acting the part?

You might have met a shadow MD—without even knowing it.

This diagram visualizes the layered nature of diagnostic pseudoprofessionalism, distinguishing between false credentials, false MDs, fake MDs, and the socially elusive figure of the shadow MD.

Let’s break them down:

🪪 Fake MD
A person who intentionally lies about being a medical doctor. This can happen anywhere—in a casual conversation, on a resume, or in public claims. It is a clear and deliberate falsehood.