KGarrad, from your post it seems that Thomas Fawell may have had to pursue a degree in medicine first before qualifying as a surgeon? Is there any source I could look up from the early 1800s which might confirm this?
I'm not disputing KG's information, nor suggesting that you shouldn't check for an academic record; but the details of a nineteenth century M.R.C.S. in my family don't support the view that he had a degree in medicine before becoming a surgeon.
He was baptized in May 1825. A newspaper of October 1848 reports that he was admitted a member of the Royal College of Surgeons, and continues to say "he was complimented by the court on the readiness and correctness of the answers he gave to the questions put to him". No mention is made of an academic qualification.
It also gives the surname of the surgeon to whom he had been pupil - one of the Bullmore brothers of Falmouth. Which of the two isn't clear, but both had practices in western Cornwall - a long way from academic institutions.
One of the brothers was Frederick Charles Bullmore (born 1808). His obituary in the BMJ says that he became a Licentiate of the Apothecaries Society in 1830 and an M.R.C.S. in 1831. That is, at 23 years of age - the same as my relative.
Put all that together and it's highly suggestive that well into the C19th the R.C.S. was giving membership status to men educated in the older system of apprenticeship to practicing surgeon/apothecaries.