The equivalent senior health official at the national level is often referred to as the chief medical officer (CMO), although the title varies across countries, for example known as the surgeon general in the United States and the chief public health officer in Canada.
[citation needed] In the United Kingdom, the municipal position was an elected head of the local board of health, however the term MOH has also been used to refer to the chief medical officer.
Under the Metropolis Local Management Act 1855, London municipalities were each required to appoint a medical officer.
They were important and influential in the establishment of municipal hospitals under the provisions of the Local Government Act 1929.
They may serve at the global, federal, state, county, or municipal level.