Lamas with degree titles enjoy lofty positions in Tibetan Buddhism circle since only a few monks could get these degree-like titles after a long time hard religious cultivations and practices. These degrees reflect the holders' authoritative accomplishment in their respective study field. Besides the "Nzhing Ram Ba" and "Tho Ram Pa" degrees awarded by the High-level Tibetan Buddhism College of China in Beijing, those degrees achieved in Tibet are collectively called "Geshe" in Tibetan language, which means "clear perception or well known", and often refer to those in the Gelug Sect of Tibetan Buddhism.
"Lharampa Geshe" is the highest "Geshe" degree in the Exoteric Tibetan Buddhism. Candidates need to attend the sutra debates and answer questions put forward by esteemed lamas from the three major monasteries in Lhasa (the Ganden, Drepung and Sera monasteries) during the "Monlam Prayer Festival" (inaugurated by Tsongkapa in 1409) held in the Jokhang Temple after Losar, the Tibetan New Year Festival. They could only get this degree after being acknowledged by the present esteemed lamas at the Jokhang Temple.
"Tsorampa Geshe" is the second highest degree title after Lharampa Geshe. Candidates need to attend the Monlam Chenmo (prayer meeting) held in the Ramoche Temple and the related sutra debates. They also need to answer questions from the esteemed lamas from the three major monasteries and get their approval to achieve the degree.
"Dorampa Geshe" is lower than the "Linsaipa Geshe" degree and can be achieved by attending the sutra debates on exoteric scriptures during a prayer meeting held in front of the main assembly hall of a monastery. Lama candidates can get this degree title in any monastery able to hold such grand prayer meetings.
Furthermore, the "Arampa Geshe" degrees achieved in different monasteries also reflect various authorities. For example, degrees achieved in the Upper Tantric College and Lower Tantric College in Lhasa are the supreme canonical "Geshes".
Usually, the medical study and practice could take a long time since the theoretical knowledge is very profound and extensive while field study on medicines and treatment in the wild is a must step that costs lot of time.
see also: Geshe