Surgeons Seal

I have no idea what this is a flag of. It's important enough to be the only piece of decoration in Dr. Cotten's clinic and I'm stumped as to what it is. I'm sure he could give me an extensive history of it but all I have to work with on my own are the words: Surgery, Royal College, Louisiana, and Confederacy. I'd say those words would be what most people would cross reference given the context of the owner.

I'm completely at a loss as to what this a symbol of.

On another note - we've got a game tonight. I'll be meeting Dr. Bizell around 7:00p and I'll need to bring a jacket. No use in freezing.