If you've ever been an inpatient in a teaching hospital, you have probably been asked if residents can observe while your doctor completes his "rounds" (bedside examinations.) As the five or six young students in white coats follow your physician out of the room, you may wonder about their qualifications.
Physicians undergo a rigorous and lengthy amount of education before they are licensed. Specialists (such as gastroenterologists) require even more schooling and training than, for instance, family practitioners. When they complete their education, all physicians must apply for a medical license before they are allowed, by law, to practice medicine.
In the U.S., all physicians must complete a four-year undergraduate degree, either a Bachelor of Science (BS) or a Bachelor of Arts (BA). Their undergraduate education is typically geared toward the sciences (biology, chemistry, physiology) and may be considered a 'pre-med' program.
After obtaining a four-year degree, students continue on to medical school and start another four years of classes. When they graduate, students receive a degree of either medical doctor (MD) or doctor of osteopathic medicine (DO). Graduates have earned the title of "doctor," but are not permitted to practice medicine on their own.
- Medical Student: Student in a graduate-level medical program
- Resident: Medical school graduate undergoing on-the-job training
- Intern: First-year resident, usually not licensed to practice medicine
- Fellow: Residency graduate undergoing continued specialty training
- Physician or doctor: Person with medical degree; may or may not yet be licensed to practice medicine
Residents and Interns
Having completed eight years of higher education, physicians that enter a residency program are known as residents. Resident programs range from three to seven years in length, depending on the chosen specialty. Occasionally, residents will be called interns during their first year of residency, though this is no longer common. After the completion of their residency program, a physician may decide to enter into practice. Upon obtaining a medical license, physicians may enter a field such as general surgery or family practice. At this time, a physician may also choose to continue their training for a specialty, such as gastroenterology or rheumatology, which will begin during his or her fellowship. Board certification (a medical "stamp of approval") happens after the completion of a residency. Certification is usually required before moving on to subspecialty training.
To become trained for a specialty, physicians enter a fellowship for one to three years and are known as fellows. After completing the fellowship, a specialist physician has undergone a minimum of 12 years of formal classroom education and practical training under the supervision of a licensed physician.
Continuing Medical Education
In order to keep current in the always changing medical field, physicians must continue their education throughout their career. Physicians may also be required to complete a certain amount of continuing medical education (CME) credits per year to maintain their medical license, hospital privileges, and professional organization memberships.
Now, the next time a doctor introduces himself or herself as a resident or fellow, you'll have a better idea of how much training he or she has had. Patients have the right to ask medical professionals about their qualifications. If you are uncomfortable being observed by residents or students, discuss your feelings with the hospital staff at the time of admittance (or ask your patient advocate to do so.)
American Medical Association. “Requirements for Becoming a Physician” American Medical Association. 2013. 30 Apr 2013.
American College of Gastroenterology. “What is a Gastroenterologist?” ACG. 2006. 14 Jun 2007.