I’ll be the first to admit that when I was in undergrad I was incredibly confused when people started throwing around terms like: M3, intern, resident, doctor, and fellow. I would usually just nod my head and act like I knew what was going on instead of asking questions. I mean I was pre-med so wasn’t I supposed to know everything there was about being a doctor? I can’t tell you how far from the truth that is. Ask questions, it’s the best way to learn! I was inspired to write this post to clear up some of the confusion that comes along with how physicians are educated because I can remember how baffled I was.
As you study in undergrad you may identify yourself pre-med and your school may actually have a major called pre-med (or a track). Other schools don’t have this, so you could be majoring in anything (Biology, English, etc.) and still identifying yourself as pre-med. Once you graduate you will most likely be earning a Bachelor in Science or Bachelor in Arts (there are tons of other degrees, for example, if you are graduating with a Bachelors in Engineering, but let’s try to keep this simple). In reality, anyone can go to medical school regardless of their major in college, as long as they finish the pre-requisites for entering medical school (each school has their own list of these which you can find on their respective websites).
Medical students start identifying as M1’s, M2’s, M3’s, or M4’s. All this means is that they are in their first, second, third or fourth year of medical school. Medical school in the United States is for the most part four years long (with exceptions if you are getting a dual MD, PhD degree). For most schools the breakdown is as follows: M1/M2 years are spent mostly in the classroom learning background knowledge to get them ready for the clinical years. M3/M4 years are the clinical years. Most of the time is spent in the hospital working on patient cases (with the supervision of course) and some time is spent in the classroom. Some people refer to the M3/M4 years as rotations as well. You will be rotating through different departments in the hospital (or clinic setting) such as Pediatrics or Internal Medicine, to get a taste of everything. This exposure helps students decide what they would like do go into for their residency. After the four years of medical school and upon successful completion of all your school’s requirements you will be granted a doctor of medicine degree (MD) of doctor of osteopathic medicine degree (DO). So, now you are technically a doctor.
Now that you have a medical degree, you still need practice and more experience to become more qualified. Once you have graduated medical school you will be going on to complete your residency. This is basically a hands-on training in a specific area of medicine, for example, Pediatrics. Residencies vary in length, lasting anywhere from 3-7 years. A family medicine residency typically is 3 years, while a surgery residency can be much longer. Now that you are in residency, we shall call you a resident. But, wait, this gets more confusing because people sometimes refer to residents (especially first-year residents) as interns. Being an intern means that you’re basically a new resident. After you have completed your residency you can either become a fellow, attending, or go onto additional residencies if you choose. A fellow is someone who has already completed a residency, for example in Pediatrics. You could then go on to complete a fellowship in Child Abuse Pediatrics. Check out this link for more examples of fellowships: https://services.aamc.org/eras/erasstats/par/. If you decide to not do a fellowship, you will be termed an attendingphysician. As an attending you will be in charge of residents and in most cases have the “final” say on cases. Obviously you will be taking input from residents and other attendings, but you may be ultimately held responsible for the patient. If you aren’t going to do a fellowship or continue on to be an attending, you may decide to get another board-certification. I know plenty of physicians who completed residencies in multiple specialties (Internal Medicine and Pediatrics is a big one because some hospitals offer a combined residency program!).
Phew….that was a lot of info and it really only covers the bare minimum. I myself have been learning a lot as I’ve gone through being pre-med and in medical school about all of this medical terminology. This got me thinking, why in the world do we expect our patients to understand this? Seriously, this terminology is not common sense. It is OUR responsibility to educate our patients and make it clear our position.
When you introduce yourself to patients be sure to give your full name and your position. For example, I could say, “Hi, my name is Aleah Chang and I’m a second year medical student at Oakland University William Beaumont School of Medicine.” Be sure if your position is a bit confusing to clarify it! For example, if you are a fellow explain that this means you have already completed four years of medical school and X years of residency training. Now, you are doing additional training in a specific area.
Patients will really benefit by understanding this, because honestly it makes you easier to trust! I don’t think patients mind helping medical students learn, but they may mind if they are lead to believe you are a doctor when you aren’t! Most patients aren’t going to ask what an intern is or what a resident is, so it’s your job to provide them with this information.
Pre-med: Most likely still in undergrad and will apply to go to medical school afterwards.
M1: First-year medical student, studies mostly in the classroom setting
M2: Second-year medical student, studies mostly in the classroom setting
M3: Third-year medical student, studying and working in the hospital setting
M4: Fourth-year medical student, studying and working in the hospital setting
MD/DO: Doctor, has completed four years of medical school, also called physician
Resident: finished medical school, is a doctor, now doing extra training
Intern: finished medical school, is a doctor, now doing extra training (most likely in very first year post-medical school)
Fellow: finished medical school and residency training, is a doctor, now doing additional training
Attending: top of the food chain, is a doctor, completed medical school and residency, leads residents
Another quick note is that in most schools/hospitals medical students should be wearing a short white coat (ends near the hip). Anyone who has graduated medical school (intern, resident, attending, fellow) will be wearing a long white coat (ends near the knee).
I plan to do another post on clearing up qualifications of different providers (ie nurses, doctors, PA’s, techs, etc) in the near future so stay tuned!
Questions? Suggestions? Comment below!