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The transition from the preclinical years to the clinical years of medical school is an important time. Understanding the new responsibilities and the general ground rules can ease this transition. Here we provide a brief introduction to clinical medical training for the new student on the wards.

*Based on a concept initially developed by Epstein A, Frye T (eds.): So You Want to Be a Toad. College of Medicine, Ohio State University, Columbus, OH.

Most services have some or all of the following team members.

The Intern

In some programs, the intern is also known as the first-year resident. This person has the day-to-day responsibilities of patient care. This duty, combined with a total lack of seniority, usually serves to keep the intern in the hospital more than the other members of the team and may limit his or her teaching of medical students. Any question you have concerning details in the evaluation of the patient, for example, whether Mrs. Pavona gets a complete blood count this morning or this evening, is usually referred first to the intern.

The Resident

The resident is a member of the house staff who has completed at least 1 year of postgraduate medical education. The most senior resident is typically in charge of the overall conduct of the service and is the person you might ask a question such as “What might cause Mrs. Pavona’s white blood cell count to be 142,000?” You might also ask your resident for an appropriate reference on the subject or perhaps to arrange a brief conference on the topic for everyone on the service. A surgical service typically has a chief resident, a physician in the last year of residency who usually runs the day-to-day activities of the service. On medical services the chief resident is usually an appointee of the chair of medicine and primarily has administrative responsibilities often with limited ward duties.

The Attending Physician

The attending physician is also called simply “The Attending,” and on nonsurgical services, “the attending.” (Note: Before we get any more letters—yes, this is a joke!) This physician has completed postgraduate education and has become a member of the teaching faculty. He or she is usually already board-certified in a specialty but may be newly trained and “board eligible.” The attending is morally and legally responsible for the care of all patients whose charts are marked with the attending’s name. All major therapeutic decisions made about the care of these patients are ultimately passed by the attending. In addition, this person is responsible for teaching and evaluating house staff and medical students. You might ask this member of the team, “Why are we treating Mrs. Pavona with busulfan?”

The Fellow

The fellow is a physician who has completed his ...

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