Table of ContentsView AllTable of ContentsLevels of SeniorityAttending PhysiciansResident PhysiciansIdentifying Who’s Who
Table of ContentsView All
View All
Table of Contents
Levels of Seniority
Attending Physicians
Resident Physicians
Identifying Who’s Who
Attending and resident physicians both have medical degrees, but there are differences in the extent of their training and ability to provide care independently.
Levels of Doctor Seniority
Upon completion of four years of medical school, medical students graduate with either aDoctor of Medicine (MD)or aDoctor of Osteopathic Medicine (DO)degree. At this point, they are referred to as physicians, even though they must embark on further training as an intern at a teaching hospital.
In the United States, the hierarchy of doctors (from lowest to highest level of seniority) is as follows:
An attending physician is a medical doctor who has completed all residency training. Attending physicians are also called staff physicians, supervising physicians, or simply “attendings.” Not all doctors become attendings, as some take different career paths or do not complete their training.
Attending physicians areboard-certifiedand/or eligible to practice independently in aparticular specialty.They are considered experts in their particular field of medicine or surgery. Depending on the field of medicine, the route from medical student to attending can take seven years or more.
An attending physician typically supervises fellows, residents, and medical students and may also be a professor at an affiliated medical school. Attending physicians have final responsibility for all patient care—even if a subordinate provides the care. (They may or may not have legal liability, depending on the circumstances.)
Why Are Physicians Called Attendings?The term “attending” may have originated from the fact that physicians are associated with a specific hospital—like a student “attending” a certain school—or the idea that they “attend” rounds (daily visits to each patient under a medical team’s care).
Why Are Physicians Called Attendings?
The term “attending” may have originated from the fact that physicians are associated with a specific hospital—like a student “attending” a certain school—or the idea that they “attend” rounds (daily visits to each patient under a medical team’s care).
Medical school graduates enter a residency program in a hospital or clinic.The goal of residency—also referred to as a graduate medical education (GME) program—is to continue training in a specialized field of medicine. A medical residency can last three to four years for a family doctor and seven or more years for a surgeon.
First-year residents are referred to as interns. After that, they are known as resident doctors, resident physicians, or simply “residents.” These physicians provide direct care under the supervision of an attending physician or senior resident.
Can Residents Prescribe Medication?Residents are generally restricted to writing prescriptions for only those under their care as part of their training. The American Medical Association notes legal cases, dating back decades, that establish residents' ability to prescribe drugs.Residents practice medicine under supervision on a restricted basis (unlike fellows) and cannot prescribe drugs outside the scope of their clinical rotations.
Can Residents Prescribe Medication?
Residents are generally restricted to writing prescriptions for only those under their care as part of their training. The American Medical Association notes legal cases, dating back decades, that establish residents' ability to prescribe drugs.Residents practice medicine under supervision on a restricted basis (unlike fellows) and cannot prescribe drugs outside the scope of their clinical rotations.
Residency Specializations
Residents can choose different specialties to train in after graduation. These include:
Chief Residents
The duties of chief residents may vary but can include patient care; mentoring, training, and advocating for team members; and carrying out some administrative duties.
Attending vs. Resident
Provides direct care to patients without supervision
No limits on services they are able to deliver
ResidentCan provide direct care to patients with supervision and guidance of an attendingAllowed to do more as they gain experienceDoes not hold ultimate responsibility for care provided
Can provide direct care to patients with supervision and guidance of an attending
Allowed to do more as they gain experience
Does not hold ultimate responsibility for care provided
How Can You Tell Who’s a Resident vs. an Attending?
You can sometimes tell where a physician fits in the hierarchy based on the length of their lab coat. Medical students wear the shortest white coats; residents typically wear longer ones; and attending physicians wear full-length coats.However,nurse practitionersandphlebotomists(technicians who draw blood) may also wear lab coats. In addition, many health professionals of all ranks now wear scrubs.
The best way to tell who is a resident versus an attending physician is to look at a staff member’s ID badge or ask what their role is. It is your right to know each person’s role and which member of a hospital staff is ultimately in charge.
Summary
People training to become medical doctors are given different titles as they progress through training. These titles denote their level of experience as well as their ability to provide care without supervision.
After medical students graduate, they become interns and then progress to residents and fellows. Attending doctors are the highest in level of seniority. They are fully licensed and can practice independently.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Medical Association.What is residency?U.S. Bureau of Labor Statistics.How to become a physician or surgeon.American University of Antigua College of Medicine.Resident vs Attending: Key Differences.National Cancer Institute at the National Institutes of Health.Definition of attending physician.Roten C, Baumgartner C, Mosimann S, et al.Challenges in the transition from resident to attending physician in general internal medicine: a multicenter qualitative study.BMC Med Educ. 2022;22(1):336. doi:10.1186/s12909-022-03400-zAmerican Medical Association.Medical specialty choice: should residency training length matter?American Medical Association Journal of Ethics.When are residents treated as doctors under the law?University of Nevada, Reno, School of Medicine.Resident prescription writing/medical treatment policy.University of Nevada, Reno, School of Medicine.Administrative chief resident position.Association of American Medical Colleges.The white coat: symbol of professionalism or hierarchical elitism?
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Medical Association.What is residency?U.S. Bureau of Labor Statistics.How to become a physician or surgeon.American University of Antigua College of Medicine.Resident vs Attending: Key Differences.National Cancer Institute at the National Institutes of Health.Definition of attending physician.Roten C, Baumgartner C, Mosimann S, et al.Challenges in the transition from resident to attending physician in general internal medicine: a multicenter qualitative study.BMC Med Educ. 2022;22(1):336. doi:10.1186/s12909-022-03400-zAmerican Medical Association.Medical specialty choice: should residency training length matter?American Medical Association Journal of Ethics.When are residents treated as doctors under the law?University of Nevada, Reno, School of Medicine.Resident prescription writing/medical treatment policy.University of Nevada, Reno, School of Medicine.Administrative chief resident position.Association of American Medical Colleges.The white coat: symbol of professionalism or hierarchical elitism?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Medical Association.What is residency?U.S. Bureau of Labor Statistics.How to become a physician or surgeon.American University of Antigua College of Medicine.Resident vs Attending: Key Differences.National Cancer Institute at the National Institutes of Health.Definition of attending physician.Roten C, Baumgartner C, Mosimann S, et al.Challenges in the transition from resident to attending physician in general internal medicine: a multicenter qualitative study.BMC Med Educ. 2022;22(1):336. doi:10.1186/s12909-022-03400-zAmerican Medical Association.Medical specialty choice: should residency training length matter?American Medical Association Journal of Ethics.When are residents treated as doctors under the law?University of Nevada, Reno, School of Medicine.Resident prescription writing/medical treatment policy.University of Nevada, Reno, School of Medicine.Administrative chief resident position.Association of American Medical Colleges.The white coat: symbol of professionalism or hierarchical elitism?
American Medical Association.What is residency?
U.S. Bureau of Labor Statistics.How to become a physician or surgeon.
American University of Antigua College of Medicine.Resident vs Attending: Key Differences.
National Cancer Institute at the National Institutes of Health.Definition of attending physician.
Roten C, Baumgartner C, Mosimann S, et al.Challenges in the transition from resident to attending physician in general internal medicine: a multicenter qualitative study.BMC Med Educ. 2022;22(1):336. doi:10.1186/s12909-022-03400-z
American Medical Association.Medical specialty choice: should residency training length matter?
American Medical Association Journal of Ethics.When are residents treated as doctors under the law?
University of Nevada, Reno, School of Medicine.Resident prescription writing/medical treatment policy.
University of Nevada, Reno, School of Medicine.Administrative chief resident position.
Association of American Medical Colleges.The white coat: symbol of professionalism or hierarchical elitism?
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