Interns, residenets, Chief of Staff???

mawhinney, the questions you've asked here are also being discussed in another thread on this forum, where a BCO member wanted to know whether we're being "tricked" into allowing non-doctors to work on us in teaching hospitals.

I'm going to copy-and-paste some of what I posted there about the hierarchy of medical training in the U.S. I've also edited and added some stuff, to make it more relevant to your post:

As lovetosail said, an "intern" is the title used for someone in his or her first year of postgraduate training.  An intern has completed medical school (so he/she is an "M.D."), passed the national board exams, and obtained a license to practice medicine.  The term "intern" was once the standard title for a first-year graduate of medical school.  That was when the internship was a separate year of general training, distinct from the specialized training of a residency.  Nowdays, though, most postgraduate training programs use the term "first-year resident" instead of intern, because the postgraduate training of a medical school graduate is continuous. 

Residents, whether newly graduated "first-year residents" or experienced "chief residents" (or "senior residents"), can legally and ethically introduce themselves as doctors, and examine and treat us.  Residents are working toward "board certification" in a medical specialty area.  To obtain board certification, a resident must complete from 3 to 5 years of supervised, in-hospital training in a particular field, such as general surgery, internal medicine, family practice, anesthesiology, psychiatry, etc.  These days, nearly all M.D.'s complete some sort of residency program before they begin practicing medicine on their own.

A few residency programs still require medical school graduates to complete a year of general training before they can begin the 3- to 5-year residency program.  And, some residency programs in highly specialized fields or multidisciplinary areas last as long as 7 years.  After completion of the residency program, the resident must pass a "board exam," and possibly meet other requirements, to obtain board certification and work independently.  Here's information about residency programs in the U.S.:  http://www.nrmp.org/res_match/about_res/index.html. 

After successfully completing a residency and becoming board-certified in a particular field of practice, a physician might want to focus even further in a subspecialty by doing a "fellowship".  Thus, "fellows" are a level above the highest-level residents.  Fellowships require from 1 to 3 years of supervised training under the true "experts" in a field of medicine, generally at a nationally-known teaching hospital. 

Collectively, the residents on duty in a hospital are called the "house staff" (http://medical-dictionary.thefreedictionary.com/house+staff).  The house staff are under the direct, day-to-day supervision of the "Chief Resident," who is the top-ranking (senior) resident in the training program.  The highest-ranking physician overall in a specialty area of a hospital is the "attending physician" (or "consulting physician").  The "attending" has completed residency training and is board-certified in the specialty area.

I think, but am not certain, that the "Chief of Staff" is the head of all the personnel assigned to work in a specialty area of the hospital, or perhaps the hospital as a whole. This Wikipedia page explains some of the titles and terminology:  http://en.wikipedia.org/wiki/Residency_(medicine)

I suppose it's possible to avoid all contact with fellows, residents, and medical students, by insisting that only the "attending physician" will be allowed to examine or treat you.

otter