A Med Student’s Guide To Moving Up The Doctor Hierarchy


Wanting to study premed in order to become a doctor someday is a noble gesture given that the profession is dedicated to saving people’s lives. However, graduating as a medical student isn’t as simple as submitting some requirements to receive a degree, like what you probably did in high school. Now, as modern as the field of medicine is, some ‘traditions’ remain to this day. One of those is the hierarchy present within a health care facility.

The Doctor Hierarchy Explained

The term ‘hierarchy’ implies a system organized by level from the higher-ups to those in the lower levels. In the medical field, those levels are divided based on experience; ergo, the higher your ranking, the more time you’ve spent in practice.

For medical students, gaining experience is their means to apply what they’ve learned from their studies and mentors so they can perform better in practical situations. However, similar to what your superiors have accomplished, you have to climb the lower levels first to reach a higher standing in medical facilities someday.

  • Intern


Being an intern could be part of your life as a medical student or as a fresh graduate in your first year of training. You may be considered ‘the grunt’ of the medical team at this stage. But it doesn’t mean that you’re insignificant—your position as an intern is just as important as the rest of your team.

Here, you’re supposed to adjust to the medical professional life outside a school setting and complete tasks assigned to you, such as:

  • Shouldering assignments handed out by doctors
  • Watching over the patients
  • Handling medical procedures (under supervision)
  • Documenting patients

When looking at this overview, you might be wondering whether you’re working toward being a doctor or a nurse. Either way, both jobs can be taxing, so you should know how to balance your health while taking care of others. Despite the exhaustion they bring, there’s no doubt that these tasks will enable you to develop skills that may be crucial in your profession in the long term. Among them are interpersonal skills, which would help you deal with patients in a professional yet caring manner.

  • Resident


Once you’ve passed the internship program and have been awarded a degree, you’re expected to undergo more hands-on training. If you thought being an intern was already rough, taking residency is on a whole other level. This stage takes up most of your checklist to become a doctor.

You’ll still be supervised when performing medical procedures on patients. However, you can also use this time to explore different specializations to grasp other fields and find what suits you the most. Doing so may prolong your period as a residence, but that shouldn’t be an issue as long as you exceed three years post-graduate.

A big problem during this period is the unhealthy lifestyle that many residents tend to have. Because there are instances when you might get called infrequently, you’ll probably start to see the hospital as your second home with the number of times you’ll sleep there in case you’re needed. This is why residents are called as such.

For those who value sleep, don’t worry. Being on call around 24 hours to 28 hours may sound like a nightmare, but it mostly depends on how demanding your specialty is. Exploring different fields at this stage is wise to allow yourself some flexibility.

  • Fellow


After undergoing the grueling stage of being a resident, you’ll reap success as a fellow. Now that you’ve finished training, you have the freedom to study and focus on the subspecialty that has piqued your interest under a doctor who’s much more experienced in it.

Compared to residents or interns, you might find yourself free most of the time from interacting with any patients since you’re specialized. So what you might do most of the time is to write down orders on a patient’s chart or have the power to decide what to do with their treatment plan.

  • Attending Physician

Attending Physician
Surgeon talking to medical interns

Now, stationed above the previous levels is the attending physician. This is the person who used to supervise your work as an intern, a resident, and a fellow. As someone who’s undergone residency training and passed a board examination in their specialty, an attending physician is considered an expert in their specialized field.

Because of this amount of experience, they can perform on their patients independently and be completely responsible for making significant decisions for a person’s treatment. So even if someone from the lower levels applies those decisions, the responsibility would still fall on the attending physician if something terrible happens to the patient.

Moving Up

Many people dream of becoming a doctor in the future. However, because of how vast the medical field is, there are many levels you must overcome prior to achieving that goal. Although you have a long journey ahead of you, knowing which steps you’ll be taking first will help clear your path toward being recognized as a licensed doctor.

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