Medical Jargon Demystified II: Pecking Order

Something that I have always found incredibly confusing until I became a part of this structure myself was the hierarchy of medical education. I thought it may be useful to just clarify who is who and how far along in their educational journey in a post.

• Attending (This person is definitely a doctor, they are what we usually think of when we say doctor. Undergrad + Med School + Residency (depending on the field, fellowship))
• Resident (All of these people are technically doctors, they have an MD or DO after their name)
• PGY (INSERT #) (post graduate year) depending on how long their residency training program is this could be PGY 1 - 10)
• PGY 1 (these guys are the interns, they are the lowest of the low in the MD totem pole.  They are first years that were medical students between 2 and 10 months ago and act fairly clueless for the better portion of the year)
• Medical Student (These people are not doctors yet, they DO NOT have MD or DO after their name)
• M4 (4th year student, operates at a similar level to a PGY1)
• M3 (3rd year medical student, fairly clueless but depending on how far along in their 3rd year are closer in performance to an M4)
• M2 (2nd year medical student.  Still in the didactic learning years with minimal clinical exposure, have net to no idea what they're doing)
• M1 (1st year medical student.  In their first year of didactic learning, little to no clinical exposure, has absolutely no idea what is happening ever)

I hope that little snippet helps give a better understanding of what all these weird letters and titles really mean. 

Medical Jargon Demystified I: Wait, I'm still an Undergrad?

I thought it was high time I wrote a post clarifying some of the terminology associated with medical school and generally about the timeline.  This may be quite obvious to many of you out there but I myself was a little bit confused by all of this jargon before I was thrown into the thick of it.

First lets take a look at the timeline from high school onwards down the path of physician-hood

1. Complete high school (4 yrs)
2. Complete bachelor's degree aka undergrad (3-4 years)
3. Complete medical school (4 years) (complete, HA . . . oh don't we all wish it was that simple) there are some added nuances here of allopathic (MD) vs. osteopathic (DO) as well as foreign grads (including some MBBS) but that is a story for another day
4. Complete a residency training program (3+)
5. OPTIONAL: Complete a fellowship training Program (1+)
6. Become a practicing physician aka be an attending (FOREVA+)

Disclaimer: this is really a barebones look at how this breaks down for some people sometimes.  All of these steps do have to be completed, in this order but not necessarily in one fell swoop straight out of high school.  Many people insert alternate careers between steps 2 and 3, some choose to travel the world, others peace out for a little bit DURING STEP 3 (not to be confused with the USMLE Step 3, but again, another day another story).  Some follow the "traditional" route outlines above while others still opt for guaranteed admissions programs that couple college + medical school into a 7 (sometimes 6) year program. 

The nomenclature that I found the most confusing was that medical school which in my mind is professional school maybe loosely referred to as graduate school is called undergraduate medical education.  I thought to myself, "are they serious? I just finished undergrad, this makes zero sense to me."  This all started to make sense when I began hearing people refer to residency training programs as graduate medical education.  

Moral of the story: in med school you're the bottom of the food chain, again. 

In any case at the completion of medical school although you may have your professional title of Doctor there is still some board exam/licensing examinations and residency training that needs to be completed before you are able to practice independently.  

I hope that this post was able to clarify some of the confusion associated with this process.  Keep an eye out for more posts aimed at simplying and clarifying this journey that often feels shrouded in mystery. 

If you have any specifics or other questions feel free to comment below or e-mail at WaitingForMD15@gmail.com