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A health problem may require that you be admitted to a hospital. Here you will be seen by the physician on call (available). At hospitals with teaching programs, the doctor on call usually will be a physician in training called a resident (see below). This person will evaluate you for tests, procedures, and consultations that you might require. Occasionally, the person who evaluates you will be a nonphysician professional, usually a physician assistant or a clinical nurse practitioner (see below). On occasions when you must be admitted to a hospital where your regular doctor does not make hospital rounds (a bedside visit to assess your progress with regard to diagnosis, treatment, and recovery), you will be assigned another physician who will act as the attending physician, taking ultimate responsibility for your care while you are admitted. During any hospital admission, your care may be shared by several members of a team. The September 10, 2008, issue of JAMA is a theme issue devoted to medical education. It includes an article about the workload of medical interns (see below) on call as it relates to how many hours they are allowed to work. To help maintain quality of patient care, there are restrictions on the number of hours physicians in training can work.
Getting to know who's on call
An intern is a first-year resident. Interns have completed the required 4 years of medical school.
A resident is a physician training in a specialty training program that may last from 3 to 5 years.
A fellow is a physician in subspecialty training who has completed residency training in a specialty (such as internal medicine) and is training in a subspecialty (such as cardiology or gastroenterology).
A physician assistant is a health care professional who has trained in a certified program to perform certain tasks that would otherwise be performed by a physician. These include taking a medical history and performing a complete physical examination, as well as ordering tests and, in some cases, assisting in surgery. These tasks are done under the supervision of a licensed physician.
A clinical nurse practitioner is a registered nurse who has advanced education and clinical training. Clinical nurse practitioners are trained to evaluate, diagnose, and treat patients. Depending on the state where licensed, some may work independently, while others may be required to work under the supervision of a licensed physician.
The attending physician is your regular physician or one who represents your physician's practice. In some instances, the attending physician may be an employee of the hospital or another physician group. Attending physicians have completed all training in their chosen specialty or subspecialty.
For more information
Association of American Medical Collegeshttp://www.aamc.org
American Board of Medical Specialtieshttp://www.abms.org
To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English, Spanish, and French. A Patient Page on your doctor's education was published in the September 6, 2000, issue, and one on medical specialties was published in the September 5, 2007, issue.
Sources: Association of American Medical Colleges, American Board of Medical Specialties
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: MEDICAL EDUCATION
Hildreth CJ, Lynm C, Glass RM. On Call. JAMA. 2008;300(10):1262. doi:10.1001/jama.300.10.1262
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