Med Student Hierarchy?

xtxrn, ASN, RN · Aug 4, 2011

I am so confused by the tons of med students I see on the unit everyday. What is the hierarchy of med students? Are the all "doctors" now? or not yet? Can they all write orders? Are some of the 3rd or 4th year students leading the lower level students? And does the length of their lab coat mean anything? How much does all of this matter to nurses?

Short lab coat = student; long coat= MD (but may be an intern or resident, or a 'full fledged' MD). Med students are like nursing students in that they can't do anything without instructor supervision- and they can NOT write orders. Most can't do much of anything at first - LOL. Watching med students on peds was a hoot- 20-something guys who have never touched a baby are good for entertainment value when you hand them a 3 month old to hold so you can change the sheets They look like they're going to spontaneously combust !! :)

Med students do have an undergrad degree- but it could be in botany or civil engineering- then they go to med school (another 4 years)... then internship, then residency and specialty training, then attending MD or moves on to private practice/hospital affiliated practice. :eek:

noahsmama · Aug 4, 2011

If they are "students", then no, they are not doctors yet, and they cannot write orders. On the other hand, if they are "residents" (new doctors who are getting additional training), then yes, they are doctors and they can write orders. It's important to know which they are -- at the hospital I used to work at, we had lots of residents, but only occasionally had med students, who mostly seemed to shadow the docs.

Residents always work under an "attending", who is a doctor with more experience (i.e. a doc who has already completed a residency somewhere). Residents have to check at least some of their decisions/orders with their attending. The amount of autonomy given to residents depends in part on how many years they've been a resident -- third year residents have more autonomy than second years, who have more autonomy than first years.

If you're unclear on what residents are allowed to do, and on who's a resident and who's a med student, I recommend asking one of the more experienced nurses, or perhaps one of the residents/students themselves.

And no, as far as I can tell, the length of their lab coat doesn't mean anything. :)

Edited to add: I just noticed xtxrn's response about short vs. long lab coats. That was definitely not true at the facility where I used to work. In fact, residents generally wore scrubs and rarely wore lab coats at all. It mostly seemed to be the med students who wore lab coats, generally long ones though I don't think there were any rules about it. Again, you'll need to ask what the norm is at your facility.

linearthinker, DNP, RN · Aug 4, 2011

The coat length issue is dogma in some institutions and anomalous in others. I have worked in several top teaching hospitals and never heard of it until talking with some med students at SDN. I asked a few physicians I know and they had never heard of either. In some places though, woe betide the person in the wrong length lab coat. It is a social faux pas from which you will never recover, lol.

Med students working with patients have to be at least 3rd year, so they already know a great deal more pathophysiology and pharmocology than most nurses, even if they lack contact experience. There is a lot they can teach you if you give them a chance. I think snickering at their inexperience is ungracious and unbecoming a professional. Not that you would do that, but here are those that do; avoid being associated with those individuals or that behavior. Quite uncouth.

As for who is whom, just ask them. I am sure they would be happy to clarify their role.

AnxiousRNtobe · Aug 4, 2011

I appreciate what you said, linearthinker, we were all beginning students at one time or another and learning is a life-long process. To make fun of someone because we think we know more then they do is highly unprofessional.

xtxrn, ASN, RN · Aug 4, 2011

The coat length issue is dogma in some institutions and anomalous in others. I have worked in several top teaching hospitals and never heard of it until talking with some med students at SDN. I asked a few physicians I know and they had never heard of either. In some places though, woe betide the person in the wrong length lab coat. It is a social faux pas from which you will never recover, lol.
Med students working with patients have to be at least 3rd year, so they already know a great deal more pathophysiology and pharmocology than most nurses, even if they lack contact experience. There is a lot they can teach you if you give them a chance. I think snickering at their inexperience is ungracious and unbecoming a professional. Not that you would do that, but here are those that do; avoid being associated with those individuals or that behavior. Quite uncouth.
As for who is whom, just ask them. I am sure they would be happy to clarify their role.

:uhoh3: Thinking they are amusing isn't the same at laughing at them.... I'm sure most of us had nurses roll their eyes at us when we were students- it's not personal....:)

KaksRN · Aug 4, 2011

By no means am I trying to laugh at them. I just want to know what's going on. From what someone said, I am now led to believe that the ones I see are all residents. So should I refer to the residents as Dr.___?

Altra, BSN, RN · Aug 4, 2011

By no means am I trying to laugh at them. I just want to know what's going on. From what someone said, I am now led to believe that the ones I see are all residents. So should I refer to the residents as Dr.___?

Yes, unless it's the norm at your hospital to be on a first-name bais. This will probably vary from person to person. But the point is ... residents are doctors.

hecallsmeDuchess · Aug 4, 2011

At the hospital I work, the med students wear short lab coats and the interns/residents/attendings wear the long ones. Some of the full docs just wear regular clothes without a lab coat. As for what I call them, I call them Dr. so or so if I have to talk to them but the students I have no clue what to call them. Then again, I don't have to call them anything as I really don't have much interaction with them except when they're asking how a pt is doing so they can write their notes.

netglow, ASN, RN · Aug 4, 2011

How about "Hey Nobody".

-yes I am a troublemaker. j/k

xtxrn, ASN, RN · Aug 4, 2011

How about "Hey Nobody".
-yes I am a troublemaker. j/k

:lol2: :lol2: :lol2: I liked the med students on peds- but bless their hearts, they always looked so terrified :)

psu_213, BSN, RN · Aug 4, 2011

Short lab coat = student; long coat= MD (but may be an intern or resident, or a 'full fledged' MD).

Intern/resident = full fledged MD (not yet an attending). While they may still have a lot to learn, they have put a lot of time and money into earning the title MD.