Do residents deserve the title of physician?


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Jul 06, 2023

Do residents deserve the title of physician?

I was unsettled by an email that our graduate medical education (GME) office

I was unsettled by an email that our graduate medical education (GME) office recently sent out to all residents at my institution "sharing a friendly reminder that parking spaces identified as ‘physician parking’ are for attending physicians only" and "residents and fellows who park in ‘physician parking spaces’ will receive a parking ticket." I have parked next to only non-physician (including non-resident physician) staff in those spaces every day for four years. The entire hospital's staff parks in the "physician parking," but this week, residents are not worthy of physician parking and are the target to ban from the labeled spaces.

I understand that a resident is a physician in training.

I understand that a resident is practicing under a physician educational limited license and under the supervision of an attending physician. But our license refers to us as a physician.

A resident, by definition, is a physician who has graduated from medical school and holds a medical degree- usually MD or DO in the U.S. Early on in residency, we have passed the multistep United States Medical Licensing Examination, a 3-step examination for medical licensure in the U.S. sponsored by the Federation of State Medical Boards and National Board of Medical Examiners (MD physicians). DO physicians pass an equivalent multistep examination.

This unsuspecting email made me think. Our institutional GME office definitely does not believe that residents qualify as physicians. Are residents only considered physicians simply when it is convenient? Our institution does not treat residents as physicians through its actions. We are banned from physician dining areas.

Last year, there was a significant movement to ban residents from our physician lounges and workspaces next to the operating rooms — meaning that we are not allowed to wait near the operating rooms for cases. As an aside, we also are not privy to the physician-only notifications that a patient is being taken back to the operating room.

Now we are banned from physician parking. Resident physicians certainly are not paid as physicians. According to ZipRecruiter, the average resident physician in my state makes $53,000 and, nationally, makes $65,000. When you divide $53,000 by 49 weeks in a year (3 weeks of vacation) and an 80-hour work week, residents make about $13.50 per hour. That is lower than the minimum wage in some states.

Although we are not treated as physicians, I can tell you all how residents are physicians. We are physicians when an abscess needs to be drained in the emergency room at 3 a.m. We are physicians when a chest tube needs to be placed emergently. We are physicians when a patient needs emergency dialysis access. We are physicians when a patient needs a gastric tube or a difficult foley catheter. We are physicians when any patient in the hospital needs a narcotic for pain at any time of the day or night. We are physicians when our institution does not want to pay for any additional coverage for any multitude of tasks that need doing: COVID-19 swabs, difficult IV access, or any kind of note in the computer for billing. We are physicians who diagnose and manage small bowel obstructions, appendicitis, diverticulitis, blunt trauma, brain bleeds, septic shock, etc., overnight without direct supervision.

We stay up all night as the physician who checks on their patients countless times to ensure IV bags are running, blood is delivered from the blood bank, labs are sent, and medications are started. We are the physician who is in-house. We are the eyes, the ears, the sweat, and the brains of the hospital most hours of the day. We adjust ventilators, vasopressors, and ECMO. We resolve tension pneumothoraces and urinary retention. This all happens while attending physicians do not have to get into their cars and do not have to use a parking space.

I understand that resident physicians are physicians in training. We cannot do everything, and we still require supervision. But we work hard. We save lives. We work the most hours out of any staff at the hospital. We don't get paid enough. I believe we deserve enough respect to be called and treated as physicians. For the last four years, after I worked my 24 to 28-hour shift every 2 to 6 days, I returned to the same parking space on autopilot. I know that my car will be there to get me home. Today I am pleading with the GME, who is supposed to advocate for positive training program policies, to please not take this away from me.

The author is an anonymous physician.

Tagged as: Residency

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