In the medical field, the terms “fellow,” “resident,” and “attending” refer to different levels of training and responsibility among doctors. Parents of hospitalized children will interact with all of these providers and it can be difficult to remember the differences. Our daughter has been in treatment over two years and we still get them confused- especially fellow and resident. We thought it would be helpful to provide a breakdown of their roles and distinctions.
1. Resident
- Role: A resident is a doctor who has graduated from medical school and is undergoing specialized training in a particular field of medicine. This period of training is known as residency, and it typically lasts 3 to 7 years, depending on the specialty.
- Responsibilities: Residents work under the supervision of attending physicians and fellows. They perform various clinical duties, including patient examinations, diagnosing and treating illnesses, and assisting in surgeries. Residents also participate in educational activities such as lectures and conferences.
- Goal: The goal of residency is to provide in-depth, hands-on training in a chosen specialty to prepare the resident for independent practice.
2. Fellow
- Role: A fellow is a doctor who has completed their residency and is undergoing further specialized training in a subspecialty. Fellowship training typically lasts 1 to 3 years.
- Responsibilities: Fellows take on more advanced responsibilities than residents, including performing complex procedures, leading research projects, and teaching residents and medical students. They still work under the supervision of attending physicians but are more independent than residents.
- Goal: The goal of fellowship is to provide advanced, focused training in a subspecialty, enabling the fellow to become an expert in that area.
3. Attending
- Role: An attending physician is a fully licensed, board-certified doctor who has completed all their training, including medical school, residency, and any fellowship if applicable.
- Responsibilities: Attending physicians have full responsibility for patient care. They supervise residents and fellows, make final decisions regarding treatment plans, perform surgeries, and lead medical teams. Attendings also often engage in teaching and research.
- Goal: The goal of an attending physician is to provide the highest level of patient care, lead medical teams, and contribute to the education of future doctors.
Key Differences
- Training Level: Residents are in the midst of their specialized training, fellows have completed residency and are further specializing, and attending physicians have completed all their training.
- Supervision: Residents are closely supervised by attending physicians and fellows. Fellows have more independence but still work under the guidance of attendings. Attendings operate independently and supervise the training of residents and fellows.
- Responsibilities: Residents focus on developing basic and intermediate skills within their specialty, fellows focus on advanced skills within a subspecialty, and attendings are responsible for overall patient care and medical team leadership.
Examples
- Resident: A third-year internal medicine resident managing a patient’s diabetes under the guidance of an attending physician.
- Fellow: A cardiology fellow performing a complex heart procedure with oversight from a cardiology attending.
- Attending: An attending pediatrician leading a team in the pediatric intensive care unit, making final treatment
Understanding these roles helps clarify the hierarchy and flow of patient care within hospitals and medical institutions. Each level of training and responsibility is crucial for the effective delivery of healthcare and the education of future medical professionals.