Resident vs. Attending Physician: What's the Difference?

A resident is someone who has graduated from medical school and is completing a post-graduate training program. An attending physician is a board-certified physician who has completed their residency training. Residents are supervised by attending physicians.

When you receive care from a resident, you are also receiving care from their attending physician. This means you'll benefit from the experience and knowledge of both providers.  

This article discusses what makes an attending and a resident. It also offers a breakdown of the other people that comprise a hospital care team who are either board-certified physicians or those on track to becoming one.

Doctors and Levels of Seniority

To better understand what a resident and an attending physician are, it's helpful to know more about all of levels of physicians and how they compare.

In the United States, the hierarchy of doctors you may encounter in a hospital is as follows:

1. Attending physician: A doctor who has finished post-graduate training
2. Fellow: A doctor who pursues optional additional training before becoming an attending
3. Resident: A doctor who has finished their first year of post-graduate training
4. Intern: Medical school graduates who are first-year residents

In order to become an intern, one must go to medical school and then embark on further training at a teaching hospital.

Attending Physicians

An attending physician is a medical doctor who has completed all residency training. They are board-certified or eligible to practice independently in a particular specialty.

An attending physician typically supervises fellows, residents, and medical students and may also be a professor at an affiliated medical school.  Attending physicians have final responsibility, legally or otherwise, for all patient care—even if the care is given by a subordinate.

An attending physician is considered an expert in their field of medicine or surgery. Attendings are also referred to as staff physicians, supervising physicians, rendering doctors, or simply "attendings."

Depending on the field of medicine, the route from medical student to attending can take seven years or more. Some specialties can take 14 years or more of post-undergraduate studies and training before credentials are fully obtained.

Fellows

A fellow is someone who has completed their residency and elects to pursue further training. A fellowship is optional but is required to practice certain subspecialties.

An example is a general surgeon who wants to pursue a career in pediatric brain (neuro) surgery or heart/lung (cardiothoracic) surgery.

There are fellowships in many fields of medicine, including:

• Internal medicine
• Neurology (nerves)
• Obstetrics/gynecology (female reproductive health)
• Ophthalmology (eyes)
• Orthopedics (muscles/bones/joints)

Interns and Residents

Medical school graduates then enter a residency program in a hospital, clinic, or doctor's office.

The goal of residency—also referred to as a graduate medical education (GME) program—is to continue training in a specialized field of medicine. A medical residency can last anywhere from two to three years for a family doctor to seven or more years for a surgeon.

First-year residents are referred to as interns. After that, they are known as resident doctors, resident physicians, or simply "residents."

Residents provide direct care under the supervision of an attending physician or senior resident.

Residency Specializations

Residents can choose different specialties to train in after graduation. Some potential specialties include:

• Emergency medicine
• General surgery
• Family practice
• Pediatrics
• Anesthesiology
• Diagnostic radiology

Chief Residents

Chief residents are selected to lead a group of residents. They are residents who are elevated to a level that puts them senior to the rest of the residents and junior to the program's management.

The duties of chief residents may vary, but can include patient care; mentoring, training, and advocating for team members; and carrying out some administrative duties.

Chief residents are chosen by hospital leadership during their residency program.

Medical Students

Medical students are those who have obtained a bachelor's degree and have been accepted to medical school after meeting certain requirements, including passing the Medical College Aptitude Test (MCAT).

The first two years of their four-year program is devoted to classroom studies. During the latter two years, time is largely spent in a hospital- or clinic-based setting.

Upon completion of medical school, medical students graduate with either a doctor of medicine (MD) or a doctor of osteopathic medicine (DO) degree.

It is only at this point that they are referred to as physicians, even though their training is not yet complete.

How Can You Tell Who's a Resident vs. an Attending?

You can sometimes tell where a person fits in the hierarchy based on the length of their lab coats. Residents typically wear longer coats, while attending physicians will wear full-length coats.

The shortest white coats, on the other hand, are worn by medical students.

Even so, a lab coat is not an absolute indication of a person's status as other health professionals also wear them, including nurse practitioners and phlebotomists (technicians who draw blood).

Today, many health professionals of all ranks also wear scrubs.

When in doubt, look at a staff member's ID badge or just ask what their role is. It is your right to know who does what and which member of the hospital staff is ultimately in charge.

Summary

People training to be a medical doctor are given different titles as they progress through the ranks. They begin as medical students, then progress to interns, residents, and fellows. Once residency and fellowship trainings are complete, a person can become a board-certified attending physician.

From the time of enrollment in medical school to board certification, it can take anywhere from seven to 14 years (or more) to become an attending physician.