A residency lexicon

Resident, intern, house officer, PGY1...these all seem to mean different things, depending on who you are, where you are, and even when you are. Though there’s some crossover in the definition of these terms, they represent the evolution of medical school postgraduate training over the past 50 years.

Red Hiss

“A year of rotating internship, a hospital-based experience in the major areas of medicine — internal medicine, surgery, pediatrics, ob/gyn and psychiatry — this was the standard and only post-medical school training that physicians had in this country, until the 1940s, when graduate medical education started to become commonplace,” says Roland “Red” Hiss (M.D. 1957, Residency 1964, Fellowship 1966), chair of the Medical School’s Department of Medical Education. “Prior to the 1940s, probably 95 to 97 percent of medical school graduates had one year of hospital-based experience known as internship. In fact, for many years, the licensure in 48 of the 50 states required just one year of postgraduate training. Nobody does only that any more, unless they have unique career plans. There was a period of time for people like me when we graduated from medical school, had an internship, and then had a residency. But by about the mid-1960s to the early 1970s, the freestanding internship was basically dropped. Now, and for the past 25 years at least, medical school graduates go into a residency directly and don’t stop with an internship. They still occasionally call the first-year residents ‘interns,’ almost as a traditional nickname, but there isn’t something called an ‘internship’ that is separate from a residency.”

It is during this residency that doctors are today often referred to as “house officers.” At U-M, the House Officers Association is a bargaining unit, founded in 1973, which represents the interests of the resident doctors.

Residents are also sometimes referred to as “PGY1,” “PGY2”, etc., referring to the first or second “postgraduate year.” It’s also interesting to note that today’s medical students receive far more hands-on training than did their predecessors; increasingly, students in the last two years of medical school are on the floor attending rounds and seeing patients under the watchful eyes of senior residents and attending physicians.

Also:

“One of those awful policies...”

The Residency Years: Then and Now