What's the difference between an Intern and a Resident????

[Guest triumph]

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[Guest PerfectMoment]

intern is a largely american term if i recall correctly. interns are first year residents, while residents are, well, residents. though i may be wrong!

[Guest Jochi1543]

Yeah, intern is a US-only thing, first year after graduating meds.

[Guest UWOMED2005]

Actually, I think most of the world has MD/MBBCH grads do a one year internship after med school.

 

They then do residency after that.

 

Canada is different. . . we do residency right off the bat. I don't know if any other countries are like that.

[Guest peachy]

I had thought that, at least in the US, intern was just another name for what Canadians call a first-year resident. Is this incorrect? That is, you said that Canada is different in starting residency right away ... is this an actual difference, or just a difference in name?

[Guest moo]

An intern in the US is a first year resident.

 

In Canada, even though you match to a specific residency program, your first year is a rotating internship (usually). This is all semantics. It's like saying someone is a second year university student in Canada versus a sophomore in college in the US.

[Guest marbledust]

In Canada, even though you match to a specific residency program, your first year is a rotating internship (usually).

 

 

My understanding is that the change to scrap the rotating internship year from Canadian programs 10+ years ago was so the actual "residency" training in one's specialty could begin sooner--ie general surgery residents don't have to rotate through psych, internal doesn't have to do surgery, etc. Of course this will vary by school and province. The focus of training is much narrower, generally, than the first year in most US programs.**

 

The rotating internship year is still found in programs like psychiatry. But I don't think it would be correct to say most Canadian programs start with a rotating internship year that is analogous to the US system.

 

**My understanding of this comes from talking to doctors who have trained in both countries and research I did for a paper looking at the benefits and drawbacks of rotating internship years.

[Guest therealcrackers]

Rotating "internship" years are usually in a few specialties... family medicine, radiology, pathology, psychiatry, emergency medicine, anaesthesia, and physiatry are close to rotating internships.

 

I'm a first-year internal medicine resident, and the only non-medicine block I have is a month of emerg. Gen surg types do 1 month of ambulatory medicine and 1 month of emerg, OB does two month of team medicine and a month of emerg, but the rest of those months are in surgical specialties.

 

There is a school of thought in the ministry of health that believes a rotating internship would alleviate the stress of med students having to pick a career path so early in medical school; a rotating internship means not having to nail down your decision until about half-way through that year. A possible compromise is direct entry for some programs (medicine, surgery of all stripes), and everyone else jumps in a melting pot for PGY-1 (post-graduate year-1) and decides over the course of their rotating internship. Crazy?

[Guest noncestvrai]

That's what has been proposed, to bring back the common PGY-1, in Canada. I can see a good thing about that, for those not settled yet. However, I can't imagine that year being equivalent in training if you go into a surgery field vs medicine...

 

noncestvrai

[Guest moo]

Actually in the US, if you match to a categorical medicine (including peds) or surgery program, it is much like Canada. You only rotate through medical or surgical specialties. Transitional year programs are one year stand-alone programs for people who don't know what they want to do or who want to do something like anesthesiology, rads, psych, etc. who need a one year clinical base year before they can do their "residency." This is a rotating internship.Some residency programs have "built-in" first year programs, so that you don't have to do the transitional year. Preliminary programs are one year programs like Medicine or Surgery (where you rotate as if you are a medicine or surgery resident), and people can do these before they go into their residency as well.

[Guest Rome1]

What did you mean by non-medicine block during your internal medicine residency? I thought doing emergency med would fit under the medicine block, maybe I am missing something, could you clarify this for me?

[Guest ploughboy]

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"I finally made it through med school, somehow I made it through

I'm just an intern, I still make a mistake or two.

I was last in my class, barely passed at the Institute

Now I'm trying to avoid, ya I'm trying to avoid, a malpractice suit..."

 

_Like A Surgeon_, "Weird" Al Yankovic

 

 

Hey,

 

I'm not 100% sure how things worked prior to the present system (which I think started in 1993), but I think at the end of your rotating internship you were able to hang out your shingle as a GP, even if you subsequently went on to specialize.

 

I've heard it argued that this could be a real advantage in some situations. For instance - somebody goes into Complicated Surgery, after 10 years burns out due to the crazy workload, comes to his senses and decides to practice family medicine.

 

If I recall correctly, anybody who entered residency prior to 1993 is able to do this immediately - it's just a matter of changing the sign on the office door. However, anybody who graduated after '93 is stuck in their specialty for the rest of their lives, unless they re-enter the match and do a second residency.

 

But what do I know, I don't even start med school for another month...

 

pb

 

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[Guest Ian Wong]

There was a good thread with all sorts of explanations about things, but unfortunately, I think it got nuked a couple months back when EZBoard got hacked.

 

Essentially, once you finish med school, you start post-graduate training. These are numbered in years. Your first year is your PGY-1 year (post-graduate year), your second year is your PGY-2 year, etc. A synonym for this is R for residency ( ie. R1 year, R2 year).

 

In Canada, as soon as you start your post-graduate training, they call you a resident. Therefore, a PGY-1 Radiology person is a first year Radiology resident. A PGY-1 General Surgery person is a first year Gen Surg resident.

 

This is largely independant of the fact that your first PGY-1 year may not have anything to do with your specialty. For example, the PGY-1 Radiology year has little to no time spent in Radiology! Rather, your time is spent on Internal Medicine, General Surgery, Pediatrics, OB/GYN, etc. The PGY-1 Surgery year may have some surgical time in it, but many of the months are spent in things like ICU, Internal Medicine, Emergency Medicine, etc.

 

In Canada, the term intern isn't widely used at all.

 

In the US, an intern is used interchangeably with PGY-1 resident. In the US, there are basically four internship possibilities. The first is a Transitional Internship, which is much like what the traditional rotating internship in Canada was like, with things like Internal Medicine, Pediatrics, OB/GYN, Surgery, etc, and makes you eligible for a state license (although you aren't board eligible in any definable specialty). Many specialties will accept a Transitional Internship as acceptable PGY-1 preparation for entry into the actual PGY-2 specialty program (ie. Radiology, Anesthesiology, Radiation Oncology, Ophthalmology, etc).

 

The other three internships are Medicine, Pediatric, and Surgery internships, which have mainly medicine, pediatric or surgical rotations. Those set you up to continue on in residencies in Internal Medicine, Pediatrics, General Surgery or the surgical subspecialties like Neurosurgery, ENT, Orthopedics, Urology, etc.

 

There is one point of confusion which occurs.

 

In Canada, as mentioned before, as soon as you start post-graduate training, you are considered a first year resident in your eventual specialty.

 

So, in Canadayou can be called a PGY-1 radiology resident, a first year radiology resident, or an R1 radiology resident (even if during your PGY-1 year you actually aren't doing any radiology rotations!)

 

In the US, you aren't considered a first year resident (R-something) in your eventual specialty until you actually START that specialty. Therefore, you aren't an R1 Radiology resident until you are in your PGY-2 year, which is the year where you start your dedicated radiology rotations.

 

So, while you are doing your Transitional Internship in preparation for your Radiology residency, you are a PGY-1 Transitional Intern, an intern, or an R0 radiology resident.

 

In the US, the following year, you are a PGY-2 Radiology resident, a first year resident, or an R1 radiology resident.

 

In Canada, the equivalent individual would be a PGY-2 Radiology resident, a second year resident, or an R2 radiology resident.

 

Most things are semantics, and are confusing. It'll make a lot more sense when you get into the hospital and start decoding the hierarchy firsthand.

 

Ian

[Guest therealcrackers]

To Rome1:

 

at UWO in clerkship, ER comes under surgery, and it fits in its own category... so it's kinda "non-medicine". That's the arbitrary line I drew.