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Residents, Fellows, Attendings…Oh, My! Who Are All These People and Are They “Real” Doctors?

When your child is in the hospital, the number of doctors who will visit during the day and on rounds can be overwhelming. Who are all of these people? Are they real doctors?

An important saying from medical school is, “You learn to swim in the water, not in the library.” However, we don’t throw students into the “deep end” and see if they drown or not. Medical education is a series of steps with increasing degrees of independence and responsibility.

All of the doctors that you know and trust began their careers in medical school, which is four years long. Most of the first two years is dedicated to university classroom work learning the basics of normal body function, human disease, pharmacology, ethics and so on.

During the third and fourth years of medical school, students rotate through all of the different major areas of medicine, including pediatrics, surgery, obstetrics and gynecology etc. Every medical student spends time with us in pediatrics and works as part of the team, learning the key concepts of child health and development. Students cannot write prescriptions nor work independently. Students then decide which path they will follow among the major disciplines of medicine. After medical school graduation, they get the title “Doctor” and enter residency.

Residents spend a certain number of years as doctors in training. This varies depending on the career they have chosen; pediatrics is three years long, neurosurgery is seven. The first year of residency is also called “Internship.” Interns start working independently, but always under the direction and supervision of senior residents and the attending physician, who is ultimately responsible for all of the care given to the patient. All major decisions are made by the attending.

Many residents will choose further training beyond residency called “Fellowship.” Most fellowships in pediatrics are an additional three years. This is how a doctor becomes a specialist, such as a pediatric pulmonologist or cardiologist. Although fellows have a lot of experience and independence, major decisions are still made by the attending.

Once residency training is complete, it’s time for board exams and to become certified to practice independently. These are the attendings who direct your child’s care and the team who carries out the plan.

Medicine is a team sport and the “learners” on our teams – the students, residents, and fellows – play an important role in your child’s care and you play an important role in their education. It is important they learn the medical facts about your child’s disease, but it is more important that they learn how to communicate with families and children. Their success in medicine is tied to how well they build relationships with patients. In essence, you are the teachers for the next generation of physicians. We thank you, and the patients that came before you, for teaching us how to care for children.

Nationwide Children’s Hospital, like all other major pediatric hospitals, is heavily involved with medical education. This is a core mission of our hospital and doctors, who serve as the pediatric faculty for The Ohio State University School of Medicine.

Garey Noritz, MD
Garey Noritz, MD is an Internist and Pediatrician at Nationwide Children’s Hospital. He is section and division chief of the Complex Health Care Service, which provides a medical home to children and adults with neurodevelopmental disabilities. He is Associate Professor of Pediatrics at The Ohio State University, and the Director of the Comprehensive Cerebral Palsy Program at Nationwide Children’s Hospital.Dr. Noritz is a graduate of Brown University School of Medicine, and a Fellow of the American Academy of Pediatrics and of the American College of Physicians. He is Board Certified in Internal Medicine, Pediatrics, Neurodevelopmental Disabilities, and Hospice and Palliative Medicine. He is active at the national level in advocating for the care of children and adults with disabilities. He is on the Executive Committee of the Council on Children with Disabilities of the American Academy of Pediatrics, and is past Chair of the Lifespan Committee of the American Academy for Cerebral Palsy and Developmental Medicine. In 2013, he was awarded “Physician of the Year” by Nationwide Children’s Hospital. Dr. Noritz’s research interests include bone health in patients with disabilities, transition of children with disabilities to adult models of care, palliative medicine, and the respiratory care of patients with neuromuscular diseases.Dr. Noritz was the lead author of the American Academy of Pediatrics’ 2013 clinical report, “Motor Delays: Early Identification and Evaluation”, which advises Pediatricians to institute screening for motor problems in early childhood

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