Terms such as “resident,” “fellow” and “attending” represent a historical role for physicians within the world of medicine. But in recent years, physician assistant and nursing programs have begun using similar terminology, which may be confusing to patients.

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“There is potential confusion for the public in the use of terms describing the training program and level of training that health care professionals enroll in or complete,” says a report whose recommendations were adopted by the House of Delegates (HOD) at the 2022 AMA Annual Meeting in Chicago.

“A standardization and understanding of terms for physicians and nonphysicians will be beneficial to the public and health care professionals,” says the report, from the AMA Council on Medical Education.

To help clarify matters, delegates directed the AMA to:

  • Engage with academic institutions across the nation that develop educational programs for training of nonphysicians in health care careers, and their associated professional organizations, to create alternative, clarifying nomenclature in place of “resident,” “residency,” “fellow,” “fellowship” and “attending” and other related terms to reduce confusion among the public.

The HOD also modified existing policy on protecting the titles of “doctor,” “resident” and “residency” to:

  • Advocate that all health professionals in a clinical health care setting clearly and accurately communicate to patients and relevant others their qualifications, and degree(s) attained, and current training status within their training program.
  • Develop model state legislation for implementation to this effect.
  • Support state legislation that would make it a felony to misrepresent oneself as a physician (MD or DO).

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The amended policy also calls for expanded educational campaigns that:

  • Address the differential education, training and licensure or certification requirements for nonphysician health professionals versus physicians (MD or DO).
  • Provide clarity regarding the role that physicians (MD or DO) play in providing patient care relative to other health professionals as it relates to nomenclature, qualifications, degrees attained and current training status.

Patients deserve care led by physicians—the most highly educated, trained and skilled health professionals. The AMA vigorously defends the practice of medicine against scope-of-practice expansions that may threaten patient safety.

Fighting scope-of-practice creep is a critical component of the AMA Recovery Plan for America’s Physicians. You took care of the nation. It’s time for the nation to take care of you. It’s time to rebuild. And the AMA is ready.

Nonphysicians’ impact on medical education

In another action based on a separate AMA Council on Medical Education report, delegates moved to clarify the role that nonphysicians have in the leadership of organizations involving physician accreditation, certification and credentialing.

“The AMA believes that all qualified health care professionals play an integral role in the delivery—of health care in this country—a role that should be clearly defined by one’s education and training,” says the AMA Council on Medical Education report that was adopted.

“To promote transparency, interprofessional students and trainees may benefit from training on the differences that exist among them in the amount and depth of training as well as supervision and testing of that training,” the council report adds. “Nonphysician roles and seats on a board that provides oversight to physicians should be clearly defined and transparent and these boards should not take actions that inhibit in any way the education, training or practice of physicians.”

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In an effort to increase the transparency the report mentions, the HOD adopted new policy to support:

  • The concept that interprofessional education include a mechanism by which members of interdisciplinary teams learn about, with, and from each other; and that this education include learning about differences in the depth and breadth of their educational backgrounds, experiences and knowledge and the impact these differences may have on patient care.
  • A clear mechanism for medical school and appropriate institutional leaders to intervene when undergraduate and graduate medical education is being adversely impacted by undergraduate, graduate, and postgraduate clinical training programs of non-physicians.

The AMA also will work with key regulatory bodies involved with physician education, accreditation, certification, licensing and credentialing to:

  • Increase transparency of the process by encouraging them to openly disclose how their board is composed and members are selected.
  • Review their conflict of interest and other policies related to nonphysician health care professionals holding formal leadership positions (e.g., board, committee) when that nonphysician professional represents a field that either possesses or seeks to possess the ability to practice without physician supervision.

Read about the other highlights from the 2022 AMA Annual Meeting.

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