Intern Vs. Resident Vs. Fellow [What’s The Difference?]

Have you ever come across the terms: intern vs resident vs fellow, and wondered what the differences are between all of them?

If you’re someone who hasn’t started a rotation or your residency yet… it can get really confusing, especially when there are a lot of semantics in medicine where you are under medical training.

In this post, we delve into the different nuances of each term. In essence, these are titles used for distinguishing different phases in one’s doctoral journey.

Let’s get right into it.

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What Is An Intern?

As an intern, it basically means you are a first year resident.

When you finally go into residency after finishing medical school, you have many different years’ spans. It can be anywhere from three years up to seven years, depending on the specialty that you choose. The first year of your residency is called your intern year.

Why Is It Called An Intern Year?

One reason is that it can help differentiate new medical graduates from experienced professionals who are at least more than a year into their residency.

During your intern year, you may actually be practicing a medicine specialty that’s a bit different from what you ultimately end up doing.

Another reason why you need to distinguish a person in their intern year is that there are specialties like neurology, psychiatry, radiation, oncology, etc. that actually don’t have a full start-to-finish program where you’re practicing that particular specialty from the very beginning.

For example, if you’re going into psychiatry, the way most programs are designed doesn’t have you practicing psychiatry from day one. In fact, it usually recommends you to do an internal medicine year, and that’s called your intern year.

If you’re going into ophthalmology, your first year may be in surgery or in medicine.

If you’re going into dermatology, your first year may likely be in medicine or surgery as well.

And if you’re going into radiation oncology, (Surprise!) your first year may be in surgery or, again, an internal medicine year. It is not going to be in radiation oncology. 

Learning The Basics

It may feel a little counterintuitive to say, “I want to become a neurologist,” and spend your first year as an internal medicine physician. But as trained professionals, you want to make sure that all of your physicians are at least a little bit trained in basic medicine or basic surgery.

While you may not be practicing your surgery field of choice in your first year, you at least start to get all the basics of surgery – skills that you’ll be using in your future career.

It’s the same everywhere else.

If you’re a neurologist and may not be practicing every single style of medicine as one, it’s still important to know basic medicine so that when you take care of patients with strokes, Parkinson’s, and Alzheimer’s, that medicine knowledge starts to apply for you there. 

And that is why we call them interns.

For one, it helps us indicate that they’re a first year doctor, and two, it also tells us that they may be in a field that’s not directly related to the field that they’re doing later on.

Preliminary

What about first year physicians who go into their intended medicinal field right from year one vs. those that intend to delve into a different field years later?

To help differentiate between the two, we use the term prelim or preliminary for the latter – e.g. a person who’s doing a preliminary year in internal medicine and will be going into dermatology is called a prelim going into terms.

What Is A Resident?

So that moves us to the second part of this post, which basically answers: What in the world is a resident?

Now thankfully, this one’s a little simpler. At the root of it all, being a resident basically means that you are anything that’s not an intern.

So, if you have a seven-year neurosurgery residency, on that first year you’d be called the intern doctor, and every year forward, you’d be called a neurosurgery resident.

Not only does it distinguish you from being an intern or a brand new doctor, but it also gives you the ability to supervise those brand new baby doctors.

There will be doctors that haven’t done a specific rotation or have certain questions that you may know the answers to, so you can be the source of their guidance or knowledge, and engage.

Basically, from your second year of residency up to the graduation of whichever residency you’re doing, you are going to be considered a resident.

What Is A Fellow?

And that moves us to the final part of this post which is: What in the world is a fellow?

In this situation, your fellow can actually be both male or female, and this usually happens after residency.

Basically, some people prefer to do additional training after completing their residency period.

As an example, you could want to go into a very specific field after internal medicine residency.

You could either think:

• I only want to work with cancer patients.
• I only want to work with really sick patients in ICU.
• I only want to work with cardiovascular or become a cardiologist.

Those specific fields will require a bit more training than what you have now.

Let’s say you want to go into a cardiology fellowship. That would be an extra three years after residency.

During those three years, you wouldn’t be called an intern. Nor will you be called a resident. Instead you’re called a fellow.

You’re a first year cardiology fellow, then a second year cardiology fellow, and finally a third year cardiology fellow. Essentially, every step along the way from that point on, you’re going to be a fellow.

Admittedly, there are some people who do multiple fellowships and stack them.

You may do a cardiology fellowship and find yourself wanting to do procedures where you’re placing stents in people. You’d probably want to be an interventional cardiologist then, making you an interventional cardiology fellow.

Basically, the term fellow just means that you’re beyond your residency. You’ve done all the basic training to be a medicine doctor or a surgeon, but you’re doing even more training for a specific kind of element in your respective specialty.

Key Takeaways

An intern is a first year doctor.

A resident is anything from the second year of residency all the way up to your graduation in residency.

A fellow is anything that requires an extra fellowship.

This will continue with you until you are officially in attending, which means that you are no longer in training. You have a full time job as an independent physician, and there’s nobody who’s technically supervising you anymore.

These are all the immediate terms you will need to know as a medical student, somebody interested in medicine, or somebody in residency.

So, hopefully this post was able to give you clarity on: Intern vs resident vs fellow.

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I hope you enjoyed this post about the differences between intern, resident, and fellow. If you did, I suggest you go check out these posts below:

• 37 Types Of Careers In Medicine
• What It’s Like Being A New Doctor In Residency
• How Long Is Residency For Each Specialty? [Full Breakdown]
• What Is Medical Residency Really Like (A Resident’s Perspective)
• Residency Personal Statement [Ultimate Guide]
• Medical Specialty Stereotypes [Fact Or Fiction?]
• How To Get Into AOA In Medical School

Until the next one my friend…