A medical intern, in the context of medical education in the United States, is a historical term for a physician in training who has completed medical school, passed step two of the USMLE or COMLEX-USA, and is undergoing his or her first year of post-graduate training (PGY1). An intern in the medical field has an M.D. or D.O. degree, but does not have a full license to practice medicine unsupervised in the U.S. In other countries medical education generally ends with a period of practical training similar to internship, but the way the overall program of academic and practical medical training is structured differs in each case, as does the terminology used (see medical education and medical school for further details). Interns have a reputation of being hazed and mentally harassed by senior residents, veteran nurses, and attending physicians as part of their "trial by fire" training. This often may involve verbal and emotional abuse, sleep deprivation, overwork and excessive scut work and other forms of intimidation in the name of "medical training". There may also be unethical economic reasons for the overwork of interns and junior interns.
A medical internship typically lasts one year (a loose term) and usually begins in late June. Internships come in two variations, transitional and specialty track. After a physician has completed an internship and step three of the USMLE or COMLEX-USA, he or she can practice general medicine. However, the majority of physicians complete a specialty track medical residency over two to seven years, depending on the specialty. The Accreditation Council for Graduate Medical Education (ACGME) no longer uses the term intern, but refers to all postgraduate physicians in training as residents. However, the American Osteopathic Association (AOA) continues to require osteopathic physicians (D.O.'s) to complete an internship before residency.
Transitional and Prelim
Some residencies start at the second year (PGY-2), including Anesthesia, Radiology, Physical medicine and rehabilitation, and Neurology. There are two kinds of internships outside the context of a "categorical" residency:
- "Prelim" internships are done in either internal medicine or surgery. Interns spend 12 months focusing on either internal medicine or surgery.
- "Transitional internships" or "traditional rotating internships," offer a schedule that rotates through all the major specialties, including emergency medicine, family practice, internal medicine, obstetrics/gynecology, pediatrics, and surgery.
Some applicants prefer transitional year programs because they generally aren't as strenuous as a prelim year. However, a prelim year can provide better preparation for the second year of residency.
A first year (PGY1) resident in a specialty residency is sometimes also referred to as a specialty track intern. For example, a first year resident in surgery can be referred to as a surgical intern.
The British equivalent of an intern is a Foundation House Officer. Although, the title of Foundation Doctor is being encouraged to be in hospitals.
In Australia, medical graduates must work for one year in an accredited hospital post prior to receiving full registration; this year of conditional registration is known the intern year.
The equivalent to an internship is the allmäntjänstgöring ("general practice"), which is requirement for obtaining a medical license. It's duration is 18 months at the least, but usually lasts a bit longer, around 2 years in most cases. After the allmäntjänstgöring, the student can complete a test to receive their medical license. Then follows specialization practice ("specialisttjänstgöring"), the equivalent of residency.
In popular culture
In the first three seasons of the popular television drama Grey's Anatomy, many of the main characters were surgical interns at Seattle Grace Hospital, where the series takes place. Beginning in season four, all but one, George O'Malley, became residents.
In the first season of the TV series Scrubs, J.D. and Elliot Reid are medical interns, and Christopher Turk and The Todd are surgical interns.
- ACGME.org (pdf) - Accreditation Council for Graduate Medical Education Glossary
- Man.ac.uk - 'A Doctor's Life: A personal (and probably biased) guide to how doctors in the UK are trained and work within the structure of the National Health Service' (last updated February 2002)