timetoshine

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Let's say a resident introduces himself to a patient, could he call himself a "psychiatrist" or would he have to say "psychiatry resident"? Does one have to complete residency and take boards before being able to use that title?
 

nitemagi

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Depends on who you ask. Most patients don't make a distinction. Only some psychiatrists care.

The middle ground is "I'm doctor X, from psychiatry."
 

shan564

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For inpatients/consults, I usually say "My name is Firstname Lastname and I'm the psychiatry doctor" or something along those lines.

For outpatients, I usually say "My name is Firstname Lastname and I'll be your doctor," since they already know that they're at the psychiatry clinic.

When I arrive and the patient specifically asks something like "Are you the psychiatrist?," I'll usually say "yes." If it's a situation in which an attending will also be seeing the patient, I'll clarify that I'm the junior doctor or the resident doctor from psychiatry (or something like that, depending on what I think the patient will understand best) and that the senior psychiatrist will also be by later. If it's a situation in which the attending won't be seeing the patient, I usually won't bog down the conversation by trying to explain how the system works unless they specifically ask.

It's rare that I'll refer to myself as a "psychiatrist" spontaneously.
 

Ceke2002

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At the CMHC, I used to attend, the Doctor who did my intake assessment introduced himself as 'Hi, I'm Dr Surname, I'm one of the registrars here' - indicating pre-Fellowship training. When I started seeing my Psychiatrist, from memory he introduced himself as 'Hi, I'm 'First Name, Last Name', I'm one of the Psychiatrists here' (or something like that).
 

MacDonaldTriad

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There has been a push to pass legislation to not allow unlicensed MDs to call themselves “doctor”. The irony is that a PhD, PharmD, PsyD, can call themselves doctor, but an MD cannot.
 

splik

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Let's say a resident introduces himself to a patient, could he call himself a "psychiatrist" or would he have to say "psychiatry resident"? Does one have to complete residency and take boards before being able to use that title?
psychiatry residents are allowed to call themselves psychiatrists. you certainly do not meet to be board certified to call yourself a psychiatrist. many psychiatrists are not board certified include people who do a lot of expert witness work.

at the same time, institutional policies and good practice say you should identify your exact role

I will typically identify myself as the resident psychiatrist during the day, and the psychiatrist on duty when on-call.

sometimes however it is best not to be a psychiatrist. i have pretended to be a cardiologist once as the patient wouldn't have seen me if i told her I was a psychiatrist. I did not tell her I was a cardiologist, she assumed and I said "let's talk about your heart!" and reviewed her EKG.

sometimes I will say "I'm a specialist and your doctor has asked me to see you to offer some additional advice" if I know the pt is averse to seeing psychiatry but they have a psychotic/cognitive disorder
 
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There has been a push to pass legislation to not allow unlicensed MDs to call themselves “doctor”. The irony is that a PhD, PharmD, PsyD, can call themselves doctor, but an MD cannot.
That would be stupid legislation. Many of my patients call their NPs doctor for goodness sakes. For us, the protected title that is dependent on the license is psychologist. Once I got my doctorate, then I could call myself doctor and even better I no longer had to correct patients and staff all the darn time. What a nightmare to be a doctor with an MD degree and have to try to explain that you are not a doctor even though the initials say that you are. Ugh.
 

NickNaylor

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On my first rotation (psych ER) I was introduced by my attending as one of the "psychiatrists" that will be taking care of them. I typically don't introduce myself as a psychiatrist but, instead, as "one of the doctors taking care of you" (inpatient primary team) or "the resident on call" (when on night float). We have the nifty "title tags" on our badges which indicate that we're "resident physicians," so there isn't much confusion about using the term resident with patients.
 

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Little off topic, but something I always wondered.

If you polled the general population, with the free response question "What is a psychiatry resident?"

Would more people respond correctly or would they think that it is a patient living in a psych hospital?

I know personally before looking into medicine I never got care in an academics setting, so I thought you went to medschool, were an intern and then done. I guess maybe scrubs and grays anatomy have raised awareness of the existence of residents.
 

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Just as long as you don't introduce the medical students as "Doctor", "Student Doctor," whatever.

That one really strikes me as unethical, despite the fact that it's used all the time. You're straight up lying to the patient about the student's role (or lack there of) in their care. The exact title of a resident has a little more gray area.

For the record, I always described myself as a resident when I was in training. "Senior Resident" when I felt like I knew what I was doing.
 

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There has been a push to pass legislation to not allow unlicensed MDs to call themselves “doctor”. The irony is that a PhD, PharmD, PsyD, can call themselves doctor, but an MD cannot.
Seriously! Most trainees are licensed, though, right, at least with a training license -- at least that's how it works in my state.

About introducing yourself as a resident, I realized when I described myself as the resident on the team, patients had no idea what that was. To patients, interns, residents and students are all kind of the same. No one understands our training structure but us. As an aside, most people I talked to think I've been in school for all these years of residency. At family gatherings, I frequently get asked "how's school going?" Makes me want to punch people, but that's OK. I started to gravitate toward just introducing myself as Dr. X from the psychiatry team or whatever team I was from. I didn't actually start referring to myself as a psychiatrist professionally until I was done with residency.
 

splik

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Just as long as you don't introduce the medical students as "Doctor", "Student Doctor," whatever.
what is wrong with student doctor? That is the name of this website after all. It's alot more clear than medical student. many people don't know what a medical student is. I always call them student doctors in front of patients.
 

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There has been a push to pass legislation to not allow unlicensed MDs to call themselves “doctor”. The irony is that a PhD, PharmD, PsyD, can call themselves doctor, but an MD cannot.
I go by "Doc". And not in a, little kid in shining, kind of way either.
 

NickNaylor

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what is wrong with student doctor? That is the name of this website after all. It's alot more clear than medical student. many people don't know what a medical student is. I always call them student doctors in front of patients.
I do the same. It's a bit of a cumbersome title but it gets the point across.
 

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what is wrong with student doctor? That is the name of this website after all. It's alot more clear than medical student. many people don't know what a medical student is. I always call them student doctors in front of patients.
Ask a layperson to describe the role of a "student doctor" and they nearly always describe that of a resident. The term "doctor" even with qualifiers implies responsibilities and privileges that students simply don't have (and for good reasons too).
 

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Someone suggested to me today that I should identify myself to collateral as an "acting intern" on our team. The fact that literally nobody outside of medicine would have the faintest idea what this really means did not seem to trouble them.
 

NickNaylor

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Ask a layperson to describe the role of a "student doctor" and they nearly always describe that of a resident. The term "doctor" even with qualifiers implies responsibilities and privileges that students simply don't have (and for good reasons too).
Personally I think the more opportunities students have to exercise those "responsibilities and privileges" the better. It's not as if students are going to be writing prescriptions, putting in orders, etc.. In a way it's just for show, but I think that can be beneficial for students who might take more ownership in their patients and grow more comfortable in the role of being a doctor (which 99.99% of them will soon find themselves in).

During clerkships, I would describe myself as "a member of the team" and allow the white coat, stethoscope, and other equipment allow patients to infer what they wanted about my role. I think it helped remove some of the hesitation of talking with a medical student and helped built rapport while still not allowing anything of consequence to be done as a result - i.e., I would still need to talk with residents/attendings, etc.. This was doubly true on my sub-I when I was effectively functioning as a resident sans putting in orders, saw patients independently, and presented directly to attendings.
 
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WingedOx

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Personally I think the more opportunities students have to exercise those "responsibilities and privileges" the better. It's not as if students are going to be writing prescriptions, putting in orders, etc.. In a way it's just for show, but I think that can be beneficial for students who might take more ownership in their patients and grow more comfortable in the role of being a doctor (which 99.99% of them will soon find themselves in).

During clerkships, I would describe myself as "a member of the team" and allow the white coat, stethoscope, and other equipment allow patients to infer what they wanted about my role. I think it helped remove some of the hesitation of talking with a medical student and helped built rapport while still not allowing anything of consequence to be done as a result - i.e., I would still need to talk with residents/attendings, etc.. This was doubly true on my sub-I when I was effectively functioning as a resident sans putting in orders, saw patients independently, and presented directly to attendings.
A number of years ago when I was in med school there was an old professor of OBGYN who argued rather persuasively that it was unethical for patients to refuse to be treated by a student/trainee/whatever. (for context where I went to med school mainly treated a wealthy population). He argued that back in the old days the main teaching hospitals were all state/county hospitals for the indigent, and if we're only having the most needy patients treated by inexperienced clinicians, then we're not giving equal care to patients across the socioeconomic spectrum. The bleeding heart liberal in me agreed.

...However...

I'm a VERY firm believer that a patient's autonomy to make medical decisions is not to be violated wherever possible, and for patients to have that autonomy they need to be fully informed about both what is being done and who is doing it. If a patient doesn't want a trainee involved in their care, that's their right, even if I don't agree with their decision. Hell, sometimes patient take that to stupid levels...insisting that the attending neurologist perform your lumbar puncture when the attending probably hasn't done one in two years for example... but if the patient is informed that the attending is likely not fresh whereas the senior residents do them daily, and it may involve you having to come back when he/she has the free time to do it, and the risks of waiting for the procedure to be done, etc, well that's their call if they want to be a stubborn ass about their care. Perhaps they should have known better than to come to a teaching hospital, but whatever. Being ambiguous or less than fully honest about roles for the sake of expediency gets the job done, but it violates a patient's autonomy.

The people who know my identity on this site (hi guys!) know I've had many a discussion about this topic, and a lot of it comes from being asked to do things as a 3rd and 4th year medical student that I simply didn't think were right. Said people know this left a bad taste in my mouth early on when I stood up for myself about the topic. (can you tell I didn't honor much as a clinical years student?). We all want students to get the skills necessary to ultimately become experienced physicians, but that comes in time either way. The patients you experience as a student are there with their own real medical problems and with their own sets of expectations about their care and those have to (if well-informed) be respected. For every patient telling you to GTFO as a student, there will be 4 or more who are more than happy that they're educating future physicians.
 

NickNaylor

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A number of years ago when I was in med school there was an old professor of OBGYN who argued rather persuasively that it was unethical for patients to refuse to be treated by a student/trainee/whatever. (for context where I went to med school mainly treated a wealthy population). He argued that back in the old days the main teaching hospitals were all state/county hospitals for the indigent, and if we're only having the most needy patients treated by inexperienced clinicians, then we're not giving equal care to patients across the socioeconomic spectrum. The bleeding heart liberal in me agreed.

...However...

I'm a VERY firm believer that a patient's autonomy to make medical decisions is not to be violated wherever possible, and for patients to have that autonomy they need to be fully informed about both what is being done and who is doing it. If a patient doesn't want a trainee involved in their care, that's their right, even if I don't agree with their decision. Hell, sometimes patient take that to stupid levels...insisting that the attending neurologist perform your lumbar puncture when the attending probably hasn't done one in two years for example... but if the patient is informed that the attending is likely not fresh whereas the senior residents do them daily, and it may involve you having to come back when he/she has the free time to do it, and the risks of waiting for the procedure to be done, etc, well that's their call if they want to be a stubborn ass about their care. Perhaps they should have known better than to come to a teaching hospital, but whatever. Being ambiguous or less than fully honest about roles for the sake of expediency gets the job done, but it violates a patient's autonomy.

The people who know my identity on this site (hi guys!) know I've had many a discussion about this topic, and a lot of it comes from being asked to do things as a 3rd and 4th year medical student that I simply didn't think were right. Said people know this left a bad taste in my mouth early on when I stood up for myself about the topic. (can you tell I didn't honor much as a clinical years student?). We all want students to get the skills necessary to ultimately become experienced physicians, but that comes in time either way. The patients you experience as a student are there with their own real medical problems and with their own sets of expectations about their care and those have to (if well-informed) be respected. For every patient telling you to GTFO as a student, there will be 4 or more who are more than happy that they're educating future physicians.
Let me say that I completely agree with you with respect to patient autonomy. I think it is wrong to be overtly deceptive to patients or to refuse to honor requests for patients that medical students not be involved in their care. I think it's a bit more dicey with residents, but I see your point.

That said, medical students need to learn, and I think they should generally be assertive with respect to ensuring they get that education. For example, when I introduced myself as a "member of the team," some patients would see my flashy "medical student" identifying badge and make a comment about it. I would remind them that I am just as much a part of the team as anyone else and would examine them, check in on them in the morning, etc.. I would clarify my role and the fact that I would be supervised (i.e., report regularly to a resident/attending), thus while I'm a trainee I was still supervised significantly. After having this conversation, I found that the overwhelming majority of patients were more at-ease and willing to allow me to see them. For those that still refused, I would honor their request and would tell the resident/attending about the conversation.

I agree that trainees should never do anything they are uncomfortable with - whether as a medical student or a resident. That's bad for the resident and worse for the patient.