---- THE ETHICAL ISSUE ----

Should Medical Students be Called "Student Doctor"?


There has been a change in recent years in how patients relate to the medical profession and vice versa. Along with the rise of consumerism, society has shown that it wants to deminish paternalistic behavior by physicians and assure informed consent on the part of the patients. Therefore the current ethical consensus is that there should be a clear understanding between patient and physician regarding all that is transpiring in medical care. This also means that any words or behavior on the part of the caregiver which may lead to deception is not right and may defeat attempts at informed consent.

Medical students have long been identified by the words "student doctor" or "student physician". Medical students, of course, have neither obtained as yet their M.D. degree nor have the legal responsibility of a physician. In keeping with the societal consensus described above, there is some concern whether using these words by medical students in identifying themselves either orally or on their name tag or by others identifying these students may itself be deceptive. The issue here is whether patients or families would misinterpret the qualifications and responsibilities of the student by these descriptions. Would you agree that these words may be deceptive and that medical students should only be identified by the words "medical student"?

Here is the question:

Are the words "student doctor" or "student physician" in identifying a medical student deceptive and should not be used?


If you have an answer (or another question), click HERE and e-mail me a response.
---- THE DISCUSSIONS ----

Date: Fri, May 21, 2004 9:30 PM From: hurt_domain@hotmail.com To: DoktorMo@aol.com

After more careful concideration of the facts, I have realised that this problem is not about who should be called what but rather about public awareness. For the past couple of years, I have been consulting Medical Practicioners (MP) at my local medical centre. I thought they were doctors and did not realize the difference but I found out recently that medical centres are a place for MP's to train.

Undoubtably they should identify themselves as students by any means but if they want to play doctor, let the kids have their toys. All you have to do is goto the world media, make the public aware of the difference and the problem should be solved. If the problem persists, see your doctor, lol.


Date: Fri, Apr 16, 2004 9:04 AM From: medpraetorpheus@yahoo.com To: DoktorMo@aol.com

There are a couple of points I wish to highlight to clear the air.

Dr is both an academic title as well as a professional title. You do not need to have a (professional) doctoral or PhD degree to be called a doctor if you are a medical doctor.

The title Dr (from doctoral degree) does not indicate vast knowledge. It indicates very DEEP knowledge in a very NARROW field of RESEARCH.

MD (in US) is Medical Doctor while MD (elsewhere) is a higher degree, equivalent to a PhD (and thus is also a RESEARCH degree).

M.B.,B.S. (Asia and Europe) = MD (US) just that the latter insists that it be a postgraduate degree.

At the end of the day, the use of student doctor or medical student is a matter of preference and the latter is in no way misleading because the student is not withholding the fact that he is a student. In any case, the student is not accountable to the patient and should politely explain to the patient of his/her capacity as a student and his/her limitations should the patient have the misperception. Personally, I used the term "medical student" when I was one simply because the words rolled better on my tongue.

Even while some may scorn the supposed ego of the student who places an early claim on the title, we must understand that these are the little boosts to their esteem. We should not blame the young ones. If the word doctor makes them act more responsibly and be able to engage the role better, so be it, but the caveat, as I mentioned above, still applies of course.

I'm uncertain why there must be much debate over a small issue as a prefix. Do the existing doctors feel that they are more deserving of the title than the students? Do they believe that using the title student doctor would result in a catastrophical malpractice litigation (then blame the supervisor for not briefing the student well enough!)? I believe we should discard the minute issues and help our students with their bigger issues. Zulkarnain A H, M.B.,B.S.


Date: Tue, Apr 13, 2004 4:40 AM From: amal6297@bigpond.net.au To: DoktorMo@aol.com

I find this point very interesting and relevant to my current studies and field of experience. I am a health science student, specifically studying paramedics, and have often found that to introduce what i do as 'a student paramedic' not only confusing for others but also shunned by qualified paramedics employed by the victorian ambulance services. to them and their profession- we university students are no closer to paramedics than a first aider, as while we may posess relevant skills and under supervision be able to initiate appropriate treatment, we have neither the autonomy nor professional responsibility which accompanies such a title. In both work experiences/ placements and general small talk, i avoid describing myself with title and prefer to say that i study paramedics at Vic Uni... and to the medical student who was "offended" at patients thinking he/she was a "student nurse" perhaps you should think about becoming a student of the sociomedical hierarchy and learn to respect others before you throw around your yet-to-be-gained-qualifications.


Date: Sat, Mar 13, 2004 12:38 PM From: Lisa and Becky@aol.com To: DoktorMo@aol.com

I am a physical therapist and when I was a PT student we identified ourself as a "student physial therapist". After reading your thoughts, I think it would be more appropriate to state "physical therapy student". This would also apply to students learning to become a doctor. They are not a doctor and do not have the qualifications of a doctor, therefore they should not call themself a "student doctor". I feel "medical student is more appropriate and would best serve in preserving the reputation of actual doctors.


Date: Sun, Feb 22, 2004 8:49 AM From: hurt_domain@hotmail.com To: DoktorMo@aol.com

My name is Michael HURT. I am not a Student and hold no qualifycations so some of you will probably concider my opinion invalid but I thought it may be relevant since I was a patient once who was assessed by a Student. I do not believe it is appropriate for a Student to be attatching qualifycations to their title as it is missleading. When I was seen by a Doctor with a Student present the Student was introduced as a Student Doctor, this was confusing as I did not understand if the Student was a Doctor under further study or simply a Student studying to become a Doctor. The title Student Doctor implies that the person is both a Student and a Doctor.

I do not know of very many Students who refer to themselves as anything other than just that, a Student. If I were studying to become a Technician I would not introduce myself as a Student Technician but rather as simply a Tafe Student or a University Student or a Colege Student and then if prompted would explain that I was studying to become a Technician. Some people refer to themselves as a Law Student or as an Art Student or a Student of Law which seems to put the point accross so I see no reason why someone shouldnt be alowed to refer to themselves as a Medical Student or a Student of Medicine.

It seems to me that they are simply trying to bignote themselves and assume a title which is not rightfully theirs. In the english language when placing an identifyer with a descryptor you must put the identifyer first which in this case is or Medical Student (Doctor Student just doesnt seem to work), other examples would be Australian Resident, Home Owner, Art Student, Bus Driver and Field Medic. By placing the word Student before the word Doctor a person is attempting to identify themselves as being in the field of Student and describe their possition in such field as Doctor. I hope I have made sence and that your eye's didnt glaze over after the first few sentences.


Date: Fri, Dec 5, 2003 9:48 PM From: dardzin@rochester.rr.com To: DoktorMo@aol.com

Hello DoktorMo, From experience I've learned people have selective hearing.........If patient is in pain, and a medical student says they are a student doctor or student physician and offers help, and the patient does't get better or gets sicker, I really believe the patient will say they thought that person was a doctor or a physician when they sue..........So to say it is deceptive is correct.........P.S. I steer clear of student drivers!.........Very interesting web site...........SteveD


Date: Mon, Oct 6, 2003 5:47 AM From: juboolim@hotmail.com To: DoktorMo@aol.com

Quite honestly a student is a student, and he not at all a doctor, and he should not deceive others by calling himself a doctor whether or not he attaches the word 'student' to that tittle In most other countries, a medical graduate holds only a bachelor's degree (MBBS), and not a doctorate (MD) degree in medicine. Academically speaking, an MD in the United States is equivalent to only an M.B.B.S. which is actually two bachelor's degrees, Bachelor of Medicine, and Bachelor of Surgery. Holders of bachelor's degree in any field, whether in medicine, dentistry, veterinary medicine, law, science or even arts are technically and legally NOT eligible to the title 'doctor' , et alone a student who is still far from reaching doctorate status. Medical graduates are addressed as a 'doctor' only as a courtesy title, and not because they are technically entitled to it. The title 'doctor' is actually only reserved for those who have actually reached an extremely high level of knowledge - those who actually have doctorate degrees such as a PhD or a DSc. In most other countries an MD is actually a higher postgraduate degree - a true doctorate degree in medicine. These are only obtainable only after medical graduates obtained their basic bachelor's degree in medicine and surgery. Only these physicians technically can be called 'doctors' . In other countries outside the US medical students are just called medical students, and NEVER 'student doctors' They are just not 'doctors' whether or not they use the title 'student' before the word 'doctor' The title 'doctor' is reserved for those who have gained very vast knowledge - a teacher or a philosopher, or those who contributed tremendously to the advancement of knowledge. Students remain a student and should not use 'doctor' tittle to deceive others.

What is a name after all? As an MD and a PhD myself, I seldom even add the title 'doctor' before my name. What is important are your acaemic and professional qualifications behind your name. The speak volumes to indicate whether or not you are qualified as one. I am a medical doctor as well as a true doctor with a PhD, and a DSc. When we publish a research paper, whether we are MD, PhD, DSc or even a university professor, we are very humble. We just publish our name as an author, and just academic institution/ department / hospital where we work, leaving out even our positions (Head / Senior Physician / Chief Investigator / Principal Scientist etc). We don't even spell out our title before or after our names. In fact the more professional and academic qualifications we acquired, the humbler we become. Let alone just mere students who wants all sorts of unqualified titles.

JC Lim, MD, PhD, DSc, FRSH, FRSMed, Malaysia


Date: Wed, Aug 13, 2003 5:01 PM From: ericamilas@yahoo.com To: DoktorMo@aol.com

I am a fourth year medical student and I think it is absolutely appropriate to present myself as "student doctor" or "student physician". I have put in a lot of time thus far and feel as if I should be treated with respect. The title is exactly what I am...a student preparing to become a physician. When I first began on my clinical rotations I introduced myself as "medical student". Patients were often confused about the term. Several times people thought I was going to school to be a nurse. I was offended by this.

I think there is a little bit of confusion by some people about medical education. When you complete your four years of postgraduate work (ie medical school) you are officially given the title of "doctor/physician". At graduation they call each and every graduate "Dr." as they cross the stage. You then go on to a residency to gain more experience. However, at this point you are no longer a "student physician"....you ARE the physician. There are people guiding and mentoring you (ie Attending physicians) but as a resident you are called on to make decisions as a physician...especially while on call. So, I do not think it is appropriate to call a resident a "student physician". They deserve more respect than that.


Date: Thu, Jul 31, 2003 7:31 AM From: bbandlb1@alltel.net To: DoktorMo@aol.com

i personally believe that a student should be called a student. If they are a student doctor or a student nurse. Linda B


Date: Tue, Jun 17, 2003 5:01 AM From: Dyspneadoc@aol.com To: DoktorMo@aol.com

Once you include "student" in the title, you have acheived the communication that this person has not completed his/her skill training, and thereby it seems to me that the patient has been adequately informed. The patient's guard is up!

David Ryon, MD


Date: Wed, May 14, 2003 12:54 PM From: lcp710@cableone.net To: DoktorMo@aol.com

I don't think that it is any more deceiving to call a medical student a "Student Dr" than it is to call a nursing student a "Student Nurse". I always emphasized the fact that I was a student wehn I was in nursing school, because some people look past the "student" part of the title and think that you have more privilege and knowledge than you actually do....most of you healthcare professionals out there know what I mean................Linda


Date: Tue, Apr 8, 2003 9:02 PM From: FritandFrat1061@cs.com To: DoktorMo@aol.com

I believe that student doctor is not deceptive. I believe that if it says student it shows that they are not a Doctor and still studying to be a Doctor. I also think that you must identify yourself as a student to any patients when you introduce yourself, make sure they completely understand that you are a student and not a Doctor.

Kathy Larson, "Student" Nurse


Date: Mon, Mar 31, 2003 5:53 PM From: pratap_cefiro@hotmail.com To: DoktorMo@aol.com

I would like to introduce myself as "Student Doctor." I have read other postings on this site and it leaves me no room to suggest that "MD" is misappropriate form of designation let alone Student Doctor. "MD" means Doctor of Medicine and by competley a 4 year program doesn't give you the privileges to be called a Doctor of Medicine. The medical course should instead be called M.B.B.S...Bachelors of Medicine and Bachelors of Surgery?

MD denotes postgraduate qualification which ever way you look at. What do you designate to someone who finishes a Medicine course and pursues a postgraduate course specialising in Medicine?

The term Doctor Universally suggests someone who holds postgraduate QUALIFICATION and not merely an undergraduate.

Example. Dr Smith, M.B.B.S

RATHER THAN

Dr Smith, M.D

Whilst studying Medicine there are two principal streams of subjects...Medicine and Surgery...I think M.B.B.S denotes that better than MD.

Thanks

N.B As far as Student Doctor is concerned, I think it's more applicable. Medical is a vague word. Many professions [work] in Hospitals including Engineers. They work in Medical Industry. But a Student Doctor verifies the role precisely.

Remember in dealing with patients you stand by the oaths and thus be allowed to interview patients and investigate, to be able to do it with a sense of righteousness, Student Doctor is appropriate.


Date: Mon, Mar 10, 2003 8:29 AM From: cbanks@kumc.edu To: DoktorMo@aol.com

I agree that students should have a proper title in respect to their intended profession. However, "medical student" is a broad interpretation and it may be confusing to the patient. The student should have a title that is specific to there specialty. For example a pediatric resident might have the title of Student Doctor:Pediatric Medicine. This may better explain exactly who they are in the medical field. It is very important for the patient as well as other health care professionals to know who they are dealing with. Clinical rotations are invaluable to a student, giving them the opportunity to interact with people and master their profession. However, it is still a learning experience and should be treated as such. That means accepting your limits and presenting yourself as a "student doctor". That is nothing to be ashamed of!


Date: Sat, Jan 11, 2003 4:36 PM From: lisafitton@hotmail.com To: DoktorMo@aol.com

You say that we should not refer to Medical students as Student doctors, well I am wondering what you think that they are studying for if not to gain a qualification as a Doctor or Physician, are nurses under training not called Student nurses ? or Nursing students ?

I think that if you have time to question what we all call Students instead of helping these people through what is considered the most difficult course to undertake, then you should find something constructive to help the Medical profession to improve.

Ask yourself a question is it important what people refer to Medical Students or are you just very bored ?


Date: Wed, Nov 13, 2002 10:43 AM From: arecker@mco.edu To: DoktorMo@aol.com

I'm currently a fourth year medical student and have seen many students represent themselves as "student doctors." I never liked the term because I thought it misrepresented their role on the medical team. Many patients are confused already when a team of 10 people walk into a room with white coats on. Most patients don't differentiate between short and long coats and think everyone present is a physician. While this may not make a practical difference, ethically I think a distinction between student and physician should be made. The title of doctor is earned after years of study. Patients expect those who represent themselves as doctors to have completed the requirements. Putting the word student in front of doctor many times just confuses patients. The public understands the title of medical student, why change it? Does it feed the egos of medical students? I've heard some students mumble the word student and pronounce doctor loudly and clearly. Misrepresentation? Of course. I find it hard to make the comparison between use of the term student nurse and student doctor. There are large differences between nurses and doctors(I am not putting down nurses!). Patients depend on their physician to make life changing decisions. Relying on the opinion of a misrepresented medical student could have dire results medically, ethically, and legally.


Date: Wed, May 22, 2002 7:14 PM From: IAB48@aol.com To: DoktorMo@aol.com

Doctor implies one has graduated with a degree to earn a doctorate in a given field. The term doctor is not the same as physician. Doctor is a title, physician is a profession. It is therefore imprecise, if not downright misleading to call one a "student doctor". Dennis Halloran, JD (Juris Doctor)


Date: Wed, Apr 3, 2002 8:57 AM From: cdh@jhu.edu To: DoktorMo@aol.com

Are the words "student doctor" or "student physician" in identifying a medical student deceptive and should not be used? I do not think "student doctor" or "student physician" are deceptive terms. In fact, they may be less misleading about the actual role of medical students than the term "medical student". I think the ordering of the word "student" makes a difference on patient impression of the person speaking. Upon introducing oneself to a patient as a "student doctor", the first word for self descripton is "student". This is very clear for the patient, that the person speaking is first and foremost a student. What are they a student of? Of becoming a doctor/physician. This would also apply to nursing students calling themselves "student nurses". Considering stress levels related to health problems and associated changes in attention span and patient recollection of titles, I think that if one describes themselves as "student doctor/physician/nurse", then the primary role of student is more clear.

However, if one describes themselves as "medical/nursing student", then it is likely the patient may be more confused and remember only the first word. When speaking the student may mumble or speak the last "student" word softly. I think there is more room for patient deception when ending a title with "student" rather than beginning with it. The patient may remember "medical" and think "medical doctor", or the patient may remember "nursing" and think the person is a licensed nurse.

The medical world is confusing enough for patients without deceptive titles, and I think that placing "student" first in a title description is less deceptive to the patient. In my undergraduate and graduate nursing education, professors suggested that I introduce myself as "nursing student" and then "nurse practitioner student", because the word "student" comes last and the patient may elect not to hear that or ignore it and think I was a nurse or nurse practitioner. Their intent was for me to have a more valid and actual experience with a patient, but I felt it may be a little deceptive for those not sharp enough to pick up on the semantics of my title. I especially felt this way when describing myself as a "nurse practitioner student" because I felt patients stopped listening to my title after the word "nurse" let alone making it to "student".

I hope my perspective added some insight for this discussion.

Courtney Holmes, RN, MSN, BSN, BA (Philosophy)


Date: Sat. Sep 22, 2001 6:27 PM From: robynann@gateway.net To: DoktorMo@aol.com

Personally I feel until they graduate and have earned the initials DO or MD they should not go by student doctor. They are not one, they are a medical student. I had to identify myself as a nursing student until I graduated and passed boards. They are called doctor at graduation, prior to taking boards. So don't jump the gun they will be a doctor soon enough.

Jason Nichols, RN


Date: Wed, Jun 6, 2001 7:13 AM From: Julian@greenwoodwinn.freeserve.co.uk To: DoktorMo@aol.com

Should Medical Students be called "Student Doctor" ?

What's in a name?

The answer to this question depends on whether you're the person asking or the person answering. But no matter your starting point, names and titles are important; they denote your gender, martial status, profession or position in society depending on how you express yourself verbally or by name tag.

Student Doctor. Breaking down the title to its consistuent parts, a student may be described as:

a.. a person in the role of learner

b.. diligent

and a doctor as:

a.. an honorary title given to those who have completed a medical degree

b.. someone who has completed a doctorate level degree

Whilst these may be considered specific, literal meanings there are also interpretative meanings. In terms of the question it is perhaps the interpretative meanings that are as important as the literal.

The title "Doctor" implies a level of knowledge and understanding, an academic attainment and status. As such it gives confidence to patients when they are at their most nervous or vulnerable.

By calling medical students Student Doctor I perceive 3 basic problems for the patient and ultimately for the medical profession.

1.. Patient perception may be misled and distracted from the student status, this may lead to inappropriate confidence being placed in the students skills and could also frustrate informed consent e.g. the right of the patient to refuse treatment from a learner. 2.. Student status means that there has to be reference to qualified practitioners before, during and after a diagnosis or treatment is delivered. If the patient believes that his/her care is subject to constant review and discussion there is a possibility that the patient could lose confidence in the practice of the student and those associated with the care delivery. Alternatively it could lead the patient to consider that he/she is more critically ill than is true if care is constantly being checked and re-checked. 3.. There is a potential for limited or wrong information to go unchecked. If the patient believes that the student is actually a doctor I proffer that information provided is less likely to be questioned, even in this consumerist society. There is a reliance and an acceptance that what the doctor tells you is true and correct. Where-as recognition of the student status ensures that the patient is aware that the practitioner is on a learning curve and not expected 'to know everything'. It is also worth looking at the motivation of those wishing to call themselves "Student Doctor".

The title doesn't add status. The individual is still a student. It doesn't add to ability; there is still close supervision. To know what is does add one would have to indulge in motivational research and perhaps that is what is required.

Another view of the title is that "Student Doctor" could be applied to any qualified member of the medical profession. Those with MDs (or BM / MB BCh in the UK) continue to study for higher qualifications or medical board exams. In fact, by its very nature, medicine is constantly changing; all MDs continue to study in order to update their knowledge as a basis of delivering good care. The MD remains diligent.

In conclusion, I would urge a move away from potentially misleading titles that do not fully describe status or function and a continuance of the universally understood and recognised title Medical Student.


Date: Fri, Jun 1, 2001 10:45 AM From: Marty.Lynn@tenethealth.com To: DoktorMo@aol.com

YES whole heartedly. When nursing students make rounds, they are identified as "student nurse" not as "nurse" and most patients understand that the person is not yet a professional nurse. Using the term "student doctor" identifies the person as STUDENT "Doctor" and as long as the student does not de-emphasize the fact that they are a student. I once worked at a medical school and I was asked to translate for the patient. I introduced the ("fixing-to-graduate-in-6-months) student doctor to the family as a student doctor and then asked if we were going to wait for the physician to begin since he was taking notes and ignoring the patient. He later reported me to his faculty for being rude and informed me that he would be making assessments on his own as an MD shortly. To my horror, it was to look as if I was wrong in introducing him as a "student" and not as a doctor! He wasn't a doctor and medical schools should NOT encourage the students to de-emphasize their role as STUDENTS until they are indeed graduated, licensed, MD's

Thanks, Marty Lynn, RN, BSN


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