Topic: Interns, RMOs, registrars - what does it all mean? (Read 6,230 times)
chinaski Administrator Dr Everything'll Be All Right member is offline
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Interns, RMOs, registrars - what does it all mean? « Thread Started on Feb 25, 2007, 4:40pm »
The following is a (largely accurate) explanation of the role of doctors after graduation which was given to me years ago as a student (which I only just found on my hard drive today). There are some slight inaccuracies, but give it a read for a start (and discussion will follow):
A Medical Guide to Who’s Who within the Hospitals
Interns – medical hospital employees who are in their first year after completing the formal medical school course. Interns are medically supervised, and are the lynchpins of patient care in the system. Their major duties include clinical assessment and clerking of patients, completing the required paperwork, arranging medical tests and compiling test results in an orderly manner, and instituting the medical care plan established for the most part by other team members.
Resident Medical Officers – this is a broad term that covers in-hospital medical employees who are registered medical practitioners. In general, RMOs are not working in an established specific training scheme, although some are in the Family Medicine Program (FMP), to become registered GPs. A RMO may be one year more experienced than an intern, termed a junior RMO (JRMO or RMO-1), or two years or more advanced, termed a senior RMO (SRMO, or RMO-2). Some RMOs have a dedicated career as RMOs, and are called Career Medical Officer (CMOs). RMOs often undertake many of the same roles as interns, although there is more latitude to make medical decisions about patient care, and in some specialties and terms, RMOs take on a role more like that of registrars.
Registrars – These medicos are more experienced in years than RMOs. They are commonly on a formal vocational training scheme, although some registrars are still in the process of ‘making it’ onto a scheme. Registrars provide the ‘middle level’ of medical care, and they make most of the day-to-day management decisions about patient care. Those on a general training scheme, such as Basic Physician Trainees, or General Surgical Trainees, are rotating registrars, who, from one term to another, progressively move between sub-specialties. The general trainees are in the process of passing their basic Trainee exams. Their general knowledge is commonly very up-to-date and comprehensive, their time availability limited, and their sub-specialty skill is variable.
Advanced trainees have completed their general specialty training and have been accepted onto a specialty or sub-specialty training scheme. They progressively acquire ‘more and more’ knowledge and skill about ‘less and less’. Some advanced trainees are Fellows, who may be from overseas and visiting (Visiting Fellows) for a limited period, and/or may be undertaking a period of research (Research Fellows).
Staff Specialists, Visiting Medical Officers (VMOs), and Academics - are recognised specialists, at the ‘top of the totem pole’ in the medical care of patients. They take ultimate responsibility for patient management, and medical in-patients are admitted under their care. They have a wealth of experience in patient care, and special skill at perceiving the ‘overall picture’, including the critical decision-making steps, and what strategies and issues are important in the medium and longer term medical care of their patients. They are commonly consulted formally by other specialists to aid in the care of patients. VMOs have a different employment arrangement with the hospital, compared with Staff Specialists, and are employed on a sessional basis, whilst Staff Specialists are paid a salary. Full Academic Professors, Associate Professors, Senior Lecturers and Lecturers, are generally salaried by the University, and they have a clinical responsibilities through their appointment, as specialists.
galtaforce Medical Student University of Melbourne 2006 Paging Dr's Pet Melbourne Student member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #1 on Feb 26, 2007, 12:05am »
In Victoria, residents are referred to as HMO-2, HMO-3 etc. standing for "Hospital Medical Officer". We've moved on from RMO because despite the long hours, residents don't actually live (reside) at the hospitals like they used to.
Disclaimer: My posts do not necessarily reflect the policies or opinions of UMMSS. Neither do they constitute official communication or advice from the University of Melbourne.
galtaforce Medical Student University of Melbourne 2006 Paging Dr's Pet Melbourne Student member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #2 on Feb 26, 2007, 12:07am »
Quote:
some are in the Family Medicine Program (FMP), to become registered GPs.
This is no longer correct. As general practice is just another specialty, you have to enrol in the RACGP training program (or maybe ACRRM soon) and become a GP Registrar.
Disclaimer: My posts do not necessarily reflect the policies or opinions of UMMSS. Neither do they constitute official communication or advice from the University of Melbourne.
chinaski Administrator Dr Everything'll Be All Right member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #3 on Feb 26, 2007, 6:22am »
Actually, that abbreviation was just specific to the hospital from which the original document derives. GP trainees (enrolled with the RACGP) were referred to being in the FMP - it just refers to a hospital peculiarity. Nonetheless, it's privvy to point out that other training can start as soon as PGY2, not just GP.
chinaski Administrator Dr Everything'll Be All Right member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #4 on Feb 26, 2007, 7:13pm »
It might the conspiracist in me, but I suspect Victoria's fondness for the "HMO" moniker is also something to do with the fact it more closely aligns with the UK "HMO" abbreviation, which stands for "House Medical Officer". I do believe NZ still have house officers too (?).
Grouchy Medical Student Flinders University 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #5 on Feb 27, 2007, 12:06am »
Quote:
This is what it really means... A Professor Leaps tall buildings in a single bound Is more powerful than a locomotive Is faster than a speeding bullet Walks on water Gives policy to God
A Senior Consultant Leaps short buildings in a single bound Is more powerful than a shunting engine Is faster than a speeding bullet Walks on water if the sea is calm Talks with God.
A Consultant Leaps short buildings with a running start and favourable winds Is almost as powerful as a shunting engine Is just as fast as a speeding bullet Walks on water in an indoor swimming pool Talks with God if special request is approved.
A Fellow Barely clears a pre-fabricated hut Loses a tug of war with a locomotive Can fire a speeding bullet Swims well Is occasionally addressed by God.
A Registrar Makes high marks on a wall when trying to clear tall buildings Is run over by a locomotive Can sometimes handle a gun without injuring himself Doggy paddles Talks to animals.
An Resident Runs into buildings Recognises locomotives two times out of three Is not issued amunition Can stay afloat with a life jacket Talks to walls.
An Intern Falls over doorsteps when trying to enter buildings Says 'look at the choo-choo' Wets himself with a water pistol Plays in mud puddles Mumbles to himself.
We had a variation of this in the army, except it was from General down to Lieutenant. And the first past is what people think, and the reality is the reverse.
kimmy Administrator University of Queensland 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #6 on Feb 27, 2007, 6:46am »
A Registered Nurse Lifts up tall buildings and walks under them Kicks locomotives off tracks Catches speeding bullets in her teeth Freezes water with a single stare Is GOD!
breezy Medical Student University of Western Australia 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #8 on Mar 1, 2007, 6:33pm »
Quote:
A Registered Nurse Lifts up tall buildings and walks under them Kicks locomotives off tracks Catches speeding bullets in her teeth Freezes water with a single stare Is GOD!
As an RN myself, I'd have to agree with that Kimmy!!!!!
Joined: Feb 2007 Gender: Female Posts: 830 Location: Adelaide
Re: Interns, RMOs, registrars - what does it all m « Reply #9 on Mar 1, 2007, 7:34pm »
Quote:
Yeah in UnZud they're House Physicians and House Surgeons (even though they're just resis)
ha when you arrive in Auckland, NZ there's a sign that says 'Welcome to New Zild'
i always wondered why everyone at home called them 'house surgeons'... that your first year out huh --- because they do their trainee intern year as part of the degree, and once they're graduated they're called house surgeons? i get confused.
gesax Medical Student University of Queensland 2008 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #10 on Apr 1, 2007, 6:52pm »
If your an intern do you work in the area you want to specialise in? (e.g. surgical intern or radiology intern ..etc), or are you assigned to in-patient wards or do you bounce around between departments?
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Re: Interns, RMOs, registrars - what does it all m « Reply #11 on Apr 1, 2007, 7:02pm »
Quote:
If your an intern do you work in the area you want to specialise in? (e.g. surgical intern or radiology intern ..etc), or are you assigned to in-patient wards or do you bounce around between departments?
As an intern (in Qld anyway, other states may have small variations), you must pass ten weeks of a general medical term, ten weeks of surgery and ten weeks of Emergency and then a combination of 5 and ten week electives e.g. urology, Psych, O&G to qualify for full registration at the end of the 52 weeks. Its quite rigid compared to the PGY2 and 4 years where you start to experience the areas you might want to specialise in.
kimmy Administrator University of Queensland 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #12 on Apr 1, 2007, 7:05pm »
No. All interns in Australia must do one term of Medicine, one term of Surgery and one term of ED. (about 10 weeks long each I think..) then you do some other random terms- normally one of nights/relief and a couple of others- some hospitals may let you have a bit of a say in it. I'm not totally clear on the details however- one of our resident doctors can fill you in I'm sure.
edit: we all answered at the same time Read redleaves response- she'll definitely know
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Re: Interns, RMOs, registrars - what does it all m « Reply #13 on Apr 1, 2007, 7:10pm »
Quote:
No. All interns in Australia must do one term of Medicine, one term of Surgery and one term of ED. (about 10 weeks long each I think..) then you do some other random terms- normally one of nights/relief and a couple of others- some hospitals may let you have a bit of a say in it. I'm not totally clear on the details however- one of our resident doctors can fill you in I'm sure.
edit: we all answered at the same time Read redleaves response- she'll definitely know
Thanks Kimmy! Interns don't do nights, except in their ED term, as they are always well supervised. The electives which are considered suitable interns get accredited on the basis of the level of supervision.
kimmy Administrator University of Queensland 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #14 on Apr 1, 2007, 7:13pm »
No nights as an intern?? Is that at all hospitals? I was reading the QHealth "promotional" posters for intern recruitment and saw that a few advertised 'no night call for interns' but I assumed it was just unique to that hospital. Anyway, sounds nice- the less night work, the better
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Re: Interns, RMOs, registrars - what does it all m « Reply #15 on Apr 1, 2007, 7:22pm »
Quote:
No nights as an intern?? Is that at all hospitals? I was reading the QHealth "promotional" posters for intern recruitment and saw that a few advertised 'no night call for interns' but I assumed it was just unique to that hospital. Anyway, sounds nice- the less night work, the better
Depending on the individual hospital, night ward call is operating out of the ED, so its actually no additional nights to the ones you'd be expected to do. There will be rostered overtime, probably about once a week to once every nine days where an intern would work 0800-2200 to do surgical or medical ward call, but no other nights than in ED.
galtaforce Medical Student University of Melbourne 2006 Paging Dr's Pet Melbourne Student member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #18 on Apr 2, 2007, 12:09am »
Quote:
Quote:
No. All interns in Australia must do one term of Medicine, one term of Surgery and one term of ED. (about 10 weeks long each I think..) then you do some other random terms- normally one of nights/relief and a couple of others- some hospitals may let you have a bit of a say in it. I'm not totally clear on the details however- one of our resident doctors can fill you in I'm sure.
edit: we all answered at the same time Read redleaves response- she'll definitely know
Thanks Kimmy! Interns don't do nights, except in their ED term, as they are always well supervised. The electives which are considered suitable interns get accredited on the basis of the level of supervision.
Disclaimer: My posts do not necessarily reflect the policies or opinions of UMMSS. Neither do they constitute official communication or advice from the University of Melbourne.
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Re: Interns, RMOs, registrars - what does it all m « Reply #19 on Apr 2, 2007, 12:17am »
You definitely do nights in NSW.
Also, may I just say that covering wards at night while operating out of ED is absolutely "hung by the toenails" horrible.
I would say that the move to having an intern covering wards and a separate intern/MO covering ED at nights is definitely an improvement. Having an intern covering both ED and wards is crappiola.
Re: Interns, RMOs, registrars - what does it all m « Reply #20 on Apr 2, 2007, 12:25am »
I agree that covering the ward and ED at night would suck. You would spend half the night running between the wards and ED
Where I did intership interns did ward and ED nights after term 1.
I found ward nights ok (although I did it at the end of internship). You always had the medical or surgical registrar to contact and there was also the week off afterwards
annie Medical Student University of Queensland 2009 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #21 on Sept 12, 2007, 4:09pm »
So I understand - how many years (from the start of MBBS) is it before you start getting into your specialty training? MBBS =4, Intern =1, RMO =2 ?, Registrar = 1?... so 8 years? is that right? (that scares the crap out of me)
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Re: Interns, RMOs, registrars - what does it all m « Reply #22 on Sept 12, 2007, 4:38pm »
Quote:
So I understand - how many years (from the start of MBBS) is it before you start getting into your specialty training? MBBS =4, Intern =1, RMO =2 ?, Registrar = 1?... so 8 years? is that right? (that scares the crap out of me)
Its actually a little longer, dependant on the speciality. It usually goes MBBS 4, Intern 1, RMO 2-4, PHO 1-3 or 4 dependant on specialty and then registrar for a couple of years, dependant on exams.
kimmy Administrator University of Queensland 2007 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #23 on Sept 12, 2007, 5:54pm »
If you wanted to be a physician of some description (eg. paediatrician, haematologist, cardiologist etc etc) The minimum amount of time you can do it in is.
MBBS: 4 years Intern: 1 year Basic trainee (as resident or registrar depending on your job title): 3 years Advanced trainee: 3 year
That's a total of 11 years from the beginning of med school until you are a 'specialist'. This assumes that you enter specialty training in PGY2. A lot of people take longer... pass rates for the exams aren't great and many people take an extra year to learn more stuff before attempting the exams.
skywalker Medical Student University of Queensland 2008 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #24 on Sept 12, 2007, 7:30pm »
11 years to become a surgeon/physician is quite acceptable in my opinion since you're working towards a higher qualification/goal all the way. but to be stuck in the middle and waste a few years in limbo, that really is a scary prospect.
Point number 9 states "Training programs are structured differently between Colleges and generally take between three and five years to complete. Some, including the Royal Australasian College of Surgeons (RACS), require trainees to complete a basic training program before applying for entry into advanced training for one of the sub-specialties. It is not uncommon for doctors to have worked 6+ years after graduation from medical school before entering advanced training, which itself is for two to four years. These periods are for full time doctors; they are extended if a doctor goes part-time or takes breaks in employment"
chinaski Administrator Dr Everything'll Be All Right member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #26 on Sept 12, 2007, 9:37pm »
Quote:
Yep - the queue for accredited positions (esp in physician and surgical specialties) are long, and those have to get extra points such as research, non-accredited years (ie getting screwed) etc...
I presume they mean advanced training as in advanced physician training or what used to be AST. If you count intern year, RMO2, then BPT 1 / BPT 2 or BST 1 / BST 2 - then 4 years is about minimum. Throw in years off or an extra year or two as un-accredited / research etc and that's about right.
For physician training, there is also the small matter of passing the exams to factor into this equation. Not everybody gets through first go, so there's an extra year of BPT regging for every time you fail before you can proceed to advanced training status.
yami Medical Student University of Wollongong 2008 overthinking things
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Re: Interns, RMOs, registrars - what does it all m « Reply #27 on Sept 12, 2007, 9:59pm »
sounds like GAMSAT. could they not be a bit kinder and hold the exam more than once a year????? that's a winkie folks, signifying rhetorical question. I am not up for a conversation about the pros and cons of weekly re-tests
chinaski Administrator Dr Everything'll Be All Right member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #28 on Sept 12, 2007, 10:05pm »
It's actually a little meaner than you even realise (and it makes GAMSAT look like a walk in the park!). If you pass the written, you can go onto the viva, which is held later in the year. Don't pass the written, you don't proceed any further - see you again next year. Pass the written, and fail the viva, and you are still stuck with an extra year in the wilderness.
skywalker Medical Student University of Queensland 2008 member is offline
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Re: Interns, RMOs, registrars - what does it all m « Reply #29 on Sept 13, 2007, 12:23am »
gasboy07, that sounds like some real hard (and smart) work that you put in during your time post-graduation. It's also good advice that i'll want to refer to again during med school and some years in the future when i graduate from med school. Much appreciated!
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gasboy07, that sounds like some real hard (and smart) work that you put in during your time post-graduation. It's also good advice that i'll want to refer to again during med school and some years in the future when i graduate from med school. Much appreciated!