This might have already been said but:
As much I'm loving all of The Pitt fanfiction, I've noticed a lot of people don't seem to understand how the med school and residency system works and it's annoying me. The basic order goes med student->resident->fellow->attending.
If you are a med student, you do not yet have your licence to practice medicine and have not matched to your specialty. If you are working, then you are completing a rotation, which is usually 4-12 weeks, depending on the specialty. Other healthcare disciplines (physiotherapy, occupational therapy, respiratory therapy, etc) refer to these as work placements. You do not get paid for these placements; actually, you pay to complete these placements. Whittaker and Javadi are med students.
At the end of your fourth year, in the States, you would write the United States Medical Licensing Examination(USMLE). In Canada, you write the Medical Council of Canada Qualifying Examination (MCCQE). The USMLE is completed in three steps. Steps one and two are typically written when you are a med student; step three is written at the end of your first year of residency. Provided you pass steps one and two, you are now a resident. Residents are doctors. Residency is a three to seven year training period in a specialty, e.g., emergency medicine, psychiatry, pediatrics, etc. You are matched into your specialty. Matching is, to my understanding, just the most complicated job hiring system in the world. The most important bit to know from a writers perspective is that there is a really good chance that a resident does not have a say in their specialty. A person preparing for residency will go on interviews and rank their preferred specialties and workplaces (meaning the hospital they complete their residency at), and then the hospitals and the departments decide to accept them or not. If you do not get matched, you can go through a process called SOAP, which places you with positions that did not get filled. The only way to change your specialty is to re-start the residency process from scratch. Santos is a first year resident, meaning she would have only passed the steps one and two of the USMLE that spring. This means she is most likely matched into emergency medicine. Although I learned recently that some surgery residencies have their residents complete a year of emergency medicine before starting in the OR. My personal headcanon is that Santos was soaped into emergency medicine, and that is why she was like that in the beginning. Mel and McKay are second year residents, which means they have been working as doctors for at least a year and already have emergency medicine as their specialty. They most likely would have completed all three steps to the USMLE It is mentioned in the first episode that Mel did her first year at a VA hospital which is apparently a common thing to do in the states. Mohan is a third year resident. I think this makes Robbie's comments to Mohan about switching to psychiatry really mean cause he's basically telling her to consider re-starting her residency when she's more than halfway finished. Collins, Langdon, and Garcia are fourth year or senior residents. Emergency medicine has a four year residency, so this means that they are almost done with their residencies. Surgery can have a five year or longer residency, so Garcia might still be a resident in the next season. Due to Langdon having to take most of the year away from work, he will have to re-start his fourth year.
After your residency is completed, you have the option to complete a fellowship. Not all specialties require a fellowship. These are take anywhere from 1 to 3 years. Emergency medicine does not require the completion of a fellowship, although there are a lot of options available. These are basically highly specialized training on topics in your specialty. For example, John Hopkins offers a fellowship in combat medicine for those specializing in emergency medicine.
After all of that: congratulations, you are now a doctor in attending aka an attending doctor. This means no more exams, just a re-licencing test every 5 years. You can take on residents and med students of your own to supervise, or not. No one is going to make you. You can also easily move now as you do not have to stay with the hospital you matched to for your residency. Getting a job goes back to the much more normal and not as stressful process of a job instead of the hellscape that is the residency matching program. Robbie, Abbot, Shen, Parker, and Walsh are attendings.
(Edit: Parker is a senior resident. I think I saw Parker's energy and assumed she was already an attending)
