The "Intern" Label: Introducing Unnecessary Confusion and Bias?

J Surg Educ. 2023 Nov;80(11):1602-1607. doi: 10.1016/j.jsurg.2023.04.014. Epub 2023 May 20.

Abstract

Objectives: The Oxford English Dictionary defines "intern" as "a student or trainee who works, sometimes without pay, at a trade or occupation in order to gain work experience." In the medical realm, the label "intern" may introduce confusion as well as implicit and explicit bias. In this study, we sought to examine the general public's perception of the label "intern" compared to the more accurate label "first-year resident."

Design: We developed 2 forms of a 9-item survey that assessed an individual's level of comfort with surgical trainees' participation in various aspects of surgical care and knowledge of medical education and work environment. One form used the label "intern" and the other used "first-year resident."

Setting: San Antonio, TX.

Participants: A total of 148 adults in the general population at 3 local parks on 3 separate occasions.

Results: A total of 148 individuals completed the survey (74 per form). Respondents who did not work in the medical field reported less comfort with interns vs first-year residents participating in various aspects of their care. Only 36% of respondents were able to correctly identify which surgical team members have completed a medical degree. Directly assessing perceptual incongruity between the labels "intern" and "first-year resident," 43% of respondents said interns have a medical degree compared to 59% for first-year residents (p = 0.008), 88% stated that interns work full-time in the hospital compared to 100% for first-year residents (p = 0.041), and 82% stated that interns get paid for their work in the hospital compared to 97% for first-year residents (p = 0.047).

Conclusions: The label "intern" may confuse patients, family members, and perhaps other healthcare professionals regarding the level of experience and knowledge of first-year residents. We advocate for abolishing the term "intern" and replacing it with "first-year resident" or simply "resident."

Keywords: Implicit bias; Microagression; Mistreatment; Patient education.

MeSH terms

  • Adult
  • Education, Medical*
  • Hospitals
  • Humans
  • Internship and Residency*
  • Students, Medical*
  • Surveys and Questionnaires