For those who are not familiar with the world of medical-colloquialism.
THE HEIRARCHY of SURGERY
Different terms are used depending on which country and which system.
Each surgical ‘team’ will usually consist of at least one member of each heirarchy.
The rule is, whoever is the most junior in the room, is to be blamed for anything that goes wrong in the operating room.
The Medical Student
Self-explanatory. Bottom of the food chain. Primary targets of bullying from senior nurses.
The Intern/PGY1 (Postgraduate Year 1)
Fresh out of medical school. First year graduates who suddenly realise there was a lot about life that medical school didn’t prepare them for.
JHO (Junior House Officers)/RMO (Resident Medical Officers)/Residents
Junior doctors, not quite qualified to make decisions, but not as naive as an intern. Usually undecided as to what they want to be when they grow up.
SHO (Senior House Officers)/PHO(Principle House Officers)/Residents/Unaccredited Registrars
The inbetweeners. These are doctors at least 3 years out of medical school. There are 3 types. The ones that have their sights set on specific specialties and are known as the Shit-kickers – they are willing to do ANYTHING for those above them to get into a specialist training program. Then, there are the ones that are just trying out different specialties before deciding – majority of which stay SHO’s forever and never get onto any specialist training program because they are so indecisive. Finally, those who are just gaining more experience before leaving the hospital system to become family doctors or general practitioners (GP) in the community – typically more focused on lifestyle rather than working overtime.
Apprentice. These are doctors who have been successfully accepted into a specalist training program and under supervision of a full qualified surgeon. Training program usually consists of 3-5 years depending on the specialty. They usually start as eager-beavers before graduating to arrogant-know-it-alls.
SR (Senior Registrar)/ CR (Chief Resident)
Almost a Surgeon. These are the final year training surgeons, who are either studying for their final exams or just completed their exams. They are only one step away from becoming the real deal. They talk big, do heroics and act like martyrs because they think they are hot stuff amongst the junior doctors.
Cooked Medium to Well. Some freshly qualified surgeon feel they need more time to fine-tune their hands-on skills before they can fly on their own, so he or she will try to do an extra year of training as a Fellow. This can be done either at a local hospital or they could choose to travel overseas to discover new experiences. They get to order the junior doctors around to do the leg work, but they don’t have the responsibilities of a qualified surgeon. These are surgeons who are capable of operating, but with a healthy dose of self-doubt when it comes to decision making.
Consultant/Attending/SMO (Senior Medical Offcers)
The boss. The buck stops here. This is a fully qualified surgeon who is in charge of the team, makes the decisions and is held responsible for all the F$%#-ups of all members in the heirarchy below him/her.
We are creatures of habit. We only haunt certain areas within the hospital.
Theatre/OR (Operating Room)/Operating Theatre
The place where surgery takes place.
Outpatients/OPD (Outpatient Departmnt)
Clinics. Where patients are seen for a consultation and decisions are made as to whether they require surgery or not. Average waiting time – how long is a piece of string……
Place where doctors meet for impromptu BMW meetings (Bitching, Moaning and Whining). Filled with junior doctors who are there for the unpalatable but free hot drink that is labelled ‘coffee’. The only place one can find instant tea (yes, the powder variety). The constant ringing of a phone or pager is the background hum and daytime TV silently flickers across the massive plasma screen on the far wall.
A small room/cubicle where the door can shut out everything and everyone. And where medical staff can pretend they are doing work instead of activities such as: napping, checking realestate, selling and buying shares, browsing shopbop online, flicking through trashy magazines, updating status on facebook, uploading blogs, forwarding jokes on internal emails, eating, staring into space, cry.
The place where patients lie in bed and wait for visitors. Single rooms are coveted – but only reserved for the very sick, nearly dying and the dead.
A special ward for prisoners. A ward with no signage. The only entry and exit is via a sliding door with reflective tinting. A place where even the doctors have their badges checked, their phones/pagers confiscated, and everything sharp emptied out of their pockets. Doctors see patients in this ward totally defenceless, without the power of even a pen.
AKA ER (Emergency Room), ED (Emergency Department) or The Zoo.
People who we work with, we love them, we hate them, and we can’t live, work or get anything done without them.
Gasman. Gaswoman. The doctor that puts you to sleep so you don’t feel pain during an operation. They also keep you alive during the operation and make sure you wake up after an operation. Basically, they are more important than most people give them credit for.
The smart doctors. The physicians who treat diseases with drugs usually before but preferably after they have worked out the diagnosis. Some of them also faint at the sight of blood, and speaks a completely different medical dialect to their surgical counterpart.
Completely different and more complex heirarchy than doctors. At the Top are the CULT’s (Clipboard Under Left Tit). These are nurses that work in admin, spot the jwellery and nail polish – they don’t need to get their hands dirty. The lowest being the ‘grads’ – new graduate nurses who have just finished nursing school, often found crying somewhere in the toilet. All nurses worship the pagan God of Teabreaks.
Big burly men (and sometimes women) who does the physical work. Most are covered in tattoos, and many have muscles to admire. Growls when being nagged by the nursing staff.
These are terms of endearment and reference; some may be matter-of-fact; none meant to be derogratory.
Those who keep coming back, with old problems or new problems. Usually on first-name basis with all the doctors and nursing staff.
Patient with Friends
Prisoners – who usually sit in the clinic waiting room or brought to the operating theatre with guards.
Discharged against medical advice. People who decide that they are more knowledgeable than their doctors and can treat themselves better outside the hospital.
The ones that wonder off the ward, and never come back.
Minding My Own Business. A patient who has multiple assault injuries but claims that he/she was attacked without provocation.