Medical residents are called that because they once lived in hospitals
In the 19th century, young doctors in training slept in hospital dormitories, on call every second or third night, paid in little more than meals, a bed and clean laundry. The name stuck. Today's residency still means years of supervised work after medical school, but the sleepless hours finally came under legal limits.
Medical school gives graduates broad knowledge; residency is where they specialise. A resident already holds a medical degree yet works under a senior clinician, in effect practising on that supervisor's licence until training ends. Programmes last from two to seven years depending on the specialty. In the United States the first year is traditionally called internship, a final-year leader may be named chief resident, and further specialist study afterward earns the title fellow. Fully trained doctors become attendings, or consultants in Commonwealth countries.
Formal residency began at Johns Hopkins Hospital in Baltimore, where William Osler and William Stewart Halsted set up the first structured programmes in the late 19th century. Other institutions followed for the main specialties early in the 20th century, but even by mid-century most family doctors went straight into practice after a single internship year. The Second World War changed the scale. The G.I. Bill funded returning veterans' education, medical schools swelled, and residency positions grew from about 6,000 in 1940 to over 40,000 by 1970. Hospitals came to depend on residents for their daily running.
Working conditions provoked a reckoning. The death of Libby Zion drew national attention in 1984 to exhausted trainees working punishing shifts. The Association of American Medical Colleges recommended an 80-hour weekly cap in 1988, and New York became the first state to regulate resident hours the following year. Compliance lagged badly; inspectors a decade later still found widespread breaches. National limits arrived only in 2003, imposed by the Accreditation Council for Graduate Medical Education.
Systems differ sharply abroad. Australia trains specialists as registrars, with programmes running from 3 years for general practice to 7 for paediatric surgery. In Colombia, acceptance into public university residencies runs at roughly 1 to 5 percent of applicants, the positions are unpaid, and private tuition can exceed US$10,000 a year, pushing many doctors to train in Argentina, Spain or the United States.
Source: Residency (medicine)
