378 - Who’s Who in the Hospital: Public Understanding of Provider Roles and Training

Publication Number: 4370.378

Jenna Fleming, University of Minnesota Medical School, Minneapolis, MN, United States; Arman A. Shahriar, Indian Health Service, Minneapolis, MN, United States; Michelle M. Kelly, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Sydney N. Loy, University of Minnesota Masonic Children's Hospital, Eden Prairie, MN, United States; Michael B. pitt, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Jordan Marmet, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Alexis Quade, University of Minnesota Medical School, Minneapolis, MN, United States; Rheanne K. Maravelas, University of Minnesota Medical School, Roseville, MN, United States; Emily Hause, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Aarohi Shah, University of Minnesota Medical School, Maple Grove, MN, United States; Maya M. Ryaboy, University of Minnesota Medical School, Eden Prairie, MN, United States; Aarabhi S. Rajagopal, Seattle Children's, Seattle, WA, United States; Cris G. Ebby, UT Southwestern Medical Center, Dallas, TX, United States; Joshua B. Morof, University of Minnesota Masonic Children's Hospital, Minneapolis, MN, United States; Marissa Hendrickson, University of Minnesota Medical School, Minneapolis, MN, United States

Background: Recent legal activity, such as the September 2025 federal ruling in California restricting doctoral nurses from using the title "Doctor," underscores public uncertainty about professional titles and training pathways in medicine. Simultaneously, the rise of housestaff unions reflects growing trainee concerns surrounding compensation, workload, and professional recognition. In clinical environments where physicians, physician trainees, and various non-physician providers all deliver care, misunderstandings of roles and training may erode trust.

Objective: To examine the general public's understanding of professional healthcare roles and their required training, work hours, and pay.

Design/Methods: We conducted a cross-sectional survey of adult visitors without prior medical training at the Minnesota State Fair (August 2025), using a novel thirteen-item instrument tested for clarity. Descriptive statistics summarized responses (R version 4.2.2).

Results: Among 336 respondents (mean age 46.1 years [SD 17.9], 66% female, 63% completing a bachelor's degree or higher), most believed an understanding of training levels and the clear identification of physicians as either "very" (63-67%) or "moderately" (23-24%) important (Table 1). The majority (87%) correctly identified attending physicians as having completed medical school (Table 2), but correct identification was less common for trainees (residents 59%, fellows 42%, interns 20%), and respondents frequently thought that several non-physician providers had completed medical school (advanced practice provider 39%, physician assistant/associate 22-23%). Estimated training length was consistently low for physicians (intern, resident, fellow, and attending) but generally accurate for non-physicians (Table 2).
Perceptions of physician training structure, hours, and compensation are shown in Table 3. Most respondents expected residents and fellows to work 40-60 hours (38% and 43%, respectively) or 60-80 hours (42% and 32%, respectively) per week. Nearly half (47%) believed residents earn less than one-third of an attending's salary. By contrast, fellows were most often expected to earn about half (22%), two-thirds (23%), or the same (15%) as attendings.

Conclusion(s): Although role awareness was widely regarded as important, the public frequently confuses physician and non-physician roles and significantly underestimates the duration of physician training. Misconceptions about trainee workload and pay further illustrate limited understanding of the medical education continuum.

Table 1. General Public Perception of Importance (N = 333)


Table 2. Public Knowledge of Training of Common Roles Within Academic Medicine (N = 335)
1 Which of the following hospital team members have completed medical school and hold a medical degree? N = 335
2 Which of the following hospital team members are still completing their professional training? N = 335
3 What is the minimum number of years of higher education (education after high school) an individual in each of the following roles must have completed? If you do not know, please make your best guess. (Free Response). N = 331
4 Estimated reference ranges: APP - 2 to 4 years of nursing or undergraduate + 2 to 4 years of masters or doctoral; Attending Physician - 4 years of undergraduate + 4 years of medical school + minimum 3 years of residency; Fellow - 4 years of undergraduate + 4 years of medical school + minimum 3 years of residency; Intern - 4 years of undergraduate + 4 years of medical school; Medical Student - 4 years of undergraduate; Nurse - 2 to 4 years (A.D.N. or B.S.N.) of nursing; Nurse Practitioner - 2 to 4 years of nursing + 2 to 4 years of masters or doctoral training; Physician Assistant / Physician Associate - 3 to 4 years of undergraduate + 2 to 3 years PA school; Resident Physician - 4 years of undergraduate + 4 years of medical school.

Table 3. Public Perceptions of Position, Workload, and Relative Pay for Medical Students, Residents, and Fellows after Explanation of the Nature of the Role (N = 335)