Medical School Hierarchy

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There has always been the unspoken Medical school hierarchy, or more commonly known as the "food chain". It's frustrating sometimes, about how people can get away with shit and be unreasonable just because they rank higher on the hierarchy.

Presenting to you the "food chain", from the lowest to the highest rank:

Medical Student: a.k.a. the shit of the plankton. Those poor students pay for exorbitant medical school fees, with up to 12k per semester (and that is post-subsidy cost), just so he or she can make copies, buy food, get vitals from patients, run about the wards filing case notes for the other "higher-ups". Unhappy about getting constantly yelled at by nurses or doctors? Suck thumb. You haven't gotten your MBBS yet, so talk to my hand. Tread carefully for you never know when a missile (from any of the higher-ups) may head your way.

House Officer: Finally! After toiling for 5 long years and levelling-up, the MBBS is in their pockets. Still, they are the planktons in the ocean. Tiny, insignificant minions scuttling about the wards, spending more than 12 hours a day in the hospital, surviving on caffeine, practically living in the hospital simply because there are at least 8 calls in a single month. With a non-existent social life, they still have to feign happiness at being overworked for the grades on your evaluation form at the end of rotation will depend on your work attitude. Oh right, and all the shit trickles down somehow, so you can get scolded by just about anyone, from MO to registrar to consultant. Just marginally better than a medical student (at least you get paid now), you'll have to somehow survive this hell year before you advance up the rank.

Medical Officer/ Resident: That's when you get a SLIGHT break - at least you're a small fish in the ocean now. You might still be overworked, but you have a somewhat existent social life.

Registrar: You can hold your own fort, somehow. Yes, life is so much better as you near the top of the food chain. You still recall how you struggled through medical school and training years, so you can relate to the poor souls at the bottom half of the food chain, and you have displays of niceties once in a while.

Associate Consultant: After rounds and rounds of exams, you have eventually reached the upper echelons of the medical world. This could go both ways. You could either end up as a really nice boss who understands the woes of your subordinates, or you could go "hell yeah! Finally it's time for me to rain shit on others instead!" Please go with the former. The world would love you better if you do so. (and you'll be able to start a "Thank You" card collection too)

Consultant: The head honcho. No one dares defy their authority. They love to quiz students on random facts during rounds/ clinics (while students will be desperately searching on UpToDate behind the cover of their clerking files).


Whether you get a nice consultant or not in your team all boils down to your luck. But remember, whatever happens, stick to the hierarchy. Always ask the HO first before heading up to the MO and etc, or you'll be (in)famous within the team by the next day.

Don't be afraid to put down your ego to apologise (even if you're not at fault). Well, hierarchy rules all. Even if you don't want to kiss asses, you'll just have to learn to appease them, at the very least. Anything is better than an official (an exaggerated) complaint against you by an angsty consultant. True story. 

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