Statement on Non-Physicians' Misuse of the Title "Resident" in Health Care Settings

Developed by: Committee on Anesthesia Care Team
Original Approval: October 15, 2025

Introduction

The American Society of Anesthesiologists (ASA) is committed to upholding the highest standards of anesthesia care and patient safety. In health care settings, the title “Resident” should be reserved for employed physicians credentialed and enrolled in Accreditation Council for Graduate Medical Education (ACGME) programs. The “Resident” designation reflects a defined level of training and expertise recognized under federal regulations. 

When nonphysicians, including students, adopt the title “resident” in the health care setting, it creates confusion, risk, and potential patient safety issues. Patients or other health care staff may mistakenly think the “resident” is a physician, which leads to confusion on who is directing patient care, undermines informed consent, and compromises patient safety. For example, in an emergency, verbal orders to nurses or respiratory therapists could be mistakenly taken from a non-physician (including a student) misrepresenting themselves as a “resident,” with potentially serious consequences.

“Resident” in a Health Care Setting Means a Physician

The title “Resident” originated in the late 19th century, when newly graduated physicians resided in hospitals and undertook rigorous, around-the-clock training in a chosen specialty.ⁱ  Over time, the term evolved into a formal designation reserved for licensed physicians employed in structured Graduate Medical Education (GME) programs. 

Today, the ACGME defines a Resident as “an individual enrolled in an ACGME-accredited residency program.”ⁱⁱ  These residency programs are structured educational experiences that prepare physicians for independent medical practice and board certification in their respective specialties. 

Federal Regulations

Federal regulations reinforce this physician-only definition. Under 42 CFR §415.152,ⁱⁱⁱ  a Resident is:

• An individual participating in an approved GME program (medicine, osteopathy, dentistry, or podiatry); or
• A physician with a temporary or restricted license practicing only in a hospital.
  

In contrast, 42 CFR §413.85(e)^v  defines approved nursing and allied health education programs as those licensed by state law or accredited by national nursing or allied health accrediting bodies. These programs, including nurse anesthesia training programs, are not GME programs and, the students cannot be “residents” in a health care setting per Federal Regulations. 

When a Student Inappropriately Uses the Term “Resident"

No student, including medical or nursing, should ever refer to themselves as a “resident”. Students pay tuition. Residents are employed and credentialed. They possess a state issued medical license as well as a DEA license – none of which a student can obtain. Applying the title “Resident” to student registered nurse anesthetists (SRNAs) is inconsistent with both accreditation standards and federal regulations, rendering such usage inaccurate and misleading. 

Potential Risks of Non-Physicians', Including Students', Use of “Resident”

1. Patient Confusion: Patients may assume that individuals using the title “Resident” have completed the same level of training as physicians, leading to misunderstandings about the qualifications of their care providers.
2. Undermining Informed Consent: Accurate representation of a health care provider’s qualifications is essential for informed consent. Misuse of the title “Resident” can result in patients making decisions based on incorrect assumptions about the practitioner’s expertise.
3. Compromising Patient Safety: Misuse of the title “Resident” can erode trust and compromise the quality of care. By calling themselves "Resident," non-physicians, including students, can cause confusion among the health care team and lead to a member of the team following the student's orders. 

ⁱWriter, Staff. (2014, November 14). The history of residency—and what lies ahead. American Medical Association. https://www.ama-assn.org/education/improve-gme/history-residency-and-what-lies-ahead
ⁱⁱAccreditation Council for Graduate Medical Education. ACGME Glossary of Terms. June 3, 2024. https://www.acgme.org 
ⁱⁱⁱ42 C.F.R. §415.152  
^iv42 C.F.R. § 413.75  
^v42 C.F.R. §413.85(e) 
^viStudents in training programs are explicitly prohibited to be employed during their training “by title and/or function.” Council on Accreditation of Nurse Anesthesia Educational Programs (2025). Standards for Accreditation of Nurse Anesthesia Programs - Practice Doctorate. https://www.coacrna.org/wp-content/uploads/2025/08/Standards-for-Accreditation-of-Nurse-Anesthesia-Programs-Practice-Doctorate-May-2025-Effective-Date-January-2026-1.pdf  
^viiAmerican Medical Association Policy H-275.925: Protection of the Titles "Doctor," "Resident" and "Residency"