What is the hospital hierarchy?

General manager. This top-tier hospital official oversees the administration of a hospital. They are tasked with developing and implementing hospital policies that favor patient safety and recovery. They are also accountable for a hospital's financial stability in terms of budgets and the operational sustainability of different departments within the hospital.

Medical directors. Many large-scale hospitals have multiple medical directors, while smaller-scale hospitals may just have one or a few. Medical directors are in charge of establishing safe and effective healthcare policies.

They should always have high patient care quality in mind. Nearly every aspect of inpatient and outpatient care is managed by medical directors. Some may oversee specific teams of specialized doctors, while others may oversee more general care. Every physician in the hospital setting reports to a medical director as their high superior.

Head of department. Heads of departments are doctors that specialize in certain fields of medicine, such as orthopedics, oncology, and pediatrics. These are the leaders of these fields of medicine in hospital settings.

They may develop and orchestrate medical strategies, and then attending physicians take their directions. They may also stand in the place of an attending physician if that physician is currently occupied by an emergency or more serious matter.

Attending physician. Attending physicians are senior doctors in the hospital setting. They are the doctors responsible for the patient's treatment plans. All attending physicians have completed at least three years of residency, and most work in specialized fields.

Fellows. Fellows are doctors right below attending physicians. These are doctors that are working on a fellowship or advanced training in a specialized medical field.

They have already completed their primary residency and are usually seeking to become attending physicians or want to open up a private practice. Most fellows do not often have direct contact with patients as they are still in training. However, they can write orders in a patient's chart and make decisions related to a patient's treatment plan.

Chief resident. This doctor is in charge of all resident doctors in the hospital. They direct the activities of residents and must have already completed at least three years of residency to obtain the role.

Senior resident. Right beneath the chief resident is the senior resident doctor. Typically, these doctors are in their third year of residency.

Junior resident. These resident doctors are generally in their second year of residency.

Resident (Intern). Intern residents are doctors in their first year of residency. Residents have already graduated from medical school. They've also taken and passed the required national licensing exams (USMLEs).

Each resident is licensed to practice medicine as an MD (medical doctor). However, this person must have supervision when working with patients until three years of hand training are completed. These years are referred to as the primary residency.

Some specialty fields require participation in specific residency programs for as long as eight years.

PA-C. A PA-C has advanced education and is trained in the same way physicians are. A PA-C performs duties with an emphasis on diagnosing, assessing, and treating diseases. This includes diagnosing acute and chronic conditions, ordering and performing diagnostic tests, and prescribing medication.

Nurse Practitioner. A nurse practitioner works directly with patients and is typically responsible for providing urgent, primary, and specialty care to a specific population of people.

This includes groups such as children, women, and geriatrics, among others. Their duties include recording and tracking patient medical histories, collecting patient samples and data, ordering lab tests, and many other direct patient tasks.

Hospital pharmacist. A pharmacist dispenses prescription medications to patients and offers expertise in the safe use of prescriptions. They also may conduct health and wellness screenings, provide immunizations, and oversee the medications given to patients in the hospital setting.

Clinical nurse specialist. A clinical nurse specialist may perform these functions in a hospital setting for patients: order tests, make diagnoses, administer basic treatments, and, in some states, prescribe medications. Beyond this, they may provide expertise and support to a team of nurses.

Nurse tech. A nurse tech has more advanced medical training than normal nurses. This allows them to participate in more technical and a wider array of tasks. They perform procedures like inserting catheters, removing stitches or staples, or operating more advanced medical monitoring equipment.

Registered nurse. A registered nurse or RN has a broad list of duties in a hospital setting.

These include activities such as preparing patients for exams and treatments, administering medications, operating and monitoring medical equipment, educating patients and their family members on treatment and supervising practical and vocational nurses.

Vocational nurse. A vocational nurse usually works under the direct supervision of a registered nurse (RN), a medical doctor, or a mid-level practitioner to offer primary bedside care for patients.

Certified nursing assistant. A certified nursing assistant or CNA provides direct care to patients in hospitals. They help patients with a wide range of basic needs, including eating, bathing, grooming, mobility, and more. CNAs report to and take orders from registered nurses, doctors, and other higher-level hospital staff.

Medical assistant. Medical assistants are some of the lowest level roles in hospitals. Their job centers around many administrative duties. They may be tasked with reaching out to patients to schedule appointments or follow-up care. Medical assistants also have a role in bookkeeping and billing. Most of their duties are performed at a desk.