A teaching hospital is a hospital that trains physicians after medical school, through residency and fellowship programs, and often trains nurses, pharmacists and other health professionals as well. Many teaching hospitals are linked to a medical school and are sometimes called academic medical centers. If you are treated at one, residents and medical students are likely to be part of your care team, supervised by fully trained attending physicians.
This guide explains how teaching hospitals work, who is who on the care team, and what it means for you as a patient. It is general information, not medical advice.
How doctor training works in the US
After medical school, new doctors must complete residency training in a specialty before they can practice independently. Residency programs in the US are accredited by the Accreditation Council for Graduate Medical Education (ACGME), and most last three to seven years depending on the specialty. Some doctors then complete a fellowship for further subspecialty training, such as cardiology after internal medicine.
Teaching hospitals host these programs. Medicare is the largest public funder of graduate medical education, paying teaching hospitals through direct graduate medical education payments and indirect medical education adjustments, which recognize the higher costs of running training programs.
Who is on the care team
| Title | Who they are |
|---|---|
| Attending physician | A fully trained, licensed physician who is responsible for your care and supervises the team |
| Fellow | A physician who has finished residency and is training in a subspecialty |
| Resident | A physician with a medical degree who is training in a specialty. First-year residents are often called interns |
| Medical student | A student in medical school who participates in care under supervision but is not yet a doctor |
| Advanced practice providers | Nurse practitioners and physician assistants, who work alongside physicians |
You can always ask a team member their role, and you can ask to speak with the attending physician.
Benefits of being treated at a teaching hospital
- Specialized services: teaching hospitals often provide complex care such as organ transplants, advanced cancer treatment, high-level trauma care and rare disease clinics.
- Clinical trials: many take part in research, giving patients access to studies of new treatments.
- 24-hour physician presence: residents are in the hospital around the clock, so a physician is on site at night and on weekends.
- Multiple specialists: complex cases can be discussed among several specialties under one roof.
Many Level I trauma centers and NCI-Designated Cancer Centers are part of teaching hospitals or academic medical centers. See What Is a Trauma Center?.
Possible drawbacks
- More people involved: you may be examined by several team members and asked the same questions more than once.
- Rounds: care teams often discuss patients at the bedside or nearby as a group, which some patients find uncomfortable.
- Hand-offs: residents work in shifts. ACGME limits clinical and educational work hours to 80 hours per week averaged over four weeks, which means more changes in who is on duty.
- New residents in July: residency years generally start on July 1. People sometimes mention a "July effect" when new trainees arrive. Studies have reported mixed results, and hospitals increase supervision during this period.
Your rights as a patient
- Know who is treating you. Staff should wear badges with their name and role. Ask if you are unsure.
- Ask questions. You can ask the attending physician to explain your plan.
- Informed consent. You have the right to understand who will perform a procedure and to consent to it. Federal guidance from CMS requires informed consent before trainees perform sensitive examinations, such as pelvic, breast, prostate or rectal exams, on a patient under anesthesia.
- Decline participation. You can decline to have medical students present for parts of your care, and you can decline to take part in research. Declining research will not affect your standard care.
Teaching hospitals and quality
Teaching status by itself does not tell you whether a hospital is right for your care. Teaching hospitals tend to treat sicker and more complex patients, which affects some measures. Look at quality data for the care you need. See How CMS Star Ratings Work and How to Choose a Hospital.
Types of teaching hospitals
- Major academic medical centers, owned by or closely affiliated with a medical school, often with many residency programs
- Community teaching hospitals, which host a smaller number of residency programs, often in family medicine, internal medicine or surgery
- VA medical centers, many of which are affiliated with medical schools. See How VA Hospitals Work
- Children's hospitals, most of which train pediatric residents and fellows. See children's hospitals
- Public hospitals, many of which have long served as major training sites. See public hospitals
Teaching hospitals can be nonprofit hospitals, public or for-profit.