Who’s Who in the Hospital?

View from below of six medical professionals in surgical scrubs and masks, gathered around a patient during surgery in an operating room.

A Student Nurse’s Guide to Doctor Levels in Australia

5 min read • Placement • Updated May 2026

The hierarchy of doctors in Australian hospitals can be confusing at first.

Here’s a simple breakdown of the levels of doctors you’ll hear on placement.

Intern

An intern is a doctor in their first year after graduating from medical school.

They are fully qualified doctors, but they’re still completing supervised training to gain general registration.

Typical responsibilities:

  • Writing notes

  • Ordering scans and blood tests

  • Completing discharge summaries

  • Reviewing stable patients

  • Prescribing medications (with supervision)

Interns are often very approachable because they’re learning too. They may ask nurses for practical guidance about ward routines, equipment, or workflows.

If you’re worried about a patient and the intern seems unsure, it’s completely appropriate to escalate further.

Resident Medical Officer (RMO) / Resident

After internship, doctors usually become Residents (sometimes called RMOs).

This stage usually lasts a few years while they rotate through different specialties like surgery, emergency, ICU, paediatrics and mental health.

Typical responsibilities:

  • Reviewing deteriorating patients

  • Managing day-to-day ward issues

  • Writing treatment plans

  • Communicating with senior doctors

  • Responding to clinical concerns

Residents often become the “workhorse” doctors of the ward. You’ll speak with them frequently during shifts.

Flowchart showing career progression from Intern at the top, followed by Resident/RMO, then Registrar, and advanced roles like Senior Registrar/Fellow/Advanced Trainee and Consultant/VMO/Staff Specialist. The chart is from The Australian Student Nurse

Registrar

A registrar is a doctor undertaking specialist training in a chosen field.

Examples include:

  • Surgical registrar

  • ICU registrar

  • Paediatric registrar

  • Emergency registrar

This is a more senior role with significantly more responsibility.

Typical responsibilities:

  • Making higher-level clinical decisions

  • Leading patient management plans

  • Performing procedures

  • Supervising junior doctors

  • Responding to emergencies

Registrars are often extremely busy and may cover multiple wards or departments. When nurses escalate concerns to a registrar, it usually means:

  • The patient is more complex

  • The issue is urgent

  • Junior doctors need support

Registrars are often the key decision-makers overnight.

Senior Registrar / Advanced Trainee / Fellow

Some specialties have doctors who are nearly finished specialist training.

These doctors:

  • Have years of experience

  • Function almost at consultant level

  • Often supervise juniors heavily

The terminology varies between specialties and hospitals.

Consultant / Staff Specialist/ Visiting Medical Officer (VMO)

A consultant is a fully qualified specialist doctor. Sometimes you might hear them called simply a "boss".

This is the senior medical role most people picture when they think of a specialist - e.g. cardiologist, surgeon, intensivist, psychiatrist.

Typical responsibilities:

  • Final clinical decisions

  • Leading medical teams

  • Complex procedures and surgeries

  • Supervising registrars and residents

  • Overall responsibility for patient care

Consultants may not spend much time on the ward, but they are ultimately responsible for the patient’s management.

During ward rounds, consultants often move quickly. Student nurses can learn a huge amount by listening carefully to the discussion during ward rounds, including their clinical reasoning and priorities of care.

Medical team performing surgery in an operating room, with a patient covered in a blanket and surrounded by medical equipment, nurses, and doctors wearing scrubs, masks, and surgical caps.

Important Things Student Nurses Should Remember

1. Junior doesn’t mean incapable

Interns and residents are qualified doctors. They simply have less experience.

2. Nurses are often the continuity

Doctors rotate constantly between wards and specialties. Nurses frequently notice subtle deterioration first because they spend more time with patients.

3. Escalation matters

If you’re concerned about a patient:

  • Start with the appropriate doctor

  • Escalate if needed

  • Follow your hospital’s chain of command

Good clinicians escalate early.

4. Every specialty works differently

An ICU registrar may function very differently from a surgical registrar. Over time, you’ll learn the culture and structure of each team.

Final Thoughts

As a student nurse, knowing who does what can help you:

  • Escalate concerns appropriately

  • Build professional confidence

  • Understand ward dynamics

  • Learn faster on placement

Understanding the medical hierarchy isn’t about status — it’s about communication, safety, and teamwork.