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          When resident physicians are sued for medical malpractice, an issue arises as to what the standard of care should be for these physicians who are still undergoing training.  Resident physicians practice medicine under a limited license which requires them to be supervised by attending physicians.  In light of the fact that resident physicians are still undergoing training, it may seem somewhat unfair to hold them to the same standard of care as fully licensed physicians.  The Supreme Court of Rhode Island recently considered what type of jury instructions should be given at trial regarding the standard of care that resident physicians are required to follow. 

            In Baccari v. Donat, the plaintiffs, Stephen and Dolores Baccaris filed a medical malpractice case against Stephen’s treating physicians and the hospital he was admitted to.  The plaintiffs claim that Stephen received negligent medical care in 1994 from the defendants that caused serious injury to both his arms and resulted in the amputation of his left arm above the elbow.  Among the defendants named in the lawsuit were resident physicians. 

            At trial, the judge instructed the jury that the resident physicians were required to exercise the same standard of care applicable to “physicians with unlimited licenses to practice.”  The judge later instructed the jury that the resident physicians were to be held to the same degree of skill and care “which was possessed and exercised by the average resident in emergency room care, pulmonary care, trauma care, plastic surgery care, orthopedic care, vascular care, and general surgical care.”  The judge then instructed the jury that the physicians were required to exercise “the degree of care and skill that is expected of a reasonably competent practitioner in the same class to which he or she belongs acting in the same or similar circumstances.”  At the time the judge gave this instruction, it was unclear whether the term “same class” was meant to refer to resident physicians or attending physicians with unlimited licenses. 

            The jury returned a verdict in favor of the defendant physicians.  On appeal, the plaintiff argued that the judge gave improper instructions to the jury regarding the standard of care applicable to resident physicians.  

            In rendering its decision, the Supreme Court of Rhode Island explained that a trial judge is required to instruct the jury with precision and clarity.  The trial judge must also be mindful that they are addressing a group of laymen when issuing instructions.  The Court also pointed out that the law in Rhode Island holds resident physicians to the same duty of care as any other fully licensed physician.  The Court then went on to determine whether by using the terms “average resident” and “physicians with unlimited license to practice”, the judge could have misled a reasonable jury. 

            After reviewing the judge’s second instruction, the Court determined that a reasonable jury could have interpreted it to mean that resident physicians are subjected to a lesser duty of care than physicians with unlimited licenses to practice medicine.  The instruction was therefore contradictory to the law in Rhode Island.  Since the Court found the judge’s instructions to be contradictory and misleading, they vacated judgment in favor of the defendants and remanded the case to the Superior Court for a new trial. 

            In the 1994 case entitled St. Germaine v. Pfeifer, the Massachusetts Supreme Judicial Court likewise held that the standard of care for first year residents is the same as for other physicians. 

Although defense attorneys in Rhode Island and Massachusetts can admit evidence to show that the resident physicians were practicing medicine under a limited license at the time of the alleged negligent treatment,  the jury will still be instructed that the resident physicians were required to conform to the standard of care of fully licensed attending physicians.  In order to preserve a defense verdict, it is important that juries are giving clear instructions on this issue before they are sent to deliberate.   


Standard 0f Care of Residents

by Attorney Frank E. Reardon

April 2000