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Academic medical centers are characterized by the variety of their graduate and postgraduate students. This can lead to confusion about who may do what to patients and who may supervise whom. In the extreme case, nonmedical personnel, such as graduate students in the basic sciences, may be confused with physician fellows and given clinical responsibilities. More generally, teaching programs are often lax in their supervision of unlicensed physicians and medical students, giving them authority beyond their legal scope of practice.[90] This creates medical malpractice liability for the attending physician when a patient is injured through the improper actions of a student or resident. Treatment by an unauthorized person can support a lawsuit for battery. Moreover, juries are unsympathetic to physicians who shirk the duty to care for patients personally.

[90]Gleicher N: Expansion of health care to the uninsured and underinsured has to be cost-neutral. JAMA 1991; 265:2388-90.

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