Medical students and residents who misrepresent themselves as fully licensed physicians or as specialists in some area of medicine defraud the patient and increase the probability of a malpractice lawsuit if the patient is injured by the care. If the patient understands that the person providing care is in training and if the trainee is properly supervised by a licensed physician, the patient may consent to care from a student or resident. The patient may not, however, waive the laws governing independent medical practice, and the providers may not subvert the patient’s right to consent.

It is particularly important that consent and billing for surgical procedures be done appropriately. If a resident is going to be performing a surgical procedure, the patient must be aware of this and the attending surgeon must be scrubbed into the surgery and directly supervise the entire procedure. It is not good enough to be available if needed. In the first case, the attending surgeon is arguably doing the surgery through the resident. In the second case, he or she is simply trying to collect a fee for services not rendered. If the patient has signed a consent for the attending surgeon to do the surgery, the absent surgeon is also perpetrating a fraud. Medical schools have paid more than $100 million in fines related to improper billing for medical student and resident care.