Beer and the pecking order

The Swedish medical system is less hierarchical than the the Australian, at least superficially. But there are still plenty of reminders of the pecking order. One thing that I find irritating is the title given to different levels of doctors in the hospital system. Since most doctors in Sweden are salaried, those who work in the hospital and have completed their specialist training are the equivalent of what in Australia are called staff specialists. Here in Sweden they are have the unpleasant title of överläkare – roughly translated as “over doctor”.

Doctors who work in the hospital system who are not qualified as specialists are called underläkare – or “under doctors”. Underläkare covers the categories of doctors that in Australia are called interns and residents. What we call registrars, which are specialists in training, are here called ST läkare. ST stands for specialisttjänstgöring, which could be thought of as “specialist training” in English.

There is something about the under- and over- nomenclature that really irks me. The junior doctor is continually reminded of his or her underdog status. The doctors at the top can take comfort in their status as overlords. The only redeeming feature of the naming system is that the abbreviation for överläkare is öl, and many staff specialists add this abbreviation to the end of their name when they identify themselves. It always makes me smile, because öl is also the Swedish word for beer, the drink of the common man.

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