The internal rules for medical residencies at the Hospital General Dr. Manuel Gea González require residents to “cumplir debidamente las órdenes de los profesores o médicos adscritos” (duly carry out the orders of the professors or attending physicians). The official standard for medical residencies, NOM-001-SSA-2023, places the work of residents under the direction and supervision of the head professor, the adjunct professors and the head of service.
In 2022, a representative of medical interns described their training to Expansión Política as “una estructura bastante rígida, híper jerárquica” (a quite rigid, hyper-hierarchical structure). The physician and lawyer Mauricio Sarmiento, quoted in the same article, gave an example: the attending physicians use the elevator, and the residents and the interns do not.