Co-signature
Formal Definition
A secondary physician signature on a clinical note, order, or prescription that confirms review and approval — typically required when a trainee (student, resident, fellow) authors a note or writes an order under a supervising physician's authority.
How It's Used on the Ward
"Needs a co-sign" or "get the attending to co-sign" — the supervisory step before a trainee's order or note takes effect in many systems.
Example
""Student wrote an order for metoprolol 25mg PO BID — order went to 'pending co-signature' in the EMR. Attending reviewed, modified to 12.5mg given the borderline bradycardia, and co-signed.""
Clinical Context
Co-signature requirements vary by institution and EMR setup. Some systems allow resident orders to go active immediately; others require attending co-signature before execution. Students' orders always require co-signature. This is a safety feature — the supervising physician reviews the order before it's carried out. Understand your institution's workflow: does the order go live before or after the co-sign?