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What is Medical Residency?

Posted by Callie Torres
May 31, 2023

After graduating from medical school, newly licensed doctors go through several more years of post-graduate training in a specialty of their choice, known as a medical residency. The specialty chosen dictates how long the residency will last. The residency program, which takes place at a hospital or academic center, is created to give both hands-on experience and technical training to resident doctors in order to prepare them to become fully licensed physicians and practice without supervision. In general, physicians cannot practice medicine without first completing residency. 

Med students commonly apply for residency during their fourth year of med school. While the actual match process only takes a month or so, students can expect to spend the greater part of their fourth year researching programs, undergoing audition rotations, interviewing, and creating their match list. This is undoubtedly a long and arduous process but is vitally important as it decides where students will spend the next three-plus years.

Quick Navigation Links and FAQ's about Residencies and Medical Residency Programs:

  1. What is a residency program?
  2. What are the duties of a resident doctor?
  3. Do residents get paid?
  4. How many hours do residents work?
  5. How long is residency?
  6. What's the difference between a resident and a medical student?
  7. What's the difference between a doctor and a resident?
  8. What's the difference between residency and fellowship?
  9. Is residency harder than medical school?
  10. How to succeed in residency?
  11. What is a senior resident?

 

What is a medical residency program?

Medical residency programs take place after training has been completed at an Allopathic or Osteopathic Medical school and offer in-depth, practical training in a chosen medical specialty. Most often these residency programs take place at a clinic or teaching hospital. It is during this period of time that a resident will function and perform the duties of an attending doctor while being supervised. This is where the resident will learn the intricacies of diagnosis and patient care. While med school has already taught doctors basic and broad medical knowledge, residency provides more focused and in-depth training in one particular area of medicine. Residency differs drastically depending on the medical specialty; however, at the completion of residency, all graduating residents are competent doctors. 

What do you do in medical residency?

A resident physician is a recent medical school graduate who is enrolled in a graduate medical education (GME) training program called a medical residency. In clinics and hospitals, resident doctors are often referred to as residents, while 1st-year residents are commonly referred to as interns. In order to continue their study and training in a particular area of medicine, residents work in hospitals, clinics, or medical offices. A resident may perform such a job for anywhere from 3 to 7 years, depending upon the medical specialty that they have chosen. This time frame is referred to as residency.

Direct patient care is what resident doctors perform while in residency. This covers diagnosing, controlling, and treating medical issues. Each resident in a medical facility is under the supervision of fully licensed doctors and senior residents. Junior residents typically begin with more oversight and simpler chores. As residents advance in education and experience, their responsibilities grow as well.

For example, a general surgery residency is typically 5 years. Here is a list of common responsibilities a general surgery resident may have throughout all of residency:

  • See surgical consults: When providers think their hospitalized patient may need surgical intervention, they order what is called a surgical consult. This requests that a surgery resident or attending come and see the patient and determine if surgical intervention is needed. Trainees of all years of surgical residents will spend time on consult service and learn to develop the skills necessary to determine when surgery is and is not necessary.
  • Round on hospitalized patients: Rounding refers to physicians going around the hospital and seeing all of their patients. This is done at least once daily. During this time, physicians, including residents, will interview and perform a physical exam on their patient, review relevant medical information and tests, and place orders.
  • Observe and perform bedside procedures: Residents will first observe, then learn to perform bedside procedures. These types of procedures can include central line insertion, debridement, etc.
  • Order and interpret laboratory tests: There are numerous laboratory tests that help surgeons determine if surgery is indicated, as well as tell how well a patient is healing from surgery. Imaging studies such as CT and MRI are commonly interpreted by a radiologist. However, surgical residents will also learn how to interpret these images throughout residency.
  • Prescribe and monitor medications: There are numerous medications, such as pain medications and antibiotics, that surgical patients may require. Surgical residents learn when to prescribe different antibiotics and pain medications, as well as their dosages and length of use.
  • See patients in clinic: Surgery residents will also see patients in an outpatient clinic setting. In clinic, residents will perform physical exams, take history and write medical notes on the patients they see. Patients may be coming to clinic to determine if they need surgery, or they may be following up with the resident after surgery has been performed.
  • Observe and perform surgeries: Performing surgeries is perhaps the most important part of surgical residency. First-year residents, also called interns, will start by observing or assisting in surgeries. As they continue on in their education, they may start to perform simpler surgeries, such as appendectomies. As more experience is gained, surgical residents will learn to perform more complex surgeries until they have mastered all surgical operations.

attending-physician-with-medical-residents

 



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Medical residents do receive reimbursement for their labor, although the income will vary depending upon the year of residency as well as the State that the residency program is located in and a resident's year in residency. According to , the average resident salary is $64,200. However, many residents feel that they are underpaid. Residents often work a high amount of hours, approaching 80, as will be discussed in the next section. Additionally, the majority of residents have a significant amount of student loan debt that they are required to pay off during school, with over a quarter owing greater than $300,000. The combination of the high amount of hours work, the advanced years worth of education and the amount of student loans leave most residents feeling underpaid. 

In addition to a salary, there are many other benefits that residents can receive. These include health and dental insurance, paid time off, parking benefits, and cafeteria benefits. Some residency programs also offer living stipends in high-cost-of-living areas like the coasts, book fund allowances, conference travel fund allowances, reimbursement for boards, and subsidized child care. These additional benefits can save residents a large amount of money during residency and should be taken into consideration when med school graduates consider residency programs.

How many hours do medical residents work?

The number of hours that residents work will vary with the year they are in, the program they are in, and the policies of the hospital they work at. According to US regulations set forth by the (Accreditation Council for Graduate Medical Education), residents are only permitted to work a total of 80 hours a week, averaged over a period of four weeks. The 80 hour limit is self-reported by residents. Certainly specialties such as surgical specialties, internal medicine, and emergency medicine may approach or even exceed their 80 hour limit.

Depending on their specialty and rotation, medical residents on average put in between 40 and 80 hours each week. The maximum number of continuous hours that first-year residents may work is 16, while more experienced residents may work continuously for 24 hour. Irregardless of their specialty, medical residents work long and hard hours throughout their entire residency.

What is the length of a medical residency?

The duration of residency training is dependent upon which specialty a doctor has chosen, but on average, it lasts 4 years. Program lengths range from three to seven years for resident training with surgical residencies having a minimum of 5 years. Some physicians additionally choose to pursue fellowship training after completing their residency, which can last on average anywhere between one and three years following residency.

According to the (National Resident Matching Program), the ten medical specialties that offered the highest number of residency positions to first-year postgraduate students (PGY1s) in the 2023 Match were:

  • Internal Medicine - 3 years in duration
  • Family Medicine - 3 years in duration
  • Emergency Medicine - 3 to 4 years in duration
  • Pediatrics - 3 years in duration
  • Psychiatry - 4 years in duration
  • Transitional Medical Year - 1 year in duration
  • Medicine (Preliminary Year) - 1 year in duration
  • Surgery - 5 years in duration
  • Anesthesiology - 4 years in duration
  • Obstetrics-Gynecology - 4 years in duration

 

medical-residency-grand-rounds

What is the difference between a medical student and a resident?

The crucial factor to realize is that while in medical school pursuing an MD or DO degree, med students are paying tuition and are not doctors. In contrast, doctors have a job during residency and are paid for their work. Being in residency means that medical school graduates are now a Physician and can see patients, but only under supervision. Residency allows the opportunity to gain knowledge and experience in one's chosen field of specialty and, upon completion, can lead to full licensure and the opportunity to become board-certified and practice independently without supervision.

What is the difference between a doctor and a resident?

Residents are doctors in post-graduate training that takes place after medical school has been completed. They are not able to practice medicine without supervision. A Residency program is a training environment where newly graduated MD or DO physicians go to begin specialized training to become a certain type or specialty of a doctor, such as an internal medicine doctor, Ob-gyn, or a kind of surgeon. Residents may be referred to as interns throughout the first year of training, as this first year of residency is often called an intern year.

When the general public generally thinks of as a doctor is usually an attending doctor or attending physician. This is a physician who has finished residency and can practice autonomously without oversight. When medical students have graduated and have finished school, and received their degrees, they are technically a doctor as well.

To summarize, a resident (doctor) is someone who has completed medical school but has not completed residency, while an attending doctor is a fully licensed doctor who was completed residency and is licensed and board certified in their medical specialty.

Residency vs Fellowship - What is the difference?

A resident physician is prepared for becoming a board-certified medical specialist through their residency experience. On the other hand, a fellowship is an educational training program that happens after a medical residency has been completed and is designed to allow a residency graduate to concentrate on a particular area of their chosen medical specialty. Fellowships most often last for one to three years and are optional. One does not need to be fellowship trained in order to become licensed or employed.

residents-with-x-rays

Is Medical Residency harder than medical school?

It is difficult to say whether residency or medical school is more difficult as they differ drastically. While medical school can be stressful due to the amount of learning and tests, residency is often stressful due to the workload and amount of hours worked. Individuals who enjoy school and education may think medical school is easier than residency, while individuals who enjoy being busy and working around people may think residency is easier. Either way of looking at it, both med school and residency are busy and stressful times for medical students and residents alike.

How to Succeed as a Resident?

While each residency will be highly variable, several rules for success can be followed in order to succeed. These include:

  • Stay motivated: It's no secret that residency is challenging and requires long working hours. With a demanding schedule, it can be hard to stay motivated. However, in order to get more out of residency and learn the most possible, it is important to stay motivated and work hard.
  • Find time to read/study: With a busy schedule, finding time to spend studying may be challenging. However, a lot of learning will occur during residency, and a portion of the education will need to be self-motivated learning. Therefore, it is essential to continue to find time to study to avoid falling behind in gaining the necessary knowledge.
  • Learn to communicate properly: Communication is one of the most essential skills one must master during residence. It is important to learn to properly communicate not only to patients but also to coworkers, nurses, other physicians, and staff. When physicians are communicating such vital information related to a patient's health or wellness, it is imperative that no miscommunications occur.

What is a Senior Medical Resident?

Medical residents in their last year of residency are often called senior residents. As one progresses through residency, more responsibilities are accumulated as residents gain experience and knowledge. As such, senior residents commonly take on other duties, which may include overseeing more junior residents. Another term that may confuse senior medical residents is "chief resident." Chief residents are often senior residents whose peers and program directors have chosen to be resident leaders. They usually complete extra responsibilities such as creating schedules, solving upcoming problems, creating program changes as needed, and communicating issues with program directors. Serving as a chief resident is considered a position of honor as it indicates that the resident was a leader among their peers.

How to get started in Medicine?

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Posted by Callie Torres

Callie Torres is a resident physician working at a top tier institute in the Midwest. She is a freelance health and medical writer as well as an author of many peer reviewed medical articles. She additionally serves as a Captain in the United States Air Force.

Topics: Feature Medical Practice

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