Can someone please explain how residency works?

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Can anyone elaborate on which physician careers can be pursued only after an IM residency? For a long time, I thought becoming a cardiologist or an oncologist had their respective residencies, but recently I heard that you need to complete a internal medicine residency first? Is this true? Which other specialities are like this?

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I'm fairly certain that there is a specific residency in Radiation Oncology that has nothing to do with IM. For Cardiology, I think you're correct.
 
Gastroenterology, Hepatology, Nephrology, etc are all specialties of Internal Medicine too, I believe.
 
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Thank you for this! But how can plastic surgery only be two years in length?! I don't think I'm reading this right…
After G Surg. It's usually a fellowship or subsequent residency .
 
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After G Surg. It's usually a fellowship.

Oh okay thanks! It wasn't listed as a speciality of something, so I got confused (most of the items show what branch of medicine the speciality falls under, but plastic surgery was not listed under GSurg). The list also says ophthalmology is 3 years, but I guess that's wrong too?

Also, this resource says plastics is 6 years, not 7 https://residency.wustl.edu/Residencies/Pages/LengthofResidencies.aspx
Is it of variable duration?
 
PRS can be categorical (done as a residency) or done as a 2 year fellowship after 5 years of gen surg residency.

Ophtho is three years after doing a general prelim year first. Others like this include neuro, Derm, radiology, rad onc. Not sure if PMR is categorical or not.

Some surg programs throw in an extra research year which may explain that.
 
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Oh okay thanks! It wasn't listed as a speciality of something, so I got confused (most of the items show what branch of medicine the speciality falls under, but plastic surgery was not listed under GSurg). The list also says ophthalmology is 3 years, but I guess that's wrong too?

Also, this resource says plastics is 6 years, not 7 https://residency.wustl.edu/Residencies/Pages/LengthofResidencies.aspx
Is it of variable duration?

Plastics has two paths (as does vascular/cardiothoracic). You can either do a 2-3 year fellowship after a 5 year G surg residency, or you can do a 6 year integrated residency, and ophthalmology is 3 years after a preliminary intern year.
 
Most medicine residencies are 3 years followed by an optional fellowship. The subspecialties of internal medicine include allergy, rheumatology, cardiology, nephrology, gastroenterology, cardiology,pulmonology, infectious disease, endocrinology, geriatrics, hematology/oncology, and general internal medicine.
 
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PRS can be categorical (done as a residency) or done as a 2 year fellowship after 5 years of gen surg residency.

Ophtho is three years after doing a general preliminary year first. Others like this include neuro, Derm, radiology, rad onc. Not sure if PMR is categorical or not.

Some surg programs throw in an extra research year which may explain that.

PMR is very rarely categorical.

To the OP:
All specialties require 1 year as an intern (either surgical or internal medicine) except pathology.
Fellowships after internal medicine are:
Endocrinology, Rheumatology, Allergy, Cardiology (then additional fellowships for interventional cardiology or electrophysiology), Pulmonology/critical care medicine, hematology/oncology, nephrology, Infectious disease, geriatrics, and Gastroenterology.

Alot of fellowships are open to multiple specialties (pain management, palliative care, sports medicine, etc)

Neurology, anesthesiology, PM&R, ophtho, Dermatology, radiology, and radiation oncology require a separate intern year to be completed before starting.

Generally speaking ob/gyn, family medicine, emergency med, psychiatry have intern years included but the intern year is more focused on their specialty. Also pediatrics is isolated to kids starting day one of intern/resident year.

Surgery is similar in that you must always complete 1 year of general surgery whether you are going into ortho, urology, neurosurgery (although theirs is sometimes more neuro focused from day one), ENT, plastics, etc. As people mentioned some surgical specialties (vascular, plastics, cardiothoracic) are fellowships after completing a 5 year general surgery residency. However, now residencies also exist to train these specialist surgeons.

It's confusing, but you will learn from exposure and mentors in med school.
 
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You can go here http://www.abms.org/member-boards/specialty-subspecialty-certificates/ for a list of official residencies and fellowships. However, this doesn't explain the process very well and is somewhat incomplete, because it only lists fellowships included by the ABMS. For example, there are no listed subspecialties for ophthalmology, but in reality, there are several (e.g. retina, oculoplastic ).

Plastic surgery is either a combined residency of 6 years total, or general surgery ( a minimum of 3 years is required, but usually these days applicants have done a complete 5 or 6 year residency ; can also have done ortho or urology or ENT ) followed by 3 years of plastic surgery. At one time it was general surgery followed by 2 years of plastic surgery, but that option no longer exists. Now it's 3 years.

I'm fairly certain that there is a specific residency in Radiation Oncology that has nothing to do with IM

Radiation oncology is a completely different field than Oncology. Rad Onc is it's own specialty. It's not a subspecialty of radiology, nor is it a subspecialty of medicine. Oncology is a subspecialty of medicine ( or pediatrics). It used to be "Hemeatology-Oncology" , and included both of those areas, but the ABMS now lists those specialties separately, so perhaps now they are distinct fellowships. I don't know if that's actually the case.

Surgery is similar in that you must always complete 1 year of general surgery whether you are going into ortho, urology, neurosurgery (although theirs is sometimes more neuro focused from day one), ENT, plastics, etc.

Just to clarify: Typically, you just match into the surgery specialty, whether ortho or urology or ENT, etc, and your program will arrange for your schedule during your early year(s) to be focused on the areas that will apply to your specialty. So in terms of applying and matching, you just apply for surgery or ortho, or ENT, and the program will have your schedule set up for the next 5 (or 6) years. You don't apply for a separate intern year, which you will need to do for some specialties, such as derm.
 
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