What to do after graduating from medical school?

[phamdmd]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

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[BlackSails]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

After you graduate from medical school, you have an MD degree, but no medical license. You apply for a residency program. After 1 year, you get your licesnse, and can quit and do whatever you want. However, if you want to actually work in a hospital or get paid by insurance, you need to complete a residency. Residencies vary in time from 2 to 7 years. After your residency, you are now a board eligable physician. Some doctors choose to do additional training in the form of fellowships. These range from 1 to 5 years.

During residency you are poorly paid (40-60k), work twice as much as the average american (or more), and are in general, treated like dirt.

 

[nevercold]

During residency you are poorly paid (40-60k), work twice as much as the average american (or more), and are in general, treated like dirt.

Salary is marginal, but it's enough to live on. You get to defer loans (at least for now) during residency.

If you're somewhere where they treat you like dirt, you didn't choose the right residency program. You shouldn't have to feel like that anywhere. You work HARD, but you should be respected and supported and be in a collegial environment.

 

[phamdmd]

Oh it's 2-7 years for residency? What makes the range so much? How do you get lucky enough to go after 2 and what makes you stay behind to 7? And the same for fellowship 1-5 years?

 

[Tired Pigeon]

Oh it's 2-7 years for residency? What makes the range so much? How do you get lucky enough to go after 2 and what makes you stay behind to 7? And the same for fellowship 1-5 years?

Depends on the specialty. Neurosurgery, for example, takes a little longer to learn how to do than, say, family practice.

 

[nhtreehugger]

Depends on the specialty. Neurosurgery, for example, takes a little longer to learn how to do than, say, family practice.

And the fellowship also depends on the specialty you are going into. For example, to be a gastroenterologist, you spend 3 years in an Internal Medicine residency, and then 3 more years in a gastroenterology fellowship. Then you can do an additional year in a hepatology fellowship if you want to specialize even further.

 

[MattD]

I've never actually heard of a 2 year residency. 3 years is for things like FP, IM, Peds. Most of the surgical specialties are 5 years, and some have a research requirement that can extend it up to 7. So the length of your residency is pretty much set by the specialty you choose. There aren't, for example, 3 year internal medicine spots competing with 5 year IM spots.

 

[Piyush]

You an also end up doing research work, and for that sometimes people get their MD, then a PhD and the setup a lab.

Cheers
Piyush

 

[RySerr21]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

you are already taking the MCAT....that seems really early. are you gonna have all your pre reqs done by then?

 

[Phoenix.]

I've never actually heard of a 2 year residency. 3 years is for things like FP, IM, Peds. Most of the surgical specialties are 5 years, and some have a research requirement that can extend it up to 7. So the length of your residency is pretty much set by the specialty you choose. There aren't, for example, 3 year internal medicine spots competing with 5 year IM spots.

I've also read about there being some 3 and (mostly?) 4 year EM residencies.

 

[BlackSails]

I've never actually heard of a 2 year residency.

Preventitive med is 2 years. I think nuc med is as well.

 

[MattD]

Preventitive med is 2 years. I think nuc med is as well.

According to FREIDA, nuc med is 3 years.

I'm not sure I'd call prev med a 'patient care' specialty, even to the extent path or rads would be. Seems more policy/research based to me. But, yes, it's a 2 year, or even 1 year (aerospace), residency.

 

[phamdmd]

I want to do clinical and anatomical pathology, how much years do you think that will take? And can you subspecialize in infectious diseases from there for your fellowship?

 

[PeepshowJohnny]

http://www.ama-assn.org/vapp/freida/spcstsc/0,1238,300,00.html

Four years.

There is a fellowship in Medical Microbiology after Path

http://www.ama-assn.org/vapp/freida/spcstsc/0,1238,314,00.html

Searching descriptions online, it's much more focused on the lab work than an Infectious Disease fellow out of Internal Medicine, who typically does a mix of clinical and laboratry work.

 

[MrBurns10]

I want to do clinical and anatomical pathology, how much years do you think that will take? And can you subspecialize in infectious diseases from there for your fellowship?

Those are two different things. Pathology is a 4 year residency with fellowships, such as forensic. Infectious disease, on the other hand, is a fellowship of internal medicine.

 

[Law2Doc]

Preventitive med is 2 years. I think nuc med is as well.

I think those are two years are usually after a year of clinical internship (at least nuclear medicine is). So it's 3 years of residency total, but only two years of specialty residency. Plan on 3+ years if you want to practice. You'd only really ever do less if you wanted to just keep your foot in the door for medicine, but go into another field altogether and not practice at the current time.

 

[NonTradMed]

you are already taking the MCAT....that seems really early. are you gonna have all your pre reqs done by then?

It's doable to have your prereqs in by the end of your sophomore year. You just take chem and physics and bio the first year, then orgo and another bio course sophomore year. I did that. I would recommend it only if you have a relatively "light" first two years....you don't want to rush through the prereqs!

 

[vmp200]

Can someone explain this.
While looking at FREIDA for Surgery- General Specialty:
http://www.ama-assn.org/vapp/freida/pgm/0,1238,4405121344,00.html

If you look under total program position, there is a difference between the available positions for Yr1 and Yr2 and typically PGY2 has fewer available positions. I am assuming that if only 9 position are available in PGY2 from 16 positions in PGY1, they choose the 9 best residents but my question is what do the residents who do not make it to the PGY2 end up doing?

 

[MrBurns10]

Can someone explain this.
While looking at FREIDA for Surgery- General Specialty:
http://www.ama-assn.org/vapp/freida/pgm/0,1238,4405121344,00.html

If you look under total program position, there is a difference between the available positions for Yr1 and Yr2 and typically PGY2 has fewer available positions. I am assuming that if only 9 position are available in PGY2 from 16 positions in PGY1, they choose the 9 best residents but my question is what do the residents who do not make it to the PGY2 end up doing?

My guess is that they're including those PGY1ers who are doing a gen surg internship year but then go on to do the subspecialties-- for the match out of med school residencies, they typically require you do your internship year in general. That's my best guess for that, though I don't know why they wouldn't just include those under, say, ortho.

 

[vmp200]

My guess is that they're including those PGY1ers who are doing a gen surg internship year but then go on to do the subspecialties-- for the match out of med school residencies, they typically require you do your internship year in general. That's my best guess for that, though I don't know why they wouldn't just include those under, say, ortho.

So no one really gets dropped after PGY1 (unless of course they are just terrible)?

 

[MrBurns10]

So no one really gets dropped after PGY1 (unless of course they are just terrible)?

That's definitely true. No resident gets dropped from a program unless they do something really bad or are severely deficient.

 

[MattD]

I think those are two years are usually after a year of clinical internship (at least nuclear medicine is). So it's 3 years of residency total, but only two years of specialty residency. Plan on 3+ years if you want to practice. You'd only really ever do less if you wanted to just keep your foot in the door for medicine, but go into another field altogether and not practice at the current time.

I was thinking that, but FREIDA usually lists if the position is for straight out of med school or requires a previous year, and it didn't mention a previous year being necessary. Still, I just skimmed it quickly and may have missed it, and I'm more inclined to think that an internship would be required first

Can someone explain this.
While looking at FREIDA for Surgery- General Specialty:
http://www.ama-assn.org/vapp/freida/pgm/0,1238,4405121344,00.html

If you look under total program position, there is a difference between the available positions for Yr1 and Yr2 and typically PGY2 has fewer available positions. I am assuming that if only 9 position are available in PGY2 from 16 positions in PGY1, they choose the 9 best residents but my question is what do the residents who do not make it to the PGY2 end up doing?

Yeah pyramid residencies don't exist in the US anymore. It used to happen the way you describe, but the program you're referring to must be adding the prelim slots in with the categoricals.

 

[njbmd]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

Medical school prepares you for residency in this country. When you graduate from medical school, most people enter residency in some specialty (3 to 5 clinical years[some have one to two additional research years]). Completing residency makes you eligible for specialty board certification which is the minimum for credentialing for practice. You can practice without board certification but most third-party payers will not allow you to see their patients.

In addition, you must pass three steps of board exams for state licensure. In general, step 1 is after your basic science years, step 2 is after your clinical year and step 3 is after graduation. To open an office and practice as a physician, you need to have a license in some state and board certification so that you can earn some money.

 

[deuce924]

Sorry to hijack the thread but this is a question I have always had. Say one wants to do cardiology. I know there is a 3 year residency in IM then a 3 year fellowship in Cardiology. My question is are you accepted into your fellowship for Cardiology while doing your IM residency or do you have to wait? What I am trying to say is does someone know they will be a cardiologist when they start their IM residency or do they roll the dice and take the chance at getting stuck with IM? Thanks

 

[nhtreehugger]

Sorry to hijack the thread but this is a question I have always had. Say one wants to do cardiology. I know there is a 3 year residency in IM then a 3 year fellowship in Cardiology. My question is are you accepted into your fellowship for Cardiology while doing your IM residency or do you have to wait? What I am trying to say is does someone know they will be a cardiologist when they start their IM residency or do they roll the dice and take the chance at getting stuck with IM? Thanks

I don't know if there are any combined IM/Cardiology programs (although there are IM/EM and IM/Pediatrics), but in general, you apply for the IM residency during med school. Then, while in residency, you have to apply for the fellowship. That's why for competitive specialties like Gastro and Cardio, residents even do research in addition to their already heavy workload (so that they'll be competitive applicants for the fellowship). I'll try to look for the link about this (I looked this up recently), and I'll add it when I find it

 

[deuce924]

I don't know if there are any combined IM/Cardiology programs (although there are IM/EM and IM/Pediatrics), but in general, you apply for the IM residency during med school. Then, while in residency, you have to apply for the fellowship. That's why for competitive specialties like Gastro and Cardio, residents even do research in addition to their already heavy workload (so that they'll be competitive applicants for the fellowship). I'll try to look for the link about this (I looked this up recently), and I'll add it when I find it

Thanks for your help. I have always wondered about that but never got around to ask it. Oh and sorry again Phamdmd for hijacking the thread.

 

[luckycharms08]

Salary is marginal, but it's enough to live on. You get to defer loans (at least for now) during residency.

When you defer loans, is there still interest accumulating?

 

[DadofDr2B]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

http://forums.studentdoctor.net/showthread.php?t=404764&highlight=aprogdirector

A lot of information about the match process from a program director. Very good.

 

[smq123]

When you defer loans, is there still interest accumulating?

Yes.

 

[njbmd]

Sorry to hijack the thread but this is a question I have always had. Say one wants to do cardiology. I know there is a 3 year residency in IM then a 3 year fellowship in Cardiology. My question is are you accepted into your fellowship for Cardiology while doing your IM residency or do you have to wait? What I am trying to say is does someone know they will be a cardiologist when they start their IM residency or do they roll the dice and take the chance at getting stuck with IM? Thanks

Once you have matched into Internal Medicine, you can generally decide to pursue a fellowship during your second year. Pursuit of fellowship is dependent upon your interests, your competitiveness (need university IM residency program + research for the more competitive fellowships) and your performance in your residency program. My colleagues in IM tell me that GI and cardiology are among the most competitive fellowships to pursue and your chances of landing them without good inservice scores in a good residency program + research are slim.

I would say that if you look at IM as being "stuck" you are probably not going to want to do Cardiology. Many internists (including my father and uncle) had IM practices where they did far more cardiology than general medicine. They didn't do intervention but more than 80% of their practice was treating cardiovascular disease.

My best friend from graduate school is now an Interventional Cardiologist who entered a university IM program, excelled in his residency performance, did three research projects with me and was able to enter an Interventional Cardiology fellowship (university program). He aced his boards and now enjoys his practice. Bottom line: if you are set on Cardiology (especially interventional) better be prepared to do well in medical school and land an excellent university-based IM program and do well there too. It's easier said than done.

 

[Vano]

Write memoirs

 

[Law2Doc]

They didn't do intervention but more than 80% of their practice was treating cardiovascular disease.

Yeah. Even if you aren't treating it during a particular admission, your patient is usually going to have hypertension, high cholesterol or other cardiovascular issues. You will be reading EKGs on nearly every patient.

 

[DrBubbles]

Hey guys. I'm new to this sdn thread and I wanted to know more about residency and fellowship after graduating. I really have no idea what this means, can someone fill me in? After I graduate from a medical school, how long will it take until I can open up my own practice as a physician? Right now, I am a second year at UCI, and I want to go to UCI medical school. I'm just maintaining my GPA and plan on taking the MCATS this summer. I was wondering if anyone can just fill me in on what goes on after the 4 years of medical school. Thank you all!!

It looks like you've got loads of info on residency and fellowship years, but as for the MCAT:

I would encourage you to wait and take it the summer before your fourth year, unless you're planning on graduating early. If you take it now, they'll be just good enough for you to apply to enter med school immediately after college. If you a) decide to take a year off, or b) don't get in the first time around, your scores won't be any good at most schools after the three years are up prior to matriculation, and you'll have to retake them. Is there a pre-health advisor at UCI? I'm sure if you met with them they can help answer any further questions you may have, and help you outline a good pre-med timeline.

Best of luck!

 

[MossPoh]

I've never actually heard of a 2 year residency. 3 years is for things like FP, IM, Peds. Most of the surgical specialties are 5 years, and some have a research requirement that can extend it up to 7. So the length of your residency is pretty much set by the specialty you choose. There aren't, for example, 3 year internal medicine spots competing with 5 year IM spots.

The 2 year residencies don't really exist anymore. In the past before family practice one could be a general practitioner (not to be confused with the british term, which is just FP) and they normally completed an internship and sometimes an extra year and then went off on their own.

As far as being paid nothing....well, things are much better than they used to be. One can actually survive on a salary now. In the 60s my dad made 80 dollars a month as a resident...in NYC. He also had two children and a wife to support at the time. Even thinking of inflation, that wasn't much money back then. His parents had to chip in for rent.

 

[MeowMix]

In the 60s my dad made 80 dollars a month as a resident...in NYC. He also had two children and a wife to support at the time.

But he almost certainly did not have $160,000 in student loans.