A quick overview of the basics of medical residency programs

Posted by Rohit Mittal

Congratulations! You are officially a doctor now that you have finished medical school. But, to be a practicing doctor you need training in the form of medical residency. Medical residency is different from medical school, it is first hand training on the job.

Here is a step by step guide to starting and understanding your medical residency program:

  • Match your Residency to your field of Specialization

Matching begins in the final year of your medical school. In order to land your residency, you need to do your research and apply on suitable residency programs. Once your application is reviewed, you will be interviewed by senior residents and attending physicians of your applied residency, you might also be given tour of the facility here. Use this opportunity to learn as much as possible about the program. To determine if this residency program is a good fit for you, consider faculty, program accreditations and all resident benefits.

After you have analyzed all your options for various residency programs, submit your list of residencies as per rank order to National Resident Matching Program. You can add/ edit your list of preference at any time before the deadline for submission, the list remains confidential. The residency programs also submit a list of candidates as per their order of preference. The computer then uses an algorithm to match students to most suitable residencies.

There is also a possibility that you may not match with any residency program. The reason for that could be applying to very few residencies or only applying to very competitive ones. Your medical school performance is of utmost importance here, it must be in line with typical candidates. In case you do not match with any residency, you can obtain a list of open residency positions from the Dean of your medical school. If you do not find anything suitable, you may apply for a one-year research fellowship program or you may take a sabbatical if you like.

If you are an international student who has finished medical school in the U.S., you will need a work visa for your residency program. You can either apply for OPT or H-1B through the hospital. Since the residency is usually for 4 years, even with OPT STEM Extension, you will not be able to complete it without filing for H-1B or some other longer term work visa.

  • Nature of Medical Residency Work

Nature of work and responsibilities of your medical residency, will again depend on your area of specialization. You will learn different procedures as emergency medicine resident, from your fellow surgery resident. Your specialized training involves assessing patients on admission, including physical examination. Residents may also be required to perform certain diagnosis and consult residents of other specialties, if needed.

Attending patient rounds, performing treatments and diagnosis as per one’s specialty are highlights of any residency program. You may prescribe treatment, educate patients about their situation and write discharge summaries as and when required. Depending on your area of specialization, you may also assist in surgeries and emergency procedures.

  • Length of the Medical Residency Program

The length of your residency program depends on the specialty you are pursuing. Most programs take between three to seven years. For example; doctors in family practice, internal medicine and pediatrics, the length of medical residency is three years. Whereas, for specialties like surgery and urology it may take much longer. You may even require additional training in the form of research fellowship in certain specialties. The fellowship can be anywhere between one to three years.

  • Hours required to work during your Medical Residency

You must have heard that medical residencies are grueling. There are no fixed working hours for medical residents. The number of hours you work, depends on your specialty and program. Most residents work 45 hours or more in their programs. Example: Residents in dermatology may work much less hours as they may not be required to work on call, whereas residents in surgery may work for much longer hours.

But remember, first year of residency is the worst. It gets much better in subsequent years, as first year students are required to work most. You may also be attending lectures and conferences along with working on your residency. But as per the law, the maximum you can be made to work is 80 hours a week. This limit of 80 hours a week may seem a lot, but it gets better with time.

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  • Pay-scale of Medical Residency

Pay-scale of all residency programs vary as per the demographics. It depends on your specialty and the place where you are practicing. As per American Medical Association, the average salary of first year medical residents in USA is somewhere between $40,000 to $50,000, as of 2012. Salaries increase every year, i.e., third year residents earn more than second year residents and second year residents earn more than first year residents.

FYI — sometimes it gets difficult to be approved for H-1B with incomes below a certain threshold. Once you start practicing, it will be easy for you to make a higher income than required in H-1B visa applications.

You are closely monitored by senior residents and attending physicians, as a first-year resident. Gradually, as you move ahead, you are given more authority and responsibility in your residency. Each year you will be a bit more independent, i.e., in your third year, you may be supervising first year interns. Eventually, you will have same responsibilities and independence as a physician. And, then you are a full-fledged doctor after you have completed your medical residency. Yay! Kudos to you!

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