Medical education in the United States

Medical education in the United States includes ed- field of specialization. These vary in competitiveness de-
ucational activities involved in the education and train- pending upon the desirability of the specialty, prestige of
ing of physicians (D.O. or M.D.) in the United States, the program, and the number of applicants relative to the
from entry-level training through to continuing education number of available positions. All but a few positions
of qualified specialists. are granted via a national computer match which pairs an
A typical outline of the medical education pathway is pre- applicant’s preference with the programs’ preference for
applicants.
sented below; however, medicine is a diverse profession
with many options available. For example, some physi- Historically, post-graduate medical education began with
cians work in pharmaceutical research, occupational a free-standing, one-year internship. Completion of this
medicine (within a company), public health medicine year continues to be the minimum training requirement
(working for the general health of a population in an for obtaining a general license to practice medicine in
area), or join the armed forces. most states. However, because of the gradual lengthening
of post-graduate medical education, and the decline of its
use as the terminal stage in training, most new physicians
complete the internship requirement as their first year of
1 Medical school residency.
Not withstanding the trend toward internships integrated
Main article: Medical school in the United States
into categorical residencies, the one-year “traditional ro-
tating internship” (sometimes called a “transitional year”)
In the United States a medical school is an institution continues to exist. Some residency training programs,
with the purpose of educating physicians in the United such as in neurology and ophthalmology, do not include
States in the field of medicine. Admission into medi- an internship year and begin after completion of an in-
cal school may not technically require completion of a ternship or transitional year. Some use it to re-apply to
previous degree; however, applicants are usually required programs into which they were not accepted, while oth-
to complete at least 3 years of "pre-med" courses at the ers use it as a year to decide upon a specialty. In addition,
university level because in the US medical degrees are osteopathic physicians “are required to have completed
classified as Second entry degrees. Once enrolled in a an American Osteopathic Association (AOA)-approved
medical school the five years progressive study is divided first year of training in order to be licensed in Florida,
into two roughly equal components: pre-clinical (consist- Michigan, Oklahoma and Pennsylvania.”[3]
ing of didactic courses in the basic sciences) and clini-
cal (clerkships consisting of rotations through different
wards of a teaching hospital). The degree granted at the
conclusion of the next four years of study is Doctor of
Medicine (M.D.) or, less commonly, Doctor of Osteo- 3 Residency
pathic Medicine (D.O.) depending on the medical school;
both degrees allow the holder to practice medicine after Main article: Residency (medicine)
completing an accredited residency program.[1][2]
Further information: Comparison of MD and DO in the Each of the specialties in medicine has established its own
United States curriculum, which defines the length and content of resi-
dency training necessary to practice in that specialty. Pro-
grams range from 3 years after medical school for inter-
nal medicine, to 5 years for surgery, to 7 years for neu-
2 Internship rosurgery. This does not include research years that may
last from one to four years if a Ph.D. degree is pursued.
Each specialty training program either incorporates an in-
Main article: Internship (medicine) ternship year to satisfy the requirements of state licen-
sure, or stipulates that an internship year be completed
During the last year of graduate medical education, stu- before starting the program at the second post-graduate
dents apply for postgraduate residencies in their chosen year (PGY-2).

1
2 7 SEE ALSO

4 Fellowship [5] “About Medical Specialties Matching Program”. Na-

tional Resident Matching Program. 2010. Retrieved 20
December 2012.
Main article: Fellowship (medicine)

A fellowship is a formal, full-time training program 7 See also

that focuses on a particular area within the specialty,
with requirements beyond the related residency.[4]
• The Flexner Report
Many highly specialized fields require formal training
beyond residency. Examples of these include cardiology, • Combined internal medicine and psychiatry resi-
endocrinology, oncology after internal medicine; dency
cardiothoracic anesthesiology after anesthesiology;
cardiothoracic surgery, pediatric surgery, surgical • Integrated Medical Curriculum
oncology after general surgery; reproductive endocrinol-
• List of medical schools in the United States
ogy/infertility, maternal-fetal medicine, gynecologic
oncology after obstetrics/gynecology. There are many
others for each field of study. In some specialties such
as pathology and radiology, a majority of graduating
residents go on to further their training. The training
programs for these fields are known as fellowships and
their participants are fellows, to denote that they already
have completed a residency and are board eligible or
board certified in their basic specialty. Fellowships range
in length from one to three years and are granted by
application to the individual program or sub-specialty
organizing board. Fellowships often contain a research
component.[5]

5 Board certification
Main article: Board certification

The physician or surgeon who has completed his or her

residency and possibly fellowship training and is in the
practice of his or her specialty is known as an attending
physician. Physicians then must pass written and oral ex-
ams in their specialty in order to become board certified.
Each of the 26 medical specialties has different require-
ments for practitioners to undertake continuing medical
education activities.

6 Footnotes
[1] Medline Plus (2012). “Doctor of Osteopathic Medicine”.
U.S. National Library of Medicine of National Institutes
of Health. Retrieved 20 December 2012.

[2] Medline Plus (2012). “Doctor of medicine profession

(MD)". U.S. National Library of Medicine of National
Institutes of Health. Retrieved 20 December 2012.

[3] DO-Online.org | Postdoctoral Training | FAQS,

[4] “Osteopathic Postdoctoral Training Structure” (PDF).

American Osteopathic Association. Retrieved 10
November 2012.
 3

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