Becoming a physician is a long road, including, for most people, going to college for 4 years after high school to earn a Bachelor’s Degree, then attending medical school for 4 years and finally completing a residency program for specialized training. Often, residency training is followed with more specialized training called a fellowship program. Residency and fellowship training combined can last about 3 – 7 years, depending on the specialization.
So, the grand total of time spent for most people is about:
4 years undergraduate education
4 years medical school
3-7 years residency (& fellowship)
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11-15 years of your life
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In the United States, medical students pay for tuition (and other expenses) during their undergraduate education (4 years) and medical school (4 years). However, during residency, residents are paid a salary of around $40,000 or so per year, depending on location, years in residency, specialty and other factors.
Most medical students accumulate well over $100,000 in student loans while attending medical school. Some students even accumulate up to $250,000 in debt to go through medical school. A piece of good news is that most physicians have no problems paying back their loans, sometimes in just a few years after completing residency training, if they handle their finances wisely. Nearly all medical students can qualify for loans easily to cover school related expenses.
Medical school
Medical school is intense. Much more intense than undergrad. Each semester is packed with roughly 24 credits of upper-division science courses including labs (no more generals or intro type of courses as in undergrad). But it is do-able – just requires lots of hard work. Many people say it’s like “taking a drink from a fire hydrant” since the volume of information covered is overwhelming. The first 2 years of medical school are classroom based to study the “Basic Sciences” (“basic” may be misleading – does not mean “easy”) and the last 2 years are typically hospital, clinical, and office based rotations devoted to Clinical Medicine. Combined, this results in a total of 4 years of medical school.
Residency
Residency is usually the final step in the training process of becoming a physician, unless you decide to pursue Fellowship training (see below), which follows Residency training. Residency training is specialty specific, whereas medical school provides the basis in science knowledge as well as a foundation in clinical medicine in a more general sense. Rotations in medical school cover all major specialty areas for a short period of time. On the other hand, residency is spent on getting specific training in one particular specialty over a period of 3 to 7 years, depending on the specialty – to become an expert in the area of training.
Residency is paid, so it is more like a job, but it is still considered training (post-graduate training) and done under varying degrees of supervision. In fact, it is THE training that turns out capable physicians with experience, who have “seen it all” in their respective fields – before beginning to practice medicine on their own, unsupervised.
Note that this is usually a very intense experience, with residents routinely working up to 80 hours a week. Recent regulations, adapted just a few years ago, have imposed an 80-hour work week limit for residents, although, historically, residents have worked up to 120 hours a week. Not all residency programs have fully committed to the 80-hour week so far. Residents usually take call every fourth night, or so, and can be in the hospital for up to 36 hours at a time, as part of their 80-hour week.
Fellowships
Fellowship training is like another small residency after residency. You may complete an Internal Medicine residency (3 years), followed by a Cardiology or Gastroenterology fellowship, for example.
Some specialties require completion of a residency before “subspecializing” with a fellowship. The specialties just mentioned fall in this category because they require completion of an internal medicine residency first.
Fellowships are very common and available for almost all specialties. Orthopedic surgeons may elect to do a fellowship in hand surgery, for example. This is “extra” specialized training that sort of makes them “hand experts” within orthopedic surgery, but they are still orthopedic surgeons, just with some additional specialized training. They usually maintain a normal orthopedic practice, not just focused on hand surgery, but they can limit their practice if they wish to.