July is upon us, and it’s a big month in the world of medicine. July 1 is traditionally the day that medical school graduates start their residency training. It’s a time of anxiety for those physicians and also can be a time of confusion for people being seen and treated by them in hospitals and clinics. I thought it might be good to review the process of becoming a physician so that if you find yourself in a teaching hospital, you’ll understand who is who.
Let’s pretend you decide you want to be a physician. You succeed in college and are accepted into medical school (either “allopathic,” which means M.D., or “osteopathic,” which means D.O. — they are essentially the same programs by the way).
Your parents are beaming and talking to their friends, and all of your relatives ask you to take their blood pressures. But what you really do is study endlessly for the first two years. Each semester of those first two years covers basic science topics needed to be a physician. And each semester accounts for about 20-25 credit hours. Along the way there are more tests, some in your classes and some standardized national tests.
Next, you’ll spend two years working and learning as a medical student in the hospital. You will continue to study and read, but will also do various rotations in medicine, pediatrics, surgery, radiology, intensive care, obstetrics and gynecology, and pretty much everything the hospital has to offer. Third-year students usually have a badge that indicates their student status; MS III stands for third-year medical student, and MS IV for fourth year.
During those last two years, you’ll spend thousands of hours involved in clinical activities, working alongside physicians. But you’re just getting started! Because during that last year of school, you’ll decide what flavor of doctor you’d like to be. And you’ll apply to various training programs, or residencies, in different places around the country, depending on your own needs, interests and geographical requirements. They will have all of your application information, and some will invite you for an interview. There’s a program called “The Match” that takes your application and preferences and the preferences of the training programs, “ranks” you and places you in a training program.
There is much rejoicing and celebrating when you graduate from medical school, find an apartment in the new city, move — and then, on July 1, you go into the hospital with M.D. or D.O. after your name and begin to learn by treating patients at the bedside.
First-year residents are traditionally called “interns,” or PGY 1 (that is, post-graduate year 1) residents and so on for years. Residency lasts anywhere from three years for some specialties like family medicine, pediatrics, internal medicine and emergency medicine all the way to seven years for some surgical specialties. Training can go on into further programs called “fellowships” in subjects like gastroenterology, cardiac surgery, intensive care, cardiology and others. Those in such programs are referred to, obviously, as “fellows.” Naturally, more tests called “board exams” follow residency and fellowship. Residency and fellowship will involve tens of thousands more hours of clinical education than medical school.
The next time you’re in a large hospital with teaching programs, whether July or any other time, you can now identify the species of doctor in the wild. You may observe, as with raccoons and other wildlife, “They’re just as scared of you as you are of them.” But the good news is, they’re really well-educated and dedicated to their professions. So be kind, be patient and say a prayer for them.
They’re going to need all the prayers they can get.