<p>I've been doing some research, but I still dont understand how i will finally become a doctor...</p>
<p>Here are the steps in the order I have been told, but if someone can clarify if this is right/wrong and tell me more about these steps (especially residency and fellowship) </p>
<ol>
<li>Pre-med</li>
<li>Med School</li>
<li>Residency</li>
<li>Fellowship</li>
<li>ACTUAL CAREER AFTER 15 YEARS OF STUDYING AND EXAMS AND STRESS PLUS WRINKLES</li>
</ol>
<p>When do you actually decide on a speciality? ( I'm thinking surgery) And how does residency influence this decision? How easy/hard is it to get the fellowship and why is residency so competitive if you can get it for just internal medicine?</p>
<p>You decide a specialty during your residency. For example, if you want to be a pediatric neurosurgeon, you have to do a neurosurgery residency as well as a pediatric residency (that’s what I was told when I shadowed them). Upon further research, though, it appears that subspecialty training is done during the fellowship.
Residency is so competitive because just like there are highly ranked schools there are highly ranked residency programs. On a resume, one would rather have a residency at Mass. General due to its Harvard ties, etc. On top of that, people want to get into the specialty that will get them the most money, therefore there is further competition in that respect.
Based on what my parents (both physicians) have told me about fellowship, you either do it at the same place you were a resident or based on how well you did as a resident your mentors would help you find a great fellowship.<br>
Obviously it is a long road with a lot of hard work, but if you enjoy medicine and science as well as human interaction and selflessness (for a while) then it is worth it.</p>
<p>As someone in medical school, let me try and shed a little more light on this, and hopefully someone like bigredmed or NCG or the other guys further along can flesh this out better.</p>
<ol>
<li><p>Undergraduate education. Pretty simple, 4 years, get a bachelor’s degree. No need to determine specialty (or even major in biology). You have to pay tuition (or get financial aid)</p></li>
<li><p>Medical school. Also 4 years. The first 2 years are similar to undergrad in that you have courses and tests. The final 2 years are hospital based rotations where you become a member of the medical team at a hospital and you assist in the limited capacity that you can. You learn some procedures and manual skills and you will actually examine patients since you learn to do that in the first 2 years. By the end of the third year you pick what field you want to go into so that you can apply for internships/residencies. With the exception of a few surgical subspecialties (ortho, plastics, urology, neurosurgery), you can just do “surgery” residency. Again, Med school has tuition. Examples of other fields are pediatrics, OB/GYN, psych, internal medicine, anesthesiology, pathology, dermatology, and others</p></li>
<li><p>Internship/Residency. At this point you are officially “a doctor” in that you have the MD after your name. You can prescribe medication and order tests and be responsible for patients but you will have an attending physician looking over what you do. Depending on the field, this is anywhere from 3-7 years. At this point you would need to pick if you wanted to specialize further. You are no longer paying tuition and instead are paid by the hospital.</p></li>
<li><p>Fellowship. NOT MANDATORY UNLESS you are going to sub specialize. As alluded to above, I believe a general surgeon does not need this but a cardiothoracic surgeon - who is more specialized- would. It’s similar to how a general internist did not do a fellowship after his internal medicine residency while a cardiologist (or infectious disease, or gastroenterologist or rheumatologist) did. Again, you have a salary.</p></li>
<li><p>Attending physician. Here you’ll get a big salary and this is the level you are thinking of when you think “doctor,” but know that probably most of the patient care (at least in terms of time spent with patient) in hospitals is not performed by attendings.</p></li>
</ol>
<p>As moon man said, residency is competitive because there are some programs better than others, some cities better than others, and some fields with better lifestyles/salaries than others and unfortunately there are more students who want to go to certain programs than those programs can handle.</p>
<p>I recommend browsing around the AAMC’s website. They have a lot of good info although it’s geared towards college students because you don’t really have to worry about this right now.</p>