<p>so i know that once you get out of med school you do a residency depending on what your area of interest is, but my question is can you choose when to do your residency or does it have to be after med school?</p>
<p>I guess I’m not sure what other options you’re imagining, but yes, you have to do it after medical school. As a resident, you are a physician (you have your MD or DO degree), so you have to have graduated. So that means you can’t do it before or during med school. And you can’t do it years after the fact because in order to actually practice medicine you have to have completed at least 1 year of supervised post-graduate education. If you didn’t do residency, you couldn’t get a job.</p>
<p>Residency is essentially an apprenticeship. You spend 3-7 years learning how to be a specialist in your field of choice by actually taking care of patients under the direction and guidance of more experienced residents, fellows (people who have finished residency, but are doing extra training to further specialize), and attendings (licensed and board certified physicians in your fields).</p>
<p>During residency you’re learning all the things that a “standard” physician in your field should know to be board certified. For example, as a pediatrics resident, over the last three years I’ve done month long rotations in the Neonatal ICU (4 months worth), the Pediatric Emergency Room (~3.5 months), the Pediatric ICU (2 months), a general pediatric clinic (~3.5 months), 10 months of inpatient hospital pediatrics (with some months having a specialty focus such as Pulmonology or Gastroenterology or Neurology) along with month long rotations in Cardiology, Genetics, Endocrinology, Developmental Pediatrics, Adolescent Medicine, newborn nursery, and Hematology/Oncology. The actual breakdown of months will vary slightly from program to program (there are 198 pediatrics residencies in the US). But the gist is that programs have to supply certain experiences as deemed essential to being a good pediatrician by the American Board of Pediatrics.</p>
<p>If you were a surgeon, you’d spend time rotating through the various specialties of surgery (ie general surgeons do rotations in pediatric surgery, burn, colo-rectal, vascular, trauma, oncology, plastics, minimally invasive, and cardiothoracic surgery). They learn how to do actual surgeries. Surgery residents have to show that they’ve completed a certain number of operations of various types in order to show competency to the American Board of Surgery before they can take the exams needed to be board certified.</p>
<p>As mentioned before, if someone wants to do something even more specialized, they’ll do a fellowship - which must be done AFTER residency. For example, I love taking care of kids in the pediatric intensive care unit, so I will be doing a Pediatric Critical Care fellowship after my residency. Instead of the board base of experiences that occur in residency, all of my training as a fellow will be geared towards the ICU. Most of my time will be in the PICU, but I’ll also spend time with the peds anesthesiologists to get better at intubations and establishing airways, as well as with the pediatric cardiologists because understanding the cardiovascular system is vitally important to being an ICU doctor (and kids with congenital heart defects often need ICU level care and their physiology is very different due to their ‘plumbing’ being abnormal). </p>
<p>What I hope is obvious is that each level builds on the experiences of the level before it. Medical school does not give you enough experience to take care of patients independently. It does provide you with the scientific basis of how the body works and gets sick, it does expose you to enough to make a decision on what type of doctor you wish to be (hopefully), and it teaches you “how” to be a doctor - in that you know how to write notes, how to take a history, how to do a physical exam, how to follow sterile technique for procedures/surgery and so on.</p>