Medical school students dream of the day when they graduate from their MD school and become independent medical practitioners. But wait… it seems like we have fast forwarded a movie till the happy ending. From medical school graduation to becoming a board-certified physician, the path is dotted with many stops and bends (and twists and turns) along the way. It takes a great deal of commitment, motivation, resilience, and self-discipline to glide through each stage of the process. Your post-graduation journey, albeit exciting and highly rewarding, includes a series of critical stages in hands-on training, self-exploration, and career development. Read on to know about the journey from graduating from med school to residency and beyond.
Residency Internship
After medical students have completed four years of md school and demonstrated that they’re ready to embark on the path to becoming a successful Doctor of Medicine (MD), there comes residency.
The first year of training after md school is called an internship, also commonly known as the preliminary year of residency or PGY-1 (Post-Graduate Year 1). This is a turning point in the life of an aspiring physician, as they realize that after 12 years of school, four years of college and another four rigorous years of Caribbean md school, how much they still have to learn. While your medical school may have given you plenty of foundational training and even some hands-on experience with patients, now is the time to learn the ins and outs of coordinating a patient’s care under the guidance and supervision of senior physician. Interns traditionally wear short white coats to distinguish themselves from senior residents and attending physicians.
During the first year of your residency, you will inevitably rotate through different specialties (such as ER, general surgery, internal medicine, intensive care, orthopedics, pediatrics and OB/GYN) or even rotate to different areas within one specialty, while gaining practical experience and honing your clinical abilities. During your internship year, you will encounter a diverse portfolio of patients across a wide spectrum of diseases. The more patients you care for, the more proficient you will become. In addition to the knowledge you gain from caring for patients, you will also need to attend lectures and conferences to broaden your skillset.
USMLE Step 3
While you have already completed the Steps 1 and 2 during medical school, the last of the three USMLE exams comes after completing the first year of residency. This exam is designed to gauge the knowledge and skills of physicians looking to practice medicine unsupervised, emphasizing patient management in ambulatory settings. The two-day exam lets you apply learned medical knowledge and clinical health practices to life-like clinical scenarios to determine an aspiring physician’s readiness to practice medicine responsibly and independently in the United States. Here’s an overview of the Step 3 test:
- Day 1 tests the Foundations of Independent Practice (FIP) with the help of 232 multiple-choice questions, spread over six 1-hour examination blocks. The aim is to access the examinee’s knowledge of basic medical sciences, including the principles of clinical medicine, biostatistics, medical literature, social sciences, and epidemiology.
- Day two of Step 3, also known as Advanced Clinical Medicine (ACM), is more focused on the application of clinical knowledge in real-world scenarios. During the nine-hour testing session, you have to answer 180 MCQs that are divided between six 45-minute blocks of 30 items each, in addition to 13 case simulations.
Step 3 aims to not only test your scientific knowledge but also determine your patient management skills. In a nutshell, USMLE Step 3 is designed to ensure that by the time you’re a licensed physician, you have the depth and breadth of knowledge necessary to provide safe and effective care to patients independently. It’s not just about what you know but how well you can apply that knowledge in practical, often complex, situations.
Residency
Following the interim year of residency, you are now an official resident – which means that you will now be practicing as a licensed physician (albeit with supervision) and no longer be staying in the back seat such as during clinical rotations. The best way to learn medicine is through hands-on experience, which is exactly what you will gain during residency. In addition to honing your clinical skills and knowledge, residency helps you develop critical thinking skills, professional knowledge, and communication abilities, which will go a long way towards helping you connect with patients and families, and collaborating with fellow medical team members.
Residency lasts anywhere from three to eight years including the resident year, depending on the specialty, during which residents gain focused and in-depth training in one particular area of medicine. Here’s an overview of residency length by specialty:
- Internal Medicine – 3 years in duration
- Family Medicine – 3 years in duration
- Emergency Medicine – 3 to 4 years in duration
- Pediatrics – 3 years in duration
- Psychiatry – 4 years in duration
- Transitional Medical Year – 1 year in duration
- Medicine (Preliminary Year) – 1 year in duration
- Surgery – 5 years in duration
- Anesthesiology – 4 years in duration
- Obstetrics-Gynecology – 4 years in duration
Residents are responsible for direct patient care in clinics and hospitals. Day to day responsibilities of a resident involve rounding on hospitalized patients, dealing with patients, performing a physical exam on their patients, developing treatment plans and following up on their progress, reviewing relevant medical information and tests, and even performing bedside procedures such as central line insertion or debridement. Residents may also order and interpret laboratory tests, prescribe medications such as antibiotics and pain medications, and even see patients in clinic, where they are tasked with performing physical exams, taking history and writing medical notes on the patients they see.
Residency is one of the toughest phases of your medical journey. Residents often work unrealistic hours, approaching 80 hours each week, so you can undoubtedly expect to spend every moment of daylight on the job. First-year resident physicians receive a median annual stipend of $62,722m depending upon your residency program, specialty, and geographic location, while fourth-year resident physicians receive an average annual stipend of $71,235.
What to do if you didn’t Match into a Residency Program?
If you couldn’t secure a spot into the residency program of your choosing, it may seem like your medical career has come to a standstill. However, the truth is that failing to match isn’t the end of the road. You still have plenty of other options, including:
Reapplying the Following year: You can take a gap year after graduating from Caribbean md school to bolster your residency application, gain some medicine related experience to appeal to the residency directors, or even conduct research to stand out as an applicant.
Transition Programs: Transition, or preliminary, programs can provide additional training and experience through surgical and internal medicine rotations to better prepare future residents for specialties where a thorough understanding of pathology, physiology and surgical procedures are necessary. Joining a transition program during your gap year will surely make you come across as a candidate for residency programs.
New Medical Pathways: Some graduates explore other career opportunities, such as professional research, public health, or medical administration.
The Windsor University School of Medicine (WUSOM) graduates have achieved high residency placement rates over the past several years. Our students match into top residency programs in top hospitals and healthcare institutions across the United States and Canada. We pride ourselves on our robust residency support system, which includes personalized guidance, interview preparation, and networking opportunities.
Specialty Board Examinations
Following medical residency, you can identify yourself as board eligible after taking a specialty certification exam – this is the timeframe you should aim to get certified within. This doesn’t just add another feather to your cap, getting board certified is the key to surviving in the cut-throat healthcare landscape. Board certification may also be essential for hospital privileges and hiring requirements. Board certifications speak volumes about your expertise, skills, and dedication in a specific medical field and give your credibility an instant boost in a saturated job market. Not to mention, board-certified doctors earn higher as compared to their non-certified peers.
To begin the certification process, you’ll need to apply for the board exam. Before that, ensure you’ve met all the prerequisites, which usually include completing an accredited residency program, having a valid medical license, and in some cases, fulfilling specific case numbers or procedural experiences. Each specialty board has its own requirements, so it’s crucial to check with the specific board related to your field. Some boards might also ask for letters of recommendation or additional fellowship training if your specialty requires it.
Once you’ve confirmed that you meet the eligibility criteria, the next step is preparing for the board examination. These exams are typically a combination of written and sometimes oral components, testing both your knowledge and clinical skills. It’s a good idea to start studying early, utilizing review courses, textbooks, or question banks tailored to your specialty’s board exam. Some medical specialties, including Diagnostic Radiology, Obstetrics and Gynecology, Radiation Oncology, Disaster Medicine, Surgery, Emergency Medicine, Orthopedics, Psychiatry, etc., require written and oral examinations. However, other specialties, such as Geriatric Medicine, Ophthalmology, Hospital Medicine, Urgent Care, Integrative Medicine, Dermatology or Family Practice only require written specialty examinations.
After passing the board exam, you’ll earn board certification, which demonstrates your expertise and commitment to ongoing professional development. Keep in mind that most board certifications require renewal every few years. Maintenance of Certification (MOC) programs often involve continuing medical education (CME), periodic exams, or practice assessments to ensure you’re staying up-to-date in your field.
Fellowship Programs
After you have completed 3- years of residency training, fellowships programs allow you to obtain additional training in a subspecialty of your chosen field, such as surgery, radiology, cardiology, ophthalmology, gastroenterology, or hematology. Many physicians choose to do a fellowship after residency, since it gives them an opportunity to experience intensive, focused training in a specific area. If you have identified a specialty that truly sparks your passion for medicine, pursuing a fellowship allows you to truly gain in-depth knowledge and advanced skills in that area that goes beyond general practice.
The fellowship application journey can surely test your mettle but it can still be rewarding. The selection process can be quite competitive, and you have to ensure that you have a strong application, are prepared for a string of rigorous interviews, and most importantly, choose the right program that aligns with your career goals. During the fellowship, you will be working hand-in-hand with experienced mentors, conducting cutting-edge research, and participating in specialized clinical rotations to hone your medical expertise.
Making a decision about pursuing a subspecialty fellowship can be quite daunting, especially if you are confused about subspecialty interests. The most important thing to consider is your interest and passion in that branch of Medicine. You may also reach out to experienced mentors in your desired specialties and explore the various opportunities and challenges in that specialty and garner their expert opinion on how they see the future of that subspecialty. It is also a good idea to talk to current fellows about their experiences, job prospects, work/life balance, and why they gravitated towards this particular specialty. You should also keep in mind that different fellowships vary in length. While most fellowships last three-year post residency, some specialties also offer additional one-to-two-year advanced training after the culmination of the fellowship program.
Take the First Leap
Graduating from medical school may seem like the end of the road, but in reality, it marks the beginning of an exciting new chapter. From intern to resident to fellow to fully licensed practitioner, medical journey is marked by many milestones, and even greater challenges. If you are ready to take the first step in this exhilarating journey, it is time to choose a school that offers a state-of-the-art curriculum, a highly credentialed faculty, award-winning academic support services, and early hands-on training.
Explore the 4-Year M.D. Program at Windsor University School of Medicine to begin your meaningful journey in medicine today!
