Medical education in the United States includes educational activities involved in the education and training of medical doctors (D.O. or M.D.) in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
, from entry-level training through to continuing education of qualified specialists.
A typical outline of the medical education pathway is presented below; however, medicine is a diverse profession with many options available.
Medical education in the United States includes educational activities involved in the education and training of medical doctors (D.O. or M.D.) in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
, from entry-level training through to continuing education of qualified specialists.
A typical outline of the medical education pathway is presented below; however, medicine is a diverse profession with many options available. For example, some doctors work in pharmaceutical
researchResearch can be defined to be search for knowledge or any systematic investigation to establish facts. The primary purpose for applied research is discovering, interpreting, and the development of methods and systems for the advancement of human knowledge on a wide variety of scientific matters of...
, occupational medicine (within a company),
public healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals." It is concerned with threats to the overall health of a community based...
medicine (working for the general health of a population in an area), or join the
armed forcesThe armed forces of a country are its government-sponsored defense, fighting forces, and organizations. They exist to further the foreign and domestic policies of their governing body, and to defend that body and the nation it represents from external and internal aggressors. In some countries...
.
Medical school
In the United States a
medical schoolA medical school is a tertiary educational institution—or part of such an institution—that teaches medicine.In addition to a medical degree program, some medical schools offer programs leading to a Master's Degree, Doctor of Philosophy , or other post-secondary education. Medical schools can also...
is an institution with the purpose of educating physicians in the field of medicine. Admission into medical school does not technically require completion of a previous degree; however, applicants are usually required to complete at least 2-3 years of "
pre-medPre-medical is a term used to describe a track an undergraduate student in the United States pursues prior to becoming a medical student...
" courses at the university level because in the US medical degrees are classified as
Second entry degreeA second entry degree is term used for an academic degree that requires at minimum 1-3 years of pre-requisite university courses for admission. It is most commonly used to refer to first professional degree programs in Canada and the United States....
s. Once enrolled in a medical school, the course of study is divided into two roughly equal components: pre-clinical (consisting of didactic courses in the basic sciences) and clinical (clerkships consisting of rotations through different wards of a
teaching hospitalA teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...
). The degree granted at the conclusion of the four years of study is
Doctor of MedicineThe Doctor of Medicine is a doctoral degree for physicians...
(M.D.) or
Doctor of Osteopathic Medicine"D.O." redirects to this page, which primarily discusses relevant qualifications and titles in the United States. In several other countries, "D.O." means "Diploma in Osteopathy", see also Osteopathy. For other uses of D.O...
(D.O.), depending on the medical school; both degrees allow the holder to practice medicine after completing an accredited residency program.
Internship
During the last year of undergraduate medical education, students apply for postgraduate
residencies in their chosen field of
specializationA specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency...
. These vary in competitiveness depending upon the desirability of the specialty, prestige of the program, and the number of applicants relative to the number of available positions. All but a few positions are granted via a national computer match which pairs an applicant's preference with the programs' preference for applicants.
Historically, post-graduate medical education began with a free-standing, one-year internship. Completion of this year continues to be the minimum training requirement for obtaining a general license to practice medicine in most states. However, because of the gradual lengthening of post-graduate medical education, and the decline of its use as the terminal stage in training, most new physicians complete the internship requirement as their first year of residency.
Notwithstanding the trend toward internships integrated into categorical residencies, the one-year "traditional rotating internship" (sometimes called a "transitional year") continues to exist. Some residency training programs, such as in
neurologyNeurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...
and
ophthalmologyOphthalmology is a branch of medicine which deals with the diseases and surgery of the visual pathways, including the eye, hairs, and areas surrounding the eye, such as the lacrimal system and eyelids. The term ophthalmologist is an eye specialist for medical and surgical problems...
, do not include an internship year and begin after completion of an internship or transitional year. Some use it to re-apply to programs into which they were not accepted, while others use it as a year to decide upon a specialty. In addition, five states still require osteopathic physicians to complete a traditional rotating internship before residency.
Residency
Each of the specialties in medicine has established its own curriculum, which defines the length and content of residency training necessary to practice in that specialty. Programs range from three years after medical school for internal medicine to five years for surgery to six or seven for neurosurgery. This does not include research years that may last from one to four years if a PhD degree is pursued. Each specialty training program either incorporates an internship year to satisfy the requirements of state licensure, or stipulates that an internship year be completed before starting the program at the second post-graduate year (PGY-2).
Fellowship
Many highly specialized fields require formal training beyond residency. Examples of these include
cardiologyCardiology is a specialty dealing with disorders of the heart and blood vessels. The field includes diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians specializing in this field of medicine are...
,
endocrinologyEndocrinology is a branch of medicine dealing with disorder of the endocrine system and its specific secretions called hormones, the integration of developmental events such as proliferation, growth, and differentiation and the coordination of metabolism,...
,
oncologyOncology is the branch of medicine dealing with tumors . A medical professional who practices oncology is an oncologist. The term originates from the Greek "Ογκολογία" derived from onkos , meaning bulk, mass, or tumor, and the suffix -logy , meaning "study of" or "to talk about".Oncology is...
after
internal medicineInternal medicine is the medical specialty concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called, "internists"...
;
cardiothoracic surgeryCardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the thorax . Generally treatment of conditions of the heart and lungs .-Cardiac / Thoracic:...
,
pediatric surgeryPediatric surgery or paediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults...
,
surgical oncologySurgical oncology is the branch of surgery which focuses on the surgical management of malignant neoplasms .The specialty of surgical oncology has evolved in steps similar to medical oncology, which grew out of hematology, and radiation oncology, which grew out of radiology...
after
general surgeryThis page is about the surgical specialty. For the goregrind band, see General Surgery
General surgery, despite its name, is a surgical specialty that focuses on abdominal organs, e.g...
; reproductive endocrinology/infertility, maternal-fetal medicine, gynecologic oncology after obstetrics/gynecology. There are many others for each field of study. In some specialties such as pathology and radiology, a majority of graduating residents go on to further their training. The training programs for these fields are known as
fellowships and their participants are
fellows, to denote that they already have completed a residency and are board eligible or board certified in their basic specialty. Fellowships range in length from one to three years and are granted by application to the individual program or
sub-specialtyA subspecialty is narrow field within a specialty such as forensic pathology, which is a subspecialty of anatomical pathology.In medicine subspecialization is particularly common in internal medicine and has grown as medicine has:# become more complex and...
organizing board. Fellowships often contain a research component.
Board certification
The physician or surgeon who has completed his or her residency and possibly fellowship training and is in the practice of their specialty is known as an
attending physicianIn the United States, an attending physician is a physician who has completed residency and practices medicine in a clinic or hospital, in the speciality learned during residency. An attending physician can supervise fellows, residents and medical students...
. Physicians then must pass written and oral exams in their specialty in order to become board certified. Each of the 26 medical specialties has different requirements for practitioners to undertake
continuing medical educationContinuing medical education refers to a specific form of continuing education that helps those in the medical field maintain competence and learn about new and developing areas of their field. These activities may take place as live events, written publications, online programs, audio, video, or...
activities.
See also