Understanding the basics about medical residencies

October 27, 2014

Article by Global Pre-Meds
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After you graduate from medical school, you have a lot to celebrate. You are officially a physician!  Although you are now a doctor, additional training is still ahead in the form of a medical residency. This article will help you understand the basics about medical residencies so that you can continue on your journey successfully.

We help aspiring doctors, nurses, midwives, and physician assistants by helping them get real world experience in international hospitals. This way, they’re ready when they begin their own medical residencies and clinical rotations.

A medical residency differs from medical school in a lot of ways, but knowing what to expect may take some of the anxiety out of the process.


During your last year of medical school, you will start the matching process in order to land your residency. After you do some research and understand the basics of medical residencies, as well as decide where you are interested in doing yours, then you can apply to their program. Residency programs review applications and most programs invite candidates they are interested in to an interview. During that time, you will likely be interviewed by a panel of senior residents and attending physicians. You may also be given a tour of the facility.

Use your interview to learn as much about the program as possible. Remember, the interview process is not just for the hospital to determine if you are the right candidate. It is also for you to decide if the residency program is a good fit. Consider asking about the faculty, program accreditation and resident benefits, such as health insurance.

After you have interviewed at different programs, submit a rank order list of your choices to the National Resident Matching Program. The residency programs also submit a list of their candidates in preferred order of acceptance. The information is inputted into a computer program, which uses an algorithm to match students to residencies.

The rank list you submit is confidential. So a residency program will not know how you ranked them. There is also no limit to how many programs you can rank. You can change the rank or add programs to your rank list even after you first submit it as long as you do it before the rank list deadline. The deadline to submit your rank list can be found on the National Resident Matching Program website.

Each year a small percentage of medical students fail to match with a residency program. One reason for failing to match may be only applying to a few residency programs. Another reason med students may not match is if they apply to very competitive residency programs and their medical school performance was not in line with typical candidates.

If you do not match, you have a couple of options. Residency programs are sometimes in the same boat. They may not have matched with enough candidates to fill their resident spots. A list of programs with open residency positions can usually be obtained from the Dean at your medical school. In addition, you can apply for a one-year research fellowship or you can just take a year off and try again next year.

Residency length

The length of your residency depends on the specialty you are pursuing. Most residencies are between three and seven years. For example, a three-year residency is required for doctors in family practice, internal medicine and paediatrics. Longer residencies exist for certain specialties, such as surgery and urology. Keep in mind; depending on your goals, you may be required to obtain additional training in the form of a fellowship after residency. Fellowship training will vary and is often one to three years depending on your subspecialty.


Salaries for medical residencies vary. The specialty you are pursuing, as well as the part of the country you are living determine your salary. According to the American Medical Association, the average salary for first-year residents in the United States in 2012 was between $40,000 and $50,000 a year. Salaries also increase with each year of residency. You will likely earn more as a second and third-year resident than you did as a first-year resident.

Hours worked during medical residencies

In understand the basics of medical residencies, it’s important to know that while the hours residents work can vary, they are usually long, grueling days. The number of hours you will work vary by program and specialty. Some residents may work 45 hours a week, while others work much more.

For example, residencies, such as dermatology, may not require being on call, which cuts down on the hours worked. Other specialties, such as surgery, require call and are more time-consuming. The first year of residency is often the worst when it comes to the number of hours you will be required to put in. First-year residents are often required to work more on call hours than third and fourth year residents.

During your residency, you may also be attending lectures and conferences, which also places additional demands on your time. The good news is laws changed in 2003, which limit the number of hours a resident can work to 80 hours a week. The bad news is 80 hours a week is still a lot.


Residency involves specialized training in your area of focus. The exact skills and procedures you will learn differ by specialty. For example, you may learn different procedures as an emergency medicine resident than you would during a urology residency.

In general, you will be responsible for assessing patients on admission including performing physical exams. Residents also order appropriate diagnostic tests and consult with other specialties as needed.

Attending patient rounds and performing treatments and diagnostic procedures appropriate to your specialty are also resident responsibilities. In addition, as a resident, you will be prescribing treatment, providing patient education and writing discharge summaries. In some specialties, you will assist with surgical procedures and respond to emergencies, such as trauma pages or codes.

During your first year of residency, you are likely supervised closely by senior residents and attending physicians. Understanding the basics of medical residencies before you begin can help start you off on the right foot. As you progress in your residency, you are given more responsibility and more independence. Each year brings a bit more of both. In your second year of residency, you may be supervising medical students. By the time you make it to the third year of residency, you are supervising first-year residents and will have many of the same responsibilities as an attending physician.