Residency

While medical school graduates have obtained their medical degree, they are far from licensed physicians who can care for patients.  Medical Students in their fourth year apply for a residency, or graduate medical education, in desired specialties in what is known as the Match Program. Matching to a residency program is very competitive and is based in large part upon academic performance in medical school and scores on the USMLE or COMLEX.
Graduate Medical Education
Upon graduation, new physicians begin a very important post-graduate training program to build upon the foundation they received in medical school.  Most physicians state that they found their residency program to be more valuable and challenging than the four years of medical school.  The length of a residency program varies by specialty and can span anywhere from three to seven years.  The new-grad physicians are given an identifier “PGY” as an acronym for Post Graduate Year that is coupled with their class year.  For example, a third-year resident is referred to as a PGY-3.  Interns are residents in their first year of post graduate training, or PGY-1.

Physicians also have not left the rigors of the licensing exams behind in medical school as they will have to pass the USMLE Step 3 or COMLEX Level 3 after completion of their first year of post-graduate training.  All residency programs require that physicians who have completed their PGY-1 course of study take and pass the Step 3 exam prior to advancing to their next year of training. This is a very important right of passage for these aspiring care-givers as it is the final step in obtaining their license to practice medicine and legally care for patients. 

Unlike the mostly standardized curriculum in medical school, graduate medical education programs vary significantly by specialty.  Despite the non-uniform approach, there are a number of common elements found in all programs.  For example, the first year of residency is usually focused on learning the fundamentals of patient care in the particular specialty with an emphasis on direct patient care and providing significant time for the PGY-1 residents to learn directly from their immediate superiors.

Residency programs serve a number of important purposes to help prepare physicians for the challenges they will encounter when they practice medicine unsupervised.  One of the most important aspects of residency is the exposure to the myriad of cases and diagnoses that these physicians will be responsible for treating in the future.  The extended length of the residency program ensures that each resident receives adequate exposure to key clinical cases to be able to demonstrate competency in treatment.