We made it through Medical School... now what?!? We are in the beginning process, obviously since T just graduated Med School early May, so I don't have a whole lot of detail for the next stages in our journey but here is what I know so far and what I've been told we can expect.
Internship
-Internship is basically just the first year of residency, so T is considered an intern presently. They generally start July 1st. Sometime during the intern year guess what? Yup! Another exam. Time for Step 3! Yay! From what I understand after Step 3 is completed and passed and after your internship is completed you are now considered a licensed doctor. This means you can practice basic medicine as a doctor.
-While every doctor's intern year is unique to what 'type' of doctor s/he will become a few things are true all across the board. The hours are horrible (typically 12-18 hour days) sometimes everyday of the week, all times of day are work times (nights, holidays, weekends, there are no exceptions), although the doctor may not be physically seeing patients there is ALWAYS charting that has to be done (sometimes 4+ hrs a day), and they are the bottom of the totem pole. All the grunt work heads their way. Ugh. It is what it is, like joining a frat. The did pass a law within the last 10 years or so. The ACGME has set up new guidelines for Medical Residents. Such as 80 hr work week cap, 24 hr limit on continuous duty shift, 10 hr rest period between shifts, 1 out of 7 days off averaged over a month, in house call no more than 1 every 3 nights, etc. For more info you can browse Medical Resident Work Hours on Wiki.
-Once the intern year is over they have a ceremony, almost like a graduation. Their last day of work is June 30. They have to complete one whole year for it to 'count'. In the military they are allowed 14 days off which can only be taken during certain periods which make it extra complicated.
Residency
Now it is time to finish your residency.
-Depending on the specialty that you chose it can be anywhere from 3-6 years (including the intern year). Typically if the specialty has primarily based clinic hours the programs run 3-4 years but if they are more procedural or surgical they run 5-6 years. Some programs in the military require that you do a year of research during your residency as well.
-Once residency is close to being complete guess what? Time for another exam? Woohoo time to take your set of boards for your specialty. After your board exam is complete (& you pass) then you
are a Board Certified Doctor.
-As I mentioned prior we are taking the military route. Our path will be a little different once we are getting close to the end of residency. Most people will be able to practice medicine at a clinic, hospital, or even private practice. At this point T will be a 'real' doctor and now it is time to pay back the military his years. Depending on how long his residency is will determine how many years he has to pay back. If his residency is a 3 yr program then he will have to pay back 4 years but if his residency program is 5-6 then he will have to pay back 5-6. Basically you have to pay back your residency length or med school length whichever is longer.
Fellowship (optional)
-Now one may think that you are finally done right!? Wrong. Depending on
your specialty you have the option to go on and do a fellowship. What
does that even mean? Now remember there are always exceptions but
generally this is how it works. Let's say your child needs to see a
Pediatric Rheumatologist (like our J). That physician has to have completed two programs and passed both sets of boards; one in Pediatrics
and one in Rheumatology. They could do Peds as their residency then Rhum
as a fellowship or vice versa. Same is true for Pediatric Infectious
Disease and several others not just Ped areas those are just examples. Now there is also another exception. Let's
say you need to see a Cardiologist. They typically do a 3 year residency
in Internal Medicine and then a 2 year fellowship in Cardiology.
Internal Medicine is one of the best residencies because there are so
many avenues that can be taken after that residency. The possibilities
are almost endless.
Maintenence
Once all these things are complete you may think you are done now but alas your are never really done. Just like other professions (esp science based ones) you have to take classes to keep up to date with new and improved bigger and better things, attend seminars, and keep your license up to date (that process varies state to state).
And now I *think* you may be done. Unless you practice for several years, get bored and decide to change your specialty, then it is back to do another fellowship and boards for that area.
Hmmm.... makes me wonder if T picked the right profession. Ahhh of course he did! It fits him to a T! Ba-zing!!
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