The length of training required to become a doctor is largely dependent on the specialty of medicine a doctor pursues in residency. So, how long is residency?
In this article, we’ll discuss the length of the complete doctor journey and include a chart that shares average residency lengths for the most common specialties.
How Long Is Residency, and Where Does It Fit in the Doctor Journey?
While medical school trains future physicians broadly in medical knowledge, residency focuses on in-depth and hands-on training in a specific field of medicine. Residents begin treating patients under the supervision of a senior medical clinician and gradually learn to practice independently. Residency also enables future physicians to experience a range of different medical specialties in order to choose the one they would like to pursue for their medical practice.
On the path towards becoming a doctor, residency comes after medical school but before becoming a fully licensed, practicing doctor.
Resident doctors have completed four years of medical school and received either an MD or DO degree. After 3-7 years of residency, they can obtain their license and begin their medical practice. Alternatively, they may choose to pursue a subspecialty by training for an additional 1-3 years in a medical fellowship.
During the second half of medical school, students complete multiple clinical rotations (clerkships) where they get a taste of what many of the most common medical specialties are like. Some of the core clerkships include internal medicine, family medicine, neurology, and psychiatry.
Fourth year medical students apply to residency for their preferred specialty and are (hopefully) matched into a program based on a number of factors. The length of this specialty training varies from 3-7 years and mostly depends on the specialty itself. The more complex the specialty, the more complex the training, which means more time is required for that residency program.
The first year of residency is known as the intern year, and resident doctors are known as interns. During residency, resident doctors gain hands-on experience providing care for patients, including assessing, diagnosing, and treating health conditions. This practical training is supervised by a senior medical clinician, known as an attending physician. Under the attendings’ supervision, residents learn to respond to complex clinical cases, perform medical procedures, and gradually practice medicine more independently.
Residency Length by Specialty
The average length of residency is 4-5 years, with the shortest residency programs lasting about 3 years and the longest lasting 7. The following chart indicates the typical length of residency programs for common medical specialties.
| Residency Specialty | Residency Length |
|---|---|
| Anesthesiology | 4 Years |
| Child Neurology | 5 Years |
| Dermatology | 4 Years |
| Diagnostic Radiology | 5 Years |
| Emergency Medicine | 3-4 Years |
| Family Medicine | 3-4 Years |
| General Surgery | 5 Years |
| Genetics and Genomics | 3 Years |
| Internal Medicine | 3 Years |
| Internal Medicine Pediatrics | 4 Years |
| Interventional Radiology | 6-7 Years |
| Neurological Surgery | 7 Years |
| Neurology | 3-4 Years |
| Nuclear Medicine | 4 Years |
| Obstetrics and Gynecology | 4 Years |
| Ophthalmology | 4 Years |
| Orthopedic Surgery | 5 Years |
| Osteopathic Neuromusculoskeletal Medicine | 3 Years |
| Otolaryngology | 5 Years |
| Pathology | 3-4 Years |
| Pediatrics | 3 Years |
| Plastic Surgery | 6 Years |
| Preventive Medicine | 3 Years |
| Psychiatry | 5 Years |
| Radiation Oncology | 5 Years |
| Thoracic Surgery | 6-7 Years |
| Urology | 5 Years |
| Vascular Surgery | 5 Years |
What Factors Determine Residency Length?
1 | Medical Specialty
The type of medical specialty is the primary factor determining the length of residency.
Some medical specialties involve advanced courses, extensive training, and mastery of intricate medical procedures, especially surgical specialty programs like neurological surgery and plastic surgery.
Generally, primary care specialties require the least amount of time in residency, such as family medicine, internal medicine, and pediatrics.
2 | Residency Program
While the type of medical specialty is the primary factor, the length of residency also varies between different programs.
For example, a residency in emergency medicine may be three years at one residency program and four years at another. Additionally, some residency programs may offer dual-specialization residencies or opportunities to subspecialize through a medical fellowship, all adding to the residency length.
3 | Post-graduate Preparatory Years
The length of a residency program can depend on the number of post-graduate preparatory years (PGY) required in a general field before beginning specialty training. Some residencies are for students who have just completed medical school, while others require one or more PGY in a general field before the resident can begin their specialty training.
For example, neurological surgery residencies require 2 PGY of general surgery before neurological surgery specialty years begin. With 6-7 years of total residency required, neurological surgery residencies are among the longest residencies. The complexity and sensitivity of neurological surgery demands extensive training for mastery, and the amount and structure of PGY varies between residency programs.
Alternatively, family medicine residencies include one PGY of basic clinical rotations and are among the shortest residencies. Despite short residency length, family medicine specialists are trained to develop long-term relationships with their patients, as well as sustain a high degree of familiarity and continuous communication to facilitate continuity of care.
What Might Make Your Own Residency Take Longer?
Ultimately, the length of your residency depends on the specialty (and potential subspecialties) you choose. These choices can extend your time in residency by years, and many residents consider the decision of what to specialize in to be one of the most difficult parts of medical training.
Your own residency may take longer if you aren’t accepted to your preferred residency programs during the Match process.
The Match is a system that annually places medical students into US residency programs. If your preferred residency programs are competitive and you aren’t matched with them during The Match process, you may choose to wait another year to apply again rather than accepting a residency in another specialty. Or you may not match at all, which could mean taking a full year to improve your skills, experience, and overall residency application.
The competitiveness of residency programs varies by specialty.
- Top 10 Most Competitive Specialties in Medicine
- Top 10 Least Competitive Specialties in Medicine
Some of the most competitive residency specialties are plastic surgery, otolaryngology, thoracic surgery, vascular surgery, neurological surgery, interventional radiology, orthopedic surgery, and dermatology. These also happen to be some of the longest and most specialized programs. Additionally, the shortest programs are often the least competitive, including family medicine, pediatrics, physical medicine, psychiatry, anesthesiology, and emergency medicine.
How Does a Fellowship Extend Training Length?
Medical fellowships are optional training programs that a resident doctor may choose to pursue upon completing their residency. They allow the doctor to pursue a subspecialty within their chosen specialty.
For example, doctors that specialize in general surgery during their residency training may pursue a fellowship in subspecialties, including vascular surgery, colon and rectal surgery, or hand surgery. Depending on the subspecialty, medical fellowships may last 1-3 years.
Pursuing a medical fellowship may add additional time and cost to the process of becoming a doctor. However, there are several benefits. A medical fellowship may be the only way to pursue a career in a given subspecialty. Because of the general shortage of subspecialization doctors, fellowship-trained doctors are highly sought-after, and they often have favorable job prospects.
Learn more by reading our guide: Understanding Medical Fellowships.
Choosing the Residency Specialty That’s Right for You
After spending only a few weeks experiencing various specialties in rotations and clerkships, residents must choose the specialty that will dominate their work for the remainder of their careers. This can be a very daunting decision. Many doctors cite the choice of specialty as one of the most difficult decisions of their medical training.
How to Make Tough Decisions — 7 Strategies for Better Decision Making
Compensation is commonly cited as a key reason for choosing a medical specialty. While becoming a doctor is expensive and compensation is a logical concern, many doctors find their compensation satisfactory in the long run. Other factors, including your medical interests, number of working hours, and whether or not you will work directly with patients, are almost always more important aspects of your decision making process.
For example, work-life balance is a key consideration when choosing a specialty. Do you work to live or live to work? Do you enjoy being immersed in your work and constantly on-call, or do you want more time for yourself and your family?
How much do you enjoy the day-to-day activities of the speciality? Or, put more simply, how much do you enjoy performing procedures? Would you like a primarily surgical practice or a primarily medical practice? Choosing a primarily surgical practice will increase your time spent in residency as well as the competitiveness of the program.
How much do you enjoy the “bread and butter” practice of the specialty—the cases that comprise the majority of your workload? How much do you enjoy interacting with patients, and what type of patients do you enjoy working with? Do you want to be in an emerging field that keeps you on your toes?
Learn more in our guide: How to Choose a Medical Specialty for Residency.
Success in Medical School and Beyond
The Med School Insiders blog is filled with hundreds of articles that are continually updated with the most recent and accurate information for premeds, medical students, and residents.
If you’re a medical student trying to choose a specialty or subspecialty, check out our So You What to Be… series, which provides insight into what it’s like to pursue different specialties. We have dozens of articles and corresponding Youtube videos. If you don’t see a specialty you’re interested in, leave a comment below to make a request.
