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by Dr. Robert Edinger
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Residency Versus Fellowship

Understanding the distinction between a resident and a fellow can be quite perplexing within the medical training hierarchy. To simplify the explanation, let's break it down.

To become a doctor, the first step is completing the necessary pre-med courses in college. The next step is getting into medical school, which lasts for four years and results in an MD or DO degree. Regardless of the type of medical school attended, both degrees signify that you are now a doctor, although you cannot practice independently just yet.

After obtaining your medical degree, you can then apply for a residency program in your desired field of specialization, such as pediatrics, psychiatry, or general surgery. The duration of the residency varies depending on the chosen field. For instance, obstetrics and gynecology (OBGYN) typically requires four years, pediatrics requires three years, and neurosurgery necessitates seven years of training.

You might wonder where the term "intern" fits into this. "Intern" simply refers to the first year of your residency training, regardless of your specialty.

Now, let's say you complete a three-year residency program in internal medicine. What comes next? You have two primary options. First, you can work independently as a general practitioner of internal medicine in a clinic or hospital. Alternatively, you can pursue additional training to specialize further through a fellowship, which is similar to a residency but within a sub-specialty.

Certain sub-specialties mandate completing a residency first and then a fellowship within their specific area. For example, to become an independent cardiologist, you would need three years of internal medicine training followed by three years of cardiology training. You cannot directly enter a cardiology fellowship after medical school; an intermediate step of completing an internal medicine residency is necessary.

When it comes to comparing the difficulty of residency versus fellowship, it's a challenging question to answer because they are inherently different. In general, residency tends to involve longer hours and more overall workload. Fellowship, on the other hand, is highly specialized, requiring in-depth knowledge and additional responsibilities within the chosen sub-specialty.

In conclusion, Residency and fellowship are distinct stages of postgraduate medical training. Residency provides a broad foundation, while fellowship allows for specialization within a sub-specialty.