Residency vs Fellowship EXPLAINED

An explanation of residency vs fellowship and the medical training hierarchy overall

[@plumbaby483]

I am not in the medical field but I have always wondered about that. I think that the dedication you all have to go and stick to all that training is amazing!

[@folumb]

Don't bother explaining, just smile and nod when they ask how more years of school you have or tell you one day you'll be a "real" doctor (even as a senior fellow)

[@jamesscott2894]

So as an EMT (well now Firefighter) I have an understanding of a lot of the basic medical stuff, but the Doctor hierarchy was always confusing (like I had no idea what happened after Med School for you guys), and while discovering your vids and Dr Glaucomflecken vids (and since I also just started a Scrubs binge earlier today to haha), certainly entertaining, but the hierarchy thing was again confusing me.... this really does help clear that up! 🙂

[@MrDrummer2127]

This is super interesting, I just filmed a pacemaker implant today and I noticed that one of the doctors had a fellowship sticker on their badge. They got me super curious, and it led me to your video. Long story short. I have no desire of becoming a doctor, but it is interesting to see all the ins and outs of a different profession. Thanks for all you nurses and doctors do!

[@emory7918]

Hey brother man. Glad to see you started a KZbin channel. I just subscribed. Hope all is well your way. Emory

[@Gerhard2770]

A specialist is someone who learns more and more about less and less.... till they know absolutely everything about NOTHING!

[@urvagrawal2358]

God this is deep

[@marilynbouziane5530]

😂 😂, you ruined my mood, dude!

[@Asgutenasen]

Accurate!

[@gillianmuspic2337]

As a pharmacist I was once handed a prescription to fill that was written by a 'right retinologist ' . A specialist in the retina of the right eye! Now that is specialisation!

[@Gerhard2770]

@@gillianmuspic2337 goodness gracious me

[@herzkonigin]

Here it's so different, we don't have any premed classes, you go into medical training straight from high-school. Med school takes 6 years, then I started a 2 year internal medicine residency, now I'm at my first year of a 2 year cardiology residency with an idea to do a fellowship in arrhythmia

[@babybobbie1000]

Ahh. Thank you for explaining all of this! And explaining what an intern is. So very helpful!

[@ednajeanamos7224]

Yes what made you want to be a GI doctor.

[@NicolasMD85]

That's complicated, we in Serbia have 6 years of medical school, than 6 months of general internship, after that state aprobation test to get your medical license ti become officially doctor of medicine. After that you can choose your special fild (internal medicine, radiology, pediatrics), and that internship lasts anything between 4 and 6 years. When you finish that, you can choose field of subspecialty, and that additionally lasts for 1-2 year. All in all, 12-13 years of medical training before you can become indipendent (sub)specialist in certain fild.

[@HawkeyeCharmer]

Wow ! That’s way more training and practice than the US before you can be independent. That’s good stuff.

[@Nightraven26]

@@HawkeyeCharmer don't know if it's the same as Croatia, but in Croatia we don't really have a lot of hands-on experience during med school, you don't even place IVs if you don't offer to place one and insist to learn how to do it, and during med school you don't have to know drug dosages for treating diseases. Also, you learn a bunch of drugs for certain diseases and then when you start working you realise you don't have a lot of those drugs available in your country... So I feel doctors in the US are far better equiped to treat patients immediately after finishing med school compared to our doctors when they finish med school. Also, here you don't do a residency in general internal medicine and then a fellowship, instead you immediately do a Cardiology/GI/etc. residency, but those residencies have a common branch where they have the same education for a couple of years and then branch of to their respective specialty training.

[@nicoleneuman24]

so cute! love your personality.

[@afiazahin4914]

Love your videos doc ❤ Can you please explain the work-life balance and compensation of Residency vs Fellowship. Again, can a person practice and do fellowship at the same time? .... What are the steps for getting into a fellowship program? 😁

[@mrsaifie]

this was best explained video simple easy understandable

[@sankaadikari7700]

Very well explained!

[@urvagrawal2358]

I am a medical student here in India, we get medical license after 5.5 years of college (MBBS) (that's directly after school). We call the last year of this program as internship. We can do independent general practice after this. Then it is 3 years of MS or MD, that's the specialty (MD has a different meaning here) And sub specialty would be DM or MCh (3 years) Seems like the US system is 2 years longer, kind of makes sense considering you guys have about 2 years worth credits of general education in college... once we are in MBBS we don't study anything else...

[@c.f.6005]

Great explanation.

[@adelea414]

That was the best explanation i’ve ever heard, thanks!!!

[@roninnr1378]

Thanks dude for this clear information!

[@shamayelsafdar4301]

Dr. Schmidt. I have a question. How did you know for sure that you wanted to be a GI doctor???

[@limiv5272]

This is interesting. In my country most doctors get directly into a medical school, and the studies last 7 years. It is possible to do a Bachelor's degree in biology [there might be other relevant fields idk] and then try to get into a 4-year medical program, but the people who do that are mostly people who weren't accepted into the regular 7-year program.

[@frostedgraves6059]

It's like this in most countries, except US, Canada, and maybe a few others.

[@MR-sx3od]

This is great. Thanks!

[@azadyadav9319]

Straight to the point.

[@marilynbouziane5530]

That's pretty interesting, we in Algeria, have 6 years of medical studies, one year of training, in which we're called interns, after that we have the degree of general doctors.. After that, we pass a test, in order to continue a fellowship in a specialty, whether it's obgyn, pediatrics, cardiology... we don't have sub specialties yet, except for internal medecine.. so a specialist, has the right to have his proper office after almost 12to 13 years of studying..

[@zombieRpoint34]

What a pleasant fellow

[@CurlyGirlChey]

Very helpful

[@robb8234]

thanks Doc

[@liahk1000]

Oh ok. I'm Sweden just as a comparison it works like this: Medical school 5.5 years Internship 21 months Specializing 5 years ( same for all specialities), However you normally can't apply to get into a Specializing program, but you start working there and are X amount of time you get the spot or not. This doesn't work well ask the time. People can spend 2 years in 'residency' without having the actual enrollment in the residency program. It seems way better as it is over there, you apply beforehand and either get it or not. It causes so much stress to not know if you'll get it. And you'd think if you do get it that is based on competence but it's not even that easy. It's not up the the hospital itself how many residency spots they can offer. Since the health care in Sweden is public, it's the politics in each region that runs the health care system ang they also decide how many residency spots they let reach clinic hire. So for example I worked in one clinic where I was hoping to get a residency spot. Since I really wanted it I couldn't say no to whatever crazy schedule they have me. After 6 months they told me they were very happy with my works and would have loved to give me a residency but wouldn't have any available spots for 5 years, they still wanted me to continue working, but that time then wouldn't be as an official resident so it spittle lead to me becoming a specialist.

[@kentrolBR]

In brazil you don't have to take pre med, the college is 6 years long and you can go in right out of high school but it is very difficult, people usually have to "train" for the national exam for years b4 they get into the college, what do you think would be better? Having to take pre med or going straight out of high school? (You have the same training even without pre med since you will have those lessons in medical school)

[@Idellle]

Same in Finland

[@zinn01hobissprite62]

Same in India

[@shelbyshelby3936]

Personally, I think it’s better that a person have the premed courses or have gone through a degree program prior to med school. It’s a pain in the ass but through those pre med years you gain personal life experience which helps to mature a person emotionally, mentally, etc. which among other things helps a person to have empathy/sympathy for their patients. It also builds character. Academically it builds a foundation for continued higher learning; you’ll be able to process information better and articulate yourself more effectively. Yes, there are some students that mature well in high school but I would say for the vast majority, post secondary education is a much needed step before their journey through med school. You need to learn to crawl before you can walk and walk before you can run. Trust me, med school is a marathon you need to train for :)

[@kentrolBR]

@@shelbyshelby3936 usually you have to study so much after highschool that you aquire those traits you talked about just because you have failed so many times over and over and didn't give up, I know people that have been trying for over 5 years

[@NO1xANIMExFAN]

as a US med student, I'd much prefer the system you desribed than what we have in the US. gaining admission to a medical program will be difficult no matter what, but the ability to get started with your career early seems huge. people in the US would need to take gap years off between finishing their bachelor's and gaining admission to med school as well due to how competitive it is. the average gap year people need to take to gain admission is 2 years. so in the end the real difference between the systems comes down to how early someone can complete training... and in the US medical training takes forever..... the average doctor would have to do 4 years undergrad, 2 gap years, 4 years med school, optional 1 year research year, 3-7 years residency, then an optional 1-3 years fellowship. i can't imagine any other country's training system lasting as long as this

[@wholeNwon]

Fellowship is very demanding. You are becoming what is, in effect, the ultimate subspecialty authority in a field for not only pts. whom you treat (usually referred by specialists such as internists) but also for other physicians. Many of these physicians will also be very well-trained specialists and subspecialists. Perhaps you can imagine the sorts of questions you're asked or the kinds of serious problems you're consulted about. Other docs may be content with "A definitive answer to that question isn't known." But they don't expect to hear, "I don't know." They might put up with that on rare occasion but they don't expect to hear it often. Keeping up is a challenge to say the least. Then there are trainees who will approach you with statements like, "Last night I read an article in "The Acta Medica Scandinavica"....and expect an intelligent discussion.

[@dogwalk3]

for some reason i thought a fellowship was before a residency, so i learned something!

[@dianam.1921]

Thanks for that explanation

[@sonintrepidus]

In india after high-school you write a competitive test get into 41/2 years of medschool, 1 year general intership, 3 years residency then you can further specialize

[@pbgd3]

Wanna blow minds? tell them about matching into your residency and fellowship. F the years what about after doing 4 years of medical school and then blindly matching and moving to another town living and working there and then matching again into a fellowship blindly and moving again.

[@sabinhong0307]

resident: slave of the hospital fellow: slave of the hospital with responsibilities

[@jasonlove8733]

Key takeaway.. residency comes before fellowship.. commit that to long term memory

[@minuyasmin4172]

Slow go man !!

[@huzaifa-682]

so dr. schmidt, i want to go to cancer surgery, what is the required electives i would have to do ? would oncology electives count or would it have to be specialized cancer surgery electives ( i am an IMG)

[@sxli3340]

Which is better career-wise, fellow or no fellowship?

[@sistakia33]

What if you don't match in the specialty you want? Like what if you want GI but you end up in Psychiatry? Do you just end up a Psychiatrist? (Or needing one?)

[@37VQV]

Well, you would have to apply to psychiatry to match into it. A lot of people apply to backup specialties. People applying to Ortho often apply to Anesthesia as a backup. Gen Surg applicants sometimes apply IM as a backup. But yes it is not uncommon for people to having to accept a residency field that was not their first choice.

[@mauve3734]

😲. A lot of work I’m sorry I don’t like school that much. I want a fellowship after I get into pt school for dance though

[@iwatchkittenvids45]

Do you end up making the same as you did in residency. I feel like there has to be a modest bump...at least I hope

[@Doc_Schmidt]

Doctors in training are actually paid specifically based off their number of years out from med school. So you have a standard increase in pay each year of residency and fellowship

[@iwatchkittenvids45]

@@Doc_Schmidt thank you for the clarification. Seeing that you're doing a GI fellowship, could you have taken a year working as a hospitalist first before applying to your fellowship? Is that allowed and if so, is it looked at in a negative light?

[@DOC_951]

You get paid more as a fellow than you do as a resident. Each year you advance as a resident you’ll get a pay increase... and since fellowship is after residency, yes it pays more. But, it’s still a lot less than what you make as an actual attending.

[@Thetrurth]

Now I missed the concept board so after 3 year’s residency you will get board certified or fellowship 😢!?!?

[@Kencan254]

Can a fellow work ( moonlight) as a licensed professional during the fellowship? Is the opportunity cost of fellowship compensated by substantial increase in salary as a fellow?

[@brianhigdon9773]

Yes, docs can moonlight once they finish their intern year, but it's often limited by the amount of normal work there is. The math on salary can go either way, sometimes a subspecialty can pay less, like for infectious disease, palliative, geriatrics. More often than for pay, fellowship can help get a job or a setting that is better in some way in regard to hours, more academic, more interesting intellectually.

[@Boroland-xl5ss]

Can you please say more about residency? Is it possible to do residency in hospital instead of medical college? Please explain.

[@ghobashy878]

What is after cardiology fellowship? When can I choose interventional cardiology ? After the fellow or within it?

[@artkahn888]

Or just got for a NP and practice independently without the intense schooling and cost.

[@charyaka]

The fellowship doesn’t have the same “lottery” system as residency?

[@Doc_Schmidt]

It does actually!

[@sathvikam.v.1129]

In US are cases admitted under our name in hospital after we complete IM residency? Or cases admitted only under the name of fellowship completed doctor? Do we get nyt calls though we are not in night shift after IM residency in US??

[@user-hy7pf6np6y]

Hey how can an img resident doctor apply for fellowship? Is usmle needed?

[@wxyzhaha]

Please explain the difference between MD and DO next time. Thanks.

[@Drxyz-tk6le]

In India things are a little /lot different. After high school you appear for Entrance test. If you are within top 5% you will get a seat in a medical college. Which will 4.5 years. Then you pass your licensing exam. Then you will undergo one year of Internship. This gives you a degree of MBBS People may further do junior residency for one or two years in a field of their choosing/intrest But you cannot practice as an specialist. You can work as a general practioner. Going further - you decide to specialise. So, Another entrance exam!! You chose a borad- speciality residencies : orthopaedics, paediatrics, General surgery, internal med, ophthal, Psychiatry etc. This is of 3 years. Once you do your broad speciality. You become a specialist in that field. You can practice independently as a specialist. But if you are looking to work as a consultant in a hospital. Then you will have to work as a senior resident for 3-5 years before you get to that position. If you want to further subspecialise (like hand surgery, cardiology, neurology, GI surgery, neurosurgery, endocrinology etc) - you go for another entrance exam, and go into a " super-speciality residency." or a "fellowship". Difference? Residency courses will be of three years, and like your broad speciality residency will pay less and demand more. And research will form a huge part of your curriculum. They are national board accredited courses. National board accredited fellowships are of two years. But you aren't under obligation to complete it. (ie you won't get your degree but you won't be monetarily penalised for leaving the course mid way). Most fellowships are offered by prestigious private hospitals which have become centres of excellence in those field. And they aren't accredited by any national body. Also there are no fellowships for Subspeciality related to general Surgery and internal medicine. Eg - neurology, neurosurgery, cardiology or cardio thoracic surgery, GI, GI surgery etc. Doing a three year Super-speciality residency is a must. Fellowship mostly tend to focus more on practical training than Academics (research) . While Superspeciality residency has focus on both.

[@sionalenne7013]

Hey doc! So, whats the difference between an internship year, a subclerkship, and a transitional year? Thanks!!!

[@eyekandy3000]

That’s not the US system

[@DOC_951]

Your first year of residency is called “intern.” Regardless of what field you’re in... you’re an intern. “Transitional year” is a resident who fail to match into a residency... so they do a TY year, which is kind of like doing a month in every field. Think of it kind of like being in limbo. As a TY resident you still have to apply for the match again... and if you fail to match again, that’s pretty much it for you.

[@eyekandy3000]

@@DOC_951 better than my response. What a sub clerkship?

[@DOC_951]

@@eyekandy3000 a sub-internship or clerkship is essentially like an extra rotation you do as a medical student to get extra preparation for that field prior to residency. For example, I did a one month clerkship in the emergency department as a 3rd year medical student to gain extra experience to help decide if I wanted to apply for emergency medicine residency... which I ultimately did, and I’m now at the last month of my second year of ER residency.

[@brianhigdon9773]

@@DOC_951 No. TY isn't for those that fail to match. TY is often more cushy than a general medicine or surgery prelim years, before starting an advanced residency, that starts PGY2 year.

[@sawa139]

I remember I asked the RN on my team what a Fellow was. She said a chap😒 boy I tell you what I was ready to throw my shoe at her

[@hannahramos1236]

I'm not in the medical field but I'm curious, do u have exams after residency and after fellowship

[@yvonnejones9940]

Yes. Throughout training from med school to residency and/or fellowship there are exams which you must pass to go further, ex. Board Exams. Also, to be able to get and keep a licence you must have CME (Continued Medical Education) credits, usually 100 every 2 years. Sounds like a small number, but try fitting in in an extra 100 hours when your already working 10 hrs a day with a call schedule. So testing never ends.

[@omarmourad1000]

Hello there! I'm confused because I heard that IM residency is 4 years So, Does the Internship year count in the "3 years" of internal medicine residency? Or is the Internal medicine residency 4 years in total when counting the internship year? Love your videos btw♥️ Thanks vm

[@omarmourad1000]

I've got another question too, does the fellow earn much more than a resident does? 😊

[@Doc_Schmidt]

Hi there! Thanks for the support! In the US, internal medicine residency is 3 total years (including intern year). And you make more more each year of training so fellows do indeed make more than residents 👍🏻

[@DOC_951]

IM residency is 3 years Omar.

[@brianhigdon9773]

@@omarmourad1000 Pay is based on number of years post-grad. So a PGY4 4th year resident in surgery gets paid the same as a PGY4 fellow in cardiology. But it's just a couple of thousand more each year, before the big 100k+ jump up when you become an attending.

[@omarmourad1000]

@@brianhigdon9773 That's Informative! Thanks very much!

[@MotherOfWednesday]

Residents and fellows are paid, no?

[@Doc_Schmidt]

Correct!

[@assila1019]

Hi! Regarding the matching process, are the doctors allowed to choose the specialty they’re interested in? Or are they allocated to a specialty that needs manpower? Secondly, if they’re allowed to choose, has there even been a problem like a surplus of doctors in a particular field as compared to the others? Thanks in advance!

[@Doc_Schmidt]

You can apply for whatever type of specialty you’re interested in! And yes unfortunately there is a primary care (internal medicine, pediatrics) shortage in the country as a result because many see these specialties as less desirable (based on salary and associated busywork that is often more than in other specialties)

[@assila1019]

​@@Doc_Schmidt I finally understand how everything goes. Again, really appreciate it!

[@DOC_951]

To further clarify what Schmidt said... you can “technically” choose to apply for the speciality you’re interested in, that doesn’t mean you’ll get to do it. In a sense, you’re forced to apply for certain specialities based on how good your application is. For example, you can wish and dream to be a dermatologist all you want. But if you only scored a 205 on your step exam, you’re pretty much destined to do family medicine (internal medicine would be a stretch, but possible). In essence, your board scores dictate what specialities you can competitively apply for.

[@catterinaopheliac9803]

How do ypu pay for med school?

[@sq5]

$200,000 in student loans.

[@BobBob-pr4eh]

Can you hypothetically get into all specialities eventually? I’m cause I want to know and do everything

[@Embrujar]

Fellowships are paid?

[@Doc_Schmidt]

Yep!

[@brendashepherd-campbell9394]

i love your tiktoks and followed you here. with an ulterior motive. you are in the field that my son died because of. i would like to share his story with you because you aren't going to find him in your normal rounds. but i will not tell you the story unless you give me permission. i am a mom on a missions to make sure that GI docs and Surgeons hear his story and maybe a different family won't lose their child because this was overlooked for too long. let me know if you are interested in the story. i won't do tiktoks, i will write it. have a great day

[@tigershenanigans6878]

No I still think that trolls know the best if we should be vaccinated 🤣🤣🤣

[@ThatgirlAngegail]

No step 1 you must be born first😂😂

[@BlackRose3610]

Please how do u have a positive outlook or any sense of humour I’m burnt out as fuck help

[@loishannha9189]

same lol

[@BlackRose3610]

@@loishannha9189 honest this guy is positive as all hell and i'm just like "dude all i see is just grimness and work"

[@loishannha9189]

@@BlackRose3610 this dude easily passes the google "airport layover" test lol

[@Matthew21117]

This video only talks about the difference between the two for 20 seconds, the rest of the video has nothing to do with the title,

[@Doc_Schmidt]

The rest is context for understanding residency and fellowship

[@alphabravo1348]

If you continue speaking like this , nobody is going to subscribe to your channel.

[@chensenhan]

I gave you thumbs down. Why? So you know you are not the best. You need to learn to be better

[@Doc_Schmidt]

Thanks?