If you’re a medical student wondering which specialty to choose, one of the things to consider is how long the medical residency in the USA will be. How many years a medical residency is depends on the specialty you choose. Primary care residency programs are the shortest, while surgical residencies are longer. With each year in training, your level of independence and autonomy increases so that by the end of the residency, you are able to practice medicine independently, without supervision. All residency programs offer further training under their respective fellowship program. Give this article a read to find out exactly how many years residency programs take.

Length of Residency by Medical Specialty

In the US, the first year of residency, after graduating from medical school — postgraduate year 1, or simply PGY1 — typically focuses on general clinical acclimation, and residency in a broad field like Internal Medicine or General Surgery. The second year onwards, programs begin to focus more on the specialization.

Residency programs that lead to board certification are called categorical residency programs, while those that are one year and do not lead to board certification are called preliminary or transitional programs. Some programs start training in the second year, and are called advanced positions. However, for such programs, residents must complete a one year transitional program in the first year.

If you plan to pursue fellowship training, bear in mind that it can take an additional 1-3 years after you complete residency.

Here’s an overview of the length of different medical residencies in the US:

  • Transitional/Preliminary Year – 1 year
  • Family Practice – 3 years
  • Internal Medicine – 3 years
  • Pediatrics – 3 years
  • Anesthesiology – 3 years plus PGY-1 Transitional/Preliminary
  • Dermatology – 3 years plus PGY-1 Transitional/Preliminary
  • Neurology – 3 years plus PGY-1 Transitional/Preliminary
  • Ophthalmology – 3 years plus PGY-1 Transitional/Preliminary
  • Physical Medicine – 3 years plus PGY-1 Transitional/Preliminary
  • Emergency Medicine – 3-4 years
  • Obstetrics-Gynecology – 4 years
  • Pathology – 4 years
  • Psychiatry – 4 years
  • Diagnostic Radiology – 4 years plus PGY-1 Transitional/Preliminary
  • Radiation Oncology – 4 years plus PGY-1 Transitional/Preliminary
  • General Surgery – 5 years
  • Orthopedic Surgery – 5 years (includes 1 year of general surgery)
  • Otolaryngology – 5 years (includes 1 year of general surgery)
  • Urology – 5 years (includes one year of general surgery)
  • Plastic Surgery – 5-6 years (includes 1 year of general surgery)
  • Neurological Surgery – 6 years (includes 1 year of general surgery)

Residency Structure By Specialty

The structure of a medical specialty also determines how long a residency is for doctors. Below is an overview of the structure of some common residency programs:

  • Anesthesiology

Anesthesiology incorporates multiple subspecialties, such as pharmacology, emergency medicine, and physiology. Anesthesiology residencies last 4 years, with training beginning in the first year of post graduation.

  • Cardiac Surgery

Like most surgical specialties, cardiac surgery residency takes several years. Cardiac surgery residency involves 5 years of general surgical training, followed by 3 years of cardiac surgical training. Multiple programs offer an integrated residency involving cardiac and thoracic surgery.

  • Family Medicine

Family medicine residencies are typically short in comparison to other specialties. Family medicine programs last 3 years with a basic clinical block in the first year and a possible fourth year for fellowship training.

  • Neurology and Neurosurgery

Neurology residency programs usually are 4 years long, with the first year focusing on internal medicine, and the remaining three years focusing on neurology.

Neurosurgery, on the other hand, is one of the longest residency programs. Neurosurgery is a complex field, demanding a lot of focus, knowledge and effort. Residency programs last 6-7 years, with the first two years focusing on general surgery, and the remaining years focusing on specialized rotations. Check with the program director of the hospital to know how your rotations will be spread.

Residencies are highly competitive and intensive. You may be interested in one specialty, but keep in mind the intensity of the program before applying, to avoid burnout. It’s best to check each residency program’s website, and their fellowship programs if available, to see which suits you best.