Medical School Training Flowchart

At least in the US. “It’s a giant hierarchy” culturally. Board certification is national. Prescribing abilities are national, licensure is by state for some reason (“Licensed in Medicine and Surgery in the State of New York.”)

March 30th is National Doctors’ Day btw.

COLLEGE / PRE-MED
    |
    v
MEDICAL SCHOOL
    |
    +--> MS1 / M1  = first year
    |       - mostly classroom / foundational science
    |
    +--> MS2 / M2  = second year
    |       - more systems / pathology / pharmacology
    |       - board exam prep
    |
    +--> MS3 / M3  = third year
    |       - core clinical rotations:
    |         internal medicine, surgery, pediatrics,
    |         OB/GYN, psychiatry, neurology, family medicine, etc.
    |
    +--> MS4 / M4  = fourth year
    |       - sub-internships / acting internships
    |       - electives / away rotations
    |       - residency applications + interviews
    |       - Match
    |
    v
GRADUATION - MD or DO
(same residency system after this point)
    |
    |
    v
RESIDENCY
    |
    +--> PGY-1
    |    intern year
    |    very supervised, heavy service workload
    .
    .
    .
    .
    |
    +--> PGY-n
    |       depending on specialty
    |       Examples:
    |         Family Medicine ............ usually 3 years
    |         Internal Medicine .......... usually 3 years
    |         Pediatrics ................. usually 3 years
    |         Emergency Medicine ......... usually 3 or 4 years
    |         Psychiatry ................. usually 4 years
    |         Anesthesiology ............. usually 4 years
    |         OB/GYN ..................... usually 4 years
    |         Neurology .................. usually 4 years
    |         General Surgery ............ usually 5 years
    |         Orthopedic Surgery ......... usually 5 years
    |         ENT ........................ usually 5 years
    |         Urology .................... usually 5 or 6 years
    |         Neurosurgery ............... usually 7 years
    |
    +--> OPTIONAL: CHIEF RESIDENT
    |       - usually done after residency, sometimes during final year,
    |         depending on program/specialty
    |       - leadership / teaching / administrative role
    |       - selective, prestigious
    |       - can strengthen academic job or fellowship applications
    |
    v
BOARD ELIGIBLE / BOARD CERTIFIED
(after finishing residency and passing specialty boards)
    |
    +------------------------------+
    |                              |
    v                              v
ATTENDING PHYSICIAN           FELLOWSHIP
(no further subspecialty      (extra training after residency)
training required)                  |
                                    +--> PGY-4, PGY-5, PGY-6, etc.
                                    |    numbering just keeps going
                                    |    based on total years after med school
                                    |
                                    +--> examples:
                                    |      IM -> Cardiology
                                    |      IM -> Gastroenterology
                                    |      IM -> Pulmonary/Critical Care
                                    |      Pediatrics -> Neonatology
                                    |      Surgery -> Vascular Surgery
                                    |      Anesthesia -> Pain / Critical Care
                                    |
                                    +--> fellow = doctor training in subspecialty
                                    |
                                    v
                              SUBSPECIALIST ATTENDING