help on clarifying timeline of med school

[seabreeze]

I wasn't too clear on the timeline involved with completing med school so I was hoping someone could chime in here.

What i've gathered so far is that you (almost always) have to finish your undergrad (so 4 years there), then you go to med school (5 years?) and is it true that after that, you cannot start practicing until you do residency? how many years is that roughly?

And in total, how many years would you be looking at spending in post-secondary education before you become a fully certified doctor (GP lets say, not necessarily a specialist) assuming you get into med school after 4 years?

[nutritional_lee]

I've only completed the undergrad portion, so I might not have the best grasp on this just yet. That said:

 

Undergrad: 3-4 years, after which point you're granted your bachelor degree

Med school: 4 years (usually ~2 years lectures, ~2 years clinical experience), after which point you're granted your MD; McMaster's program is only 3 years long.

Residency: 2-5 years (depending on your specialty), required in order to practice, even if you just want to become a GP.

 

Again... probably not the most accurate. And I'm sure there are always exceptions/other paths, as well.

[futuredoc]

Sometimes one does a fellowship (usually one year I think) above all that too. It is a long road even without it.

[Icebox]

Here's how it typically goes:

 

1. Undergrad

 

Admissions processes vary depending on the school. Some schools require at least a bachelors' degree, but there are also schools that will admit students after a minimum of 2 years of undergrad. So, this may vary from 2 years, to 4 years (undergrad degree) to 6-10 years (undergrad + Master's/Ph.D).

 

2. Medical School

 

Medical school is either 3 years at UofC & McMaster, or 4 years everywhere else. As someone else mentioned, it's typically 2 years preclinical and 2 years clinical, though this varies slightly from school to school.

 

3. Residency

 

A typical family medicine residency lasts 2 years, and you can also do what's known as a "2+1" where you complete an additional year in a subspecialty. This may be in obstetrics, emergency, or any area that you may find useful doing in addition to family practice.

 

For any other specialty, the residency usually lasts 5 years.

 

4. Fellowship

 

For any specialty besides Family Med, you have the OPTION of subspecializing further. This is usually taken on particularly if you will be an academic, and will focus on one particular area in your specialty (ex. in Neurology, you focus on stroke. Or in cardiology, you focus on interventional cardiology). This typically lasts 3 years.

 

...so in total, it can be anywhere from 7 to 16 total years. It really varies depending on when you enter medical school, and what specialty you pursue.

[futuredoc]

Here's how it typically goes:

 

1. Undergrad

 

Admissions processes vary depending on the school. Some schools require at least a bachelors' degree, but there are also schools that will admit students after a minimum of 2 years of undergrad. So, this may vary from 2 years, to 4 years (undergrad degree) to 6-10 years (undergrad + Master's/Ph.D).

 

2. Medical School

 

Medical school is either 3 years at UofC & McMaster, or 4 years everywhere else. As someone else mentioned, it's typically 2 years preclinical and 2 years clinical, though this varies slightly from school to school.

 

3. Residency

 

A typical family medicine residency lasts 2 years, and you can also do what's known as a "2+1" where you complete an additional year in a subspecialty. This may be in obstetrics, emergency, or any area that you may find useful doing in addition to family practice.

 

For any other specialty, the residency usually lasts 5 years.

 

4. Fellowship

 

For any specialty besides Family Med, you have the OPTION of subspecializing further. This is usually taken on particularly if you will be an academic, and will focus on one particular area in your specialty (ex. in Neurology, you focus on stroke. Or in cardiology, you focus on interventional cardiology). This typically lasts 3 years.

 

...so in total, it can be anywhere from 7 to 16 total years. It really varies depending on when you enter medical school, and what specialty you pursue.

 

BAH. Why must they force us to waste so much time in undergrad?

[Satsuma]

It is true it is a long road. Something to keep in mind though, is that residency can be considered "on the job training" in a way. So you are in the specialization you want (hopefully) so are more focussed, you can prescribe without needing a co-sign like when you are in med school etc., you are responsible for teaching med students and residents more junior than you etc. You are paid...although not much for the hours you work and the work you do.

 

So, yes it is long, but part of the training is doing what you want to do, with some independence but with support when you need it.

[NurseNathalie]

I don't personally see it as 'wasting' time in undergrad

 

everything you do- and everything you learn, helps you while in medical school. This doesn't only include formal studies- but volunteering, personal attributes, and life experiences too! I like to think that I have been getting ready for medicine since I was very young... not only through undergrad and MD undergrad. It's all just a great (and sometimes rocky) journey.

 

It's less discouraging to see it as stepping stones to the end result... and remember.. learning doesn't stop once you start practicing- this is the rest of your life as a physician.

[lostintime]

Yeah, but in that respect, we could also call having a Masters and Ph.D. degree also valuable "life experiences" and then a double Ph.D. would be even more valuable, and a triple one....but we only live so long.

 

And if some of the learning could be done while in med school (proven in other countries), I don't see the point in lengthening the process when the country has a shortage of doctors.

[NurseNathalie]

Yeah, but in that respect, we could also call having a Masters and Ph.D. degree also valuable "life experiences" and then a double Ph.D. would be even more valuable, and a triple one....but we only live so long.

 

And if some of the learning could be done while in med school (proven in other countries), I don't see the point in lengthening the process when the country has a shortage of doctors.

 

I see your point. It's not that one experience is more valuable than another, but I do think that its not wasted to need an undergrad before med school. I guess I was just trying to put a 'positive' spin on the process, so that he (or she) didn't feel so discouraged at the lenght of time to be anticipated in getting ready for practice.. s'all

[A-Stark]

Yeah, but in that respect, we could also call having a Masters and Ph.D. degree also valuable "life experiences" and then a double Ph.D. would be even more valuable, and a triple one....but we only live so long.

 

And if some of the learning could be done while in med school (proven in other countries), I don't see the point in lengthening the process when the country has a shortage of doctors.

 

But the shortage has everything to do with the number of physicians being trained, not whether they must complete a first-entry undergrad first. The undergrad requirement is, at minimum, to show evidence that an applicant can handle the sort of independence and responsibility required of uni students that, frankly, is not altogether as necessary in high school. What's more, physician education in other countries simply takes 6-7 years before post-grad training, so the difference is not as large as you seem to allude.

[Wolvenstar]

Well if you want the realistic answer, it is because they at one time had a surplus of doctors, so the government decided to make it harder for people to get into medical school, by putting in all these pre-reqs.

 

If you want the utopian view, it give you life experience, and valuable skills.

 

If you want the optomistic view, it's to weed out those not good enough or smart enough to be doctors.

 

If you want my view, the government makes more money this way. We could have one doctor per province and the government wouldn't do anything. I mean seriously one has to wonder about the necessity of taking university physics, or statistics or even spending a number of years getting ANY degree before being accepted into med.

 

I could understand an actual pre-medical program, set up to weed out the unworthy and prepare the rest for med school, with it's courses actually being geared towards the human body and medicine. But they just want to do whatever undergrad degree pops into your mind (as long as you take the pre-reqs)

 

I hate having to fight tooth and nail to get through waiting lists because my university offers so few courses having to deal with the human body. I tend to change majors every semester to get the classes I want. I would stay with one major, but I don`t want to be taking random useless classes that have nothing to do with the career area I am interested in pursueing, and subjects that I have even less interest in.

 

Frankly I would rather spend my time volunteering at the hospital and being usefull rather than wasting away in some useless class that has nothing to do with the human body or medicine

[Satsuma]

It is true that life experience can help alot with many aspects of med school a student will encounter.

 

I have had some doctors who trained in other countries comment how they thought it was a good thing that here many that come into med school have these life experiences. They reflect on how much harder it was for them dealing with many issues we deal with in medicine at a young age. Of course they are great physicians now..maybe just had to mature a little faster.

 

I don`t think the selection process requires 3 years and now 4 years in many places because they think they need the extra year or 2 of study/life experience to be good doctors.

 

I think that medicine has just become more and more competitive. It is a reality that many are applying to medicine with and MSc or PhD, with a previous career as a lawyer, teacher etc. The schools have only so many spots and obviously they will fill them with the best candidates they can.

 

15 (probably even 10) years ago you could get into med school with just 2 years of undergrad...and come out and be a great and competent doctor. But now with all the high quality applicants, the schools just have to weed the applications out somehow.

[lansky]

Here is another point of view: in Eastern europe you could get into med school straight out of high school. I spoke to a woman who is in my psych class who was in med school in Czech Republic, she dropped off the middle because she realized that she did not like it. She is now in her late 20s learning to become a social worker which she says she enjoys much more.

 

According to her opinion, going to med school straight after high school is a bad idea for the following reasons:

 

1) how many of you were 100% sure you wanted to become doctor righ after finishing high school? She said that she did not realize what becoming a doctor involves....when you are 18,19 you may not always understand what medicine is...having few years of undergraduet degree along with extracuricculras exposes to a wider variety of career options, this variety is usually not availabe in a more structured high school setting .

 

2)How many of you feel that your high school marks did not reflect your true academic strenghts? I personally find that my studying habits improved dramatically while in university...so someone like me would not have a good chance of getting into med school despite having a true passion for it due to marks not being exceptionally high....so undergrad years provides another oppurtunity to improve yourself

 

3)even if you have volunteer experience in a hospital during high school, you may not be mature/attentive enough to truly undrestand what medicine involves (I know that some may not even be mature at age of 22 but likelihood is that past the teenage years people are more often form good grasp of who they are and what they are intereted in) volunteer work in undergard (thus, at older age) may provide you with a better insight.

 

This lady told me that she enjoyed the physiology part alot in med school but as soon as the practical part begun she could not tolerate it and did not like it all.

 

This is not my opinion but these are just some good things to keep in mind...Both paths have their goods an bads

[lansky]

Wolvenstar, just because you are taking classes in undergrad that are not related to your future desired career path does'nt mean that its a waste of time. I found that I have gained that most valuable communicative skills and in my humanities and psych classes, I became more open minded and got understand others better. So I think the reason med school dont require student to follow only one major is because people are normally intereted in many things unrelated to medicine, like history music dance psychology, so having an ability to lstudy these subjects while gaining good peoples' skills and maturity is not such a bad idea in my opinion...

[Wolvenstar]

Wolvenstar, just because you are taking classes in undergrad that are not related to your future desired career path does'nt mean that its a waste of time. I found that I have gained that most valuable communicative skills and in my humanities and psych classes, I became more open minded and got understand others better. So I think the reason med school dont require student to follow only one major is because people are normally intereted in many things unrelated to medicine, like history music dance psychology, so having an ability to lstudy these subjects while gaining good peoples' skills and maturity is not such a bad idea in my opinion...

 

 

 

This may be true, though there are some universities, such as Northern Ontario which require you to have a degree before applying. This may or may not be so bad depending on the university you do your undergrad at.

 

Frankly I have ended up taking the psychology route because other majors at my university require me to take several what I would call random courses - that is courses that can not be explained in how they relate to the major you have chosen. These are not broad things like the humanities but random specific courses.

 

I can completely appreciate how one would wish to take courses in areas other than medicine that interest them, which is why I asked how come we don't actually have a pre-medical program set up that is actually medically geared for students who wish to go to med school. This program would include programs about the human body and medically related subjects. Then just as a regular degree you would have your optional or GLER classes where you could take any course you desire.

[A-Stark]

Well if you want the realistic answer, it is because they at one time had a surplus of doctors, so the government decided to make it harder for people to get into medical school, by putting in all these pre-reqs.

 

If you want the utopian view, it give you life experience, and valuable skills.

 

If you want the optomistic view, it's to weed out those not good enough or smart enough to be doctors.

 

If you want my view, the government makes more money this way. We could have one doctor per province and the government wouldn't do anything. I mean seriously one has to wonder about the necessity of taking university physics, or statistics or even spending a number of years getting ANY degree before being accepted into med.

 

Given the government funds medical education to a still-substantial degree, they are certainly not profiting from the exercise, on a strict expenditures basis.

 

Anyway, if you don't think that physics and statistics are relevant to medicine, I'd offer that you (a) haven't written the MCAT yet and ( don't have the slightest idea of how medical/health research is presented.

[Wolvenstar]

technically the MCAT isn't relavent to medicine, it is a general test of one's academic knowledge and skills. It is relavent to getting into med school.

 

As for physics, I know several people who have written the MCAT, although I have only written the practice samples that they have for purchase on the MCAT website. From what I have done, and what my friends have told me, highschool physics has been sufficient for writing the MCAT.

 

As for statistics, I do understand how that can be important to research in medicine, but again, looking at what my friend who is currently in the class is doing, it is just a review of highschool stats, and not worth the $500 it costs to take the course.

[Satsuma]

I could understand an actual pre-medical program, set up to weed out the unworthy and prepare the rest for med school, with it's courses actually being geared towards the human body and medicine. But they just want to do whatever undergrad degree pops into your mind (as long as you take the pre-reqs)

 

I hate having to fight tooth and nail to get through waiting lists because my university offers so few courses having to deal with the human body. I tend to change majors every semester to get the classes I want. I would stay with one major, but I don`t want to be taking random useless classes that have nothing to do with the career area I am interested in pursueing, and subjects that I have even less interest in.

 

Frankly I would rather spend my time volunteering at the hospital and being usefull rather than wasting away in some useless class that has nothing to do with the human body or medicine

 

I can understand that you know what you want to do and want to just focus on that and get on with it.

 

This sounds cheese...but try to keep an open mind and enjoy the journey toward med school. There are very few classes you could take that would be completely irrelevant to medicine. Given that medicine is about people and relating to them, the broader your experiences, the broader the population you will be able to relate to. There has been more than one occassion where I wished I had at least taken a high school shop or mechanics class so I could understand what my patients were telling me about their jobs!

 

If you do want to focus on medical type courses...choose a bio-med or life sciences degree. I chose bio-med cause it was the only bio program that didn`t require botany. It was great prep for med school, although since I tend to have very broad interests, I did find it very restricting in terms of electives and exploring my other interests. But it's all, physiology, anatomy, pharmacology etc. all "medicine related". If I had to do it over, I probably would have just done a general biology program where I had more flexibility of electives.

 

Good luck

[Wolvenstar]

Satsuma if you don't mind me asking what university do you go to? I kinda shot myself in the foot with the deciding factor in what university I went to was the fact that I wouldn't have to pay rent if I went to the U of L (my rents own a second house here).

 

However their "health science/life science" program is a continuation of the nursing program that starts at the Lethbridge Community College, and in order to take many of those courses offered at the University in this area you have to be part of the Nursing program, which means taking 2 years at the college, which costs twice as much in tuition.

 

As well the U of L doesn't offer a bio-med program so that doesn't work for me either. Frankly after spending two years at this university I don't think I would recommend it for a student wishing to go into a professional program afterwards. Great Ed program, and the neuroscience isnt too bad either, but otherwise not that great of a school. Maybe I will transfer if I hear enough good things about another university.

[Satsuma]

I don`t mind you asking!

 

I did my undergrad at U of Guelph (at Ottawa U now)...a bit a ways away from your home province! Excellent program, no complaints.

 

http://www.ovc.uoguelph.ca/academics/biom/schedule/

 

Above is a link to the program description I found online. It has been awhile since I graduated but looks pretty much identical to when I was there.

 

I am not familiar with the schools out your way.

 

Since you have already completed 2 years though perhaps it is best to just finish where you are and perhaps you will get in after 3rd year?

 

That is unless you really don`t find it is a good fit for you...then you will just be miserable and not do well in your classes anyway.

 

So if you truly cannot find a program that you are interested in where you are, then perhaps you have a good reason to transfer. However, I wouldn`t transfer just because you are worried you won`t be competitive for med school because people get in from all backgrounds....philosophy, teaching, chemistry, engineering, law, and of course biology and related areas etc.

 

If you do decide to transfer look into the specific course descriptions before you go. At Guelph for example, physiology can be human or mammalian (you choose) ...both use the same text (Guyton) and so even in the mam phys you end up with alot of human physiology knowledge, you just end up with a bit of extra stuff too. However, I once was a lab instructor at UVic for 3rd year physiology....and their physiology turned out to be alot of invertebrate and non-mammalian stuff (alot like a course you would find in the zoology program at Guelph..which weren`t the courses I took...and so had to read alot to prep to teach those labs!). Some of the basic principles were the same, but could be disappointing if you want to focus on humans.

 

I am just guessing here ...and I could be completely wrong...but if you want your courses to be more medical, you may need to find a school that has a medical program or veterinary program or something along those lines since they will have faculty with interests/knowledge in that area and so more likely courses with that kind of emphasis.

 

Hope you eventually find something that interests you.

[Wolvenstar]

For Competitiveness for med school I am not worried, and it is my hope that after next year I will get accepted into med school. If not though I will be serious contemplating transfering schools, as I will have taken all the programs offered that have to do with human biology or medicine. It's completely understandable that some people enjoy their undergrad years before med school, it's just that I have to find a school that offers the courses I am interested in(which pretty much entails courses dealing with humans biology/evolution/physiology). I will look up the university you mentioned, it doesn't sound too bad.

[A-Stark]

What year are you in now?

[Ian Wong]

As previously mentioned, the "typical" timeline for most Canadian premeds is to complete a 4 year undergrad degree, 4 years of med school, and then anywhere from 2-5 years of residency.

 

Some individuals then do on to do fellowships, which are areas of subspecialization within a specialty (ie. Cardiology is a subspecialty of Internal Medicine, or Vascular Surgery is a subspecialty of General Surgery), which can take anywhere from just 1 to 3-4 more years.

 

If you are really crazy, you could then go on and do further fellowships. For example, you could do an Interventional Cardiology fellowship after a Cardiology fellowship. If you completed a Diagnostic Radiology residency, you could do a 1-2 year Diagnostic Neuroradiology fellowship, and then another 1-2 year Interventional Neuroradiology fellowship after that.

 

There are not that many ways of shortening the "typical" timeline if you are in Canada. The few ways include getting into med school after only 3 years of undergrad, or going to a 3 year med school (like Mac or U of C).

 

At this point, I'm a PGY-4 radiology resident. I did 3 years of a Biology degree for undergrad, and was then accepted to UBC med school.

 

I graduated in 2003, but didn't match for ENT, and subsequently took a year off to reevaluate medicine as a career, and to explore an alternative specialty, which I ended up matching into, that being radiology.

 

I will finish residency in June 2009, and will then start a 1 year musculoskeletal imaging fellowship (bones and joint imaging), which finishes at the end of June 2010. After that, I'll be looking for a job, whether that be in academics or private practice.

 

So for me, undergrad started in 1996, and I won't have my first "real" job as an attending until 2010. That's pretty daunting for anyone. I lost a year by going unmatched, although that was counterbalanced by getting into med school after 3 years of undergrad, so I'm still on a conventional timeline.

 

My thoughts on the whole thing. The first 2 years of med school were not bad, but certainly nothing memorable. Lots of books. Lots of time in the library memorizing details. The last two years of med school were a LOT of hard work. Being exposed to q4 call nearly year-round during Med 3, and being the lowest members of the totem pole while not knowing anything about the inner workings of the hospital is pretty intimidating. Still, it is a definite clear transition where you start to really feel like you are becoming a physician.

 

Residency has been good so far. I'm at the point in residency now where I feel like I can handle most things that come in while on call, and feel like I can give reasonable interpretations for most anything imaging-wise that I would likely encounter in a general community setting. It's a pretty cool feeling when you are sitting in the reading room knowing that you can take on anything that comes in either through the ER, or most everything that could occur on the floors.

 

I'm not really sure what fellowship will bring. I think it will be fun, but I'm a little worried that a complete year focussed just on one subspecialty of radiology might lead to atrophy of some other radiology skillsets I've been developing. Things like mammography or obstetrical ultrasound are things that you need to keep doing in order to keep up your skills. Every radiologist can read a chest-xray or a CT abdomen and pelvis, but the more subspecialized things get, the more you need to keep up with then in order to do them safely.

 

All in all, I'm happy that I ended up in Radiology. I think there are very few specialties in medicine that I would be happy practicing on a daily basis. The hardest part of the game is figuring out what specialties would interest you and keep you happy.

 

This is particularly difficult because specialties in the academic setting may be totally different out in the community, which you have limited access to as a medical student. As well, there's just not that time in med school to get a wide exposure to specialties before you are forced to start committing in certain directions through either your elective choices, or your letters of reference.

 

Ian

[Wolvenstar]

What year are you in now?

 

 

 

Funny question, I started university in spring semester, so technically I am a second year student, but when I plan to apply (which will be not the next school year but the one after), I will technically be apply with 3.5 years of undergrad.

[kaymcee]

Ian, thanks for your post. It's good to hear that things worked out alright regardless of the bump in the road with CaRMS. It seems to always be about the next step, and navigating them can be rather daunting.