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what exactly happens after medschool?

Guest monkey

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Guest monkey



I am VERY confused about the steps once you graduate from medschool. i think the steps are as follows-


1. Residency in field of choice after graduation

1a. write some exam to certify you to work in that field

2. once that is done:

2a. you can go practise

2b. you can do fellowship in your field (whcih requires a few years of residency-type work...or is it purely academia??)

3. now you can work...or can you do some more specialization?


are there steps i am missing, or ignoring? thanks very much!

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Guest Ian Wong

Here's a similar post as the one you are asking:



Essentially you've basically hit upon it. After med school, you cannot legally do any clinical work with just an MD. You could, of course, go and do research, become a professor, join up work in a drug company etc, but you cannot treat patients.


Once you've completed a residency and passed that residency's exit exams, you are certified in that specialty. In the US, you would be called "Board-certified", in Canada, that certification is through the Royal College, so perhaps the description would be that you're "Royal College-certifed in XYZ."


At that point, you can practise and see patients legally.


You can always go back and do more specialization, but most people tend not to be that insane. More specialization means either going back for another residency (very rare), or for a fellowship which expands upon a subset of your original specialty (fairly common).


ie. If you did a General Surgery residency, you could go back and do a Transplant fellowship (a "subspecialty" of GS). If you did an Internal Medicine residency, you could go back and do a Cardiology fellowship (a "subspecialty of IM). etc, etc.


With Internal Medicine, in Canada the residency is 4 years long. However, if you are applying to a subspecialty/fellowship, you only need 3 years of the IM residency in order to apply. A Cardiology is a 3 year fellowship, so it would take a total of 6 years (3 + 3) to become one after medical school.


The fellowship itself is usually just like residency; you are working long hours with patients. That's how you build up your skills, so a Transplant fellow would manage transplant patients, and be scrubbing in on all those surgeries, and a Cardiology fellow would be devoted towards patients with a cardiovascular problem.



UBC, Med 3

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