Residencies in the United States

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As with other countries, in the United States every doctor, surgeon, dentist or podiatrist has to undergo a medical residency to fully qualify and become a licensed professional. Residencies are undertaken by health professionals who have obtained a medical degree. The residency is an essential part of medical training and involves working for several years under the supervision of fully licensed medical practitioners, usually in a clinic or hospital, for between 3 to 7 years depending on the field of medicine studied. While medical school teaches a broad range of medical knowledge, residency offers trainee doctors the chance to practice what they have learned, and offers the chance to study a particular branch of medicine.

In the United States, the first year of residency is commonly known as an internship. All interns need to have obtained a medical degree, such as MD or DO. Interns and residents work alongside fully qualified doctors, treating patients and performing the same tasks. Residents are essential for healthcare settings and often make up a large proportion of the house staff. The term resident dates back to when junior doctors traditionally lived at a hospital residence, although this is less common these days. In some states in the United States, residents that have completed just a one-year internship are permitted to practice medicine without supervision, often in urgent care centers, where staff shortages and high influx of patients are common.

The path to a residency is quite rigorous and medical graduates need to demonstrate and interest in the type of medicine practiced at the setting of the residency program. An interview is normally conducted to ascertain the suitability of the applicant and where the best location to place him or her. Often, medical graduates have to undertake several of these interviews in several different hospitals before the right residency is offered. This process of matching graduates with resident program is known as “The Match” and is highly competitive, with many graduates applying for the same residencies in the most sought after locations and settings. There are currently 200,000 residents working in hospitals and clinics throughout the United States.

Residencies are notoriously hard work, and usually involve long hours, unsociable shift, periods of being on-call, and undertaking tasks other professionals prefer not to do, sometimes non-medically related. In recent times, the hours that residents work in the United States has been the subject of reform. A limit to the number of hours a resident works a week has been set at 60 hours, although exceptions to this figure are often granted. It is not uncommon for interns to work shifts of 16 hours-a-day and for second and third year residents to work 24 hour continuously. While such hours are normally voluntary, most residents feel pressurized to accept, due to the highly competitive nature of residencies. Critics suggest that current conditions for residents are unhealthy and create an unsafe environment for patients. It is expected that long-overdue reforms will further limit the working hours that hospitals and clinics can force residents to work in the future.

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