The path from student, to resident, to doctor

Sunday, July 3, 2016 | 2 a.m.

Becoming a doctor typically requires nearly a decade of schooling, and ongoing training and education for years beyond that. Throughout this period, the most influential component for many young doctors is their time in residency. While most of us know doctors to be well-educated, dedicated, even prestigious figures, what actually goes into becoming a doctor is an intense grind. Here is a glimpse into the amount of training every physician receives and a closer look at medical residency — the years-long final step between being a student and being a practicing doctor.

How someone becomes a doctor

It’s a long road to attaining a medical degree. Here are steps doctors take to get there:

• Bachelor’s degree (4 years): Anyone aspiring to be a doctor will have to earn an undergraduate degree. Many choose pre-med or another relevant, science-based discipline as their major, though doing so is not a requirement for medical school acceptance.

• Take the MCAT (Medical College Admission Test): This test is required 
for application and acceptance into medical school.

• Medical school (4 years): The first two years of medical school are dedicated to formal instruction about anatomy, physiology, psychology, biochemistry, pharmacology and ethics. The second two years involve much more hands-on learning, as students begin the integration into the clinical environment at hospitals, clinics and laboratories.

• Get licensed: Once they complete medical school, students will have to become licensed to receive their Doctor of Medicine degree (MD) or their Doctor of Osteopathic Medicine degree (DO). The requirements and licensing exams for attaining an MD or a DO are different. MDs participate in a three-part exam: Step 1 is usually completed after the second year of medical school; Step 2 is usually completed during the fourth year of medical school; Step 3 is the final exam in the series and is usually completed after the first year of residency.

• Residency (3-5 years): Residency is the final hurdle in being able to practice medicine 
without supervision.

• Fellowships (1-4 years): Fellowships occur at the completion of residency training and are specific 
to the individual medical or surgical discipline.

What is a resident?

Residents work and are trained within their hospital of residency for a minimum of three years, though some specialty fields require a longer amount of time. For example, internal medicine residents will have to complete a three-year residency, but someone who wants to practice obstetrics/gynecology will have to complete four years. A general surgery resident will have to complete five years. All residents are supervised closely by their residency team and presiding doctors to ensure they’re being trained properly and attaining the necessary clinical skills.

“At the completion of a residency program, the doctor can apply and be granted acceptance to a specialty fellowship. Fellowships can range from one to four years — sometimes even longer — of additional training,” said Swenson.

Stages of residency

The first year of residency is referred to as the internship year. “During the internship year, the primary focus is on communication with patients, taking an in-depth history and physical exams, and ordering basic medications, laboratory testing and radiology,” Swenson said. A faculty physician and a more senior resident both supervise interns directly.

The years following the internship year are referred to as residency training. “During this time, the resident is given progressive responsibility and agency when treating patients — while still under supervision — until eventually reaching full autonomy by the completion of their training program,” Swenson said.

Why are residency programs 
important in Nevada?

Local medical schools and graduate medical education programs tend to benefit the larger medical community of the region. Considering this, there is an initiative in Las Vegas to grow our medical education programs —which many hope will help retain resident physicians in Nevada at the completion of their training. This is crucial in Nevada, where we rank 48th in the country for the number of physicians per capita. The national average is 307 physicians per every 100,000 people; Nevada has 218 physicians per every 100,000 people.

UNR and Touro University are the only operating medical schools in the state, but the UNLV School of Medicine, founded in 2014, is growing steadily and anticipates welcoming its inaugural class by 2017. Roseman University is also in the process of building a medical school. With this, the demand for residency programs in Las Vegas will increase as well. One of the most recent hospitals to attain accreditation to host a residency program is MountainView Hospital, which was set to have 53 residents in internal medicine and surgery starting July 1. As Las Vegas continues to expand its medical-education offerings and build its pipeline of physicians, residency programs will become even more important in the Valley.