When Does Residency Start

Residency training length depends on the specialty you pursue. Primary care residency programs are the shortest while surgical residencies are longer. Regardless of how long your residency training, your level of responsibility, autonomy, and independence increases in each year of residency so that by the end of your residency training, you are functioning independently in your chosen specialty. All residency specialties also offer the option for further specialization after residency, called fellowship training.

Medical Residency Timeline and Length (2022-2023)

Residency training length depends on the specialty you pursue. Primary care residency programs are the shortest while surgical residencies are longer. Regardless of how long your residency training, your level of responsibility, autonomy, and independence increases in each year of residency so that by the end of your residency training, you are functioning independently in your chosen specialty. All residency specialties also offer the option for further specialization after residency, called fellowship training.

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Categorical Versus Preliminary Programs

Residency programs that lead to board certification in that specialty are called categorical residency programs.

Residency programs that are one year and do not lead to board certification, are called preliminary or transitional programs.

There are also some specialties that start residency training in the second year after medical school or post graduate year two (PGY2). These are called advanced positions. Residents that start specialty training in the PGY2 year must also complete a one year transitional or preliminary program in the PGY1 year.

The following specialties offer advanced positions and start in the PGY2 year, however, some may also start in the PGY1 year:

• Anesthesiology
• Dermatology
• Diagnostic radiology
• Neurology
• Ophthalmology
• Physical medicine and rehabilitation
• Psychiatry
• Radiation oncology
• Urology

How Long Is Medical Residency? (By Specialty)

The average length of residency training is about four and a half years. The shortest residency training programs are three years and the longest are seven. After residency training, some people pursue fellowship training which can range in length from one to three years, on average. So, keep in mind that your overall training might be extended by one to three years depending on whether or not you choose to subspecialize.

Residency Specialty	Program Length
Transitional/Preliminary Year	1 year
Family Practice	3 years
Internal Medicine	3 years
Pediatrics	3 years
Anesthesiology	3 years plus PGY-1 Transitional/Preliminary
Dermatology	3 years plus PGY-1 Transitional/Preliminary
Neurology	3 years plus PGY-1 Transitional/Preliminary
Ophthalmology	3 years plus PGY-1 Transitional/Preliminary
Physical Medicine	3 years plus PGY-1 Transitional/Preliminary
Emergency Medicine	3-4 years
Obstetrics-Gynecology	4 years
Pathology	4 years
Psychiatry	4 years
Diagnostic Radiology	4 years plus PGY-1 Transitional/Preliminary
Radiation Oncology	4 years plus PGY-1 Transitional/Preliminary
General Surgery	5 years
Orthopaedic Surgery	5 years (includes 1 year of general surgery)
Otolaryngology	5 years (includes 1 year of general surgery)
Urology	5 years (includes one year of general surgery)
Plastic Surgery	5-6 years (includes 1 year of general surgery)
Neurological Surgery	6 years (includes 1 year of general surgery)

What To Expect

Applying To Medical Residency

You will apply to residency through The Electronic Residency Application Service (ERAS) through MyERAS for the majority of specialties. Ophthalmology and plastic surgery use the SF Match service.

For each system, you will need to include your biographical and educational information. Additional documents you need are a personal statement, information about your experiences (work, volunteer, and research), letters of evaluation, your medical school transcript, and standardized test reports (USMLE or COMLEX).

What to Expect in Residency

All residencies have graduated levels of responsibility throughout training which means that you will become more independent and responsible for every year of your residency training. The ultimate goal is that, by the end of residency, you are functioning independently within your specialty. As you gain more knowledge, expertise, and skill, you will feel comfortable taking on more responsibility and your attendings will welcome the help. Additionally, you will have increased supervisory and teaching roles throughout residency. By the end of residency you will be supervising your interns and junior residents. Therefore, you will need to delegate roles and duties, oversee your interns and junior residents, and often you will be the one those junior doctors turn to with questions.

After Medical Residency

After residency training, residents choose to either practice in the chosen specialty or pursue further fellowship training. Within one to two years of finishing residency, doctors also take specialty boards to become board certified in the specialty in which they trained. These specialty boards always involve a written exam and some specialties have an oral exam component as well.

Medical Residency Salary

Residency salaries do not vary much between specialties and residency salaries increase every year of training. There tend to be salary differences between geographic areas with areas that have higher costs of living paying slightly more than areas where the cost of living is lower.

Frequently Asked Questions for AY 2024-2025

The deadline is October 31, but we encourage you to submit your application as soon as possible because we do run out of interview slots every year.

**If you are selected for an interview- we strongly recommend that you DO NOT double book yourself with another program on that day. Time can run over, and we would not want you to be late to your interview for either program.

What are the minimum USMLE score requirements for your program?

We review applicants’ entire applications, including transcripts, USMLE scores/pass status, letters of recommendation, CVs, and personal statements and do not use a minimum score filter. **Please note that you must take and pass Step 1 and Step 2, or equivalent COMLEX, for us to rank you for your program** We may offer interviews without Step 2 scores in certain scenarios, but we cannot rank you without it.

When is your start date for intern year?

If your Deans and faculty advisors haven’t told you yet, there is an old wives’ tale that residency always starts at the beginning of July — most of us in fact start in June! Our start date for AY2022-2023 is on or around June 13, 2023 — this includes required institutional orientation, credentialing activities, and officially starting patient care before July! On the flip side, our residency program finishes about a week before July, so if you choose to do a fellowship you will have time to move to your new location and get situated in time for fellowship orientation!

What about International Medical Graduates (IMGs)?

We accept the best qualified applicants to our program, regardless of the medical school they attend. For IMGs, we require at least 1 month of hands-on US clinical experience. We also recommend IMGs to have graduated from medical school or have had clinical experience within 3 years of applying to our residency program. An understanding of the medical language and the basics of the American medical system is necessary so that the transition to internship can be as rapid and smooth as possible. We are only able to accommodate J1 visas per our GME policies.

Do you offer externships or observerships?

Unfortunately, at this time we do not offer these options. If you’re an international medical graduate, please visit our International Medicine Programs Office. They currently offer various opportunities for international medical graduates.

How are our residents evaluated?

In addition to regular on-the-fly verbal feedback from attendings, at the conclusion of each rotation, housestaff receive formal written evaluations from their attendings. They also receive anonymous written peer evaluations, student evaluations, and nursing evaluations for rotations where this is appropriate. We use MedHub (residency database), where residents have immediate access to all their evaluation information. Our Clinical Competency Committees (CCCs) review each resident’s evaluations and progress in our program at least twice per year (and per ACGME requirements, assess their progress on achieving the Internal Medicine Milestones). Faculty on the CCCs are each assigned 5-6 housestaff for whom they closely follow evaluations and with whom they sit down twice per year for a semi-annual meeting in which they discuss feedback and input from the CCC, as well as the resident’s goals for training and beyond. For continuity, by the conclusion of categorical residency training, each resident should have had 6 semi-annual meetings with the same CCC faculty advisor.

Do your interns or residents work extended overnight shifts on any rotations?

Yes, housestaff in our program work q4 overnight shifts (24+4 hours) in our intensive care units and our NIH rotation only. This is to provide continuity of patient care and educational experience but we are regularly reevaluating if these schedules are optimal for these clinical experiences, resident wellbeing and patient safety. Our wards and cardiology service utilize a night float system so trainees do not work extended shifts outside of our ICUs and NIH.

Do you use electronic medical records (EMR)?

YES! We are paperless and use EMR for patient notes, orders, and results. This is true of our clinic, GWU Hospital, and all affiliated sites. The EMRs are different at different affiliated sites, but our residents find them to be straightforward and user-friendly.

What is the on-call schedule?

At GW, ward teams are on long call every sixth day (q6) within a drip system (teams getting a small number of admissions each day) and night float team for overnight cross-cover and admissions. The VA has a geographic drip system (with teams getting admissions each day) and a night team for overnight admissions. The GW ICU and VA MICU team are on overnight extended call every fourth night (q4) with intern-resident pairs working together. The NIH rotation has extended call every 4th night.

Remember, since we are a 4+1 system and we respect the ambulatory/clinic weekend, every 5th weekend is a bonus golden weekend.

What about days off?

In addition to scheduled vacation weeks, interns and residents average at least four days off during each ward, ICU, and cardiology month. We strictly abide by the one day off in seven!! Many electives have 2 days off. In addition, the 4+1 schedule provides more weekend days off during each ambulatory week (or +1 week for prelims).

Is there a nightfloat team?

At GW, there is a nightfloat team consisting of two to three residents, two interns, a medicine admitting attending, and admitting advanced practitioner. At the VA, there is a night team for cross-cover and admissions, except on weekends, when they are done by the on-call resident or moonlighter.

Is there a research requirement?

Yes, we require all categorical and primary care residents to complete scholarly activity, and to submit their work for publication or for presentation at a regional or national conference. Scholarly activity can be in various forms (health services, clinical, and/or bench research; quality improvement, case reports, medical education, and other forms of scholarship). Our research and writing curriculum and quality improvement and high value care curriculum equip residents with the skills to complete this requirement. Residents work closely with faculty mentors on projects. Residents may present their work internally, at GW research day, and at local, regional, and national conferences (and we cover the costs!)

Please see our Resident Research page for more information.

Is there support for travel to a national meeting?

Conference and travel expenses are reimbursed for housestaff who present scholarly work performed at GW for up to $1200 per year. We love when our residents get to show off their achievements and represent us around the country!

Can residents at GW qualify for Public Service Loan Forgiveness?

As an employee of The George Washington University (which is a 501c3 organization), time spent as a resident here can count towards the Public Loan Forgiveness Program through Direct Loans!

How do you help residents prepare for the ABIM certification exam?

We offer each PGY-2 a free access to MKSAP or money towards UWorld for board preparation.

Residents do not receive an additional book allowance during their residency, but they do receive a 10% discount on purchases at the university bookstore. We keep MKSAP books in our offices for residents to borrow. All housestaff have free access through the GWU library to MDConsult, DynaMed, Clinical Key, Epocrates, and Lexicomp, as well as over three dozen textbooks and almost 1,000 journals in full text. Residents get access to Up to Date through the VA Medical Center. Library resources and Up to Date can be accessed online from any location, including from home.

NBME In-Training Exam: All of our PGY2s and PGY3s take the in-training exam to help define areas of improvement for individuals and the program. Results of this examination directly guide the content of our academic conferences and help inform individual learning plans for residents.

Didactics/Teaching: At least once per week, didactics at GW has an exam preparation focus. Topics selected are informed by in-training exam results.