Specialty Profiles

Medical specialty choice: Should residency training length matter?

Brendan Murphy , Senior News Writer

Medical specialty choice is largely about passion. Residency training will require new physicians to channel that passion. It also may require a bit of patience.

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The duration of training is all that stands between a physician and practice. For those selecting a specialty, the length of that training may be a factor.

”For some, the balance of that length of training against practical considerations like debt, family plans or age may play into decision making,” said John Andrews, MD, the AMA’s vice president for graduate medical education innovations. “I’m not aware of anybody making a decision about the specialty they plan to pursue solely on the basis of duration of training. It ultimately boils down to the way you want to spend your time and the type of medicine you want to practice.”

For those considering their steps after medical school, FREIDA’s Specialty Guide—and corresponding series of videos offering expert insight on specialty choice—a clear, approachable overview of medical specialties and subspecialties and can help you choose a career path. It’s designed to simplify medical students’ specialty selection process, highlight major specialties, detail training information and provide access to related association information.

Learn about the right time to choose a medical specialty.

The amount of time a physician spends in residency varies greatly by specialty. Typically, primary care specialty training requires the least time—somewhere between two and four years—while surgical specialty programs tend to be longer.

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The list below consists of all pipeline specialties (those leading to board certification) accredited by the Accreditation Council for Graduate Medical Education. The information details the total years residents can typically expect to spend in graduate medical educationto complete a course of training in a specialty. Programs may approach training differently, so there are likely to be exceptions to the durations listed below. Remember that you may want to pursue special experiences as a resident, such as research, which would add to this time in training.

Three years:

  • Internal medicine.
  • Medical genetics and genomics.
  • Osteopathic neuromusculoskeletal medicine—up to five years depending on program.
  • Pediatrics.
  • Preventive medicine.

Three–four years (depending on program):

  • Emergency medicine.
  • Family medicine.
  • Neurology.
  • Pathology—anatomic and clinical.

Four years:

  • Anesthesiology.
  • Internal medicine-pediatrics.
  • Nuclear medicine.
  • Obstetrics and gynecology.
  • Ophthalmology.
  • Dermatology.
  • Psychiatry.

Five years:

  • Child neurology.
  • Diagnostic radiology.
  • Orthopaedic surgery.
  • Otolaryngology—head and neck surgery.
  • Radiation oncology.
  • General surgery.
  • Urology.
  • Vascular surgery.

Six years:

  • Plastic surgery—integrated.
  • Interventional radiology (up to seven years depending on program).
  • Thoracic surgery (up to seven years depending on program).

7 years:

  • Neurological surgery.  

To find program-specific information, be sure to consult FREIDA™, the AMA’s comprehensive residency and fellowship database, allows you to search for a residency or fellowship from more than 12,000 programs—all accredited by the Accreditation Council for Graduate Medical Education.

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A shorter residency training period in a specialty to “which you are not committed is worse than accepting lengthy training in an area that is your passion,” said the AMA’s Dr. Andrews. “Carefully considering what you are most interested in doing is the highest priority in picking a specialty. Then things like geography and the culture of the program and other factors weigh in. Length is one of many considerations, and in some respects, I’d rank it as a second-tier consideration.”

Dr. Andrews’ view seems to align with the way most medical students pick a specialty.

A 2019 survey of graduating medical students conducted by the Association of American Medical Colleges asked students how influential a list of 11 factors were in helping them choose their specialty. Length of residency ranked eight out of 11 options—29% of respondents said training length had a moderate influence on their decision while 13.5% said it had a strong influence. By contrast, nearly 99% of respondents said that fit a specialty’s fit with their personality, interests, and skills was either a moderate or strong influence.