Learn more on how to systematically research your doctor in this series of articles.

In Part 1, we looked at the prerequisites for medical school, the MCAT, the application, as well as some statistics.

In Part 2, we glanced at what medical school entails-from various basic sciences courses to clinical rotations. We looked at the Boards, costs, and the actual medical degree.

In this article, Part 3, we will delve a little deeper into what Internships are all about.

PART III - Internship

As we discussed last week, a medical degree is simply a degree granted by the school that the student has completed training. Finishing medical school alone is not enough for the new doctor to actually practice medicine. In order to see patients, a doctor needs to have a license granted by the state.

Medical License

In the United States, the “license” to practice medicine is regulated by each individual state. It is not controlled by the federal government or the medical school itself.

In order to obtain a medical license, almost all states require a year of residency training. The first year of residency training is also known as internship. Another requirement is passing the third and final part of the United States Medical Licensing Examination (USMLE - or “The Boards”). As we remember from Part 2, the first two parts of the exam are administered during medical school itself.

So how does getting into residency work?

The Match

Residency programs are specific to medical specialties. For example, there is a general surgery residency, pediatric residency, and so forth. During the last year of medical school, the student must decide which specialty of medicine he or she is interested in. Then the student will need to apply to various residency programs, visit the hospital, and interview there.

Unlike other job interviews where you can apply to many places, wait to see who hires you, and then pick from your options, the residency selection program goes through a “Match”.

The Match is run by the National Resident Matching Program (NRMP). The NRMP is a non-profit corporation that uses complex computer algorithms to “match” students to residency programs - or you can think of it the opposite as well - to “match” residency programs to students.

Here’s how it works:

After interviews, the medical student ranks the various residency programs in order of preference. This list is submitted to the NRMP. At the same time, the residency program (the faculty and other staff) ranks the students based on who they want most. This list also gets sent to the NRMP.

The computer system at NRMP then tries to match both the student and the residency program based on their highest possible preference in a way that’s fair to both.

Every student that participates in the match finds out which residency they got into on the same day, “Match Day.” Both student and residency program are committed to accept each other, meaning the student can’t change his or her mind. Likewise, the residency program can’t change it’s mind either.

The Scramble

Students who failed to match (when the student ranked A, B, and C programs, but none of them picked her) or residency programs who failed to fill (not enough students ranked the program), they both undergo a stressful process of the “Scramble”. The Scramble begins two days before the Match day. In the Scramble, students frantically call for positions while programs try to fill their spots. Those who don’t have to scramble only know that they have successfully Matched, but not to which program until Match Day.

Statistics

According to the NRMP, in 2009 there were 29,890 applicants for one of 25,185 residency positions. There were 1,146 positions that were unfilled.

Some programs such as Plastic Surgery are particularly competitive. In 2009, there were only 49 programs, offering a total of only 101 positions in the nation. Over 50% of those who applied for a plastic surgery residency did not match into a program.

Residency

As stated earlier, Internship is simply the first year of residency. After completing Internship and passing the USMLE part 3, the doctor can obtain a medical license. A medical license allows the doctor to see patients, treat illnesses, prescribe medication (narcotics and other restricted drugs will require an additional Federal license from the Drug Enforcement Administration), and even perform any and all types of surgery.

We’ll go over this more in the next article as well as the role of Residency beyond Internship.

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