How Long Is Residency? A Comprehensive Breakdown

Residency Lengths: Why it Matters

Transitioning to a residency after medical school is a pivotal moment, marking the start of specialized medical training. Choosing the right specialty is crucial, as changing fields later involves additional residency, possible pay cuts, and relocation. Residency demands significant commitment, with trainees often working 60-80 hours weekly, including up to 24-hour shifts. It's essential to choose a program where you can grow professionally without being overwhelmed by the demands.

This is where the length of residency programs comes into play. For instance, you may have a strong interest in neurosurgery, but the reality of nearly 7 years of surgical resident workload/scheduling is not to be underestimated. It’s in your best interest to consider the length of commitment involved in a program in relation to your strengths and limitations.

Of course, residency length is only on determining factor when it comes time to make your decision. One of our consultants shared:

“The learning experience and quality of training was my number one factor when choosing a residency program. The program’s emphasis on resident wellness and call structure. Ability to undertake a variety of electives in senior years as well as preparation/resident support.” Dr. Neel Mistry, MD, Diagnostic Radiology, University of Saskatchewan

How Long is Each Residency?

The first year after graduating from medical school—post-graduate year 1, or PGY1—is almost always dedicated to general clinical acclimation and residency in a broad field like Internal Medicine or General Surgery. Following this, programs begin to diverge and specialize. Here’s an overview of residency lengths:

Residency Lengths and Structure by Specialty

Not only the length but the structure of residencies can vary by specialty. Some residencies are intended for students just leaving medical school, while others require one or more post-graduate preparatory years, or transitional year residency, in a general field before launching into the specialty fully.

Anesthesiology 

Anesthesiology residency, blending disciplines like pharmacology and emergency medicine, spans 4 years in the U.S., starting with a broad-based preliminary year, followed by focused training and multiple subspecialty fellowships. In Canada, the 5-year program starts with a foundational clinical year, then dives into subspecialties, including critical care, with ample opportunities for fellowships. This structure equips anesthesiologists with a versatile skill set for diverse career paths. Need assistance with applying for your Anesthesiology residency? We can help:

“I had the privilege of working with a BeMo admissions expert on my personal statement for anesthesiology residency. They helped me revise my personal statement multiple times until it was perfect! They gave excellent feedback and a clear delivery of it for me to follow and revise accordingly. I am so grateful to this BeMo admissions expert!” – Erica Pieper, Former BeMo Student

Cardiac Surgery

Cardiac Surgery residency in the U.S. typically involves a 5-year basic surgical residency followed by 3 years of specialized training, with variations like 6-year integrated programs. Canada's residency spans 6 years, incorporating a broad clinical base in early years, focused surgical competency development, and later, specialized surgical training alongside academic enrichment opportunities.

Community Medicine/Public Health and Preventative Medicine

Community Medicine residencies span 3 years in the U.S., focusing on Public and Preventative Health, and start with a preliminary clinical year. In Canada, the duration extends to 5 years, initially concentrating on Family Medicine, then progressing to Community Medicine and field placements, reflecting RCPSC requirements for comprehensive training. This pathway prepares residents for diverse roles beyond traditional clinical settings, including in government and academia.

Dermatology

Dermatology residencies in both the U.S. and Canada begin with a foundation in Internal Medicine or Pediatrics, lasting 4-5 years. In the U.S., this includes 1-2 years of basic clinical work, followed by dermatology-specific training, with subspecialties potentially extending the timeline. Canadian programs have a 2-year clinical block, then 2 years in Dermatology, with some programs offering an additional year for enrichment in areas like research or teaching.

Diagnostic Radiology

Diagnostic Radiology residency, lasting 5 years in both the U.S. and Canada, begins with a clinical year in a field like internal medicine, followed by intensive training in Radiology and its numerous subspecialties, including Neuroradiology and Interventional Radiology. This comprehensive program develops advanced interpretive skills across various imaging techniques, supported by a strong emphasis on research in Canada.

“In your residency personal statement, it’s important to highlight specific personal experiences where you have demonstrated key skills required for your specialty. For instance, collaboration, communication, and independent problem solving are essential to the job of a radiologist. I made sure to give specific (and ideally different) examples to demonstrate how I have developed each of these skills throughout medical school. This helps the selection committee to know that you are aware of what you’re getting yourself into.

When it comes to residency interviews, practice makes perfect! And, you can use non-medical experiences to stand out as an applicant, too – for instance, I took part in cooking sessions and a karaoke competition.” – Dr. Neel Mistry, MD, University of Saskatchewan School of Medicine, Radiology

Practice with these hardest residency interview questions!

Emergency Medicine

Emergency Medicine residencies, lasting an average of 4 years in both Canada and the U.S., focus on high-pressure decision-making and adaptability, covering a broad range of specialties such as Anesthesia and Critical Care. The program includes elective and research opportunities, with an optional fifth year for subspecialties like Disaster Medicine or Medical Toxicology.

Emergency Medicine is easily one of the most intense specialities and is incredibly emotionally demanding.

Family Medicine

Welcome to the shortest residency! Family Medicine residencies, crucial for developing long-term patient relationships, typically last 3 years in the U.S., with an optional fourth for fellowships. In Canada, the program spans 2 years, focusing on broad clinical training and Family Medicine, with the possibility for subspecialty fellowships like Palliative Care in an additional year. This specialty emphasizes the importance of social and psychological aspects of patient care.

Rural Family Medicine 

Much of the same structure applies to Family Medicine residencies in rural settings, but with the added emphasis on non-urban communities. One of the central differences in Rural residencies lies in the decreased prevalence of sophisticated diagnostic technology and specialists, and so residents are required to exercise even greater discipline and clinical responsibility. Rural Family Medicine is an emergent specialty with growing interest, and those wishing to explore this option in the U.S. should consult the RTT Collaborative for detailed listings of schools offering Rural Health specialization. As with Family Medicine generally, RFM residencies are organized around 2 years of clinical development with optional 3rd years in subspecialty.

Need help with your Family Medicine Residency Application? We recommend speaking with an advisor, as the takeaways can be invaluable:

“Dr. Ian Robertson helped me focus on what I learned from non-clinical and clinical examples and the application of these takeaways as a future family med resident, which has helped elevate my answers to the next level. He is super!” – Anonymous, Former BeMo Student

General Surgery

General Surgery residencies, vital for a range of surgeries including gastrointestinal and trauma, last a minimum of 5 years in Canada and the U.S., with potential extension for subspecialties. The program starts with two core years covering surgical and non-surgical areas, followed by focused General Surgery rotations, culminating in a senior or Chief Resident year.

Internal Medicine

Internal Medicine residencies in the U.S. are 3 years, focusing on a broad range of diseases, with options for extensive subspecialty fellowships. Canadian residencies last at least 4 years, requiring a broader clinical base and allowing for up to 6 years if subspecializing. Both stress community involvement, teaching, and research, with rotations designed to ensure a wide exposure across various specialties. Internists, much like Family Medicine specialists, focus lately on diagnosis and treatment for a range of common and complex conditions. Many internists participate in teaching, advocacy and research.

Laboratory Medicine/Pathology

Laboratory Medicine is an umbrella term for various subspecialties within Pathology residency. These include Anatomical Pathology, General Pathology, Hematological Pathology, Medical Biochemistry, Medical Microbiology, and Neuropathology among many others.

Pathology residencies in the U.S. typically last 3 years, with most residents pursuing additional fellowship training in subspecialties like Surgical Pathology. Canadian Laboratory Medicine residencies span about 5 years, combining general medicine training with specialized laboratory work and optional electives. Variations exist between programs in both countries, reflecting the diverse nature of the field.

Medical Genetics

Geneticists are frequently part of multidisciplinary teams focusing on diagnosis of a broad range of genetic diseases affecting the full variety of bodily systems. It is therefore an especially academically demanding specialty; residency varies significantly between the U.S. and Canada, from 2 to 5 years. In Canada, it's a standalone program starting with core clinical development. In the U.S., it's a subspecialty after completing a primary residency, making the total training time comparable in both countries. Further subspecialization is common, extending residency duration.

Neurology

Neurology residency spans 4 years in the U.S., focusing initially on Internal Medicine then specializing in Neurology with options for subspecialty fellowships. Canadian programs extend to 5 years, adding a year for research or further specialization, maintaining a strong emphasis on diverse neurological disciplines and patient care complexities.

Neurosurgery

Neurosurgical residencies rank among the longest and most demanding in all of medicine—and for very good reason. The complexity and sensitivity of Neurosurgery demands incredible focus, breadth of knowledge, and technical mastery from practitioners. As such, Neurosurgeons are among the highest paid doctors.

Neurosurgery residencies in the U.S. generally last 6-7 years, incorporating general surgery and specialized rotations, with program-specific structures, like at Johns Hopkins. Canadian programs also begin with core surgical training, followed by 4 years of specialized Neurosurgery and a year of senior residency, including time for research.

Obstetrics and Gynecology

OB/GYN residency in the U.S. is a 4-year program, starting with a mix of general and specialized practice in the first year. In Canada, the residency extends to 5 years, including a general clinical year followed by four years focusing on OB/GYN, with the final year as Chief Resident, preparing for practice. Both countries offer further fellowship training in subspecialties like Gynecologic Oncology and Maternal-Fetal Medicine.

Ophthalmology

Ophthalmology residency in the U.S. spans 4 years with a focus on a wide range of specialties, lacking elective practice in later years. Fellowships cover subspecialties like Glaucoma and Pediatric Ophthalmology. Canadian residencies last 5 years, offering a broad clinical foundation and more opportunities for elective study in advanced years, though program structures vary.

Orthopedic Surgery

Orthopedic Surgery residencies in both the U.S. and Canada are 5 years long, emphasizing diagnosing, treating, and preventing musculoskeletal diseases. The U.S. programs start with rotations in Internal Medicine and General Surgery, followed by extensive Orthopedic training and options for subspecialty fellowships. Canadian residencies also begin with broad-based surgical rotations, then focus solely on Orthopedic Surgery, developing specialized skills.

Otolaryngology

Otolaryngology residencies in the U.S. and Canada last 5 years, focusing on developing surgical and medical skills for treating ear, nose, and throat conditions. Early years concentrate on general skills, while later years emphasize subspecialization and surgical techniques. Both countries offer fellowships for further specialization, including facial reconstructive and trauma surgery.

Pediatrics

Pediatrics residencies, among the shortest, average 4 years in both the U.S. and Canada. U.S. programs typically span 3 years, focusing on core pediatric medicine, followed by optional 2-3 year fellowships in subspecialties. Canadian programs cover core knowledge in fields like Neonatology and Child Psychiatry over 3 years, with a flexible PGY4 for subspecialization, research, or additional general training.

When applying to pediatrics—or any specialty—it can be helpful to connect with an advisor who has been in your shoes:

“I especially appreciated how she [advisor] utilized her background and extensive knowledge as a practicing professional in pediatrics to help me formulate even stronger answers to the questions. This was something unique from my other sessions! She also provided me with useful perspective on interviews and stress management tools.” – Anonymous, Former BeMo Student

Physical Medicine and Rehabilitation

Physical Medicine and Rehabilitation (PM&R) residencies in the U.S. typically last 3 years, focusing on diagnosis and treatment to restore function, with less emphasis on research. Canadian PM&R programs are longer, at 5 years, starting with a year of broad medical or surgical training before moving into 4 years of specialty-specific education.

Plastic Surgery

Plastic Surgery residencies in the U.S. offer 6-year integrated programs or 3-year independent programs for those with prior surgery experience. In Canada, the 5-year residency includes 2 years of core surgery and 3 years in specialized areas, encompassing plastics and related fields.

Psychiatry

Psychiatry residency programs in the U.S. and Canada focus on a broad set of skills for diagnosing and treating mental illnesses. U.S. programs are typically 4 years with a less structured emphasis on research, while Canadian programs are 5 years, offering more flexibility in later years for subspecialization and research. Psychiatry is seen as more accessible in the U.S. due to its competitive nature and requirements for entry. Both countries offer fellowships in areas like Addiction and Child Psychiatry.

“Psychiatry specifically focuses on a holistic view of applicants and creating cohesive residency classes. I showed preparedness and interest in psychiatry by engaging in research and taking advantage of unique psychiatry rotations offered at my medical school. These both gave me plenty of stories to talk about how I validated the field and showcase how I see my career progressing in psychiatry.” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry 

Urology

Urology residencies in both the U.S. and Canada last around 5 years, integrating significant surgical training with a broad knowledge base from related fields such as Internal Medicine and Gynecology. U.S. programs start with a general surgery block, leading into urology-specific training. Canadian programs follow a similar structure, focusing on core surgical training before specialized urology rotations. Both countries offer competitive programs with options for subspecialization, though the U.S. has fewer fellowship opportunities compared to Canada.

A recap of residency lengths:

FAQs

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