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Internships, Residencies and Fellowships

Internship
The old term used to describe the first year of postgraduate training following graduation from medical school. Physicians participating in this training were formerly called interns but are now known as Postgraduate Year 1 (PGY-1) residents and the year is called the PGY-1 year. It is usually taken under the sponsorship of a single clinical department. See Transitional Year PGY-1.

Residency
A variable period of postgraduate education and training (3- 7 years), based upon the specialty selected, in which a physician participates with the expectation of becoming a specialist in a field of medical practice. These educational experiences occur in a variety of settings including hospitals, clinics, offices and other relevant medical educational centers.

Transitional Year Residency
A training program for physicians equivalent to the PGY-1 residency training year, but organized and sponsored by several institutions or clinical departments to provide training in multiple specialties of medicine rather than in a single specialty.

Fellowship Training
A period of training, usually 1-2 years, which occurs after completion of a general or primary residency. Its goal is to qualify a physician as a subspecialist in an area of medical practice such as cardiology, hand surgery, etc.

Residency Matching
The process by which most medical students obtain an appointment for their postgraduate training. The matching process is performed by independent agencies such as the National Resident Matching Program (NRMP). The NRMP receives rank order preferences from students and training institutions and "matches" them by computer according to the highest ranked match. Residency information is available from medical schools, training programs, The AMA Directory of Graduate Medical Education Programs, hard copy and online, and the Fellowship and Residency Electronic Interactive Data Access (FREIDA) service of the AMA.

Licensure (Medical)
Legal permission granted by a state or territorial government to a physician to take personal, unsupervised responsibility for the diagnosis and treatment of patients in the practice of medicine. Most states and territories require that physicians complete at least 1 year, and several require 3 years, of graduate medical education to qualify for licensure. In addition, applicants for licensure must pass an examination. Qualifications for medical licensure in each jurisdiction are determined by that jurisdiction. Federal, state and territorial governments do not license physicians as specialists nor certify physicians as specialists.

Certification
The process of voluntary testing and evaluation of physicians who wish to become board certified in a particular medical specialty. A physician may elect to begin the certification process only after completion of an approved residency training program.

Certification by a specialty board enables the public to identify those practitioners who have met a standard of training and experience set beyond the level required for licensure. Certifying boards, unlike state licensing boards, are national in scope and independent.

Specialty Boards
There are 24 approved medical specialty boards that grant certification. These boards form the umbrella organization, the American Board of Medical Specialties (ABMS).
The specialty boards influence graduate medical education since they set the criteria required of physicians seeking admission to the certification examinations. Each board sets the minimum length of time for education in an accredited residency and the content of the certifying exam.