Specialty training and residency positions are a next step

After the rigorous journey of medical school, a graduate embarks on a new phase of their career: additional training in a residency position. This is not a simple task, as many students compete for a residency slot through the National Residency Matching Program (NRMP), which provides results in mid-March for residency training slots starting in July every year. A resident is a physician in training beyond medical school. These physicians-in-training work tirelessly to learn their field over three to seven years, depending on the chosen specialty. These specialties include anesthesiology, surgery, internal medicine, pediatrics, obstetrics/gynecology, family medicine and other specialties. The first year of training is known as the intern year. After a residency, physicians may choose to complete a fellowship. Individuals who complete subspecialty training are known as fellows. Fellowships include disciplines such as cardiology, pediatric surgery, gastroenterology, cytopathology, forensic psychiatry and others. All physician trainees in residency or fellowship are known as house officers (a traditional term for physicians who live in the hospital). Following residency and/or fellowship training, a physician may achieve board certification in their specialty. Board certification is obtained through written and/or oral examinations and operative reviews in some specialties and is renewed every seven to 10 years.

Residencies and fellowships for physicians are governed by the Accreditation Council for Graduate Medical Education (ACGME), which creates standards and guidelines regarding the appropriate training parameters for each specialty.

All residents are supervised by an attending physician who has previously completed residency and fellowship training. Patient care activities occur with the input of the attending physician, who provides insight and teaching points to advance the knowledge of the resident/fellow physician.

Residencies were created in the late 19th century/early 20th century as a means for advanced training in a medical or surgical specialty. The first residency programs were established at Johns Hopkins University by Sir William Osler and William Halsted to formalize the training process. The residency and fellowship years allow the new physician to refine and enhance their medical knowledge and procedural skills. After completing a residency and/or fellowship, a physician is trained to practice in their chosen specialty.

Most residency programs are located at teaching hospitals in the traditional sense, but residents and fellows now often complete training at other hospitals in the current educational environment. Quality care is provided to patients in these clinical learning environments where the medical teams work together to achieve optimal outcomes. These medical teams comprise residents and/or fellows, attending physicians, medical students and others who strive to provide patient-focused care that improves the patient’s health. On average, a patient in the hospital will see seven physicians on their care teams who review the chart. These additional clinicians can care for patients and provide extra safety mechanisms to prevent errors through quality improvement activities.

Formal training in graduate medical education began in the late 1940s in Shreveport prior to the creation of LSU Health Shreveport in the precursor hospital to Ochsner LSU Health Shreveport. Over the last seven decades, more than 5,000 residents and fellows have completed training in our region. Over 600 residents and fellows are currently receiving training at LSU Health Shreveport in Shreveport, Monroe and Alexandria in 45 different ACGME-accredited specialties and two Commission on Dental Accreditation (CODA) programs. These trainees are supervised by physicians and dentists who are board-certified in their specialty. Earlier this month, LSU Health Shreveport welcomed 175 new residents and fellows to the campus and Shreveport-Bossier region. LSU Health Shreveport is proud of its tradition of training more than 70% of the physicians in the area in residency or fellowship training. LSU Health Shreveport commits to continuing to provide high-quality graduate medical education training in an academic environment that places the patient at the center of care with compassion.

James D. Morris, MD, FACG, FACP, AGAF, FASGE, is the assistant dean for graduate medical education and VA affairs at LSU Health Shreveport.