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MD Program

Graduate Medical Education

Culmination of your medical training

Once you complete your four years of medical education, you continue your training as a resident physician. In that role, you practice medicine under the supervision of an attending physician.


As you proceed through training as a resident and fellow, you assume more independence and more supervisory responsibility in the training of junior residents and medical students.

Years of training

  • Residency lasts 3 to 7 years, depending on the field of medicine you choose.
  • Fellowship training—specialized training beyond the residency years—adds another 2 to 3 years to the process. It is similar to residency training, but with an added emphasis on conducting research.

For most states (including Washington), the minimum required residency training is 2 years. A few states require completion of just one year of residency training.

Terms used to describe residency

  • Internship refers to the first year of residency training. Interns are first-year residents.
  • R-1 (Resident-1) or PGY-1 (postgraduate year one) is a resident in the first year of training. Similar terms (such as R-2) identify residents in later years of training.


United States Medical License Examination (USMLE)

At the end of the first year of residency training, you take the third and final part of the USMLE. Upon passage of all 3 parts of the test and completion of adequate time in residency training, you can receive a license to practice medicine.

National certifying examination

At the end of your residency or fellowship, you also take a national certifying examination administered by specialty boards. This enables you to become a certified physician in a particular field or subspecialty.

Recertifying examinations

Most branches of medicine require certified physicians to undergo recertifying examinations every 10 years. 

Continuing medical education

As a physician, you are committed to being a lifelong learner. To maintain your license to practice medicine, you must demonstrate that you are maintaining current knowledge in your field. You must also fulfill continuing education requirements.

Once you complete your residency and/or fellowship, you must complete a certain amount of continuing medical education (CME) to maintain your license.