Is Your Doctor for Real?

When you go to the doctor, sometimes you’ll see diplomas, certificates, and etc. on the walls of the examination rooms. Sometimes, however, these may not be posted in the rooms. So how do you know your doctor is a board certified physician that has been trained in a specialty? In most areas of concentration (Family Medicine, Psychiatry, Internal Medicine, etc.) medical school graduates have to go through a residency program in order to obtain the necessary certification to be board certified. The residency usually encompasses either two or three years. During these years, while being taught/mentored by board certified physicians, residents are exposed to all kinds of patient health concerns, diagnoses, situations, and problems. The training usually occurs in a hospital setting and can encompass a clinic setting as well. Presentation of lectures, participating in on-call responsibilities, attending lectures from other physicians are just part of a resident’s training. There are criteria for each resident to complete during their years of residency and required numbers of hours in different arenas of healthcare. For example, Family Medicine residents have to complete required hours of patient care in OB, GYN, Behavioral Medicine, Emergency Medicine, ENT, Pediatrics, Geriatrics, etc.

In order for a resident to be certified and licensed, the program has to be approved by the Accreditation Council for Graduate Medical Education (AGME). The council, which is a non-profit entity, evaluates and accredits residency programs in the United States. Advancing the resident physicians’ education through accredited programs is the mission of the AGME.

So, how does a resident get accepted into an AGME-approved program? It is a timeline process. Each year, beginning in July, graduating medical residents begin working on their applications through a system called ERAS (Electronic Residency Application Service.) Applications contain test scores, letters of reference, an application form, personal statement, education information, etc. The first of September, medical students can begin to send their application to the various programs they have selected and the ACGME programs can begin to download applications, as well. This is done through the NRMP (National Resident Matching Program.)

Residency programs usually begin a process of interviewing candidates during November-January. Allowing program directors and applicants to consider all of their options is vital to the success of the match. In mid-January, programs can begin ranking in order their preference of applicants. At the same time, residents are deciding their preferences and putting them in rank order as well. The choices are confidential until the actual match day occurs. In mid-February, programs and applicants certify their preferences and the match application process is closed. In March on a specific date and after 2PM (EST) the matches are announced and each program finds out who their residents will be and the applicants find out where they will be starting their residency. It is a win-win situation, as both the program and applicant want to work together.

Once matches are announced, then medical graduates prepare to move, the programs begin the process of scheduling various aspects of orientation as well as activities for welcoming the new residents into the program. While it is an exciting time in the life of a medical student, it can also be somewhat stressful. Application fees are expensive, and depending upon where an applicant interviews-travel can be expensive. Some programs provide lodging and meals, while other programs do not. Most programs do all they can to attract the best and brightest of the applicants.

Some programs have a grueling interview process that lasts two days, while other programs have a full day of interviews and various ways to get to know an applicant. One program in North Carolina incorporates into the interview process a technique called "Family Circles" which is a non-threatening way for applicants to tell who they are and for the faculty to make assessments of the candidates. The behavioral medicine faculty from this particular program facilitates this unique approach. "Family Circles" are included in addition to the regular one-on-one interview with faculty and residents.

This past year, there were over 37,000 medical graduates who made application to over 4,000 medical education programs and 25,000 slots for first and second year positions. As you can see, being accepted into a residency is very competitive.

When a resident finishes their two-three year program, they can begin the process of being board certified in their respective area. If you do not see certificates of an undergraduate degree, medical school degree, completion of a residency, or board certification, you should ask. Knowing that your physician has been through a lengthy training process is crucial to putting your life and health in the hands of someone that has been properly educated, trained, and mentored.

By Deborah Lambeth