Residency vs. Fellowship

To fully understand the medical profession and the pathway to become a medical specialist, it is essential to grasp the difference between residency and fellowship. These two stages of postgraduate medical education shape a physician’s skill set and ultimately define their area of expertise.

A physician’s training path starts in medical school but extends into postgraduate training, consisting of residency and fellowship. Both programs are required for physicians to specialize, but they serve different purposes in the overall trajectory of a medical career.

Medical Fellowship example

Residency Overview

After graduating from medical school, new doctors embark on a journey known as residency. A residency is a stage of graduate medical training where doctors work under the supervision of fully licensed physicians. Residency training is typically three to seven years, depending on the specialty, and provides hands-on experience.

Residents gain practical skills and knowledge, caring for patients in a real-world medical setting. They gradually assume responsibility for patient care under the close supervision of experienced physicians. Throughout their residency, doctors will learn to make crucial decisions, refine their clinical skills, and navigate the complexity of modern healthcare.

Residents rotate through different sub-specialties related to their chosen field, allowing them to gain a broad understanding of the different areas of their specialty. For example, an internal medicine resident will rotate through cardiology, pulmonology, endocrinology, and several other sub-specialties.

Moreover, residents typically participate in educational activities like case conferences, grand rounds, and journal clubs. They also learn to work in interdisciplinary teams and understand the logistics of hospital operations. Completing a residency program leads to board eligibility in the respective specialty.

Fellowship Overview

On the other hand, a fellowship is a type of graduate medical training that doctors can pursue after completing a residency. Fellowships allow physicians to focus on a particular subspecialty within their field. Depending on the specific program, fellowship training usually ranges from one to three years.

Fellows dive deeper into their chosen subspecialty, whether pediatric gastroenterology, interventional cardiology, forensic psychiatry, or any other available options. This additional training allows fellows to cultivate more excellent knowledge and skills within a specific area.

Doctors have more independence during a fellowship than in their residency years, but they still work under supervision. This is a critical period for honing advanced skills and engaging in research, teaching, and leadership roles within their subspecialty.

The Difference Between Residency and Fellowship

The critical difference between a residency and a fellowship lies in their purpose and level of specialization. A residency aims to provide comprehensive training in a broad specialty, such as family medicine, psychiatry, surgery, and pediatrics. In contrast, a fellowship provides super-specialized training in a narrow area of interest within a specialty.

In simple words:

Residency vs. fellowship

  • Residency is additional training after graduation (internship).
  • Fellowship is training after residency.
  • The fellowship represents training in the subspecialty area of clinical practice.
  • Fellowship is optional in training; it is not required to practice medicine, while residency is mandatory.

Residency is the period that begins after a student is done with medical school and needs to gain experience in treating patients in person. Fellowship is what begins after residency, and people need expertise in a specific field of medicine. Though certain fields are paid higher than residency, at times, it’s even lesser than physicians who are working.

While the residency focuses on breadth, a fellowship focuses on depth. During their residency, physicians learn to manage various conditions related to their specialty. In addition, they acquire advanced knowledge and skills related to a specific subspecialty during their fellowship.

Usually, residency represents additional training in an individual’s chosen field of specialization after graduation and internship. In contrast, fellowship is further training on his specialization after residency.

The decision to pursue a fellowship often depends on the individual’s career goals. For instance, a physician may decide to specialize further if they are interested in an area of research or want to focus on a particular type of patient care. However, not all physicians choose to pursue a fellowship. Some decide to practice as a generalist in their specialty after completing their residency.

In our articles, you can learn about Fellowship Doctor Salary and see Pediatric Surgery Fellowships List. I gave answer on Do You Get Paid During Medical School and overall Do You Get Paid During the Fellowship. Please read How Long Is Pediatric Surgery Fellowship and understand the differences between Residency vs. Fellowship.


Residency and fellowship are two crucial steps in the journey to becoming a specialized physician. The time, dedication, and energy doctors invest into these programs make them experts in their chosen fields, capable of providing their patients with the highest level of care.

Understanding the differences between residency and fellowship helps underscore the substantial training that physicians undergo after medical school. From the broad experience of residency to the focused expertise gained in fellowship, these stages of training equip doctors with the comprehensive knowledge and skills they need to provide quality care in the ever-evolving world of medicine.


Daniel Smith

Daniel Smith

Daniel Smith is an experienced economist and financial analyst from Utah. He has been in finance for nearly two decades, having worked as a senior analyst for Wells Fargo Bank for 19 years. After leaving Wells Fargo Bank in 2014, Daniel began a career as a finance consultant, advising companies and individuals on economic policy, labor relations, and financial management. At, Daniel writes about personal finance topics, value estimation, budgeting strategies, retirement planning, and portfolio diversification. Read more on Daniel Smith's biography page. Contact Daniel:

Recent Posts