How Long Is Residency?

The AMA groups specialties by their usual training length:

Physical medicine and rehabilitation isn't on the AMA's list. Washington University's residency length chart puts it at 3 to 4 years.

The AMA published its list in 2020 and adds that programs "may approach training differently, so there are likely to be exceptions." Treat each row as the usual length, then check the programs you're interested in.

If you add 4 years of college and 4 of medical school, those rows become 11 to 15 years after high school. How long it takes to become a doctor runs that math by specialty and estimates how old you'll be at the finish.

In most specialties, your first year out of medical school is the first year of your residency. These are categorical programs: you match once and stay for the full length.

A handful of specialties work differently. You match into the specialty program and a separate one-year program, called a preliminary or transitional year, and you start the specialty itself as a second-year resident (PGY-2). WashU's chart lists six specialties built this way:

• Anesthesiology: 3 years plus a PGY-1 year.
• Dermatology: 3 years plus a PGY-1 year.
• Neurology: 3 years plus a PGY-1 year.
• Ophthalmology: 3 years plus a PGY-1 year.
• Diagnostic radiology: 4 years plus a PGY-1 year.
• Radiation oncology: 4 years plus a PGY-1 year.

The separate year doesn't make the total longer. Dermatology still comes to 4 years either way, and diagnostic radiology to 5. It changes how you apply: you rank two kinds of programs, sometimes in two different cities, and you may move after your intern year.

In practice, the split varies a lot by specialty, and the NRMP's 2026 Advance Data Tables show by how much. Anesthesiology and neurology now offer most of their positions as categorical PGY-1 spots, while dermatology and diagnostic radiology still start most residents at PGY-2.

Here's how four of those specialties split in the 2026 Match.

Ophthalmology isn't listed in those tables. For how one of these paths adds up stage by stage, the dermatology timeline shows a PGY-2 start, and the anesthesiology timeline shows a specialty that now offers both.

The one-year programs are a sizable part of the Match on their own. In 2026, programs offered 1,937 transitional year positions, 1,565 medicine-preliminary positions and 1,207 surgery-preliminary positions, for 4,709 in all. Surgery-preliminary filled 664 of its 1,207, or 55.0 percent, the lowest fill rate of the three.

Programs count residency in postgraduate years. PGY-1 is the first year after medical school, often called the intern year, and the count keeps going through fellowship. A first-year cardiology fellow who finished a 3-year internal medicine residency is a PGY-4.

What a resident doctor is covers the titles from intern to attending. For length, the PGY count is the number to watch: when someone says a residency is "5 years," they mean you finish as a PGY-5.

Research years

Some programs build research time into residency, most visibly in general surgery. The American Board of Surgery requires "a minimum of five years (60 months) of progressive residency education," with at least 48 weeks of full-time clinical activity in each residency year. Research time comes on top of those five years.

At Johns Hopkins, according to a 2020 paper by Giuliano and colleagues in Medical Science Educator, "the standard general surgery training pathway includes five years of clinical training interrupted with two years of dedicated academic development/research time." That's 7 years from intern to graduation. The authors report that 84% of Hopkins general surgery residents take that time, against an estimated 36% of general surgery trainees nationally.

The AMA makes the same point for every specialty: research and other "special experiences" during residency "would add to this time in training."

Combined programs

A combined residency trains you in two specialties at once, and it's shorter than doing them back to back. The AMA lists internal medicine-pediatrics at 4 years. Separate residencies in the two would take 6 (3 plus 3). In the 2026 Match, 404 med-peds positions were offered and all 404 filled.

Leave

Taking leave doesn't have to push back your finish date. Under an ABMS policy in effect since July 1, 2021, the specialty boards must allow at least 6 weeks of parental, caregiver or medical leave, once during training, "without exhausting all other allowed time away from training and without extending training." The rule covers residencies of 2 or more years. Leave beyond what your board allows can still extend your training, so check your specialty board's rules.

Fellowship

A fellowship comes after residency and adds 1 to 3 years in a narrower field, according to WashU's chart. In some fields it's optional, and in others, like cardiology, it's the only route in. The fellowship explainer covers which specialties add one and for how long.

• What's the shortest residency? 3 years, in internal medicine, pediatrics, medical genetics and genomics, and preventive medicine. Family medicine and emergency medicine run 3 or 4 years depending on the program.
• What's the longest? Neurological surgery, at 7 years. Interventional radiology and thoracic surgery can also reach 7 at some programs.
• How long is surgical residency? 5 years for general surgery, or 7 at programs that add 2 research years.
• Is the intern year part of residency? In categorical programs, yes. In specialties that start at PGY-2, the intern year is a separate preliminary or transitional program, but it still counts toward the total.
• Do residents get paid? Yes. Residents are doctors with an MD or DO, and they earn a salary from PGY-1 on.

Every one of these timelines starts with getting into medical school, and that starts with the MCAT^®. The PurpleCAT concept library breaks the exam's science into short topics you can study one at a time.

Last verified November 4, 2026, against the NRMP's 2026 Advance Data Tables, the American Board of Surgery's training requirements, the ABMS leave policy and the AMA's residency length list. Residency lengths vary by program; check individual programs for their exact terms.