What is a Fellow Doctor? Understanding Medical Fellowships

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What is a fellow doctor? Premed, resident, fellow, attending—there are a lot of different names for doctors and soon-to-be doctors, and it all depends on where they are in their medical training.

So, what does it mean if a doctor is a fellow, and what are the benefits of pursuing a fellowship? In this post, we’ll answer those questions and break down the different terminology used to describe medical students, trainees, and doctors.

 

What is a Fellow Doctor?

A fellow doctor is a physician who has pursued additional, optional training in a subspecialty of medicine, known as a fellowship. Fellow doctors have completed both medical school and residency and are fully credentialed physicians. Pursuing a fellowship for an additional 1-3 years after residency allows them to become experts in a particular subspecialty of medicine.

For example, a doctor may complete residency and go into practice as a fully credentialed physician in general internal medicine. However, instead of going into practice, they may elect to pursue a fellowship to train in a subspecialty of internal medicine, such as cardiovascular disease (heart and vascular system), hematology (blood), nephrology (kidneys), and many others. During this training, they are known as a fellow doctor, and once they complete their fellowship, they are known as a fellowship-trained doctor.

 

What is a Medical Fellowship?

What is the difference between a fellow and a fellowship? A fellow is a doctor who is currently in training for a subspecialty. The training is known as the fellowship, and it typically takes between 1-3 years, depending on the subspecialty. A fellowship only occurs after a doctor has completed medical school and residency, and it is completely optional. Doctors do not need to pursue a fellowship in order to practice medicine, but they are necessary for training in a subspecialty.

Fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME) to ensure they meet standards for US graduate medical education. In 2021-2022, the ACGME accredited 871 institutions for 182 specialties and subspecialties.

The physician training process begins when medical school graduates enter a residency program in a specific specialty, such as internal medicine, obstetrics and gynecology, surgery, or pediatrics. Completing residency in a specialty allows that physician to enter a fellowship for subspecialization training within that specialty.

For example, doctors who specialize in general surgery during their residency training may pursue a fellowship in subspecialties, including hand surgery, pediatric surgery, vascular surgery, colon and rectal surgery, or plastic and reconstructive surgery. During a fellowship program, a fellow subspecializing in hand surgery may participate in hundreds of hand surgeries throughout their training to earn their subspecialty.

Likewise, doctors of the specialty obstetrics and gynecology (OB/GYN) may subspecialize in reproductive endocrinology, maternal fetal medicine, gynecologic oncology, or female pelvic medicine and reconstructive surgery through a medical fellowship.

 

What Are the Benefits of Pursuing a Medical Fellowship?

Pursuing a medical fellowship is becoming more and more common each year. Doctors may choose to subspecialize through a fellowship for many reasons, but the choice to do so is ultimately a personal one.

There are extra costs involved in pursuing fellowship training. Fellows have a lower salary than doctors who go directly into private practice. They also spend more time pursuing training. After 4 years of medical school and 3-7 years of residency, fellows then spend an additional 1-3 years training in their subspecialty.

Despite the cost and extra training, there are many benefits to becoming a fellow doctor. The only way to pursue a career in many subspecialties is through fellowship training. Fellow doctors are able to achieve specific career goals by becoming an expert in their specific subspecialty of choice. Through intensive fellowship training, they develop skills that would otherwise take many years to develop in a private practice setting.

Fellowship-trained doctors are highly sought-after due to the general shortage of subspecializing doctors, which means they often have their choice of job opportunities upon completing their fellowship.

General physicians and surgeons must refer critical cases to fellowship-trained doctors of all subspecialties. However, fellow doctors in many subspecialties may be in short supply, and patients may experience long wait times to see a subspecialist who can help them.

 

Fellow vs. Resident Doctor: How Do They Differ?

What is the difference between a resident and fellow doctor? To begin with, all doctors must complete a residency before becoming certified and credentialed physicians, including those who go on to become fellow doctors. Not all resident doctors will become fellow doctors, as fellowship training is optional. It’s pursued by doctors who have already completed their residency and wish to pursue a specific subspecialty.

Here are the other ways resident doctors differ from fellow doctors.

1 | Amount of Training

Both residents and fellow doctors completed 4 years of medical school. Next, residency training lasts anywhere from 3-7 years, depending on the specialty. For example, residency in family medicine lasts 3 years, but residency in neurosurgery lasts 7 years.

Fellow doctors receive an additional 1-3 years of training after their residency training. The amount of training depends on the subspecialty and the program offering the fellowship. The American Medical Association offers a database of all accredited residency and fellowship programs.

2 | Credentials and Status

A resident has not yet completed the training required to become a board-certified and fully credentialed physician. Therefore, they are not a full doctor and are supervised by attending physicians throughout their residency. They may participate in the care of a patient, but their supervisor, the attending physician, is ultimately in charge of the patient’s care.

However, a fellow doctor has already completed their residency training and is a fully certified physician. They can consult in their subspecialty and can also act as attending physicians and supervise residents.

3 | Pay

The American Medical Association reports that the average resident earns about $60,000 per year. Fellow doctors earn a similar but possibly higher salary.

Fellowship-trained doctors can be highly sought-after, and it’s possible for them to make hundreds of thousands of dollars more than a physician who only completed residency and not a fellowship.

A fellow doctor’s salary also depends on their specialty or subspecialty, city, country, and institution of employment. Detailed salary information for all types of doctors, specialists, and subspecialists is reported on through the Medscape Physician Compensation Report.

Learn about the top Doctor Specialties with the Highest Hourly Rate.

 

The Complete Doctor Journey

Becoming a doctor, especially a fellowship-trained doctor practicing in a subspecialty, is quite the endeavor. They will pass through many different phases and have several different titles throughout their journey.

1 | Premed

All future doctors must begin with a bachelor’s degree. Premed is not a major; instead, it’s a term used to describe students who intend to apply to medical school after college. If you’re planning to apply to medical school after earning your bachelor’s degree, you must take several prerequisites in order to qualify, such as biology, physics, general and organic chemistry, biochemistry, English, and math.

2 | Medical Student

Medical school generally lasts 4 years. Students in medical school are either pursuing a degree as a doctor of medicine or a doctor of osteopathy. During the first 2 years, medical school is primarily based in the classroom. During the final 2 years, med students spend more time in the hospital and clinic, getting hands-on training.

3 | Resident

Physicians will complete rotations and training in their specialty for an additional 2-7 years during residency. Throughout this time, residents are supervised by a certified physician, known as an attending physician, who is ultimately in charge of patient care. Under their supervision, the resident performs medical exams and procedures as part of patient care. Ultimately, a resident program prepares a resident doctor for their certification so that they may become a practicing doctor.

4 | (Optional) Fellows

After completing residency, a physician can earn their certification and become a professional, practicing doctor. Alternatively, they may choose to pursue additional training in a subspecialty through a fellowship. The fellow is a fully credentialed physician who chooses to pursue additional training. The fellowship is optional but necessary for practicing in a subspecialty.

5 | Attendings

Attending physicians are fully credentialed doctors. The term ‘attending physician’ is typically used in supervision situations to distinguish the supervising doctors from those who are still completing their training and may not yet practice independently.

 

Find Success Wherever Your Doctor Journey Takes You

The Med School Insiders blog is filled with hundreds of articles that are continually updated with the most recent and accurate information for college, premed, and medical students.

If you’re a medical student trying to choose a specialty or subspecialty, check out our So You What to Be… series, which provides insight into what it’s like to pursue different specialties. We have dozens of articles/videos, and we’re always adding more. If you don’t see a specialty you’re interested in, leave a comment below to make a request.

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