How Specialized Is Your Physician?
What kind of Doctor are you seeing?
When the Health Educator on the LFA's helpline asks a caller, "What kind of doctor did you go to?" the caller's response is often, "a regular M.D." But who are these people really seeing for their health care needs? When you hear that a medical school graduate has been accepted to a residency program, do you wonder if that means a special place to live while they attend more classes? If you meet a doctor who says he is an internist, do you know what he really does? A recent national survey found that 1 out of 4 Americans thinks internists are "interns," students just out of medical school. These are just a few examples of the many gaps in our understanding of the various specialties in medicine and what is involved in becoming a specialist. A better understanding There are many different types of physicians practicing medicine today. Knowing the kind of doctor managing your care, and the training and credentials they have, can help you assess the depth of experience they can offer. The following sections provide a brief explanation of the terms used in medical education and outline the training required for the various specialties and sub-specialties involved in treating people with lupus. Medical SchoolPhysicians complete 4 years of medical school following college. Typically, the medical student spends two years in the classroom and two years working under supervision in clinics and hospitals. The degree they earn -- either an M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy, whose education also includes the therapeutic manipulation of the body) -- entitles the graduate to use the initials after his/her name and to be addressed as Doctor. Internship The first year after graduation from medical school is referred to as "the internship year." During this time, the graduate practices medicine under the supervision of licensed physicians. Prior to or after the completion of this year-long training, each new doctor must pass a licensing exam in order to become a licensed physician. Residency -- the road to becoming a specialist
Most medical school graduates choose to specialize in an area of medicine; this means additional years of training beyond the first year of internship. Below are the total numbers of years (including the internship year) required after graduation for those who wish to train in various fields.
| Primary Care |
Number of Years |
| Family Practice (for families) |
3 |
| Pediatrics (for children) |
3 |
| Internal Medicine (for adults) |
3 |
| Specialties |
Number of Years |
| Obstetrics/Gynecology |
4 |
| Neurology |
4 |
| Dermatology |
4 |
| Anesthesiology |
4 |
| General Surgery |
5 |
| Pathology |
5 |
| Urology |
5 |
During this specialty training, the residents practice medicine under the supervision of licensed physicians who are already Board certified in their specialty. Upon completion of the residency period, each resident may hang out his/her shingle as a specialist. Each graduate resident also is eligible to take the Specialty Board Certification exam. Passing this exam gives the physician the credentials as Board certified in their specialty, as a Family Practitioner, Pediatrician, Internal Medicine Specialist (Internist), Dermatologist, etc.
After residency, some doctors continue their training to specialize even further. For example, Internal Medicine graduates may choose to sub-specialize in any one of a number of areas. All require an additional two or three years of fellowship training. For example:
| Sub-specialties |
Number of Years |
| Rheumatology (diseases of muscles, tendons, joints, bones) |
2 |
| Pulmonology (diseases of the lungs) |
2 |
| Nephrology (diseases of the kidneys) |
2 |
| Gastroenterology (diseases of the stomach and intestines) |
3 |
| Hematology/Oncology (diseases of the blood and tumors) |
3 |
| Cardiology (diseases of the heart) |
3 |
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