Question on a medical education?

Question

I know of the types of subspecialties that require a residency in internal medicine, but what if you want to go into surgery? what are the requirements and when along the path do you choose from all the types of surgical specialties that there are? do you also have to do a residency in internal medicine?

Answer 1

You do a residency in General surgery and then go on into whatever sub-specialty.

Answer 2

This answer relates mostly to US programs.  During the last 2 years of medical school, you will do your rotations: surgery, internal medicine, pediatrics, psychiatry, etc.  

Usually during these rotations, a medical student decides what he likes or dislikes.  Some of these rotations will be pleasant, others less so.  During the last 6-9 months of medical school you will apply to internships and residency programs.  Your scores will determine how easily you will get into a program.  This is the time you will choose you specialty.  For surgery, there are surgical internships and residencies.  After 5 years of residency, you can choose your sub-specialty (orthopedics, cardiac surgeon, neurosurgery, plastic surgery, pediatric surgery, etc)  You do not have to do an internship or residency in internal medicine before you go into surgery (unless you want to)

Most surgery programs are extremely competitive and usually have a  pyramid program, meaning for example, they take 7 1st year surgery residents, 5 2nd year surgery residents, 3 3rd year surgery residents, so there is a mandatory attrition rate.  This doesn't happen for internal medicine, you should be aware of this before you choose.  

Answer 3

It depends on what type of surgery you're talking about.  Some are fellowships to be done after a general surgery residency, where others are separate training from the beginning.  The main areas that are done as fellowships after general surgery residency are cardiovascular/cardiothoracic, vascular, colorectal, plastics, pediatric general surgery, surgical oncology, transplant, hepatorenal, et cetera.  

Other areas, such as orthopedics, neurosurgery, otolaryngology (ear, nose and throat), ophthalmology, and urology are separate training programs that may require a surgical internship, but not a general surgery residency.  

There really aren't very many pyramid type programs anymore.  A lot of surgery programs have more interns (1st year residents) than second years because of the subspecialty residents (ortho, neurosurg, etc) that complete a surgical internship and then go on to their own specialties - it isn't because they purposefully cut people out from year to year.