Currently, somewhat more than half the hospitals
have maternity leave policies but
the types of programs vary considerably.
One-third of the hospitals treat maternity leave
as sick leave, another third have specific
guidelines, and the others consider it as short-
term disability leave, without pay or
vacation.
RESIDENCY TRAINING
After the first postgraduate year comes
specialization. The function of this extended
period of training has changed greatly since its
start a century ago. At that time a resi-
dency was a special period of additional
clinical education for a few promising and
scholarly young physicians who wished to become
the teachers or leaders in medicine.
Residency training since the period after World
War II has become standard for the aver-
age physician and more than 1,500 American
hospitals offer such programs. Completing
an approved residency and passing a written
and/or oral examination given by a spe-
cialty board are the basic requirements for
certification as a specialist.
In the early 1900s, nearly half of all medical
school graduates entered general practice.
By the 1960s this figure had shrunk to about
20%. A recent study concerning medical spe-
cialization showed that there has been a
significant increase in interest in primary
care/family practice over the past several
decades (see page 393). Economic factors are
comparatively minor in determining medical
specialization, while up to 87% of the sam-
pling indicated intellectual interests to be a
major determining factor. Most recruits are
entering internal medicine, surgery,
psychiatry, obstetrics/gynecology, and pediatrics.
Women physicians have generally favored
fixed-schedule specialties (anesthesiology, radi-
ology, psychiatry, pediatrics, public health)
and work settings (state hospitals and industry).
The length of residency training varies among
the different specialties and is indi-
cated in Table 12.1; their characteristics are
outlined starting on page 430.
It is possible to apply for a residency in a
manner comparable to AMCAS. This is
by means of the AAMC-sponsored Electronic
Residency Application Service (ERAS).
Offices of Deans of Students at medical schools
(both allopathic and osteopathic) can
provide the necessary material needed to apply.
Canadians can also use ERAS.
It should be noted that many of the specialties
listed have subspecialties that
may require two to three years additional
fellowship training beyond that listed in
Table 12.1.
Securing a Residency
Appointments to residency positions are
competitive and usually made through the
Resident Matching Program (page 428). Your
ranking by the Resident Program Director
largely depends on three
considerations:
1. medical school performance;
2. summary of recommendations from clinical
clerkship supervisors; and,
3. residency interview
performance.
The success of the interview can impact
decisively on your future career. For this
reason, we offer advice on preparing for your
residency interview in this section.
Obtaining a residency appointment is not a
hit-or-miss affair. Careful planning can
avoid many pitfalls and improves your chances
for success. Medical students frequently
underestimate the importance of residency
selection. The training program determines the
specialty tract, and within the program, the
curriculum and its monitoring staff can pro-
foundly influence your career path. In
addition, each program has its own philosophy and
work environment. In selecting a program, a
determination is made as to the amount of
time that you will have to devote to meet the
program's requirements over a period of sev-
eral years. The residency interview provides a
possible means of enhancing your chances
for securing a house staff appointment as well
as finding out if it is the right one for you.
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