HealthJune 26, 2020

Is residency required after medical school?

By: Heidi Moawad, MD

Is residency required after medical school? Nonclinical jobs for physicians without residency experience are available but require a career strategy.

Are you considering pursuing nonclinical jobs for physicians without residency experience after medical school? As healthcare increases in complexity, there's a growing need for physicians to work in jobs that don't involve patient care. And you might have a gut feeling that a career in electronic medical record (EMR) development or medical education is a better fit for you than a career diagnosing and treating patients. You can - and should - follow the path that makes the most sense for you.

But is residency required after medical school when it comes to landing these jobs? Companies aren't typically recruiting medical students. For most well-paying jobs that entail leadership or responsibility, you'll have to complete a residency and even practice medicine in your specialty to add value as a nonclinical doctor. You can also work your way up from the bottom rungs, potentially earning a lower income as you gain the skills and experience necessary to work in a position that rivals that of a practicing physician. If you already know that you want to pursue a nontraditional job, you can achieve success without going to residency - as long as you strategize early.

The value of hands-on experience during residency

It's true that you earn your MD or DO at your medical school graduation, but many doctors feel that it's residency that truly makes you a physician. Experience on the front lines of patient care is something that you simply can't substitute with any amount of memorization, books, tests, observation or continuing medical education (CME).

If you've never written STAT orders for a patient, never had to make rushed life-or-death decisions for patients and never advocated for your own patients' diagnostic tests or treatments, you may not be able to grasp the impact of behind-the-scenes decisions on real-life patients. Without an intimate understanding of the twists and turns inherent in patient care, it's hard to fully appreciate the scenarios you're asked to solve as a nonclinical doctor.

If you skip residency but still find your way into an entry-level nonclinical role, you can work hard and get a promotion. But you might not be taken seriously by the practicing physicians you'll ultimately have to gain approval from if it seems that you only have a superficial understanding of medical nuance. Clinically experienced physicians complain when medical products and services are problematic, which ultimately affects the professional standing of a nonclinical physician and the whole company that relies on that physician's work.

So even if you're thinking about working in a relatively hands-off medical area like regulation or communications, it could be beneficial to do a residency so you can competently speak about healthcare matters.

What about a medical license?

A state medical license is the most valuable physician credential, and you can't earn it without at least one year of residency. As Academic Medicine notes, a doctor without a medical license can't examine a patient even with supervision, which is less than they could do as a medical student.

And for medical license renewal, most states also require that you maintain CME, don't have your hospital privileges terminated and keep a clean legal record. Because medical licensing requirements are relatively stringent, some companies that hire physicians in nonclinical roles consider licensing to be a sign of physician quality.

Completing at least some residency also helps companies prove to their selective clients that they have a reputable physician working on the project, even if your work is primarily behind the scenes.

Is residency required after medical school?

As you can see, the answer to this question isn't exactly straightforward. Here's a look at two ways you can move forward.

Completing residency

To qualify for a medical license without finishing residency, you can complete one transitional residency year. Or if you decide to go ahead with residency so you can also get boarded in a specialty, select a residency that would help you in the nonclinical field you have your eye on.

Just about any residency will give you a background that you can apply to working with EMRs or medical education. Family practice or emergency medicine will give you a solid three years taking care of adults and children with a variety of medical problems, which is a good background for a healthcare news correspondent. Psychiatry can be a helpful background for work that involves influencing consumers. And pathology can be an asset in medical legal work.

Bypassing residency

If working in patient care is definitely not for you, residency can feel like a detour along your career path. And you may be right, especially if you want to work in a field that won't require you to get the nod of approval from practicing physicians.

Nonclinical jobs for physicians without residency experience are available, and when that's what you want, you need to start planning early so you'll have a job lined up immediately after medical school. You could consider doing a postdoctorate research program so you can learn the ins and outs of bench research. You could also apply for an entry-level job at a medical communications company or a pharmaceutical company to write up experimental study reports or grant applications. You can also consider focusing in an area like marketing, sales or technology by learning the basics on the job or through a course.

Companies that get their revenue from providing healthcare products and services to medical professionals ask physicians who have patient care experience about the potential value of their products. You can use your background as a physician, even without residency, to help mediate these meetings so that everyone feels heard and understood. This way of adding value takes personal communication skills that you can't learn in residency - you can only learn through practice and listening insightfully to feedback from all sides.

Heidi Moawad, MD