Postgraduate Medical Education (PME) Project
United States
The information listed for the United States was provided by individuals knowledgeable about PME in the United States. If you note errors or omissions or would like to provide additional information, please click here.
- Duration of studies
- Trainee selection process
- Specialty curriculum authority
- Licensing authority
- Areas of specialization
- Legal references
Duration of studies
Undergraduate medical education:
- Allopathic medicine (MD degree): 4 years
- Osteopathic medicine (DO degree): 4 years
Both allopathic and osteopathic programs generally accept students after completion of a four-year undergraduate bachelor degree.
PME specialty training: 3-7 years, depending on the specialty pursued. Certain specialties accept applicants after one year of study in another specialty. For those specialties, that year is included in the number of years of study provided under Areas of specialization.
Trainee selection process
PME specialty training programs exist specifically for allopathic or osteopathic graduates; however, many allopathic postgraduate programs accept both types of graduates. There are approximately 130 schools of allopathic medicine in the United States. Allopathic medical programs are accredited by the Liaison Committee on Medical Education (LCME). There are approximately 25 schools of osteopathic medicine in the United States. Osteopathic medical schools are accredited by the Commission on Osteopathic College Accreditation (COCA) of the American Osteopathic Association (AOA).
Medical graduates from U.S. allopathic schools, U.S. osteopathic schools, and international medical schools compete for positions in specialty and subspecialty training programs. PME programs establish their own criteria for admission, and trainees are generally selected based on a variety of factors including examination performance, medical school transcripts, letters of recommendation, and personal interviews. Nearly all entry postgraduate year-one (PGY-1) positions are accessed through the National Resident Matching Program (NRMP). Detailed information regarding eligibility, registration, and the matching process can be obtained from the NRMP website.
Specialty curriculum authority
PME (locally referred to as “graduate medical education” or “GME”) programs in the United States are accredited by the Accreditation Council for Graduate Medical Education (ACGME). ACGME includes 26 review committees, each responsible for the accreditation of programs in a particular medical specialty and its subspecialties.
Independent medical specialty boards set the standards for certification in their respective specialties. The requirements for board certification in each specialty generally include successful completion of PME training in an accredited program and passing certification examinations. A directory of medical specialty boards can be found on the website of the American Board of Medical Specialties (ABMS). Specialty certification is voluntary; it is not a requirement for medical licensure or practice.
Licensing authority
There is no national system of licensure for medical practice in the United States. Each U.S. state and territory assumes responsibility for medical licensure in its own jurisdiction. Requirements for licensure, including the number of years of required PME training, vary from state to state. In most states, graduates of international medical schools are required to complete more years of PME training prior to licensure than graduates of U.S. and Canadian medical schools.
Some states have separate medical licensing boards for allopathic physicians and osteopathic physicians. A directory of the 70 U.S. state medical boards, including their contact information, can be found on the website of the Federation of State Medical Boards (FSMB) of the United States, Inc.
Areas of specialization
PME training programs accredited by the ACGME are offered in the specialties and subspecialties listed below, which are followed by total program duration (number of years required for completion).
- Allergy and Immunology: 5 years
- Anesthesiology: 4 years
- Adult Cardiothoracic Anesthesiology: 1 additional year
- Critical Care Medicine: 1 additional year
- Pediatric Anesthesiology: 1 additional year
- Colon and Rectal Surgery: 6 years
- Dermatology: 4 years
- Dermatopathology: 1 additional year
- Procedural Dermatology: 1 additional year
- Emergency Medicine: 3 years
- Medical Toxicology: 2 additional years
- Pediatric Emergency Medicine: 2 additional years
- Sports Medicine: 1 additional year
- Undersea and Hyperbaric Medicine: 1 additional year
- Family Medicine: 3 years
- Geriatric Medicine: 1 additional year
- Sports Medicine: 1 additional year
- Hospice and Palliative Medicine: 4 years
- Internal Medicine: 3 years
- Cardiovascular Disease: 3 additional years
- Clinical Cardiac Electrophysiology: 1 additional year
- Interventional Cardiology: 1 additional year
- Critical Care Medicine: 2 additional years
- Endocrinology, Diabetes, and Metabolism: 2 additional years
- Gastroenterology: 3 additional years
- Transplant Hepatology: 1 additional year
- Geriatric Medicine: 1 additional year
- Hematology: 2 additional years
- Hematology and Oncology: 3 additional years
- Infectious Disease: 2 additional years
- Nephrology: 2 additional years
- Oncology: 2 additional years
- Pulmonary Disease: 2 additional years
- Pulmonary Disease and Critical Care Medicine: 3 additional years
- Rheumatology: 2 additional years
- Cardiovascular Disease: 3 additional years
- Medical Genetics: 4 years
- Medical Biochemical Genetics: 1 additional year
- Molecular Genetic Pathology: 4 years
- Neurological Surgery: 6-7 years
- Endovascular Surgical Neuroradiology: 1 additional year
- Neurology: 4 years
- Child Neurology: 1 additional year
- Clinical Neurophysiology: 1 additional year
- Neurodevelopmental Disabilities: 2 additional years
- Neuromuscular Medicine: 1 additional year
- Vascular Neurology: 1 additional year
- Nuclear Medicine: 4 years
- Obstetrics and Gynecology: 4 years
- Ophthalmology: 4 years
- Orthopaedic Surgery: 5 years
- Adult Reconstructive Orthopaedics: 1 additional year
- Foot and Ankle Orthopaedics: 1 additional year
- Hand Surgery: 1 additional year
- Musculoskeletal Oncology: 1 additional year
- Orthopaedic Sports Medicine: 1 additional year
- Orthopaedic Surgery of the Spine: 1 additional year
- Orthopaedic Trauma: 1 additional year
- Pediatric Orthopaedics: 1 additional year
- Otolaryngology: 5 years
- Neurotology: 2 additional years
- Pediatric Otolaryngology: 1 additional year
- Pain Medicine: 5 years
- Pathology – Anatomic and Clinical: 4 years
- Blood Banking/Transfusion Medicine: 1 additional year
- Chemical Pathology: 1 additional year
- Cytopathology: 1 additional year
- Forensic Pathology: 1 additional year
- Hematology: 1 additional year
- Medical Microbiology: 1 additional year
- Neuropathology: 2 additional years
- Pediatric Pathology: 1 additional year
- Selective Pathology: 1 additional year
- Pediatrics: 3 years
- Adolescent Medicine: 3 additional years
- Developmental-Behavioral Pediatrics: 3 additional years
- Neonatal-Perinatal Medicine: 3 additional years
- Pediatric Cardiology: 3 additional years
- Pediatric Critical Care Medicine: 3 additional years
- Pediatric Emergency Medicine: 3 additional years
- Pediatric Endocrinology: 3 additional years
- Pediatric Gastroenterology: 3 additional years
- Pediatric Transplant Hepatology: 1 additional year
- Pediatric Hematology/Oncology: 3 additional years
- Pediatric Infectious Diseases: 3 additional years
- Pediatric Nephrology: 3 additional years
- Pediatric Pulmonology: 3 additional years
- Pediatric Rheumatology: 3 additional years
- Pediatric Sports Medicine: 1 additional year
- Physical Medicine and Rehabilitation: 4 years
- Pediatric Rehabilitation: 2 additional years
- Spinal Cord Injury Medicine: 1 additional year
- Sports Medicine: 1 additional year
- Plastic Surgery: 6 years
- Craniofacial Surgery: 1 additional year
- Hand Surgery: 1 additional year
- Preventive Medicine: 3 years
- Medical Toxicology: 2 additional years
- Undersea and Hyperbaric Medicine: 1 additional year
- Psychiatry: 4 years
- Addiction Psychiatry: 1 additional year
- Child and Adolescent Psychiatry: 2 additional years
- Forensic Psychiatry: 1 additional year
- Geriatric Psychiatry: 1 additional year
- Psychosomatic Medicine: 1 additional year
- Radiation Oncology: 5 years
- Radiology – Diagnostic: 5 years
- Abdominal Radiology: 1 additional year
- Musculoskeletal Radiology: 1 additional year
- Neuroradiology: 1 additional year
- Nuclear Radiology: 1 additional year
- Pediatric Radiology: 1 additional year
- Vascular and Interventional Radiology: 1 additional year
- Sleep Medicine: 4 years
- Surgery: 5 years
- Hand Surgery: 1 additional year
- Pediatric Surgery: 2 additional years
- Surgical Critical Care: 1 additional year
- Vascular Surgery: 2 additional years
- Thoracic Surgery: 7 years
- Congenital Cardiac Surgery: 1 additional year
- Urology: 5 years
- Pediatric Urology: 1 additional year


