{"id":12194,"date":"2026-04-24T15:03:16","date_gmt":"2026-04-24T15:03:16","guid":{"rendered":"https:\/\/www.roshreview.com\/blog\/?p=12194"},"modified":"2026-05-04T18:57:30","modified_gmt":"2026-05-04T18:57:30","slug":"fellowship-vs-attending-whats-the-difference","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/fellowship-vs-attending-whats-the-difference\/","title":{"rendered":"Fellowship vs Attending: What\u2019s the Difference?"},"content":{"rendered":"\n<h6 class=\"wp-block-heading\" id=\"h-every-year-as-residency-comes-to-an-end-many-decide-between-doing-a-fellowship-or-starting-practice-as-an-attending-it-s-an-individualized-decision-that-hinges-on-professional-goals-and-personal-circumstances-the-roles-fellows-and-attendings-serve-are-different-in-structure-and-purpose-if-you-re-approaching-a-similar-decision-and-are-wondering-what-is-an-attending-physician-and-how-are-they-different-from-a-fellow-here-are-a-few-key-distinctions-between-being-a-fellow-vs-attending-to-ensure-you-re-informed-and-can-choose-what-s-right-for-you\">Every year as residency comes to an end, many decide between doing a fellowship or starting practice as an attending. It\u2019s an individualized decision that hinges on professional goals and personal circumstances. The roles fellows and attendings serve are different in structure and purpose. If you\u2019re approaching a similar decision, and are wondering \u201cWhat is an attending physician, and how are they different from a fellow?\u201d, here are a few key distinctions between being a fellow vs attending, to ensure you\u2019re informed and can choose what\u2019s right for you.<\/h6>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"h-key-difference-1-training\"><strong>Key difference #1: Training<\/strong><\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">The biggest difference between a fellowship vs attending is <strong>a fellow is still in training while an attending completed their training and is practicing independently. <\/strong>To become a fellow, you first must complete a residency, teaching broad skills relevant to your field. Then, you work with and learn from attendings who completed the same fellowship to gain expertise in a narrower subspecialty.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For example, cardiologists complete an<a href=\"https:\/\/www.roshreview.com\/blog\/internal-medicine-residency-is-subspecialty-fellowship-right-for-me\/\"> internal medicine residency<\/a> first to learn how to manage a wide breadth of medical conditions. Then, they complete a cardiology fellowship to gain expertise specifically in cardiac diseases. Of note, while usually viewed as the next step after internal medicine, pediatrics, and general surgery residencies, fellowship options exist after almost every residency including dermatology, anesthesiology, and psychiatry.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By contrast, <strong>an attending is no longer training but also no longer further subspecializing.<\/strong> They completed all of the requirements to work within their field and are functioning without the oversight of another physician. If you completed a general surgery residency and elected to start practicing without a fellowship, you would be able to do the core operations you learned through your training. Importantly, however, you would not be qualified to do more specialized procedures like transplants or certain pediatric operations without the additional experience that comes with fellowships in transplant or pediatric surgery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Simply put, a fellowship may add multiple years to your training before you can start working on your own. The advantage, however, is the skills it will give you to become an expert in your specific field.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"h-key-difference-2-job-responsibilities\"><strong>Key difference #2: Job responsibilities<\/strong><\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">Key difference #1 goes a long way in explaining what is an attending physician vs a fellow, but there are a number of other differences as well. It\u2019s also important to note the responsibilities of a fellow and an attending differ in certain ways. The structure and duration of <strong>fellowships<\/strong> <strong>vary by type, but they<\/strong> <strong>usually involve both research and clinical or surgical components. <\/strong>Most fellowships that follow an internal medicine or pediatrics residency frontload patient care duties. You will spend most of your first year doing inpatient hospital consults and establishing a panel of clinic outpatients before transitioning to primarily focusing on research. While surgical fellowships naturally include more surgical time, they often also follow this general format. What\u2019s different as an <strong>attending is your schedule is less regimented and more flexible<\/strong>. In addition to caring for patients, you&#8217;ll also have more freedom for medical education, research, or administrative projects.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, because attendings practice independently while fellows are still training,<strong> fellows collaborate with attendings when providing patient care. <\/strong>For example, attendings and fellows commonly work together on services for hospitalized patients. In this context, a fellow will often see a patient first and develop a treatment plan. Then, they see the patient again with the attending who signs off on that plan or modifies it as needed. This allows the fellow to learn from the attending and gain the skills to eventually also practice on their own.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On the outpatient side, fellows may be supervised by a more senior physician and treat a panel of patients. This ensures safe and effective patient care while allowing fellows to have autonomy in anticipation of when they become attendings.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"h-key-difference-3-application-process\"><strong>Key difference #3: Application process<\/strong><\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">The<a href=\"https:\/\/www.roshreview.com\/blog\/how-to-get-into-fellowship-after-residency\/\"> fellowship application process<\/a> is similar to the process for residency and involves sending your CV through an interface like the Electronic Residency Application Service (<a href=\"https:\/\/students-residents.aamc.org\/applying-fellowships-eras\/applying-fellowships-eras\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">ERAS<\/a>), interviewing at programs, and finally being matched to an institution. You have control over the process insofar as you submit a ranking of programs in order of your preference, but the matching algorithm ultimately will determine where you\u2019re placed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On the other hand, securing employment as an attending more closely resembles the job application process in other industries. Rather than through an application service, you directly communicate with prospective employers who may review your CV and cover letter. After receiving job offers, you can weigh the strengths of different options and choose one rather than being matched to one.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"h-key-difference-4-compensation-and-benefits\"><strong>Key difference #4: Compensation and benefits<\/strong><\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">When explaining what is an attending physician vs a fellow, the issue of compensation cannot be avoided. Your<a href=\"https:\/\/www.roshreview.com\/blog\/how-to-make-extra-money-in-residency\/\"> pay as a resident<\/a> or fellow rises incrementally the further you are into your training. However, the compensation for fellows is similar to that of a resident, and only a fraction of an attending&#8217;s pay.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fellows and attendings may also have differential access to other benefits. For example, attendings may have a percentage of annual retirement account contributions matched by their employer, but this may not be the case for trainees.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nevertheless, while the benefits and pay you receive may be important, it ideally shouldn\u2019t be the only one. <strong>Don\u2019t let the prospect of a higher salary in the near future hold you back from pursuing a career you will love in a slightly more distant future.<\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h6 class=\"wp-block-heading\" id=\"h-in-summary\"><strong>In summary<\/strong><\/h6>\n\n\n\n<p class=\"wp-block-paragraph\">What is an attending physician vs a fellow? Briefly restated, the ultimate distinction between these two paths is an attending has finished training, while a fellow has not. Some attendings practice in more general fields like internal medicine or general surgery, while others did a fellowship to practice in narrower fields.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you\u2019re nearing the end of residency and thinking about these options available to you, think about your career goals. If you hope to have a <strong>broad scope in your practice, becoming an attending<\/strong> out of residency streamlines the path. Conversely, if you <strong>love a niche area of patient care, you should consider doing a fellowship.<\/strong> Consider what you want to do with your life and identify the best path to make that dream a reality.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Rosh Review is a <\/em><a href=\"https:\/\/www.roshreview.com\/\"><em>board review<\/em><\/a><em> company providing Qbanks that boost your confidence for your boards and beyond. Gain access to board-style practice questions, detailed explanations, beautiful medical images, and more with a <\/em><a href=\"http:\/\/app.roshreview.com\/trial\"><em>Rosh Review free trial<\/em><\/a><em> to the Qbank of your choice!<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Originally published September 2022 \/ Reviewed April 2026<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Every year as residency comes to an end, many decide between doing a fellowship or starting practice as an attending. It\u2019s an individualized decision that hinges on professional goals and personal circumstances. The roles fellows and attendings serve are different in structure and purpose. If you\u2019re approaching a similar decision, and are wondering \u201cWhat is <a href=\"https:\/\/www.roshreview.com\/blog\/fellowship-vs-attending-whats-the-difference\/\">read more&#8230;<\/a><\/p>\n","protected":false},"author":136,"featured_media":12199,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[1996,3815,2025,2027,2029,2007,3810,2010,2011,2013,2016],"tags":[2650,2919,3454],"coauthors":[3929],"class_list":["post-12194","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blogtype","category-child-and-adolescent-psychiatry","category-emergency-medicine","category-family-medicine","category-internal-medicine","category-md-do","category-med-peds","category-ob-gyn","category-pediatric-emergency-medicine","category-pediatrics","category-psychiatry","tag-fellowship","tag-job-search","tag-residency"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.7 (Yoast SEO v26.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Fellowship vs Attending: What\u2019s the Difference? 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