PGY stands for “postgraduate year” and refers to how far a doctor has progressed through residency training after graduating from medical school. PGY-1 is the first year, PGY-2 is the second, and so on. The number keeps climbing until training is complete, which can take anywhere from three to seven or more years depending on the specialty.
How PGY Numbering Works
The PGY system is straightforward: the clock starts the day a new physician begins residency. A doctor in their first year is a PGY-1 (also called an intern), a doctor in their second year is a PGY-2, and the count continues until they finish. If a physician goes on to pursue subspecialty training through a fellowship after residency, the PGY number keeps incrementing. For example, someone who finishes a four-year residency and starts a fellowship would enter it as a PGY-5.
This numbering matters because it determines pay, level of responsibility, licensing eligibility, and how much independence a physician has in clinical settings.
What Changes at Each PGY Level
The jump from one PGY level to the next isn’t just a title change. Each year brings a measurable shift in what a doctor is expected to handle on their own.
During PGY-1, interns focus on caring for patients with acute and chronic illnesses across multiple settings, but they work under close supervision from senior residents and faculty. The learning curve is steep. Interns are building foundational skills: taking histories, managing admissions, writing orders, and learning how a hospital actually runs.
By PGY-2, the role shifts noticeably. Second-year residents take on supervisory responsibilities, overseeing interns on both general and specialty teams. They’re developing clinical independence and starting to lead. Most residents also take their final licensing exam (USMLE Step 3) during this year, since they need those scores in PGY-3 to apply for a permanent medical license.
PGY-3 and beyond bring even more autonomy. Third-year residents often spend significant time supervising inpatient teams, working in ambulatory care and emergency settings, and building teaching skills. In longer residencies like surgery or neurosurgery, the later PGY years involve progressively complex procedures and greater decision-making authority.
How Long Each Specialty Takes
The total number of PGY years depends entirely on which specialty a physician chooses. Some of the most common training lengths:
- Three years (PGY-1 through PGY-3): Internal medicine, pediatrics, family medicine
- Five years (PGY-1 through PGY-5): General surgery
- Seven years (PGY-1 through PGY-7): Neurological surgery
Some specialties require preliminary training before the main residency begins. In the national matching system, these show up as “advanced” positions that start at PGY-2, meaning the physician first completes a separate preliminary year in something like internal medicine or surgery. By contrast, “categorical” positions start at PGY-1 and include all the training needed for board certification in one continuous track.
Physicians who pursue combined residencies, such as internal medicine paired with pediatrics or psychiatry, typically train for four or five years. That means they enter any subsequent fellowship at a higher PGY level than someone coming from a standard three-year program.
PGY Levels During Fellowship
Fellowship is subspecialty training that follows residency, and the PGY count doesn’t reset. A physician who completed a three-year internal medicine residency and enters a cardiology fellowship starts as a PGY-4. Someone from a four-year combined residency would start the same fellowship as a PGY-5.
This distinction has real financial implications. Fellowship programs sometimes set pay based on PGY level, but not always consistently. A physician entering their second fellowship after already completing one could technically be a PGY-7 but might receive compensation pegged to a PGY-4 level, creating significant pay gaps between fellows with different training histories.
What Residents Earn at Each PGY Level
Resident salaries are modest relative to the hours worked and rise incrementally with each PGY year. As a reference point, UCLA’s 2025 salary schedule lists the following annual rates:
- PGY-1: $93,777
- PGY-2: $96,396
- PGY-3: $99,605
- PGY-4: $102,954
- PGY-5: $106,565
These figures vary by institution and region. Programs in high cost-of-living areas like Los Angeles or New York tend to pay more than programs in smaller cities, but the general pattern of incremental raises per PGY year is standard across the country. The bump from one year to the next is typically a few thousand dollars.
Work Hour Limits by PGY Level
All residents, regardless of PGY level, fall under the same national work hour rules set by the Accreditation Council for Graduate Medical Education. The key limits apply uniformly:
- Weekly cap: No more than 80 hours per week, averaged over four weeks. This includes clinical work, education, and any moonlighting.
- Shift length: No more than 24 consecutive hours of scheduled clinical work. Up to four additional hours are allowed for handoffs and education, but no new patient care responsibilities can be assigned during that window.
- Rest between shifts: Residents should have at least eight hours off between scheduled work periods.
- Rest after 24-hour call: At least 14 hours free of clinical work and education.
- Days off: A minimum of one day per week free from clinical duties and required education, averaged over four weeks.
In practice, the experience of these hours feels different at each PGY level. An intern on a 24-hour call shift is often managing a heavy patient load with limited autonomy, while a senior resident on the same shift may be supervising multiple interns and making higher-level clinical decisions. The hours are the same on paper, but the nature of the work changes substantially as the PGY number climbs.