You'll complete extensive training before becoming a practicing physician. We've created this guide to help you understand the path to becoming a doctor. Use it to familiarize yourself with the training and process of medical education.
Medical School (Allopathic Schools)
With rare exceptions, entry to medical school requires a college degree. Students who are in college may apply to medical school, but must finish their degree before starting their medical training. You don't need a specific college major to apply, but most medical schools require courses in the sciences and more recently in social-behavioral studies.
Students apply to medical school through the American Medical College Application Service (AMCAS). It's a national system that collects information in a central repository. Applicants then choose which medical schools should receive their application.
The Medical College Admissions Test (MCAT) is required for application to medical school.
Medical school is four years long. It includes classroom study, laboratory work and clinical work with patients. Courses include basic science and clinical skills. Usually, students spend at least half of the four years in a clinical setting so they can learn how to take care of patients and apply the skills they have acquired.
Testing during Medical School
Students take three national examinations during medical school. These are the United States Medical Licensing Examination (USMLE) Step I, USMLE Step II clinical skills and the USMLE Step II clinical knowledge. Students must pass all three to get licensure and many schools require students to pass all them to graduate.
After four years, graduates earn the M.D. degree, but they are not permitted to practice medicine without further training in a residency program.
A residency is a period of paid, on-the-job training where medical school graduates train to become specialists in a field. For example, a graduate who wants to become a pediatrician would do a residency in pediatrics. While the length of the residency varies by field, most last between three and five years.
You're required to complete a residency before you can practice medicine. Some states will grant provisional licensure during residency, but others require full completion of a residency to become an independent practitioner.
Many fields offer residencies, including family medicine, pediatrics, internal medicine, surgery, obstetrics/gynecology, radiology, dermatology, anesthesiology, pathology, ophthalmology, urology, neurosurgery, neurology, orthopedics, emergency medicine, psychiatry and others.
What to Expect
A resident works with a senior, licensed physician, sometimes called an attending physician. The resident sees patients, decides on a plan and reviews it with the senior attending physician. Residents can write prescriptions, give medical orders and document in the medical record. They also attend required lectures and take examinations to ensure that they gain the knowledge required to become a specialist in their field.
Hospitals with residency programs are often able to hire new physicians from this pool. Residents also provide direct patient care under supervision, which helps hospitals manage their patient population. Having a residency is a sign that the hospital staff physicians are highly skilled and capable of serving as role models for the new generation of physicians.
Requirements and Exams
There are national requirements for what must be taught to residents, how they must be supervised and even how many hours per week they are allowed to work. These standards are set by the Accrediting Commission on Graduate Medical Education (ACGME). Every specialty has a committee within the ACGME that oversees specialty-specific requirements. This committee visits programs regularly to ensure they are following requirements.
All specialties have national board examinations which are given after completion of residency. Physicians who pass these boards are board-certified in their field, which is a mark of distinction that is universally desired.
After completing their residencies, many physicians start practice. Some, however, go on to do more training through a fellowship.
A fellowship is training that a specialist takes to become a sub-specialist. For example, an internal medicine specialist might do a cardiology fellowship to become a cardiologist. Fellowships are usually two to three years long. Fields include, but are not limited to:
- Infectious diseases
- Critical care
- Maternal-fetal medicine