Career Guide for Doctors in the U.S.

Written by
Rebecca Smith

Published
Apr 17, 2020

Apr 17, 2020 • by Rebecca Smith

Although the process is lengthy and difficult, anyone can become a doctor through discipline and proper training. Training for new physicians can last anywhere between 7-15 years; the curriculum and training methods are constantly changing alongside new scientific breakthroughs, disease discovery and research, and our understanding of the human body. Teaching hospitals and medical schools in the U.S. ensure that doctors-in-training are ready to practice the medical arts in this dynamic environment.

Before medical school, students interested in becoming physicians must take demanding pre-med courses and, usually after graduation, the MCAT or Medical College Admission Test . While review boards for medical school admissions look at many aspects of each candidate, such as life experiences, GPA, and extracurriculars, the crucial role of the MCAT and the necessity of getting a high score on the exam should not be understated. This facilitates the need for MCAT prep; it should be noted that many MCAT preparatory courses, including online MCAT courses, are available worldwide to assist students in gaining the exam scores needed to enter top institutions. Including breaks, the exam is 7.5 hours long, so it is recommended that students spare no expense in preparing for this notoriously rigorous and lengthy exam.

After undergraduate studies and MCAT preparation comes medical school. The coursework for med school usually takes about 4 years. The classes in medical school programs usually cover advanced topics in science, the treatment, prevention, and diagnosis of disease, and medical ethics. All med schools in the U.S. have a research component to their curricula, such as biomedical or clinical research.

In the final year of med school, students will go through a process known as the Match. During this time students will choose the type of medicine they will practice as doctors and apply to residency programs. Some factors to consider include personal preference, one’s level of interest, and research and clinical experiences. There are over 120 different types of medicine to choose from, such as pediatrics, emergency medicine, psychiatry, gynecology, or neurosurgery. These 120 types can be divided into three broad categories: primary care physicians, surgeons, and specialists like cardiologists or ophthalmologists. During this time, medical students will often develop the skills necessary for their specialties and explore research options and opportunities for service in public and global health. The majority of students will be matched via the National Resident Matching Program, and they learn where they will train for residency on Match Day in the month of March.

Next begins the residency training process, which takes between 3-7 years. This period of time is known as graduate medical education or GME, and students are now called resident physicians. Resident physicians will receive first hand medical training and will train on a patient care team with supervision from attending physicians. Here residents will learn about specialized medicine and different care settings, like community health clinics and rural medical care. Some residents may participate in a fellowship after post-residency, which adds extra training in a subspecialty area and can add an additional 1-3 years of study.

Once the residency is completed, residents, now physicians, must obtain the state licenses necessary to practice in their respective locations and become board-certified in a specialty if required. Since the field of medicine is constantly evolving, continuing medical education and professional development are essential to meet the ever-changing needs of the healthcare industry.

To earn a state license, you must pass the United States Medical Licensing Examination (USMLE). This exam has three steps, and you must complete all three before you are permitted to practice medicine in the U.S. Each state allows you to attempt the USMLE a different number of times. The different exam sections are taken separately, and pass rates exceed 90% for all sections. Step 1 tests the application of scientific concepts to medical practice; it includes many topics like anatomy, behavioral sciences, pathology, nutrition, and genetics. Step 2 consists of two exams, Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills). Step 2 focuses on patient practices and clinical treatments as well English skills and communication. It is only offered in Philadelphia, Chicago, Houston, Atlanta, and Los Angeles. USMLE Step 3 tests unsupervised medical practice in ambulatory settings, and it is usually taken during the first year of residency. The total fees for the USMLE are about $2,660.

Later on, if you decide to practice a specialty, you will need to become board-certified. There are 24 different boards that certify specialist physicians in the U.S. These certifications, although not legally required, demonstrate core competencies in relevant subjects. A core competency document that physicians will be tested on is drafted by each specialty board and constantly updated. For the actual exam, there is usually a comprehensive written test and sometimes practical examinations using fake patients or computers. Although pass rates are typically above 90%, this is only indicative of how much candidates prepare for these extraordinarily difficult exams. Specialties include subjects like family medicine, hospital medicine, or internal medicine, and exam fees are upwards of $2,000 all told.