“My doctor gave me six months to live, but when I couldn’t pay the bill he gave me six months more”.
2nd way less expensive and almost 100%. The schools of the Caribbean are becoming more and more popular with Americans. For example St. George University in the Caribbean. Among the students of such schools, 69% are US citizens.
First, go to such honey. schools are much easier (4 out of 5 applicants are enrolled)
Second, cheap tuition fees compared to North American medical schools, cheap insurance and accommodation
Thirdly, a diploma issued in the Caribbean is recognized in the United States (students take USMLE)
Fourth, all rotations take place in US hospitals.
In total, you need to pass three exams:
USMLE Step 1 the cost of $ 740 (Basic Science: physiology, pathology, anatomy, pathological anatomy, microbiology, pharmacology, embryology, behavioristics, biochemistry, etc.), then
USMLE Step 2 cost $ 840 (Clinical Knowledge: all clinical subjects) and last
USMLE Step 2 cost of 1200 dollars (Clinical Skills - passing practical skills on actors).
In total, the third method costs about 2 thousand dollars. True, this is without a flight to the USA (practical skills are surrendered only in America).
The length of the first and second step: 8 hours each, taken on a computer in the form of a test. Practical skills take 2 days for 8 hours for the actors in a special center. After the delivery, you apply for a match in which you choose a clinic, and she you. Go to an interview and sign a contract (if offered). After residency, you pass the last exam for a medical license, and voila - you are a doctor! with a minimum starting salary for a therapist in a hospital of 15 thousand dollars per month (minus tax from 22 to 33%, you will receive $ 12 thousand in your hands),
Despite salaries of 15, 30 and even 50 thousand dollars a month, there is a shortage of doctors in America, and it is not only the high cost of education, but the length of study, competition for admission, exhausting study in medical school and a large amount of work in the future. For example, no one is surprised by the almost 100 hour schedule per week of a medical resident, so probably many do not even consider such a difficult and expensive path of a doctor for themselves. (the video is just about that).
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461 thoughts on “ Three Ways to Become a Doctor in the USA”
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Yes, I came from Russia. I don’t know the answer to the second question. Perhaps you need to get a job (I did).
Everyone is different. I don't know what your knowledge base is. Some prepare for the first exam for 2 weeks (usually Hindus from England), my friends from Russia take from 1 to two years to prepare for the first exam.
It's hard to pass exams in America, especially USMLE Step 1.
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Do I need to take exams in this specialty for admission? besides ultrasound diagnostics, who else can you learn without having a basic medical education? shortly within 1-2 years? and in what place is it better to teach? jefferson? what is the salary of ultrasound specialists and others of this kind when you can learn without basic medical. Thank you. at the present time in Russia, at 36 I wanted to change the direction of work.
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You can learn to be an X-ray technician (training for 2 years), the salary is 55 thousand per year (for an MRI or CT scan it can reach 85 thousand). I don’t know better where they teach. For me, it’s better to study at community college, cheaper and easier to do.
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Sorry, what does MPT or KT mean?
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MRI - magnetic resonance imaging, CT - computed tomography. More accurate methods for examining human internal organs using nuclear magnetic resonance (MRI) or X-ray radiation (CT).
Doctors work on such machines in Russia together with X-ray technicians, in the USA only special technicians - x-ray. or MRI, CT technician or radiology technician.
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Thanks for the clarification. Can you tell me what exams you need to take? One user also wrote on your blog that the training is from 6 to 10 pm - I doubt that this is so, but can it really ?? I ask because I have a family and I think it will be possible to study, while still having time to take care of the children.
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Hello. I need your advice, I need it very much. I live in Georgia in Tbilisi, I am 19 years old studying at the state medical university. I decided to go to another university where the training is in English, that is, it’s medical cheekbones, all those subjects are taught there from those books like in the USA. Since childhood, I want to become a cardiac surgeon, this is probably a dream and goal of my whole life. I want to go to the USA. I know that it is difficult, etc. I have a friend and today he kind of opened my eyes, it really was a big blow for me. He said that I have almost no chances of getting into surgery in the USA. He himself has 99% in both steps, and says that even with such glasses you can't get into surgery. Speaks or change your views. or change the country of residency. I could come to Moscow to my friends and study there in residency, but I want to go to the USA. Probably because of the salaries. Or even in Bakulev I think cardio will be taught very well. Tell me I have a chance to get in the USA for surgery a conversation with a friend, as if someone died in mourning (Thanks in advance. I've been reading for 2 years now and learn about smile, I know that sooner or later I will be there. If I take a goal in life, I go to the end, and now it turns out I have no chance , since I live in Georgia and do not study at a prestigious university in the USA? ...
Or to Russia. My friend is an interventional cardiac surgeon (minor invasive operations such as stenting, balloon angioplasty, etc.) 10 thousand bucks a month in Russia. True, he is the only one in the department, but still.
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I wrote a bit wrong. Since childhood, I have dreamed of becoming a cardiac surgeon, except for dreams, I study well. That is, in any case, I have to be a cardio surgeon, if even a beggar ... it's just that in America they will pay me very, very well for my dream. It is even strange when for your dream gets paid. Do I have a chance? Anything? What to do advise ... I wrote as much as possible about myself. Thank you
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I am sorry, my previous comment has not been preserved.
Your friend is right. It is very difficult to enter a cardiac surgery residency, and almost impossible for IMG. I think that in 10 years only US graduates will be accepted to any residency. In any case, such work is already underway here (for example, an increase in university entrants).
But theoretically there are always chances. Your connections in the USA will help you. To gain such connections, you need to search the entire Internet for internships, clinical clerkship, observership in American hospitals where there are resident programs. Or perhaps a professor from the USA comes to your city and you need to befriend him and convince him that you really need a clinical internship. Either way, you need to achieve such an internship or training program.
During such an internship, you demonstrate your knowledge and desire to work (come to the hospital by 5-6 in the morning), leave at the last hours of 11 in the evening. Know by heart everything about all patients. Participate actively in student reporting. Report one or two patients at rounds every day, help interns (call the pharmacy, have a fight with the MR technician, etc.). Get referrals from attorneys, get to know the program director. Finally, get the maximum score on the USMLE exam.
Of all my IMG friends (40 people), one person got into radiology (in terms of the complexity of admission, it is almost the same as cardiac surgery).
Go for it!
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Please tell me, in Russia, an internship in radiology also involves a description of the images made on CT and MRI. You wrote above that doctors in the United States do not deal with CT and MRI. Then what do radiologists in the USA do? I doubt it is just a description of the radiographs .. Maybe then radiation therapy?
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You helped me a lot, I try to take everything easier in life, but this information from the tavarische really influenced me. So there is still a chance if you do all this ... and of these 40 people, about how many tried to enter surgery? Such a question is immediately sent to cardiac surgery or for a start in general and only then in cardio? And another question, is it possible, for example, to go to therapy and then go to surgery? thanks for answers
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If you buy a lottery ticket and ask me if I have a chance to win, I will answer - yes, but small. Also here, there is, but small. Buy a “ticket” for a start (that is, pass the first exam for 260)
Out of 40 people, few were going to surgery, so my example is not entirely correct. True, almost no one in their homeland was engaged in therapy, and in the states they ended up in internal medicine and primary care.
First, you need to go through a preliminarily 1 year of therapy, then to general surgery (4-6 years, depending on the program), and then to cardiac surgery.
If you take a residency in therapy, then in surgery you are protected only for one year (and then therapy), everything else needs to be done again, so it makes sense to go to internal medicine, and then to surgery there probably isn't (IMHO)
Good afternoon Roman,
If I am not mistaken, then you need a surgical residency (general). In the first year you will undergo a preliminaries in therapy, then for 4 years in general surgery, and then in cardio. But first you need to create steps, and pass it very well (at least 240).
In my opinion, the difference in procedures, cardio mainly on coronary, and a little on periphery, radiologist cavafilters, embolization, but the head with its aneurysms (coloration) is probably for neurosurgeons.
Here is the list (IC cardio, IR radiologist)
IC does:
a. coronary angio
b. coronary interventions (plasty, stents, ia thrombolysis, thrombectomy)
c. renal angio / intervention
d. peripheral angio / intervention
e. carotid angio / interventionIR does:
c-e plus
- embolization therapy for various applications (pre-op tumors, uterine fibroids, varicocele, pelvic congestion, penetrating trauma, blunt trauma, GI bleeds, hemoptysis, AVMs)
- trans-catheter liver tumor treatment (chemo or radio-embolization of HCC and chemo-resistant colorectal mets)
- biliary intervention (percutaneous biliary drainage etc.)
- GU intervention (perc.nephrostomies, ureteral stents)
- abscess drainage
- tubal re-canalization / tubal occlusion
- percutaneous gastrostomy tubes
- biopsies of various solid organs, lymph nodes using imaging guidance
- image guided tumor ablation (liver, kidney, lung, bone-mets)
- transvenous liver biopsy
- placement of IVC filters
- retrieval of IVC filters
- dialysis access management (intervention on dialysis access grafts / fistulas, Perm-A-Caths)
- venous access (difficult PICCs, central lines, chest-ports)
- catheter directed thrombolysis (arterial bypass grafts, DVT)Like
What about citizenship? Can I enter residency without him? or with him?
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Anton, it will be great if we can look through medical cases little by little. Especially the first step. it was a long time ago.
Apparently some of the cycles in the Medical Institute passed me by .. please clarify what kind of subject of behavior studies?
Good afternoon. Tell me, are there any age restrictions for admission to residency in the USA ???
The hostel does not provide programs. Residents are paid a stipend of $ 4,000 per month, which is comparable to the average salary in the United States.
To the medical specialty - through the Caribbean
Maxim Chumak was born in Ukraine. In 1992 he immigrated to Israel, and from there to the United States. Even before moving to America, he was educated as a nurse and dreamed of a career as a doctor.
“When I came to the United States, I was 26 years old, and I understood that if I didn’t go to study as a doctor now, I would never do it,” Maxim recalls.
To save a little on tuition, he decided to study in one of the Caribbean countries - at the American University of Antigua. Caribbean medical colleges are slightly cheaper and have a much simpler admission process. However, only 4 of them are recognized by all states, and the American University of Antigua is just one of them. You also need to keep in mind that finding a place for residency (analogous to an internship) after graduating from a university in the Caribbean is still more difficult than after an American college. When considering applications, priority is usually given to graduates of American medical colleges, then students who graduated from medical school in the Caribbean are considered, and then everyone else.
Maxim's training lasted from 2003 to 2008: first he graduated from medical school and for another 2 years he did an internship in Chicago.
“My training cost something like $ 36,000 a year. I paid part of the amount myself, and to pay for the second part I took out a bank loan, ”says Maxim Chumak.
During his studies, Maxim managed to earn extra money as a nurse - the corresponding education received in Israel, he had previously confirmed in the United States.
After university, I had to get into residency. It was not at all easy to do this - in some hospitals, as Maxim recalls, the competition was about 900 people per place, depending on the specialty.
While looking for a hospital for his internship, he went through several interviews. Thanks to his persistence, 2 weeks before the start of the practice, he received a call from the hospital at the University of Michigan and was offered a place with a contract for 1-2 years in surgery. Maxim agreed. After working there for a year, he moved to Henry Ford Hospital and changed his specialty to a family doctor. He currently works in the Emergency room at Memorial Hospital in Hollywood, Florida.
In parallel with this, Maxim was selected to the reserve of the American army, where he received the rank of captain, and serves as a military doctor under contract. When the contract is signed, the army gives the opportunity to take advantage of various benefits, one of which is the repayment of student loans.
After several years of work in hospitals, Dr. Chumak wants to work for himself and is now opening his own practice.
Three options
There are several options for becoming a registered physician in the United States.
1. Education at the US College of Medicine
Takes about 10 years or more if you want to become a neurosurgeon or plastic surgeon. Requires a solid financial investment - the cost of training can vary from $ 150 to $ 400 thousand dollars.
2. Studying at a medical college in one of the Caribbean countries
Certain Caribbean medical colleges are recognized in the United States. Tuition fees are significantly lower than in the United States. It's easier to do it. Residency can be completed in an American clinic, which ultimately will allow a person to get the desired profession.
3. Confirmation of the doctor's diploma
This path is the cheapest, fastest, but most difficult. In addition to passing difficult exams, you need to find a place to undergo residency, and for this category of applicants it is quite difficult. It is impossible to obtain a doctor's license and practice in the United States without undergoing residency. The positive point in this case is that doctors during retraining do not acquire huge debts, and from the moment they receive a place in the hospital, they start to work “with a plus”.
Proof of professionalism
Lyubov Clemin moved to the United States from Ukraine in 1995. Together with her husband, she settled in Chicago. Prior to that, at home, she worked as an obstetrician-gynecologist for 11 years. In the USA, she decided to confirm her specialty. She prepared for the exams herself with the help of American textbooks on medicine. It took 9 months to prepare. The exam was called USMLE and consisted of 3 stages, which she successfully passed and began a 3-year residency at the hospital under the Match program.
Dr. Clemin. Photo from personal archive
Its essence lies in the fact that students are looking for a place to undergo a residency program, and the programs choose their residents. It is similar to the TV program "Love at First Sight" - the interests of the applicant and the hospital coincide or not.
“Now it is very difficult for a foreigner to get into residency,” says Lyubov Klemin. - In my time it was more realistic, because there was a shortage of doctors in the United States. In addition, it is important for American hospitals that after graduation from a medical school by a foreign specialist whom they are considering, no more than 3 years have passed. That is, no one is interested in a lot of experience here and is viewed rather as a minus ”.
In residency, a medical professional works under the supervision of other doctors, but still as a doctor, not as a student. Moreover, he receives a good salary for a professional who has not yet taken place, by American standards - $ 50-60 thousand a year.
“In order to get a residency, I sent out my CVs to hospitals. I had 3 interviews related to obstetrics and 3 as a family doctor. As a result, I practiced as an obstetrician-gynecologist. Well, after my residency, I received a license and started my own practice in Chicago as a family doctor and obstetrician-gynecologist, ”says Lyubov Klemin.
Love loves her job and says that she sees no disadvantages in the work of an American doctor. “If you have already passed this difficult path, then it will be easy. And the earnings are excellent. But the important point is that you should always be aware of the latest research and innovations in medicine. You cannot smear a wound, for example, with brilliant green, if all doctors in the United States are already treating wounds differently. That is, an American doctor needs to constantly engage in self-development. Something changes every year! This is a huge difference compared to the health care system in Ukraine, ”says Lyubov.
What you need to confirm your doctor's degree in the USA
- Register on the website ECFMG ( Educational Comission for Foreign Medical Graduates ). Application fee - $ 65;
- Send documents: diploma translation, completed application forms, photos.
- Register for and pass the first exam: USMLE Step 1 Basic Science (Fundamentals of Science: Physiology, Pathology, Anatomy, Pathology, Microbiology, Pharmacology, Embryology, Behavioral Science, Biochemistry, etc.) Cost - $ 880;
- Pass the second USMLE Step 2 Clinical Knowledge exam (clinical subjects). Cost - $ 880;
- Pass the third USMLE Step 2 Clinical Skills exam (a practice exam that tests knowledge using actors). Cost - $ 1,535.
- After successfully passing the exams, you participate in the Match program, pass interviews at the clinics that invite you, and, with a successful combination of circumstances, conclude a contract for the residency.
- After completing residency and passing the medical license exam, you become an American physician.
Good time
Alexander Merson moved to New York from Riga in the 90s. In Latvia, he has been dealing with blood diseases and malignant lymphomas for 13 years. He also defended his Ph.D. thesis on this profile.
According to Alexander, the 90s were a good time to confirm a medical degree, because in the mid-1980s an outbreak of AIDS began in America, and the health care system was not ready for this. Doctors were needed, but they were not.
Dr. Merson. Photo: from personal archive
Alexander decided to confirm his diploma. He was prepared for exams at the famous Kaplan preparatory courses, the cost of which at that time was equal to $ 1000. The Russian doctor passed the exams perfectly and found a place to undergo residency.
“I remember my first month in residency very well. It was terribly difficult. As an ignorant person, I was put in the worst place - I was a doctor running errands and doing all the bestial work. I wandered around 3 hospitals where I had a rotation. By the way, one of them was a military man. In the first week, I showed up at home only 2 times, because I finished my shift at 1-2 nights and stayed overnight in the hospital. I don’t know how I survived at all. On the other hand, thanks to this experience, I learned to do absolutely everything: to sew up wounds, to put a hose in my mouth for feeding, and even to stop malaria. I did and saw such things that I read only in textbooks, ”the doctor shares his impressions.
When Alexander was undergoing residency, there was still no law prohibiting a doctor from working for more than 24 hours in a row. Thus, he could often be on his feet for 36 hours - day shift, night shift and the next day shift.
For his work-practice, the doctor received $ 34 thousand a year. This salary allowed his family of 4 to live normally. For comparison, Alexander then paid $ 700 for an apartment.
“I finished my residency in 2 years instead of the prescribed three. The program director petitioned to be allowed to finish early. However, New York did not give a license, and I had to go through an additional two-year fellowship in blood diseases (hematology), ”says the doctor.
In September 1995, Alexander had already opened his practice in Brooklyn, having bought an office where he had previously received a Chinese doctor. “I found an advertisement for the sale of the practice in the New York Times. It turned out that the office is 5 minutes walk from my house. It was very convenient, and the declared value was low, which allowed me to go for this deal. Of course, many clients left after the former owner of the office, but the place was familiar, and they began to visit me, ”Alexander shares his memories.
For over 20 years he has been working as an internal medicine in his office. His working week is 6 days: 4 days he sees patients, and the other two are spent on filling out government papers. The doctor openly dislikes the current US President Barack Obama because of his reforms that have made life difficult for doctors.
“Before, I went to medicine because of a great love for her. Things are different now: I spend a lot of time on paperwork after Barack Obama introduced the ObamaCare program. As the famous US neurosurgeon Ben Carson said: “Obamacare is the worst event in America after slavery,” Alexander confesses. According to him, after the introduction of ObamaCare, many doctors lost their patients, but many checks began to be carried out and the cost of liability insurance for doctors increased extremely, for which some ended their practice and left the profession.
Alexander hopes that Donald Trump will win the next presidential election, who promised to cancel ObamaCare if he wins, and advises everyone to think three times before connecting their lives with medicine: “This is a very difficult and long way, a loan of $ 200-300 thousand if you study in the USA and work in crazy conditions. "
But those who still overcome this path will receive a good bonus - on average, doctors' salaries start at $ 100,000 a year and, according to Payscale, can go up to $ 800,000.
Admission to medical schools for an international student is not an easy task. First, because less than half of all US medical schools accept students from overseas. And even they accept very few foreigners, giving preference to local students. Secondly, because of the high entrance requirements.
The financial issue also plays an important role here. Medical programs in all countries of the world are one of the most expensive, as they require a lot of laboratory studies, clinical practice, and almost constant participation of a scientific supervisor. In addition, US medical education is the most expensive in the world.
Tuition fees and scholarships
Medical training takes 11 to 15 years, including a bachelor's degree, and prices at American medical schools are rising every year. So, over the past 10 years, the cost of medical programs has increased by more than 40%. On average, you should focus on the cost of $ 40'000-50'000 and above.
Foreign students in medical schools hardly have to rely on scholarships - although there are rare exceptions to this rule. But given the highest competition, in order to receive a scholarship, you need to have really outstanding knowledge, academic and life achievements, have excellent recommendations, and write exceptional motivation letters.
General requirements for applicants to medical schools
The general requirements of medical schools for applicants are as follows:
- Bachelor's degree with compulsory study of biology and chemistry. Some schools also require hours in some liberal arts, English, mathematics, science.
- Good MCAT scores - a required test for admission to US medical schools. If necessary / desired, the results of other standard tests are indicated - GRE, GMAT, LSAT.
- Good results on the test of knowledge of English - TOEFL, IELTS or other.
In addition, the applicant must carefully read all the requirements of the university, which will often differ from the standard ones. Additional tests, exams and interviews may be required, which will be conducted directly by representatives of the university.
Application submission and admission
International students apply uniform applications to all US medical schools through the AMCAS - American Medical College Application Service. The application system is administered by the Association of American Medical Colleges.
The applicant fills out a standard form that includes personal information about him and his family, all educational institutions that he attended, subjects studied, assessments, activities directly related to medicine, letters of recommendation available.
Then the applicant indicates the medical universities to which he plans to send the application. After that, he adds motivational essays - from one to three, depending on the program and level of study. Applicants to M.D. or Ph.D required: personal motivational essay - Personal Comments Essay, master's or doctoral essay - M.D./ Ph.D. essay, as well as an essay describing the student's research experience - Significant Research Experience essay.
Education
Study at the US medical school lasts 4 years, continuing with residency training from 3 to 7 years. After that, for those wishing to expand or deepen their specialization, to strengthen their practical skills, there are additional programs that last from one to four years and do not lead to the award of degrees. Students must be prepared for huge and diverse loads - hours of study in classrooms, laboratories and anatomical theater, practice in clinics.
To obtain a medical diploma, students must pass the United States Medical Licensing Examination (USMLE), or Board exam, which consists of three stages:
- The first exam is taken at the end of the second year of medical school,
- The second - during the fourth year of study,
- The third - after the first year of residency.
These exams vary in structure and content, but collectively they ensure that the young professional's knowledge and skills meet the standards of American medical education.
Degrees
Graduates of US medical schools are awarded the following degrees: Doctor of Medicine, M.D., Doctor of Osteopathic Medicine D.O., Ph.D.
After the entry into force of the third generation federal education standard in the Russian Federation, the approach to the training of future doctors will change. Since January 2016, internship for those who have chosen dentistry and pharmaceuticals as their specialization has been abolished, and since 2017 - for pediatric and preventive medicine faculties. Those who have enrolled in a medical school since 2013 are affected by the innovations.
The choice of a medical university.
The Association of American Medical Colleges was founded in Washington in 1876. Its mission is to improve healthcare and healthcare delivery through innovative medical education, advanced patient care, and pioneering medical research. AAMK includes 145 American and 17 Canadian universities accredited in the field of medicine, about 400 large clinical hospitals and more than 80 scientific communities.
Traditionally, Ivy League colleges are considered the best medical universities:
-Harvard University
-Yale University
-Columbia University
-University of Pennsylvania
And:
Johns Hopkins University
-Stanford University
-University of California and others.
It should also be borne in mind that the cost of education in the most prestigious universities will be much higher than in less popular ones.
Studying proccess
After graduating from high school, the graduate will not be able to immediately apply to the university for a medical specialty. Before that, he must receive a bachelor's degree in any discipline, but preference is given to subjects as close as possible to medicine. It can be chemistry, biology, ecology, or even environmental protection. Usually this training, called a pre-medical study, lasts 4 years. Similar programs are offered by various colleges throughout the country. After four years of study in the "pre-med" program, the student takes the MCAT (Medical College Admission Test) exam, after which he can apply to the medical university. Of course, each university has its own additional criteria for selecting students, but absolutely everyone takes the MCAT.
In the United States, there are no direct medical universities - documents are submitted to ordinary universities accredited in the field of medicine (higher medical schools). Since there are not so many similar universities in the country, the competition in them is quite strong. Upon admission, preference is given mainly to applicants living in the state, since after graduation they will be able to stay on the job. Also important is the high score obtained in secondary school and during the period of study in the undergraduate degree, as well as in the entrance exam.
The student studies at the higher medical school for another four years. The first two years are spent exclusively in classrooms. Students listen to lectures, attend practical classes in general subjects: anatomy, biochemistry, physiology and others. Clinical practice in hospitals begins in the third year of study. Students go to the hospital, where they meet with patients for the first time. Practical lessons are divided into modules. Each module lasts from six to eight weeks and includes practice in one of the departments: surgery, therapy, pediatrics and others. The fourth year is also spent in the hospital, but now students can spend more time in those departments that are of the most interest.
Not all universities follow such clear rules. Some institutions admit their students to hospitals much earlier, but the course of lectures can last all four years.
After graduating from medical school, the student takes the United States Medical Licensing Exam (USMLE). This exam is tiered.
USMLE Step 1 is a computerized test that consists of questions in the subjects of the first two years of medical school.
USMLE Step 2, which is divided into two stages. Clinical Knowledge is a computerized test with questions in the subjects of the last two years of medical school. Clinical Skills is a practical exam in which actors take part in the role of patients with various diseases and conditions.
This exam is paid and takes place on certain dates. Retaking is also paid separately, and the difference between the dates of exams can be from several months to a year.
Postgraduate medical education
After successfully passing the first two stages of the USMLE, in order to become real doctors, students must complete an internship in their chosen specialty. For each specialty, the internship lasts a certain number of years, depending on the complexity of the chosen profession (therapy - 3 years, various types of surgery - from 5 to 9 years). The most successful students are accepted into the internship, who not only passed the exams perfectly, but also engaged in scientific activities during their studies, helped in hospitals in their free time, and also proved themselves in the workplace.
During the internship, young doctors take internal exams in their discipline, and after the internship - USMLE Step 3. After passing the last level of USMLE, interns receive a license, thanks to which they are officially considered practicing doctors and can work in their specialty throughout the United States.
Some specialties, such as neonatology, oncology, cardiology, require additional training called fellowship. This training lasts another 2-4 years.
Thus, medical training in the United States lasts a minimum of 11 years. If a practitioner decides to change his specialization or take a narrower direction, then he also enters fellowship and goes through the entire course of study with the rest of the students.
For foreign specialists
To work in the United States by profession, a Russian certified doctor must confirm his qualifications and obtain a license to practice medicine. This can be done in two ways.
The first way is to go to a higher medical school. Since training at the medical faculty of Russian medical universities usually lasts six years, a diploma in higher medical education in the United States will be equated to a bachelor's degree. That is, having a Russian diploma, you can skip a general four-year study. Also, having in hand a transcript of the grade book, you can go through a simplified training program in the medical school itself. For example, if at a Russian medical university the subject "Pathological anatomy" lasted 48 hours, during this time 2 credits and 1 exam were provided, and in an American university this subject is given only 24 hours and 1 credit, then the student does not need to repeat the course of pathological anatomy. have to. Or vice versa, if fewer hours were given to the subject at a Russian university, then they will have to be completed abroad.
However, not all American medical schools accept international students. It is worthwhile to study in detail the website of each university separately to find out about such a possibility.
Having selected medical schools that are ready to accept foreign students for training, you need to send a request to each of them (Requests for Application Materials). The educational institution will provide a list of documents required for admission, including the required TOEFL language test result, and will also offer a list of entrance exams, for example, MCAT (Medical College Admission Test). The presence of scientific papers will add additional points for admission to the university.
(In the photo Rogozov Leonid Ivanovich. Surgeon, member of the 6th Soviet Antarctic Expedition, in 1961, he underwent surgery for acute appendicitis himself.)
After enrolling in a medical school, a Russian applicant will have to study for three or four years (depending on the number of hours passed at a Russian university). During the training, preparation for the USMLE exams will be carried out on a par with American students.
In total, you will need at least three years of additional education and thousands of dollars to pay all expenses for education, housing, food, and so on.
Another way is to confirm your diploma and get a place in residency. But in this case, the candidate will have to independently prepare for the exams. From costs - the cost of the exams themselves and the cost of related needs.
The first thing to do in this case is to contact the Educational Commission For Foreign Medical Students (ECFMG) and find out if the Russian university is on the list of those whose diplomas can be confirmed in the United States. If it is, ECFMG will send out various brochures that tell you about the admission process. After submitting the documents, the Commission will send an invitation to USMLE 1, which can be taken in Russia. You can prepare for it yourself, using special literature or enrolling in the one-year Kaplan Medical courses, which are aimed at preparing for all parts of the USMLE exam.
After successfully passing the first two levels of the USMLE (USMLE 2 is held in some US cities), you can apply for residency.
Applications with test results and CVs can be sent to all clinics of interest via the Internet. After reviewing the application, the hospital invites the applicant for an interview. Further, all information about the results of interviews, the candidate's preferences in choosing a hospital, and vice versa, is sent to the American Medical Association (AMA - American Medical Association) for consideration and processing. After that, the computer produces a Match (a special program of combinations), and the applicant receives a list of places ready to accept it.
If the candidate did not enter the residency in the specialty of interest, and the number of places was limited, he can apply for admission to the residency in the less popular specialties with the largest number of places. Typically, job seekers find jobs in the "second wave".
If a foreign doctor has proven himself well during his residency, the hospital can guarantee him employment as a licensed medical specialist. This will help in obtaining a residence permit if he wants to stay in the country.
Let's start our conversation with the existing myths, the main part of which boils down to a couple of main stereotypes. The first stereotype: working as a doctor in the States is cool. Doctors make huge amounts of money, have complete respect in society, and are part of a social caste called the "cream of society." The second stereotype: it is impossible for an emigrant from another country to be a doctor in America. It’s as if foreign medical degrees are not recognized here, and the process of studying at medical faculties in America itself is so expensive that it’s scary to think about it. In fact, the situation is not quite as dire as they say.
Let's go straight through the statistics, which, as we know, are quite stubborn things. And she (that is, statistics), armed with numbers, says that now every fifth doctor in America is a foreigner, namely a specialist with a medical education received outside the United States. How did they do it?
It would be a great exaggeration to say that this is very simple. However, nothing is impossible.
Diplomas of medical institutions received outside the country, in the United States, are not that they are not recognized at all - they are recognized, but special confirmation will be required, and not formal, as a ton of additional certificates and confirmations, but the real thing, expressed in the amount certain knowledge and skills. In the United States, there is a structure called ECFMG (Educational Commission for Foreign Medical Graduates). From its name it becomes quite clear that it is engaged in confirming the qualifications of foreign doctors, in other words, it is a kind of filter. In order to be eligible to practice medicine, a foreign doctor must pass the USMLE licensed exams, which include two stages - Step1 and Step2. There is no discrimination - medical students from America pass exactly the same in the course of their studies, so here we are talking about the usual restoration of justice.
What are these exams?
Step1 is a standard computerized test consisting of questions in areas such as pathology, pharmacology, physiology, microbiology, anatomy (with a focus on neuroanatomy) and biochemistry, in addition to a special subject called behavioral science - a certain complex discipline that requires knowledge in the field of psychiatry, statistics and medical ethics. In addition, the test contains questions about interdisciplinary knowledge - genetics, embryology and molecular biology.
The exam must be passed in one day, seven hours are given for it (with a break of one hour). The questions (and there are 350 of them) are quite complex, and few people can answer everything. In practice, it can be seen that the correct answers to about half or a little more questions guarantee the minimum passing level. At the same time, the higher the result, the better the opportunity to get to work in a decent place.
In order to prepare for the exam, specialized literature is offered, which, of course, does not replace basic medical education, but allows you to master its format and eliminate standard errors. There is also an opportunity to buy a bank of template questions in advance (there are about 1500-2000 of them) and practice answering them using the Internet in real time. It is worth saying that the result pays off.
The one who went through the first stage will have to overcome the second. There are two parts to the Step2 exam, a theory part and a practice part. The first (Clinical knowledge) is 9 sections with 46 questions from such areas as surgery, pediatrics, therapy and gynecology. And the second (Clinical skills) is a simulation of a doctor's consultation. A future doctor needs to examine 10 "patients" - specially trained people who were tasked with simulating a certain disease - and then diagnose everyone and prescribe treatment, adding the necessary data to the medical history.
The level of knowledge of the English language does not need to be confirmed by any additional tests, although it is quite understandable that a low language level can be a significant barrier during the passing of all sections of the medical licensed exams.
But those who cope with them - and there are enough people like that - can be enrolled in residency (like our residency), that is, to start work in a clinic in which they will practice under the guidance of more knowledgeable doctors, receiving a salary ... The duration of the residency will depend on the specific specialization: family medicine, therapy and pediatrics - three years; radiology and anesthesiology - four years; surgery and gynecology - five years; neurosurgery - six years. After the end of the residency, you need to pass another exam, which also has a theoretical and practical part: a computer test of 480 questions and consideration of 9 clinical cases. Having successfully overcome the tests, the doctor receives a class "H" visa and the right to carry out medical practice, as well as continue his studies in medical graduate school.
So, we seem to have sorted out the myth about the unreality of becoming a doctor in the United States. And we can say that it is still possible and more than real. Difficult, but possible. It remains to be seen whether American doctors are really bathed in gold?
Their salary level is actually quite high: depending on the line of work, from 150 to 650 thousand dollars per year. The highest paid are anesthesiologists and radiologists, while pediatricians are considered “poor”. Even in the first year of residency, American doctors' salaries are kept at a level of at least 45 thousand per year. However, this ointment has its own fly in the ointment. As we know, no doctor is immune from making mistakes. However, in the United States, the whole matter is not limited to moral agony. A physician who has committed a medical error turns into a defendant in a lawsuit, and the amount of payments to the injured client (or his family) can reach quite astronomical proportions. So, doctors cooperate in insurance associations, and a fairly large part of the salary goes to pay for insurance. According to all-knowing statistics, the profit of doctors in the United States between 1995 and 2004 fell by about 7%. Perhaps everything is learned in a clear comparison. Therefore, even taking into account the cost of a decent life, high tax levies and insurance premiums, American doctors are definitely among the wealthiest classes of society.
