MedConnect

You read the title right. There’s only eight steps keeping you from becoming a doctor in the US. It’s simpler than it seems—on paper, though. At the very least, an American doctor will spend four years earning their undergraduate degree, another four earning their doctorate, and three finishing their training in residency. That’s eleven years. With most high school students graduating at age eighteen, that means the youngest fully licensed physician would be around twenty-nine years old. It’s a long journey, and it’s one worth looking through with a fine-tooth comb. The process can be complicated and difficult to understand, however, so that’s what this article is here to help with.

The first step is the most important. Before you even fully commit to becoming a doctor, spend some time getting to know the field. This means: taking classes that will challenge you, to see if the educational burden alone is bearable; listening to or conducting your own interviews with physicians (which you can access for free here on the MedConnect website); and getting some clinical experience. The latter is perhaps the most broad, but some common avenues include shadowing and volunteering at a private practice or a hospital. The allure of a medical career is enticing, but it can be just as misleading. That’s why it’s so crucial to give yourself a better idea of what’s to come. It’ll save you a lot of time down the line if you realize now that this isn’t the job you’ll be happy with. But if it is, you’ll also learn early how experienced professionals deal with the uglier sides of their work.

Now that you know what you’ll be getting yourself into, it’s time to start searching for colleges. Ignore a university’s prestige—completely and totally. This isn’t law—it’s medicine, and you don’t need to get into a T14 school to secure a job at a competitive firm. Your goal is to learn how to heal. But that’s not to say that you should ignore the nation’s leading schools altogether. Many have large endowments allocated towards exciting research, and professors picked from the world’s finest experts across various fields. So make this decision as you would any other—by objectively weighing the university’s opportunities and down-sides. Also consider that you can pursue baccalaureate-MD programs, which condense under- and post-graduate studies into seven years of schooling at one institution.

Once you’re in your chosen university, it’s time to settle into the routine you’ll be following for the next four years. Primarily, focus on your studies. Medicine is a profession for lifelong students, and med schools only want to consider accepting applicants that succeed academically. So, pass all your classes while sticking as close as possible to a 4.00 GPA. It is for this reason that your choice of major should be one that you are genuinely interested in—the greater your enjoyment of what you’re learning, the more likely you are to perform at your best. But, keep in mind that, while med schools don’t usually require specific majors from applicants, they have a list of classes that must be taken and passed prior to admission. They vary by school, but commonly are:

• One year of biology with labs
• Two years of chemistry with labs, including general, organic, and biochemistry
• One year of English
• One class in genetics
• One year of math, ideally with calculus and statistics
• One year of physics with labs
• One psychology course
• One sociology course

To access the requirements of specific med schools, you can visit the Medical School Admission Requirements database from the Association of American Medical Colleges. Many of these classes also fall in line with the topics covered in the Medical College Admission Test (MCAT) that all pre-med students must pass before being admitted to med school. This is an exam that covers: biology and biochemistry; chemistry and physics; psychology and sociology; and critical analysis and reasoning skills. Med school requirements and the MCAT are why many pre-med students flock to a select few majors. Ultimately, however, your choice depends on how you prefer to structure your education and schedule, especially given the many extracurriculars (ECs) that a pre-med student needs to tend to. Nowadays, community service and clinical experience are must-haves, with competitive applicants having hundreds of hours dedicated to these. Across four years, however, these numbers all break down to a few weekly hours of commitment. Suppose that, per week, a student spends two hours volunteering and another two shadowing. After a month, they accumulate about eight hours for each. By the end of the first year, both would total out to ninety-six hours. But, in the interest of not over-estimating, let’s round to two rough estimates of eighty hours. If a pre-med student sticks to this, they could finish earning their bachelor’s degree with 320 hours of community service and another 320 hours of shadowing—from a measly two hours devoted to each every week. That leaves a lot of time to get involved with other ECs. However, it’s important to note that you should only pursue ECs that you will be able to get something out of. For instance, research is a soft requirement at many med schools, so it can feel as if any degree of involvement will look strides better than none. But you shouldn’t join the teams whose investigations barely inspire any enthusiasm. Rather, focus on those that pique your curiosity so that you are more likely to contribute meaningfully. Simply put, it comes down to one principle—quality over quantity. Choose the ECs that will allow you to truly make a difference in your life, the lives of others, or your community. Your undergraduate years are about succeeding holistically, dedicating yourself to strengthening your resume to present med schools with the most competent and able version of yourself.

The next step you’ll take is to apply to med schools. However, it’s completely fine to postpone this and take a gap year after you finish your bachelor’s degree. Many successful doctors do it because of how much pressure it can lift off their shoulders. Without the worry of school, you can dedicate yourself to that aforementioned self-development, taking time to involve yourself in research, shadowing as much as possible, or even studying to get your best MCAT score. But once you’re ready, you’ll start applying to med schools. For students that aren’t taking a gap year, this is done towards the end of the undergraduate junior year in order to attend the fall after receiving their bachelor’s degree. The process will seem similar, as you’ll once again start by researching universities. Take a moment to decide between MD and DO schools, and whether you want to attend an institution with a greater focus on research or primary care. Being early is once again key, since it ensures you have time to properly communicate who you are and what distinguishes you from other applicants. In the case of rolling admissions, too, finishing your application early can even give you a greater chance of acceptance. After you apply, impressed schools will send you a secondary application, where you’ll be asked much more specific and refined questions. These help narrow down the applicant pool for med schools to then choose who to interview. These interviews are especially important. It’s here that you can make or break your acceptance, so prepare well and give it your best. Remember, though, that getting an interview is a great sign in the first place. You managed to impress the school twice to even be invited.

After you’ve enrolled in med school, your post-graduate education will begin. Each year of this stage is referred to as “MS” followed by the year in progress. MS1 and MS2 consist of traditional classroom learning, while clinical rotations comprise MS3 and MS4. The first half of med school gives you the theoretical foundation to practice medicine, while the last half builds practical knowledge. Each year will inch you closer towards becoming a doctor, culminating in MS4’s sub-internship rotations. Because the next step in your journey is residency, this last set of rotations will give you a better idea of which programs to apply for, while serving as a way for institutions to gauge how well you fit into their programs. The rotation years can be difficult, as you’ll have to study and pass tests while spending most of your time in a hospital or clinic. Further, significant portions of your grades are subject to evaluations from physicians you will be working under. Another trial you’ll have to endure are the USMLE or COMLEX-USA licensing exams for MDs and DOs, respectively. Both are three-stage exams that can be even more difficult than the MCAT. In general, you will take step one—their first stages—in the first half of med school, and step two in the second half. During MS4, you’ll also start applying to residencies through the National Resident Matching Program. Like with med school, you will be invited to various interviews. Afterwards, both you and the institutions will submit rankings of the most-liked programs and applicants, respectively. As the name implies, the Match Program then uses these lists to match students to residencies.

It’s as a resident that you’ll really start practicing medicine for the first time. You are now a doctor, and, although you will still be learning, you’ll be sitting more in the co-pilot’s seat than the backseat. These programs are incredibly difficult to persevere through, however. Residents are worked thoroughly, with some having little room for a personal life. Only those who have truly and fully committed to their careers will submit themselves to the most intense programs. The length of a residency is also taxing—the shortest ones are three years long. Many go on for more time, with some extending all the way to seven years. Even though programs are typically by specialty, the training is structured in a funneling spiral of rotations. Much like during MS3 and MS4, they work their way down in breadth. You’ll cycle through various specialties in the first year and continually move closer to what you have chosen. Residents may also participate in elective rotations, wherein they can expose themselves to sub-specialties to pursue later on. By now, though, you might be wondering what happened to the last stages of the USMLE and COMLEX-USA. Don’t think the tests forgot about you. Doctors take step three in the first year of residency. There is a distinction between a physician’s MD or DO doctorate and their MD or DO license. The latter allows you to practice what you learned through obtaining the former, albeit, by itself, not on your own in most cases. After passing the USMLE or COMLEX-USA, you earn that license. There is one last part of residency to cover. Towards the end, doctors can be appointed chief residents of their programs. This is a prestigious position, as the physician will be responsible for all the residents of their program, recruiting, training, and guiding them. In some cases, they may even hold a say in how they are trained. Even though chief residents are still only residents, their place in the hospital hierarchy can open many doors to further leadership opportunities.

Following the end of residency, doctors have the option of sub-specializing. This is done through a fellowship, which builds on what a physician just finished learning. These programs offer highly technical training and usually last one to three years, but can certainly go on for longer. Some example fellowships include skull-base neurosurgery, pediatric anesthesiology, and sleep medicine. Because of how particular this kind of training can be, there are many different fellowship programs available to explore. They are never strictly necessary for a doctor to undertake, however. A fellowship is only an extra step between a doctor and the finish line, taken if required by an interest in a sub-specialty.

At this point, there is only one last hurdle to clear—board certification. You will once again face an examination, but this time it will come from a specific specialty branch of the American Board of Medical Specialties. Once you pass it, however, you’re done. It is at this point that you are finally an attending physician, an independently-practicing and fully-licensed doctor. Your journey doesn’t end here, though. Medicine constantly evolves. As mentioned earlier, doctors are lifelong students. New studies will be published, new techniques will be conceived, and new tools will be invented. It is your responsibility to keep yourself familiar with all of these developments as they come. It is your responsibility to continuously give your patients the best care available.

References

1. Crouch, Maddy. “Everything You Need to Know Before You Become Chief Resident.” MedStudy, 08 March 2023, https://explore.medstudy.com/blog/role-of-chief-resident-tips-for-your-new-position#:~:text=What%20is%20a%20chief%20resident,new%20doctors%20to%20the%20program.
2. “High School to Doctor | Physician/Surgeon Training Overview 👩‍⚕️👨‍⚕️.” YouTube, uploaded by Med School Insiders, 11 January 2020, https://www.youtube.com/watch?v=FY-Z6dWGCtU.
3. Kowarski, Ilana. “How to Become a Doctor: A Step-by Step Guide.” USNews, 30 November 2020, https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/how-to-become-a-doctor-a-step-by-step-guide.
4. Kowarski, Ilana. “How to Fulfill Med School Admission Requirements.” USNews, 25 August 2022, https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/how-to-make-sure-you-fulfill-medical-school-requirements-for-admission.
5. “Medical School Timeline.” American Osteopathic Association, https://osteopathic.org/students/osteopathic-medical-school-timeline/#:~:text=Take%20COMLEX%202,fourth%20year%20of%20medical%20school.
6. “What’s on the MCAT Exam?” AAMC, 2020, https://students-residents.aamc.org/media/9261/download.