Medical Education in the USAJuly 4, 2012
Medical education in the United States is highly prized, with schools such as Harvard Medical School among the top medical schools in the world. United States medical education follows a similar path to other countries, but without a state-funded healthcare system, it is also highly expensive. However, bursaries, grants and scholarships provide medical students from low-income backgrounds with opportunities to enter the profession. In the United States, there are two types of medical doctor, the MD (Medical Doctor) and the DO (Doctors of Osteopathic Medicine). Both types of doctor are equally qualified to practice all aspects of medicine and have to go through the same rigorous education program.
As with other countries, medical education in the United States starts at medical school. Because of the highly competitive nature of medicine in the United States, most medical schools expect undergraduates to have completed either a previous degree or at least three years of pre-med courses at university level. Medical schools divide a student’s time into theoretical, pre-clinical training, where students learn all the basic medical knowledge required to practice medicine, and clinical training at teaching hospitals, where students first interact with patients. It is here that medical students, under strict supervision, begin to learn the processes of diagnoses and treatment. Both MD and DO degrees take four years, but success at medical school is only the first step to becoming a licensed professional.
Following graduation, all medical school students are expected to take part in an internship before being able to practice medicine. Internships are a one-year program where graduates work under the supervision of qualified practitioners in hospital or medical center environments. During internships, most graduates take either the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) in order to qualify to practice general medicine. Only after successfully passing these exams and completing an internship, is a graduate licensed to practice medicine. Increasingly, internships are becoming less common with first year residencies taking over many of the aspects of an internship.
Residencies are for graduates wishing to enter a field of specialization, and involve continued supervision in a medical setting. These can vary from another couple of years to a further seven years of training, depending on the specialization. Residencies are notoriously hard work with long hours and shifts extremely common. Residents perform all the same tasks as qualified medical practitioners, but work under supervision. Many medical settings such as hospitals and urgent care centers rely heavily on residents to provide much of the day-to-day healthcare for patients. After completion of a residency, further formal training is required for certain specializations, such as surgery or cardiology. This additional training is known as a fellowship and these can also take several years. Even after completion of a fellowship, before a doctor can practice his or her chosen specialization, further examinations are required. These are both written and oral, but once passed they enable the resident to become board certified, entitling them to work in his or her chosen field of specialization.