Process of becoming a physician in the USA plus some advice...

doctalk101
Aug 21, 2023
4 min read

Updated: Sep 3, 2023

What are some reasons people become physicians?

Interest in subjects of science and medicine, such as anatomy, physiology, medicine(subspecialties), OB etc.

Respectable/prestigious

Good income

Challenging

Sick family member lead to interest in medicine

Good employment prospects

Variety practice settings: hospital, clinic, solo, group, industry, consulting.

How do you get there?

Most will be working on a bachelors degree

Take MCAT(Medical college admissions test) towards end of third year, this is much tougher then SAT/ACT, there is a new version since 2015 with a different scoring system

Apply to medical schools in fourth year

Interview and admissions on rolling basis.

Some people who do not get in do research etc and apply again

There are combined programs where you are accepted to both undergrad and med school (you need to take the required undergrad course work and maintain a certain GPA, then automatically start med school, usually after 3 years.) If you know that this is what you want to do you may save 1-2 years of additional college.

I got in, now what? There are a lot of different curriculums out there but generally the first two years are considered the basic sciences, ie anatomy, physiology, pathology, microbiology etc. Some schools will incorporate some clinical work/experience in the early years.

Then you take USMLE step I exam, you have to pass this before starting clinical rotations (2 day exam). The last two years are clinical rotations, here you will work with residents and attendings to see patients in the core medical fields, eg internal medicine, surgery, ob-gyn, family medicine, and pediatrics. Before you graduate from medical school you take USMLE step II. Apply for residency in 4th year and start in your chosen specialty in July after graduation. Residency is anywhere from a minimum of three years to five years, some people may have a 1-3 year fellowship.

It's a lot of work, only 3wks vacation, and may only have 2 weekends off in a month and may work more then 80hrs/week in the early part of training. Usually after 1st year residency you take USMLE step III. After you pass and finish 1 year residency then one can apply for a license. After you graduate from residency become board eligible, and you take the board exam in your specialty to be board certified. You need this last step to have the flexibility to work anywhere and to sign up with insurance companies for payment.

Summary To get through all this you need intelligence, perseverance, patience and a little luck…to name a few. Bachelors+MD+Residency = (3 to 4)+(4)+(3 to 5)=10 to 13 years

Exams: SAT, MCAT(huge jump up), USMLE I, II, III, IIcs, board exam, medical law exam

Do not do this just for the money, you need to enjoy what you do or a least be good at it! So among all these tests and rankings the focus eventually has to shift to what it is that you now have the skills to do, which is taking care of the patient. What can you expect: salaries can be from $150,000 to well over $300000 depending on specialty. Once you finish it is just the beginning of your responsibilities. You need to be a strong person with most everything falling into place as outlined. If you have an illness, personal issues etc. you may not make it thru, and I’m not kidding. Practice types and settings are for another discussion.

There has been a lot of talk about burnout, frustrations etc also for another

discussion, but if we can hold on to a practice model that is taking care of a real illness and not get sucked into some manufactured business, then it can be rewarding. There are so many conditions that are treatable, there are many cases where you increase the lifespan of a person! Medical breakthroughs with some of the oldest being vaccines(have eradicated many diseases such as polio), antibiotics(completely reverses cellulitis), anesthesia, lasik surgery (one I had done and can see 20/20 at age 40) are just a few examples. Radiology, where we can see inside the body to a few millimeters is absolutely amazing. With the experience of having gone through this I can give numerous examples of good outcomes. There can be negative consequences, the dark side to medicine, but the appropriate use has saved countless lives and as a medical profession we should not forget that. In addition patients and the general population have to be educated. Hopefully all those physicians and patients can stick to their integrity and find solutions instead of being pulled by too many outside influences. Respect is deserved and should be demanded.

The US must be able to come up with a reasonable solution to insuring patients. Physicians, other healthcare workers, and administrators must do their job to promote better healthcare policy and also cost contain. It is much more expensive then exercising and having a proper diet so patients also need to do their part.

With that being said no one wants to be sick but it happens to all of us at some point in our lives. I was blessed to be healthy for most of my life and even I had a few unexpected bumps. My advice below got me back on track with the help of family after some much needed rest.

Have exposure to the profession by shadowing someone, do volunteer work in a hospital or clinic, and research is also helpful in this competitive world. There is information online. When I was a student I would occasionally read sites such as studentdoctornetwork.com and look at forums especially about the application process. If you are in collage there will be some type of premed club. Besides the basic requirements it is a good idea to take at least some electives in say anatomy & physiology, biochemistry, or microbiology if you are not a biology major. The pace is fast and furious and taking some science courses makes it easier to understand and memorize the material once you start medical school.