After the federal standard for third generation education comes into force in the Russian Federation, the approach to training future doctors will change. Since January 2016, internships have been abolished for those who have chosen dentistry and pharmacy as their specialization, and since 2017 – for pediatric and medical and preventive faculties. The innovations apply to those who have entered a medical school since 2013.
Choosing a medical university.
In 1876, the Association of American Medical Colleges was founded in Washington. Its mission is to improve health care and health care delivery through innovative medical education, advanced patient care and pioneering medical research. AAMC includes 145 American and 17 Canadian universities accredited in the field of medicine, about 400 large teaching hospitals and more than 80 scientific societies.
Traditionally, the best medical schools are considered to be colleges that are members of the Ivy League:
-Harvard University
-Yale University
-Columbia University
-University of Pennsylvania
And:
Johns Hopkins University
-Stanford University
-University of California and others.
You should also keep in mind that the cost of studying at the most prestigious universities will be much higher than at less popular ones.
Educational process
After graduating from high school, a graduate will not be able to immediately apply to the university for a medical specialty. Before this, he must obtain a bachelor's degree in any discipline, but preference is given to subjects as close to medicine as possible. This could be chemistry, biology, ecology or even environmental protection. Typically this training, called pre-medical study, lasts 4 years. Similar programs are offered by various colleges across the country. After four years of study in the pre-med program, the student takes the MCAT exam (Medical College Admission Test), after which he can apply to a medical university. Of course, each university has its own additional criteria for selecting students, but absolutely everyone takes the MCAT.
There are no direct medical universities in the USA - documents are submitted to regular universities accredited in the field of medicine (higher medical schools). Since there are not 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 completing their studies they will be able to remain working locally. Also important is a high score obtained in high school and during the period of undergraduate study, as well as in the entrance exam.
The student studies at a higher medical school for another four years. The first two years are spent exclusively in classrooms. Students listen to lectures and attend practical classes in general subjects: anatomy, biochemistry, physiology and others. Clinical practice in hospitals begins in the third year of study. Students enter a hospital where they meet patients for the first time. Practical classes 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 arouse the greatest interest.
Not all universities follow such clear rules. Some educational 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 multi-level.
USMLE Step 1 is a computer-based test consisting of questions covering subjects from the first two years of medical school.
USMLE Step 2, which is divided into two stages. Clinical Knowledge is a computer-based test with questions covering subjects from the last two years of medical school. Clinical Skills is a practical exam that involves actors playing the role of patients with various diseases and conditions.
This exam has a fee and is held on specific dates. Retaking is also paid separately, and the difference between exam dates can range from several months to a year.
Postgraduate medical education
After successfully passing the first two levels 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 internship accepts the most successful students who not only passed exams well, 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 pass internal exams in their discipline, and after the internship, USMLE Step 3. Having passed the final level of the USMLE, interns receive a license, thanks to which they are officially considered practicing physicians 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 USA lasts a minimum of 11 years. If a practicing doctor decides to change his specialization or choose a narrower direction, then he also enters the fellowship and goes through the entire course of study with other students.
For foreign specialists
To work in the States by profession, a Russian certified doctor must confirm his qualifications and obtain a license to practice medicine. There are two ways to do this.
The first way is to enroll in a medical school. Since training at the medical faculty of Russian medical universities usually lasts six years, a diploma of higher medical education in the United States will be equivalent to a bachelor's degree. That is, having a Russian diploma, you can skip the general four-year education. Also, having a transcript of the grade book in hand, you can go through a simplified training program at the medical school itself. For example, if in 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 is not required to take the pathological anatomy course again. have to. Or vice versa, if fewer hours were devoted to a subject at a Russian university, then they will have to be completed abroad.
However, not all American medical schools accept international students. It is worth studying the website of each university separately to find out about this opportunity.
Having chosen medical schools that are ready to accept foreign students, 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 when enrolling at the university.
(in the photo Leonid Ivanovich Rogozov. Surgeon, member of the 6th Soviet Antarctic Expedition, who in 1961 performed an operation on himself for acute appendicitis.)
After being admitted to medical school, a Russian applicant will have to study for three or four years (depending on the number of hours completed at the Russian university). During your studies, you will prepare for the USMLE exams on an equal basis with American students.
In total, you will need at least three years of additional training and thousands of dollars to pay all the costs of 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 prepare for the exams on his own. Costs include the cost of the exams themselves and expenses for related needs.
The first thing to do in this case is to contact the Commission that assists foreign medical students ECFMG (Educational Commission For Foreign Medical Students) and find out whether the Russian university is on the list of those whose diplomas can be confirmed in the United States. If accepted, ECFMG sends out various brochures that explain the enrollment procedure. After submitting the documents, the Commission sends an invitation to USMLE 1, which can be taken in Russia. You can prepare for it yourself by using special literature or by enrolling in 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 offered in some US cities), you can apply for residency.
Applications with test results and resumes can be sent to all clinics of interest via the Internet. After reviewing the application, the hospital invites the applicant for an interview. Next, all information about the results of the interviews, the candidate’s preferences in choosing a hospital, and vice versa, goes to the American Medical Association (AMA - American Medical Association) for consideration and processing. After which the computer produces a Match (a special combination program), and the applicant receives a list of places ready to accept him.
If a candidate has not been accepted into a residency program in the specialty of interest, and the number of places was limited, he can apply for admission to a residency program in less popular specialties with the largest number of places. Typically, applicants 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.
Medical education in the USA and the training system are not comparable with the program of Russian universities. American education is considered one of the best, after Great Britain and Canada. There are more than 120 medical educational institutions in America that are ready to accept not only their own applicants, but also foreign applicants. At the same time, the competitive basis for selecting students is the same for everyone. Only applicants with high academic performance can enter. For foreigners, the requirements are even higher; it is necessary to take language courses, pass a language exam, pass testing and only then submit documents to the university of interest.
Today, the most highly qualified universities with promising employment opportunities are:
● University of Rochester;
● University of Washington;
● Oregon Medicine and Science University;
● University of Iowa;
● University of Minnesota;
● University of California, San Diego.
Admission Requirements
To be admitted to a medical university, Russian applicants must pass the MCAT test and provide documents with academic grades. In order to take the test, you must contact a special center (not available in Russia). The “exam” is paid – $270. Lasts about 6 hours. The test program includes: an essay, an interview and answer questions on biology and physics.
On a note! The average cost of medical education is from $100,000.
Education system
Complete medical education in the USA includes: university, medical school and residency:
● University studies take about 4 years;
● Completing medical school takes from 4 years, while students listen to lectures and perform laboratory work for 2 years, then clinical practice begins;
● Residency – from 3 to 5 years.
Traditional training plan:
1. In the first year, students receive a general education program.
2. Second year - the following subjects are studied in detail: anatomy, pathology, pharmacology, physiology, biochemistry. Students undergo practical laboratory work in the anatomy laboratory.
3. The third year is clinical practice, where the student, under the supervision of an experienced doctor, consults patients. Moreover, the practice is carried out in several departments of the hospital: therapy, pediatrics, obstetrics and others. The student’s work includes collecting data (history) and a proposed treatment plan.
4. The fourth year – deepening clinical practice. Having tried himself in each department, the student can choose one direction and intern for a month.
After graduating from medical school and passing state exams, the university, based on the results of the final certification, assigns graduates to residency, the so-called postgraduate hospital training. It must be completed from 3 to 8 years. At the same time, competition for admission to residency is excessively high. The admissions committee selects the best students who have distinguished themselves during their studies or participated in volunteer programs.
Upon completion of education, the educational institution issues a diploma - MD. Some schools have an innovative “double degree” system - Doctor of Medicine and Doctor of Philosophy (MD/RhD). To obtain this type of diploma, you must complete training for 7-8 years. According to statistics, 90% of students receive a single diploma conferring the title of Doctor of Medicine. After completing all stages of training, you can officially work as a doctor in the USA.
Employment issue
Higher medical education in the USA provides its students with work without fail. The so-called ORT program is vocational practice. It is worth noting that this is a temporary job. The internship period is one year. After graduation, the student is offered the following opportunities:
● Obtain citizenship and get a job in the USA;
● Complete training at another university in a new specialty;
● Leave the country within 60 days after ORT.
According to American researchers, in the next ten years unemployment will overtake the following industries - medicine, engineering, education. Statistics and surveys also show positive results: unemployment among young professionals is 4%, among experienced doctors - about 2%. Salary is one of the highest from $48,000 to $64,000 per year. Therefore, we can safely say that large and small universities provide work for every student in the medical field, since the demand for specialists grows exponentially every year.
How to get a medical education in the USA?
How to become a general practitioner, dentist, surgeon?
This article was written for parents and future doctors themselves who dream of getting a medical education in the USA in order to become a PRACTITIONING DOCTOR there.
If you already have a higher education and have ALREADY graduated from any Russian/Ukrainian/Kazakh medical university,
then you need to refer to another article on our website:
And the material presented below contains information on how to “start from scratch”...
In the USA it is impossible to “become a doctor” right away. In principle, impossible!
First you need to obtain a Bachelor's degree in any discipline, but preferably in the natural sciences. The duration of undergraduate studies is usually 4 years.
IN PARALLEL with receiving a bachelor's degree, the student, IN ADDITION to the main program, enrolls in a program called Pre-Med.
Usually, students do not enroll in this program before the 4th or even the 5th semester of study.
For clarity, let’s look at obtaining a medical education using the example of one of the universities -
University of New Hampshire.
You can enroll in a bachelor's degree program, such as Chemistry or Chemical Engineering, or you can enroll in one of the Environmental Science programs.
While studying in these programs, you contact the university's Pre-Professional Health Programs Advising service, which will ask you a bunch of questions before giving you this advice... The main question: What kind of doctor do you want to become? Dentist or osteopath, or want to get another medical specialty? The exam you will need to pass after completing the Pre-Med course depends on the chosen medical specialty. For example, allopaths and osteopaths must take the MCAT exam, dentists must take the DAT, and ophthalmologists must take the OAT. Well, the type of exam determines the courses (subjects) that you will study in the Pre-Med program...
More information about the types of programs and corresponding courses can be read on the university website on this page. The duration of the Pre-Med program is unlimited in the sense that ONCE a student has completed all the required courses, he can enroll in the exams. This can be done in both the third and fourth year of study - here everything depends on the student himself - how quickly he “masters” the program.
A question that interests all students:
What to do if you fail the MCAT exam?
Here is the official response from our colleagues from the University of New Hampshire Pre-Med Advising:
“The exam can be retaken; this can be done an infinite number of times. However, you need to keep in mind that information about all retakes will be known to all medical schools to which you will be admitted, so we advise a) not to rush into taking the test and prepare better for it and b) we do not recommend retaking the exam more than 3 times once."
An important, very important and pleasant point:
additional classes in the Pre-Med program are absolutely free for all University of New Hampshire students! The student pays only for his main bachelor's program.
So, 4 years after starting your studies at the University of New Hampshire, you have in your hands everything that is necessary for admission to any medical school in the USA, namely:
* Bachelor's degree in Natural Sciences
* completed pre-med (or pre-dent) course with passed exams
To top it off, it is worth noting that these 2 points are complemented by excellent command of the English language (without which medical practice is, for obvious reasons, impossible) and experience in academic life. Are you ready for medical school!!!
You apply to medical school (either on your own or with the help of a university academic tutor) and wait for their admission decision. If the GPA (grade point average - academic performance) in the bachelor's program was high enough, and you passed the Pre-Med exams with a high score, then you are ALMOST guaranteed admission to one of the schools! This "almost" comes from the fact that some medical schools do not accept foreign students... But there are many others that are willing to accept foreign students! It goes without saying that the more prestigious the medical school, the more successful applicants they expect, so ultimately, success depends on you.
So, you received a bachelor's degree with a Pre-Med course, passed the exam and finally entered the coveted Medical School.
How many more years do you need to study there?
4 more years!
But that's not all!
After training you will have to undergo an internship (residency). Its duration also depends on your medical specialization. Here are examples of internships in various specialties:
Emergency medical services - 3-4 years
Family practice - 3 years
Pediatrics - 3 years
Gynecology - 4 years
Psychiatry - 4 years
General surgery - 5 years
Specialized surgery, including plastic surgery - 5-6 years (depending on specialization)
Urology - 5 years
etc.
So, above we described the path that needs to be taken in the USA,
to become a qualified, professional doctor.
If the path is clear to you, then now let’s dwell on the details and “little things”, which, as usually happens, frighten our compatriots when... “What to do” is already clear, but “How to do” is incomprehensible and scary...
STEP ONE.
We are collecting documents for admission to the University of New Hampshire. For admission you need:
1) School certificate. If a potential student is currently still studying in the 11th grade, then a transcript with grades for the last 3 years is first submitted, and the Certificate is sent in the summer. The class teacher can also write out the grades, the main thing is that there is a seal of the school and its (school) address.
4) IELTS or TOEFL certificate with the required score (minimum IELTS 5.5 or TOEFL iBT 69).
5) A copy of the first page of the passport.
6) Bank certificate addressed to the student or one of his parents (sponsor), confirming the availability of funds sufficient to pay for tuition and living expenses for one year. The amount in the account must be at least $46,000 (in any currency).
STEP TWO.
Sending documents for the PREPARATORY program to the university. Don't be scared by the word "preparatory". After completing such a program, a foreign student goes directly to the second year of a bachelor’s degree, that is, he does NOT lose a year of study at all! Why is she preparatory? Yes, because when applying to it, foreigners do not need to take the SAT exam (the American equivalent of the Unified State Examination, which Russian schoolchildren take at the end of 11th grade) and the level of English of a foreign applicant may be slightly lower than if they were admitted directly without such a preparatory course. Thus, a 3-semester Preparatory program will be taken with an English level of IELTS 5.5 or TOEFL iBT 69, and if the knowledge of English is higher (IELTS 6.0 or TOEFL iBT 78), then the duration of the Preparatory course will be shorter - only 2 semesters. IN ANY CASE, after the preparatory course, you (subject to its successful completion) are guaranteed to move on to the SECOND year of the bachelor's degree.
We left one of the main questions for last:
Why do we offer training in this area at the University of New Hampshire?
Here are a few reasons that tip the scales in favor of this university when choosing a university:
1. The University of New Hampshire is included in TIER-1 of US universities - this is the “major league” - the best universities in the country. They make up only 2% of the total number of universities in the country.
2. According to the 2011 U.S. rating. News and World Report University is ranked 47th among ALL American public universities!
3. Only THIS university and only 2 others (Harvard and MIT) have contracts and research funding from NASA! This fact speaks of the highest level of academic preparation of students and, accordingly, the level of teaching staff!
4. On the campus of this university, especially for foreigners, there is an admission program described above through the Preparatory Course without losing a year of study!
There are also a lot of other reasons, but the financial component, you see, plays an important role! The cost of training here cannot be called low, but it is not high either! For a university of this level, the price of tuition is more than normal and even competitive when compared with universities of a similar class! As of 2011-2012, the academic year of study for bachelor's programs was 28,570 USD for 1 year. Additionally, the student will need about 9.5 thousand dollars more for accommodation with meals and other expenses. Not much when compared with other prestigious universities in other regions. Why does it cost less money to live here? For one simple, but VERY pleasant reason... The state of New Hampshire has almost the lowest taxes (state tax) - only 8.0% and... NO sales tax AT ALL! We don’t know why New Hampshire gets such a preference... Maybe because it was the first state that at one time declared independence from Great Britain... Read more about the city in which the university is located and about the university itself on the Students International website this link.
Assistance in admission, preparation of documents, filling out all application forms, as well as visa support for admission to the University of New Hampshire will be provided to you by the Students International Study Center.
In addition, you can contact any of the company’s many offices located in various cities of Russia, Ukraine and Kazakhstan.
OR WRITE TO US WITH YOUR QUESTIONS ONLINE:
Long road to diploma
In the USA there are about 120 medical schools or medical universities, as they would say in Russia. Let me remind you that only students with the best grades are accepted into medical schools.
Each of them sets its own standards and selection procedure. The Medical School Admission Requirements directory is published annually, containing a set of requirements for admission to each medical school and statistics on the results of last year's entrance exams. But the MCAT admissions test, developed by the AAMC in collaboration with medical schools in America and Canada, is the same for all applicants. We have already talked about it.
Some schools offer a dual degree program MD/PhD (Doctor of Medicine/Doctor of Philosophy). However, about 98% of all medical graduates receive one degree - MD. There is also an MD/MBA diploma (Doctor of Medicine/Master of Business Administration) - medicine plus business, but this is even less common. The duration of training for an MD/PhD is 7-8 years, which is approximately twice as long as for an MD.
The best medical universities in the USA are:
- University of Washington;
- Oregon Medicine and Science University;
- University of Minnesota;
- Michigan State University College of Osteopathic Medicine;
- University of California, San Diego;
- University of Wisconsin;
- University of New Mexico;
- University of Rochester;
- University of Iowa.
Traditionally, medical school education lasts 4 years, half of which consists of lectures and laboratory work. Then - the same amount of clinical practice.
The first 2 years study anatomy, biochemistry, pathology, physiology, pharmacology, histology and microbiology. The most impressive thing at this time was the first experience of working in an anatomical laboratory.
In the third year, during clinical practice, the student encounters a patient for the first time.
The year is usually divided into several periods: the student attends the departments of pediatrics, internal medicine, surgery, obstetrics and gynecology, psychiatry and family medicine. Each period lasts 6-8 weeks, and each student, under the supervision of doctors, provides care to hospitalized patients. The job includes taking a medical history, performing an examination, and creating a list of possible diagnoses and treatment plans.
During the fourth year the student's scope of practice increases, he is given greater responsibility towards the patient and works through a series of month-long courses in areas of greatest interest. For example, a student interested in pediatrics might spend one month of training in the pediatric cardiology department.
Some medical schools do not follow this traditional curriculum and instead have a more integrated learning experience. Students begin clinical practice much earlier, studying and attending lectures throughout all four years.
8 years after graduating from High School, it’s time for residency. After receiving their diploma, students take the state exam - USMLE. Based on its results, they are assigned to a residency - an analogue of the Russian residency, only taking more years. Residency in the USA is postgraduate hospital training for doctors, providing specialization for one year as an intern and for 3 to 8 years as a resident.
For example, students interested in pediatrics apply for residencies at children's hospitals, and those interested in becoming surgeons apply to surgical departments at university hospitals. Admission to residency, like medical school, is a highly competitive process. Admissions committees select students with the best grades and also look favorably on those who have volunteered and assisted others in academic work and who perform well during the interview process.
During residency, the young specialist is hired by the hospital, receives a salary, works about 60-80 hours a week and provides care to both hospitalized and outpatient patients, but under the supervision of a more qualified physician.
The resident may be the first doctor to contact the patient, but before starting treatment he seeks the advice of a more experienced colleague.
Upon completion of this level of specialization, the graduate becomes a fully licensed physician. He can work as a therapist and provide assistance in private practice. For example, a pediatric residency graduate may work as a pediatrician in a clinic as part of a pediatric team. An alternative may be to obtain additional, highly specialized education in a specific area. Then it is called “fellowship” and includes training for another 3-6 years. For example, after completing a pediatric residency, a young physician may choose to pursue an additional four years of training to become a gastroenterologist.
The general picture of obtaining permission to practice independently is approximately as follows. If you are going to work in emergency medicine, it will take 3-4 years; engage in family practice or pediatrics - 3 years. Gynecology and psychiatry will take 4 additional years. Urology and general surgery - 5 years each. Specialized surgery, including plastic surgery - 5-6 years (depending on specialization). And if you dream of becoming, for example, a cardiologist, add 7 years, a neurosurgeon - 8 years.
After this stage comes the “last battle”. He is, accordingly, “the most difficult.” The doctor passes a difficult exam and finally receives the degree of Doctor of Medicine - MD (Medical Doctor). After this, you can work as a doctor in the USA.
An important difference in the American medical tradition
I would like to draw the attention of Russian readers to the fact that in the United States there is a practice when they treat not the whole person, but their individual organs. Treatment is left to “narrow” specialists who pay attention only to what is the object of their professional qualifications, without noticing the rest of the body.
A distinctive feature of American medicine is the special personal relationship between doctor and patient. The patient is considered a partner of the doctor, his condition is explained to the patient in detail and his opinion is listened to when choosing treatment tactics. The patient's opinion in assessing the quality of medical care is given great, sometimes excessive, importance. This situation, according to a number of experts, leads to a distortion of the assessment, since the patient is always subjective and is not always able to objectively assess the quality of service. This state of affairs is most likely due to fear of lawsuits.
Paul Frumkin, USA
(to be continued)
Medical education in the USA and its structure differs significantly from the education system that is accepted in Russia and Europe. The learning process for a student who decides to get a medical education lasts 11-13 years. Schematically it looks like this: university (4 years) - medical school (4 years) - residency (3-5 years).
Admission to a US medical university or medical school
To enter a US medical university or medical school (Medical School), as they are called there, you must obtain a bachelor's degree from any university, additionally taking several courses in chemistry, biology and physics. Then you need to submit an application to the selected Medical School. The medical profession in America is considered prestigious and the competition in medical schools is quite serious.
The training program at the Medical School lasts 4 years, 2 of which students attend lectures and perform laboratory work, and the next 2 undergo clinical practice. At the medical school, students are given lectures on anatomy, physiology, biochemistry, histology, pathology, microbiology and pharmacology. They visit the anatomical laboratory and the most impressive action at this stage of training is the first experience of independent dissection of corpses.
During clinical practice, students have to deal with hospital patients. Students practice for 6-8 weeks in different departments of the hospital, where, under the supervision of a doctor, they provide care to hospitalized patients. During their internship, they manage to work in the departments of pediatrics, surgery, psychiatry, internal medicine, family medicine, obstetrics and gynecology. In the third year of study, students are entrusted with a physical examination, collecting anamnesis (information about the patient obtained through a survey), compiling a list of probable diagnoses and possible treatment plans. During the final year of study, students have the opportunity to work in a series of month-long courses in areas of greatest interest to them. For example, a student planning to study pediatrics can spend one month of study in any children's department. At this stage of training, the scope of practice increases, as does the responsibility of students to patients.
Residency in the USA
Getting into residency is just as difficult as getting into Medical School. Preference will be given to candidates who have the highest grades, have worked as volunteers or have participated in scientific work, and those who perform well in the interview. During residency, students study only the area of medicine that interests them most.
The best medical universities in the USA are:
- University of Washington;
- Oregon Medicine and Science University;
- University of Minnesota;
- Michigan State University College of Osteopathic Medicine;
- University of California, San Diego;
- University of Wisconsin;
- University of New Mexico;
- University of Rochester;
- University of Iowa.
To be admitted to a US medical school, Russian applicants will need to take the MCAT (Medical College Admission Test) and submit a document with their academic grades. The cost of such a test is $270. It lasts 5 hours 45 minutes, during which the applicant is asked to complete 4 tasks. He must answer questions on biology and physics, pass an interview and write an essay on the topic: why he wants to study in the USA and why at the chosen university. Testing takes place in specialized centers, of which there are about 600 in the world, but in Russia, unfortunately, there is not a single one.
The total cost of medical education in the USA can be $100-150 thousand.