Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (3): 160-163.doi: 10.6040/j.issn.1673-3770.1.2019.034

• Overseas Communication • Previous Articles     Next Articles

US Medical Education and Training

Jing SHI   

  1. Yale New Haven Hospital, New Haven, CT 06510-3202, United States
  • Received:2019-04-10 Revised:2019-05-01 Online:2019-05-20 Published:2019-08-07

Abstract:

Physicians are privileged to hold one of the most prestigious careers worldwide. People are always reliant on physicians′ expertise; their skills, knowledge, dedication and compassion are all important factors that influence the decision-making process when dealing with health issues, or even with life and death. However, the education, training and licensure requirements for physicians differ significantly across the world. For example, most countries allow candidates to apply to medical schools right after high school graduation; whereas, in the United States, candidates can only apply to medical schools after four years of college. If you are a foreign medical graduate or one who is not currently in the medical field but have aspirations to practice medicine in US, the sophistication of the US medical education system may be confusing. To help people understand the journey of becoming a physician, this article will serve as a basic overview of the US medical education system. Although the journey is long, the reward is priceless.The US has more than 140 medical schools and thousands of graduate medical programs dedicated to educating future physicians. To become a physician in US, there are many steps to follow: candidates must apply to medical school after four years of college; take the USMLE (United States Medical Licensing Examination) step 1, step 2 and step 3 tests; go through a match process to find an ideal training program during senior year of medical school; and undergo GME (Graduate Medical Education) training, which varies depending on specialty, before finally receiving board certification. As one can see, the time commitment to becoming certified is extremely rigorous, and takes about 7-11 years after college. However, it doesn′t just start after college graduation. You must be preparing your medical school application since day 1 of college life, since the MCAT (Medical College Admission Test) involves science and medicine-specific knowledge. If your college major is more focused on the liberal arts, then you need to take some elective classes to meet the minimum science requirements. Even after successful admission to medical school, students need to start preparing for their USMLE tests and participate in medical research, if possible, which will help to increase their chances of matching into a better program for training. The match process is extremely stressful and unpredictable. Foreign graduates who are ECFMG (Educational Commission for Foreign Medical Graduate) certified can apply to match as well; however, there are usually fewer programs open to ECFMG applicants. Because government funding is GME's major source of funding, there is a cap to the number of residents and fellows each teaching hospital can have before they are required to pay out of pocket. If residents or fellows want to switch specialties, they need to reapply next year and receive training again in their new field. ACGME (Accreditation Council of Graduate Medical Education) established the standards for each program, and the skills, knowledge, professionalism, communication, and empathy are required before any physician can practice independently. In general, medical education in the US involves multiple years of formal training and standardized examinations before you can become an attending physician. However, medicine is an ever-changing field. Even after you become a board certified physician, you still have CME (Continue Medical Education) tests to complete every year. Learning is truly a lifelong aspect in the medical occupation.

Key words: Medical education, Residency, Continue medical education

Table 1

List of specialties with length of residency"

Programs of TrainingYears of Training
Anesthesia4
Dermatology4
Emergency Medicine4
Family Medicine3
Internal Medicine3
Neurology4
Neurological Surgery7
Thoracic Surgery6
Obstetrics and Gynecology4
Ophthalmology4
Orthopedic Surgery5
Otolaryngology5
Pathology-Anatomic and Clinical4
Pediatrics3
Plastic Surgery6
Physical Medicine and Rehabilitation4
Psychiatry4
Radiation Oncology5
Radiology-Diagnostic5
Surgery5
Urology5
Vascular Surgery6-7
Medical Genetics4
Nuclear Medicine4
Prevention Medicine3

Table 2

Examples of internal medicine subspecialties and length of additional training"

Cardiovascular Disease+3 years
Clinical Cardiac Electrophysiology+1 year
Critical Care Medicine+2 years
Endocrinology, Diabetes and Metabolism+2 years
Gastroenterology+3 years
Geriatric Medicine+1 year
Hematology+2 years
Hematology and Oncology+3 years
Infectious Disease+2 years
Interventional Cardiology+1 years
Nephrology+2 years
Rheumatology+2 years
Pulmonary Disease and Critical medicine+3 years
Allergy and Immunology+2 years

Table 3

Example of Cardiology rotation schedule"

7-8:30 am New patient assignment, assign coverage, pre-round; be sure to review telemetry of all patients and print any EKGs from overnight to discuss on rounds

8:30 am rounds; Rounds starting at the discretion of attending cardiologist, usually between 8-8:30 am

12 pm Noon conference

1:15 pm Care coordination rounds

Sign out between 6-6:30 pm

Weekly Conference:

Cardiology grand rounds: Tuesday 8-9 am

Echocardiography conference: Tuesday 12:15-1 pm

Electrophysiology conference: Thursday 7:30-8:30 am

Electrocardiography conference: Friday 7:30 -8:30 am

Imaging conference: Friday 12-1 pm

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