Becoming an MD or DO


The typical physician completes a 4-year undergraduate degree usually in Biology or Chemistry; however any major is acceptable providing all prerequisites have been met.  The undergraduate degree is followed by 4 years of either medical or osteopathic school, followed by a minimum of 3 years of residency training (for a list of common residency lengths click here).  This is equal to a minimum of 11 years after high school.

Medical School

The first two years (didactic) of medical school involve intense study in the basic sciences.  This is mainly performed in the classroom.  There is little patient contact, learning about disease, or time spent in the hospitals or clinics.  Many medical schools are now looking into ways in which they can make these first two years more relevant.  The third and fourth years of medical school are spent in hospitals and clinics where an “on-the-job” type of format is used.  The medical student evaluates patients, and with the help of resident physicians and staff physicians, develops treatment plans and performs procedures.  Different areas of medicine are explored through 1-2 month long rotations.  The student is part of a team composed of other medical students and resident physicians directed by a staff physician.  Students work weekends and spend some nights on call in the hospital.  A written test typically follows each rotation.

During your third year of medical school, you must decide which medical specialty area you would like to purse.  Once decided, you apply for a residency program for your chose specialty.  The early you decide which specialty you would like to pursue the better.

Residency

Following the completion of medical school, you are an M.D. or a D.O. and now carry the title doctor.  However you cannot practice medicine in the United States until you have completed one (realistically, three) years of residency.  The first year of residency is the “intern” year.  Residencies are intense and take place in large hospitals.  Training involves days, nights, weekends, and holidays.  As much as every 3rd night is also spent “on-call.”  Typically 2 weeks of vacation are given per year.  During the residency,  specifics on specialties are learned.

Residency Lengths

Primary Care Residencies:

Primary care refers to the physician who controls your access to medical care.  A primary care physician is often referred to as a “gate keeper.”  In the United States, a nurse practitioner and a physician assistant can also be a primary care provider.

Family Practice:  3 years
Internal Medicine:  3 years
Pediatrics:  3 years

General Internal Medicine Subspecialties:

These specialties do not involve any surgery and require the completion of a 3 year general internal medicine residency prior to starting the subspecialty training.  The additional training for these subspecialties is referred to as a “fellowship” and training programs are applied for in the same manner as a residency.


Allergy and Immunology:  2-3 years
Cardiology:  3-5 years
Endocrinology:  2-3 years
Gastroenterology:  2-3 years
Infections Disease:  2-3 years
Nephrology: 2 years
Oncology: 2-3 years
Pulmonary Medicine: 2-3 years

Surgical Subspecialties:
General Surgery:  5 years
Colorectal Surgery:  6-7 years
Neurosurgery:  7-8 years
Otolaryngology:  4-5 years
Plastic Surgery:  6 years
Thoracic Surgery:  7-8 years
Urology:  5 years
Vascular Surgery:  6-7 years

Other subspecialties:
Anesthesiology:  4 years
Dermatology:  4 years
Emergency Medicine:  4 years
Medical Genetics:  4 years
Neurology:  4 years
Ophthalmology:  4 years
Pathology:  6 years
Physical Medicine and Rehabilitation:  4 years
Psychiatry:  4 years
Radiology:  4 years

It is important to understand that residencies and fellowships provide financial support for their students that culminates with years after graduation PGY-1 for example stands for post graduate year one, they may have a salary for the year of around $50,000.  A PGY-7 may have a salary of slightly more, perhaps around $60,000.

MD/PhD Programs

Many medical schools offer joint programs where a student can simultaneously earn an M.D. and Ph.D.  These training programs emphasize research and prepare students for research and teaching careers as opposed to clinical careers in medicine.  Graduates of these programs are typically employed in medical schools, research facilities, and pharmaceutical companies.  Depending on the situation, these physicians have little or no patient contact.  They usually do not complete residencies.

D.O. vs M.D.

There are two ways in which one can acquire the education necessary to become a physician and practice medicine in the United States.  The most common route is to obtain an M.D. (Doctorate of Medicine).  The other, less common, alternative is to obtain a D.O. (Doctorate of Osteopathic Medicine).  In general, the educational requirements and the length of training are the same, as are the opportunities for specializations, job scope, job availability, and salaries.  Hospitals and clinics typically employ both M.D. and D.O. physicians and use them interchangeably.  The difference between the two doctorate degrees is that the D.O. degree includes exposure to spinal manipulation and tissue palpation as a means of diagnosis and treatment.  The overall emphasis in osteopathic schools is slightly different, as well.  Osteopathic education claims to emphasize how a disease affects the entire person/body.  This is called an “holistic emphasis.”  There are 17 osteopathic medical schools in the United States and 122 M.D. (sometimes called allopathic) medical schools.

The Application Process

Most US and Canadian Medical Schools use an application service to handle prospective students. The student arranges for official transcripts and MCAT scores to be sent to the service and completes an application containing additional information. The service then distributes these materials (for a fee) to the medical schools designated by the student. The medical schools then send out "secondary" applications, seeking more information and recommendations, to students they deem qualified. "Traditional" students typically apply through the service the summer or fall before their senior year for entry to medical school the fall semester following graduation.  Because of rolling admissions policies, it is to your benefit to apply as early as possible.  Many students apply to several medical schools (8-10). The student may request and complete a paper application by mail; however, it is highly recommend using the electronic submission process. You may request a paper application or download the electronic application at the following links:

Allopathic Medicine (MD)
http://www.aamc.org

Osteopathic Medicine (DO)
http://www.aacom.org

Podiatric Medicine (DPM)
http://www.aacpm.org


In addition to grades and MCAT performance, medical school admissions committees pay close attention to extracurricular activities and recommendations of prospective students.  They want to select students that get along with others and are intelligent, motivated, well-rounded, giving, and compassionate.  Get an early start participating in these activities so that you have an established record of involvement.  Also, make sure the people you will ask to write your recommendations get to know you very well!  Suggested activities are listed below:

GPA
Grade trend
Course difficulty
MCAT scores
Essay
Motivation for entering medicine
Personal attributes
How you interview. For a list of common interview questions, click
here.

Volunteer Experience
Extracurricular activities
Leadership in the Pre-Med Club
Life experience
Medical experience
CNA (Certified Nursing Assistant)
EMT (Emergency Medical Technician)

Work experience
Research Experience
Letters of recommendation, be sure to get to know your professors so they can right good letters of recommendation.
Honors program participation
State of residence (especially for public schools)

For details about specific medical schools please view their respective webpage.

 

Information taken from: “Becoming an MD/DO.” Pre-Medicine Program. University of Wisconsin– La Crosse. Jan. 2010. Web. Dec. 2009. <http://www.uwlax.edu/sah/premed/html/becoming.htm>