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Many Indian students opt to study medicine in the U.S. This requires an understanding of the structure of medical education in that country. Unlike in India, where direct enrolment into MBBS is common after Class 12, students in the U.S. must complete a four-year Bachelor’s degree or pre-medical degree first, then pass the Medical College Admission Test (MCAT) to apply for admission to a medical school. Apart from the U.S., medical schools in Canada, Australia and the Caribbean Islands consider MCAT scores for admissions.
What it involves
The MCAT is a computer-based exam that evaluates problem-solving and critical thinking skills and analyses the applicant’s understanding of scientific concepts and principles. To excel in the MCAT, assess your baseline with a full-length practice tests. Prioritise application over rote memory and balance content review with timed practice. Emphasise accuracy over speed and build endurance. Try to simulate real exam conditions for adaptability, continuous self-evaluation and stress management.
Once a student enters a medical school, the first two years of the four-year curriculum focuses on pre-clinical studies, covering basic concepts, anatomy, diseases, and essential skills. This phase often involves lectures, small group discussions, and laboratory work. The next two years provide hands-on experience with patients in various medical specialities through clinical rotation.
To be able to practise in the U.S, aspiring doctors have to clear all three stages of the United States Medical Licensing Examination (USMLE). This serves as a standardised benchmark for medical licensing authorities. Conducted by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME), the first step is usually taken at the end of year two and step two at the end of year four and step three at the end of the first year of residency.
Preparing for the USMLE involves online resources and guidance from experienced mentors. Students can consult tools such as Kaplan, UWorld, Pathoma, Sketchy among others. The First Aid for the USLMLE and Kaplan Medical Qbook offer an effective combination of review material and practice questions. The USMLE also offers additional preparation resources, including insights into test formats, practice questions, and review materials and medical schools also provide practice exams to assess readiness.
Clinical rotations, also known as clerkships, are a pivotal part of medical education as students work closely with senior doctors. They also learn by engaging and monitoring patients on a daily basis giving them a preview of the everyday routine of a practising doctor.
Exploring departments
Students undergo rotations in different departments, including family medicine, ob/gyn, internal medicine, surgery, paediatrics, psychiatry and more. This allows them to explore the nuances of various departments, understand the challenges, discover personal interests, make informed decisions about their future trajectories and interact and build their networks with senior doctors and residents.
The residency marks the final phase and is usually considered the first step towards becoming a practising doctor in the U.S. Depending on the specialisation, residencies may range from three to seven years. In some cases, the residents continue to super specialise in their area of interest.
The application process for residency is facilitated through National Residency Matching Programme (NRMP), which interviews applicants and uses an algorithm that matches them with suitable residency programmes and specialities. Student’s clinical exposure and practical insights could be key factors for assessment. Several prominent paths for physicians in the U.S. involve internal medicine, family practice, psychiatry, paediatrics, ob/gyn, anaesthesiology, and surgery.
With the journey to becoming a doctor in the U.S. spanning around 10-15 years — from pre-medical through residency to full licensure — aspirants need to be both patient and determined to achieve their aim.
The writer is Associate Vice-President, Student Acquisition, International American University of Antigua College of Medicine, Antigua
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