The document summarizes the typical educational and training path to become a physician in the United States. It involves undergraduate studies, 4 years of medical school to earn an MD degree, 3-9 years of residency training in a specialty, and optionally 1-3 years of fellowship training for further specialization. The entire process can range from 11-20 years. Key steps include undergraduate prerequisites, the MCAT exam, USMLE licensing exams, residency matching, and obtaining board certification in a specialty. Mixed degree programs and alternative paths are also outlined.

1. Doctors in America
THE MAKING OF AN AMERICAN PHYSICIAN

2. The big picture
UNDERGRADUATE MEDICAL SCHOOL RESIDENCY FELLOWSHIP
4y 4y 3-9y 1-3y
Range: 11-20y
MD
degree Optional

3. Alternative paths
Undergraduate/MS/PhD MD Residency/Fellowship
Undergraduate MD/PhD/MPH/MBA Residency/Fellowship
6-year medical
program
Residency/Fellowship
4y
4-8y
5-9y 3-9y
3-9y4y
6y 3-9y
11-21y
12-22y
9-15y

4. Step-by-step: Undergraduate
Before undergraduate: High school, take ACT, SAT, apply as a Junior (11th grade)
Year 1 | Year 2 | Year 3 | Year 4
Pick major(s) Take MCAT
Apply for medical schools

5. Step-by-step: Undergraduate
• The great gate-keeper
• Usually 4 years to earn BA or BS (or multiple degrees)
• Fulfill reqs for med school: # credits science, math, English
• MCAT: Entrance exam to medical school
• The exception: 6-year medical program
• Only 2, one in KC (UMKC)

6. Step-by-step: Medical school
Before med school: Undergraduate, take MCAT
Year 1 | Year 2 | Year 3 | Year 4
Basic sciences Basic sciences Clinical rotations Clinical rotations
Take Step 1 Take Step 2 Apply for residency
Residency interviews
Match day in March

7. Step-by-step: Medical school
• 4 year program*
• Degree: MD (or DO)
• Allow you to apply for accredited residency programs
• Board certification exams: Step 1, Step 2
• First 2 years: Basic sciences
• Next 2 years: Clinical rotations
• Programs vary by content, rotations, grading scale
• Cost: $25-75,000/yr (total $100-300,000)
*6-year programs combine undergrad + med school

8. Step-by-step: Residency
Before residency: Graduate medical school, pass Step 1, Step 2
Year 1 | Year 2- (x-1) | Last year
Intern year Progressive training Apply for fellowship
Step 3 Specialty boards OR Apply for work as an attending

9. Step-by-step: Residency
• 3-9 year training program
• 3: Family Medicine, Internal Med
• 5: General Surgery
• 9: Neurosurgery
• Already have MD degree, but not board
certification in a specialty
• Board certification exams: Step 3,
specialty boards
• First year: Intern
• Salary: $50-60,000/yr

10. Step-by-step: Fellowship
• 1-3 year training program
• 1: Pain medicine (Anesthesia residency)
• 2: Transplant (General surgery residency)
• 3: Cardiology (Internal medicine residency)
• Optional for further specialization
• Already have MD degree and board
certification in a specialty
• Salary: $50-60,000/yr

11. Step-by-step: Attending
• Range from medicine to surgery, private to
academic practice
• Salaries by specialty US:
• All average: $195,000 (primary care),
$248,000 (specialties)
• Pulmonology/ Critical Care: $296,000
• Orthopedic surgery: $421,000
• Responsibilities: Unit patients, clinic,
departments, administration

12. Step-by-step: Mixed degrees
• MD/PhD: Physician scientist with research or
corporate focus
• MD/MBA: Business, leadership focus
• MD/MPH: Policy, leadership focus
• MD/MS: Research or other specific focus
• MD/JD: Policy, leadership, social justice, law focus
• DO: Osteopathic medicine

13. UNDERGRADUATE MEDICAL SCHOOL RESIDENCY FELLOWSHIP
Summary: The big picture
4y 4y 3-9y 1-3y
Range: 11-20y

14. Thank you!
Dr. Aihong Meng and
her family
Department Chair, Dr. Xin Yan and the faculty,
residents, and staff of 2nd Hospital of Hebei
Medical University