There are many kinds of medical doctors. They may be differentiated by their approach: allopathic (M.D. or M.D./Ph.D.), chiropractic (D.C.), homeopathic (H.M.D.), naturopathic (N.D.), osteopathic (D.O. or D.O./Ph.D.), etc., or by the scope of their practice: dentistry (D.D.S. or D.M.D.), optometry (O.D.), podiatry (D.P.M.), veterinary (D.V.M.), etc.
M.D. and D.O. physicians and surgeons now have similar education, training, certification and legal privileges. Historically, osteopathic schools emphasized preventive medicine, using less invasive and drastic therapies, treating people (not just diseases), and, up until WWII, were more similar to chiropractors than allopathic physicians. In addition to conventional therapies, D.O. physicians are still trained in osteopathic manipulative therapy (O.M.T.).
For more information on M.D. medical education, see www.aamc.org/students/considering/start.htm.
For more information on D.O. medical education, see www.aacom.org/Pages/default.aspx.
Most students complete a full undergraduate education, including 2 semesters each of English, biology, chemistry, organic chemistry and physics. It is possible to enter medical school with any bachelor’s degree (e.g., B.A., B.F.A., B.G.S., B.S., etc.) and any major (including social sciences, humanities or fine arts).
Important factors for admission include:
• academic performance, especially in science courses
• Medical College Admission Test Scores (MCAT)
• activities, especially health care related
• recommendation letters
• written application answers
• interview
Legal state residency often determines where people are accepted.
Medical school admission is truly competitive. Most pre-medical students change their career goal before they ever apply for medical school, and only about one-half of those who do apply or re-apply are accepted.
For additional information, see www.medadvising.ku.edu/medicine/medapp.shtml.
Extensive: 4 full years
Intensive: Normal to spend 60-70 hours per week going to classes and studying.
Expensive: Four years of tuition, books and living expenses costs about $150,000 for a resident at a state school, or about $250,000 at a private school. A few students participate in service-obligation programs (military, rural primary care, etc.), but most borrow. Medical practices sometimes offer to help re-pay loans as part of hiring after residency.
There are different ways of organizing the first two years of basic sciences (by discipline, physiological system, presenting case, etc.), and different ways of teaching (lecture, lab, small-group, problem-based, computer-assisted, etc.).
KU School of Medicine Curriculum – For details, see www2.kumc.edu/mesu.
Biochemistry, Cell & Tissue Biology, Gross Anatomy, Microbiology, Pharmacology, Physiology, and Introduction to Clinical Medicine.
3rd Year: 6-8 week clinical clerkships in Internal Medicine, General Surgery, Neuro-Psychiatry, Family Medicine, Ambulatory Medicine/Geriatrics, Obstetrics and Gynecology, Pediatrics and Introduction to Clinical Medicine.
4th Year: 4 week clerkships in Sub-Internship Selectives, Rural Preceptorship, Critical Care, Ambulatory Specialty Selectives, Public Health, and Electives.
Step 1: Basic Sciences, after 2nd year
Step 2: Clinical Skills, at the beginning of 4th year
Step 3 Advanced Clinical Skills, after first year of residency
Many osteopathic students now take the USMLE in addition to the Comprehensive Osteopathic Medical Licensing Examination (COMLEX), which is also a thee-stage exam.
Most medical students apply through the “Match” in their 4th year of medical school. Results are posted in March. Most successfully match with one of their top three choices, though there is a lot of self-selection before applying.
A residency is a period of supervised on-the-job-training. The length of a residency is usually 3-5 years, depending on the medical specialty. The first year of a residency program is sometimes called an “internship,” and first-year residents are often called “interns.”
Some sub-specialties require an additional 1-3 years of training after completing a residency. This period is sometimes called a “fellowship.”
Residents and fellows are doctors, they have a temporary license to practice medicine, and they are paid a modest salary (typically starting at about $37,000 per year). Depending on the specialty, they are likely to be based in hospitals, and some work very long, irregular shifts.
For more information about residency matching, see www.nrmp.org.
Specialty boards certify physicians as having met a set of standards. Requirements usually include graduating from a recognized M.D. or D.O. medical school, completing a related residency program, documentation and assessment from residency supervisor, and a written and oral examination. Periodically, specialists have to seek re-certification.
Licensure is the legal privilege to practice medicine. Each state has its own standards and procedures, usually overseen by a board of medical examiners.
Good News: Over 90% of those accepted to medical school eventually pass their courses, pass the USMLE, successfully match with a residency, pass their certifying exams, and become full-fledged physicians!
There are more than thirty specialty areas, and literally hundreds of sub-specialties. Salary figures are from the U.S. Bureau of Labor Statistics' Occupational Outlook Handbook at www.bls.gov/oco/ocos074.htm, and most of the specialty information is from the American Board of Medical Specialties, www.abms.org.
Internists, family physicians and pediatricians prevent and diagnose disease, treat many kinds of non-surgical conditions, and coordinate care by other providers. They tend to work long hours (~60 hours per week), and are not paid as highly as medical specialists in other fields. Average salaries usually run ~$160,000 per year. These specialties each require a three year residency.
Many primary care physicians go on to sub-specialize. Internists, for example, may further specialize in:
• Cardiology
• Endocrinology
• Gastroenterology
• Hematology
• Infectious Disease
• Nephrology
• Oncology
• And, many other sub-specialties
General surgeons diagnose and treat diseases and injuries to abdominal organs and soft tissues of the neck and trunk, while orthopaedic surgeons diagnose and treat diseases and injuries of the musculoskeletal system. They average 60 hour work weeks and are often on-call, but their earnings are among the highest of any profession. General surgeons who have been practicing for more than one year average $283,000 per year, and sub-specialists earn even more. Residencies are scarce, and competition for placement is intense. For those who get a residency, initial training lasts five years. Most surgeons go on to sub-specialize, often in treating a particular region of the body.
• Administration
• Allergy & Immunology
• Anesthesiology
• Dermatology
• Emergency Medicine
• Medical Geneticist
• Neurology
• Obstetrics & Gynecology
• Ophthalmology
• Otolaryngology (ear, nose & throat)
• Pathology
• Physical Medicine & Rehabilitation (physiatry)
• Psychiatry
• Public Health & Preventive Medicine
• Radiology, Diagnostic
• Urology
For more information about specialty areas, see http://abms.org/Who_We_Help/Consumers/specialties.aspx.
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Paul J. Crosby Premedical Advisor pcrosby@ku.edu © 2008 The University of Kansas This file was updated 03/20/08 03:23 PM |