Guide to getting a doctorate of medicine (M.D.)

Working as a doctor can be immensely satisfying if you love to help people and solve problems. A recent survey found that doctors are among the most respected professionals worldwide. The compensation they receive reflects this, with an average salary of $208,000.

Not all doctor roles are patient-facing. M.D. holders can work as consultants, medical writers, educators, expert witnesses, entrepreneurs, and even inventors. Those who provide patient care typically work in hospitals, office, and clinics.

For many doctors, becoming an M.D. is just the start of their educational journey. Upon graduation they can focus on a specialty, such as pediatrics, dermatology, surgery, infectious diseases, obstetrics, and oncology.

What can you do with an M.D.?

An M.D. can you set you off on a clear career path that leads to stable and well-paid work. Most graduates progress to a residency at a hospital or doctor’s office, where they learn the advanced skills required to practice. After residency, doctors often begin work in hospitals, private practice, and group practices. Others opt for fellowships in the specialties they want to pursue, such as neurology or surgery.

The difference between an M.D. and D.O.

The doctorate of medicine (M.D.) and doctorate of osteopathic medicine (D.O.) are medical degrees that allow you to become a licensed physician. The main difference is that a D.O. takes a holistic approach to help prevent illness and injury, whereas an M.D. focuses on treating the specific illness. Some other key differences are shown in the table below.

M.D.

A Doctor of Medicine degree takes 4 years to complete, is more competitive, and requires higher MCAT and GPA scores for admission. Students in this program go to a conventional medical school and treat specific conditions with medicine. There may be some additional coursework required upon graduation, but it depends on the specialty.

D.O.

Doctor of Osteopathic Medicine takes 4 years + 200 hours or more to complete. This program has a less competitive admission process and accepts lower MCAT and GPA scores. These students go on to treat patients using a holistic approach. This means they treat whole body with medicine, plus complementary therapy, such as osteopathic manipulative treatment. Upon graduation, students may be asked to complete 200 hours of additional coursework focusing on how bones, muscles, and nerves, affect overall health. Other additional coursework depends on the specialty.

How to pick an M.D. program

The first question to ask is whether the school is accredited. A recent survey showed that there are currently 155 M.D. granting schools and 41 accredited D.O. granting schools in the U.S.

Passing the United States Medical Licensing Exam (USMLE) is a requirement to practice medicine. It is helpful to check how a program’s students perform on the 3 USMLE tests.

Some medical programs focus on research, primary care, or specific specialties. Check the concentrations available, these can be as wide as urban medicine, public health, business of medicine, and healthcare innovation.

Can I study an M.D. online?

Currently, there are no online medical schools in the U.S., because the program requires a significant amount of laboratory work and clinical rotations. In the future, some medical schools may offer select courses online, but fully-online seems unlikely.

Financial aid and scholarship options for medical school students

Financial aid can help to pay for college expenses, such as tuition fees, board, books, and personal expenses. The first step is to fill out the Free Application for Federal Student Aid (FAFSA), to determine your eligibility for federal, state, and local government student loans, as well as medical school loans, scholarships, and other financial aid. FAFSA offers Federal Stafford loans, the primary loans used to pay for medical school.

» Read: Alternative ways to pay for college

There are a wide range of scholarships available, some specifically for medical school students. Discovering which you may be entitled to requires some research.

M.D. holders may be eligible for loan forgiveness programs, whereby the debt is erased if they meet a set of criteria.

• The NHSC Loan Repayment Program repays loans for physicians who work at least 2 years at an NHSC-approved site in a Health Professional Shortage Area (HPSA).
• The Indian Health Service (IHS) Loan Repayment Program repays up to $40,000 for doctors serving American Indian or Alaska Native communities.

Many states offer loan forgiveness programs, and the National Health Service Corps provides grants through the State Loan Repayment Program to all 50 states and U.S. territories.

» Read: Student loan repayment options

What to expect from an M.D. program

Most 4-year medical schools organize training into 2 parts:

• pre-clinical – Typically includes 2 years of science training, where students learn about basic medical concepts, anatomy and functions of the body, diseases, diagnoses, and treatments. This phase also includes the basics of practicing medicine, such as taking medical histories.

• clinical – This takes place during the last 2 years of the program. It involves clinical rotations, where students work in various departments of approved healthcare sites.

Admission requirements for medical school

Every medical school has its own list of recommended or required premedical coursework. Some accept advanced placement (AP), online courses, and community college courses, others do not.

General acceptance criteria may include:

• academic performance
• MCAT score at or above 510
• minimum GPA of 3.71
• service and leadership experience, such as community and volunteer service, research, artistic and athletic endeavors, and work experience
• personal statement
• letters of recommendation

» Read: Decision fatigue: how to manage during the application process

M.D. Internships

Also known as post graduate year 1 or PGY-1 interns, medical interns perform many of the same duties as doctors. These include taking patient histories, performing examinations, and conducting medical procedures, such as intubations, catheterizations, and biopsies.

Internships usually include 4 basic specialties:

• internal medicine
• general surgery
• gynecology and obstetric
• pediatrics

Interns who choose a medical specialty other than general practitioner need to complete a period of residency under a licensed physician of that specialty.

The United States Medical Licensing Examination (USMLE)

The USMLE is a 3-step test that medical students need to pass before they can get their medical license.

Students typically take step 1 at the end of their second medical school year. This examines their knowledge of basic sciences, such as anatomy, physiology, biochemistry, microbiology, behavioral sciences, immunology, pathology, and pharmacology.

Step 2 is typically taken in the fourth year and includes:

1. A multiple-choice clinical knowledge exam that covers clinical sciences, e.g. surgery, internal medicine, obstetrics and gynecology, pediatrics
2. A clinical skills test that has students examining and diagnosing actors posing as patients

Step 3 is a 2-day test, usually taken after the first year of residency. This uses both multiple choice questions and simulations to determine if a physician is ready to provide unsupervised patient care.

For best results, students often begin to study for the USMLE during their first 2 years of medical school. They can take USMLE prep courses to help them prepare. USMLE practice exams, such as NBME Self-Assessments, are also available. USMLE also offers mock exams and other resources.

Courses on an M.D. program

Typical core courses offered by M.D. programs include:

• anatomy – Students study the structures of the human body, such as bones, muscles, vessels, organs, and nerves. The course also includes development of the fetus (embryology), microscopic study of human body cells (cytology), and microscopic study of body tissue (histology).
• biochemistry – Students learn about the metabolic pathways where the body breaks down food and produces energy, proteins, and other substances. The course also touches on endocrinology (hormones) and nutrition.
• biostatistics and epidemiology – Studies the processes involved in measuring, preventing, and controlling diseases in populations, with a significant focus on graphical and data analysis.
• medical ethics – Students review ethical questions related to healthcare, the overall role of a physician, and the legal boundaries that govern the work of doctors.
• immunology – includes information on the immune system, especially how the body fights diseases, learns how to build antibodies, and factors that damage immunity.
• microbiology – covers bacteria, viruses, fungi, and other pathogens that threaten the human body, including methods of testing for specific pathogens, and ways to contain and treat the diseases that pathogens cause.
• physiology – Often taught alongside anatomy, physiology covers how organs and the body function.

What careers can I do with a doctorate of medicine?

An M.D. can open the door to many exciting careers. Some involve direct patient care, others allow doctors to use their medical expertise in a non-patient facing role.

The next educational steps

Most medical school graduates progress to residency at a hospital or doctor’s office, where they learn the advanced skills to practice medicine in those environments.

Departments a student might rotate through during residency can include:

• cardiology
• critical care
• emergency medicine
• endocrinology
• hematology
• infectious disease
• intensive care
• nephrology
• oncology
• palliative care
• psychiatry
• pulmonology
• rheumatology

Some students progress to fellowships, working under expert supervision to learn a specialty in depth, such as surgery or cardiology.