Higher medical education in the US is one of the most prestigious, and the doctor is perhaps the most respected, highly paid, and privileged profession. Read about the trends in medical education in the US and changes that have occurred in the past 10–15 years.
Which medical school to choose
In 1876, the Association of American Medical Colleges (AAMC) was founded in Washington. Its tasks include improving healthcare and organizing medical care through innovative medical education, advanced patient care, and innovative research in the field of medicine. AAMC includes 145 American and 17 Canadian universities accredited in the field of medicine, about 400 large clinical hospitals and more than 80 scientific communities.
Traditionally, the best medical universities are colleges that are members of the Ivy League:
• Harvard University
• Yale University
• Columbia University
• University of Pennsylvania
• Johns Hopkins University
• Stanford University
• University of California and others
A list of all accredited medical schools and links to their official sites can be viewed here – research paper outline.
It should also be borne in mind that the cost of training in the most prestigious universities will be much higher than in less popular ones.
After graduating from high school, a graduate will not be able to apply immediately to a university for a medical specialty. Before that, he must obtain a bachelor’s degree in any discipline, but preference is given to the specialties that are very close to medicine. It can be chemistry, biology, ecology, or even environmental protection. Typically, this training, called a pre-medical study, lasts 4 years.
Similar programs are offered by various colleges throughout the country. After four years of training under the pre-med program, the student passes the MCAT (Medical College Admission Test) exam, after which he can apply to the medical university. Of course, each university has its own additional criteria for selecting students, but MCAT is passed absolutely by everyone.
In the United States, there are no separate medical universities – documents are submitted to ordinary universities and colleges accredited in the field of medicine (higher medical schools). Since there are not many such universities in the country, the competition is quite large.
During the application process, preference is given mainly to applicants residing in the state, since after graduation they will be able to stay on site and work there. Also important is the high score obtained in high school and during the period of study for the bachelor’s degree, and also at the entrance examination.
In the higher medical school, the student is trained for another four years. The first two years pass exclusively in the classrooms. Students listen to lectures, attend practical classes in general subjects: anatomy, biochemistry, physiology, and others. Clinical practice in hospitals begins with the third year of training. Students enter the hospital, where they meet with patients for the first time.
Practical classes are divided into modules. Each module lasts from six to eight weeks and includes practice in one of the departments: surgery, therapy, pediatrics, and others. The fourth year also takes place in the hospital, but now students can spend more time in those offices that are of the greatest interest to them.
Not all universities follow such clear rules. Some schools admit their students to hospitals much earlier, but the course of lectures can last all four years.
After graduation from the higher medical school, the student passes the United States Medical Licensing Exam (USMLE). This exam is multilevel.
• USMLE Step 1 is a computer test consisting of questions on the subjects of the first two years of study at a medical school.
• USMLE Step 2, which is divided into two stages. Clinical Knowledge is a computer test with questions on the subjects studied for the last two years of training in a medical school. Clinical Skills is a practical exam, in which actors take part, playing the role of patients with various diseases and conditions.
This exam is paid and conducted on certain dates. Retake is also paid separately, and the difference between exam dates can range from several months to a year.
Postgraduate medical education
After successfully passing the first two steps of USMLE, students must pass an internship in the chosen specialty to become real doctors. For each specialty internship lasts a certain number of years, depending on the complexity of the chosen profession (therapy – 3 years, various types of surgery – from 5 to 9 years).
The internship is attended by the most successful students who not only passed the exams well, but also engaged in scientific activities during the training, helped in hospitals in their spare time, and also proved themselves in the workplace.
During the internship, young doctors take internal examinations in their discipline, and after the internship, they must pass the USMLE Step 3. After passing the last level of USMLE, interns receive a license through which they are officially considered as practicing physicians and can work in their specialty throughout the United States.
Some specialties, such as neonatology, oncology, and cardiology require additional training, which is called fellowship. This training lasts 2–4 more years.
Thus, medical training in the US lasts at least 11 years. If the practitioner decides to change his specialization or choose a narrower direction, he also enters the fellowship and goes through the entire training course with the rest of the students.
The main trends and changes in medical education for the past 10–15 years
Recently, the American Medical Association has initiated a study on the quality and structure of curricula in 128 medical schools in the US and Canada.
A common feature of all US university curricula is the focus on matching the changed social conditions and a more practical approach to education while preserving scientific and research traditions.
Social problems, unequal access to medical services, palliative care, and diseases common to older people are something that is increasingly reflected in the curricula of many universities.
In recent years, such new subjects have been introduced into the curriculum:
• Critical thinking and clinical thinking
• Bioterrorism and geriatrics
• Cultural differences between patients
• Research methods for students
Some universities, for example, the Boston University School of Medicine, are studying the issues of trending gender and same-sex relationships. The Yale University School of Medicine teaches a course of inter-professional relations in medical institutions.
However, everything is not limited to the introduction of separate new academic disciplines. Leading universities systematically revise their training programs. Thus, Johns Hopkins University School of Medicine introduced the Genes to Society program, the New York University School of Medicine reformed its program, and introduced the so-called Curriculum for the 21st Century.
Changes in the teaching methodology
In all universities, there is a reduction in hours devoted to lecture classes and an increase in the number of practical classes and group projects. As a form of practical training, simulations are used in all medical schools.