So You Want To Go To Medical School? Demystifying the Journey

By: Uzair Sarmast and Eman Rashed

This article is the first in a series intended to provide guidance to those who are interested in fulfilling every uncle and auntie’s dream; namely, becoming a doctor. (that was a joke)

Before we begin we feel it is important to remind you to honestly decide if medicine is the right career for you (not your parents).  If you’re already decided, then that’s great. However, if you’re on the fence, remember to carefully weigh the challenges of the career, namely the longevity of training, countless hours of work/studying, and the personal sacrifices that inevitably accompany such an undertaking, with the pros: the self-satisfaction of helping and treating people, working in a riveting and exciting career, etc. These aspects will all be addressed in detail in future articles.  For now, view this article as a road map clarifying all the major stops of the journey. Of course, there are multiple ways to get to each destination, each of which possess their own validity and will also be addressed subsequently in the series.

Additionally, it is our hope that this series will inspire people in other fields to write similar guides for their respective professions.  By serving as mentors for our communities, inshallah we can help people pursue fields that they will enjoy, and ultimately excel in, for it is rather difficult to excel in something you do not enjoy.

Road Map

4 years undergraduate/premed

4 years medical school

3-7 years residency

1-3 years fellowship (may or may not be required)

11-16 years of education/training

Undergraduate/Pre-med

(4 years)

You often hear people saying, “I’m doing pre-med,” or, “My son/daughter is pre-med.”  What exactly is “pre-med?”  Pre-med in the simplest sense refers to a group of courses (i.e. Biology, General Chemistry, Organic Chemistry, Physics, and their respective labs) that are pre-requisites for preparing for the MCAT, and for entering medical school.  “Pre-med” isn’t a degree, nor does it mean you have been accepted to medical school.

While many students planning/hoping to attend medical school will often major in a science related field (i.e. Biology), by no means is it a requirement.  You can major in any field you desire (i.e. business, humanities, etc), and still get in and excel in medical school.  It is essential that you maintain a competitive GPA, which would be greater than a 3.6 (based on the schools you are applying to it may be higher). Keep that in mind as you choose your major and select courses. Your ability to excel in undergraduate classes will be used as a barometer of your future performance in medical school.

MCAT

MCAT stands for Medical College Admissions Test. Depending on your timeline of application, the MCAT can be taken whenever you complete your required prerequisite pre-med classes. According to the Association of American Medical Colleges, the MCAT is, “a standardized, multiple-choice examination designed to assess the examinee’s problem solving, critical thinking, and knowledge of science concepts and principles prerequisite to the study of medicine.” [i]

The MCAT, in addition to other factors which we’ll discuss elsewhere, is an integral part of your medical school application.  Generally speaking, like any admissions test, a higher MCAT score will garner your application higher consideration.  In fact, there are certain scores below which some schools may not even review your application.

You can learn more about the MCAT (and its changes for 2015) here: https://www.aamc.org/students/applying/mcat/

Medical School

(4 years)

Medical school is a 4-year program which consists of 2 years of coursework (“basic sciences”), and subsequently 2 years of clinical rotations (“rotations,” “clinicals,” or “clerkships”).  The basic sciences curriculum is a rigorous study of Anatomy, Histology, Biochemistry, Immunology, Physiology, Microbiology, Behavioral Sciences, Pathology, Pharmacology, and Genetics.  After the completion of these courses, you will then take the first part of the United States Medical Licensing Examination (USMLE Step 1).

The next two years of medical school will be comprised of clinical rotations which include Internal Medicine, Family Medicine, Obstetrics & Gynecology, Pediatrics, Psychiatry, Surgery, as well as elective rotations in specialties which you are interested in learning more about or are considering pursuing beyond medical school.  After completing the aforementioned core rotations, you will take the USMLE Step 2, usually in your fourth year of medical school. Clinical rotations are designed to introduce you to the practical application of the basic sciences knowledge which you learned during the first two years.  Completing rotations, however, does not make one proficient in the practice of medicine; that is part of the next stage.  By your fourth year will have selected a specialty and will spend the majority of fourth year taking electives in your chosen field. You will complete a 1 month Acting Internship where you will act as an Intern in the field you have chosen and will be afforded more responsibility and entrusted with more patient care matters. During the first half of your fourth year, you will focus on collecting letters of recommendation, writing a personal statement, and applying/interviewing for your residency of choice.

Residency

(length varies by specialty; generally 3-7 years)

While medical school provides a general overview of medical theory and a limited experience in its clinical application, residency provides in-depth training in a specific specialty (i.e. Internal Medicine, Pediatrics, Surgery, etc) with extensive experience in the practice of medicine in a hospital and/or outpatient clinic setting.  You can think of residency like “on-the-job training.”

Residency is by no means guaranteed; rather it requires a dedicated application/interviewing process (“the match”), a large part of which is dependent upon your medical school performance and USMLE performance. Your letters of recommendation and any research experience you may have will also play a role in the selection process. Programs that are interested in you as a potential resident at their program will select you for an interview. Many desirable specialties are among the most competitive to get into, therefore, simply your desire to pursue a certain specialty will not be sufficient if your academic performance does not meet the field’s standards.

View a complete list of specialties & sub-specialties here: https://www.aamc.org/cim/specialty/list/us/

Fellowship

(length varies by program; generally 1-3 years)

Fellowship is additional, optional training (on-the-job) to further specialize within a specialty (i.e. sub-specialize).  You will focus on becoming particularly knowledgeable/experienced in a specific aspect of your specialty.  For example, a Cardiology fellow trains in matters of the heart.  Or a Neuroradiology fellow trains in advanced imaging/procedures related to the nervous system.

Similar to medical school and residency, fellowship also requires an application process and is reserved for qualified candidates.

That brings us to the conclusion of this overview article outlining the stages of becoming a physician.  In subsequent articles, we will discuss each stage in detail, such as specifics with regards to MCAT & USMLE preparation/scores, extracurricular activities, research, away rotations, interviewing, and more.

In the meantime, we invite you to speak with someone who’s already gotten into or completed medical school, residency, or fellowship through IMANA Connect, a free community mentorship initiative under the Islamic Medical Association of North America.  If you’re anywhere along this journey and would like to help guide others, I encourage you to register as a mentor.

Uzair works with the IMANA Student/Resident Committee and is someone who believes in sharing resources to empower one another. In his words, “Given the plethora of healthcare professionals in our community, not a single person should have to stumble around in the dark on their journey to a career in medicine. No matter what your situation is, there’s someone who’s already been there, done that, and can guide you.” This belief is what inspired the development of IMANA Connect.

[i] https://www.aamc.org/students/applying/mcat/about/