Applying to US Medical Schools

Level of Medical Education
In the US medicine is taught only at the postgraduate level after an undergraduate university education. You cannot apply to US medical schools after completing A levels or Scottish Highers. You must first complete an undergraduate degree.

Length of Medical Education
Medical education in the US is generally considerably longer than medical education in the UK. Four years of undergraduate study (pre-medical education) are followed by four years of medical school, then three to seven years of residency training. Upon successful completion of the four-year medical school curriculum and exams, the Doctor of Medicine (MD) degree is conferred. The entire process can take anywhere from 11 to 15 years. Due to educational, cultural and language differences, many US medical schools encourage international applicants to enrol for at least one year of undergraduate coursework at a regionally-accredited American university prior to starting the MD programme. Contact medical schools directly to find out what they recommend.

Practising Medicine in the US
Please note that holding a US professional medical degree does not give you the right to work in the US. When applying for a visa, it is important to remember that you need to show intent to return to your home country after finishing your degree. Check with the appropriate professional association in your home country to see if a US degree meets your home country's requirements to practise medicine. Questions regarding specific education credentials, visa requirements and examinations required for licensure should be directed to the individual state medical boards.

Acceptance Rates at US Medical Schools
Admission to US medical schools is extremely competitive. Many US medical schools, especially at state-supported institutions, will not consider international students for admission to MD programmes. The representation of foreign students in US medical schools stands at less than 1% of all students. US medical schools have a primary obligation to train US citizens and are strict about accepting international students into the first year class. This obstacle can be overcome if you can establish permanent residency status prior to making an application. If you plan to apply to a state-supported school, be aware that most are required to give preference to in-state residents. Most international students accepted by US medical schools had attended a US undergraduate institution for at least one year.

Expenses and Financial Aid
Average annual cost of tuition and fees for first year medical students is approximately $11,000 for state residents and $25,000 for international students at a state-funded medical school, and $30,000 at a private school. In addition, the cost of living for one academic year (nine months) ranges from $8,000-$15,000 depending on location in the US. Few scholarships are announced for international students to pursue medical education, and loans are generally not available from US lending institutions without a US citizen as a co-borrower. For further information on loans please refer to our Loans for Study in the US. However, individuals with permanent residency in the US may be eligible for federal student loan programmes. It usually takes a permanent resident one year as a non-student to establish residency in a state. State residency will allow you to pay in-state tuition fees, which are lower than both out-of-state and private university fees.

Biology or Zoology, 1 year with lab
Inorganic Chemistry, 1 year with lab
Organic Chemistry, 1 year with lab
Physics, 1 year with lab
English, 1 year

A number of schools also require coursework in mathematics, behavioural science, the humanities and computers. Note that a "pre-med" degree does not guarantee admission to medical school and may not even be treated as the best curriculum for all students. Students should choose a major based on their interests, not based on concern for admission to a postgraduate programme in medicine; it is possible to take the above list of subjects at a US university while majoring in an unrelated subject.

In addition to successful completion of required undergraduate coursework, a strong cumulative Grade Point Average (GPA) is also necessary. The GPA for the average matriculant is about 3.5 on a 4.0 scale (the approximate equivalent of a B+ or 2:1 degree classification). A high GPA by itself, however, does not guarantee admission to medical school. As already mentioned, admission to US medical schools is extremely competitive, so students applying with degrees lower than a 2:1 would have a very slim chance of admission.

Postbaccalaureate Programmes
Individuals who have completed a postbaccalaureate pre-medical education now comprise a small but significant part of the medical school applicant pool. These programmes are aimed at individuals who wish to change careers, have been uncommitted as to their career but now have decided to study medicine, or have been rejected by a medical school and are looking to improve their chances when re-applying. These programmes vary in length and content. Your choice of programme will quite often depend on your prior academic history. They can assist non-science majors with the relevant courses or help prepare candidates for the Medical Colleges Admissions Test (MCAT - see below).

Medical College Admission Test (MCAT)
The MCAT is an eight-hour multiple choice standardised exam required by most US medical schools. This test is very important among the admission criteria and admissions officers rank it among the top three selection factors. The MCAT is given twice a year and nearly all medical schools suggest you take it in the spring of the year before you aim to gain admission. Each of the multiple choice sections of the test is scored on a scale of 1 to 15 and medical schools view scores above 10 as superior. The Writing Sample section is scored on a scale of 1 to 6. The MCAT assesses mastery of basic concepts in biology, chemistry (general and organic), physics, scientific problem solving, critical thinking and writing skills. Registration materials can be obtained from EAS by sending an A4-sized SAE for 150 grams.

Other Factors

Personal statement
this is the chance for you to sell yourself and your abilities to the admissions committee, as well as express your motivation for wanting to attend medical school. A good essay requires careful planning, reviewing and revision. EAS offers an Application Essay Review service for £25 per institution, per review. Responses can be provided by telephone or preferably in-person by attending a 30-minute Application Essay Review service. For more information, please contact EAS directly.

Letters of Recommendation
these can be from undergraduate advisers and faculty, from physicians or other members of the health profession, community leaders, and other individuals who have employed you or supervised your volunteer experience.

Exposure to medical field and community service
This includes extracurricular activities that reflect public or health-related services. This experience shows that you are genuinely dedicated to the field.

Interview with an admissions officer
This interview can be used to show the personal characteristics you will bring to the profession. Interviews are held towards the end of the application process. Many medical schools invite the most promising applicants to an interview at the medical school with faculty and other members of the admissions committee. This can pose problems for students who apply from abroad.

Extracurricular activities
Especially those reflecting public or health-related service, volunteer work and other evidence of your initiative.

Medical Residencies/Fellowships for Foreign Medical Graduates
After completing the MD degree, it is standard for doctors to undertake a period of residency training, usually in a hospital, specialising in one area of medicine. The length of residency training varies among the different specialities but is usually between three and seven years. Foreign medical graduates must hold a valid standard ECFMG Certificate in order to enter residency programmes accredited by the Accreditation Council for Graduate Medical Education. If you do not wish to commit to a speciality at the beginning of your training then you may want to consider a "transitional year" programme. These programmes last 12 months and give graduates exposure to multiple clinical disciplines to assist them with their choice of speciality. Note: it is not a complete graduate medical education programme in itself and is not significant preparation for the practice of medicine. ECFMG certification is required for participation in transitional year programmes.

Please note: Check with health officials in your home country as to which credentials will be recognised when you return. Residency programmes do not offer degrees. You may want to consider obtaining certification from a medical speciality board approved by the American Board of Medical Specialities for recognition of medical competence.

Fellowship Training
A fellowship usually provides advanced training in a medical subspeciality and is generally undertaken after several years of residency training.

Obtaining a Residency or Fellowship Position
At least 12 months before you wish to start a residency programme, consult The Graduate Medical Education Directory (the "Green Book") published annually by the American Medical Association (AMA) and/or the "FREIDA" database, on the AMA website to choose an appropriate programme. These guides list accredited graduate medical education programmes in the US. State licensing boards, speciality societies and hospitals refer to this guide to verify the authenticity of programmes presented by doctors who wish to qualify for licensure, certification or hospital privileges. The Graduate Medical Education Directory is available for reference in the EAS library. You can obtain this book through Oxford University Press, Science Medical and Journals Division, Walton Street, Oxford OX2 6DP. Tel: 01536 741727. The guide costs approximately $64.95 (ISBN 0-89970-920-6).

The Fellowship and Electronic Residency Database is another way to find residencies. This is located at the American Medical Association's website.

You should contact residency programmes as early as possible to determine eligibility requirements and institutional employment policies and to request application materials. Carefully review information to find out deadlines, whether the programmes require on-site interviews and whether the programmes require applicants to enrol in the National Residency Match Program (NRMP) (see below for information on the NRMP). You are responsible for requesting recommendations, arranging transcripts and forwarding materials directly to each programme by the established deadline. A transcript is a record provided by the medical school that lists the courses taken during your medical education and the grades you achieved. Residency salaries will usually support a single person so if you have a family you may need additional resources. Before signing a contract you should consider:

Visas for Residencies or Training
All details should be confirmed with the relevant US authorities.

J-1 Exchange Visitor Visa
This is the visa most commonly used by foreign medical graduates to undertake postgraduate medical education. The United States Department of State regulates the Exchange Visitor Program (EVP) and designates various organisations and institutions as sponsors. The ECFMG is the only organisation that is authorised to sponsor foreign national doctors to graduate medical education. To be eligible for the EVP you must:

Arranging Medical Observations in the US
If you are a foreign doctor wishing to enter the US for advanced training, you may do so in programmes involving observation, consultation, teaching or research with or without patient contact. It is possible for you to enter the US on a J-1 visa. The ECFMG is authorised to sponsor foreign doctors for this purpose. The US Department of State may also authorise medical or health professional schools to sponsor foreign doctors in the Scholar and Short-Term Scholar category. You are not required to obtain ECFMG certification or pass the USMLE if no, or only incidental, patient contact is involved. Arrangements for observations should be made directly with the institution and doctors should provide evidence of qualifications and financial support so that the institution can issue the form DS-2019 which enables the doctor to apply for a J-1 visa at the American Embassy. It may also be possible for doctors who do not speak English as a first language to study English on the F-1 student visa while conducting observations in a hospital. The doctor must maintain F-1 status and may make the arrangements directly with the appropriate hospital or medical school.

Medical Student Electives
Many medical schools worldwide now offer opportunities for students to pursue such activities as independent study, honours programmes and special research projects, at home or abroad. At the time of publication of this document, students wishing to obtain a position in the US for their short-term elective period were not required to take the USMLE. To find out about opportunities for electives in the US, contact the US medical school of your choice.

For students who have already obtained an elective position, the Medical and Dental Defence Union of Scotland (MDDUS) might provide financing of round-trip travel to the US for clinical clerkships. Contact: Sheila Baumann, MDDUS, McIntosh House, 120 Blythswood St, Glasgow G2 4EH. Tel: 0141 221 5858.