So currently I am finished with my second year of medical school and I am halfway done until I graduate. I am taking this time to explain the journey of becoming a physician so that people understand and don't get confused when I explain the terminology. I will start start from year one!
Year 1of Medical School (book work)
1. Review and learn about all the basic sciences and how they relate to the human body
2. Subjects include biochemistry, genetics, pharmacology, epidemiology, anatomy, physiology
Year 2 of Medical School (more book work)
1. Learn about each human body system and everything that can go wrong and everything we do to treat the problems
2. Body systems are categorized as Cardiovascular System, Pulmonary System, Endocrine System, Musculoskeletal System, Nervous System, etc
Summer between Year 2 and Year 3
Students take their 1st Boards. This is where I am at now. Now to make things a little more complicated there are two different tests I can take. The test that all Doctors of Osteopathic Medicine aka DOs are required to take is called the COMLEX Level 1. This COMLEX Level 1 exam is 400 questions long and is a nine hour test. Why is the COMLEX important? My future residency program will judge my competitiveness and future based on this score. Now if I want to pursue a residency that does not accept the COMLEX Level 1 exam, then I have to take another exam called the USMLE Step 1. This exam is required for any Doctor of Allopathic Medicine aka MDs to take, but is optional for any DOs, like myself, to take. The benefits of taking both the COMLEX and USMLE will basically open my options to apply for more residencies in the United States. Especially residencies on the West Coast as many of the residencies prefer USMLE over COMLEX for political reasons. I will be taking both these exams in June. So far for studying I have done about 5,000 practice questions and countless hours of board review that are about to drive me crazy, but I love it. That's why I sent out those crazy movie I guess. Work, work, work, work, work!
Year 3 of Medical School (clinical work)
This year is called Rotations....not Residency. I repeat, the third year of medical school is called ROTATIONS. This year is still guided under the supervision of my medical school PNWU. I have not received a degree yet. What are rotations? Each medical student is pared one on one with a physician in a core speciality of medicine for about 6-8 weeks. The physician who teaches during a rotation takes each student under his/her wing and teaches students medical procedures, lets student examine patients, helps students develop clinical knowledge and basically apply book knowledge to the real world. Then the student moves on to another physician for 6-8 weeks. Then to another physician and then another. The medical student does this for the entire 3rd year. The core specialties include family medicine, pediatrics, surgery, women's health, emergency medicine, internal medicine, and psychiatry. I just want to repeat once again that third year is not residency, it's called rotations. Haha. The most important part of 3rd year rotations is finding a field in medicine that I am passionate in and want to pursue as a physician. My top 4 now are Family Medicine, Internal Medicine, Pediatrics, and OB/GYN. Not really sure what real medicine is like in these fields and how they are going to change in the future so I am keeping my options open.
Summer of year 3
This is where students take COMLEX Level 2 and the PE. Level 2 is a multiple choice exam and the PE is a day full of fake patients that test the knowledge and clinical skills the student has developed during his/her third year. The PE exam is not very fun as students have to take the exam in Philadelphia and the exam is pretty stressful.
Year 4 of Medical School (more clinical work)
This is the main preparation year for residency. Each student by now has an idea what he/she want to do in medicine so now it's time to find a residency in that field. So each student sends out applications to different residencies in order to do what is called an AUDITION ROTATION. This involves going to the residency and rotating with the doctors(faculty) and residents(students) in that residency. At the end of the audition rotation the student gets an interview with those uncharge of the residency and they treat it kind of like a job interview, but for residency. These auditions vary in length, but hopefully at the end of the audition the faculty and residents want you in their program and will be looking for you name when you submit your application for residency. Audition rotations are expensive and time consuming. Student's have to travel out of state and live out of state for weeks at a time for these rotations. I am not looking forward to these, but hope I can find one that I love.
Graduation from Medical School (get a degree)
After 4 years of medical school students graduate with a degree. Mine will be a Doctorate in Osteopathic Medicine. For Allopathic medical students, it is a Doctorate in Medicine. Both are equal as far as scope of practice, our training mainly varies depending on our residency and wether or no we incorporate osteopathic philosophy and treatments in our practice. If doctors tell you that they are not equal then they are full of prideful crap because a good chunk of my professors who gave me my critical education were MDs and not DOs. So the education and training is basically what we make it. So now that a medical student is no longer a student and has a degree they go off to residency.
Summer after Year 4
Students take the final part of COMLEX called COMLEX Level 3.
The Match
A giant complicated system exists that is design to match each student to a residency. Each students submits his or her application to this system called The National Residency Matching Program. This program has algorithms and formulas that are designed to match students in one of the residencies they have chosen based on scores, letters of recommendation, experience, etc. Students will usually pick 3-10 residencies they want to be in and hopefully they match to one of those residencies or they are stuck in limbo for year.
Residency (our first job...kinda)
This is the time a doctor becomes a real doctor and not a student. Residents are actually payed during residency. The salaries on average are about $40,000-$60,000 a year depending. Each resident sees his/her own patients and for the first year is under the close supervision of another physician. During this first year residents can't prescribed medications without an attending physician's approval. After the first year in most programs, residents can then legally prescribe meds and are not under as close as supervision as the first year. As far as the length of residencies, if a residency includes surgery, these residencies are 4 or more years long. Family medicine, pediatrics, and internal medicine residencies are each 3 years long. After those three years, internal medicine and pediatric residents can choose to further specialize in another fields which often requires another 3-4 years of training. Just a side note. Not all hospitals have residencies. Residencies are national funded training programs for doctors. A branch of Medicare pays for a majority of the funding of residencies so establishing new residency require a lot of hoop jumping and red tape cutting if you know what I mean. Residencies also have political struggles and biases when it comes to which medical school students they allow into their programs. After residency training residents take their final specialty boards and are real doctors.
Finally a real doctor!!!! Money in the bank!!!!
Hopefully everyone can get a feel of what the journey is like. I feel it stinks and is too long and complicated. In the end it will be worth it. I just can't wait for the day when I finally am on my own and can focus on my patients and care for them the way they want.
