.Pathway of Medicine.

Many people have no idea what the path to a career in medicine entails.  There are many steps to becoming a doctor.  My husband is currently in Med School Year Four.  Some people say it gets better.  Other people say it gets worse.  We just take it one day at a time.  I try to avoid any sort of "countdown," because, really, the path to a career in medicine is never ending (that's not pessimistic - it's realistic). 

But, without further ado: The Pathway to a Career in Medicine.
  1. Graduate from undergrad school (normally majoring in something science-y, but my husband has classmates who were majors in history, literature and various other things).
  2. Take MCATS (Medical School Admissions Test).  Do well. If you think you can do better, take it again.
  3. Apply for and be accepted into medical school.
  4. Med School Year One - Preclinical.  Lots of lectures, labs and exams.  Purchasing of doctor equipment, learning how to use it to perform physical exams, and practicing them often.  Copious amounts of studying (my husband spends roughly 12 hours on school every day, sometimes more if a difficult exam is looming).  Shadow doctors in various fields to begin to learn interests.  Be matched to a location for years three and four clinical rotations.  Accept that most conversations will revolve around medicine. 
  5. Med School Year Two - More preclinical. Similar to year one, but separated by domains (Cardio/GI/etc) as opposed to subjects (immunology/microbiology/etc), with a Problem Based Learning format.  Fewer exams, but more heavily weighted.  Optional: take on research and leadership roles, ones that are both enjoyed and look good on paper.  Keep shadowing to remember why you are becoming a doctor.  Study pants off for the pricey Step One Test.  Set up your clinical rotations for Year 3.
    1. USMLE Step 1 - United States Medical Licensing Examination, Step 1.  This will test students on their ability to apply basic science concepts to the actual practice of medicine.  Pass this to continue medical school.  So no pressure.
  6. Med School Year Three - Clinical.  Rotations (also called clerkships) throughout various major medical specialties (OB/GYN, Pediatrics, Psych, Internal Medicine, Jr. Surgery, Family Medicine). Learning takes place primarily in a teaching hospital as opposed to lecture halls, and students assist doctors and their medical teams on a daily basis. Have first taste of the beauty of night float weekend call shifts. 
  7. Med School Year Four - Clinical.  Similar to year three, but with more freedom.  Known as "The Best Year."  By now, students (hopefully) have a good idea of what type of medicine they want to practice.  They complete their final rotations, one-month-long stints in the programs with which they hope to match (see sub-step 3!), the required rotations and other various areas of interestStudents keep on top of schooling, study for the Step Two Test and apply to residency programs. 
    1. USMLE Step 2 - United States Medical Licensing Examination, Step 2.  This will test students on their ability to apply their knowledge, skills and understanding of clinical science, while under supervision.  Huge part of how residency programs gauge applicants.
    2. Residency Applications - Includes applying to residency programs all over the country (this wife is rooting for Hawaii - kidding - not).  Start setting up interview dates then travel all over the country.  Spend a lot of money on travel, then rank your programs and submit your life. 
    3. Match Day.  The day when residency programs rate their applicants and applicants rate the programs, and a big computer program matches it all together. Anxiety meds recommended.
  8. Graduation from medical school - Yay!  Husband is now officially Dr. Husband!  Throw a big party!
  9. Residency - "On the job training."  This phase can last anywhere from three to six years.  Residents, while they are officially doctors, are still learning.  They are supervised by attending doctors and senior residents.  The hours of residents are long and arduous - 80 hours a week on average.  Lots of being on call and night shifts.
    1. USMLE Step 3.  United States Medical Licensing Exam, Step 3.  The last one!  It tests how well med school grads can apply medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine.
  10. (Potential) Fellowship.  A fellowship is basically becoming specialized in a specific field (for instance, a general surgery resident may wish to complete a fellowship in vascular  surgery).  Fellowships tend to last somewhere in the 1-3 year range. Not all doctors complete fellowship - it completely depends on what they are choosing to do.
Then?  You're "done."  Breathe a big sigh of relief.  At the very least, it takes eleven years to become a doctor: four years of undergrad, four years of med school, and three years of residency.  But if you do a longer residency followed by a fellowship?  We're talking upwards of 16 years.  Oh, and if you took time between earning your undergraduate degree and beginning medical school, like we did?  Even longer.  When all is said and done, from the time my husband started his undergraduate degree to when he will finish his fellowship will be that big number above - 16 years. Hey-oh!

And don't forget about staying board certified!  That means studying for tests to stay up-to-date every 7-10 years.