Medical School

United States medical schools graduate about 25,000 doctors per year, yet that number falls shy of the number of doctors our health care system needs. Consequently, efforts are underway to increase the number of physician graduates, as the numbers indicate that job availability will remain strong.

At the pinnacle of health careers, doctors study for four years of undergraduate education to complete a bachelor's degree before embarking on their medical school journeys. Entry to medical school is highly competitive, requiring substantial planning and effort. Individuals interested in health careers should only choose medical school if they wish to be physicians, are prepared to accept the responsibility of being a physician, are capable of the significant academic challenge of medical school, and can afford the required time and financial investment. The American Medical Association's 2007-2008 tuition and fees report (its latest version) indicates that tuition alone averages $22,199 for state residents at public schools and about $40,000 per year at private schools. After adding living expenses, fees, and the cost of books, the investment is substantial. The average physician graduates with roughly $150,000 in student loans. The time investment is no less substantial. Following medical school, physicians will spend three to eight years in residency programs, following blistering schedules while earning far less money than an established physician.

Medical School

Choosing a Medical School. The path to medical school is challenging and competitive. It is imperative that applicants identify several schools to which they are likely to be admitted and can experience success in the program. Two paths exist to becoming a physician. The first is a Doctor of Medicine Degree (MD) from one of the 133 medical schools represented by the Association of American Medical Colleges, AAMC (www.aamc.org). The second is a Doctor of Osteopathic Medicine Degree (DO) from 29 other medical schools. Osteopathic schools receive enhanced programming in comprehensive medicine focusing on personal context and the musculoskeletal system. You should choose the first step on the path by deciding which degree will best meet your goals and career plans.

After deciding on a degree path, evaluate your personal compelling factors when choosing a school. Perhaps your goal is a particularly prestigious medical school, a school close to home, or a school known for excellence in your anticipated specialty.

Carefully consider the location of the medical school. If you plan on staying at your current location for an extended time, it makes sense to apply to a medical school near your home. During school and during residency, you should be able to work locally and make contacts to continue your career in the area. If, however, your after-school goal is to live elsewhere, consider applying to a medical school at or near your future location. Local connections are meaningful when starting out in a new career.

Although cost often factors in to choosing a school, it is better to apply to schools without regard for the published tuition and fees. The actual cost of education will not be evident until the financial aid process is complete and you have explored loan, grant, and scholarship information. A school with relatively modest tuition may not offer as much aid as a school with comparatively high tuition. As a result, the school with the higher published tuition may cost no more to attend.

To winnow the possibilities from the 162 medical schools is the U.S. to just a few, rule schools in and out based on degree offered and location. Then, gather additional information. Visit schools to get a sense of the atmosphere and speak with students and staff there. Ask plainly about the pros and cons of becoming a student at each school. Speak with local doctors you respect for their opinion on the schools you are considering. Evaluate each school's curriculum. Have you already selected a specialty? Which school offers better faculty and training in your proposed specialty? Do any schools offer special coursework or programming unavailable at other schools? Evaluate the size of the school and classes. These answers should narrow your list substantially to focus on just a few schools.

Applying to Medical School. Students considering health careers must begin planning for graduate school well in advance of completing their undergraduate education. Applicants for medical school should evaluate entry requirements during their high school or early college career to build the proper body of coursework. While medical schools look for well-rounded students, applicants must complete a strict schedule of math and science courses to be considered for admission. Every prerequisite course must be complete before beginning medical school. Additionally, schools look for a rigorous undergraduate program and academic excellence. Applicants with mediocre grades, particularly in science courses, might benefit from retaking the class(es) for an improved grade.

The general requirements for medical application include completing the prerequisite courses, and, usually, a bachelor's degree; a minimum grade point average; the Medical College Admission Test (MCAT); letters of recommendation; and interviews. Only half of all medical school applicants will be accepted. Medical schools look for strong grades, high test scores, and challenging coursework, but that doesn't show the entire picture. Medical schools also look for applicants that demonstrate knowledge of the medical field, a dedication to the practice of medicine, and experience working in the field.

Most accredited U.S. medical schools participate in the American Medical College Application Service (AMCAS), under the auspices of the AAMC, which simplifies the application process. Through this program, applicants complete a single applicati and send an official transcript to apply to these medical schools. Applicants must take care to contact each school for individual admission requirements. Schools will receive the centralized AMCAS information, but may also request recommendations and other supporting documents be sent directly to the school. Applicants under consideration for admission are invited for interviews with faculty and admissions officers. The application process often begins during the third year of a student's undergraduate career.

Medical School Accreditation. Health careers are highly monitored professions. Medical schools are monitored through an accreditation process that ensures that schools are providing a quality, consistent education. The Accreditation Council for Graduate Medical Education (ACGME) accredits all U.S. medical training programs offering an M.D. degree. Schools offering a D.O. degree are accredited by the COCA, the Commission on Osteopathic College Accreditation.

Accrediting bodies regularly assess each school's educational programs and determine compliance with the standards established by the members of the accrediting body. For example, members of the ACGME are the American Hospital Association, the American Medical Association, the Association of American Medical Colleges, the American Board of Medical Specialties, and the Council of Medical Specialty Societies. A team evaluates standards by reviewing program information and completing a site visit to verify accuracy of the information. Schools that meet or exceed standards become accredited and are regularly reviewed for compliance. Medical schools that fail to meet established standards have an opportunity to improve and repair any deficiencies. For applicants, accreditation offers the best available guarantee that a medical school offers an appropriate standard of education with a consistent quality of instruction. Additionally, eligibility for federal financial aid programs depends on enrollment at an accredited medical school.

Health Careers Certification

Certification is the process by which individuals in specific health careers prove they are proficient in their field. While certification isn't strictly necessary for many positions, it is practically necessary. Certification has become a standard for many positions. Employers can ask for certification rather than having to ascertain a candidate's level of education and experience for themselves.

For job applicants, then, certification is an important part of the educational and job preparation process. Applicants pursuing frequently certified health careers should become educated on the process and try to align the certification process with their academic program. Certification may require proof of practical experience as well as coursework.

Some certifications are for short courses necessary for a number of job positions. For example, most health care providers maintain CPR and first aid certification. This certification is given at the end of a standardized short-term program offered by hospitals and the Red Cross.

Licensing differs from certification. Licensing is a national or state process which grants permission to engage in an activity, such as the practice of medicine. The licensing process also involves proof of knowledge and skills. Certification, however, is for the benefit of employers and consumers, to judge level of expertise in a specific area. For example, licensed physicians may become certified in their specialty, nurses may pursue certification as a post-anesthesia nurse, or emergency medical technicians as be certified as wilderness first responders.

What it is. Medical licensure is a government process that ensures that individuals licensed in health careers meet minimum competency requirements. Certification, on the other hand, is a process monitored and conducted by health care organizations and associations to validate an individual's level of proficiency. The goal of certification is to validate a health care worker's proficiency in his/her field. Certification indicates commitment to the highest standards of the profession and to the highest quality of patient care.

Many employers require certification, just as they would require a degree to ensure a level of knowledge and skill. Hospitals, for example, choose to hire certified medical interpreters to ensure patient safety by knowing that the interpreter has proven skills with medical terminology in each language he/ she translates. Poorly chosen words could have serous consequences. A certified nursing assistant is known to have completed a state-approved training program and passed the Nurse Aide Competency Evaluation. Physician specialists are certified through testing and peer-reviewed experience.

With the number of medical training programs and the availability of certification exams, support positions such as medical assistant and nursing assistant would be hard to earn without certification. The first step in the certification process is to identify and check with the particular certifying organization to determine the eligibility requirements. To be eligible for certification, candidates may need to complete an accredited or state-approved program of study, a particular degree, and/or a period of specific work experience. Once eligible, candidates complete an application, submit the appropriate fee, and take the certification exam. Most exams are offered at testing centers. Some certifications demand a written test and an oral test or submission of supplemental materials.

Since the goal of certification is to ensure competency, ongoing assessment is needed. Health care workers must recertify periodically, a process that may require additional examination or proof of job-specific continuing education.

For example, to become a certified medical interpreter, an interpreter must possess one year of experience as a medical interpreter or the following qualifications: be 18 years of age, have a high school diploma or GED, have completed a registered medical interpreter educational program, and be proficient in spoken English and the other translated language. Interpreters pay a $30 fee to register for the certification process. The National Board Written Exam is taken first. An interpreter who passes the written exam is then invited to take the oral exam. Candidates become a Certified Medical Interpreter after passing the oral exam. To maintain the credential, medical interpreters must compete 30 hours of continuing education every five years and maintain active membership in a professional interpreter organization.

Types of Certifications. Certifications are prevalent in health careers. Certification may represent competency in job tasks as a whole or a small task that forms a portion of an entire job. For example, emergency medical technicians, or EMTs, obtain EMT certification through the National Registry of Emergency Medical Technicians. Technicians also pursue certification related to specific tasks including First Aid-CPR-AED certification. EMTs may also pursue certification as a Wilderness First Responder and Wilderness EMT.

The American Board of Medical Specialties certifies physician specialists. Board certification indicates that the physician has demonstrated exceptional expertise in a particular medical specialty or sub-specialty. Board certification represents a commitment to maintaining expertise and consistently achieving superior clinical outcomes in a patient-focused setting. Physicians can obtain board certification through one of the 24 American Boards of Medical Specialties. To do so, physicians must pass a written exam, and, sometimes, an oral exam. To maintain certification, physicians must maintain their license, participate in continuing medical education, pass a written examination, and submit to a performance assessment by peers.

The American Health Information Management Association certifies registered health information technicians and administrators, coding associates and specialists, health data analysts, and those in healthcare privacy and security. Certification as a registered health information technician denotes that a technician can ensure the quality and accuracy of medical records and can use computer applications to assemble and analyze patient data.

The National Board of Certification for Medical Interpreters certifies medical interpreters through testing following an interpreter program or direct work experience. The American Association of Medical Assistants offers testing of candidates through the National Board of Examiners to become a Certified Medical Assistant. Candidates must complete an accredited medical assisting program with practicum, pay a $125-$250 fee, and pass the examination. To retain certification, medical assistants must recertify every five years by passing the certifying exam or completing 60 recertification points from continuing education. Candidates must also maintain CPR certification.

The American Nurses Credentialing Center certifies advanced practice nurses and nurses in specialties. To be eligible for certification, advanced practice nurses must possess a master's degree or graduate education from an accredited school. To be eligible for certification as a nurse executive, nurse executive advanced, or nursing professional development, candidates must have completed a bachelor's degree or higher in nursing or informatics. Eligible candidates must pass the certification exam to become certified. Nurses may become certified in one of 22 specialties including community health nursing, pain management, and gerontological nursing. Recertification every five years is necessary. Other nursing boards also offer certification. The American Board of Perianesthesia Nursing, for example, offers certification as a post-anesthesia nurse or ambulatory perianesthesia nurse. To be eligible for the certification exam, registered nurses must have a minimum 1800 hours of directly related experience. Certification is granted for three years, after which nurses must recertify through continual learning.

The AAPC offers medical coding certification, medical auditing certification, and medical compliance certification. The American Society for Clinical Pathology confers technician certification, technologist certification, specialist certification, diplomate certification, and international ASCP certification. Nursing assistants must complete a state-approved training program and pass the Nurse Aide Competency Evaluation to become certified. Pharmacy technicians must take and pass the Pharmacy Technician Certification Exam which is offered at test centers under the direction of the Pharmacy Technician Certification Board.

Prepare for Certification Tests. Academic health careers programs and degrees for will adequately prepare candidates for certification examinations. Still, candidates should make a prudent effort to prepare for an examination to ensure the best result, and an unsatisfactory score can delay a career.

While still working toward the education and skills for a health care position, candidates should contact the credentialing organization or visit its website to determine the specific rules of testing eligibility. Determine the schedule on which certification tests are offered. Candidates should mark their calendars with the application deadlines and make sure they are filed on time along with the necessary fees. Many applications can now be submitted from the website of the credentialing organization.

When studying for the test, candidates should obtain sample test questions and practice tests, when available, from the credentialing organization. To do so, search the organization's website for recommended study materials. Some organizations will recommend study books, while others may have their own online resources. The more a candidate reviews materials to become familiar with the format and questions of the examination, as well as refresh her memory of required information, the better a candidate will perform. It is best to review information in short periods rather than in marathon sessions. Some test-takers find it beneficial to work with a partner when studying for an exam.

To manage any anxiety and have one's mind sharp for an examination, candidates should get a good night's sleep the night before a test. On the morning of the test, a healthy breakfast containing some protein will help regulate energy levels, and an appropriate distraction, such as a book or music, at the testing center can help test-takers stay focused and calm. If it helps, bring a good luck charm and remind yourself that you have been working towards this for a long time.

Last Updated: 05/21/2014