Medical School Milestones
The medical school experience includes many medical school milestones that you must pass on your way to becoming a Dr. While some are necessary for graduating medical school others are needed for licensure if you want to practice medicine in the U.S. Others create a nomenclature that causes a great deal of confusion.
Your first milestone happens before you even enter medical school. The Medical College Admission Test (MCAT) is used to asses your proficiency in subjects necessary for medical school. This test is an important part of your application, and most students complete it during junior year of college. There is no passing or failing score, it is simply used to compare students to each other. The exam can be taken multiple times if you are unhappy with your score, but potential schools will see all of your scores. Please note that “test” is part of the acronym so saying “MCAT Test” is superfluous. Similarly saying “I just took my MCATs” would give the impression that you had to take the MCAT multiple times because you were unsatisfied with your score.
Seeing a cadaver for the first time is considered a rite of passage by many physicians. While many schools start using more and more online materials, videos of dissections, and cadavers all ready dissected by professionals (called prosections) most schools still have students dissect cadavers in their first year of medical school. It is a tough, emotional experience that teaches you about the human body. It also creates strong friendships and many students find they become very close to the students in their dissection group.
The United States Medical Licensing Examination (USMLE) and the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) are the licensing examinations used by allopathic and osteopathic schools respectively. While all D.O. students take the COMLEX many opt to take the USMLE as well to open up a greater number of residency options. These exams are actually several examinations, called “steps”, taken in sequence that are necessary to achieve full licensure. Step 1 is typically taken between your preclinical and clinical training while Step 2 can be taken any time before beginning residency. The timing of the examination should be calculated to maximize your chance of getting the residency you desire. Some medical schools require a passing score on Step 1 and Step 2 to graduate while others do not, however you must pass these exams if you will be doing a residency. Step 3 is taken during residency.
Unlike when you applied to medical school, when you apply for residency you do not wait for offers and then select from amongst them. Instead, everyone applies through a central service and submits a ranked list of their preferences. Residency programs submit a ranked list of all candidates that they have interviewed. A giant computer then goes through these lists and matches appropriate students to their desired residency spots. Students are told if they have or have not matched into a program in March. Students that have not matched must go through a second matching process for any unfilled slots. Students that have matched find out where they will be going for residency at exactly the same time across the country. This can be a stressful, but rewarding, process.
This term creates a great deal of confusion. Internship is simply the first year of residency. For some specialties you must complete an internship in medicine or surgery before beginning specialty training. These field include ophthalmology, dermatology and radiation oncology. In other fields, like medicine, your internship is the first year of your three year residency. Residency length depends on the field you enter.