Doctors

1. Education and Training

• Applicants for certification must have graduated from an accredited medical school in the U.S. or Canada, or be certified by the Educational Commission for Foreign Medical Graduates.
• They must also have completed a minimum of five years of progressive training in a residency program in the U.S. or Canada accredited by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada. During this period, they must acquire broad knowledge in disease management as well as extensive operative experience.

2. Application for Certification

• Upon completion of their residency training, surgeons may apply for board certification by the ABS. As part of the application, the residency program director must attest to the applicant's surgical skills, ethics and professionalism. Applicants must also hold a license to practice medicine in the U.S. or Canada before they can become board certified.
• If the application is approved, the surgeon is admitted to the required examinations for certification.

3. Examinations for Certification

• Surgeons must first pass a written examination known as the Qualifying Examination, which assesses their surgical knowledge.
• Surgeons must then pass an oral examination called the Certifying Examination, which tests their surgical judgment and decision making. Candidates are interviewed by experienced surgeons who evaluate their ability to diagnose and treat diverse surgical problems.
• If successful on this examination, the surgeon is deemed board certified and becomes a "diplomate" of the ABS.

While many individuals who pursue a career as a physician major in biology at the undergraduate level, many others come from a variety of other educational backgrounds. You should meet with a career counselor at the college or university you attend for what options exist for you. The important issue is preparing for the appropriate prerequisites required for medical school. The student should have a strong background in the following areas.

• Biology (cell biology, biology of the organism)
• Chemistry (inorganic, organic)
• Physics
• Communication (written and oral)
• Higher level math's
• Computer literacy
• Development of good critical thinking skills.

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The common path to practicing as a physician requires 8 years of education beyond high school and 3 to 8 additional years of internship and residency. All States, the District of Columbia, and U.S. territories license physicians.

Education and training. Formal education and training requirements for physicians are among the most demanding of any occupation-4 years of undergraduate school, 4 years of medical school, and 3 to 8 years of internship and residency, depending on the specialty selected. A few medical schools offer combined undergraduate and medical school programs that last 6 years rather than the customary 8 years.

Premedical students must complete undergraduate work in physics, biology, mathematics, English, and inorganic and organic chemistry. Students also take courses in the humanities and the social sciences. Some students volunteer at local hospitals or clinics to gain practical experience in the health professions.

The minimum educational requirement for entry into medical school is 3 years of college; most applicants, however, have at least a bachelor's degree, and many have advanced degrees. There are 146 medical schools in the United States-126 teach allopathic medicine and award a Doctor of Medicine (M.D.) degree; 20 teach osteopathic medicine and award the Doctor of Osteopathic Medicine (D.O.) degree.

Acceptance to medical school is highly competitive. Applicants must submit transcripts, scores from the Medical College Admission Test, and letters of recommendation. Schools also consider an applicant's character, personality, leadership qualities, and participation in extracurricular activities. Most schools require an interview with members of the admissions committee.

Students spend most of the first 2 years of medical school in laboratories and classrooms, taking courses such as anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, pathology, medical ethics, and laws governing medicine. They also learn to take medical histories, examine patients, and diagnose illnesses. During their last 2 years, students work with patients under the supervision of experienced physicians in hospitals and clinics, learning acute, chronic, preventive, and rehabilitative care. Through rotations in internal medicine, family practice, obstetrics and gynecology, pediatrics, psychiatry, and surgery, they gain experience in the diagnosis and treatment of illness.

Following medical school, almost all M.D.s enter a residency-graduate medical education in a specialty that takes the form of paid on-the-job training, usually in a hospital. Most D.O.s serve a 12-month rotating internship after graduation and before entering a residency, which may last 2 to 6 years.

A physician's training is costly. According to the Association of American Medical Colleges, in 2004 more than 80 percent of medical school graduates were in debt for educational expenses.

Licensure and certification. All States, the District of Columbia, and U.S. territories license physicians. To be licensed, physicians must graduate from an accredited medical school, pass a licensing examination, and complete 1 to 7 years of graduate medical education. Although physicians licensed in one State usually can get a license to practice in another without further examination, some States limit reciprocity. Graduates of foreign medical schools generally can qualify for licensure after passing an examination and completing a U.S. residency.

M.D.s and D.O.s seeking board certification in a specialty may spend up to 7 years in residency training, depending on the specialty. A final examination immediately after residency or after 1 or 2 years of practice also is necessary for certification by a member board of the American Board of Medical Specialists (ABMS) or the American Osteopathic Association (AOA). The ABMS represents 24 boards related to medical specialties ranging from allergy and immunology to urology. The AOA has approved 18 specialty boards, ranging from anesthesiology to surgery. For certification in a subspecialty, physicians usually need another 1 to 2 years of residency.

Other qualifications. People who wish to become physicians must have a desire to serve patients, be self-motivated, and be able to survive the pressures and long hours of medical education and practice. Physicians also must have a good bedside manner, emotional stability, and the ability to make decisions in emergencies. Prospective physicians must be willing to study throughout their career to keep up with medical advances.

Advancement. Some physicians and surgeons advance by gaining expertise in specialties and subspecialties and by developing a reputation for excellence among their peers and patients. Many physicians and surgeons start their own practice or join a group practice. Others teach residents and other new doctors, and some advance to supervisory and managerial roles in hospitals, clinics, and other settings.

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