How to practice medicine in the United States in 7 steps


Following the line of content about professions in the USA, now I will talk about how to work with medicine in the United States, in the two possible situations: for those who are already graduated or are going to graduate in Brazil and for those who want to go to medical school in the USA. 

Are you interested in this subject? So read on and learn more about working with medicine in the USA and also about college. 

Important points about medicine in the United States 

For those who are already graduated or are going to graduate in medicine in Brazil, the first point that you need to know is working with medicine in the United States, and you need to do your residency here in the USA. This is also true for those who are already experts in some area in Brazil. 

To get a place in a residency, you will need to pass some tests that are also charged to people who go to medical school in the United States. These tests are applied by the United States Medical Licensing Examination, the USMLE

After passing the exams, you will apply for residency. But first of all, there are some steps you need to take, as I explain below. 

Steps to practice medicine in the United States 

Step 01: Check if your medical school is recognized in the United States 

The first step is to check if your college is recognized in the United States. This is currently done through registration with the World Directory of Medical Schools, the World Directory of Medical Schools (WDOMS), and the conference that the USMLE recognizes. 

So, to get this information, you must go to the WDOMS website and search for the name of your medical school. When you find your institution, click on it and then on “Sponsor Note,” which is where the statement will be that the college is accredited by the Educational Commission for Foreign Medical Graduates (ECFMG) and is eligible for students to apply for exams USMLE.

Bonus tip: search only for one of the words in the name university and do not include the city. For example, if it is the University of São Paulo, search only for São Paulo in the field “Medical School Name.” Or, if you graduated from PUC, search only for Pontifical. I say this because, in some tests, I didn’t find universities if it wasn’t that way. 

Changes planned for 2024 

Still, regarding this first step, there are some changes underway. Beginning in January 2024, the process for eligibility to take USMLE exams will no longer be done by the World Directory but by a country-specific organization. In Brazil, it will be through the Medical Schools Accreditation System (Same)

Not all medical schools are registered with SAEME, and the interest in registering should come more from the student than from the college itself. So, if you plan to apply for USMLE exams after 2024, you can go to the ECFMG website and check the requirements for the university to be accredited. 

Step 02: I have attended at least 2 years of graduation in medicine. 

To start taking the USMLE exams, you do not need to have already completed a medical degree. However, you must have completed at least 2 years of graduation. People who study medicine in the USA usually take the first test (step 01) at the end of the second year of the course. Then, when you finish your second year of medical school in Brazil, you can also take the exam. 

Step 03: first test – Step 01 

The next steps to becoming a doctor in the United States are a series of tests. The first is Step 1, which aims to assess the ability of medical students or graduates to apply fundamental science concepts to the practice of the profession. 

To do so, you must first register on the ECFMG website by paying the registration fee (the US $ 145.00). This registration is online, and you will receive a number, which is your USMLE Number, which will be used throughout your process. 

Once your registration is approved, you can apply online for Step 1, which has a $ 965 fee. 

The test lasts 8 hours, divided into seven parts, held on the same day, and it can be done in Brazil. It has about 280 questions and, although there is no time limit per question, the tip is that candidates take up to a minute and a half to answer each question. 

It is a very complex test that requires the student to know very well all the contents charged. On the USMLE website, you have a series of materials for practice, in addition to information about everything that is charged. 

Step 04: second test – Step 02 CK (Clinical Knowledge)

The second test to be a doctor in the United States is Step 02 Clinical Knowledge, also called Step 2 CK. Usually, students at American universities perform this step when they are in their fourth year of college. It is also quite difficult and requires a focused study of the candidate. 

This test assesses the clinical application of medical knowledge, different from the more theoretical character of Step 1, where the focus is more on clinical practice. The test is a multiple-choice exam, 9 hours long, 7 parts, and 280 questions. It also costs the US $ 965 and can be performed in Brazil at specified locations. 

Step 05: Step 2 CS (Clinical Skills) 

Step 02 CS is the third test you need to act with medicine in the United States. Due to the Covid_19 pandemic, it is suspended until June 2021, and information about this situation can be consulted on the website. 

However, considering that you are still at an early stage, it is likely that the exam has already resumed when the time comes to take it. 

In short, it is a practical test in which the candidate will attend a series of standard patients, actors. It is necessary to make history, physical examination, determine differential diagnoses and make notes on certain patterns. 

For this, the examinee will have 15 minutes of meeting with the patient and 10 minutes to write the notes, determining 3 possible diagnoses. There are 8 hours of exam to see 12 standard patients. 

The fee for performing Step 2 CS is US $ 1,600, and you must do it in the United States at medical centers in the cities of Atlanta (Georgia), Chicago (Illinois), Houston ( Texas ), Philadelphia (Pennsylvania), or Los Angeles (California).

Step 06: Step 3

And the last test you need to take is Step 3, which evaluates all of your knowledge and skills in multiple-choice and clinical case analysis questions. The focus here is general medicine. 

It is a 2-day exam, with 232 questions on the first day for 7 hours. On the second day, there are 9 hours for 180 multiple-choice questions and 13 more case simulations. 

The first day focuses on Fundamentals of Medical Practice and the second day on Advanced Clinical Medicine. The fee for the exam is the US $ 895 and is organized by the Federation Of State Medical Boards (FSMB) in the United States only.  

Step 07: Apply for medical residences. 

After you pass all the exams, it’s time to finish your preparation for medical residency in the United States. To apply for these residency programs, you need letters of recommendation from American doctors. Therefore, you will need to gain some experience with internships in the United States. 

You can do these internships at any time during your graduation and in your validation process. Interestingly, it is in the area where you intend to do the medical residency. In addition to making letters of recommendation possible, these experiences also enrich your CV, which is very important for getting Match, the term used when you are selected for a residency. 

So, to be accepted into the residency, you will need to know the programs very well and prepare for them, either with internships, scientific publications, or other activities. The grades obtained in the Steps also count.

When you get residency, you will move to the United States on a J1 visa for the clinical years required for training. Another option is to migrate with an EB-2 visa that already guarantees the Green Card to you and your family. However, to qualify for this visa, you need to comply with some requirements. To learn more, download our EB-2 NIW e-book. 

Medical School in the USA 

For those who dream of attending medical school in the USA, it is necessary to understand that more years of study will be necessary because medical school in the USA is actually a postgraduate course. In addition, the course is quite popular and offers few scholarships for foreigners. 

So, the first part is to do a bachelor’s degree that doesn’t need to be directly related to Medicine but needs to fulfill certain credits. Many Americans study nursing, for example, and with this diploma, they enter the medical university

But there is also a Pre-Med course that offers preliminary medical knowledge and all the necessary credits for the university but does not train you for any profession. Therefore, many people choose to graduate in other areas of health and complement the necessary disciplines.  

To graduate with a bachelor’s degree takes 4 years of study. The process to enter a college involves a selective test, interview, proficiency in English, among other institution requirements.  

Then, you should apply to medical universities that have very similar selection processes. At the Faculty of Medicine, you will study for 4 more years, take all the tests mentioned above, and then enter the medical residency that lasts 3 to 7 years. 

Only doctors with residency can work in the USA. Unlike in Brazil, there is general practice for those who do not have a specialty. 

As you have seen, the process for practicing medicine in the United States is made up of 7 steps if you already have a medical degree. Going to college in the USA may not be as interesting financially speaking, but it is also possible. Finally, the whole process requires dedication and study, but it will certainly be worth it to make your dreams come true. 

Now that you know how medicine works in the USA, I invite you to follow me on social media and stay up to date on this subject and others related to immigration to the USA. I’m on InstagramFacebook, and Youtube

And also, check out the recording of a Life I did on being doctors in the USA and learn even more.


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