Becoming a Physician


Preparing for Medical School

Most medical schools require a strong background in biology, chemistry, physics and mathematics. Courses in the humanities, social sciences and English are also important because physicians need to understand people and be effective communicators. Becoming a physician is an enormous investment, so it's important to learn as much as you can about the educational process and the work of physicians to make sure that it is the field for you. Reading about medicine and medical careers can help, so can talking with medical students, residents and physicians. Shadowing a physician and having a summer job in a medical setting can also be useful.

A college or university premedical advisor can help with the application process. Also, every year, the
Association of American Indian Physicians (AAIP) conducts a pre-admission workshop in conjunction with the annual AAIP meeting. Topics include: selecting a school, the admissions tests (the MCAT), writing a personal statement, and financial resources. There are even mock interviews that help students prepare for the medical school interviews linked to the application process.

The
Medical School Admissions Requirements, published by the Association of American Medical Colleges provides the specific admission requirements of each U.S. and Canadian medical school

Medical School

Two kinds of medical degrees are available: the MD (medical doctor) and the DO (doctor of osteopathy). There are 125 medical schools in the US and 23 schools of osteopathy. In the past the DO programs differed more from the MD programs than then they do today. Now graduates of DO programs are welcomed into many MD-based residency programs. In general DO programs tend to be more primary care oriented than the majority of MD programs. Most DO programs teach osteopathic manipulative techniques.

Even among themselves, MD schools differ. Some are more primary care and community oriented. Others are more focused on producing physician-scientists. Some medical schools offer combined MD-PhD programs.


For many decades, medical students spent most of the first two years of medical school in lectures and labs where they studied anatomy, biochemistry, microbiology, pathology, pharmacology and the behavioral sciences. In their second year, they also took introductory courses in physical examination and interviewing. In the last two years of medical school students rotated through hospital-based clerkships in such specialties as internal medicine, pediatrics, surgery, and psychiatry.

The awareness that real learning needs to take place in the context of patient care has led to innovations. In a growing number of schools, first and second year students participate in problem-based learning. Meeting in small tutorial groups with a faculty member, students learn the sciences basic to medicine in the context of real patient problems, usually presented as a paper case that is sometimes illustrated with video clips. First and second year medical students begin to learn how to examine and treat patients, often with the help of standardized patients - people who have been trained to present with real health problems. As they develop their patient care skills, first and second year medical students have opportunities to be involved in the care of real patients, under the supervision of a physician.

In addition to the traditional hospital-based clerkships, most third and fourth year medical students have community-based clerkships in family medicine and/or the other primary care specialties. Primary care is the foundation of medicine so first and second year students are also spending more time in community practices with family physicians, and other generalists.


Residency

Following medical school, physicians who want to practice medicine spend 3 to 7 years in a residency program in the specialty of their choice. Specialties include: family medicine, internal medicine, pediatrics, obstetrics and gynecology, emergency medicine, dermatology, surgery, orthopedic surgery, anesthesiology, psychiatry, preventive medicine, allergy and immunology, and urology.

Fellowship

Physicians who want to become highly specialized in a subspecialty field such as pediatric urology (a subspecialty of urology) or gastroenterology (a subspecialty of internal medicine and pediatrics) need additional years of education.

Advice


Dr.
Everett Rhoades advises: “There has to be a love a learning and determination. You need to be able to set aside immediate gratification and be able to differentiate between college as an opportunity to learn and college as a social event.”

Dr.
Erik Brodt, suggests getting a mentor, following your dream, and staying in school.

Dr.
Pat Rock says, “Becoming a physician is very doable as long as you have direction and the drive and the stick-to-itness to see the process through. The process can be trying but support from your family or extended family can help you cope. Becoming a physician was worth every cent and sweat I put into it. It’s very fulfilling work.

For descriptions of a few programs that recruit/support American Indian and Alaska Native students, see
Schools/Programs.

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This article was originally published in the Winter 2006 issue of Winds of Change. (The cover artist, Roxanne Chinook, is a tribal member of the Confederated Tribes of the Warm Springs Indian Reservation in Oregon. "My art emulates a personal and cultural experience, from the spirit of the trickster to healing from the traumas of my past." For more conformation, contact American Indian Art from the Pacific Northwest.