The formal study of medicine in the U.S. usually begins after receipt of the bachelor's degree, which may be in any subject. After four more years of study, including two years of rotating clinical practice, the M.D., or first professional degree, is awarded. There is no required undergraduate degree for entrance to medical school, but most medical schools require completion of basic courses in biology, chemistry, physics and math, and a suitable score on the MCAT (Medical College Admission Test). For details about these requirements see Medical School Admission Requirements. The MCAT is given twice a year. MCAT bulletins may be obtained by writing to:

MCAT Program Office
P.O. Box 4056
Iowa City, IA 52243-4056
www.aamc.org

Admission to medical school is very competitive even for American students, and some schools are legally barred from admitting out-of-state students, thus the chance of admission for a foreign application becomes even smaller. There is a slightly better chance of admission if the foreign applicant has satisfactorily completed several years of undergraduate study in the U.S. However, such students in 1998-99 still constituted only about 1% of the total new entrants to U.S. medical schools. Of the total number of medical school applicants, 2.93% were foreign, and of that only 25% were granted admission.

Licensing is a function of each of the states. However, all the states require at least possession of an MD degree or its equivalent, and passing Step 3 of the U.S.M.L.E. (United States Medical Licensing Examination). In addition, all require from one to three years of graduate medical education after receipt of the MD.

Graduates of foreign medical schools listed in the World Director of Medical Schools are also eligible for licensure if they have ECFMG (Education Council on Foreign Medical Graduates) certification, one to three years as graduate medical education in the U.S., and have passed U.S.M.L.E. Step 3.

The requirements for the states for licensure for both U.S. and foreign-educated physicians are given in the Graduate Education Medical Directory.

These may last for three to seven years, at the end of which the resident may be certified as a specialist in the appropriate field. This requires certification by the Education Commission on Foreign Medical Graduates, a U.S. based organization. An important part of obtaining the certification is passing Step 1 and Step 2 of the USMLE (United States Medical Licensing Examination). For more information about the USMLE and ECFMG certification, write to:

For information about how to apply to the residency programs see the Directory of Graduate Medical Education Programs.

Ph.D. programs in one of the basic medical sciences, such as anatomy, microbiology, or physiology, prepare physicians for research or teaching careers in medicine. For other career goals, a master's in public health, health administration, or hospital administration may be a good choice. TOEFL and GRE may be required. Since patient contact is not necessary for these programs, ECFMG certification is not required.

Short-term, non-degree programs for the purpose of observation, consultation, teaching, or research are available. For many of these programs, ECFMG certification may not be required. These opportunities are often arranged informally, through direct personal contacts.

The R.N. (Registered Nurse) diploma or A.D.N. (Associate Degree in Nursing) requires at least two years of education beyond high school, and is sufficient for entry-level positions. However, the four-year Bachelor of Science degree in nursing is desirable for management opportunities and career advancement. Entrance requirements include high school courses in science, and the SAT may be required for entry to the B.S.N. programs.

All states require graduation for a nursing school accredited by the state, and passing of a two-day national licensing examination (usually the National Council Licensure Examination for Registered Nurses (NCLEX-RN) for licensing). At least one state has made a BSN a requirement for licensing as a R.N. Many states require that foreign nurses, before being eligible to take the NCLEX-RN, must first obtain certification from the Commission on Graduates of Foreign Nursing Schools (CGFNS).

CGFNS certification includes a review of the applicant's nursing credentials to determine the nurse is a first-level, general nurse. When the review is successfully completed, the applicant is eligible to take the CGFNS Qualifying Exam, a one-day test of nursing knowledge and proficiency in the English language. For information about the CGFNS certification and the exam, write to:

Commission on Graduates of Foreign Nursing Schools
3600 Market St., Suite 400
Philadelphia, PA 19104-2651
Or search at: http://www.cgfns.org

Entry into master's and Ph.D. nursing programs requires at least licensure as an R.N., or for foreign nurses, at least passing the CGFNS with the obligation to take the state licensing exam at some stated point after entry into the program. Other requirements include TOEFL, GRE, and a bachelor's or master's degree from a NLN (National League for Nursing) accredited program.