The most common questions we receive are “where are you in the process,” “how many years are left” and “what’s next.” I remember when we first started this journey, we thought that the most difficult part was getting in, but I’ve come to realize that it’s not quite the case. Yes, we both knew medical school would be challenging and long but there was a lot more to it than we realized and keeping all the years and steps straight has been difficult. So to make it all a little less confusing, I’m outlining the basic medical school timeline. Each school and program are different, as well as if you’re in a DO program or an MD program.
My husband had decided to pursue a DO degree because there’s additional training in osteopathic manipulation and the philosophy aligns better with his own. Both DO’s and MD’s are doctors, they ultimately take the same licensing exams(DOs take an extra one) and have the same training.
Year One (MS1 or OMS1)
The first year of medical school is not easy, and you start immediately without training wheels. You’ll see quite a bit of students drop out after the first term, unfortunately. The first exam is always the scariest and hardest. You have no idea what to expect really, and it feels like it can make or break you. That isn’t necessarily the case. If you don’t do well, you can work harder next time and pull your grades up. Your first year is the time for you to sort out exactly how you are going to need to schedule your time and how you study best.
-You receive your white coat (some schools may wait until the end of medical school)
-You need to take your core science classes which are the basis of medicine. Some of the ones that Conor took his first year are the following: the cellular and molecular basis of medicine, osteopathic principals and practice, primary care skills, emergency medicine, cardiovascular, renal and pulmonary medicine, clinical reasoning, and quite a bit more.
Year Two (MS2 or OMS2)
The second year of medical school does get substantially more difficult; however, it’s not because of the content of classes getting more complicated, it’s because, on top of your coursework, you need to also study for Step 1 (which I’ll explain further later). The courses the second year do get more specific as they prepare you for upcoming rotations. Some of the courses that Conor will be taking this fall are gastroenterological sciences, reproductive genitourinary and obstetrics, gynecologic medicine, medical law, musculoskeletal skin, preventative and community-based medicine, and more primary care skills training.
-You’ll continue all your classes
-You’ll begin studying for Step 1
Step 1 (USMLE & COMLEX)
USMLE stands for US Medical Licensing Exam, and COMLEX stands for the Comprehensive Osteopathic Medical Licensing Examination, and there is a total of 3 parts/steps to licensing. The reason why this is so incredibly important to do well on is that if you don’t pass, then you retake it but if you do pass, no matter what score you get (even one point above passing) you have to keep your score; there are no retakes. This exam will help determine where you’ll go for rotations as well as how competitive you’ll be for residencies. If you’re someone who is going into family medicine, you won’t have to worry too much about it, but if you are looking to specialize heavily, then you need to do the best that you possibly can.
-The exam is a total of 8 hours and is usually done in May or June of MS2/OMS2
-USMLE is for both MD & DO medical students
-COMLEX is for only DO students. However, DO medical students will often take both licensing exams
Year 3 (MS3, OMS3, Clinical Rotations, or Clerkships)
Following your passing of Step 1, you’ll be able to go onto your clinical rotations. This is the stage where you’ll be traveling a little bit, and you’ll be working in different hospitals and practices. Although you’re working in a hospital, you’re still not getting paid for the work you do; this is still school. For this year you’ll be exposed to the biggest fields of medicine; think Pediatrics, Internal Medicine, Psych, OB/GYN and others. Rotating through these fields will not only expose you to different cases and opportunities to learn more about these fields, but it will also give you an idea of what you may or may not want to go into. Following every few weeks, you’ll complete a rotation by taking a Shelf exam. Shelf exams are a way to ensure you’re getting the most out of your rotations and as a way to prep you for the upcoming Step 2. The USMLE Step 2 is taken sometime in between the end of MS3 and the start of MS4
Year 4 (MS4, OMS4, Clinical Rotations, or Clerkships)
MS4 and MS3 are very similar; however, rotations this year will be in more specialized fields. Sometimes students will do a rotation at a hospital that they’re hoping to apply to as a resident. On top of doing rotations, you’ll be actively applying to different residencies. You cannot go just anywhere for a residency, it needs to be an ACGME accredited residency program, and it needs to be a program in the specialty that you’re looking to join. Following applying to programs, eventually you’ll hear back from a few, and you’ll have to travel to interview with them. When you’ve done all your interviews, you’ll then rank the residency programs by your preferences. Students will base their ranking on the program, location, and a few other areas. Once you submit your residency program choices, you’ll have to sit and wait until a special day in March. This day is called Match Day, and basically, the residency programs will have ranked the students they want in their programs, and a computer uses this as well as your preferences to match doctors to residencies to the best of their ability. The reason you’ll hear a lot of talk about Match Day is not just because it’s exciting to find out where you’ll be for your residency but it’s because not every person is matched. Following Match Day there is something called The Scramble where spaces will open up in residency programs as students accept and deny acceptances. Students who didn’t match will then apply again and hopefully, find a place to do their residency. Finally, after all the craziness of this year, students finally graduate medical school. Phew!
Although you may have graduated, you’re still learning and still working towards becoming a doctor. Your residency can be 3-5 years or even more depending on your specialty. The first year of residency is called the internship year and following this year, residents or interns will take the final USMLE Step 3. Although you’re still learning, residents are paid for the work they during the residency program. Salaries typically range between $40,000-$60,000 depending on which city and state the residency program is located. An example would be that you’ll get paid more in a residency program in New York City, but the cost of living is much higher. After taking Step 3 and the board examinations, you have become a board certified doctor.
After the completion of residency, it’s an option to go into a fellowship program. If you’re someone who will be going into a specialty, then you will most likely do a fellowship over starting directly at a hospital or practice. When you’re finally at a point where you’re at your practice or working in the hospital, many people refer to this as IGB, or it gets better years because finally, after all that work you’ve reached your goal of being a doctor and you can start paying off student loans 😉