requirements for medical practice/taking up specialization in the US?

[zen_virgil]

hi! i would just like to know what's required of you to be able to practice medicine in the US. if you finished your specialization here, say, in neurosurgery, then how easy is it to establish a foothold there? how about if you decide to continue your specialization abroad?

i'm currently a 2nd year med student and i'm just pondering about my future. i'm also a US immigrant but i'm studying medicine here as of the moment. sometimes it makes me wonder how i am going to go through this as a US immigrant while having a "vacation" here to study in the strict sense of the word. although our doctors at school always stress out that we should eventually return here if possible to serve the Philippines....uh well, i'll just have to think about that.

my family is also considering me to migrate for good after i finished medicine here. what are my chances of doing specialization in the US? what are the requirements? is there something i need to do before anything else? any help is appreciated.

[pexxerdoc]

hi! i would just like to know what's required of you to be able to practice medicine in the US.
After graduation here in the Philippines at 2008, you have to take the United States Medical Licensing Examinations ( http://www.usmle.org/About/About.htm ) or USMLE.

Step1 and Step2b (CK) can be taken here in Manila but Step2b (CS) and Step3 must be taken in the United States.

Surely, you know that in the United States and its territories, the individual medical licensing authorities ("state medical boards") of the various jurisdictions grant a license to practice medicine. Each medical licensing authority sets its own rules and regulations and requires passing an examination that demonstrates qualification for licensure. Results of the USMLE are reported to these authorities for use in granting the initial license to practice medicine. The USMLE provides them with a common evaluation system for applicants for initial medical licensure.

The USMLE is sponsored by the Federation of State Medical Boards (FSMB) of the United States, Inc., and the National Board of Medical Examiners® (NBME®) .

The USMLE assesses a physician's ability to apply knowledge, concepts, and principles, and to demonstrate fundamental patient-centered skills, that are important in health and disease and that constitute the basis of safe and effective patient care.

Each of the three Steps of the USMLE complements the others; no Step can stand alone in the assessment of readiness for medical licensure. Because individual medical licensing authorities make decisions regarding use of USMLE results, physicians seeking licensure should contact the jurisdiction where they intend to apply for licensure to obtain complete information. Also, the FSMB can provide general information on medical licensure.

If you are planning to practice in California, check with the California Medical Board requirements ( http://www.medbd.ca.gov/). 1426 Howe Avenue, #54 Sacramento, CA 95825 phone: (916) 263-2382

Here’s a list of Neurosurgical Residency Programs in California ( http://www.acgme.org/adspublic/)

1. University of California (Davis) Health System Program
University of California Davis Medical Center
4860 Y Street, Suite #3740 Sacramento, CA 95817
Neurological Surgery Jan Paul Muizelaar, MD, PhD (916)734-3685
(916)452-2580

2. Loma Linda University Medical Center, Room 2562 B
11234 Anderson Street
Loma Linda, CA 92354
Neurological Surgery Austin Colohan, MD (909)558-4417
(909)588-4825

3. University of Southern California/LAC+USC Medical Center Program
Los Angeles County-U S C Medical Center, Suite 5046
1200 North State Street
Los Angeles, CA 90033
Neurological Surgery Steven L. Giannotta, MD (323)226-7421
(323)226-7833
kguzman@usc.edu

4. UCLA Medical Center Program
David Geffen School of Medicine at UCLA
Box 957039
10833 LeConte Avenue
Los Angeles, CA 90095
Neurological Surgery Neil A. Martin, MD (310)794-7362
(310)267-2707
cbruton@mednet.ucla.edu

5. University of California (San Francisco) Program
University of California (San Francisco) Medical Center
505 Parnassus Avenue, M779, Box 0112
San Francisco, CA 94143
Neurological Surgery Nicholas M. Barbaro, MD (415)502-2965
(415)753-1772

6. Stanford University Program
Stanford University Medical Center
300 Pasteur Drive
Edward Building, R281
Stanford, CA 94305
Neurological Surgery Griffith R. Harsh, MD, MBA (650)725-0701
(650)498-4686
gharsh@stanford.edu

7. University of California (San Diego) Program
University of California (San Diego) Medical Cente
200 West Arbor Drive #8893
San Diego, CA 92103
Neurological Surgery Lawrence F. Marshall, MD (619)543-5540
(619)543-2769

if you finished your specialization here, say, in neurosurgery, then how easy is it to establish a foothold there?
Depends on your definition of “easy.” The application process is extremely time-consuming. Therefore, I would strongly suggest, you take the earliest possible opportunity to apply for residency in the states. According to the number of programs and filled positions - by specialty for the current academic year - as of June 30th, 2005, the 95 programs in Neurological surgery, 796 positions are already filled.

Some hospital programs require you to match. All University Hospital residency programs are the most sought-after, hence, the sooner you apply - the better chances you will have.

Many recommend General Surgical residency before specialization. Most have internship combined as first year surgical residency.

how about if you decide to continue your specialization abroad?
This would be another option.

i'm currently a 2nd year med student and i'm just pondering about my future.
It is very commendable of you to think ahead! I admire visionaries!

i'm also a US immigrant but i'm studying medicine here as of the moment. sometimes it makes me wonder how i am going to go through this as a US immigrant while having a "vacation" here to study in the strict sense of the word.
But don’t lose the fact that it’s your "working vacation." Going to Medical school is no picnic.

although our doctors at school always stress out that we should eventually return here if possible to serve the Philippines....uh well, i'll just have to think about that.
I wish you would too. I did. :) Know that whenever you decide to return, Mother Philippines will always welcome you back with open arms.

my family is also considering me to migrate for good after i finished medicine here. what are my chances of doing specialization in the US?
I agree! Your family invariably thinks of your best interest. Chances for you in the US are very good to excellent!

what are the requirements?
For application forms, click: USMLE ( http://www.usmle.org/applicationmaterials/default.htm )

is there something i need to do before anything else? any help is appreciated.

Study hard. Aim high for the best transcript of records. Accumulate your stock knowledge now for future use:

A. RP board exam, if you opt to return.
B. USLME
C. State boards
D. Felllowship boards for membership to Fellow status, in the American College
E. Specialty board towards Diplomate status and Board Certification

Click also on this: It's an actual timeline (http://fmg.2ya.com/) of an applicant doctor from India. It's uncanny; He even has a tailored-made message for you, zen! Very informative and insightful.

CASE 1. THE MEDICAL STUDENT

“Boy! You are sharp and wise if you have already decided at this early stage to go ahead and try for a US residency.
If you have entered a medical school outside the US and are reading this, you have the best opportunity of all others. This is because you have a spread out schedule which is easy on your time and pocket. Also, you will not need to strain unduly over academics. Although policies in the US may take a more favorable or unfavorable turn by the time you complete the process, you have the luxury of time on your side, which most FMGs do not have.

This is how best you can carry out the initial steps in your campaign:

1. Apply for and take Step 1. Get registered with the ECFMG and apply for USMLE Step 1 on the same form when you are completing studying anatomy, physiology, pathology, pharmacology, and social medicine. This should be at least 2 years after joining the medical school. Your medical school Dean will need to verify your medical school status. Give the registration 4-8 weeks. When this is complete, you receive your ECFMG ID which you should learn clearly by heart. This will not change lifelong. Plus, you should have received an orange permit for taking the Step 1 exam. You will also receive a letter with these telling you your eligibility period for taking Step 1, which usually begins the following month and lasts 3 months. This period may be extended by paying a fee if you cannot take the test in the specified 3 months. Rules are available in a booklet that ECFMG sends you or from their website.

2. Apply for and take Step 2. For this you should apply to the ECFMG while undergoing your rotating internship preferably before January of the year in which you wish to begin your residency in the US. You are required to complete at least 4 years of medical school. Orange permit and other things will be as for Step 1.

3. Apply for and take TOEFL.

4. Proceed with the rest of the steps as listed above.”

Good Luck! :)

[spo5_santos]

^^When I found out that an MD has to go through 13 years of college schooling and training before she can get board certified, I discouraged my daughter.

:(