Dear Mentor:

Can I study medicine in the US after my MBBS?

I am a medical student studying in the third year of MBBS [first degree in medicine] in Nepal. I am a citizen of India. I want to know if I can do my internship in USA immediately after completion of my fourth year of MBBS. One more thing: If I want to take up basic sciences part of medical sciences - that is, anatomy, physiology and microbiology for my post graduate course in the USA, what exams are required and what are the procedures?

Medical Scientist, Warangal, India

Dear Medical Scientist:

The system of education for medicine in the US is entirely different from that in Nepal or India. The first degree in medicine in the US is MD (Doctor of Medicine), a program which students enter after completing a 4-year Bachelor's degree. The MD program typically takes 4 years: 2 years of classroom study and 2 years of rotations, which are mini-apprenticeships with doctors in a variety of clinical settings and disciplines. Subsequent to completing the MD, one must complete a residency program - 3 to 4 years in duration depending on the specialization - before one can practice medicine in the US.

The fundamental requirement for obtaining the right to begin a medical residency in the US is the completion of the US Medical Licensing Exam (USMLE). We have answered a question on completing USMLE and obtaining residency in the US in an earlier column: How do I do medical residency in the US? You would essentially have to complete the 3 steps of the USMLE. Steps 1 and 2 can be completed in various parts of the world, including India. Step 3 must be completed in the US. Thus you require a reasonable sum of money to visit the US for the purpose of taking the USMLE. You would then have to take the risk of whether you can find residency in the US and whether you can obtain appropriate employment authorization from the US INS (Immigration & Naturalization Service). An employment authorization is required for foreign residents because medical residency is a form of employment and foreign resident are not legally authorized to gain employment in the US without appropriate legal documents.

The undertaking is expensive and presents significant risks.

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