Congratulations! Your child has made an incredible, awe-inspiring decision to pursue their medical degree. The path to their MD, DO, PhD and more is longer and windier than most would expect from the outset.

Have no fear: We have lived and breathed medical education for 14 years now, working with countless students and parents in the process. We’re here to help paint the picture for you of what you can expect, and how you can support your child in the process.

Settle in, get comfortable, feel free to take notes, and if you don’t have a ton of time now, bookmark this page in your browser so you can refer to it as needed (or PRN, as we say in medicine) going forward.

The Pre-Medical or Pre-Health Path

First things first: If your child (we’ll refer to them as your student going forward) has just started out in their undergraduate or post-baccalaureate pre-medical training, be sure to check out this Pre-Med Parent’s Guide first before reading this post further. If you already have a handle on the pre-med/health world, read on.

Students who want to practice medicine will apply to medical schools after taking the MCAT (Medical College Admissions Test) and before graduating from their pre-med or pre-health program.

Types of Medical Schools

Oh, the places they’ll go! If your student is a United States citizen, they will most likely want to go to a U.S. MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) program.

You probably just thought, “Well, duh!” But, here’s why this is important: If your doctor-to-be wants to practice medicine in the United States, they will need to take and pass the United States Medical Licensing Examinations (USMLEs) or the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) throughout medical school and in residency to obtain their medical license.

U.S. medical schools’ curricula are often created with part of the end goal being to ensure their students have covered the necessary content and received adequate support to ensure they are set up for success on the USMLEs or the COMLEX-USA.

Caribbean and international programs are a little more touch and go on this front, and students who go to these programs, *usually* are not able to pursue the more competitive medical residencies and specialties. More on this later.

Types of Medical Degrees

In the United States, there are a few different degrees and advanced degrees that medical students work to obtain. Here are the different paths and their usual length, assuming there are no delays or breaks in the midst of medical training:

• MD or DO — 4 years of training.
• MD/MPH — 5 years of training.
• MD/PhD —  7 years of training. Most often, students complete two pre-clinical years, then spend three years in research, and then finish their two remaining clinical years.

Both MDs and DOs go through very similar medical training and go on to practice medicine, with the primary difference being that DOs are also trained in Osteopathic Manual Manipulation.

The Difference Between Undergrad and Medical School

A common adage is that the first subject test in med school is harder than the MCAT, so don’t be surprised if your student starts off med school with a quantum expression of emotions — excited, nervous, hopeful, scared… pick an emotion, and they’ll probably experience it.

While in undergrad, most soon-to-be medical students are near the top of their class, crushing their courses and exams, and are essentially the big fish in a small pond.

When they get to med school, all of a sudden, they find that they are now a big fish in a small pond with a ton of other big fish. Some students expect this and handle it without taking massive blows to their confidence. Others, however, feel the sickening onset of the comparison and self-doubt monster start to set in when they no longer are at the top of their class, and are instead “just average.”

One thing you can do for your student if you start to see this happen for them is to remind them of how extraordinary they had to be to get into medical school, and that “just average” is something they should be incredibly proud of. If you want to pull a dad-ish joke out, you can ask them, “What do you call a med student who just barely passed all their courses? A doctor.”

Pre-Clinical and Clinical Years

The majority of medical schools’ programs have students begin with two years of pre-clinical training (think basic science foundation setting). Then, after passing the USMLE Step 1 and/or the COMLEX-USA Level 1 if they’re a DO student, they’ll begin their clinical years, which, as you would imagine, entail clinical experience.

Other programs do away with the “traditional” 1st, 2nd, 3rd and 4th year approach. These programs generally commencing with ~1.5 years of foundational training, a year of clinical training, then the final ~1.5 years that begin with dedicated time to study for and pass the USMLE Step 1 and/or COMLEX-USA Level 1, and finish with electives.

Clinical years are comprised of rotations (also known as clerkships) in hospitals, and usually begin in 3rd year. “Core rotations” last from 2-12 weeks, and are usually the following:

• Internal Medicine (12 weeks)
• Emergency Medicine
• Surgery
• Ob/Gyn
• Pediatrics
• Psychiatry
• Neurology
• [Family Medicine — not required by all schools]

These clerkships are the times when students get to try these different specialties on for size, usually while wearing an overlong white coat. They’ll start to get a sense of which specialties interest them, and it’s usually around here that students begin to self-sort themselves into surgical and non-surgical callings, and start to get a sense of what specialties they might want to pursue.

The USMLEs & COMLEX-USA

As mentioned above, medical students must take and pass the USMLEs & COMLEX-USA in order to graduate and practice medicine. As they stand as of 2020, the USMLE Steps 1, 2 CK (Clinical Knowledge) and 3 — as well as the COMLEX-USA Levels 1, 2 CE (Clinical Experience) and 3 are all scored exams. (You can read more about the 2022 scoring changes here.)

Medical students take Step 1 and Level 1 usually at the end of their second year of medical school and definitely before they apply to residency. You may be thinking, “Scored exams are nothing new. Why is my student so stressed? They’ve gone into full hermit mode….”

Here’s why:

• Residencies put an incredible amount of weight on students’ Step and Level 1 scores when selecting applicants for their programs.
• Students usually only have 4–8 weeks of dedicated study time to prepare for Step and Level 1 which essentially test them on their ability to integrate two years’ worth of pre-clinical medical knowledge.
• For Step 2 CK and Level 2 CE, students basically usually only have 2–4 weeks of dedicated study time to prepare for these exams — and this is at the end of their first clinical year that’s been full of demanding and exhausting clerkship hours.

4th Year of Med School, Away Rotations, Residency Match & Graduation

Fourth year is the year of elective rotations, some of which can be “away rotations” or sub-internships (sub-i’s) which take place at other hospitals than the student’s home institution. These electives are how students can gain more experience in the specialties that interest them, and also be exposed to new programs in the process.

Residency applications are usually top of mind for fourth year med students, as they generally interview at different residency programs they’ve applied to from October through late January/early February. This usually entails a good deal of traveling for students and is no small undertaking. Once the interviews are complete, students submit their rank lists and wait for Match Day (which is Friday, March 20th, in 2020) to find out where they’ve matched for their medical residency.

Students will often take hard-earned vacations or just enjoy time off with friends, family and loved ones after graduation — when they officially earn their title of Doctor — to soak up some down time and relaxation before beginning residency.

We hope this has been helpful! If you have any questions about the process, please don’t hesitate to reach out to our team at HQ@medschooltutors.com or 212.327.0098. We’re here to help make sense of the process and provide guidance for your student’s success!