4 Things to Consider Before You Study MBBS from USA
It is not always easy to give first preference to Indian medical colleges. Few seats are there for MBBS inIndia. Moreover, landing a seat in the medical college in India is further complicated by capitation fees. In2017, there were 10+ lakh medical applicants for around 52,000 MBBS seats in public and private colleges.Private medical schools further charge high fees not affordable by everyone. This is why many studentsprefer to study MBBS from USA. MBBS in USA for Indian students is the right choice for medical aspirantslooking for quality courses and MCI recognized universities.
- How to Choose the MBBS Course
If you are looking for MBBS from USA, the first thing to consider is the overall budget for the MBBS. EvenMBBS in USA for Indian students has several categories of medical colleges and universities. Grade Acolleges tend to charge higher tuition fees. If you get a scholarship, that can solve financial concerns. Buteven tier-2 colleges in the US are well recognized as beacons of education.
- Government or Private Colleges?
Another big question is whether you need to choose government run colleges or private medical schools.The accreditation of the college or university is also important. The college or university must be authorizedby the MCI to ensure you can clear their screening test and practice as a doctor in India.
- Medium of Education
The standards of education are important, but so is the medium. This is not a worry for Indian students inthe US as colleges here teach in American English.
- Living Costs Yet another area to consider is the living costs. MBBS from USA can offer a lot of value, but accommodationand other costs should also be factored in, when you spend money on a medical education abroad.
- Opportunities for Internship
Of course, students who study MBBS from USA may prefer to practice there as well. After all,
MBBS in USAfor Indian students should have internship opportunities to open doors for you to be able to practice in theUS itself.
- Medical education in the United States of America
Introduction to the USA healthcare system
- The USA is a large country (population 300 million) with a robust healthcare system. The medical education system is extensive, with over 140 medical schools, and thousands of postgraduate training programs. Healthcare facilities are a mix of public and private institutions, both non-profit and forprofit. The USA healthcare system is also the most expensive in the world, both on a gross domestic product and per capita basis (Anderson et al. 2007). The payment system is a mixed public and private system, but without universal coverage. There continues to be contentious debates in government regarding the future of healthcare spending and the reduction in the number of uninsured.
- History of medical education in the USA
- The dominant form of medical education in the USA is allopathic (the 125 allopathic schools accounted for 84% of USA medical school graduates in 2007); the other type is osteopathic medicine (Gevitz 2009). The application requirements and training of osteopathic students are similar to allopathic physicians, with the primary difference being the teaching of manipulation in the osteopathic schools (Gevitz 2009). In recent years, osteopathic medical schools have been expanding even more rapidly than allopathic schools, increasing from 10 schools in 1977 to 28 currently (Gevitz 2009). As a result, by 2019, Gevitz (2009) predicts that 25% of all USA medical school graduates will come from osteopathic schools.
- Becoming a physician in the USA
- The educational steps to become a physician in the USA are slightly different than in Europe and other parts of the world. After graduation from ‘‘high school’’ (kindergarten followed by 12 years, or grades, of school) at age 18, students attend a college or university and obtain a 4-year bachelor’s degree before being eligible to begin medical school (though some medical schools permit the first year of medical school to count simultaneously as the final year of a Bachelor of Science degree).
- Medical school faculty weigh several factors when deciding whom to accept for admission. One is the Medical College Admissions Test (MCAT, www.aamc.org/students/applying/ mcat; Julian 2005). This standardized exam assesses knowledge in verbal reasoning, biological sciences, and physical sciences; it also requires a writing sample. The MCAT score is used by nearly all medical schools and is predictive of medical school and licensure exam performance (Julian 2005).
- Undergraduate medical education
- All allopathic medical schools in the USA are 4-year programs accredited by the Liaison Committee on Medical Education (www.lcme.org). There are 126 allopathic schools that have completed the accreditation process. These schools are located in 44 of the 50 states, plus the District of Columbia, and Puerto Rico. An additional 10 schools have achieved preliminary accreditation (five are accepting students) and seven more schools have applied to begin the accreditation process. Of the schools accepting new students, 58% are publically funded, 41% are privately funded, and the remaining school (Uniformed Services University of the Health Sciences) is a federally funded school that trains physicians solely for military and public health service (Barzansky & Etzel 2011). The average class size is 146 students, of which 47% are women (Barzansky & Etzel 2011). Osteopathic schools are accredited by the American Osteopathic Association.
- Graduate medical education
- Upon completion of medical school, physicians enter GME. The first year of training is typically called ‘‘internship,’’ although some organizations no longer recognize this term, preferring PGY-1 (postgraduate year 1) residents. For the next few years, trainees are called ‘‘residents’’ until they are eligible for certification in their specialty. After completion of GME training, if sub-specialization is desired (e.g., medical oncology or oncologic surgery), the physician can apply for a fellowship. Nearly, all GME is accredited by the Accreditation Council of Graduate Medical Education (ACGME, www.acgme.org). A physician is eligible for licensure in most states after successful completion of 1 year of GME in an accredited program, but the vast majority will complete a residency program. Currently, there are 93,000 residents training in 4100 programs and 18,000 fellows training in 4800 programs (Brotherton & Etzel 2011). Residents are paid a salary and nearly all programs are at least partially publically funded.
- Once in independent practice, all state licensing boards require evidence of continuing education, usually about 50 h per year. This training, referred to as continuing medical education (CME), can be accomplished in a variety of ways and is regulated by the Accreditation Council of Continuing Medical Education.
- Current topics and challenges in USA medical education
- Since 2005, 75% of allopathic medical schools have initiated curriculum reform (Anderson & Kanter 2010). Many institutions are moving from a traditional 2 years of ‘‘basic’’ or ‘‘preclinical’’ sciences and 2 years of ‘‘clinical’’ sciences to earlier clinical experiences in the form of modules or blocks that provide education through an organ-system approach as opposed to a subject or discipline approach. There is a movement away from lecture-based instruction and toward small-group, often case-based education. Research investigating the benefits of such curricular change and how to best use small-group education in this context is limited, to date, and empirical answers to questions of quality and ‘‘best practices’’ are needed. However, as many schools are making these changes isolated from other schools, it may be difficult to generalize these findings.
- Medical students in the USA are required to pass a clinical skills examination (USMLE Step 2 Clinical Skills) in addition to knowledge-based (multiple-choice type) examinations. The National Board of Medical Examiners is also working on a number of new assessments to include a joint project with other nations (Swanson et al. 2010). New assessments in this area are needed as the current exams have not been shown to predict future clinical performance and patient care, the outcomes most relevant to society.
- The USA medical education system is large enterprise that is simultaneously growing larger and reinventing itself on multiple levels. Exciting areas of change include the restructuring of the undergraduate years to provide more patient contact earlier in the curriculum, a renewed emphasis on student and trainee well-being, providing milestones in GME, and linking training to more meaningful outcomes, emergence of advanced degree medical educators, and more efficient research regulations. As collaborations between institutions continue to form on multiple issues, best practices from these new innovations should emerge and result in more efficient and meaningful educational activities.