How to Become an MD in Just 5 Years

Remember in your high school days how most diligent students were asked if they were interested in becoming a doctor? Unless those students were the progeny of doctors themselves (thus giving them a high moral commitment to medicine as well as at least an upper middle class background) or were from some other upper/upper-middle class background, their answers normally consisted of phrases like “No, I don’t want to be stuck in school for eight years.” or “My family can’t afford medical school.” Such answers were common even if the student was interested in medicine.

In 2006, CNN Money reported that the total cost of college was $30,367 per year for private universities, and $12,796 per year for in-state public universities. Total cost figures for US medical schools were difficult to find, but figures from the University of VA indicate that the total cost of medical school for an in-state resident would be approximately $211,000. Averaging the public and private university undergraduate figures and adding the UVA figure for medical school, the total cost of obtaining an MD degree for someone attending US schools would be $297,000.

So a college freshman today would have to go through 8 years of tertiary education and find some way of coming up with close to $300,000 before entering their residency program. Facing these hurdles, it’s no wonder why even capable students balk at the prospect of becoming a doctor. There happens to be a shorter and less expensive path to becoming a doctor in the US that your high school guidance counselor might not have told you about. That is, attending a foreign medical school with an integrated pre-med program.

It’s no secret that many US doctors are born and educated overseas. According to the American Medical Association (AMA), one out of every four physicians in the US received their medical degree overseas. It’s difficult to determine the exact number of US citizens that obtain their medical degrees overseas but, in 2007, the Educational Commission for Foreign Medical Graduates (ECFMG) reported that almost 28% of the National Resident Matching Program (NRMP) participants educated overseas were US Citizens. From the AMA and ECFMG figures, you can surmise that about 7% of the United States’ physicians are US citizens that attended medical school overseas.

Perhaps the current physician shortage reported in the US can be partly attributed to the high cost and lengthy time requirements of becoming a doctor in the US. Your high school guidance counselor or even health profession counselor is often not familiar enough with US Physician licensing requirements for International Medical Graduates (IMGs) to offer counsel to prospective foreign medical school students. These people consider foreign medical school because they are concerned with the high cost and long time duration of becoming a doctor exclusively through US medical schools and universities. Vikas D. Reddy, who’s studying medicine in India, said he chose to study abroad because it’s cheaper, slightly faster, and has less competition. But he noted that extra hard work would be required for clinical rotations and studying for the USMLE.

Several friends of mine recently enrolled in Universidad Iberoamericana (UNIBE) School of Medicine, a Caribbean medical school. Their reasons for enrolling there as opposed to going through the US to become doctors were the lower cost, shorter time requirement, and less complicated application procedure. For someone without a bachelor’s degree, UNIBE offers an MD degree in five years. This is achieved by an integrated pre-med program and year round attendance, broken up into three 16 week semesters. The total cost of attendance is about $24,000 per year, which would translate into a total cost of $120,000. The typical American route to an MD is about 250% more expensive and three years longer than this particular Caribbean route. MCAT scores are not required for admission either.

But these benefits come with a price, both academic and personal. On the academic side, additional personal preparation is required to successfully pass and maximize scores on the US Medical Licensing Examination (USMLE) because professors do not focus on subjects covered on the USMLE. USMLE preparation is so rigorous that many students take entire semesters off to prepare for the examination, which would lengthen the time required to graduate. IMGs must be certified by the ECFMG before they are allowed to sit for Step 3 of the USMLE. Finally, IMGs have to compete with each other for a US residency and more IMGs are available than IMG residencies, meaning a US residency is not guaranteed.

The personal sacrifices required to attend medical school abroad are significant. Students have to acclimate to a new culture, country, and language. Students are isolated from friends and family. In the Caribbean, they have to adapt to living in a 3^rd World country. When back in the US on a break from UNIBE, my friends have reported the many things they took for granted when living in America that they lack in the Dominican Republic: continuity of power, ability to drink tap water, high-speed internet, American food, and the ability to seamlessly interact with the general population to secure everyday services.

When asked what the greatest challenge of attending medical school in the Dominican Republic, Kathryn Syed, a 3rd year medical student at UNIBE, said the following:

“The most difficult part has not been actual school itself, but rather the struggle of adjusting to living in a third world country and experiencing things like not having electricity for many hours at times. There were times in the beginning when we would not have running water all day. Also, learning another language has been difficult. Now we have begun clinical rotations in the hospital. That is all in Spanish, so sometimes it is frustrating if you don’t understand what a doctor is saying.”

The personal challenges and the lower admission standards used by foreign medical schools have lead to a higher attrition rate when compared to their US counterparts. So, while the prospect of becoming a doctor by attending medical school abroad is less costly and doesn’t take as long as in the US, it may not necessarily be easier overall.

Without knowing it from the beginning, it appears Syed has found a way to overcome the social isolation that’s inherent in attending medical school abroad. She enrolled in medical school with her husband, Faisel. Faisel illustrates this point, when he responded to what he thought the greatest challenge in attending medical school abroad was. He said “Being away from family and friends is the most difficult aspect of doing what I’m doing here. Even that isn’t so bad because I’m going through this with my wife.” The Syeds noted that many of their fellow students who have been successful there are married and have also been going through the program together.

If you’re passionate about becoming a doctor but can’t afford 8 years and $300,000, attending medical school abroad might be the option for you. While there are incentives to pursuing your MD this way, there are still plenty of hurdles.

List of Sources

Rob Kelley, “Average college cost breaks $30,000.” CNN Money.com.

UVA School of Medicine Financial Aid, “UVA School of Medicine 2008-09 Cost of Attendance Budgets.” UVA Health System.

IMG Section, “International Medical Graduates in the United States.” American Medical Association.

ECFMG, “ECFMG Fact Card/Summary Data.” ECFMG.

AAMC Center for Workforce Studies, “Recent Studies and Reports on Physician Shortages in the US.” Association of American Medical Colleges.

Crosby & Cannon, “International Medical Schools for US Citizens: Considerations for Advisors and Prospective Students.” National Association of Advisors for the Health Professions.

US Medical Licensing Examination. USMLE.