Many students from around the world are interested in becoming a doctor in the US to treat certain conditions, contribute to specific research, or pursue numerous other interests. According to Results and Data: 2020 Main Residency Match from the National Resident Matching Program (NRMP), more than 4,000 applicants who are citizens of other countries obtained US residencies in 2020.

You could achieve similar success by carefully completing each of the steps below.

7 Essential steps to become a doctor in the US

While some international students pursue medical school in the US, it’s wise to research other options. In many cases, a slightly longer MD program may end up being a better fit for your educational background.

1. Apply to medical school

Medical degrees differ throughout the world, but it’s best to obtain either a Doctor of Osteopathic Medicine (DO) or Doctor of Medicine (MD) to practice in the US. When comparing medical schools, make sure to evaluate whether you meet program eligibility requirements. US medical schools that accept international students often have very specific requirements, so it may be worth looking into programs located elsewhere. Students who didn’t earn a bachelor’s degree in the US may discover that MD programs with multiple entry points, which exist in the Caribbean, are the best fit for their academic backgrounds.

It is also important to make sure you have completed an English language test, such as the International English Language Testing System (IELTS) exam. Your IELTS exam score can be used to help evaluate International MD students because it demonstrates the ability to use English competently during the study and practice of medicine.

When it comes to choosing a program, be sure to identify schools that have strong graduate outcomes. For instance, student data from September 2020 reveals that 92 percent of eligible non-US graduates of the St. George’s University (SGU) School of Medicine who applied for a postgraduate position obtained one at the time of graduation. It’s also wise to ask medical schools about what support services they have to ensure students are successful.

2. Attend medical school, and begin the licensure process

Depending on the program you choose, your first year or two of classes might entail completing preclinical courses that establish the scientific knowledge base you’ll need for your dedicated medical classes. Once you begin the four-year MD program format, you’ll spend two years attending lectures, completing lab sessions, and working in small groups. Students should also plan to take the United States Medical Licensing Examination (USMLE) Step 1 soon after completing their second year as an MD student.

The final two years of medical school are when students complete clinical rotations to further develop their practical skills and professionalism. Experienced physicians oversee these experiences, and they can often be valuable mentors. Sometime during these final two years, you will also need to pass the USMLE Step 2 Clinical Knowledge (CK) examination. Because students who graduate from a school outside the US will eventually need to obtain certification from the Educational Commission for Foreign Medical Graduates (ECFMG) to practice, they should also identify the appropriate pathway through which they should apply for certification.

3. Address additional requirements for obtaining a residency

Again, obtaining certification from the ECFMG is essential for becoming a physician in the US. You must meet this requirement to apply for US residency positions through the Electronic Residency Application Service (ERAS). Obtaining ECFMG certification is very simple—just submit an application, USMLE scores, and a few other documents for verification. Plan to complete this step during the third year of your MD program.

4. Apply for residency positions

Medical students need to begin working on residency application materials, such as gathering letters of recommendation and writing a residency personal statement, near the end of the third year of their MD program. It’s essential to research programs you’re interested in to ensure they’re willing to provide either H-1B or J-1 visa sponsorship. While a J-1 visa requires the graduate to return to their home country for two years upon completing their training, it’s also possible to obtain a waiver through an option like the Conrad 30 waiver program.

The ERAS timeline shows that the platform becomes available for international students in the spring and opens for submissions in the fall. Try to apply as early as possible because residency programs offer interviews on a rolling basis. The next step is compiling a rank order list, which should include every program that interviewed you, and submitting it through the National Resident Matching Program (NRMP). Students discover where they will complete their residency training during the third week of March, which is referred to as “Match Week.”

5. Complete a postgraduate training program

Depending on the specialty, residency can last between three and seven years. During this postgraduate training, graduates will progressively deepen their knowledge and skills. They will also be assigned more responsibility as it becomes appropriate.

All resident physicians must take the USMLE Step 3 during the first two years of residency, or they cannot enter the third year, and many choose to take it after they’ve completed one year of training. Those who wish to further subspecialize need to complete a fellowship. For instance, you could pursue a fellowship in cardiology or gastroenterology after three years of internal medicine residency. Upon completing all postgraduate training, graduates should pursue permanent residence and make sure to extend their visa status if necessary.

6. Obtain your license

Before you can begin your career, you need to obtain a medical license for any state in which you intend to practice. It’s a good idea to contact individual state medical boards to verify how to proceed.

Many physicians also wish to obtain specialty or subspecialty certification to further demonstrate their expertise. Most physicians complete this additional step through a member organization of the American Board of Medical Specialties(ABMS) or the American Board of Physician Specialties (ABPS).

7. Begin practicing

Once you’ve completed all licensure requirements, you can become one of the many foreign doctors in the US. There are numerous medical practice models, so think carefully about which option best meets your needs. Keep in mind that you will be subject to continuing education requirements throughout your career, which means you will always have opportunities to learn and grow.

Identify the best medical school options

If you are interested in becoming a doctor in the US, it’s a good idea to begin thinking about which medical schools will accommodate your needs. For many students from outside the US, Caribbean MD programs are good options. Discover what you can do to ensure you select the right one by reading “How to Find the Best Medical Schools in the Caribbean.”