Dr. Raphael Emanuel International Director The Med Exchange

Traditionally, international physicians have enjoyed unparalleled educational opportunities in the US and account for almost 25 per cent of practicing physicians in the nation's hospitals and clinics.

Among the most respected of the professions, physicians enjoy quality of life and the opportunity to help people in a variety of ways. The US continues on its health care spending spree, each year allocating more money to physical well-being than any other industrialized nation. Research is a priority and vast improvements in health care are around the corner based on molecular genetics and population based research.

Times are changing, as recent new media coverage of physician issues illustrates. Stories about US courts involved in resident physician disputes regarding working hours and salaries, and new requirements in English language skills for international graduates are found in the media daily.

What are the most important points for international students and physicians seeking to study and practice medicine in the US?

Importantly, once graduated from an accredited US medical school, a physician may practice anywhere in the world. Physicians find employment both in and outside of the US after graduation. Gaining admission to medical school may be the most difficult step.

Year after year, only 10 to 20 per cent of all applicants find a seat in first-year medical school classes. This statistic is even more disconcerting for the international student, as only one per cent of enrollments by future physicians is from outside the US.

However, this statistic should not dissuade the most qualified of Hong Kong students from applying to even the top-tier schools such as Harvard, Stanford and the Mayo Clinic. There is a continuing trend toward greater diversity, and international students who can present a compelling application package that dramatizes their "competitive advantages" will be successful.

Second-tier but still accredited schools also seek diversity and these programs, often scattered in smaller cities throughout the US, should be explored and considered by the majority of Hong Kong applicants. Excellent English language skills, solid undergraduate marks and respectable scores on the standardized Medical College Admission Test are still important, and the competition is fierce. However, these schools tend to put even greater value on attracting more worldly students who have cross-cultural perspectives beyond those of many US applicants.

International physicians who have already graduated from non-US medical schools often seek to become resident physicians in the US to complete their post-graduate training. In some programs, up to 50 per cent of residents are foreign medical graduates, often from Asia. Necessary visas may be difficult to acquire, and only graduates of certain medical schools may qualify for the practice of medicine in the US. Further information on this topic may be found at www.amsa.org and www.ama-assn.org.

There is also an economic reality to be considered by Hong Kong-based aspirants. Medical school in the US is expensive with graduates commonly facing $100,000- $200,000 of debt over the four-year program. After medical school, residents typically earn US$6-10 per hour for the 80 to 120 hour workweeks. This post-graduate training can last three years but may be as long as seven years for the surgical sub-specialties. Average physician salaries after residency vary upon the specialty and location, but measure up well against most other professions.

Overall, selected international students or practicing physicians with strong credentials can expect to find a place in the US medical system. With the aging "baby boomers" about to require more care, and the documented training in the US of both generalists and specialists, international doctors can continue to expect to fill more than 25 per cent of professional positions. The key, however, is to overcome that first hurdle by gaining admission to the best possible medical school.

Return to these pages on 18 October to learn more about the procedures of application to US medical schools. Med School Exchange will present an in-depth article on the hurdles of getting into a medical school and ways to overcome them.

The Med School Exchange, a US-based international admissions consulting firm, counsels applicants from Hong Kong and 25 other countries on all aspects of admission to the world's top medical schools, including credentials assessment, school targeting, application strategy, essay development and interview planning. Web site: www.medschoolexchange.com

Taken from Career Times 2002/09/20