Difficulties in Becoming a Doctor for International Student in US
International students come to the US with the hope of getting a better education that will enable them to climb the social ladder in the US as well as in their home countries. There have been attempts to compare the health systems of different countries with a view to finding which system is the best and gives value for investment. Most of these measures are based on such factors as infant mortality and mortality amenable to health care, measures in which the US generally scores poorly compared to Europe, Japan or even Australia, giving an erroneous impression that its health system is poorer compared to the other countries. However, such measures use unadjusted aggregate data that is affected by non health-care factors, use process measures that do not reflect doctors’ productivity and may be biased based on health care financing (Glen 5). Comparative studies of international health systems do not take into account innovation in the medical field, where the US is a leader, incorporating new treatment within its heath system more than any other country (Stossel 905).
Owing to the innovativeness of the American health care system, it provides the best place that an aspiring doctor will train, as it will expose him to cutting edge medical practices. In addition, America has some of the leading brains in the medical field, a fact that is evident from the number of Nobel prizes awarded to American scientists, with the country having produced sixty per cent of the science Nobel laureates in the past 40 years (Nobel Prize no pag.) The US is also the leading investor in basic medical research, with the government and the private sector combining to make the US the biggest investor on health care in the world (Phillipson 1396). The US is also a multicultural country with significant minority populations, making it a good destination for international students, as they are likely to meet compatriots who can help ease the adaptation process. However, despite these factors, international students in the US face a number of challenges in graduating and becoming doctors. The following are some of the difficulties that international students face when working towards becoming doctors in the US.
Most US universities have stringent admissions criteria, which are a challenge for foreign students to attain. Some universities even discourage international students from applying to join their medical programs citing the difficulty in successfully going through the training program (Prep np.). Most American universities do not accept any foundational medical coursed done in foreign universities, implying that international students who come to the US having done foundational courses in medicine are not given any preferential treatment. For an international student looking to join an American university to pursue medicine, the student must have at least a year of extra work in an approved university in the US, in addition to the qualifications that the student already possesses. This is discouraging for international students that have already done a foundational course in medicine because they feel they are wasting at least a year to do what they may have already done in a foreign university.
The type of foundational work that is accepted in American universities is very particular and constrains international students who are struggling to adapt to a new country. Work done online is not acceptable in addition to work done through evening classes unless it is identical to the courses that the university offers in its regular programs. This requirement disqualifies most of the evening class programs because they tend to condense the content owing to the time constraints faced in evening classes. This is especially disadvantageous to international students who are sometimes forced to take evening classes due to financial constraints that force them to look for work as they study. The stringent entry requirements are a consequence of the limited number of places that are available in university medical schools across the US. The lack of sufficient medical places in college affects even US residents but is especially detrimental to the chances of international students gaining admission in medical school.
Another admission challenge for international students is the Medical College Admissions Test (MCAT), which all students have to take before they are admitted to medical school. MCATs are mandatory before admission to college because research has shown that performance in the MCAT is positively correlated to the performance of students in medical school (Julian 915). The MCATs, however, are a formidable entry barrier for international students, who find it difficult to excel in the test. The MCAT is considered as one of the most difficult academic test that a student can face and requires rigorous and intensive preparation. The test is divided into four sections namely critical analysis and reasoning skills, biological and biochemical foundations of living systems, chemical and physical foundations, and psychological, social and biological foundations of behavior, with each section having a time limit. All of the questions are multiple-choice with the test being non-adaptive implying that it is not possible to shorten length of the test by answering harder questions correctly. International students do not have the time to prepare adequately for the MCATs nor the resources that are required to be ready for the test. Therefore, they have a higher likelihood of failing the test; hence missing admission to medical school.
International students usually have English as a second or third language and their proficiency in the language is limited. Some international students, for example from China, are proficient in grammar and the written form but they cannot be able to speak fluently ((Wan, 28). This is a challenge for an aspiring doctor because communication is a basic requirement for a doctor, considering that they have to diagnose patients through oral interviews. This puts international students at a disadvantage since they will have problems fitting into the health system considering that they have to do rounds in hospitals while they are studying. Poor grasp of the English language is also detrimental to the student in their academic life considering that instruction is carried out in English. In addition, all assessments are carried out in English, with students required to write academic papers in the course of their study in college. If a student cannot understand what the instructor is saying, his performance is likely to be poor irrespective of their intelligence.
Before being admitted to college, students are expected to sit for a Test of English as Foreign Language (TOEFL), which they are required to pass in addition to the MCAT. Therefore, the international student is at a disadvantage compared to a resident who has only to take a MCAT to be admitted to medical school. This implies that even if an international student has an exemplary score in the MCAT, s/he will not be admitted to medical school because the TOEFL test is also a prerequisite for admission to college. The TOEFL test is comprehensive and challenging, requiring that a student who wants to sit for it be well prepared through tuition and intensive coaching. The tuition for the TOEFL test is expensive and the cost of getting appropriate coaching for the test can be challenging to an international student. In addition, time constraints can be an issue for an international student, who may be forced to postpone joining college so that s/he can sit and pass the test. Any such suspension of studies has a negative impact on the student’s economic situation because s/he has to stay in the country for sometime as s/he waits to sit for the tests.
Language also disadvantages international students when it comes to seeking for admission in the elite American universities due to their stringent entry requirements. In addition to requiring a very high score in the MCAT, elite universities require that prospective students should be among the top percentile in the high school grades. This automatically disqualifies most international students because universities do not consider foreign qualifications as valid for the purposes of admission. Therefore, international students are restricted in the number of medical colleges they can apply for admission. However, postgraduate international students have a relatively easier route to admission in prestigious universities because their admissions are arranged prior to their coming to the US.
The cost of obtaining a university medical degree is prohibitively high, running into hundreds of thousands of dollars. International students, unlike residents do not usually have access to government grants, which help to cut the training costs considerably. This implies that international students have to pay the full training cost of the medical degree from their own pockets. Medical universities sometimes offer scholarships to students. However, these scholarships are very limited even to American students and are extremely competitive considering the large number of students applying for medical courses. For an international student, it is almost impossible to obtain these scholarships, especially for basic medical training, considering the entry barriers that face an international student.
A good number of international students who come to America to study are from poor developing countries and poor family backgrounds, and their major hope is to obtain training that will open the doors of opportunity for them in America as well as their countries. Consequently, most come to America with very little money, hoping to work as they study so that they can pay for their education as well as get sufficient money for their upkeep. In addition, some of the international students are expected to send some upkeep money for their poor families in their home countries. Therefore, international students are under immense pressure to navigate the financial pressures and find a way to pay for their education. The precarious existence of international students has been worsened by new government regulations that make it illegal for persons with student visas to work. This regulation is a major blow to international students and it is likely that a good number will wind up as illegal immigrants once their student visas expire. Poor international students cannot afford to leave the country because that will end whatever hope they have of making a better future for themselves. Therefore, the cost of the medical program is a major hindrance to the chances of international students graduating as medical doctors in the US.
Integration to Local Communities
The US is one of the most culturally diverse countries on the planet and there are indications that the country may become the first industrialized nation that where immigrants are more than the indigenous population. However, integrating into the local community is not easy for international students. Most international students suffer from culture shock because the values and norms of the US are diametrical to their values. This shock can cause disorientation for the student who has to struggle to get his bearings before he can begin to adapt. International students coming to the US are rarely given an orientation about life in the US. They often have to find their way through trial and error, wasting valuable time and making ignorant errors. The lack of an orientation program for international students puts them at a disadvantage, making it difficult for them to excel in academics. Considering that medicine is an extremely demanding field, disorientation will have a negative impact on the student’s academic life.
Duration of the Program
The process for a person to become a doctor in the US is very lengthy taking up to 14 years for a person to qualify as a doctor. Before admission to medical school, international students are required to do between one and three years of premed. This is then followed by approximately two years of preclinical training that mainly deals with the science of medicine, and then two more years of clinical training. In the last year of medical training, doctors apply for internship in their area of specialty and are posted in hospitals for a year of supervised work. This is then followed by between three and five years of residency, depending on the specialty chosen. After residency, one can undergo further training in fellowship, where the doctor goes for full-time training focused on a particular area of her specialty. After fellowship, the doctor then sits for an oral and written exam for him to be certified by the board. Each certified doctor is required to take various continuing education courses to ensure that he is abreast of the latest development in his field of specialty.
This process is very long and requires patience and dedication from the aspiring doctor to go through the whole process. The long time that is needed before a doctor is certified by the board is a challenge to international students who want to be doctors. International students who may want to return to their countries after graduation may find the approximately 15 years that is needed before a doctor becomes certified as too long. Therefore, for an international student to graduate as a certified doctor in the US s/he needs to be very patient and willing to sacrifice time and resources to achieve the dream
International students coming to the US to study medicine face many challenges before they can graduate as doctors. Although some of the challenges have been discussed above, the list is by no means exhaustive as there are other challenges that were not addressed. However, despite the challenges, the US remains as one of the best places that an aspiring doctor can study medicine and will continue to attract some of the best brains in the world.
Julian, Erich. Validity of the Medical College Admission Test for Predicting Medical School Performance. Acad Med 80.10 (2005): 910-7. Print.
Nobelprize.org, “All Nobel Laureates in Medicine.” 2014. Web. 7 December 2014.
Phillipson, Lennart. “Medical Research Activities, Funding, and Creativity in Europe: Comparison with Research in the United States.” JAMA 294 (2005): 1394–98.
Prep, Veritas. “3 Tips for International Students Applying to U.S. Medical Schools.” US News Education 16 July 2012. Web. 7 December 2014.
Stossel, Thomas. “The Discovery of Statins.” Cell 134 (2008): 903–05. Print.
Wan, G. “The Learning Experience of Chinese students in American Universities: A Cross-Cultural Perspective.” College Student Journal, 35.1 (2001): 24-33.
Whitman, Glen “WHO’s Fooling Who?” Cato Institute Briefing Paper no. 101, February 28. Web. 7 December 2014.