This is SCIENCE IN THE NEWS in VOA Special
English. I'm Bob Doughty.
And I'm Faith Lapidus. On our program this week, we look at how
people become medical doctors in the United States.
It is not easy to become a doctor in the United
States. The first step is getting into a
medical college. More than one hundred
twenty American schools offer study programs for people wanting to be doctors.
People can get advice about medical
schools from many resources. One of
these is the Princeton Review. The
publication provides information about colleges, study programs and jobs.
The Princeton Review says competition to enter
medical schools is strong. American
medical schools have only about sixteen thousand openings for students. But more than two times this many seek entry. Many of those seeking to be admitted are
Most people seeking admission contact more than one
medical school. Some applicants contact
many. An important part of the
application usually is the Medical College Admission Test, or MCAT. The Association of American Medical Colleges
provides the test by computer. It is
offered in the United States and in other countries.
The applicant is rated on reasoning, physical and
biological sciences and an example of writing. Applicants for medical school need to do well on the MCAT. They also need a good record in their college
who want to become doctors often study a lot of biology, chemistry or other
science. Some students work for a year
or two in a medical or research job before they attempt to enter medical
direct meeting, or interview, also is usually required for entrance to medical
schools. This means talking with a
school representative. The interviewer
wants to know if the person understands the demands of life as a medical
student and doctor in training. The
interviewer wants to know about the person's goals for a life in medicine.
A medical education can cost a
lot. One year at a private medical
college can cost forty thousand dollars or more. The average cost at a public medical school
is more than fifteen thousand dollars. Most students need loans to pay for medical school. Many finish their education heavily in
Americans become doctors by joining the United States Army, Navy, Air Force or
Public Health Service. They attend the
F. Edward Hebert School of Medicine of the Uniformed Services
University of the Health Sciences in Bethesda, Maryland. These students attend without having to
pay. In return, they spend seven years
in government service.
Doctors are among the highest paid people in the United
States. Big-city doctors who work in
specialties like eye care usually earn the most money. But some other doctors earn far less. That is especially true in poor
medical students spend their first two years mainly in classroom study. They learn about the body and all its
systems. They also begin studying how to
recognize and treat disease.
the third year, students begin working with patients in hospitals. Experienced doctors who have treated many
patients guide them as they work. As the
students learn, they think about the kind of medical skills they will need to
work as doctors.
During the fourth
year, students begin contacting hospital programs for the additional training
they will need after medical school. Competition to work at a top hospital can be fierce.
in hospitals are known as interns or residents. They are usually called interns during their first year. After that, the name of the job is resident. The trainees treat patients
guided by medical professors and other experts.
fifty states require at least one year of hospital work for doctors-in-training
educated at medical schools in the United States. Graduates of study programs at most foreign
medical schools may have to complete two or three years of residency, although
there are exceptions.
To be accepted for a residency, a person
must meet the requirements of the Educational Commission for Foreign Medical
Graduates. This process involves several
tests before a person can receive a visa to stay in the United States for the
Those completing study programs at foreign medical
schools may be required to return to their own country for at least two years
after their training ends. But because
of doctor shortages or other needs, some have been able to get visas without
the required two-year stay in their home country.
receive experience in different kinds of care. Interns, for example, may work with children for one month. The next month, they may be assisting at
births. How long a residency lasts
depends on the chosen area of medicine.
There are many medical specialties. Some people become cardiologists and care for
the heart. Others become oncologists and
treat cancer patients. Still others
become pediatricians and take care of children. And some doctors go into medical research, either at a university or
with a private company.
whatever they choose, they first need experience. Some doctors work a long time in hospitals
before they are fully trained in a specialty. Some spend six years or more as residents before beginning private
A doctor in Illinois remembers that before his
internship, he wanted to work in crisis medicine in the emergency room. But later he chose surgery, because it lets
him have more time to decide how to help his patients.
nineteen ninety-nine, the Institute of Medicine of the National Academies, the
I.O.M., released a report on mistakes in American hospitals. The report said preventable mistakes resulted
in at least forty-four thousand deaths each year.
Five years ago, the New England Journal
of Medicine published two government-financed studies of serious mistakes. The studies found that the mistake rate in
two intensive-care areas decreased when interns worked fewer hours.
Accreditation Council for Graduate Medical Education supervises medical
education. In two thousand three, the
Council reduced the hours that residents may work. It limited residents to no more than thirty
hours of continuous duty. A hospital was
not supposed to require more than eighty hours of duty in a week. Some residents were spending more than one
hundred hours a week at their hospitals.
Last year, the United States Congress
ordered the I.O.M. to study the situation again. The I.O.M. reported that the shorter work
week did not help residents. It said they
were getting far less sleep than they should.
The report said the residents were attempting
to do as much work in the shorter time as they had done while working more hours. So the I.O.M. proposed that residents be
required to get five continuous hours of rest for every sixteen hours on duty. It also asked that residents be given fewer
duties and more supervision.
some American researchers have questioned the value of the I.O.M.
proposals. They say the proposed changes
could cost American hospitals about one billion six hundred million dollars a
researchers work for the RAND Corporation and the University of California at
Los Angeles. Their report was published
last month in The New England Journal of Medicine.
report also said few medical mistakes cause injury. And, it said changing work rules could cause
other kinds of mistakes. If resident
doctors work shorter hours, for example, mistakes could happen when one
resident takes over a patient's care from another.
New England Journal of Medicine published an editorial with the report. The writers expressed concern that the proposed
changes would place too much importance on the number of hours worked. They said residents would face ethical questions
about making others responsible for sick patients just because their working
hours were ending. The editorial
questioned whether reduced work hours could give the residents the education they
will need as doctors.
SCIENCE IN THE NEWS was written by Jerilyn Watson and produced by Mario Ritter. I'm Bob Doughty.
And I'm Faith Lapidus. Read
and listen to our programs at voaspecialenglish.com. Listen again next week for
more news about science in Special English on the Voice of America.