Undergraduate Medical Education

Training to Become a Physician

The process for becoming a doctor is educationally intensive – students first attend four years of baccalaureate college before matriculating into four years of undergraduate medical education (commonly known as medical school). Traditionally, during the first two years of medical school, the majority of time is spent in a classroom setting where students study the basic sciences. During years three and four, students spend the majority of their time learning clinical skills in patient care delivery settings.

Clinical Training in Medical School

Clinical training is conducted through rotations/clerkships, traditionally in hospitals or ambulatory care settings, affiliated with the originating medical school. Clinical rotations provide the foundation for the development of future doctors. The standard approach to clinical education was created at the end of the 19th century. In his seminal report, Abraham Flexner made access to clinical training a key element in medical education, and used the number of available hospital beds at a clinical training site a major determinant of quality measurements. Indeed, his recommended student-to-bed formula provided the impetus for many medical schools to establish academic affiliations with hospitals.

In clinical rotations, students learn the basics of specific specialties (i.e. internal medicine, psychiatry, pediatrics, surgery, etc). It is these clinical experiences that provide closely supervised training in basic medical skills and assist the students in their determination of which area of medicine they ultimately want to practice. During their fourth year of medical school, students continue to participate in more advanced clinical rotations (often called “acting internships”) as they apply for residency programs in which they will complete their clinical training after graduating from medical school.

Residency

It is during residency training (see page on GME) that in-depth knowledge of the area in which they have decided to specialize is developed. Residency programs last between three years (for internal medicine or pediatrics) to up to seven years (for some surgery subspecialties, such as neurosurgery). Upon completion of residency, students often continue their education through fellowship programs.