Medical and Dental Education in the US.
Spring 2004 PAL program report

Oksana Anistratenko
Educational Advisor
Moscow, Russia
Oksana@useic.ru

When I was offered to submit a proposal for the PAL program, I had very little, if no at all, hesitations about the topic to work on. American medical and dental education is always something designing, at least in my part of the world. And when the component on medical and biomedical research opportunities added up to my program, it all felt quite natural.

I was honored to spend almost the whole month of month in the Nation's capital, Washington, DC, visiting various medical and nursing schools over there (George Mason U, Georgetown U), American Association of Medical Colleges, Howard Hughes Medical Institute and National Institutes of Health. I also had a 2-days retreat to Philadelphia to visit the ECFMG office, Medical College of Pennsylvania - Hahnemann hospital, Temple U - School of Dentistry.

Despite that now I can talk both about my trip (20th USBT Anniversary celebration in Baltimore made it unforgettable) and the topic of my project forever, I will summarize the most important advising-related outcomes of my visit.

One thing that is very confusing for Russian students is that there are no undergraduate degrees neither in Medicine nor in Dentistry, though there is a PhD in Nursing. The admissions to these professional schools are highly competitive even for the Americans. Though good grades are very important, volunteer work along with extraordinary personal skills also play key role in getting into a medical or dental school in the US. The other hurdle to overcome are the test requirements - neither MCAT (Medical College Admissions Test) nor DAT (Dental Admission Test) can be taken outside the US. And very few schools will accept international students without spending at least 2 years at an American college.

There are 2 types of medical schools in the US: allopathic and osteopathic. It might be easier for a foreigner to get into an osteopathic school, and then to try to get into an allopathic residency program.

Those who already hold a degree of higher education from not-American school, can make the following steps.

Depending on the state, Foreign Dental Graduates can apply for the license to practice dentistry in the US. All the requirements are listed on the American Dental Association web site: www.ada.org. The other thing someone might consider is applying for the post-graduate training in Dentistry.

Speaking of opportunities for international medical graduates (IMG), I would like to refer to some statistics first. Nowadays, according to James A. Hallock, President and Chief Executive Officer, ECFMG, Americans who visit a physician have a one in four chance of meeting with an IMG who completed his or her undergraduate medical education in a country other than the United States or Canada. But it is undeniable that getting access to the US training is an enormous challenge for those who have been trained abroad.

Non-citizen IMGs have to pass through the ECFMG certification process in order to get into a residency program in the US. The USMLE Step 1 and Step 2 Clinical Knowledge are required for obtaining the ECFMG Certificate. Starting July 2004, the CSA is no longer given and is replaced with the Step 2 Clinical Skills Test. The TOEFL score is no longer needed as English Language Proficiency test became a part of the Step 2 CS. Another new thing is that final school transcript has to be submitted in addition to the diploma to complete the Certification process.

After obtaining the Certificate, a person can apply for the residency training. There are 2 ways to do so: through the ERAS (Electronic Residency Application Service) and through the NRMP (National Residency Matching Program). These 2 programs complement to each other, and a student has to apply for both. Also, there are about good 40% of IMGs who get into a residency outside of the Matching Program through the Observership. A prospective resident can come to a hospital on B1/B2 visa (on the invitation of the respective hospital) to observe the treatments for 2-3 months, and apply for the residency afterwards.

After completing the residency program and passing the Step 2 CS and Step 3, a resident can apply for the license. Once again, licensing requirements differ from state to state.

RESEARCH OPPORTUNITIES:

1. HOWARD HUGHES MEDICAL INSTITUTE. HHMI is a non-profit medical research organization with the labs all over the US and grants programs throughout the world in the biomedical field.

Currently there are 2 grants that would be interesting for the foreign scientists - the one for those dealing with infectious diseases and parasitology, and the second one is for the biomedical researchers in Baltics, Central and Eastern Europe, Russia and Ukraine. For more information please visit their web site: www.hhmi.org/grants/individuals. Please note that both grants are aimed on conducting the research outside the US, though small travel grants to attend conferences can be included into the proposal.
2. NATIONAL INSTITUTES OF HEALTH. The NIH is the core medical and behavioral research for the US, and it operates under the US Department of Health and Human Services. It's an absolutely fascinating establishment, comprised of 27 institutes and centers, with the headquarters in Bethesda, MD. The NIH web site www.nih.gov has all sorts of information that one can benefit from both personally (those who are not in medicine, but care about their own health, their kids and parents, will find LOTS of useful information on drugs, clinical trials, etc.) and professionally (medical students can carry out surgeries on virtual cadavers long before they touch a real patient). Those professionals who are looking for the team projects with the US partners should visit the following link: http://grants1.nih.gov/grants/. The NIH also brings international scholars on J-1 and H-1 visas.