HOW TO BECOME A DOCTOR

A step-by-step primer with only minimal color commentary. I'm sorry if this is really boring? Spoiler alert: it's a lot of tests, and now that I've finished writing it, I realize it's also a lot of money.
  1. Go to college and take the premedical requirements:
    1 year of biology, 1 year of chemistry, 1 year of physics, 1 year of organic chemistry, +/- biochemistry, calculus, statistics. Many of these classes are only loosely related to being a doctor but you can not attend medical school without them.
  2. Alternatively, take all those classes as a "post-bacc" (a post-baccalaureate program) prior to applying.
    Many people don't decide to be a doctor until after post-college experiences. That's cool too.
  3. Take the MCAT. It costs a bunch of money to take. So do all the study materials for this and every test you take in the future (upwards of $1000 per test).
    This is a shitty standardized test that essentially makes sure you took all those classes above. I cried in the bathroom between sections.
  4. It's usually wise to have some sort of extra-curricular activities, whether they be clubs, volunteer work, sports, a job, etc.
    "Well-rounded."
  5. Fill out the AMCAS -- the medical school common application -- and send it to a bunch of schools. Pay for this honor.
    This includes a personal statement, very detailed explanations of the extracurriculars, and a whacky hand-written transcript. You also have to attach 3-5 letters of recommendation. Fun fact: all the free writing has CHARACTER limits, not word limits, so you start to be aware of the length of many common adjectives and their shorter alternatives. It's. Awesome.
  6. Most schools will then send you a secondary application!
    Some are compulsory (as soon as they get the AMCAS, they send it to you), some are more selective. They include more questions and essays of various lengths. If I remember correctly, there were up to 10 essays in one application. Most ask why you want to go there specifically. And of course, character limits again.
  7. Write 1 billion characters worth of essays.
    I think I ended up writing 39 unique essays for around 20 applications. You can definitely reuse some of them (just change the name of the school, you probably want to go to most of them for the same reasons ¯\_(ツ)_/¯ ).
  8. Now, you get some interview invitations!
    Interview days widely vary, but include anywhere from 1-5 interviews with faculty, students, admissions counsellors. Some are group interviews. Some are 15 minutes. Some are over an hour. Some are stress interviews (to see how you react to high pressure environments). Some are just hanging out. There is usually a tour and information session. And food.
  9. Congratulations, you've been accepted to medical school--no wait, schools! How do you decide?
    "Second look" weekends. One giant wooing process.
  10. Here's where things vary widely: it's very trendy in medical education to be doing "curriculum reform." For the sake of ease, I'll go for traditional medical school.
  11. Years 1-2: basic sciences
    More biochemistry, biology, genetics etc. Anatomy (parts of the body), physiology (how they work together), pathology (how they can go wrong), pharmacology (drugs!), microbiology (bugs!), psychology (hugs!). Most curricula now include doctor-patient communication classes, ethics, learning via theoretical medical cases, and exposure to patients and fake patients.
  12. Take USMLE Step 1: It is a good amount of money. Most students take at least a month to study for it full-time, with no classes. Study time is built into most medical schools' schedule.
    This is the most heinous test I have ever taken, designed to prove you did the above 2 years of med school. It is 308 questions divided into 7 sections, each an hour long. You get 45 minutes of break to allot for yourself throughout the WHOLE day. I used most of those minutes to stare at myself blankly in the bathroom mirror. And cry. Also I ate a banana.
  13. Year 3: clinicals
    A year of rotating through specialties in the hospital: obstetrics and gynecology, internal medicine, pediatrics, surgery, anesthesia, emergency medicine, neurology, psychiatry, family medicine. These are called clerkships. You are the lowest on the totem pole and your name becomes "The Medical Student." I have never said "thank you" and "I'm sorry" so many times in my life. There is endless list material to be had here.
  14. Shelf exams
    You take these at the end of every clerkship to prove competency. They suck, but not as bad as Step 1.
  15. Year 4: more clinicals, less pressure
    Most programs require a sub-internship (pretending to be an intern). Depending on the specialty you're going into, you may need to do "away rotations" at your desired residency program. Some schools spill over the year 3 clinicals to year 4. Most places, year 4 is pretty chill to allow for strong applications to residency.
  16. Take USMLE Step 2: Clinical Knowledge (CK). Again, $.
    Basically a giant shelf exam. The process is essentially identical to Step 1, only it's impossible to care as much. Study for less than half the amount of time as Step 1. Fun fact: for all these tests, at EVERY break, in and out, you need to show photo ID, scan your fingerprint, empty all your pockets, pull up all your sleeves, and be metal wanded. Also, you can not have any food or drink in the test room and you may not put on or take off any clothes, including sweaters. I am not joking.
  17. Time to apply for residency! You pay for this pleasure as well.
    Lemme just save you the reading: it's essentially the same as applying to medical school, but the AMCAS is the ERAS, your "transcript" is a long fancy conglomerate of clerkship evaluations called a Dean's Letter, there are usually no secondary applications, and interview days are longer and more complicated. Some specialties have very stressful/high pressure interview days, but pediatrics don't play like that.
  18. Submit your residency rank list.
    You put all the programs where you interviewed in order of how much you like them. Don't worry about being judgy; they're doing the same for all their applicants (if they really like you, some schools will send you what's referred to as a "love letter" 😉)! Then it gets put in a big computer, and it gets matched up so everyone's happy (hopefully). Oh and by the way, in submitting this list, you're signing a contract to go wherever you match. Just FYI.
  19. Match Week!
    On Monday of Match week, you find out IF you matched. If you did not, you do a mad dash called "scrambling" to reapply in 4 days to any program with open spots.
  20. Match Day!
    You hold an envelope in your hand with your fate (this was one of the most unique and surreal moments of my life). Matches are released at the same time, on the same day at every med school in the country. Many traditions exist: some schools have everyone in an auditorium open the envelope at the same time, some have students walk across the stage one at a time and open the envelope there, some show it on a big screen etcetc.
  21. Wait! More tests: USMLE Step 2: Clinical Skills (CS). This one is $$$ (over $1000), and you can only take it at a few special centers in the U.S.
    A bunch of clinical "scenarios" with fake patients to make sure you're not a monster and can speak English. It's pretty hard to fail (if you're not a monster and can speak English). It's a bit of a racket to take med student money. Most people take it after they match.
  22. Welcome to residency!
    When you graduate med school, you are a doctor, but not qualified to practice any medicine. Residency trains you to do that, for 3-7 years, depending on what you go into (ie pediatrics: 3 yrs, surgery: 5-7 yrs). You rotate through different parts (specialties, clinics, intensive care units) of your chosen field, and supervise more junior residents and medical students.
  23. Jk another test: USMLE Step 3 (obviously, this costs money to sign up for as well)
    I dunno, makes sure you're qualified to be a doctor. They're just fucking with you at this point.
  24. Work really hard, learn lots of things.
    Residents are the boots on the ground, but they're usually not the name on the chart. Lots of work, limited liability (and credit). There are "duty hour" restrictions that limit how many hours in a row you can work (28), how many hours a week you can work (80), and how many days off you need (an average of 1 a week over 4 weeks), among other things. These are observed to varying degrees depending on your program/specialty. You make just above minimum wage when hours are taken into calculations.
  25. Apply to fellowship if you'd like more training because why not.
    After residency, you can practice, for example, pediatrics, surgery, or internal medicine, but you'll need more training to be a pediatric gastroenterologist, a cardiac surgeon, or an infectious disease specialist. Basically, apply the same way you did to residency. Pay for that too. Match the same way. Jesus, you're a glutton for punishment.
  26. Welcome to fellowship--wait did you take the boards? Take the boards to prove you can be a board certified doctor.
    These tests are not super easy to pass. They are also extremely expensive.
  27. Also you need a license. Apply for one of those bad boys (lol of course you have to pay for it).
    How arduous a process this is depends entirely on what state you plan to practice in, so choose wisely.
  28. Ok, now welcome to fellowship.
    It's like residency (rotations, but through a smaller, more specialized set) but slightly more power and a teeny tiny bit more pay. And a lot of being "on-call." Also, you're expected to publish papers.
  29. Take MORE boards.
    PROVE that you're not just a doctor, but a specialized doctor!
  30. Now you're a board certified doctor! Congratulations!
    Take a recertification exam every 8 years! 👍🏽