Becoming a doctor is a noble pursuit, marked by years of rigorous education, pre-med, practical training, and, most importantly, a deep commitment to the well-being of others. Throughout this journey, medical school serves as the foundational crucible where aspiring physicians acquire essential knowledge and skills. Still, the path to a successful medical career extends beyond the confines of lecture halls and clinical rotations. 

Graduating from medical school is undoubtedly a significant achievement. However, it is the subsequent steps, such as residency, fellowships, and continuous professional development, that truly sculpt a doctor’s expertise and define their impact in the healthcare landscape. If you want to know more about what happens after medical school, keep reading and discover the key steps that help shape a proficient medical practitioner.

8 Steps You Must Follow to Become a Doctor

Regardless of where you completed your medical school, whether in the United States or elsewhere, there are specific steps that you must take to develop the necessary skills and gain the experience required to become a doctor in the U.S. The process usually involves undergoing additional training or exams, successfully completing a U.S. residency program, and, if applicable, assessing your foreign medical education and English proficiency.

Step 1: USMLE 1 and 2

In the United States, aspiring doctors typically take the United States Medical Licensing Examination (USMLE) 1 and 2 during their medical school years. The timeline for taking these exams can vary slightly among medical schools. Still, in general, Step 1 is often taken after the preclinical years, typically at the end of the second year, and then Step 2 is taken during the clinical years of medical school.

On the other hand, foreign medical graduates aspiring to practice in the United States may take these exams during their medical school years, particularly if they are considering applying for U.S. residency programs directly after graduation. However, many others may also take the exams after completing medical school, during dedicated preparation before applying for U.S. residency positions.

In both cases, USMLE Step 1 assesses the comprehension of fundamental scientific principles and their application to medical practice. This exam is crucial for demonstrating proficiency in basic medical knowledge. Meanwhile, Step 2 evaluates clinical competencies and the practical application of medical principles through its two components: Clinical Knowledge (CK) and Clinical Skills (CS). Step 2 CK emphasizes clinical diagnosis and management, while Step 2 CS evaluates communication and interpersonal skills. 

Scoring well on both steps is vital for obtaining a medical license and securing a position in a U.S. residency program. Adequate preparation, often involving rigorous study schedules and comprehensive review resources, is essential to excel in these exams. Ultimately, success in the USMLE Steps 1 and 2 indicates a candidate’s readiness to navigate the complexities of the U.S. healthcare system, fostering the confidence of licensing authorities and prospective employers.

Step 2: Occupational English Test (OET)

For all individuals aspiring to pursue a medical career in the United States, language proficiency is a critical aspect of their professional journey. The Occupational English Test (OET) is designed to assess English language skills in a healthcare context. Recognized globally, the OET provides a reliable measure of language proficiency for healthcare professionals seeking opportunities in English-speaking countries, including the U.S.

OET comprises four sub-tests: Listening, Reading, Writing, and Speaking. The content of each sub-test is tailored to the healthcare sector, reflecting scenarios and tasks encountered by medical professionals. Because the OET focuses specifically on healthcare communication, it is particularly relevant for medical professionals, more so than other general English language tests.

Step 3: ECFMG Certification (Educational Commission for Foreign Medical Graduates)

The Educational Commission for Foreign Medical Graduates (ECFMG) aims to evaluate and certify foreign medical graduates seeking a medical career in the United States. This certification is a mandatory process that assesses international medical graduates before entering U.S. residency or fellowship programs. Its primary purpose is to ensure that these graduates possess the necessary medical knowledge and clinical skills, as well as meet the English language proficiency requirements essential for the practice of medicine in the U.S.

To be eligible for this certification, foreign medical graduates must complete a series of prerequisites. As mentioned, individuals must pass Step 1 and Step 2 Clinical Knowledge (CK) of the USMLE. Additionally, ECFMG certification requires clinical and communication skills. To satisfy this requirement, ECFMG created Pathways, an online platform that tests candidates’ communication and clinical skills. It involves passing the OET Medicine and the clinical skills assessment.

Step 4: The Match


The residency matching process, or the National Resident Matching Program (NRMP), helps graduates secure positions in U.S. residency programs. The Match utilizes a computer algorithm to align each applicant’s preferences with a residency program, determining where medical professionals will continue their training.

To navigate the Match successfully, aspiring residents should take into account the specific attributes of each residency program, including location, specialty focus, and program structure. Prioritizing programs that align with your career goals and personal preferences is best. In addition, it’s essential to craft a compelling CV and personal statement that showcase your achievements, experiences, and reasons for pursuing a particular specialty, as well as secure strong letters of recommendation from mentors who can attest to your skills and suitability for the chosen specialty.

Although candidates must remain optimistic about their top choices, it is also wise to have a contingency plan in case they do not match. For example, participating in the Supplemental Offer and Acceptance Program (SOAP) could be an alternative backup plan.

Step 5: Interviews

Residency interviews hold immense significance in the match process, serving as a crucial opportunity for both applicants and programs to assess mutual fit and compatibility. These interviews allow applicants to showcase their personalities, interpersonal skills, and commitment to their chosen specialty. Successful interviews can significantly impact the likelihood of applicants securing a desired residency position. 

Adequately preparing for the interview is essential to leave a lasting impression. Begin by thoroughly absorbing the information on your application, reflecting on your experiences, and understanding the motivations behind your chosen specialty. Research the prospective program, its faculty, and unique attributes to demonstrate genuine interest during the interview. Practice your interview skills, focusing on clear communication, confident body language, and the ability to articulate your thoughts clearly. Anticipate behavioral questions and be prepared to provide concrete examples from your experiences.

Common questions, such as those about your motivations, strengths, and teamwork skills, require thoughtful responses that reflect your genuine passion for the specialty and your unique qualities as a candidate. Ultimately, a well-prepared and authentic approach to residency interviews enhances your chances of securing a position in a program that aligns with your career goals.

Step 6: Residency

Residency follows the completion of medical school and provides practical, hands-on experience for doctors-in-training. Its primary aim is to bridge the gap between the theoretical knowledge gained in medical school and its application in real-world patient care. Residency is arguably the most critical phase in medical training.

During residency, medical graduates, known as residents, work under the supervision of experienced physicians in various clinical settings, refining their clinical skills, decision-making abilities, and medical judgment. The duration of residencies varies depending on the chosen specialty, typically lasting between three to seven years. The diversity of medical specialties ensures that each residency program offers a unique training experience. Typical specialties include Internal Medicine, Surgery, Pediatrics, Obstetrics and Gynecology, Psychiatry, and more.

Step 7: USMLE 3

USMLE Step 3 is the final component of the USMLE series and plays a crucial role in the medical licensing process for both U.S. and international medical graduates. Unlike Steps 1 and 2, which assess a candidate’s foundational and clinical knowledge, Step 3 evaluates their ability to apply medical knowledge and understanding to patient care. The exam encompasses various topics, including patient management, disease prevention, and health promotion.

USMLE Step 3 is often taken during the first year of postgraduate training, commonly during residency. The exam consists of multiple-choice questions assessing clinical knowledge and diagnosis and computer-based case simulations assessing the candidate’s ability to apply clinical knowledge and skills in a simulated patient care setting.

Step 8: Fellowship

Lastly, pursuing a fellowship is another strategic and enriching step in a physician’s career, providing specialized training and expertise in a particular medical subspecialty. The primary purpose of a fellowship is to offer in-depth, focused training beyond the scope of residency, allowing physicians to become experts in a specific area of medicine.

The benefits of undertaking a fellowship are multifaceted. Fellows gain advanced clinical and research skills, broaden their knowledge base, and often have the opportunity to contribute to advancements in their selected field. Additionally, fellowships can enhance career prospects, offering a pathway to academic positions, leadership roles, and specialized clinical practice.

Key Takeaways

So, all in all, once medical school is completed, there still are many essential steps one needs to take to enter the medical field, such as conquering the USMLE exams, obtaining ECFMG certification, navigating the residency matching process, undergoing residency training in various specialties, and potentially pursuing fellowships for specialized expertise.

However, before worrying about these stages in your medical career, you must ensure you have successfully finished medical school. Here at the American University of Antigua (AUA) College of Medicine, we provide an excellent platform for aspiring medical professionals, offering a comprehensive education that prepares students for the challenges and opportunities in their medical journey. Explore the possibilities at AUA to establish a strong foundation for a fulfilling and impactful journey in medicine.

Frequently Asked Questions

How many medical students do not match into residency?

Generally, fewer than 10% of graduates from U.S. medical schools fail to secure residency program placements.

What happens if you don’t match into residency?

In the event of a non-match, students can engage in the Supplemental Offer and Acceptance Program to fill unfilled positions. Alternatively, they may reapply in subsequent years, acquiring additional experience to strengthen their competitiveness in the application process.