Medical school

A medical school (often spoken as med school) is a tertiary educational institution—or part of such an institution—that teaches medicine. In addition to a medical degree program, some medical schools offer programs leading to a Master's Degree, Doctor of Philosophy (PhD), Bachelor/Doctor of Medicine (MBBS, BMed, MDCM, MD, MBChB, etc.), Doctor of Osteopathic Medicine (DO-USA), or other post-secondary education. Medical schools can also employ medical researchers and operate hospitals. Medical schools teach subjects such as human anatomy, biochemistry, pharmacology, immunology, neurology, obstetrics and gynecology, anesthesiology, internal medicine, family medicine, surgery, psychiatry, genetics, and pathology.

The entry criteria, structure, teaching methodology and nature of medical programs offered at medical schools vary considerably around the world. Medical schools are often highly competitive, using standardized entrance examinations to narrow the selection criteria for candidates (e.g. GAMSAT, MCAT, UMAT, NMAT, BMAT, UKCAT and many others).

In many European countries, in India, China and others, the study of medicine is completed as an undergraduate degree not requiring prerequisite undergraduate coursework. However, an increasing number of places are emerging for graduate entrants (i.e. in the UK, Ireland and Australia) moving medical education closer to the US/Canadian model. In other countries (e.g. the USA, Canada), medical degrees are second entry degrees, and require at least several years of previous study at the university level. Students wanting to enter medical school often complete a bachelors degree with a (pre-medical/medical science) curriculum including physics, chemistry, genetics, biochemistry, pathology, anatomy and physiology, and human biology. However, many medical schools will accept students of varying academic background so long as they complete the required prerequisite coursework and have a university degree, and some students obtain Master and PhD credentials before entering medical school.

Although medical schools confer upon graduates a medical degree (BMBS, MBBS, MBChB, MD, DO, MDCM, BMed, etc.), a doctor typically may not legally practice medicine until licensed by the local government authority. Licensing may also require passing a test, undergoing a criminal background check, checking references, and paying a fee. Medical schools are regulated by each country and may appear on the WHO Directory of Medical Schools or the FAIMER International Medical Education Directory.

Contents 1 Africa 1.1 Egypt 1.2 Ghana 1.3 Kenya 1.4 Nigeria 1.5 South Africa 1.6 Tunisia 1.7 Uganda 2 Americas 2.1 Brazil 2.2 Bolivia 2.3 Chile 2.4 Canada 2.5 El Salvador 2.6 Panama 2.7 United States 3 Asia and Oceania 3.1 Australia 3.2 Bangladesh 3.3 Commonwealth of Northern Marianas Islands 3.4 Hong Kong 3.5 India 3.6 Indonesia 3.7 Israel 3.8 Japan 3.9 Jordan 3.10 Kyrgyzstan 3.11 Myanmar 3.12 Nepal 3.13 New Zealand 3.14 Pakistan 3.15 People's Republic of China 3.16 Philippines 3.17 Republic of China (Taiwan) 3.18 Saudi Arabia 3.19 South Korea 3.20 Sri Lanka 3.21 Thailand 4 Europe 4.1 Belarus 4.2 Bosnia and Herzegovina 4.2.1 Admissions 4.2.2 Curriculum 4.3 Belgium 4.4 Bulgaria 4.5 Croatia 4.6 Finland 4.7 France 4.8 Germany 4.9 Hungary 4.10 Iceland 4.11 Ireland 4.12 Italy 4.13 Netherlands & Belgium 4.14 Norway 4.15 Poland 4.16 Romania 4.17 Sweden 4.18 Turkey 4.19 Ukraine 4.20 United Kingdom 5 Medical students 6 See also 7 References 8 External links

Africa

Egypt

In Egypt, medical school is a faculty of a university. Medical education lasts for 6 years, at the end of which the student is granted a MB BCh (بكالريوس الطب و الجراحة). After graduating there is a mandatory 12 month full time internship at one of the University or Government Teaching hospitals after which medical licensure as a General Practitioner (GP) is obtained. After that, the doctor has to register with the Ministry of Health, and the Egyptian Medical Syndicate (نقابة الأطباء). The first 3 years of medical school cover the basic medical sciences, while the last 3 years are focused on clinical sciences.

Admission depends on the score of the applicant in his last 2 years of Egyptian Secondary Schoolالثانوية) العامة). Students who have taken either the IGCSE or SAT can also apply, however there is a very strict quota to the number of student who get accepted by the admission office which regulates entry into public universities. This quota does not apply to private universities. There are no entrance exams required for entry.

Ghana

There are four medical schools in Ghana: The University of Ghana Medical School in Accra, the KNUST School of Medicine in Kumasi, the University of Cape Coast Medical School and University for Development Studies School of Medicine in Tamale. Students who graduate from any of these medical schools get the degree MBChB and the title Dr. They are then registered provisionally with the Ghana Medical and Dental Council. Upon completion of the compulsory 2 years Housemanship (This housemanship is done only in the Teaching hospitals and Regional Hospitals,) these doctors are permanently registered with the Medical and Dental Council and can practice as General physician (called Medical Officer in Ghana).

Following the permanent registration with the medical and dental council, doctors can specialize in any of the various fields that is organized by either the West African college of Physicians and Surgeons or the Ghana College of Physician and Surgeons.

General Physicians (medical officers) are also sometimes hired by the Ghana Health Service to work in the Districts/Rural areas as Primary Care Physicians.

Kenya

In Kenya, there are three established medical schools:

• 1. University of Nairobi (oldest, established 1967)
• 2. Moi University in Eldoret (established in 1980s with major support from the Indiana University School of Medicine - USA, and with whom there remain significant ties)
• 3. Kenyatta University at Kahawa (established 2008)

Admissions are considered after completion of a high school education. The first two years are basic science years and the three remaining years clinical. On completion, a bachelors degree in Medicine and Surgery is awarded, MBChB. This is followed by a one year period of internship.

Both Nairobi and Moi Universities run post graduate medical training programs that run over 3 years and lead to the award of master of medicine, MMed, in the respective specialty.

There has been progress made by the Aga Khan University in Karachi, Pakistan and the Aga Khan University Hospital (AKUH) in Nairobi towards the establishment of a Health Sciences University in Kenya with an associated medical school. AKUH in Nairobi, already offers post graduate, MMed programmes. These are run over 4 years.

Completion of formal specialty training in Kenya is followed by two years of supervised clinical work before one can apply for recognition as a specialist, in their respective field, by the medical board.

Nigeria

There are several medical schools in this populous nation. However, there are three tiers under which the schools are categorized, based on the quality of faculty, facilities, and performance. In the top tier, there are Thirteen medical schools: Bayero University Kano,University of Benin, University of Nigeria, University of Lagos, University of Ibadan, Obafemi Awolowo University, Lagos State University, University of Maiduguri, University of Port-Harcourt, University of Ilorin, University of Calabar, University of Jos and Ahmadu Bello University. Entrance into these schools is highly competitive. Candidates graduating from high school must attain high grades from the West African Examination Council's (WAEC) Senior School Certificate Exam (SSCE/GCE) and high scores in four subjects (Physics, English, Chemistry, and Biology) in the University Matriculation Examination (UME). Students undergo rigorous training for 6 grueling years and culminate with a Bachelor of Medicine and Bachelor of Surgery (MBBS). The undergraduate program is five years and one year of work experience in government hospitals. After medical school, graduates are mandated to spend one year of housemanship (internship) and one year of community service before they are eligible for residency.

South Africa

There are eight medical schools in South Africa, each under the auspices of a public university. As the country is a former British colony, most of the institutions follow the British-based undergraduate method of instruction, admitting students directly from high school into a 6 or occasionally five year program. Some universities such as the University of the Witwatersrand in Johannesburg and the University of Cape Town have started offering post-graduate medical degrees which run concurrently with their undergraduate programs. In this instance, a student who has completed an appropriate undergraduate degree with basic sciences, can enter into a four-year post graduate program.

Most South African medical schools award the MBChB degree (except the University of the Witwatersrand which styles its degree MBBCh). Following successful completion of study, all South African medical graduates need to complete a two-year internship as well as a further year of community service in order to register with the Health Professions Council, in order to practice as a doctor in South Africa.

Specialisation is usually a five- to seven-year training process (depending on the specialty) requiring registering as a medical registrar attached to an academic clinical department in a large teaching hospital with appropriate examinations. The specialist degree may be conferred as a Fellowship by the independent Colleges of Medicine of South Africa (CMSA), following British tradition, or as a Magisterial degree by the University (usually the degree M Med (Master of Medicine)). The Medical schools and the CMSA also offer Higher Diplomas in many fields.

Medical students from all over the world come to South Africa to gain practical experience in the country's many teaching hospitals and rural clinics. The language of instruction is English but a few indigenous languages are studied briefly.

Tunisia

In Tunisia, education is free for all Tunisian citizens and for foreigners who have scholarships. Medical school is a faculty of the University of Tunis. There are four medicine faculties situated in the major cities. Admission is bound to the success and score in the baccalaureate examination. Admission score threshold is pretty high based on competition amongst all applicants throughout the nation. Medical school curriculum consists of five years. The first two years are medical theory, containing all basic sciences related to medicine, while the last three years consists of clinical issues related to all medical specialties. During these last three years, the student gets the status of "Externe". The student has to attend at the university hospital every day, rotating around all wards. Every period is followed by a clinical exam regarding his knowledge in that particular specialty. After those five years, there are two years on internship, in which the student is basically a physician but under the supervision of the chief doctor; the student rotates over the major and most essential specialties during period of four months each. After that student has the choice of either passing the residency national exam or extending his internship for another year, after which he gains the status of family physician. The residency program consists of four to five years in the specialty he qualifies, depending on his score in the national residency examination under the rule of highest score chooses first. Whether the student chooses to be a family doctor or a specialist, he has to make a doctorate thesis, which he will be defending in front of a jury, after which he gains his degree of Doctor of Medicine.

Uganda

There are four recognized medical schools in Uganda. Three of them belong to government-owned universities, while the fourth belongs to a private university:

• Makerere University School of Medicine - Kampala
• Mbarara University, School of Medicine - Mbarara
• Gulu University, School of Medicine - Gulu
• Kampala International University, School of Health Sciences - Ishaka^[1]

Admission

Admission to medical school in Uganda requires the candidate to have attained the pre-requisite minimum score on the A-level national examinations leading to the award of the Uganda Advanced Certificate of Education or UACE, administered by the Uganda National Examination Board. Proficiency in Biology or Zoology, Chemistry and Physics at A-level standards are requirements for entry into Ugandan medical schools.

Medical training

Training leading to the award of the degree of Bachelor of Medicine and Bachelor of Surgery (MBChB) lasts five (5) years, if there are no re-takes.

• The first year is spent on the Basic Sciences i.e. Anatomy, Physiology and Biochemistry.
• The second year is devoted to Histology, Pathology, Microbiology, Pharmacology, Psychology and Introductory Psychiatry.
• The third year is spent rotating through the four major clinical disciplines of Internal Medicine, Surgery, Pediatrics and Obstetrics and Gynecology.
• The fourth year is devoted to Public Health (including community health projects) and the surgical specialties of Otolaryngology, Orthopedics, Urology, Neurosurgery and Ophthalmology. Clinical Psychiatry, Infectious Diseases and Tropical Medicine are also covered.
• The fifth year is spent rotating through the four major clinical disciplines, similar to the third year.

Examinations

There is a major examination after the first year. If the candidate does not pass, the candidate will repeat first year. Another major examination is given after second year. A failing candidate will have to repeat second year. After each clinical rotation, the candidate is examined and failing candidates are required to repeat that rotation during the next vacation period.

The last major examination is the final 5th Year MBChB examination. This is divided into three parts:

• A written Examination in each of the following disciplines: Internal Medicine, Surgery, Pediatrics and Obstetrics and Gynecology
• A bedside clinical examination with living patients, involving a "long case" and a series of "short cases" in each of the four specialties.
• An oral examination (also called a "viva"), before two clinical examiners, in each of the four subjects.

The final year clinical examinations in each of the four clinical disciplines are attended by an "External Examiner", often a professor of International or Regional repute, from a foreign medical school. The examiners arrange it so that the excelling students and those who are on the verge of failing are seen by the External Examiner in at least one of the clinical face-to-face encounters. So if you are a candidate and you go before the "External Examiner", it usually means that you are either excelling in your field or you are on the verge of failing that subject.

Internship

After successfully passing the final 5th year examinations, one is awarded the degree of Bachelor of Medicine and Bachelor of Surgery (MBChB). A year of internship in a hospital designated for that purpose, under the supervision of a specialist in that discipline is required before an unrestricted license to practice medicine and surgery is granted by the Uganda Medical and Dental Practitioners Council.

Six months of the internship must be spent in a medical discipline (either Internal Medicine or Pediatrics) and another six months in a surgical discipline (either Surgery or Obstetrics and Gynecology). Uganda has fifteen (16) hospitals, designated as "Internship Hospitals". These include the thirteen (13) Regional Referral Hospitals, Mulago National Referral Hospital, Mengo Hospital and St Francis Hospital Nsambya. There must be a specialist in the required field willing to supervise the intern at the particular hospital.

Postgraduate training

Specialization training, lasting three years, (provided there are no re-takes), leading to the award of the degree of Master of Medicine (MMed) in the particular discipline is available at Makerere University School of Medicine in several disciplines. Makerere University School of Public Health, offers the degree of Master of Public Health (MPH) following a twenty two (22) month period of study which includes field work.^[2]

The degree of Doctor of Philosophy (PhD) is awarded following a period of instruction, research and examination (typically three to five years), in select clinical disciplines. A recognized masters degree is required prior to admission into the PhD program.

Americas

Brazil

There are 181 public or private medical schools in operation in Brazil.^[3] Entrance is based on getting the higher grades on two university entrance exams Vestibular and or ENEM taken after the completion of high school and is the most competitive entrance exam in most universities. The total number of applicants across the country is occasionally more than 100 times the number of students finally accepted.^[4] For example if there are 500 places at one Medical School; the 500 students that have applied for that university that gets the higher marks on the university entrance exams, are offered a place on the course. Applicants can only apply for two courses per year at government funded universities.

A medical student must complete a full-time program consisting of six years. The first four years are focused on pre-clinical and clinical subjects and the last two years are dedicated to internship practices at University Hospital, in which the students work under supervision of residents and fully-licensed staff physicians.

Upon successful completion of the six years the degree 'Physician' is conferred. However, medical graduates are titled as Doctors. After graduation, physicians can either work as General Practitioners or undertake a post-graduate medical training.

Graduate physicians must pass an exam in order to attend a residency program. Residencies are offered at various different hospitals throughout Brazil, and at numerous medical specialities. They last at least two years, according to the chosen speciality. After this period, another exam must be taken.

Physicians who successfully complete the specialisation may apply for sub-specialisation programs in the respective specialty.

Bolivia

In Bolivia, all medical schools are faculties within a university and offer a five-year M.D. equivalent. To acquire a license to exercise medical science from the government, all students must also complete 1 year and 3 months of internship. This consists of 3 months each of surgery, internal medicine, gynecology, pediatrics and public health. At least one of the internships must be done in a rural area of the country. After getting the degree and license, a doctor may take a post-graduate residency in order to acquire a speciality.

Chile

In Chile, there are 18 medical schools. The pre-grade studies are distributed in 7 years, where the last 2 are the internship, that include at least surgery, internal medicine, gynecology and pediatrics. After getting the degree of Licenciate in Medicine (General Medicine) the M.D. must pass the EUNACOM "Examen Único de Conocimientos de Medicina" and can take a direct speciality or work before in primary attention in order to gain accces to a residency.

Canada

In Canada, a medical school is a faculty or school of a university that offers a three- or four-year Doctor of Medicine (M.D. or M.D.C.M.) degree. Generally, medical students begin their studies after receiving a bachelor's degree in another field, often one of the biological sciences. Minimum requirements for admission vary by region from two to four years of post-secondary study. The Association of Faculties of Medicine of Canada publishes a detailed AFMC.ca, guide to admission requirements of Canadian faculties of medicine on a yearly basis.

Admission offers are made by individual medical schools, generally on the basis of a personal statement, undergraduate record (GPA), scores on the Medical College Admission Test (MCAT), and interviews. Volunteer work is often an important criterion considered by admission committees. Francophone medical schools in Quebec and two Ontario schools (University of Ottawa, Northern Ontario School of Medicine) do not require the MCAT.

The first half of the medical curriculum is dedicated mostly to teaching the basic sciences relevant to medicine. Teaching methods can include traditional lectures, problem-based learning, laboratory sessions, simulated patient sessions, and limited clinical experiences. The remainder of medical school is spent in clerkship. Clinical clerks participate in the day-to-day management of patients. They are supervised and taught during this clinical experience by residents and fully-licensed staff physicians.

Students enter into the Canadian Resident Matching Service, commonly abbreviated as CaRMS in the fall of their final year. Students rank their preferences of hospitals and specialties. A computerized matching system determines placement for residency positions. 'Match Day' usually occurs in March, a few months before graduation.^[5] The length of post-graduate training varies with choice of specialty.

During the final year of medical school, students complete part 1 of the Medical Council of Canada Qualifying Examination (MCCQE). Upon completion of the final year of medical school, students are awarded the degree of M.D. Students then begin training in the residency program designated to them by CaRMS. Part 2 of the MCCQE, an Objective Structured Clinical Examination, is taken following completion of twelve months of residency training. After both parts of the MCCQE are successfully completed, the resident becomes a Licentiate of the Medical Council of Canada. However, in order to practice independently, the resident must complete the residency program and take a board examination pertinent to his or her intended scope of practice. In the final year of residency training, residents take an exam administered by either the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada, depending on whether they are training for specialty or family practice.

El Salvador

The Universidad de El Salvador (University of El Salvador), wich has the most prestigious school of medicine in the country has a program of 8 years for the students who wants to study medicine, each year is divided in two semesters, after complete succefully the 8 years of medicine, the students decide to continue to take an specialization (surgery, pediatry, etc.) for 3 years more.

Panama

The system of Medical education in Panama usually takes students from high school directly into Medical School for a 6 year course typically with an internship year . ISMS only takes students after a bachelor's degree. The International School of Medical Sciences (ISMS) offers university level classes in English and is dedicated to the development of professional physicians, preparing graduates to work on becoming qualified doctors in the United States. International School of Medical Sciences ISMS is conveniently located in middle of the Americas, in the Republic of Panama. The School is a private institution that shares the will of the best medical schools around the world, a place dedicated to enlighten students in scientific research, employing the highest university-level teaching standards.http://www.isms.edu.pa/

United States

The Association of American Medical Colleges and American Association of Colleges of Osteopathic Medicine list 130 accredited MD-granting and 28 accredited DO-granting medical schools the United States, respectively.

Admission to medical school in the United States is based mainly on GPA, MCAT score, admissions essay, interview, and volunteering activities, along with research and leadership roles in an applicant's history. While obtaining an undergraduate degree is not an explicit requirement for a few medical schools, virtually all admitted students have earned at least a bachelor's degree. A few medical schools offer pre-admittance to students directly from high-school by linking a joint 3-year accelerated undergraduate degree and a standard 4-year medical degree with certain undergraduate universities, sometimes referred to as a "7-year program", where the student receives a bachelor's degree after their first year in medical school.

As undergraduates, students must complete a series of prerequisites, consisting of biology, physics, and chemistry (organic and inorganic). Many medical schools have additional requirements including calculus, genetics, statistics, biochemistry, English, and/or humanities classes. In addition to meeting the pre-medical requirements, medical school applicants must take and report their scores on the MCAT, a standardized test that measures a student's knowledge of the sciences and the English language. Some students apply for medical school following their third year of undergraduate education while others pursue advanced degrees or other careers prior to applying for medical school.

In the nineteenth century, there were over four hundred medical schools in the United States. By 1910, the number was reduced to one hundred and forty-eight medical schools and by 1930 the number totaled only seventy-six. Many early medical schools were criticized for being diploma mills that turned out quacks. This and other problems lead to the creation of the American Medical Association in 1847 for the purpose of self-regulation of the profession. Abraham Flexner (who in 1910 released the Flexner report with the Carnegie Foundation), the Rockefeller Foundation and the AMA are credited with laying the groundwork for what is now known as the modern medical curriculum.^[6]

The standard U.S. medical school curriculum is four years long. Traditionally, the first two years are composed mainly of classroom basic sciences education, while the last two years primarily include rotations in clinical settings where students learn patient care firsthand. Today, clinical education is still spread across all four years, with the final years being more heavily weighted towards clinical rotations.

Upon successful completion of medical school, students are granted the title of Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.). Residency training, which is a supervised training period of three to seven years (usually incorporating the 1st year internship), is typically completed for specific areas of specialty. Physicians who sub-specialize or who desire more supervised experience may complete a fellowship, which is an additional one to four years of supervised training in their area of expertise.

Unlike many other countries, US medical students finance their education with personal debt. In 1992, the average debt of a medical doctor after residency was $25,000. For the class of 2009, the average debt of a medical student is $154,067 and 11% of students had debt in excess of $250,000 (prior to residency). For the past decade the cost of attendance has increased 5-6% each year (roughly 1.6 to 2.1 times inflation).^[7]

Licensing of medical doctors in the United States is co-ordinated at the state level. Most states require that prospective licensees complete the following requirements:

• Graduation from an accredited medical school granting the degree of DO or MD
  • United States and Canada schools must be accredited by the American Association of Colleges of Osteopathic Medicine or the Liaison Committee on Medical Education.
  • Foreign medical school graduates generally must complete some training within the United States.
• Satisfactory completion of at least one year of an AOA- or ACGME-approved residency.
• Passage of the United States Medical Licensing Examination or the Comprehensive Osteopathic Medical Licensing Examination (USMLE, COMLEX, or simply "the boards"). USMLE and COMLEX both consist of four similar parts:
  • Step I is taken at the end of the second year of medical school and tests students' mastery of the basic sciences as they apply to medicine.
  • Step II CK is taken during the fourth year of medical school and tests students' mastery of the management of ill patients.
  • Step II CS is taken during the fourth year of medical school and tests students' mastery of clinical skills using a series of standardized patient encounters.
  • Step III is taken after the first year of a residency program and tests physicians' ability to independently manage the care of patients.

Asia and Oceania

Australia

In Australia, students wishing to study medicine have two options: they can either attempt to gain entry through the UMAT exam and interview to a five-year or six-year undergraduate MBBS or BMed program; or complete an undergraduate degree and then attempt to gain entry to a graduate entry program which requires a student to sit the GAMSAT exam and interview to a four-year graduate entry BMBS or MBBS. The first four-year graduate entry medical program in Australia was at Flinders University in South Australia. Graduate entry medicine is now an option which is present at most Australian medical schools.

Bangladesh

In Bangladesh, admission to medical colleges is organized both by the Govorning body Dhaka University or the autonomus private trends. These exams are super-competitive and the total number of applicants across the country is usually around 78 times the number of students finally accepted. Admission is based solely on the entrance examination and academic records have minor consequences on an application. The undergraduate program consists of 5 years, followed by one-year internship (rotating housemanship). The degree granted is Bachelor of Medicine and Bachelor of Surgery (M.B.B.S.). Further postgraduate qualifications may be obtained as Diploma or Degree (MS or MD), MPhill and FCPS.

Commonwealth of Northern Marianas Islands

University of Loyola at CNMI is a medical school on the island of Saipan.

Hong Kong

In Hong Kong, prospective medical students enter either one of the two faculties of medicine available (University of Hong Kong or the Chinese University of Hong Kong) from high school. The medical program consists of 5 years, leading to a degree of bachelors of medicine and surgery (MBBS or MBChB). An entry level exam specific to medicine is unnecessary, as the schools evaluate students based on the results obtained from the Hong Kong's Advanced Level Examination test (HKALE). After a 5 year degree, one year of internship follows in order to be eligible to practice in Hong Kong.

India

In India, admission to medical colleges is organized both by the central government CBSE as well as the state governments through rigorous tests known as entrance examination. Students who have successfully completed their 10+2 education (higher secondary school) can appear for the tests the same year.

The All-India Pre Medical/Dental Test for filling up of 15% of total MBBS seats in India, conducted by CBSE (Central Board for Secondary Education) in the month of April/May intakes about only 2,500 students out of a total applicants of over 200,000. The Supreme Court Of India has mandated the necessity of entrance examination based upon multiple choice questions and negative marking for wrong answers with subsequent merit over 50% for selection into MBBS as well as higher medical education. The entrance exams are highly competitive and students start preparing for them from grade 9. Admission is based "solely" on the entrance examination and previous academic records hold no consequences on an application.

The graduate program consists of three professionals consisting of 9 semesters, followed by one-year internship (rotating housemanship). The degree granted is Bachelor of Medicine and Bachelor of Surgery (M.B.B.S.) of five years and six months.

The graduate degree of MBBS is divided into 3 professionals, with each professional ending with a professional exam conducted by the university (a single university may have up to dozens of medical colleges offering various graduate/post-graduate/post-doctoral degrees). After clearing this the student moves into the next professional. Each professional exam consists of a theory exam and a practical exam conducted not only by the same college but also external examiners. The exams are tough and many students are unable to clear them, thereby prolonging their degree time. The first professional is for 1 year and includes preclinical subjects, anatomy, physiology and biochemistry. The second professional is for 1 and a half year and has subjects pathology, pharmacology, microbiology (including immunology) and forensic medicine. Clinical exposure starts in the second professional. The third professional is divided into two parts. Part 1 consists of ophthalmology, otorhinolaryngology, and PSM (preventive and social medicine) and part 2 consists of general-medicine, general-surgery, pediatrics and gynaecology and obstetics. This is followed by one-year of compulsory internship (rotatory house-surgeonship). After internship, the degree of MBBS is awarded by the respective university. Some states have made rural service compulsory for a certain period of time after MBBS.

Selection for higher medical education is through entrance examinations as mandated by the Supreme Court Of India. Further postgraduate qualifications may be obtained as Post-graduate Diploma of two years residency or Doctoral Degree (MS:Master of Surgery, or MD) of three years of residency under the aegis of the Medical Council of India.50% of all MD/MS seats in India are filled up through "All-India Post-Graduate Medical Entrance Examination conducted by AIIMS (All-India Institute Of Medical Sciences) under the supervision of the Directorate General Of Health Services. Theses/Dissertations are mandatory to be submitted and cleared by university along with examinations(written and clinicals) to obtain MD/MS degree. Further sub-speciality post-doctoral qualification (DM - Doctor of Medicine, or MCh - Magister of Chirurgery) of three years of residency followed by university examinations may also be obtained.^[8]

PG (post-graduate) qualification is equivalent to M.D./M.S., consisting of two/three-years residency after MBBS. A PG diploma may also be obtained through the National Board of Examinations, which also offers three-years residency for sub-specialisation. All degrees by NBE are called DNB (Diplomat of National Board). DNB's are awarded only after clearance of theses/dissertations and examinations. DNBs equivalent to DM/MCh have to clear examinations mandatorily.^[9]

At international level, Indian medical education is rated to be amongst the toughest, most exhaustive and lenghtiest in the world apart from being up-to-date in all relevant syllabii. Also its medical education system has multiple checks, filters and barriers at all levels to weed out unfit candidates. All university examinations at all levels of medical education consist of two examiners from the same university and two examiners from other universities.

Indonesia

In Indonesia, high school graduates who want to enroll to national medical schools must take entrance test called "SPMB" arranged by Directorate General of Higher Education, Ministry of National Education. For private medical school, the entrance test is conducted independently by each university.

The standard Indonesian medical school curriculum is six years long. The four years undergraduate program is composed mainly of classroom education, continued with the last two years in professional program primarily includes rotations in clinical settings where students learn patient care firsthand. If they pass undergraduate program they will have "S.Ked" in their title and if they finished the professional program and pass the national examination arranged by IDI (Indonesian Medical Association) they will become general physician and receive "dr. (doctor)" title.

Upon graduation, physician who plans to become a specialist in specific field of medicine must complete a residency which is a supervised training with period of three to four years. Physician who sub-specializes or who desires more supervised experience may complete a fellowship, which is an additional one to three years of supervised training in their area of expertise.

Israel

There are four university medical schools in Israel, including the Technion in Haifa, Ben Gurion University in Beer Shiva, Tel Aviv University and the Hebrew University in Jerusalem. They all follow the European 6 year model. However, as of 2009, Tel Aviv University has introduced a four year program similar to the US system for students with a bachelor's degree in certain biological sciences. The entrance requirements of the various schools of medicine are very strict. Israeli students require a high school Baccalaureate average above 100 and psychometric examination grade over 740. The demand for medical education is strong and growing and there is a lack of doctors in Israel. The Technion Medical School, Ben Gurion University, and Tel Aviv University Sackler Faculty of Medicine offer 4 year MD programs for American students who have American college degrees and have taken the MCAT interested in completing rigorous medical education in Israel before returning to the US or Canada.

Japan

In Japan, a medical school is a faculty of a university thus undergraduate program. Programs are generally 6 years. Entrance is based on an exam taken at the end of high school and considered to be the most competitive for university entrance exam.

Medical students study Liberal Arts and Science for the first 1–2 years, which include Physics, Mathematics, Chemistry, Foreign Languages together with 2 years long Basic Medicine (Anatomy, Physiology, Pharmacology, Immunology), and Clinical Medicine, Public health and Forensics for the next two years.

Medical students train in the University Hospital for the last two years. Clinical training is a part of the curriculum. Upon completion of the graduation examination, students are awarded an MD. Medical graduates are titled as Doctor, as are Ph.D. holders.

At the end, Medical students take the National Medical License examination, and if they pass it, become a Physician and registered in the record in the Ministry of Health, Labour and Welfare. The scope of this exam encompasses every aspect of medicine.

Jordan

The Bachelor of Medicine and Surgery (MBBS) degree is awarded in Jordan after completion of six years comprising three years of medical sciences and three clinical years. Currently, four state supported universities include a medical school and grant the degree which are:

• Jordan University of Science and Technology in Ramtha
• University of Jordan in Amman
• Mutah University in Al Karak
• Hashemite University in Zarqa

Further Information: Medical education in Jordan.

Kyrgyzstan

In Kyrgyzstan, the International School of Medicine at the International University of Kyrgyzstan^[10][11] offers a five year medical program, with a requisite for English knowledge, that is recognized by the World Health Organization, GMC, and UNESCO. The medical school is also partnered with the University of South Florida School of Medicine, the University of Heidelberg (Germany), the Novosibirsk Medical University (Russia), and the University of Sharjah (UAE).

Other medical schools located in Kyrgyzstan include the Asian Medical Institute, Kyrgyzstan^[12] and the Medical Institute, Osh State University^[13]

Myanmar

There are five medical institutions, UM 1, UM 2, DSMA, UM Mdy and UM Mgy in Myanmar. Myanmar medical schools are government-funded and require Myanmar citizenship for eligibility. No private medical school exists at this moment. In Myanmar, admission to medical colleges is organized under the Department of Health Science which is the branch of Ministry of Health of Myanmar. A student can join one of the Five medical universities of Myanmar if he gets the highest scores in the science combination of the matriculation examination. This exam is highly competitive. Entrance is solely based on this examination and academic records have very minor consequences on an application. The undergraduate program is five years plus one year for work experience in government hospitals. After medical school, Myanmar medical graduates are under contract to spend one year of internship and three years of tenure in rural areas before they are eligible for most residency positions. The degree granted is Bachelor of Medicine and Bachelor of Surgery (M.B.B.S.). Further postgraduate qualifications may be obtained as a Degree (M.Med. Sc).

Nepal

In Nepal, medical studies start at undergraduate level. The program is of five and half years duration. There are three main medical bodies in Nepal:

• Tribhuwan University (own college: Institute of Medicine Maharajgunj, affiliated colleges: National Medical College, Janaki Medical College, Universal College of Medical Sciences)
• Kathmandu University (Own college:Kathmandu University School of Medical Sciences (KUSMS), Affiliated colleges: Manipal College of Medical Sciences, Kathmandu Medical College, Nepal Medical College, Nepalgunj Medical College, College of Medical Sciences, Nobel Medical College, Lumbini Medical College
• B. P. Koirala Institute of Health Sciences.

The first two years of studies are called "Basic Sciences" followed by two and half years of "clinical sciences" and one year of internship. After the successful completion of this course, a student is awarded Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) degree.

New Zealand

New Zealand medical programs are undergraduate-entry programs of six years duration. Students are considered for acceptance only after a year of undergraduate basic sciences or, in a small number cases, following the completion of a bachelor's degree. There are two main medical schools in New Zealand: the University of Auckland and the University of Otago. Each of these has subsidiary medical schools such as Otago's Wellington School of Medicine and Health Sciences and Auckland's Waikato Clinical School.

The first year of the medical degree is the basic sciences year which comprises study in chemistry, biology, physics, biochemistry as well as population health and behavioural sciences. The following two years are spent studying human organ systems and pathological processes in more detail as well as professional and communication development. Towards the end of the third year students begin direct contact with patients in hospital settings.

The clinical years begin fully at the beginning of year 4 where students rotate through various areas of general clinical medicine with rotation times varying from between two and six weeks. Year 5 continues this pattern focusing more on specialized areas of medicine and surgery. Final medical school exams (exit exams) are actually held at the end of year 5 which is different from most other countries where final exams are held near the very end of the medical degree. Final exams must be passed before the student is allowed to enter year 6.

The final year (Year 6) of medical school is known as the "Trainee Intern" year where a student is known as a "Trainee Intern" (commonly referred to in the hospitals as a "T.I."). Trainee interns repeat most rotations undertaken in years 4 and 5 but at a higher level of involvement and responsibility for patient care. Trainee interns receive a stipend grant from the New Zealand government (not applicable for international students). Currently this is $NZ 26,756/year (about $US 18,500). Trainee interns have responsibility under supervision for the care of about one third the patient workload of a junior doctor, however, all prescriptions and most other orders (e.g. radiology requests and charting of IV fluids) made by trainee interns must be countersigned by a registered doctor.

New Zealand medical schools currently award the degrees of Bachelor of Medicine and Bachelor of Surgery (MBChB).

Pakistan

In Pakistan a medical school is more often referred to as a medical college. A medical college is affiliated with a university as a department. There are however several medical universities and medical institutes with their own medical colleges. All medical colleges and universities are regulated by the respective provincial department of health. They however have to be recognized after meeting a set criteria by a central regulatory authority called Pakistan Medical and Dental Council (PMDC) in Islamabad. There are almost equal number of government and private medical colleges and universities, with their number exceeding 50. Entrance in to the medical colleges is basd on merit under the guidelines of PMDC. Both the academic performance at the college (high school, grades 11-12) level and an entrance test like MCAT are taken into consideration for the eligibility to enter most of the medical colleges. After successfully completing five years of academic and clinical training in the medical college and affiliated teaching hospitals the graduates are awarded a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree. The graduates are then eligible to apply for a medical license from the PMDC. A house job of one year duration is mandatory in a teaching hospital after completing five years of academic and clinical training in the medical college.

People's Republic of China

Medical education is normally a five-year Bachelor degree, including one year internship (or clinical rotation, during which students are actively involved in patient care) before the final degree is awarded. Clinical specialization usually involves a two or three-year Master degree. Acceptance is based on the national entrance examination used for all universities. There are a few colleges that teach in English and accept foreign medical students. Some of those universities have increased their course duration to 6 years.

Philippines

The Dominicans, under the Spanish Government, established the oldest Medical School in the Philippines in 1871, known as the Faculty of Medicine and Surgery of the Pontifical and Royal University of Santo Tomas in Intramuros, Manila. Medical education in the Philippines became widespread under the American administration. The Americans, led by the insular government's Secretary of the Interior, Dean Worcester, built the University of the Philippines's College of Medicine and Surgery in 1905. By 1909, nursing instruction was also begun at the Philippine Normal School. At present there are a number of medical schools in the Philippines, notable examples include the University of the Philippines, Manila, Our Lady of Fatima University, Valenzuela City, Far Eastern University - Nicanor Reyes Medical Foundation, Saint Louis University International College of Medicine in Baguio City, the De La Salle Health Sciences Institute, the University of Santo Tomas, Pamantasan ng Lungsod ng Maynila, University of the East Ramon Magsaysay Memorial Medical Center, St. Luke's College of Medicine-William H. Quasha Memorial, Cebu Doctors' University, Cebu Institute of Medicine, Southwestern University, West Visayas State University in Iloilo City and Xavier University - Ateneo de Cagayan, Dr. Jose P. Rizal School of Medicine in Cagayan De Oro.

Any college graduate may apply for medical school as long as he or she as accumulated a set number of units in biology, chemistry, physics, and math. There is also a test known as the National Medical Admissions Test or NMAT. Scores are given on a percentile basis and a high ranking is a must to enter the top medical schools in the country.

In most institutions, medical education lasts for four years. Basic subjects are taken up in the first and second years, while clinical sciences are studied in the second and third years. In their fourth year, students rotate in the various hospital departments, spending up to two months each in the fields of internal medicine, surgery, obstetrics and gynecology, and pediatrics, and several weeks in the other specialties. After this, students graduate with a Doctorate in Medicine and apply for post-graduate internship in an accredited hospital of their choice. After PGI, the student is eligible to take the Medical Licensure Examination. Passing the examinations confers the right to practice medicine as well as to apply in a Residency Training Program.

Republic of China (Taiwan)

The medical education in the Republic of China (Taiwan) is usually 7 years in duration, starting right after high school. The reason for such a long period of study is because Taiwanese medical schools include undergraduate education. Currently, only Kaohsiung Medical University offers a 4-year medical program, similar to the US medical school system, for university degree holders. The first 2 years in the 7-year system is composed of basic sciences and liberal art courses. Especially, all the medical schools there compete with each other on how enthusiastic their graduates become. Massive doctor-patient classes are emphasized, and most schools require compulsory amounts of volunteer hours. Clinical sciences are compressed into a two year program in the 3rd and 4th years. Many medical students in Taiwan call this 2-year hell. The duration of clerkships and internships varies from school to school, but all of them end at the 7th grade.

Saudi Arabia

In Saudi Arabia medical education is free for all Saudi citizens. A medical student must pass an entrance examination and complete a 1-year pre-medical course containing some basic medical subjects including: Biology, Organic Chemistry, Inorganic Chemistry, Physics, Medical Biostatistics, and English for medical uses. Passing this year is commonly considered as the most challenging. Saudi Arabia has approximately 8 medical schools. It offers an MBBS (Bachelor of Medicine, Bachelor of Surgery) degree. after one pre-medical course, five medical years and one training year. By 2010, there are 24 medical schools in KSA... 21 nonprofite and three private medical schools the last college opened was Sulaiman Alrajhi colleges with its partenership with Maastricht in the Netherlands

South Korea

Medical program used to be a direct entry program like the UK system and used to take 6 years to complete. However, the universities are currently going through a transition from the direct-entry medicine into 4+4 years system found in the US. There are 41 medical schools in South Korea.^[14] All 10 Flagship Korean National Universities have the medical schools.

Some argue that oriental medical colleges and school in Korea should be considered as typical medical school, however, the fact is that the license and curriculums of the oriental medical schools and oriental medical doctors are quite different with those of typical doctors, physicians, and surgeons in Korea and the world, and generally they are not accepted to be typical physicians and surgeons. The students from oriental medical schools in Korea are only able to participate in 'Korean national oriental medical doctor license examination', instead of 'Korean national medical doctor license examination(KMLE)'.^[15] The oriental doctors are only able to perform acupuncture and herb medicine which are based on Eastern philosophy, not evidence based science. The oriental medical doctors in Korea do not authorize to prescribe ordinary medicines such as antibiotics, operate on patients, and diagnose disease with modern medical technologies including ultrasound, CT, MRI, PET and so on.

Sri Lanka

There are eight medical schools in Sri Lanka that teach evidence based (sometimes called "western") medicine. The oldest medical school is the Faculty of Medicine, University of Colombo (Started as Ceylon Medical School in 1870) and is 137 years old. Peradeniya medical school which is the second most old medical school in the country (formerly known as university of Ceylon) situated in hills with a prestigious natural beauty and affiliated to the university of peradeniya, one of the most renown varsities in south Asia. Peradeniya medical school holds no responsibility on Allied Health Science degree program which acts as a separate body within the university with a minimum number of infrastructure stated in 2006 for offering degrees for allied health students. There are medical faculties in Kelaniya, Sri Jayawardanepura, Galle, Batticaloa, Jaffna and Rajarata as well. Kelaniya Medical Faculty initially started as the North Colombo Medical College (NCMC), a private medical institution. It was one of the earliest private higher educational institutions (1980). Heavy resistance by the Maxist JVP political movement to private sector growth led to its nationalization and to its renaming as the Kelaniya Medical Faculty. The output of all medical schools is around 1200 and they receive the degree MBBS (Bachelor of Medicine, Bachelor of Surgery. However, since the intake into these faculties are very limited, a large number of students graduate from foreign countries. As the country is a former colony of Britain, lot prefer England, Australia, New Zealand. Former Socialist countries are also attractive due to their low tuition fees as well as Bangladesh and Pakistan. The training period is around five years plus a residency period of one year for full registration. [Post Graduate institute of Medicine] (PGIM)is the only postgraduate degree awarding institution. Course period may vary according to the discipline. It is mandatory for graduates to undergo a training period of one to two years in a center of excellence outside Sri Lanka. The Institute of Ayurvedhic Medicine of the University of Colombo, the Gampaha Wickramarachchi Ayurvedhic Medicine Institute of the University of Kelaniya and the Faculty of Siddha Medicine, University of Jaffna teach Ayurvedha/ Unani / Siddha Medicine. Medicina Alternativa or the Open University of Complementary Medicine teaches acupuncture and homeopathy.

Thailand

Most of the Thai medical schools are government-funded and require Thai citizenship for eligibility. Only one private medical school exists at the moment. Some Thais choose to attend the private medical school or attend a medical school in a foreign country due to relatively few openings and high college entrance examination scores required for enrollment in public medical schools.

The Thai medical education is six years consisting of 3 pre-clinical and 3 clinical years. Upon graduation all medical students must pass the national examination and a university-based comprehensive test. After medical school, Thai medical graduates are under contract to spend one year of internship and three years of tenure in rural areas before they are eligible for most residency positions.

The students will receive Doctor of Medicine (MD) degree.

Europe

Belarus

There are 4 Medical Schools (Medical Universities) in Belarus:

• Belarussian State Medical University, Minsk (byelorussian: Беларускі дзяржаўны медыцынскі ўніверсітэт; Russian: Белорусский государственный медицинский университет) - http://www.bsmu.by/english/, which contains the famous Bosef Institute for AIDS Research.
• Gomel State Medical University (byelorussian: Гомельскі дзяржаўны медыцынскі ўніверсітэт; Russian: Гомельский государственный медицинский университет) - http://www.medinstitut.gomel.by/index.php?module=documents&item=379
• Grodno State Medical University (byelorussian: Гродненскі дзяржаўны медыцынскі ўніверсітэт; Russian: Гродненский государственный медицинский университет) - http://www.grsmu.by/eng/
• Vitebsk State Order of Peoples' Friendship Medical University (byelorussian: Віцебскі дзяржаўны медыцынскі ўніверсітэт; Russian: Витебский государственный ордена Дружбы народов медицинский университет) - http://www.vgmu.vitebsk.by/eng/index.html

Bosnia and Herzegovina

There are five Medical Schools (Medicinski Fakultet) in Bosnia and Herzegovina:

• University of Banja Luka School of Medicine
• University of Sarajevo Medical School
• University of Tuzla Medical School
• University of East Sarajevo Medical School (Foca)
• University of Mostar Medical School

These medical schools are usually affiliated with regional hospitals.

The course of study lasts 6 years or 12 semesters. Students are conferred degree Doctor of Medicine (MD) upon graduation.

Admissions

Entry to BH Medical Schools are very competitive due to limited places imposed by the government quota. Students are required to complete Secondary School Leaving Diploma (Gimnazija-Gymnasium (school) or Medicinska skola matura/svedocanstvo/svjedodzba).

Entrance examination is usually held in June/July. Combined score of Secondary School Diploma assessment (on scale 1-5, with 2 minimum passing grade and 5 maximum grade) and entrance examination is taken into consideration. Usually, 5 in Chemistry, Biology, Mathematics, and Physics are required for entry to medicine.

Curriculum

Course structure is more traditional and divided in pre-clinical (year 1-3) /clinical part (year 3-6) and subject-based.

Practical examinations are held throughout the degree (Anatomy, Biochemistry,Pathology, Physiology practicals etc.). Dissection is part of all medical curricula in Bosnian and Herz. Medical Schools.

Course content in BH Medical Schools:

• Biophysics
• Biology and Human Genetics
• Medical Chemistry
• Sociology
• Statistics and Computer Science in Medicine
• Ethics in Medicine
• Social Medicine
• English Language
• Anatomy
• Biochemistry
• Histology and Embryology
• Physiology
• Microbiology and Immunology
• Pathological Anatomy
• Pathological Physiology
• Basic of Oncology
• Nuclear Medicine
• Clinical Propaedeutic
• Epidemiology
• Radiology
• Neurology
• Psychiatry
• Pharmacology and Toxicology
• Infectious Diseases
• Dermatovenereology
• Internal Medicine
• Gynaecology
• Surgery
• Medical Ecology
• Pediatrics
• Forensic Medicine
• Otorhinolaryngology and Maxillofacial Surgery
• Ophthalmology
• Physical Medicine and General Rehabilitation
• Primary Health Care and Occupational Medicine

Belgium

In Belgium, medical education consists of a 7 year program. In the first 3 years, which are very theoretical and lead to a university bachelor degree, general scientific courses are taken like chemistry, biophysics, physiology, biostatistics, anatomy, virology, etc. To enter the bachelor course people have to pass an exam in Flanders (Dutch part of Belgium) (Toelatingsexamen arts - tandarts) due to the numerus clausus. In the French part, only the best students that pass the first year of the bachelor course in medicine are admitted to the second and third year.

After the bachelor courses, students are allowed to enter the 'master in medicine' courses, which consist of 4 years of theoretical and clinical study. Generally, the first 2 master years are very theoretical and teach the students in human pathology, diseases, pharmacology,... The 3rd year is a year full of internships in a wide range of specialities in different clinics. The 4th year is devoted to the subject that the student chooses for his career.

Bulgaria

In Bulgaria, a medical school is a type of college or a faculty of a university. The medium of instruction is officially in Bulgarian. A six to one year course in Bulgarian language is required prior to admittance to the medical program. For European candidates an exam in Biology and Chemistry in Bulgarian, is also required. However, a number of Bulgarian medical schools have now started offering medical programmes in English.^[16][17]

Students join medical school after completing high-school. Admission offers are made by individual medical schools. Bulgarian applicants have to pass entrance examinations in the subjects of Biology and Chemistry. The competitive result of every candidate is the based on their marks these exams plus their secondary-school certificate marks in the same subjects. Those applicants with the highest results achieved are classified for admission.

The course of study is offered as a six year program. The first 2 years are pre-clinical, the next 3 years are clinical training and the 6th year is the internship year during which students work under supervision at the hospitals. During the 6th year students have to appear for 'state exams' in the 5 major subjects of Internal Medicine, Surgery, Gynaecology and Obstetrics, Social Medicine and Pediatrics. Upon successful completion of the six years of study and the state exams the degree of 'Physician' is conferred.

For specialization, graduates have to appear for written tests and interviews to obtain a place in a specialization program. For specialization in general medicine, general practice lasts three years, cardiology lasts four years, internal medicine lasts five years, and general surgery lasts five years.

Croatia

In Croatia there are four out of seven universities which offer a medical degree, the University of Zagreb (offers also medical studies in English), University of Rijeka, University of Split and the University of Osijek. A Medical school is a faculty of those four universities. Medical students enroll to Faculties of medicine after finishing secondary education, typically after the Gymnasium, but also after the four-year nursing school or other secondary schools with a duration of 4 years. During the application process, the grades of the last four years of secondary school, the scores at the final secondary school examination (Matura) and the score at the obligatory entrance examination are taken into account, and the best students are enrolled.

The course of study lasts 6 years or 12 semesters. During the first 3 years students are engaged in pre-clinical courses (Anatomy, histology, chemistry, physics, cell biology, genetics, physiology, biochemistry, immunology, pathological physiology and anatomy, pharmacology, microbiology, etc.). The contact with patients begins, however, already at the 3rd year. The remaining 3 years are composed of rotations at different departments, such as internal medicine, neurology, radiology, dermatology, psychiatry, surgery, pediatrics, Gynecology and Obstetrics, Anesthesiology and others. During every academic years students also enroll in two or three elective courses. After each rotation the students take exams, a total of circa 60 exams. At the end the students must pass a final examination, which is a multiple-choice exam comprising questions about clinical courses, and finally they gain the title Doctor of medicine (dr. med.) which is written after one's name. Now doctors must complete a one-year, supervised, paid internship in a hospital of their choice, after which they take the state (license) examination, which is an eight-part oral examination containing eight most important clinical branches. Now doctors are eligible to practice medicine as general practitioners. Residencies are offered at various different hospitals throughout Croatia, and at numerous medical specialities.

Finland

In Finland, basic medical education is given in five universities: Helsinki, Kuopio, Oulu, Tampere and Turku. Admission is regulated by an entrance examination. Studies involve an initial two-year preclinical period of mainly theoretical courses in anatomy, biochemistry, pharmacology etc. However, students have contact with patients from the beginning of their studies. The preclinical period is followed by a four-year clinical period, when students participate in the work of various hospitals and health care centres, learning necessary medical skills. Some Finnish universities have integrated clinical and preclinical subjects along the six-year course, diverging from the traditional program. A problem-based learning method is widely used, and inclusion of clinical cases in various courses and preclinical subjects is becoming common. All medical schools have research programs for students who wish to undertake scientific work. The duration of basic medical education is six years and the course leads to the degree of Licentiate of Medicine.

France

Medical studies in France are organized as follow:

Right after graduating from High School with a scientific background (Baccalaureat S), any student can register at a university of medicine (there are about 30 of them throughout the country). At the end of first year, an internal ranking examination takes place in each of these universities in order to implement the numerus clausus. First year consists mainly of theoretical classes such as biophysics and biochemistry, anatomy, ethics or histology. Passing first year is commonly considered as challenging and requires hard and continuous work. Each student can only try twice. For example, the Université René Descartes welcomes about 2000 students in first year and only 300 after numerus clausus.

The second and third year are usually mainly quite theoretical although the teachings are often accompanied by placements in the field (e.g. internships as nurses or in the emergency room, depending on the university).

During 4th, 5th and 6th years, medical students get a special status called 'Externe' (In some universities, such as Pierre et Marie Curie, the 'Externe' status is given starting in the 3rd year). They work as interns every morning at the hospital plus a few night shifts a month and study in the afternoon. Each internship lasts between 3 and 4 month and takes place in a different department. Med students get 5 weeks off a year.

At the end of 6th year, they need to pass a national ranking exam which will determine their specialty. Indeed, the first student gets to choose first, then the second et caetera. Usually students work pretty hard during 5th and 6th years in order to train properly for the national ranking exam. During these years, actual practice at the hospital and some theoretical courses are meant to balance the training. Such interns' average wage stands between 100 and 300 euros a month (which is far from being enough to make a living).

After that ranking exams, students can start as residents in the specialty they have been able to pick. That is the point from which they also start getting paid (decently).

Germany

In Germany, admission to medical schools is currently administered jointly by the Zentralstelle für die Vergabe von Studienplätzen (ZVS), a centralized federal organization, and the universities themselves. The most important criterion for admission is the Numerus clausus, the final GPA scored by the applicant on the Abitur (highest secondary school diploma). However, in light of the recent gain in influence of medical schools in regards to applicant selection, additional criteria are being used to select students for admission. These criteria vary among medical faculties and the final Abitur GPA is always a core indicator and strongly influences admission.

The first two years of medical school consist of the so-called pre-clinical classes. During this time, the students are instructed in the basic sciences (e.g. physics, chemistry, biology, anatomy, physiology, biochemistry, etc.) and must pass a federal medical exam (Erster Abschnitt der ärztlichen Prüfung), administered nationally. Upon completion, the students advance to the clinical stage, where they receive three years of training and education in the clinical subjects (e.g. internal medicine, surgery, obstetrics and gynecology, pediatrics, pharmacology, pathology, etc.). The last year of medical school consists of the so-called "practical year" (Praktisches Jahr, PJ). Students are required to spend four month clerkships each in internal medicine, surgery, and one elective.

After six years of medical school, the students graduate with a final federal medical exam (Zweiter Abschnitt der ärztlichen Prüfung). Graduates receive the license to practice medicine and the professional title of physician (Arzt). The academic degree Doctor of Medicine is awarded if the graduate has additionally successfully completed a scientific dissertation. Many medical students opt to perform their thesis during their studies at medical school. If physicians wish to independently care for patients, they are required to further complete a residency in their field of specialization.

There are 36 medical faculties in Germany.

Hungary

Hungary has four medical schools, in Budapest, Debrecen, Pécs and Szeged. Medical school takes six years to complete, of which the last year is a practical year. Students receive the degree dr. med. univ. or dr. for short, equivalent to the MD degree upon graduation.

Iceland

In Iceland, admission to medical school requires passing an organized test, controlled by the University of Iceland, which anyone who has a gymnasium degree can take. Only the top 48 scores on the exam are granted admission each year. Medical school in Iceland takes 6 years to complete. Students receive a cand.med. degree upon graduation. Following this, Icelandic regulations require 12 months of clinical internship before granting a full medical license.^[18] This internship consists of internal medicine (4 months), surgery (2 months), family medicine (3 months) and a three month elective period. Upon receiving a license to practice, a physician can start specialist training, in Iceland or abroad.^[19]

Ireland

There are six medical schools in Ireland. They are at Trinity College Dublin, the Royal College of Surgeons in Ireland, University College Dublin, University College Cork, University of Limerick and the National University of Ireland, Galway (the National University of Ireland is the degree-awarding institution for all except the University of Limerick and Trinity College). Training lasts four, five or six years, with the last two years in the affiliated teaching hospitals (UCD - St. Vincents University Hospital, Mater Misericordiae University Hospital) (Trinity - St. James's Hospital, Adelaide and Meath Hospitals incorporating the National Children's Hospital) (RCSI - Beaumont Hospital, Conolly Hospital, Waterford Regional Hospital). For Programmes that are six years in length, entry is based on secondary school qualifications. Programmes that are four years in length require previous university degrees. The Royal College of Surgeons in Ireland and the University of Limerick were the first medical institutions to offer Graduate Entry Medicine of four years in duration in the Ireland. This is now also offered in University College Dublin and University College Cork. The National University of Ireland, Galway will launch a graduate entry programme in 2010.

Medical education is regulated by the Irish Medical Council, the statutory body which is also responsible for maintaining a register of medical practitioners. After graduation with the degrees of BM BS (Bachelor of Medicine and Bachelor of Surgery) or MB BCh BAO (Medicinae Baccalaureus, Baccalaureus in Chirurgia, Baccalaureus in Arte Obstetricia), a doctor is required to spend one year as an intern under supervision before full registration is permitted. Graduates of the Royal College of Surgeons in Ireland also receive the traditional "Licenciate of the Royal Colleges of Surgeons and Physicians in Ireland" (LRCP&SI), which was awarded before the Royal College of Surgeons in Ireland became an Affiliate of the National University of Ireland and thus was allowed grant degrees, under the Medical Practitioners Act (1978).

Italy

In Italy, the contents of the medical school admission test is decided each year by the Ministry of Education, Universities and Research (MIUR) and consists of eighty questions divided in five categories: logics and "general education ("cultura generale"), mathematics, physics, chemistry, and biology. The test is usually taken in early September, following the conclusion of a 5-year high school cycle in July.

Each medical school administers the test separately, and the result of the test is only valid for entry in the medical school where the test was taken. As a general rule, all state-run medical schools in the country administer it on the same day, whereas all privately run medical school administer it on another day, so that a candidate may take the test once at a state-run school and once at a private school of his/her choice, but no more.

Medicine is one of the university faculties implementing numerus clausus ("numero chiuso"): the overall number of medical students admitted every year is constant, as each medical school is assigned a maximum number of new admission per year by MIUR.

Medical school lasts 6 years (12 semesters). Traditionally, the first three years are devoted to "biological" subjects (physics, chemistry, biology, biochemistry, genetics, anatomy, physiology, immunology, pathophysiology, microbiology, and usually English language courses), whereas the later three years are devoted to "clinical" subjects. However, most schools are increasingly devoting the second semester of the third year to clinical subjects and earlier patient contact. In most schools, there are about 36 exams over the 6-year cycle, as well as a number of compulsory rotations and elective activities.

At the end of the cycle, students have to discuss a final thesis before a board of professors; the subject of this thesis may be a review of academic literature or an experimental work, and usually takes more than a year to complete, with most students beginning an internato (internship) in the subject of their choice in their fifth or sixth year. The title awarded at the end of the discussion ceremony is that of "Dottore in Medicina e Chirurgia" ("Doctor of Medicine and Surgery"), which in accordance with the Bologna process is comparable with a master's degree qualification.

After graduating, new doctors must complete a three-month, unpaid, supervised tirocinio post-lauream ("post-degree placement") consisting of two months in their university hospital (one month in a medical service and one in a surgical service) as well as one month shadowing a general practitioner. After getting a statement of successful completion of each month from their supervisors, new doctors take the esame di stato ("state exame") to obtain full license to practise medicine. They will then have to register with one of the branches of the Ordine dei Medici ("Order of Physicians") which are based in each of the Provinces of Italy.

Registration makes new doctors legally able practice medicine without supervision. They will then have to choose between various career paths, each usually requiring a specific admission exam: most either choose to train as general practitioner (a 3-year course run by each Region, including both general practice and rotation at non-university hospitals), or of entering a Scuola di Specializzazione ("specialty school") at a university hospital 5-year or 6-year course.

Netherlands & Belgium

In the Netherlands and Belgium, medical students receive respectively 6 and 7 years of university education prior to their graduation.

In the Netherlands, students used to receive four years of the preclinical training, followed by two years of clinical training in hospitals. However, for a number of medical schools this has recently changed to three years preclinical training, followed by three years of clinical training. After 6 years students graduate as basisarts (comparable with Doctor of Medicine), which in accordance with the Bologna process is comparable with a master's degree qualification. All medical students are permitted entry from the highest level of secondary school: VWO, the entrant is not required to have a previous bachelor's degrees qualification.

The Belgian medical education is much more based on theoretical knowledge, whereas in the Netherlands medical education is focused more on skill than theoretical knowledge. In Belgium the first three years of education lead up to a bachelor's degree, followed by a four-year master's program.

Norway

Medical education in Norway begins with a six to six and a half year graduate university program. Admission requires a relatively high GPA from secondary school, with the medical program at the University of Oslo requiring the highest. Upon completion, students are awarded a candidatus/candidata medicinae (cand. med.) degree. Following this, the Norwegian Registration Authority for Health Personnel (Statens autorisasjonskontor for helsepersonell) requires a minimum of 18 months of internship (turnustjeneste) before granting a medical license. Once the doctor has got a license to practice, he or she is able to apply for a post to start specialist training. There are currently 43 recognized medical specialties in Norway.

Poland

Romania

In Romania, medical school is a department of a medical university, which typically includes Dentistry and Pharmacy departments as well. The name facultate is used for departments in their universities too, but the Medicine departments distinguish themselves by the length of studies (6 years), which grants to graduates a status equivalent to that of a Master in Science. The Medicine departments are also marked by reduced flexibility - in theory, a student in a regular university can take courses from different departments, like Chemistry and Geography (although it usually doesn't happen, majors being clearly defined), while the medical universities do not have any extra offers for their students, due to their specialization. Admission to medical faculty is usually awarded by passing a Human Biology, Organic Chemistry and/or Physics test. The program lasts 6 years, with first 2 years being preclinical and last 4 years being mostly clinical. After these six years, one has to take the national licence exam (which consists of mostly clinically-oriented questions, but some questions also deal with basic sciences) and has to write a thesis in any field he/she studied. Final award is Doctor-Medic (titlu onorific) (shortened Dr.), which is not an academic degree (similar to Germany). All graduates have to go through residency and specialization exams after that in order to practice, although older graduates had different requirements and training (e.g., clinical rotations similar to sub-internship) and might still be able to practice Family Medicine / General Medicine.

Sweden

Medical education in Sweden begins with a five and a half year undergraduate university program leading to the degree "Master of Science in Medicine" (Swedish: Läkarexamen). Following this the National Board of Health and Welfare requires a minimum of 18 months of clinical internship (Swedish: Allmäntjänstgöring) before granting a medical license. This internship consists of surgery (3–6 months), internal medicine (3–6 months), psychiatry (three months) and family medicine (six months). Upon receiving a license to practice, a physician is able to apply for a post to start specialist training. There are currently 52 recognized medical specialties in Sweden. The specialist training has a duration of minimum five years, which upon completion grants formal qualification as a specialist.

Turkey

In Turkey medical education is quite like the one in Thailand. All high school graduates who wish to pursue further education are required to take an MCQ exam (abbreviated as OSS - Student Selection Examination). The exam covers most of the high school and secondary school curricula. Currently there are disputes about the exam's objectivity. A student who scores high enough gets a place in a faculty of his/her desire.

Medical education takes six years, first three years being Pre-clinical years and the latter three being Clinical years. Right after graduation, graduates can either work as GPs or take another exam called TUS (Medical Specialization Examination) to do residency in a particular department of a particular hospital.

Most of the medical schools in Turkey are state schools but the number of private schools is on the rise. The language of instruction is generally Turkish, but few universities also offer schools with English as the language of instruction. This makes Turkey a popular place to study medicine for students from nearby areas like the Balkans, the Middle East, and to a lesser extent North Africa.

Ukraine

Medical degrees in Ukraine were offered only in institutions called medical universities, which are separate from traditional universities. However, some medical schools are now associated with classical unioisities. These include:

• Danylo Halytsky Lviv National Medical University
• Kharkiv National Medical University
• Dnipropetrovsk State Medical Academy
• Ivano-Frankivsk State Medical University
• Bukovynian State Medical University
• Zaporizhia State Medical University
• Ukrainian Medical Stomatological Academy
• Donetsk National Medical University
• I. Y. Gorbachevsky Ternopil State Medical University
• Bogomolets National Medical University Of Ukraine
• Crimea State Medical University
• Luhansk State Medical University
• Odessa State Medical University
• National Pirogov Memorial Medical University
• School of Medicine of V N Karazin Kharkiv National University
• Medical Faculty of Sumy State University
• Medical Faculty of Uzhgorod University
• Medical Faculty of Dnipropetrovsk National University
• Kyiv Medical Institute of non traditional Medicine

United Kingdom

There are currently 32 institutions which offer medical degrees in the United Kingdom.^[20] Completion of a medical degree in the UK results in the award of the degrees of Bachelor of Medicine and Bachelor of Surgery. Admission requirements to the schools varies; most insist on solid A-Levels/Highers, a good performance in an aptitude test such as the UKCAT, the BMAT or the GAMSAT, and usually an interview. As of 2008 the UK has approximately 8000 places for medical students.^[21]

Methods of education are diverse, with some courses offering problem-based learning, some having a more traditional pre-clinical/clinical structure, and others combining several approaches in an integrated approach.

Following qualification, UK doctors enter a generalised two-year, competency-based "foundation programme", gaining full GMC (General Medical Council) registration at the end of foundation year one, and applying for specialist training (in medicine, surgery, general practice etc.) after foundation year two.

Many medical schools offer intercalated degree programmes to allow students to focus on an area of research outside their medical degree for a year.

Most medical schools offer graduate entry programmes, which are typically accelerated (i.e. four years in length). These may restrict entry to those who hold degrees in, or have previously worked in, other areas of healthcare, or may require a degree (not specifically in a science subject). Moreover, medical schools typically admit many more students into undergraduate programs than into graduate entry programmmes. For example, each year, the Newcastle University School of Medicine has 322 positions for the typical five year course and only 25 positions for its four year “graduate entry programme” course.

Medical students

A person accepted into a medical school and enrolled in an educational program in medicine, with the goal of becoming a medical doctor, is referred to as a medical student or student doctor. Medical students are generally considered to be at the earliest stage of the medical career pathway. In some locations they are required to be registered with a government body.

Medical students typically engage in both basic science and practical clinical coursework during their tenure in medical school.^[22] Course structure and length vary greatly among countries (see above).

Upon completion of medical school in the United States, students transition into residency programs through the National Residency Match Program (NRMP). Each year, approximately 16,000 US medical school students participate in the residency match. An additional 18,000 independent applicants—former graduates of US medical schools, US osteopathic students, US podiatry students, Canadian students, and graduates of foreign medical schools—compete for the approximately 25,000 available residency positions.^[23]

See also

• American Association of Colleges of Osteopathic Medicine (AACOM)
• American Medical College Application Service (AMCAS)
• American Association of Colleges of Podiatric Medicine (AACPM)
• Bimaristan (historical medical schools)
• Flexner Report
• Graduate Australian Medical Schools Admissions Test (GAMSAT) [Australia, Ireland, UK]
• International medical graduate
• List of medical schools
• Medical College Admission Test (MCAT) [United States, Canada]
• Scut
• Society of General Internal Medicine (SGIM)
• Undergraduate Medicine and Health Sciences Admission Test (UMAT) [Australia]

References

External links

• Association of American Medical Colleges
• American Association of Colleges of Osteopathic Medicine
• American Medical Student Association
• Medical College Admission Test
• US News & World Report 2008 Medical School Research Rankings
• UK Clinical Aptitude Test
• Medical School Interview Guide
• Russia medical education
• Council of Heads of UK Medical Schools
• UK Application Process
• IFMSA

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