Medical Education in the USA

Dr. Frank Nelson and his colleagues from the Johns Hopkins University School of Medicine had been guests for some time of the Sech-enov Moscow Medical Academy. They had a meeting with the Professors and students of the Medical Faculty. This is what Dr. Nelson told them about the training of doctors in the USA.

Dr. Nelson: To begin with, after finishing his primary school and secondary studies at the age of 18, the candidate for a medical school must complete at least three years of higher education in a college or university.

This period of college or-univef8fty3fcj$es is called «the pre-medical phase». The students who are taking this course of studies preparing them for a medical school are called «pre-meds». A student applies to a medical school when he has completed pre-medical studies. The application costs approximately $ 50.

Sasha Nikiforov: Dr. Nelson, would you kindly tell us about the selection of students for medical schools?

248 ♦ Learning To Discuss Medicine

Dr. Nelson: Sure. Academic achievement is the most important fac
tor in the selection of students. In most medical schools candidates are
required to pass the admission test. This is a national multiple-choice
test. The test lasts about eight hours over a one-day period and include»
questions in biology, chemistry, physics, mathematics, and English. Then, _Lspecial admission committees have personal interviews with the appli- f
cant in order to issfeii the candidate's general qualities, his character |
and his ability to study medicine. |

Nina Mironova: Dr. Nelson, is there any competition among the ap- I
plicants to medical school? ; • |

Dr. Nelson: There certainly is. I must tell you that the competition is | very high and only about half of those who apply to medical school are | accepted and begin their medical education. By the way, what we call \ «medical school» is «medical institute» in your country.

Dean of the Medical Faculty: Dr. Nelson, we know that the curriculum of medical schools in the USA does not greatly differ from the curriculum in our medical institutes. Is that right?

Dr. Nelson: Well, the basic sciences are taught largely during the first two years of medical studies. For instance, in the first year at Johns Hopkins students study anatomy, biophysics, biochemistry, physiology, bacteriology, histology and other subjects. In the second year they study microbiology, pathology, physical diagnosis, pharmacology and laboratory diagnosis.

The curriculum of the final two years includes clinical subjects. Med
ical students do their practicum at teaching hospitals affiliated to the_wmedical school. Students in small groups meet their teachers in the
wards and in the out-patient departments where they participate in the
treatment Of patients. ^

At the end of four years all students receive the Degree of Doctor of \ Medicine, that is the M.D. Then they must work for one year as interns, This course of training at the hospital or clinic is called an internship.

Dr. Smirnov: Dr. Nelson, yesterday we spoke about the work of yoWig
doctors. You told us thatbfter their internship young doctors must have
a period of residency at the clinic^ For how many years must a doctor
work as a resident? *

Dr. Nelson: First of all, the period of residency is obligatory for all medical graduates. This period varies, depending on the specialty of the doctor. Generally, the period of residency is three or four years. For instance, residency in surgery and neurosurgery in the Johns Hopkins School of Medicine lasts four years. Residency in internal medicine,

Medical Education in the USA ♦ 249

preventive medicine and radiology- lasts for three years. After the residency, the graduate is granted a licence to practice and he may work cither in government service or in private practice.

Sasha Nikiforov: Dr. Nelson, what is the cost of medical education in America?

Dr. Nelson: Well, medical schools are gradually increasing their tuition Гее in all the universities of the USA. Only a small percentage of the students receive scholarships. The majority of the students have to work to pay for their studies. The government-financed universities charge less, while the tuition of the private colleges and universities is extremely high. For instance, when I was a student (and it's much higher now), the cost of medical studies for one academic year at the Medical School of Cornell University in New York, which is privately endowed, was as follows:

Tuition - 9,100 dollars; books, instruments, etc. - 600 dollars; food

- 1,800 dollars; lodging and utilities - 1,400 dollars; health service fee

- 200 dollars; hospital insurance — 143 dollars, personal - 1,200. All in all it amounted to 14,443 dollars. These figures represent what used to he a typical budget for an academic year.

The Dean of the Medical Faculty thanked Dr. Nelson and his colleagues for the talk and invited them to visit the clinics of the Academy.

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