[rscho]

> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world

Rest of the world, yes. Rest of the developed world, not at all. The major difference is that becoming a doc in the US is much more expensive than pretty much anywhere else. You could also argue it's proportionally harder because of the more numerous competitors. But on an absolute level of knowledge and capability no, it's not harder than say, in western european countries.

[whiddershins]

I believe it takes longer in the US, when all is said and done.

It’s hard to casually verify this because each country uses different terms and has a different track but I think, when you include the various phases of training, starting from the bachelors degree, the US one is more total years.

Edit:

So for example the UK and France don’t appear to require any sort of bachelor’s degree as a prerequisite for medical. Which saves you 4 years on average. So their tracks may be longer but you can start sooner.

[jimnotgym]

Citation definitely needed here

And just to be sure, I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine.

I note this Wikipedia article that suggests 4 years messed school plus 1 year internship could get me a license in the US. That sounds like Western Europe to me. Or India...

https://en.m.wikipedia.org/wiki/Medical_education_in_the_Uni...

[triceratops]

> I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine.

Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. In the UK or India it's something like 5.5-6 years.[1]

In the US it's 3-4 years of "pre-med", then 4 years of med school. That's from the article you referred.

1. https://en.wikipedia.org/wiki/Medical_school_in_the_United_K...

[bialpio]

> Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school.

Because if the requirement in the US is indeed "bachelor's degree required, any will do", then it exists solely for gate-keeping and says nothing about the standards of education.

Edit: looking at wiki, the requirements are actually a bit more reasonable, but it does seem strange that they are not just rolled into the first year (or two) of medical degree. Why force people to finish undergrad studies if only a few courses are relevant?

[ameister14]

Some universities in the US offer a 7 year undergrad and medical degree. Those usually have an extremely high GPA requirement but it's possible to do just that.

[bialpio]

Interesting, thanks! That's more in line with what I'd expect coming from Poland - medical degree is 6yrs (& is equivalent to Master's, I don't believe you get a Bachelor's degree during those), specialization then takes additional 5-6 years. For context, "normal" degrees are 3y (BSc) + 2y (MSc), which is also 1 year shorter than comparable education in the US. OTOH, I believe there's no such thing as "associate degree", and colleges are more focused from the get-go - you pick your major when applying for college (& the admission criteria are different based on that).

[google234123]

They typically have acceptance rates in the low single digits too.

[kaesar14]

Of the people who attempt the pre-med track not all will make it. Forcing students to get an actual Bachelor's degree gives students some fallback.

I think really it's just the system was built this way and nobody's going to change it now.

[bialpio]

> Forcing students to get an actual Bachelor's degree gives students some fallback.

That may be one reason, but seems to me that it doesn't really raise the standard of education. So it doesn't really help with proving that "US > the world" in this aspect.

I imagine you could still fall-back from medical college to undergrad & get credit for the completed coursework that is relevant towards the Bachelor's degree you fall-back to. This way, you don't incur unnecessary costs on folks who succeed.

> I think really it's just the system was built this way and nobody's going to change it now.

Channeling my inner cynic: nothing's going to change given that the decision-makers benefit financially from the system being set up like this.

[gowld]

They can switch to a Bachelors when they transfer off the med track.

[jimnotgym]

Not at all, because the question at hand was 'how long does it take to train to be an doctor in the US'. I don't understand why one would include time spent training to be something else? It is like saying 'it took me 30 years to learn to code, 3 months on Udemy and 29 years learning to solve problems as a carpenter'.

Premed is gatekeeping, and not all countries enforce that form of gatekeeping.

[triceratops]

> 'how long does it take to train to be an doctor in the US'. I don't understand why one would include time spent training to be something else?

Because you can't train to be a doctor in the US without that gatekeeping? I thought the point GP was making was it takes in the longer because of this pointless gatekeeping.

[trosi]

I'll bring an example for the sake of comparison. In Italy the path to becoming a physician involves a six year degree focused entirely on medicine (so not a bachelor), followed by a specialized degree of variable length (4-6 years depending on the chosen specialty) during which you practice in a hospital and study for exams at the same time, mostly the former. Entrance exams are required at both levels and acceptance rates are very low. Also, many students end up needing 1-2 extra years to complete it all.

[rscho]

Well, I can answer that very clearly from personal experience: you are wrong. Medical education is much shorter in the US compared to most western countries. You have to understand that in medicine, school years are not all there is to it. The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Basically, a short residency and 1-2 years of fellowship and... done! In Europe, you're still a junior at 35.

[triceratops]

> The real issue is when do you get to truly practice without supervision, and that's much earlier in the US.

Is it? If a doctor in the UK can graduate from medical school and practice as a GP 6 years out of secondary school, but for a US doctor it takes 8-9 years, it's not really "earlier". What you're talking about is status within the profession.

[rscho]

For GPs, it may be true. I admit I was speaking from the POV of a specialist.

[KptMarchewa]

Isn't the problem that US requires having bachelor's degree before you even can start studying medicine, which effectively makes people start 4 years later?

[rscho]

The question is not "when do you leave school?" it's actually "when are you employable as an independent practitioner?". In my personal experience, it's _much_ easier to get an attending/private practice position in the US at a younger age. Just because the country is huge and lots of places lack docs, probably. Of course, that's my experience and I could be wrong.

[opo]

Just because there is a Dr shortage in the US due to having a limited number of medical schools, there are still thousands of students who get their degree and can't find a residency:

>.... The matching challenge comes as the U.S. faces a physician shortage. The nation could be short as many as 139,000 physicians by 2033, according to the Times, which cites Association of American Medical Colleges data. Despite this shortage, thousands of medical school graduates are consistently rejected from residency experience, rendering their MD or DO "virtually useless," according to the report.

https://www.beckershospitalreview.com/hospital-physician-rel...

[phobosanomaly]

That must be understood in the context of the number of applicants to U.S. residency programs from Caribbean medical schools (which are well-known to be a little predatory).

From that article you cited: International medical graduates in particular have low match rates for residency programs. American medical students have a 94 percent match rate, according to the Times, which cites information from the National Resident Matching Program. However, Americans who study at international medical schools have a match rate of 61 percent."

Kids from the U.S. get sold on a Caribbean M.D. school, and spend thousands and thousands of dollars only to find out that things get really complicated when it comes time to do clerkship rotations or apply to residency.

An M.D. or a D.O. from a school on U.S. soil is definitely not useless, and your chances at matching a residency are extremely high, as cited above.

[HDMI_Cable]

It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GPA, and lab time to even get in to a mid-range school.

[laputan_machine]

You are either deliberately misleading people or are ignorant of the UK education system.

Highschool in the uk ends at 16, you graduate with GCSEs. After this there are 2 extra years of education (compulsory in England), you start university at 18 (at the youngest).

Medical schools are competitive and require strong a-level results, typically 3 As (the second highest grade, after A*) [0]. It's a 4 year degree, you then go onto train for another 5 years as a junior doctor.

There is a _lot_ of training for UK doctors.

[0] https://www.manchester.ac.uk/study/undergraduate/courses/202...

[1] https://www.healthcareers.nhs.uk/explore-roles/doctors/train...

[signal11]

From the link numbered [1] above, medical school in the UK is normally five years long. Followed by 2 years of Foundation training, and 5-8 years of specialist training, or 3 years if you go into general practice.

Note that the US education system is more expensive though, so becoming a doctor costs more.

[ameister14]

> You are either deliberately misleading people or are ignorant of the UK education system.

I don't think either is necessarily the case - he isn't saying it's easy to become a doctor in the UK, he's saying it's easier than in the US, and that's sort of true, if not by all that much.

In the US you also start university at 18 - med school is a 4 year degree you must have completed your undergraduate degree to begin, then you go on to train for 3-7 years as a resident, depending on specialization. Then maybe more for a fellowship.

That said, I've got both doctors trained in the UK and in the US in my immediate family, I don't really see much of a distinction in difficulty of training to be honest but I'm not a doctor myself so what do I know.

[google234123]

22.5% of students get 3 As or better so that doesn't sound very impressive to me. US med schools are much more competitive than that.

[laurencerowe]

There is a weird discontinuity in the data for 2020 which your quote - it was 12.3% the previous year according to https://lginform.local.gov.uk/reports/lgastandard?mod-metric...

This is also a proportion of students who take A levels which is already filtering down to about 38% of the population in that age group (766k 18 year olds in U.K. so about 643k in England of which about 250k take at least one A level.)

So in a normal year that 12.3% of A level students getting 3 A’s is only 4.8% of the age cohort.

Edit: I should add that medicine is about the hardest subject to get into in U.K. (other than vet med which has so few places) and one of the only ones where they expect you to demonstrate suitability beyond academic performance, e.g. work experience in a caring setting. (Source: shared a house with a med student in undergrad.)

[alistairSH]

The US only accepts doctors who went to Canadian or American medical schools.

That's absolutely not true. Foreign medical graduates do have to take the US board exams, complete a US-based residency, and possibly take additional courses to fill educational gaps, but they absolutely can practice in the US with a foreign medical degree.

[JamesBarney]

-> complete a US-based residency

This is the kicker. There are incredibly difficult to get, they are incredibly stressful, and it's another 3-5 years of your life.

If you allowed any non-us developers to practice in the US but you made them work a 5 year 80hr/week internship for 1/6th of what professional developers made first, that basically bans non-us developers from writing code in the U.S.

[alistairSH]

Absolutely. And that's due to AMA lobbying in the 90s. It doesn't have anything much to do with stringency of US medical licensing or ensuring quality and everything to do with existing MDs protecting their lucrative practices.

[phobosanomaly]

Practicing medicine must be lucrative because it costs an individual student around $240,000 in tuition for the M.D. itself, excluding cost of living.

Doctors are made out to be predatory vultures, but unless they come from money they must undergo massive debt burdens that they are not able to even begin paying down the principal on until they're well-into their thirties. Imagine the feeling of taking out half-a-million dollars in student loans to cover both undergrad, and graduate-level training. After that look forward to your 80-hours a week of residency making below hourly minimum wage. [1]

Make medical school free, and you'll have people lining up the door to practice for low-cost. Make it half-a-million pay-to-play, and you'll have people desperately clawing their way out of debt so that some day they can have a family and own a home after a decade of hellish training.

Cut the docs some slack. They're taking on unimaginable debt burdens for a job that often isn't in the same universe of cushiness as something at FAANG (inspecting that anal fissure in the ED at 3am with perks including, well, hospital food), but involves an tremendous service to society.

[1] https://www.mdlinx.com/physiciansense/is-it-better-to-be-a-d...

[signal11]

Here's an article that describes the pathway by which foreign doctors can get a medical license in the US: https://www.voanews.com/student-union/how-indian-doctors-get...

In brief, they have to sit the MLE (medical licensing exams), but the real hurdle is getting into a US-based residency program beforehand. In practice, this means only the best candidates tend to make it.

[rscho]

I'm european, never set foot in a us or canadian medical school but worked in Boston. So no, it's not as set in stone as you think it is.

[lr1970]

> The US only accepts doctors who went to Canadian or American medical schools.

This is factually incorrect. There are tons of doctors that graduated from European, Indian and Chinese medical schools. To practice medicine in the USA they need to pass the ECFMG tests (US graduates take similar USMLE tests) and then complete medical residency. The last part is the hardest, for the medical residency admission offices are routinely discriminating against the foreign medical graduates.

[google234123]

Why shouldn't domestic medical students have priority over foreign medical graduates?

[matheusmoreira]

Why should they? If I take the same tests as US medical students and pass, am I not at least as good as they are?

[djdjdjdjdj]

Global market?

It's much easier for an us citizen anyway as it is easier for an employee.

[tephra]

Only accepting doctors who went to medical school in the u.s or Canada is not the same as having higher standards (necessarily).

[djdjdjdjdj]

In Germany the grades you need to study medicine is really high. You need the best grade of 1.0. you can wait if you just have something like 1.3

Do you have sources which shows your argument?