Medical school

A medical school is a tertiary educational institutionâ€"or part of such an institutionâ€"that teaches medicine, and awards a professional degree for physicians and surgeons. Such degrees include the Doctor of Medicine (MD) or Bachelor of Medicine, Bachelor of Surgery (BMBS, MBBS, MBChB). Many medical schools offer additional degrees, such as a Doctor of Philosophy, Master's degree, a physician assistant program, or other post-secondary education.

Medical schools can also employ medical researchers and operate hospitals. Around the world, criteria, structure, teaching methodology, and nature of medical programs offered at medical schools vary considerably. Medical schools are often highly competitive, using standardized entrance examinations, as well as grade point average and leadership roles, to narrow the selection criteria for candidates. In most countries, 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 who have completed an undergraduate degree including some required courses. In the United States and Canada, almost all medical degrees are second entry degrees, and require several years of previous study at the university level.

Medical degrees are awarded to medical students after the completion of their degree program, which typically lasts five or more years for the undergraduate model and four years for the graduate model. Curricula are usually divided into preclinical sciences, where students study subjects such as biochemistry, genetics, pharmacology, pathology, anatomy and physiology, among others, and clinical rotations, which usually include internal medicine, general surgery, pediatrics, psychiatry, and obstetrics and gynecology, among others.

Although medical schools confer upon graduates a medical degree, a physician 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, paying a fee, and undergoing several years of postgraduate training. Medical schools are regulated by each country and may appear in the AVICENNA Directory for medicine or the FAIMER International Medical Education Directory.

Africa

Kenya

In Kenya, medical school is a faculty of a university. Medical education lasts for 3 years, at the end of which the student is granted a diplomaلريوس. After graduating, there is a mandatory 12-month full-time internship at one of the Un Government 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 Kenyan Medical Syndicate (نقابة الأطباء). The first 2 years of medical school cover the basic medical sciences, while the last 1 year are focused on clinical sciences.

Admission depends on the score of the applicant in his last 2 years of Kenyan Secondary Schoolالثانوية) العامة). Students having taken either the AS Level or the SAT can also apply, however there is a very strict quota to the number of students that 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.

Sudan

In Sudan, medical school is a faculty of a university. Medical school is usually 6 years, and by the end of the 6 years the students acquires a Bachelor degree of Medicine and Surgery. Post graduating there is a mandatory one year full-time internship at one of the University or Government Teaching hospital, then a license is issued.

During the first three year the curriculum is completed, and throughout the next three years it is repeated with practical training. Students with high grades are accepted for free in Government Universities. Students who score a grade less than the required would have to pay and must also acquire a still high grade. Students who take foreign examinations other than the Sudanese High School Examination are also accepted in Universities, students taking IGCSE/SATs and the Saudi Arabia examination.

Ghana

There are five medical schools in Ghana: The University of Ghana Medical School in Accra, the KNUST School of Medical Sciences in Kumasi, University for Development Studies School of Medicine in Tamale, University of Cape Coast Medical School and the University of Allied Health Sciences in Ho, Volta Region.

Basic Medical education lasts 6 years in all the medical schools. Entry into these medical schools are highly competitive and it is usually based on successful completion of the Senior High School Examinations. The University of Ghana Medical School has however introduced a graduate entry medical program to admit students with mainly science-related degrees into a 4-year medical school program.

Students graduating from any of these medical schools get the MBChB degree and the title "Dr". For the First 3 years Students are awarded BSc in the field of Medical science for University of Ghana medical school; and Human biology for KNUST and UDS medical schools. The University of Ghana Medical School and KNUST School of Medical Sciences in Kumasi use the Tradition medical education model whiles University for Development Studies School of Medicine uses the Problem-based learning model.

Medical graduates are then registered provisionally with the Medical and Dental Council (MDC) of Ghana as House Officers (Interns). Upon completion of the mandatory 2-year housemanship, these medical doctors are permanently registered with the MDC and can practice as medical officers (General Practitioners) anywhere in the country. The housemanship training is done only in hospitals accredited for such purposes by the Medical and Dental Council of 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.

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 four established medical schools:

• University of Nairobi (oldest, established 1967)
• 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)
• Kenyatta University at Kahawa (established 2004)
• Egerton University in Nakuru (established in 2007)
• Jomo Kanyatta University of Agriculture and Technology
• Maseno University

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. Entrance into these schools is highly competitive. Candidates graduating from high school must attain high scores on 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 years and culminate with a Bachelor of Medicine and Bachelor of Surgery (MBBS/MBChB). The undergraduate program is six 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

See also: List of medical schools in South Africa; Healthcare in South Africa; Category:Teaching hospitals in South Africa

Related: Dental degree#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 that run concurrently with their undergraduate programs. In this instance, a student having completed an appropriate undergraduate degree with basic sciences can enter into a four-year postgraduate program.

South African medical schools award the MBChB degree (except the University of the Witwatersrand, which styles its degree MBBCh). Some universities allow students to earn an intercalated degree, completing a BSc (Medical) with an additional year of study after the second or third year of the MBChB. The University of Cape Town, in particular, has spearheaded a recent effort to increase the level of medical research training and exposure of medical students through an Intercalated Honours Programme, with the option to extend this to a PhD. Following successful completion of study, all South African medical graduates must complete a two-year internship as well as a further year of community service in order to register with the Health Professions Council and practice as a doctor in the country.

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 M Med, Master of Medicine, degree). The Medical schools and the CMSA also offer Higher Diplomas in many fields. Research degrees are the M.Med and Ph.D. or M.D., depending on university.

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. The University of the Free State has a parallel medium policy, meaning all English classes are also presented in Afrikaans, therefore students who choose to study in Afrikaans, do so separately from the English class. The University of Pretoria and the University of Stellenbosch have a double medium Afrikaans policy, meaning both languages may be used during lessons.

Tunisia

In Tunisia, education is free for all Tunisian citizens and for foreigners who have scholarships. The oldest Medical school is a faculty of the University of Tunis. There are four medicine faculties situated in the major cities of Tunis, Sfax, Sousse and Monastir. Admission is bound to the success and score in the baccalaureate examination. Admission score threshold is very high, based on competition among 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, and 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 the student's knowledge in that particular specialty. After those five years, there are two years on internship, in which the student is 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 (MD).

Uganda

As of September 2013, there are eight recognized medical schools in Uganda. Two more are expected to begin operations within the next three years. The list of Uganda medical schools include the following:

1. Makerere University School of Medicine: - Kampala - (Founded in 1924)
2. Mbarara University School of Medicine: - Mbarara - (Founded in 1989)
3. Kampala International University School of Health Sciences - Ishaka - (Founded in 2003)
4. Gulu University School of Medicine: - Gulu - (Founded in 2004)
5. International Health Sciences University School of Medicine: - Namuwongo, Kampala - Founded In 2008
6. Uganda Martyrs University School of Medicine: - Nsambya, Kampala - (Founded in 2010)
7. St. Augustine International University College of Health, Medical & Life Sciences: - Mulago, Kampala - (Founded in 2012)
8. Busitema University Medical School: - Mbale - (Founded in 2013)
9. Kumi University Medical School: - Kumi - (Planned for 2015)
10. Muteesa I Royal University School of Medicine: - Masaka - (Planned for 2015)

Medical training

Training leading to the award of the degree of Bachelor of Medicine and Bachelor of Surgery (MBChB) lasts five 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 (UMDPC).

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 seventeen hospitals designated as "Internship Hospitals". These include the thirteen Regional Referral Hospitals, Mulago National Referral Hospital, Mengo Hospital, Rubaga Hospital and St Francis Hospital Nsambya. There must be a specialist in the required field willing to supervise the intern at that 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.

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.

Zimbabwe

In Zimbabwe medical school is offered at the University of Zimbabwe and the National University of Science and Technology. Medical training is offered as an undergraduate course.

The Americas

Argentina

There are public and private universities which provide medical tuition in Argentina, with the fundamental and unresolved dispute being which system of education is of higher quality. A person who can afford to attend a private university, quite expensive for the average person, will choose that over public education. Nevertheless, quality of education is generally not the reason they make that choice: private universities have smaller groups of students in each class, which means the professor can deliver a more tailored education by not having to deal with hundreds of students at a time. The Universidad Adventista del Plata, for instance, has about 70 students in each class, turning classes into an environment in which the students feel freer to participate and ask questions. Another advantage of private over public is that it is considerably easier to be admitted. In general, the admission process for a public School of Medicine (which involves a very competitive examination) is more difficult than that of a private institution, the main reason being a large number of applicants in public universities and not enough place for all who apply. When it comes to educational quality, however, it is now generally believed that inequalities are not significant between public and private education.

The course usually takes six years to complete, with some private universities making it seven years long (Universidad Adventista del Plata, for example). Each one of the 3000 medical students who graduate each year in Argentina are required before graduation to dedicate a minimum of 8 months to community service without pay; although in some provinces (especially round the more developed south) there are government-funded hospitals who pay for this work. Some universities, either public or private, have cultural exchange programmes that allow a medical student in their final year to serve their community time overseas.

Upon graduation, one of the following degrees is obtained, according to the university: Doctor of Medicine, or both Doctor of Medicine and Doctor of Surgery. Public universities usually confer both degrees, and private universities bestow only Doctor of Medicine. In daily practice, however, there is no substantial difference between what a Doctor of Medicine or a Doctor of Medicine and Doctor of Surgery are allowed to do. When the degree is obtained, a record is created for that new doctor in the index of the National Ministry of Education (Ministerio Nacional de Educación) and the physician is given their corresponding medical practitioner's ID, which is a number that identifies him and his academic achievements. In addition, there is a provincial ID, i. e. a number to identify doctors in the province they practise medicine in.

Doctors wanting to pursue a speciality must take entrance exams at the public/private institution of their choice that offers them. Again, it is with less difficulty that doctors can enter a residency at a private teaching hospital than at a state-funded one, for the above stated reason. Speciality courses endure for about two to five years, depending on the branch of medicine the physician has chosen. There is no legal limit for the number of specialities a doctor can learn, although most doctors choose to do one and then they sub-specialise for further job opportunities and less overall competition, along with higher wages.

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 specialty.

Brazil

The Brazilian medical schools follow the European model of a six year curriculum, divided into three cycles of two years each. The first two years are called basic cycle (ciclo básico). During this time students are instructed in the basic sciences (anatomy, physiology, pharmacology, immunology etc.) with activities integrated with the medical specialties, allowing the student an overview of the practical application of such content. Since then medical schools provide students direct contact with patients. After its completion, the students advance to the clinical cycle (ciclo clinico). At this stage contacts with patients intensify and work with tests and diagnostics, putting into practice what was learned in the first two years. The last two are called cycle internship (ciclo do internato). In this last step the students focus on clinical practice, through training in teaching hospitals and clinics. The teaching of this last step respecting an axis of increasing complexity, enabling students to make decisions and participate effectively in form and operative care under the direct supervision of faculty and qualified to act as teaching aids physicians. The performance of the internal develops redemption of ethical and humanistic dimensions of care, causing the student to recognize the values and principles that guide the physician-patient relationship.

After six years of training, students graduate and are awarded the title of physician (Médico) allowing them to register with the Regional Council of Medicine (Conselho Regional de Medicina). The recent graduate will be able to exercise the medical profession as a general practitioner and may apply to undertake postgraduate training. In 2012, the Regional Council of Medicine of São Paulo (Conselho Regional de Medicina do Estado de São Paulo) established that physicians who graduate from this year must pass a test to obtain professional registration. Passing the exam, however, is not linked to obtaining registration. It required only the presence of the candidate and the test performance. Already at the national level, pending in the Senate a bill creating the National Proficiency Examination in Medicine (Exame Nacional de Proficiência em Medicina), which would make the race a prerequisite for the exercise of profession.

Physicians who want to join a specialization program must undergo a new selection examination considered as competitive as that required to join a medical school. Works in health institutions under the guidance of medical professionals with high ethical and professional qualification. The specialization programs are divided into two categories: direct access and prerequisite. The specialties with direct access are those in which the doctor can enroll without having any prior expertise. Any physicians can apply to examinations for these specialties, regardless of time of training or prior experience. To apply to proprietary pre-requisite, the doctor should have already completed a specialty prior. The programs may range from 2 to 6. In Brazil are currently recognized by the Federal Council of Medicine (CFM), the Brazilian Medical Association (AMA) and the National Commission of Medical Residency (CNRM) 53 residency programs. Fully complied with, gives the title of resident physician specialist.

Physicians who successfully complete the specialization may apply for sub-specialization programs in the respective specialty or start master's degree and doctoral programs.

Canada

In 2013, the Association of American Medical Colleges lists 17 accredited MD-granting medical schools in 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. All four medical schools in Quebec and two Ontario schools (University of Ottawa, Northern Ontario School of Medicine) do not require the MCAT. McMaster requires that the MCAT be written, though they only look for particular scores (6 or better) on the verbal reasoning portion of the test.

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. 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 College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada, depending on whether they are seeking certification in family medicine or another specialty.

Caribbean

In 2011, the International Medical Education Directory listed 59 current medical schools in the Caribbean. 54 grant the MD degree, 3 grant the MBBS degree, and 2 grant either the MD or MBBS degree.

30 of the medical schools in the Caribbean are regional, which train students to practice in the country or region where the school is located. The remaining 29 Caribbean medical schools are known as offshore schools, which primarily train students from the United States and Canada who intend to return home for residency and clinical practice after graduation. At most offshore schools, basic sciences are completed in the Caribbean while clinical clerkships are completed at teaching hospitals in the United States.

Several agencies may also accredit Caribbean medical schools, as listed in the FAIMER Directory of Organizations that Recognize/Accredit Medical Schools (DORA). 25 of the 29 regional medical schools in the Caribbean are accredited, while 14 of the 30 offshore medical schools are accredited.

Curacao

Curaçao Curaçao currently has 4 medical schools. All of them are located within the city of Willemstad. All four medical schools off the degree of Medical Doctor or Doctor of Medicine. A few also offer other degrees such as MBBS or PhD. Three of which are for profit and one is non-profit - CIMTESES cimteses which is registered as such with the Curaçao government. Almost all students who attend medical school in Curaçao apply to either take USMLE step exams or Canadian board exams. Almost all the students who attend these medical students are either from North America or Europe.

Chile

In Chile, there are 21 medical schools. Principal medical schools are Pontificia Universidad Católica de Chile in Santiago, Universidad de Chile, Universidad de Concepción, Universidad de Santiago de Chile and the University of the Andes, Chile. 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 a medicine knowledge exam called National Unic Exam of Medical Knowledge (EUNACOM "Examen Único Nacional de Conocimientos de Medicina" in Spanish) and can take a direct specialty or work before in primary attention in order to gain access to a residency.

El Salvador

The Universidad de El Salvador (University of El Salvador) has a program of 8 years for students who want to study medicine. The first six years are organized in a two semesters fashion, the seventh year is used for a rotating internship through the mayor specialty areas in a 10-week periods fashion (psychiatry and public health share a period) and the eighth year is designated for Social service in locations approved by the Ministry of Health (usually as attending physician in Community Health Centers or non-profit organizations). The graduates receive the degree of MD and must register in the Public Health Superior Council(CSSP) to get the medical license and a registered national number that allows them to prescribe barbiturates and other controlled drugs. In order to attend further studies( Surgery, Internal medicine, G/OB, Pediatrics, Psychiatry), the students in the year of Social service or graduates of any Salvadorian university must apply independently for the residency to the hospital of choice; the preliminary selection process is based on the results of clinical knowledge tests, followed by psychiatric evaluations and interviews with the hospital medical and administrative staff. The basic residencies mentioned above commonly last 3 years; at the last trimester of the third year, the residents can apply to the position of Chief of residents(1 year) or follow further studies as resident (3 years) of a specialty (for example:orthopedic surgery, urology, neurology, endocrinology...). No further studies are offered to the date; therefore, specialist looking for training or practice in a specific area (For example: a neurosurgeon looking for specialty in endovascular neurosurgery, spine surgery or pediatric neurosurgery) must attend studies in other countries and apply for such positions independently.

Guyana

In Guyana the medical school is accredited by the National Accreditation Council of Guyana. The medical program ranges from 4 years to 6 years. Students are taught the basic sciences aspect of the program within the first 2 years of medical school. In the clinical sciences program, students are introduced to the hospital setting where they gain hands on training from the qualifying physicians and staff at the various teaching hospitals across Guyana.

• Texila American University
• American International School of Medicine
• University of Guyana

Students graduating from the University of Guyana are not required to sit a board exams before practicing medicine in Guyana. Students graduating from the American International School of Medicine sit the USMLE, PLAB or CAMC exams.

Haiti

Medical schools in Haiti conduct training in French. The universities offering medical training in Haiti are the Université Notre Dame d'Haïti, Université Quisqueya, Université d'Etat d'Haïti and Université Lumière.

The Université Notre Dame d'Haïti (UNDH) is a private Catholic university established by the Episcopal Conference of Haiti. According to the UNDH website, "the UNDH is not just about academic degrees, it is mainly the formation of a new type of Haiti, which includes in its culture and moral values of the Gospel, essential for serious and honest people that the country needs today."

The other two private schools offering medical degrees are Université Quisqueya and Université Lumière. The Université d'Etat d'Haïti is a public school.

Attending medical school in Haiti may be less expensive than attending medical universities located in other parts of the world, but the impact of the country's political unrest should be considered, as it affects the safety of both visitors and Haitians.

Duration of basic medical degree course, including practical training: 6 years

Title of degree awarded: Docteur en Médecine (Doctor of Medicine)

Medical registration/license to practice: Registration is obligatory with the Ministère de la Santé publique et de la Population, Palais des Ministères, Port-au-Prince. The license to practice medicine is granted to medical graduates who have completed 1 year of social service. Those who have qualified abroad must have their degree validated by the Faculty of Medicine in Haiti. Foreigners require special authorization to practice.

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 a two years internship.

United States

In 2012, the Association of American Medical Colleges and American Association of Colleges of Osteopathic Medicine listed 141 accredited M.D.-granting and 30 accredited D.O.-granting medical schools in the United States.

The Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) are graded to be equivalent to a Professional Doctorate.

Admission to medical school in the United States is based mainly on a GPA, MCAT score, admissions essay, interview, clinical work experience, 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 (general chemistry and organic). 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 to 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 not sufficiently preparing their students for medical professions, leading 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.

The standard U.S. medical school curriculum is four years long. Traditionally, the first two years are composed mainly of classroom basic science education, while the final two years primarily include rotations in clinical settings where students learn patient care firsthand. Today, clinical education is spread across all four years. The final years contain more clinical rotation time.

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)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 those in many other countries, US medical students typically 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 $157,990 and 25.1% of students had debt in excess of $200,000 (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).

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

• Graduation from an accredited medical school granting the degree of D.O. or M.D.
  • 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.
• Passing 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.

Uruguay

The university in Uruguay is the oldest in Latin America, being public and free, co-gobernada por el orden estudiantes, egresados y docentes. The progress of medical and biological sciences in the nineteenth century, the impact of the work of Claude Bernard (1813â€"1878), Rudolf Virchow (1821â€"1902) Robert Koch (1843â€"1910), Louis Pasteur (1822â€"1895) and all the splendor of French medical schools, Vienna, Berlin and Edinburgh, was a stimulus for the creation of a medical school in the country.

Asia and Oceania

Australia

Historically Australian medical schools have followed the British tradition by conferring MBBS degrees to medicine graduates. The notable exception is the Bachelor of Medicine (BMed) joint program of the University of Newcastle and the University of New England. Australian MBBS degrees can be either undergraduate-entry (i.e. after high school) programs of 5 or 6 years duration, or graduate-entry programs of 4 years duration.

Recently, some universities have begun to rename the MBBS to Doctor of Medicine (MD). This new MD is not to be confused with the traditional MD in the Australian medical education hierarchy, which is a terminal research degree akin to a Doctor of Philosophy (PhD). These programs are required to conform to the Australian Qualifications Framework Level 9 (Extended Masters) requirements, particularly in relation to research publication. The University of Melbourne was the first to rename their MBBS to MD, with University of New South Wales and Griffith University following suit, and University of Queensland expected to follow.

Currently accredited basic medical qualifying degrees are listed below (as at 31 May 2014):

Bangladesh

In Bangladesh, admission to medical colleges is organized by the Governing Body of Dhaka University. A single admission test is held for both government and private colleges. 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 on the entrance examination and academic records, which have minor consequences. The exam consists of 100 marks of objective type questions with a time limit of one hour. Subjects and marks are biology 30, chemistry 25, physics 20, English 15, and general knowledge 10, and then another 100 marks based on previous SSC (Secondary School Certificate) and HSC (Higher Secondary School Certificate) exam syllabus, i.e. high school certification result. In case of English-medium students who seek admission to medical schools, they usually prepare themselves for the admission test ahead of time as the O Level and A Level exams does not cover the required syllabus. The undergraduate program consists of 5 years, followed by one-year internship (rotating houseman-ship). 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), M.Phil and FCPS (Fellowship of the College of Physicians and Surgeons).

BSc in Radiology and Imaging Technology Course has been started first in this year under University of Dhaka. This course offers 30 students to admit at a session. This course goes to 25% for the HSC passed students and 75% (50% for the government service holder and the rest for the general Diploma passed) goes to Diploma holder students. Duration of the course is 4 years plus 12 weeks for project submission. Subjects of the course - 1st Year - 1. Behavioral Science and Radiological Ethics. 2. Radiology and Imaging Physics. 3. Fundamentals of Computer and Its Application. 4. Radiological Anatomy. 5. Radiological Physiology. 2nd Year - 1. General Radiological Procedure. 2. Radiological Pathology. 3. Radiological Photography and Quality Assurance. 4. Bio-Statistics. 3rd Year - 1. Radiological Contrast Study and Digital Radiography. 2. Radiological Instruments. 3. Radiological Findings (Part-I). 4. Radiological Biology and Patients Care.

Cambodia

After 6 years of general medical education (a foundation year + 5 years), all students will graduate with Bachelor of Medical Sciences (BMedSc) "áž"រិញáŸ'ញាáž"័តáŸ'ážš វិáž'áŸ'យាសាសáŸ'ážšáŸ'តវេជáŸ'ជសាសáŸ'តáŸ'ážš"'. This degree does not allow graduates to work independently as Physician, but it is possible for those who wish to continue to master's degrees in other fields relating to medical sciences such as Public Health, Epidemiology, Biomedical Science, Nutrition...

Medical graduates, who wish to be fully qualified as physician must do as below:

• General Practitioner's (GP) course is of 8 years ( BMedSc + 2-year internship). Clinical rotation in the internship is modulated within 4 main disciplines (general medicine, surgery, gynecology, pediatrics).The medical degree awarded is Doctor of Medicine (MD) "សញáŸ'ញាáž"័តáŸ'ážš វេជáŸ'ជáž"ណáŸ'ឌិត" (equivalent to master's degree).

• After graduating with BMedSc; candidates, who wish to enter Specialist Training Programs, are required to sit for a rigorous Contesting Entrance Exam. Normally, the programs last from 9 to 10 years from the beginning of medical school (BMedSc + 3â€" 4 years of specialization) to the conferment of degree of DES (Diplôme d'Etudes Spécialisées) or in English meaning Diploma of Specialized Studies; which graduates are officially entitled as (after thesis defense) Doctorate in Medicine with Specialization (MD-DES) វេជáŸ'ជáž"ណáŸ'ឌិតឯកáž'េស as "Professional Doctorate".

All Medical graduates must complete "Thesis Defence and pass the National Licensing Exam áž"áŸ'រឡងអជáŸ'ញាáž"័ណáŸ'ណជាតិ to become either GPs or Medical Specialists.

Hong Kong

Hong Kong has only two comprehensive medical faculties, the Li Ka Shing Faculty of Medicine, University of Hong Kong and the Faculty of Medicine, Chinese University of Hong Kong, and they are also the sole two institutes offering medical and pharmacy programs. Other healthcare discipline programs (like nursing) are dispersed among some other universities which do not host a medical faculty.

Prospective medical students enter either one of the two faculties of medicine available (held by The University of Hong Kong and The Chinese University of Hong Kong) from high schools. The medical program consists of 5 years for those who take the traditional Hong Kong's Advanced Level Examination (HKALE) for admission, or 6 years for those who take the new syllabus Hong Kong's Diploma of Secondary School Education Examination (HKDSE). International students who take examinations other the two mentioned will be assessed by the schools to decide if they will take the 5-year program or the 6-year one.

The competition of entering the medical undergraduate programs is cut-throat as the number of intake each year is very limited with a quota of 210 from each school (420 in total) and candidates need to attain an excellent examination result and good performance in interview. The schools put a great emphasis on students' languages (both Chinese and English) and communication skills as they need to communicate with other health care professionals and patients or their family in the future.

During their studies at the medical schools, students need to accumulate enough clinical practicing hours in addition before their graduation.

The education leads to a degree of Bachelor of medicine and Bachelor of surgery (M.B.,B.S. by HKU or M.B.,Ch.B. by CUHK). After a 5- or 6-year degree, one year of internship follows in order to be eligible to practice in Hong Kong.

Both HKU and CUHK provide a prestigious bachelor of pharmacy course that is popular among local and overseas students. Students of most other health care disciplines have a study duration of 4 years, except nursing programs which require 5 years.

India

In India, admission to medical colleges is organized both by the central government CBSE as well as the state governments through tests known as entrance examination. Students who have successfully completed their 10+2 (Physics,Chemistry and Biology Marks are considered and PCB is mandatory) 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 600,000. 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.

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, ENT, and PSM (preventive and social medicine) and part 2 consists of general-medicine[including dermatology, psychiatry as short subjects], general surgery [including radiology, anaesthesiology and orthopaedics as short subjects] and pediatrics and gynaecology and obstetrics . 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.

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 (NBE), which also offers three-years residency for sub-specialisation. All degrees by NBE are called DNB (Diplomate 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.

Indonesia

In Indonesia, high school graduates who want to enroll to public medical schools must have their names enlisted by their high school faculty in the "SNMPTN Undangan" program, arranged by Directorate General of Higher Education, Ministry of National Education. Depending on the high school accreditation, only the class' top 10%-15% will be considered for admissions. Fewer places are available through entrance exam conducted autonomously by each university. These exams are highly competitive for medicine, especially in prestigious institutions such as University of Indonesia in Jakarta, Airlangga University in Surabaya, and Gadjah Mada University in Yogyakarta. For private medical school, almost all places are offered through independently run admission tests.

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" (Bachelor of Medicine) 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)" / MD title.

Upon graduation, a physician planning 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. A 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 his/her area of expertise.

Israel

There are five university medical schools in Israel: the Technion in Haifa, Ben Gurion University in Be'er Sheva, Tel Aviv University, the Hebrew University in Jerusalem and the Medical school of the Bar-Ilan University in Safed. These all follow the European 6-year model except Bar-Ilan University which has a four-year program similar to the US system.

The Technion Medical School, Ben Gurion University, and Tel Aviv University Sackler Faculty of Medicine offer 4-year MD programs for American Bachelor's graduates who have taken the MCAT, interested in completing rigorous medical education in Israel before returning to the US or Canada.

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 700. The demand for medical education is strong and growing and there is a lack of doctors in Israel.

The degree of Doctor of Medicine (MD) is legally considered to be equivalent to a Masters degree within the Israeli Educational System .

Japan

In Japan, medical schools are faculties of universities and thus they are undergraduate programs that generally last for six years. Admission is based on an exam taken at the end of high school and an entrance exam at the university itself, which is the most competitive.

Medical students study Liberal Arts and Science for the first 1â€"2 years, which include Physics, Mathematics, Chemistry, and Foreign Languages together with 2 years long Basic Medicine (Anatomy, Physiology, Pharmacology, Immunology), 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 M.D. Medical graduates are titled as Doctor, as are Ph.D. holders. The University does have an MD/PhD program that enables Doctors of Medicine to become Ph.D. holders, as well.

At the end, Medical students take the National Medical License examination and, if they pass it, become a Physician and register 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 Irbid
• University of Jordan in Amman
• Mutah University in Al Karak
• Hashemite University in Zarqa

Kyrgyzstan

In Kyrgyzstan, the International School of Medicine at the International University of Kyrgyzstan offers a five-year medical program, with a requisite for English knowledge, that is recognized by the World Health Organization, the General Medical Council, 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 and the Medical Institute, Osh State University

Lebanon

Lebanon is the leader in medical education in the Middle East. In Lebanon, there are two programs of medical education followed: the American system (4 years) and the European system (6 years). Programs are offered in English and French. Admission requirements to the American system requires a candidate to complete a bachelor's degree along with specific pre-medical courses during the undergraduate years, and writing the MCAT examination. European programs usually requires a candidate to complete 1 year of general science followed by a selection exam by the end of the year.

Schools following the American system (M.D. degree) are:

• American University of Beirut: located in Beirut and is the oldest medical school in Lebanon. Training will take place at the American University of Beirut Medical center (AUBMC) in Beirut.
• Lebanese American University (LAU): LAU Medical school is located in Byblos and has a 10-year affiliation with Partners Harvard Medical International. Training will take place at the University Medical center - Rizk Hospital (UMC-RH) located in Beirut. It is also affiliated with Clemenceau Medical Center and Rafik Hariri University Hospital.
• University of Balamand: located in Koura, north Lebanon. Training will take place at the Saint George University Medical center in Beirut.

The language of instruction in all three is English.

Schools following the European system (MBBS degree) are:

• Lebanese University: languages of instruction are French and English. Training will take place at the Rafik Hariri University Hospital located in Beirut.
• Saint Joseph University: language of instruction is French. Training will take place in Hôtel-Dieu de France hospital located in Beirut.
• Beirut Arab University: language of instruction is English. Training will take place at Hammoud Hospital UMC located in Sidon and Rafik Hariri University Hospital located in Beirut.

All three Medical schools are in Beirut.

Malaysia

In Malaysia, getting into medical school is regarded as difficult, due to high fees and a rigorous selection process. Some new medical schools do offer a foundation in medicine course before admission into a full-time medical programme. Most government, and some private medical schools offer M.D., and others mostly offer MBBS degrees. In a recent government's assessment on the quality of institutions in Malaysia, International Medical University and Monash University, Malaysia have a gained TIER 5, which is the second highest grade.

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) and (Dr.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:

• Tribhuvan 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.
• Patan Academy 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, as alternative, 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, and 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. Toward 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, wherein 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). At the current time, 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).

Upon completion of the 6th year, students go on to become "House Officers," also known as "House Surgeons" for 1â€"2 years where they rotate through specialities in the first year and then begin to narrow down to what they'd like to do for speciality training in the second year. After 2 years of house officer work they apply to get into a training scheme and start to train towards the speciality.

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.Admission to a government medical college is highly competitive. Entrance into the medical colleges is based 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.

The degree conferred is known as Bachelor of Clinical Medicine (BCM).

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 (at that time was one with the University of Santo Tomas Faculty of Pharmacy, also considered the oldest pharmacy school in the Philippines) 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 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 College of Medicine, Our Lady of Fatima University, Far Eastern University â€" Nicanor Reyes Medical Foundation, Saint Louis University International School of Medicine, De La Salle Health Sciences Institute, University of Santo Tomas Faculty of Medicine and Surgery, Pamantasan ng Lungsod ng Maynila, UERMMMC College of Medicine, St. Luke's College of Medicineâ€"William H. Quasha Memorial, Cebu Doctors' University, Cebu Institute of Medicine, Mindanao State University College of Medicine, Cagayan State University College of Medicine in Tuguegarao, Southwestern University, West Visayas State University in Iloilo City, Davao Medical School Foundation in Davao City, Xavier University â€" Ateneo de Cagayan, Dr. Jose P. Rizal School of Medicine in Cagayan de Oro, and University of Northern Philippines in Vigan.

In 2007, the Ateneo School of Medicine and Public Health was established. It is the first medical school in the country to offer a double degree program leading to the degrees Doctor of Medicine and Masters in Business Administration.

Any college graduate may apply for medical school given that they satisfy the requirements set by the institutions. There is also a test known as the National Medical Admission 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 postgraduate internship (PGI) 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 (6-year learning plus 1-year internship) in duration, starting right after high schools. The first 2 years in the 7-year system is composed of basic sciences and liberal art courses. 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. The duration of clerkships and internships varies from school to school, but all of them end at the 7th grade. Taiwan's medical education began in 1897 and is over 100 years old now. Students graduate with a Doctor of Medicine (MD) degree. Starting from the year 2013, incoming students will have a 6+2 year curriculum, in which the first 6 years are oriented similarly as before and the last two years are Post Graduate Years; this change aims to increase primary care capabilities of medical school graduates.

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. 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 nonprofit and three private medical schools the last college opened was Sulaiman AlRajhi Colleges with its partnership with Maastricht in the Netherlands.

South Korea

Currently, there are 41 medical schools in South Korea. Medical programs in South Korea used to be direct-entry programs such as in the UK, taking six years to complete. However, most universities are currently going through a transition from direct-entry to a 4+4 year system, such as those found in the United States and Canada.

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, established as Ceylon Medical School in 1870. There are medical faculties in Peradeniya, 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 medical professionals, university students and other professionals led to its nationalization and to its renaming as the Kelaniya Medical Faculty.

Faculty of Health-Care Sciences is the faculty that offers MBBS together with other para-medical courses. It is an entity of the Eastern University - Sri Lanka.

The Open International University for Complementary Medicines, established under World Health Organization teaches various field of Medicines and related program of Environmental Sciences.

Graduates from these medical schools revive Bachelor of Medicine, Bachelor of Surgery degree, MBBS, which takes a period of five to six years plus a residency period of one year for full registration. Due to the limited intake a large number of students go abroad to study medicine, these include commonwealth countries, as well as in recent years Bangladesh, Russia and China. However private medical schools are in the process of being established at present with the South Asian Institute of Technology and Medicine. Establishment of private medical schools have been opposed by all professionals in Sri Lanka due to the poor quality of the facilities and the qualifications of the students enroled. The Higher Education Minister and the University Grants Commission (UGC) were criticised by the Government Medical Officers' Association (GMOA) for offering degree awarding status to the South Asian Institute of Technology and Medicine. despite having basic problems of training programme.

Postgraduate Institute of Medicine (PGIM) is the only institution that provides specialist training of medical doctors.

The Institute of Indigenous 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.

Thailand

The first medical school in Thailand has been established back in 1890 at Siriraj Hospital, which is now become Faculty of Medicine Siriraj Hospital, Mahidol University. At the current time, there are 20 medical programs offers nationwide. 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 6 years system, consisting of 1 year in basic-science, 2 years in pre-clinical training, and 3 years for clinical training. Upon graduation, all medical students must pass national medical licensing examinations and a university-based comprehensive test. After medical school, newly graduated doctor are under contract to spend a year of internship and 2 years of tenure in rural areas before they are eligible for any other residency positions or specialized training.

The students will receive Doctor of Medicine (MD) degree. However the degree is equivalent to Master's degree in Thailand.

Europe

Albania

There are four Medical Schools (Fakultete te Mjeksise) in Albania:

• University of Tirana Faculty of Medicine
• Kristal University Faculty of Medicine
• WORLDWIDE University Faculty of Medicine
• Zonja e Keshillit te Mire

These medical schools are usually affiliated with regional hospitals. The course of study lasts 6 years. Students are conferred degree Doctor of Medicine (M.D.) upon graduation.

Austria

• Medical University of Vienna
• Medical University of Graz
• Innsbruck Medical University

Belarus

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

• Belarusian State Medical University, Minsk (byelorussian: Ð'еларускі дзяржаўны медыцынскі ўніверсітэт; Russian: Ð'елорусский государственный медицинский университет) - which contains the famous Bosef Institute for AIDS Research.
• Gomel State Medical University (byelorussian: Ð"омельскі дзяржаўны медыцынскі ўніверсітэт; Russian: Ð"омельский государственный медицинский университет)
• Grodno State Medical University (byelorussian: Ð"родненскі дзяржаўны медыцынскі ўніверсітэт; Russian: Ð"родненский государственный медицинский университет)
• Vitebsk State Order of Peoples' Friendship Medical University (byelorussian: Ð'іцебскі дзяржаўны медыцынскі ўніверсітэт; Russian: Ð'итебский государственный ордена Ð"ружбы народов медицинский университет)

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 (M.D.) 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.

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. While a number of Bulgarian medical schools have now started offering medical programmes in English, Bulgarian is still required during the clinical years.

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 sixth year is the internship year, during which students work under supervision at the hospitals. During the sixth 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 that offer a medical degree, the University of Zagreb (offers medical studies in English), University of Rijeka, University of Split (also offers medical studies in English), and the University of Osijek. The Medical schools are a faculties of those four universities. Medical students enroll into medical school after finishing secondary education, typically after a Gymnasium, or after a four-year nursing school, or any other high school lasting four years. During the application process, their high school grades, and the grades of their matriculation exam at the end of high school (Matura) and the score at the obligatory admission exam 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, Pathologic Physiology And Anatomy, Pharmacology, Microbiology, etc.). Contact with patients begins at the third year. The remaining 3 years are composed of rotations at various departments, such as Internal Medicine, Neurology, Radiology, Dermatology, Psychiatry, Surgery, Pediatrics, Gynecology and Obstetrics, Anesthesiology, and others. During each academic year, students also enroll into two or three elective courses. After each rotation, the students take a total of about 60 exams. In the end, the students must pass a final multiple-choice exam comprising questions about clinical courses, after which they finally gain an MD, and the title of Doctor of Medicine, which they put after their name. Now the 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 the eight most important clinical branches. After that, the doctors are eligible to practice medicine as general practitioners. Residencies are offered at various hospitals throughout Croatia, and at numerous medical specialities.

Czech Republic

There are eight public medical schools in the Czech Republic:

• First Faculty of Medicine, Charles University in Prague
• Second Faculty of Medicine, Charles University in Prague
• Third Faculty of Medicine, Charles University in Prague
• Faculty of Medicine in Plzeň, Charles University in Prague
• Faculty of Medicine in Hradec Králové, Charles University in Prague
• Faculty of Medicine, Masaryk University
• Faculty of Medicine and Dentistry, Palacký University Olomouc
• Faculty of Medicine, University of Ostrava

There is one military medical school, Faculty of Military Health Sciences, University of Defence.

Denmark

In Denmark, basic medical education is given in four universities: University of Copenhagen, Aarhus University, University of Southern Denmark and Aalborg University. The duration of basic medical education is six years and the course leads to the degree of Candidate of Medicine (M.D.) after swearing the Hippocratic Oath upon graduation.

Medical school is usually followed by a year residency called clinical basic education (Danish: Klinisk basisuddannelse or just KBU) which upon completion grants the right to practices medicine without supervision.

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 Baccalaureat, 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 months and takes place in a different department. Med students get 5 weeks off a year.

At the end of sixth 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 cetera. 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 externs' average wage stands between 100 and 300 euros a month.

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.

Towards the end of the medical program, French medical students are provided with more responsibilities and are required to defend a thesis. At the conclusion of the thesis defense, French medical students receive a State Diploma of Doctor of Medicine (MD) or "Diplôme d'Etat de Doctorat en Medecine for general medicine. For those who are in speciality training will also receive a Diploma of Specialized Studies (DES= Diplôme d'Etudes Specialisees) to mark their specialties. Some students may also receive a Diploma of Specialized Complementary Studies (DESC)= Diplôme d'Etudes Specialisees Complementaires.

Germany

In Germany, admission to medical schools is currently administered jointly by the Stiftung für Hochschulzulassung (SfH), 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. Admission remains highly competitive. A very small number of slots per semester are reserved for selected applicants which already hold a university degree (Zweitstudium) and for medical officer candidates (Sanitätsoffizieranwärter).

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 three four-month clerkships, two of them in a hospital (internal medicine and surgery) as well as one elective, which can be one of the other clinical subjects (e. g. family medicine, anesthesiology, neurology, pediatrics, radiology etc.).

After at least 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 or dentistry and the professional title of physician (Arzt) or dentist (Zahnarzt). The academic degrees Doctor of Medicine (Dr. med.) and Doctor of dental Medicine (Dr. med. dent.) are awarded if the graduate has, in addition, successfully completed a scientific study and dissertation. It is a doctoral degree and therefore different from the MD or DDS degrees in the U.S., which as professional degrees are awarded after passing the final exams and do not require additional scientific work. Many medical students opt to perform their thesis during their studies at medical school, but only a fraction of them is able to finish the dissertation-process during their studies. The requirements for getting a Dr. med. degree across the board are not as hard as for the doctor in natural science (Dr. rer. nat.). Therefore many critics advocate to adopt a system similar to that of the Anglo-Saxon countries with an MD as a professional degree and a PhD showing additional scientific qualification. If physicians wish to open up a doctor's office, they are required to further complete residency in order to fulfill the federal requirements of becoming Facharzt (specialized in a certain field of medicine like internal medicine, surgery, pediatrics etc.). Oral and maxillofacial surgeons must complete both studies, medicine and dentistry, then afterwards specializing another 5 years.

There are 36 medical faculties in Germany.

Greece

The most prominent medical school in Greece is the University of Athens since 1843. Other big medical schools are in Patras, Thessaloniki, Ioannina, Larissa where Hippocrates died) and Crete. The medical school in Greece is 6 years or 12 exams.

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 M.D. degree upon graduation. All Hungarian medical schools have programs fully taught in English.

Iceland

In Iceland, admission to medical school requires passing an organized test, controlled by the University of Iceland, which anyone with 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. 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.

Ireland

See also: List of medical schools in 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 Hospital incorporating the National Children's Hospital) (UCC - Cork University Hospital) (RCSI - Beaumont Hospital, Connolly 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 also launched a graduate entry programme in 2010.

Medical education is regulated by the Irish Medical Council, the statutory body that 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. Until 2013 the test was taken in early September, following the conclusion of a 5-year high school cycle in July and each medical school administered the test separately. The result of the test was only valid for entry in the medical school where the test was taken. From 2013 admission test is taken in July and is composed by sixty questions to compile within ninety minutes. Results are express in a national ranking.

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.

There are also some universities in Italy which do provide a degree course in Medicine entirely in English. These school are: the university of Pavia, Roma La Sapienza, Roma Tor Vergata, Milano La Statale, Vita-Salute San Raffaele University, Napoli Federico II, and Bari.

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 choose to enter a Scuola di Specializzazione ("specialty school") at a university hospital 5-year or 6-year course.

Lithuania

Lithuania has two medical schools, in Kaunas - LSMU http://lsmuni.lt/ and Vilnius. Studies are of six years, of which the last year is a practical year. All Lithuanian medical schools have programs in English. Since 1990, LSMU has been the Alma Mater of many international students and 550 full-time foreign students from 42 countries (mainly Israel, Germany,Finland, Norway, Spain, Sweden, Lebanon, Poland, India, South Korea, Ireland and the United Kingdom) are currently enrolled here.

The Lithuanian University of Health Sciences (LSMU) is the largest university-type school in Lithuania preparing the health specialists. It unites the Veterinary Academy and the Medical Academy. LSMU traditions of studies and scientific work go back to the times of the Faculty of Medicine at Vytautas Magnus Universitythat was later turned into Kaunas Institute of Medicine.

LSMU collaborates with more than 140 European, American and Asian universities for study and research purposes.

The University is a member of numerous international organizations, such as the European University Association (EUA), Association of Schools of Public Health in The European Region (ASPHER), Association of Medical Schools in Europe (AMSE), Association for Medical Education in Europe (AMEE), Organisation for PhD Education in Biomedicine and Health Sciences in the European System (ORPHEUS), European Association of Establishments for Veterinary Education (EAEVE), World Veterinary Association, and more.

LSMU is also a member of the World Health Organization (WHO), where it fulfils the role of a collaboration centre for research and training in epidemiology, as well as for the prevention of cardiovascular and other chronic non-communicable diseases.

The study programmes at LSMU meet university education standards applied in EU countries.

Netherlands and 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 preclinical training, followed by two years of clinical training (co-assistentschappen, or co-schappen for short) in hospitals. However, for a number of medical schools this has recently changed to three years of preclinical training, followed by three years of clinical training. At at least one medical faculty, that of Utrecht University, clinical training already begins in the third year of medical school. After 6 years, students graduate as basisartsen (comparable to Doctors of Medicine). As a result of the Bologna process, medical students in the Netherlands now receive a bachelor's degree after three years in medical school and a master's degree upon graduation. Prospective students can apply for medical education directly after finishing the highest level of secondary school, vwo; previous undergraduate education is not a precondition for admittance.

The Belgian medical education is much more based on theoretical knowledge than the Dutch system. In the first 3 years, which are very theoretical and lead to a university bachelor degree, general scientific courses are taken such as chemistry, biophysics, physiology, biostatistics, anatomy, virology, etc. To enter the bachelor course in Flanders, prospective students have to pass an exam, as a result of the numerus clausus. In the French-speaking part of Belgium, 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. In general, the first 2 master years are very theoretical and teach the students in human pathology, diseases, pharmacology. The third year is a year full of internships in a wide range of specialities in different clinics. The seventh, final year serves as a kind of 'pre-specialization' year in which the students are specifically trained in the specialty they wish to pursue after medical school. This contrasts with the Dutch approach, in which graduates are literally 'basic doctors' (basisartsen) who have yet to decide on a specialty.

Norway

Medical education in Norway begins with a six- to six-and-a-half-year undergraduate university program. Admission requires a very high GPA from secondary school - medicine consistently ranks as the most difficult university programme to be admitted to in Norway. Furthermore, certain high school subjects are required for admission (chemistry, mathematics and physics). Upon completion, students are awarded a candidatus/candidata medicinae (cand. med.) degree (corresponding to e.g. and MD in the USA). Those completing a research programme (Forskerlinje) get this added to their 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

Portugal

Universidade do Minho, Braga
Universidade do Algarve, Faro
Faculdade de Medicina da Universidade de Coimbra, Coimbra
Faculdade de Ciências da Saúde, Covilhã
Faculdade de Medicina da Universidade de Lisboa, Lisboa
Faculdade de Ciências Médicas da Universidade Nova de Lisboa, Lisboa
Faculdade de Medicina da Universidade do Porto, Porto
Abel Salazar Biomedical Sciences Institute, Porto

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 does not 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.

Russia

Medical schools in Russia offer a 6-year curriculum leading to award Doctor of Medicine (MD) "Physician". Russian medical authorities reluctantly agrees with inclusion in list of international medical schools FAIMER-IMED. FAIMER can't include medical schools without cooperation from Russia. For example, Orel State University Medical Institute isn't included in this list.

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 to be fully qualified as Medical Doctor (MD).

This internship consists of surgery (3â€"6 months), internal medicine (3â€"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.

Switzerland

There are five universities granting medical degrees in Switzerland (plus the University of Fribourg that provides the bachelor but not the master in medicine) and five university hospitals:

• Faculty of Medicine of the University of Basel (see also University Hospital of Basel)
• Faculty of Medicine of the University of Bern (see also University Hospital of Bern)
• Faculty of Medicine of the University of Geneva (see also University Hospital of Geneva)
• Faculty of Biology and Medicine of the University of Lausanne (see also University Hospital of Lausanne)
• Faculty of Medicine of the University of Zurich (see also University Hospital of Zurich)

Turkey

All high school graduates who wish to pursue further education are required to take an MCQ exam. 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. Entrance to medical schools is extremely competitive, only very top scoring students are accepted to medical schools.

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. MCQ exam(YGS and LYS) scores required to be accepted to private medical schools are lower compared to their public counterparts. The language of instruction is, in general, 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 universities. These include:

• Danylo Halytsky Lviv National Medical University
• Kharkiv National Medical University
• Dnipropetrovsk State Medical Academy
• Ivano-Frankivsk State Medical University
• Bukovinian State Medical University
• Zaporizhia State Medical University
• Ukrainian Medical Stomatological Academy
• Donetsk National Medical University
• Ternopil State Medical University
• Bogomolets National Medical University Of Ukraine
• Crimea State Medical University
• Luhansk State Medical University
• Odessa National 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

Due to the UK code for higher education, first degrees in medicine comprise an integrated programme of study and professional practice spanning several levels. While the final outcomes of the qualifications themselves typically meet the Expectations of the descriptor for higher education qualification at level 7 (the UK master's degree). These degrees may retain, for historical reasons, "Bachelor of Medicine, Bachelor of Surgery" and are abbreviated to MBChB or MBBS.

There are currently 32 institutions that offer medical degrees in the United Kingdom. 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.

Methods of education range from courses that offer a problem-based learning approach (alongside lectures etc.), and others having a more traditional pre-clinical/clinical structure. Others combine 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.

Some medical schools offer graduate entry programmes, which are four years long. The name refers to the fact that students on these courses already have a degree in another subject (i.e. they are graduates). Due to the shorter length of the course, the timetable of these degrees are more intense and the holidays are shorter, compared to students on the 5-year course. In terms of entrance requirements, the 4-year degree restricts entry to those who already hold a first degree, and have previously worked in an area of healthcare. The first degree doesn't necessarily have to be a BSc degree (this is the criteria for some of the medical schools), whereas other medical schools specify that the prior degree has to be in a science subject. Competition for this course is fierce, with students having to also sit an entrance exam prior to being considered for an interview.

Medical schools typically admit more students into undergraduate programmes than into graduate entry programmes.

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. 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. 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 Resident Match Program (NRMP). Each year, approximately 16,000 US medical school students participate in the residency match. An additional 18,000 independent applicantsâ€"former graduates of U.S. medical schools, U.S. osteopathic medical schools, U.S. podiatry students, Canadian students, and graduates of foreign medical schoolsâ€"compete for the approximately 25,000 available residency positions.

Bullying

Medical students, perhaps being vulnerable because of their relatively low status in health care settings, commonly experience verbal abuse, humiliation and harassment (nonsexual or sexual). Discrimination based on gender and race is less common.

Burnout and depression

A US study estimated that approximately 50% of students experience burnout during medical school, as measured by depersonalization, emotional exhaustion, and feelings of professional inadequacy. Burnout in medical students, in addition, seems to be associated with increased likelihood of subsequent suicidal ideation.

It has been estimated by a US study that approximately 14% of medical students have symptoms of moderate to severe depression, and roughly 5% have suicidal thoughts at some point during training. In a South Korean study, 40% of medical students appeared to have depression. Medical students with more severe depression also may be less likely to seek treatment, largely from fear that faculty members would view them as being unable to handle their responsibilities. Students who feel that they lack a social support system are 10 times more likely to be depressed compared with students that consider themselves to have good social support.

Approximately 10% experience suicidal ideation during medical school.

Lemon and Stone hypothesised in what has become termed the 'Lemon Stone Hypothesis', that medical students from lower socio economic backgrounds increase in prevalence during times of national economic adversity. Their hypothesis was a formulation of Becker Maimans' health belief model and Adaption theory. This hypothesis has to some extent been supported by a series of surveys.

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]
• Society of General Internal Medicine (SGIM)
• Undergraduate Medicine and Health Sciences Admission Test (UMAT) [Australia]

Notes and 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
• The Medical Schools Council (UK)
• UK Application Process
• IFMSA

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