The Path to Becoming a Doctor

by Michael Doughty

December 30, 2019

While many people think of a medical doctor as simply a doctor, there are several hundred medical specialties and subspecialties. This article will discuss the path one might take to become a physician or surgeon.

Doctors in the United States have roots going back to colonial times. In the beginning, doctors were medical professionals practicing as surgeons, physicians, or apothecaries. There was little regulation, licensing, or standardized education. Today, there are more than 140 accredited medical institutions in the United States, and every state has standard education, licensing, and certification requirements.

In 2017, more than 10,000 doctors were employed practicing medicine in Oregon. That number doesn’t include doctors who have progressed to management roles or who spend their work lives training new practitioners as they enter the field.

What Doctors Do

While all doctors treat illnesses and injuries, the types of activities a doctor performs depend on the type of medicine they practice. The two types of medical degrees for physicians are Medical Doctor (M.D.) and Doctor of Osteopathic Medicine (D.O.). The difference between the two is that a Doctor of Osteopathic Medicine practices a holistic approach to medicine, emphasizing preventive care and the body’s musculoskeletal system.

As part of a patient’s diagnosis and treatment, physicians take medical histories; prescribe medications; and order, perform, and interpret diagnostic tests. They may counsel patients on general health care and, they work closely with healthcare staff. Some physicians may also perform surgery. Surgeons also take patient’s medical histories, order and review tests, and design treatment plans, but additionally operate on patients to treat injuries and diseases.

Most physicians and surgeons choose some area of specialization. For example, surgeons may choose to specialize in areas such as cardiovascular, reconstructive, neurological or orthopedic surgery. There are many other areas of specialization which physicians or surgeons may choose, including anesthesiology, family and general practice, general internal medicine, obstetrics and gynecology, or research.

What It Is Like As a Doctor

Physicians and surgeons generally work in climate-controlled environments, often standing for long periods of time. Their work is done in hospitals, physician’s offices, outpatient care centers, and laboratories. Doctors work for both private-sector entities and for governmental bodies.

Doctors may work irregular and long hours. An article published by the American Medical Association, “How many hours are in the average physician’s workweek?,” reported that while most doctors worked between 40 and 60 hours a week, few doctors worked less than 40 hours a week. About half reported working more than 50 hours a week.
According to the Oregon Employment Department, the average annual salary for physicians and surgeons, all other in Oregon is $206,280. This is one of the highest paying jobs in the Oregon economy and across the nation. In comparison, the average annual wage for 2019 for all Oregon jobs was estimated to be $53,361. The Oregon area with the highest estimated annual wage for physicians and surgeons, all other was Northwest Oregon ($288,245). The Portland-Metro area had the lowest estimated average annual wage ($160,065).  

Wages for doctors in physician and surgical specialties can be even higher. Among the roles where Oregon wage estimates are available, earnings of general internists ($255,418) and psychiatrists ($246,248) are at the higher end. Wage estimates for anesthesiologists and surgeons aren’t available, but are likely even higher, as these roles are the most highly paid on average nationally.

What It Takes to Become a Doctor

The education requirements to become a doctor are rigorous. Post-secondary education will include both a bachelor’s degree and a medical degree, each of which are usually completed in four years. In addition, it is typical to spend three to seven years in residency, gaining practical experience under the supervision of a licensed physician. To qualify for a sub-specialization, further residential training is required. Once the residency requirements have been met, doctors may enter into a one- or two-year fellowship in order to gain knowledge on special techniques or to complete research. In total, physicians and surgeons spend anywhere from eleven to seventeen years completing their training.

While no specific undergraduate degree is required, all medical students are expected to have completed a four-year university degree which included coursework in mathematics, chemistry, biology, and physics. Prospective students must also take the Medical College Admissions Test (MCAT). The American Medical Association reported that about 40 percent of the 53,371 medical school applicants for the 2019-2020 academic year enrolled in medical school. The new students had a mean Medical College Admission Test score of 511.5 and a mean grade point average of 3.73.

Doctors are expected to continue their education throughout their careers. While each state differs on the particulars of continuing medical education, the State of Oregon Medical Board requires 60 hours of continuing medical education every two years relevant to the doctor’s medical practice.

The Oregon Health & Science University School of Medicine offers a four-year Medical Doctor degree. The College of Osteopathic Medicine of the Pacific Northwest offers a four-year Doctor of Osteopathic Medicine degree.

What It Costs

The National Center for Education Statistics reported in its “Fast Facts” that for the academic year of 2016-2017 the estimated cost of tuition, fees, room and board at public institutions was $17,237. At private nonprofit institutions, the estimated cost was $44,551. Note, these estimates include tuition rates for both nonresident and resident status students. The estimated average cost of four years of medical school education in 2017 dollars would be between $68,948 and $178,204.

An Association of American Medical Colleges report estimated the average cost of resident tuition and fees of medical school for the 2019-2020 academic school year to be $57,319 for private schools and $35,125 for public schools. Over the course of four years, the private school cost would be $229,276 and $149,500 for public medical school. Note, these amounts do not include room and board. The average cost of medical school has been increasing about 3 percent annually for the last five years.
Future Demand

Employment of physicians and surgeons is expected to grow over the coming years at a slightly faster pace than for all occupations. The Oregon Employment Department projects job growth of about 12 percent across the economy between 2017 and 2027. Physicians and surgeons are projected to grow more than 14 percent over the same period. Job growth among physician and surgical specialty occupations should grow even faster, with growth estimates for internists, obstetrics, and pediatrics topping 20 percent over the decade.

While growth for this group of occupations is expected to outpace growth in the economy overall, the bulk of anticipated job openings will come from replacement openings, as many workers in our aging workforce look toward retirement.

The path to becoming a doctor starts with a passion to help others, fascination with the field of medicine, and a strong foundation in academics. The process is highly competitive and demanding. For those that make it through the selection and training process, the medical field offers a wide variety of areas in which to practice. The relatively high compensation the profession enjoys reflects the education and training necessary to become a doctor and the responsibility doctors shoulder in service to the community.

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