The Path to Becoming a Doctor

by Henry Fields

March 6, 2023

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 150 accredited medical institutions in the United States, and every state has standard education, licensing, and certification requirements.

In 2021, nearly 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. A 2018 survey published by the Physicians Foundation reported that while most doctors worked between 40 and 60 hours a week, fewer than one out of four doctors worked fewer than 40 hours a week. More than half reported working more than 50 hours a week.
Graph showing physicians' typical hours worked each week (2018)

The average for all jobs in 2018 was 34.5 hours per week, so it’s clear that doctors spend significantly more time at work than the average person. The number does appear to be edging down slightly. The 2018 survey showed an average workweek of 51.4 hours, down an hour and a half per week from 2012. We are still getting back to the “new normal” after a severe upheaval to the medical system in 2020 so it remains to be seen what physician hours will look like long term. The 2022 survey did not ask the same question, but more than one in five doctors reported cutting back their work hours during the last year.

According to our 2021 wage estimates, the average annual salary for physicians (all other) in Oregon is $228,699. This is one of the highest paying jobs in the Oregon economy and across the nation. In comparison, the average annual wage for all Oregon jobs was estimated to be $61,465. The Oregon area with the highest estimated annual wage for physicians was the Rogue Valley ($308,941). The Portland-Metro area had the lowest estimated average annual wage ($186,333). Central, Southern, and Eastern Oregon tend to have higher physician wages than the state, which isn’t a typical pattern for most occupations.

Wages for doctors in physician and surgical specialties can be even higher. Earnings of internal medicine physicians ($288,846), ophthalmologists ($277,412), and pathologists ($243,567) are higher than general practitioners. In general, the highest paying specialties require more time in residency learning the specialty, which delays earnings.

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 11 to 17 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 41% of the 55,188 medical school applicants for the 2020-2021 academic year enrolled in medical school. The new students had a mean MCAT score of 511.9 and a mean grade point average of 3.75.

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 2020-2021, the estimated cost of tuition, fees, and room and board at public institutions was $19,374. At private nonprofit institutions, the estimated cost was $49,210. Note, these estimates include tuition rates for both nonresident and resident status students.

An Association of American Medical Colleges report estimated the average cost of resident tuition and fees of medical school for the 2022-2023 academic school year to be $62,570 for private schools and $39,905 for public schools. Over the course of four years, the private medical school cost would be $250,280 and $159,620 for public medical school. Note, these amounts do not include room and board. The average cost of medical school increased by around 2% for the last two years, while there was a significant slowdown in price increases in 2019 and 2020.
Graph showing change in tuition from previous year (first year students)

Future Demand

Employment of physicians and surgeons is expected to grow over the coming years at a slightly slower pace than for all occupations. The Oregon Employment Department projects job growth of about 13% across the economy between 2021 and 2031. Physicians and surgeons are projected to grow about 7% over the same period. Projections can be higher or lower based on specialty. Psychiatrists are projected to grow more than twice as fast, and pediatricians, obstetricians, and gynecologists only 1-2% during that time.

While growth for this group of occupations is expected to lag 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.
Table showing physicians and surgeons employment and growth, Oregon, 2021-2031


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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