From premed to physician: Pursuing a medical career

| December 2017

Premed student Matthew Zelig has wanted to become a doctor ever since taking a college biology class in which he learned about cancer. “The desire to understand and treat serious illnesses, like cancer, has shaped my time as a student,” he says. “It’s inspired me to do everything I can to become a doctor.”

As Zelig and other premed students know, becoming a physician requires an academic commitment to complete 4 years of medical school and up to 7 years of training after earning a bachelor’s degree. It also demands commitments of money and time to meet all the requirements, which vary by state. Only you can decide for yourself whether such investments are worthwhile.

The data in this article may help with your decisionmaking on the path from premed student to doctor.

Doctor and nursing students

Undergraduate preparation

Many students launch their physician or surgeon career goals as undergraduates in a premed program. Medical schools generally require students to have core knowledge of the life and physical sciences—including chemistry, physics, and biology—along with subjects such as English and calculus. Learning these disciplines helps students prepare for medical study.

Premed studies

As table 1 shows, biology was the most prevalent major for physicians and surgeons who were employed in 2015. Although science subjects were popular fields of an undergraduate degree for these doctors, liberal arts subjects such as English, history, and fine arts also made the list.

Table 1. Selected undergraduate fields of degree for physicians and surgeons, 2015
Field of degree Physicians and surgeons, 2015 employment (1)
Number Percent

All majors

710,300 100.0

Biology

346,114 48.7

Medicine(2)

102,241 14.4

Physical science(3)

100,469 14.1

Psychology

46,683 6.6

Engineering

27,312 3.8

Social science

25,473 3.6

Business

15,488 2.2

Mathematics

11,536 1.6

English

10,951 1.5

Foreign language and literature

10,121 1.4

History

9,084 1.3

Education

8,539 1.2

Interdisciplinary studies

8,531 1.2

Physical fitness, parks, recreation, and leisure

8,496 1.2

Fine arts

7,819 1.1
Footnotes:

(1) Data pertain to physicians and surgeons with a doctoral or professional degree who were employed in 2015 and who reported the field of their undergraduate degree. Physicians and surgeons with multiple degrees are counted more than once. Data do not sum to totals for all majors because not all majors are shown.

(2) Includes medical-related subjects such as nursing and operation of medical technology.

(3) Includes subjects such as chemistry and physics.

Source: U.S. Census Bureau, American Community Survey.

Science majors often must supplement their classroom time with laboratory time. Laboratory research is strongly encouraged for premed students. To build research credentials, consider enrolling in a summer program or applying to internships that involve working in a lab, such as those with the National Institutes of Health. Demonstrated commitment to volunteering in the community also is encouraged.

College student studying

 

In addition, shadowing a doctor at work is recommended for prospective medical students. Job shadowing involves following a doctor during his or her interactions with patients. Not only can shadowing give you a perspective on the day-to-day realities of providing healthcare, but it also may help confirm your plans.

Applying to medical school

Toward the end of their undergraduate education, premed students take the standardized Medical College Admission Test (MCAT) as part of the medical school application process. Medical school applications also typically require academic transcripts, essays, and letters of recommendation that highlight applicants’ science and research background.

Admission to medical school is competitive. According to the Association of American Medical Colleges, of 53,000 medical school applicants in the 2016–17 school year, about 21,000 matriculated—that is, 40 percent of first-year applicants were accepted and enrolled in the fall of 2016. 

Medical school

There are two types of medical degrees in the United States: Medical Doctor (M.D.) and Doctor of Osteopathic Medicine (D.O.). Both degrees require 4 years of medical school in addition to a bachelor’s degree. Both also allow physicians and surgeons to use the same treatment methods, but D.O.s may emphasize preventive medicine and holistic care.

Regardless of which degree students decide to pursue, medical school typically begins with preclinical education. This phase focuses on science, physiology, disease processes, and treatment with a combination of classroom instruction and experiential learning. Preclinical students often work with a practicing physician who mentors them in applying their knowledge of patient care.

Following the preclinical phase, advanced medical education finds students engaging in clerkships at hospitals or clinics affiliated with the school. Clerkships involve participating on a healthcare team and assuming a number of responsibilities that increase over time. Students may do a variety of rotations—including, for example, internal medicine, surgery, and anesthesiology—to get a feel for which specialties interest them.

In addition, third- and fourth-year students begin the process of taking a three-part series of licensing exams required for physicians and surgeons to practice medicine. Students usually must pass the first two parts of these tests before graduating from medical school.

The number of medical degrees conferred increased almost 44 percent between 1990–91 and 2014–15, according to data from the U.S. Department of Education National Center for Education Statistics. Although M.D. degrees continue to be more common than D.O. degrees, chart 1 shows that the latter have increased their share of the total over the 25-year period. 

Residency and licensure

To become a licensed physician or surgeon, medical school graduates must continue their training in a residency program. According to American Medical Association data, there were more than 131,000 medical residents in 2016. As table 2 shows, the ranking for common residency specialties for M.D.s differed somewhat from that for D.O.s.

Table 2. Most common residencies for physicians and surgeons, by medical degree and specialty, 2016
Degree and specialty Number of
residents
Percentage of
all residents

M.D.

 

 

Internal medicine

28,982

22.06

Pediatrics

10,623

8.09

Surgery

9,608

7.31

Family medicine and general practice

8,630

6.57

Radiology

6,133

4.67

Anesthesiology

5,851

4.45

Emergency medicine

5,717

4.35

Psychiatry

5,666

4.31

Obstetrics and gynecology

4,965

3.78

Orthopedics

4,249

3.23

Cardiology

3,539

2.69

Neurology

3,538

2.69

Pathology

2,907

2.21

Oncology/cancer

2,323

1.77

D.O.

 

 

Internal medicine

1,064

0.81

Family medicine and general practice

933

0.71

Pediatrics

516

0.39

Emergency medicine

410

0.31

Psychiatry

350

0.27

Anesthesiology

320

0.24

Radiology

280

0.21

Obstetrics and gynecology

276

0.21

Physical medicine and rehabilitation

225

0.17

Surgery

203

0.15

Neurology

126

0.10

Cardiology

112

0.09

Pathology

103

0.08

Oncology-cancer

85

0.06

Source: American Medical Association, courtesy of National Center for Health Workforce Analysis, Health Resources and Services Administration.

Residents usually work in a hospital or clinic under the supervision of an attending physician. They may work a fluctuating number of hours per day doing the duties of a physician or surgeon, including interviewing patients. And residents generally are “on call” during some shifts—a status that requires extended and overnight hours.

Residencies generally last 3 to 7 years. The purpose of a residency is to continue experiential learning, exposing medical graduates to a variety of patients and diagnoses. Residents usually are scheduled to work in different rotations so that they become familiar with the duties and environments they may encounter as physicians or surgeons. If they want to practice a subspecialty in a niche field, residents may need even more years of training.

After completing their residency, doctors are eligible to apply for an unrestricted medical license, allowing them to work in private practice or at a hospital or clinic. Doctors may enter a 1- or 2-year fellowship to learn techniques or research in a particular specialty.

Many physicians and surgeons also obtain board certification, a voluntary credential, in their specialty. Physicians and surgeons earn board certification after successfully passing an examination given by the American Board of Medical Specialties.

Surgeon talking to interns

Working as a doctor

The specific duties of physicians and surgeons vary by specialty. But tasks generally include ordering diagnostic tests, reviewing test results and recommending a treatment plan, and discussing patient self-care, such as proper nutrition.

Most physicians and surgeons work full time, and many have irregular schedules that require them to be on call and to take overnight or weekend shifts. And they may stand for long periods while interacting with patients. In addition, they may encounter hazardous materials or situations and may need to wear protective gear, such as latex gloves.

Employment

Data from the U.S. Bureau of Labor Statistics (BLS) show that about 82 percent of physicians and surgeons worked in the healthcare and social assistance industry sector in 2016. Employment was concentrated in physicians’ offices and in hospitals, with more growth projected from 2016 to 2026 for offices than hospitals. In addition, about 48,000 physicians and surgeons (7 percent of the occupation) were self-employed in 2016, and this group is projected to increase to more than 51,000 by 2026. (See chart 2.)

Outlook and wages

If you’re not sure what type of medicine you’d like to practice, data from BLS may help you decide. BLS projects 106,500 new jobs and 15-percent growth in employment—much faster than the 7 percent projected for all occupations—for physicians and surgeons overall from 2016 to 2026. And the mean annual wage for physicians and surgeons was substantially higher than the $49,630 mean wage for all occupations in 2016. But employment projections vary by specialty, as do wages. (See table 3.)

Table 3. Physicians and surgeons' employment and wages, 2016, and employment growth, projected 2016–26

Occupation

Employment, 2016 Employment, projected 2026 Employment growth,
projected 2016–26 (percent)
Mean annual wage, 2016 1

Physicians and surgeons, total

713,800

820,300

15

$210,170

Anesthesiologists

33,000

38,900

18

269,600

Family and general practitioners

134,800

157,100

16

200,810

Internists, general

49,800

58,200

17

201,840

Obstetricians and gynecologists

21,700

25,500

18

234,310

Pediatricians, general

29,600

34,800

18

184,240

Psychiatrists

27,500

31,200

13

200,220

Surgeons

45,000

52,600

17

252,910

Physicians and surgeons,
all other

372,400

422,000

13

205,560

Footnotes:

1 Excludes wages of self-employed physicians and surgeons.

Source: U.S. Bureau of Labor Statistics, Employment Projections (employment, projected employment) and Occupational Employment Statistics (wages).

Other medical careers

Not all premed students become physicians or surgeons working in medical practices and hospitals. Perhaps you’re among those who realize that you don’t want to provide patient care—or don’t want to go to medical school at all. If so, you have other options. For example, you may want to consider pursuing a degree in public health.

Nurse speaking to patient

 

But if you do want to work with patients and just don’t want to go to medical school, or if you know you want to focus on a particular specialty, consider the occupations listed in table 4. According to BLS, the healthcare practitioners and technical occupational group is projected to add the most jobs from 2016 to 2026. This group consists of a number of healthcare occupations in addition to physicians and surgeons.

Table 4. Selected healthcare occupations that typically require at least a bachelor's degree to enter, by education and training; employment and wages, 2016; and percent employment growth, projected 2016–26

Occupation

Education and training 1 Employment, 2016 2 Employment growth,
projected 2016–26 (percent)
Mean annual wage, 2016 2
Degree On-the-job training

Athletic trainers

Bachelor's

None

27,800

22

$47,880

Dietitians and nutritionists

Bachelor's

Internship/residency

68,000

14

59,670

Exercise physiologists

Bachelor's

None

15,100

13

50,310

Medical and clinical laboratory technologists

Bachelor's

None

171,400

12

62,440

Registered nurses

Bachelor's

None

2,955,200

15

72,180

Genetic counselors

Master's

None

3,100

28

74,960

Nurse practitioners

Master's

None

155,500

36

104,610

Occupational therapists

Master's

None

130,400

21

83,730

Physician assistants

Master's

None

106,200

37

102,090

Speech-language pathologists

Master's

Internship/residency

145,100

18

78,210

Audiologists

Doctoral or professional

None

14,800

20

79,290

Dentists, general

Doctoral or professional

None

132,800

17

173,860

Optometrists

Doctoral or professional

None

40,200

17

117,580

Physical therapists

Doctoral or professional

Internship/residency

239,800

25

87,220

Veterinarians

Doctoral or professional

None

79,600

18

100,560

Footnotes:

1 The degree shown is typically required for a person to enter the occupation; on-the-job training is typically required for a person to attain competency. At the entry level, none of these occupations requires work experience in a related occupation.

2 Employment and wage data exclude self-employed workers.

Source: U.S. Bureau of Labor Statistics, Employment Projections (education, training, and projected employment growth) and Occupational Employment Statistics (employment and wages).

For more information

Learn more about the occupations discussed in this article, along with hundreds of other occupations, in the Occupational Outlook Handbook.

If you’re interested in science or other STEM (science, technology, engineering, and mathematics)-related subjects, you may want to explore career options besides medicine. A BLS Spotlight on Statistics provides information and data to get you started.

Detailed projections of occupations and industries are available from the BLS Employment Projections program.

Related Career Outlook articles include the following:

Allen Chen is an economist in the Office of Occupational Statistics and Employment Projections. He can be reached at (202) 691-5868 or chen.allen@bls.gov.

Suggested citation:

Allen Chen, "From premed to physician: Pursuing a medical career," Career Outlook, U.S. Bureau of Labor Statistics, December 2017.

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