International Training Sampler
The world may be getting smaller, but medical education systems remain varied
The New Physician December 2009
by Steve Woo Volume 58, Number 9
U.S. medical students might take for granted the nation’s standardized route to becoming a doctor. But medical education in other countries is often as different as the languages spoken.
The intricacies are so complex, a comprehensive guide to the way medical education is conducted around the world is not readily available even among organizations that focus on global health.
Globally, medical education systems are so involved that it is difficult to sum them up simply, says Dr. David T. Stern, president of the Institute for International Medical Education (IIME). Groups such as IIME have advocated for more standardization of medical education.
Many countries follow the British model of six years and medical school starting in the undergraduate years of college, according to Stern, who also serves as vice chair for professionalism at Mount Sinai School of Medicine.
Another difference is that American students generally shoulder the high tuition costs of medical education. In some other countries, tuition is free or greatly subsidized by the government. Some countries require new doctors to work in a national health service after graduation.
About a quarter of American medical students spend some time training abroad, and it may be useful to know how doctors elsewhere are trained. In this article, we examine how medical training is conducted in a handful of countries.
Chile
Cost of training
Students pay for medical education. Tuition varies among medical schools.
When training begins
Chilean students begin medical training as college undergraduates.
Duration of medical school
Medical education in Chile lasts seven years.
Required preclinical and clinical training
Chilean medical schools require an internship for the final year or two years of school.
Residency and postgraduate studies
Doctors may pursue specialization as an option. Physicians practice general medicine with the Public Health System, seek a residency or practice privately.
China
Cost of training
China’s government pays for medical education.
When training begins
Chinese students begin medical school as college undergraduates.
Duration of medical school
China’s system varies with how far a student desires to go in their education. It takes five years to earn a Bachelor of Medicine degree, or seven years for a Master of Medicine degree.
Required preclinical and clinical training
Chinese medical students begin performing clinical work in their third year. The last year is a one-year internship.
Residency and postgraduate studies
Residency training can last from two to five years.
Germany
Cost of training
The government subsidizes medical education, and students pay a minimal amount of tuition.
When training begins
German students start medical school as college undergraduates.
Duration of medical school
Germany’s medical school education takes six years.
Required preclinical and clinical training
German students train throughout their education to combine practical training and theoretical knowledge.
Residency and postgraduate studies
Graduates may pursue specialist training while also serving as full-time practicing doctors.
Great Britain
Cost of training
Medical students are responsible for tuition, which is relatively inexpensive compared to the United States. The tuition varies by institution.
When training begins
British students begin medical school as college undergraduates.
Duration of medical school
British medical education lasts five years.
Required preclinical and clinical training
Students perform clinical training as part of their courses.
Residency and postgraduate studies
British students must complete two “foundation years” that focus on clinical work. After medical school, duration of postgraduate work ranges from three years to train for general practice to five to six years for specialties such as pediatrics or orthopedics.
Japan
Cost of training
Japanese students pay their way through medical school. Tuition varies among institutions.
When training begins
Japanese students start medical school as college undergraduates. Applicants who are already college graduates are in the minority.
Duration of medical school
Japan’s medical education lasts six years.
Required preclinical and clinical training
The last two years of medical school are dedicated to clinical training.
Residency and postgraduate studies
Graduates must complete two years of mandatory postgraduate clinical training to become a general practitioner. Specialty training can last an additional four to six years.
Kenya
Cost of training
Medical students pay minimal tuition. The Kenyan government subsidizes most of the cost of medical education.
When training begins
Kenyan students begin medical school as college undergraduates.
Duration of medical school
Medical education in Kenya is six years, and students graduate with a M.B.Ch.B. degree (Bachelor of Medicine and Science).
Required preclinical and clinical training
Internship training is conducted during the third, fourth and fifth years of medical school.
Residency and postgraduate studies
Students may pursue a three-year Master of Medicine degree to specialize.
Russia
Cost of training
Russia’s government pays for medical education.
When training begins
Russian medical students begin as college undergraduates.
Duration of medical school
Medical education in Russia takes six years.
Required preclinical and clinical training
After graduation, a one-year internship must be completed in one of three specialties: internal medicine, surgery or OB/Gyn. Graduates can also pursue a two-year subspecialization in areas such as neurology.
Residency and postgraduate studies
Specialty training takes place as continuing medical education that physicians must seek themselves.
Have you experienced training beyond our borders? Let us know about it: tnp@amsa.org.