Medicine

Medical school in the US is very different from the Netherlands. While Dutch students can study medicine immediately after finishing high school, institutions in America expect you to obtain a Bachelor’s degree in pre-med at a university or college in America before you can apply to medical school. This medical school takes an additional four years to complete, after which you are awarded the title of MD (Medical Doctor). Afterwards you are expected to gain experience during (research) internships in hospitals for an additional three to seven years.

Medical School in the US

Keep in mind that American medical schools are extremely competitive. International students who did not acquire an American Bachelor’s degree in pre-med are rarely accepted into a medical school: only about 5% of foreign students are accepted into the program. Your chances increase if you have a green card/permanent residency in the US, or if you obtained your Bachelor’s in the US. Another concern is the fact that an American MD degree won’t qualify you for practice in the Netherlands, and is not a guarantee of a work visa or job in America. Without permanent residency in the US, applying for an MD program is not recommended.

Tips:
  • American medical schools rarely have grants or loans for international students. Make sure you start researching your financial options in advance. The average costs of tuition for state financed medical schools is $30.000 a year. Private universities ask for $50.000 in tuition. This amount does not include cost of living, which adds up to around $10,000 to $15,000 a year. Studying medicine in the US will cost close to $250.000. Are you an American citizen? Then you might qualify for a federal loan. International students do not qualify for American loans.
  • Transfer students are rarely admitted into American medical schools. For more information about opportunities and possibilities, visit the Educational Commission for Foreign Medical Graduates.

Medical internships in the US

As a medicine student in the Netherlands, you are welcome to apply for an internship in the US. Many American medical schools offer foreign students the opportunity to gain professional experience through a clinical clerkship. These clerkships do not substitute the regular internships that need to be completed in the Netherlands. Most students who opt for a clerkship hope to gain some additional work experience. Previous clerkship experience can also be useful when pursuing a residency in the US. You can do one or more clerkships. Each will take three months to complete. In order to apply, you have to be enrolled at a university included in the World Directory of Medical Schools.  You also need to make sure you have malpractice and liability insurance coverage. Usually you do not need to take an entrance exam, although it can be beneficial to take the USMLE step 1.

Tips:
  • American universities offer mandatory core clerkships as well as elective clerkships. International students are more likely to be accepted for an elective clerkship position, as most American universities will prioritize their own students for the core electives.
  • International students are more likely to be admitted into private medical schools than state universities.
  • Most Dutch students find their clerkship in the US through the networks of their Dutch professors. Some Dutch universities even offer exchange programs to American universities. The international office at your university can tell you more about your options. You can find more information about exchange options on the International Federation of Medical Student’s Association.

Specialization in the US

If you intend to take on a specialization in the US as a Dutch doctor, you may qualify for a medical residency training or fellowship program. A fellowship program mainly revolves around (lab) research and teaching than a medical residency at a hospital. See ‘medical researcher in the US’ for more information.

 

Medical residency

The time it takes to complete your medical residency differs depending on your specialization. On average this will be between three and seven years. To apply for a medical residency in the US, you need to have a standard ECFMG certificate. These certificates can be acquired through the USMLE exams: step 1, Step 2 CK (Clinical Knowledge) and Step 2 CS (Clinical Skills). An EXFMG Certificate does not guarantee placement at a residency or fellowship program. It is recommended to start contacting residency programs as soon as possible to ask for information about their admission requirements.

Tip:
  • You can find more information about the USMLE in the section about American entrance exams required for a Master’s or PhD program in the US.

Finding a residency program

The American Medical Association (AMA) contains a database with the contact information of American residency programs: FREIDA online. Here you can search this database by specialization, region, or admission requirements. You can find information about the available spots, finances, etc.

 

Finances

You can find many addresses and phone numbers of accredited programs in the Graduate Medical Education Directory. Contact us to set up an appointment to view the book at the Fulbright Commission.

 

Application

Most applications are submitted online, through the Electronic Residency Application Service (ERAS). This system will send all required documents, such as your references, grade lists, and USMLE testing scores, directly to the residency program directors.

It is vital to send your application to the National Residency Matching Program (NRMP) as well. Many hospitals only admit candidates that participate in this program. The NRMP is not a centralized application service, but rather it operates as a matching system for candidates and hospitals that pairs both parties based on their preferences. Candidates can select up to 20 preferences.

Admission into American medical residency programs is very competitive, which means that placement is not guaranteed. About half of the candidates who hold international degrees will be matched with an American hospital through the NRMP. Candidates that did not find a placement through the matching process can apply again after March to obtain one of the leftover positions. This means that you will need to travel to the US again for the interview.

Tips:
  • Reach out to the programs’ contact person(s) before selecting your preferences. Not all medical residency programs will accept applicants with international degrees.
  • It may be helpful to interview in person at your preferred hospitals. Interviews are held between August and October in the year before starting with the National Residency Matching Program. Without an in-person visit, you have little chance of entering the rankings in their NRMP program.
  • It may be helpful to apply to several flexible programs or family practices alongside your preferential programs. These usually have a less competitive admission rate. A flexible program will take one year to complete, which gives you the opportunity to continue your specialization afterwards. You might lose a year, but your flexible program will give you a greater chance of residency placement.

Most medical residency programs start in July. Applications are open from September to March. In March the matches will be made public. You need to have obtained your ECFMG certificates prior to the interviews, so remember to take the exams during the year before starting the process. For more information, see NRMP.

 

Working as a doctor in the US

Although international students are able to work through a medical residency program, they are usually not allowed to start their own practice in the US. International doctors who completed their specialization in the US are required by J-1 visa regulations to return to their home country for a period of two years.

US medical licenses are issued by the State Medical Board. Every state’s medical board has its own conditions, rules and examinations. Most State Medical Boards expect you to have several years of experience through an American medical residency position, and have completed an USMLE Step 3 exam. For further questions regarding the medical license, you can contact the individual State Medical Boards. All contact information can be found at the  Federation of State Medical Boards.

 

Working in the US as medical researcher

Medical practitioners looking to conduct research at an American university won’t necessarily need to take the USMLE. See which universities are highly rated in your field. You can find more information about finding a research position under “finding a research position in the US”. The International Federation of Medical Student’s Associations website offers further information about research positions.

Tip:
  • Medical researchers are eligible for grants through American universities, or through other foundations, such as the Fulbright scholarship.

Master’s program

With your Dutch medicine degree, it might be an option to obtain a second Master’s degree in the US in certain fields, such as public health and core sciences such as physiology and anatomy. If your program does not require you to interact with patients you will not have to take the USMLE, although you might be required to take the GRE. Refer to the page about admissions exams for more information.