Pre-Med Requirements at US Universities

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By Matt Killorin
Last updated on August 11, 2023

Take the first steps toward becoming a doctor in the United States.

Three international students in a pre-med program stand in lab coats and discuss a chart in their US university hospital

There are many paths to becoming a doctor in the United States, but all pass through medical school. Students on a pre-medical — or pre-med — track at university in the United States take required courses to qualify for medical school after earning their bachelor’s degree. You don’t have to major in biology or any STEM discipline to study to become a doctor, but you do have to fulfill specific pre-med requirements. Shorelight universities have pre-med programs that help international students feel confident as they begin the med school application process and move closer to becoming a doctor.

But first, let’s look at what it means to be a doctor with a degree from a US-based university and the steps an international student needs to take to become one.

How to Become a Doctor in the United States

Becoming a doctor can mean several different things depending on your specialty and, in the United States, may require different amounts of schooling, experience, and training. With this in mind, we will approach the med school process from the perspective of general medicine or Doctor of Medicine (MD).

In the United States, a general internal medicine physician makes almost $250,000 a year. That may sound like a lot of money, but becoming a doctor is usually expensive and challenging. An international student can expect to spend approximately $54,000 yearly on private undergraduate and postgraduate medical school degree programs. In addition, there’s a three- to seven-year residency program requirement after you earn your MD. That’s more than $400,000 in tuition costs and as much as 15 years of learning and practical experience before you become an official fully licensed MD in the US.

Here’s the most common road to becoming a general physician, starting at university and ending with board certification and state licensure.

Undergraduate School: Pre-Med

You have a degree of flexibility when choosing a major on a pre-med track. You can pursue a degree in humanities, social sciences, or STEM-related fields — from literature to chemistry — and still be pre-med, as long as you also fulfill the pre-med course requirements. Your Medical College Admissions Test (or MCAT) entrance exam score, undergrad grade point average (GPA), and the courses you take in college matter much more to medical school application officials than the declared major on your bachelor’s degree.

Perhaps that’s why, according to the Association of American Medical Colleges, only 54% of medical students graduated college with biology-related bachelor’s degrees. Approximately 20% of the class of 2026 combined have physical, social, and specialized health science undergraduate degrees, while 4% come from humanities backgrounds.

Regardless of your college major, make sure you meet with an advisor to discuss your professional goals and chart a course that leads to med school and sets you up for success. That means:

Take pre-med courses. Most med schools require one year of the following, with labs: biology, organic chemistry, general chemistry, and physics, as well as a year of English and a semester of biochemistry.

Get good grades. According to most estimates, the average GPA for students enrolling in medical school in 2022 was between 3.60 and 3.75 (the AAMC estimate). Most med school resources encourage students to maintain a 3.4 or higher to be competitive in med school admissions.

Do well on the MCAT. The MCAT is the benchmark exam given in the United States by the AAMC to determine how a prospective medical school student will perform.

What Is the MCAT Exam?

The MCAT is a multiple-choice exam that tests your problem-solving and critical thinking skills, as well as your knowledge of natural, behavioral, and social science concepts and other principles prerequisite to the study of medicine. The average score for first-year med school students in 2022–2023 is 511.9, within a range of 472 to 528.

The MCAT exam has four test sections. Each of the first three sections below has 59 questions to be completed in 95 minutes and is worth between 118–132 points. The final section, Critical Analysis and Reasoning Skills, has 53 questions to be completed in 90 minutes for the same range of points.

  1. Biological and Biochemical Foundations of Living Systems: Expect passage-based and discrete questions that cover biochemistry, biology, general chemistry, organic chemistry, and physics.

  2. Chemical and Physical Foundations of Biological Systems: Passage-based and discrete questions that cover biochemistry, biology, general chemistry, and organic chemistry.

  3. Psychological, Social, and Biological Foundations of Behavior: Passage-based and discrete questions covering biology, psychology, and sociology.

  4. Critical Analysis and Reasoning Skills: Passage-based questions from sections called Foundations of Comprehension, Reasoning Within the Text, and Reasoning Beyond the Text.

The AAMC website can tell you more about the MCAT exam and the average MCAT scores and GPAs for medical schools across the United States and Canada (for a fee), so you can see how you measure up against other applicants.

Check out Shorelight’s ultimate guide to the MCAT for international students >

An Overview of Med School

In the United States, medical schools can range in size, location, specialty, teaching methodology, and many other characteristics. Fortunately, applicants can use a centralized medical school application processing service called the American Medical College Application Service (AMCAS) to apply to multiple schools simultaneously, with 16 being the average. Students should still begin researching different medical schools as early as possible — many med school advisors recommend starting the research process by the first semester of your undergraduate junior year.

Throughout the typical four-year medical school program, students take courses and build mastery in medical knowledge and other skills such as patient care, critical thinking, communication and professionalism, and organizational health care management. Courses range from The Practice of Medicine to Human Pathology to and decision-making analysis classes. The student’s specialties and focus will determine the specific courses they will need to take.

By junior year of medical school, however, most med school students have already begun the United States Medical Licensing Examination (USMLE) process.

Getting Licensed: Steps 1 & 2

Parts one and two of the three-part USMLE licensing process begin while the student is still in medical school. The first part, called Step 1, consists of seven one-hour examination blocks across eight hours. Most students take Step 1 at the end of their second year of med school and Step 2 during the fourth year. Step 2 is even more grueling than Step 1, with eight one-hour examination blocks over a nine-hour session.

Students must complete Steps 1 and 2 before they are eligible to take the Step 3 examination, which usually happens during post-graduate training.

The Match: Residency Process Begins

By now, most students have an eye on or have already started the long and complicated residency matching process. The matching process allows students to select which residency program they prefer to begin practicing and continue learning medicine. The process is highly competitive and based on a complex algorithm that promises fair, impartial matching of applicants’ and residency programs’ preferences to each other. You match up based on experience, grades, recommendations, evaluations, and interviews.

The Match process, run by the National Resident Matching Program (NRMP), culminates in a Match Week and Match Day in March. Here’s an overview of the hectic and often emotional Match Week for prospective residents:

Monday: Students learn if they were matched with one of their preferred residency programs, but not which one.

Tuesday–Thursday: Students who do not match may then enter an accelerated residency matching program called the Supplemental Offer and Acceptance Program (SOAP), which consists of interviews and matching rounds where programs make offers to prospective residents until Thursday. Any open residencies left, and unmatched hopefuls, can then contact each other after Thursday and try to make a deal.

Friday: At noon, prospective residents who have been matched will finally discover where they will spend the next approximately three to seven years when they receive notification from the NRMP.

What Comes After Med School: Residency, Licensing, and Certification

A residency in the United States is a doctor of medicine’s postgrad training program. The program is usually conducted at a hospital or doctor’s office where the resident postgrad delivers direct care to patients and must be recognized by the Accreditation Council for Graduate Medical Education (ACGME).

The first year of residency, often called PGY1 — Postgraduate Year One — is considered an internship year. After interning, the doctor’s residency continues with focus work in an area of specialty and then culminates with further certification and, often, a fellowship.

Getting Licensed: Step 3 - Certification (or the Final Step)

Certification includes Step 3, the final USMLE licensing requirement. Step 3 is an examination meant to determine if a postgrad is trained and able to practice unsupervised medicine — doctors can take Step 3 after completing, or nearly completing, one year of a residency program.

Post-Residency Options for Doctors

Most residencies last three years; however, some can last much longer, such as neurosurgery residencies, which continue for seven. After the residency is completed and licensing is secured, a doctor of medicine has a few options to consider:

Board certification: Many pursue American Board of Medical Specialties (ABMS) certification after completing a residency in a chosen specialty. Board certification reflects expertise and is recognized across the US.

Fellowship: Fellowship programs offer further training in a field or even a subset of a field that demonstrates specialized knowledge. Some doctors prefer to study general medicine, while others pursue specialties and require fellowship training.

Practice: Doctors can also start to practice medicine after their residency concludes. The first step is to apply for an unrestricted medical license.

Obtaining a full or unrestricted medical license is a state-by-state process, with different requirements and fees depending on where you wish to practice. In Massachusetts, for instance, a doctor has full licensure requirements that include proof of good moral character and pre-medical, medical, and postgraduate medical training requirements. Once a doctor obtains a state license, they can apply to open roles.

How to Find the Right Pre-Med Program

Several Shorelight universities have top-ranked pre-med programs that provide holistic support to students, from application assistance to postgrad career development. Students enrolled in a Shorelight pre-med program have advisors who can help them chart a pre-med course that aligns with their career aspirations while helping them acclimate to US campus culture, learn English, and pick suitable courses.

Here are a few to consider:

Auburn University

Auburn University, less than two hours from Atlanta, Georgia, is ranked #97 among US National Universities and #56 in first-year experiences, according to U.S. News & World Report. Auburn has pre-medical tracks in Microbiology and Organismal Biology.

Learn more about Auburn Global and attending Auburn University as an international student >

Louisiana State University

Louisiana State University (LSU) is located in Baton Rogue, Louisiana, not far from the historic city of New Orleans. LSU is ranked #176 among National Universities and #87 among Top Public Schools. LSU has a Pathway to Medical School program and several non-degree pre-health programs, including Pre-Medical Technology.

Learn more about LSU Global and attending LSU as an international student >

American Collegiate Los Angeles

American Collegiate Los Angeles offers a pre-med certificate option through UCLA Extension. The certificate path is an excellent option for students hoping to enroll at a top-ranked institution after completing two years of undergraduate courses. Students who attended American Collegiate LA have transferred to New York University, Purdue University, and Boston College, among other high-ranked universities.

Find the Right Pre-Med Program

They say becoming a doctor is a calling. Perhaps that’s because the road to practicing medicine is long and requires fortitude. Making it from a pre-med track to graduating from med school can take almost 10 years, and that doesn’t include residencies and postgrad training, certifications, or licensure. And as an international student, you still have to navigate visa, finance, language, and other requirements to study in the United States.

Shorelight can help in your journey to med school in the United States. Our advisors can answer your visa, admissions, and career-based questions and help set you up for success in a pre-med program in the United States.

Talk to an advisor >