How to Become a Doctor in the United States, Step by Step

If you want to know how to become a doctor in the United States, the path follows a defined order. You earn a bachelor’s degree while completing premedical courses, take the MCAT, apply to medical school and complete four years for an MD or DO degree. You then pass the USMLE or COMLEX-USA licensing exams, match into and complete a residency of three to seven years and obtain a license from the state medical board where you plan to practice. Most physicians pursue board certification, while some complete an optional fellowship.

That sequence matters because a different organization controls each gate, from a college and medical school admissions committee to an exam program, residency program and state licensing board. Four years of college, four years of medical school and three to seven years of residency add up to 11 to 15 years after high school before any fellowship; our stage-by-stage physician training timeline shows where that time goes. Understanding the order now helps you choose courses, schedule the MCAT and assess the financial and personal commitment before you reach the next decision point.

The Physician Training Path at a Glance

• The professional degree you need is an MD or DO. You may choose any undergraduate major, but you must complete the coursework required by the medical schools you plan to apply to.
• Of 54,699 applicants to U.S. MD-granting schools in 2025-2026, 23,440 matriculated. That works out to about 43% for that applicant group, not an individual admission probability or a DO admission rate.
• In the 2026 Match, 93.5% of U.S. MD seniors and 93.2% of U.S. DO seniors who certified rank order lists matched to a first-year (PGY-1) residency position.
• A medical degree alone does not authorize independent practice. A state board reviews your degree, postgraduate training, licensing exams and fitness to practice before issuing a license.

The Steps From College to Licensed Practice

The AAMC document The Road to Becoming a Doctor outlines the main stages of physician training. The organizations responsible for admissions, examinations, residency and licensure set the requirements shown for the other stages in the table.

The table above separates milestones that students sometimes group together. Graduating from medical school, for example, gives you an MD or DO degree, but as the Federation of State Medical Boards (FSMB) explains in its guide to physician licensure, the degree does not automatically give you a license to practice. In the same way, entering residency requires a separate application and matching process after medical school admission and graduation.

Step 1: Complete College and Premedical Preparation

You need a four-year bachelor’s degree from an accredited institution before entering medical school, but the Bureau of Labor Statistics (BLS) profile of physicians and surgeons says no particular undergraduate major is required. Biology and related sciences are common choices, yet a nonscience major can work if you complete the medical school prerequisites required by your target programs.

The AAMC says students will generally complete one year of biology, one year of English and two years of chemistry through organic chemistry. Requirements still differ by school. Some programs accept AP, online or community college work that others do not, while some use competency-based admissions without a fixed course list. Compare requirements before registering for classes rather than assuming one checklist applies everywhere.

Grades are only one part of preparation. Schools establish their own expectations for laboratory work, volunteering, clinical experience and shadowing. AAMC guidance emphasizes the quality and depth of clinical exposure over simply accumulating hours, and shadowing is not the only accepted route. Hospice volunteering, work as a nursing assistant, EMT service, medical scribing and caregiving can also provide exposure. Use guidance on how many shadowing hours medical schools expect to plan experiences that help you understand a physician’s work and explain why medicine fits you.

Step 2: Take the MCAT

The AAMC describes the Medical College Admission Test (MCAT) as a standardized multiple-choice examination assessing problem solving, critical thinking and concepts from the natural, behavioral and social sciences. All U.S. medical schools require an MCAT score for regular admission, and many will not accept a score more than three years old. That makes timing important: take it after you have covered the tested material but while the score will remain valid for your planned application cycle.

The exam has 6 hours and 15 minutes of content and about 7 hours and 30 minutes of total seated time, excluding check-in. Its four section scores combine into a total from 472 to 528. Among matriculants to U.S. MD-granting schools in 2025-2026, the mean was 512.1, but a useful score depends on the programs and broader application you are considering. Our guide to what counts as a good MCAT score places the scale in context.

Practice results can help you decide whether your preparation is progressing or whether you should adjust your test date. An MCAT score calculator can help you convert and interpret those practice results, but an estimate is not an official score or an admission decision.

Step 3: Apply to Medical School

You normally begin the application process in the year before you intend to enroll. Most U.S. medical schools use AMCAS, the centralized application service run by the AAMC, as their primary application. AACOMAS serves U.S. colleges of osteopathic medicine, while TMDSAS serves participating Texas programs. You may apply to MD programs, DO programs or both, depending on which training approach and schools fit your goals.

The primary application typically includes academic records, an MCAT score and recommendation letters. Most schools then require a secondary application, usually with another fee. Admissions committees review the full application, and most schools interview candidates before making their decisions. The BLS notes that schools also consider qualities such as leadership, personality and extracurricular involvement.

Admission is competitive. In 2025-2026, AAMC data show 54,699 applicants and 23,440 matriculants at U.S. MD-granting schools. Dividing the second count by the first gives about 43%, but that is arithmetic from national MD counts, not an official acceptance rate, a DO figure or your personal probability. Those matriculants had a mean total GPA of 3.81, alongside the mean MCAT score given in Step 2. The comparison of how medical schools weigh MCAT and GPA together can help you interpret those means without treating them as minimum requirements. The AAMC says applicants apply to 16 schools on average through AMCAS and advises applying only to schools you would seriously consider attending.

Deciding When to Apply

You do not have to enter medical school immediately after college. Among first-year U.S. MD students who answered the 2025 AAMC Matriculating Student Questionnaire, 72.7% reported that at least one year had passed since college graduation, and the median age at matriculation was 23. Time between college and medical school can be used to complete missing coursework, strengthen academic preparation or gain sustained exposure to patient care. International Medical Aid offers pre-med internships abroad involving clinical rotations and physician shadowing for students seeking that type of exposure.

Step 4: Earn an MD or DO Degree

Both MD and DO programs lead to physician licensure and entry into the same accredited residency system. MD programs are accredited by the LCME (Liaison Committee on Medical Education), while DO programs are accredited by the American Osteopathic Association Commission on Osteopathic College Accreditation (COCA). The differences between MD and DO programs matter when selecting schools, but either degree can lead to licensed medical practice in the United States.

Most medical school programs last four years. Training is commonly divided into a preclinical phase focused on medical science and the foundations of patient care, followed by clinical rotations in hospitals and clinics under supervision. Clerkships usually include fields such as internal medicine, family medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery. For a closer look at how medical school is organized year by year, use the separate curriculum guide.

By the end of the third year, most students have selected a specialty area or patient population and begin preparing for residency applications. Your medical school determines whether you meet its academic, clinical and professional requirements for graduation.

Step 5: Pass the Medical Licensing Examinations

MD students generally follow the USMLE sequence. USMLE Step 1 assesses the basic sciences needed for medical practice, Step 2 CK evaluates clinical knowledge and its application to patient care and Step 3 tests whether you can apply biomedical and clinical knowledge for unsupervised practice. Step 1 has been reported only as pass or fail for examinations taken on or after January 26, 2022.

Students at U.S. medical schools routinely take the first two steps before graduation. MD students commonly take Step 1 during the second year and Step 2 CK during the third or fourth year. Step 3 usually follows during the first or second year of residency.

DO students take the three-level COMLEX-USA sequence, and AACOM notes that Level 1 and Level 2-CE are required for graduation from an osteopathic medical college. Level 1 is generally taken in the second year, Level 2-CE in the third or fourth year and Level 3 during residency. State medical boards require completion of either USMLE or COMLEX-USA, and the USMLE is open to MD and DO physicians. Many boards also limit examination attempts and the time allowed to finish a sequence, so passing each stage affects your ability to continue toward licensure.

Step 6: Match Into and Complete Residency

Applying Through the Match

During the final year of medical school, you apply to residency programs in the specialty you plan to practice, attend interviews and create a rank order list. Programs rank applicants as well. The NRMP matching algorithm uses those preferences to pair applicants and programs. On Match Day in March, students learn where they will begin training in July.

The 2026 Main Residency Match results describe the largest Match in NRMP history. Among applicants who certified rank order lists, the match rate for first-year (PGY-1) positions was 93.5% for U.S. MD seniors and 93.2% for U.S. DO seniors. These are group outcomes, not a prediction for an individual applicant. The NRMP also reported that 86.1% of U.S. MD seniors matched to their preferred specialty in 2026, showing that obtaining a position and obtaining your first-choice specialty are related but distinct outcomes.

Training as a Resident

Residency lasts three to seven years depending on specialty and provides supervised, hands-on training in an ACGME-accredited program. Under ACGME program requirements, a family medicine residency is 36 months, general surgery is 60 months and neurological surgery is 84 months. Most state boards issue a resident or training permit that authorizes practice only within the supervised setting of the program.

A fellowship is optional rather than a universal step. Physicians who want subspecialty training may complete another one to three years after residency.

Step 7: Obtain a State License and Consider Board Certification

State Medical Licensure

Medicine is licensed by individual states. According to the FSMB guide, boards review medical education, postgraduate training, examination performance and fitness to practice. Applicants also provide records such as their work history and information about criminal convictions or malpractice judgments.

Every state medical board requires at least one year of postgraduate training for a full and unrestricted license, while some jurisdictions require two or three years. You must also complete the USMLE or COMLEX-USA sequence accepted by the board. Once licensed, physicians usually renew their licenses every one or two years, and nearly all states require continuing medical education.

Board Certification

Board certification is different from state licensure. It is voluntary but widely expected in clinical practice and academic settings. The 24 member boards of the American Board of Medical Specialties (ABMS) certify physicians across 38 specialties and 90 subspecialties. ABMS certification requires an MD or DO degree, qualifying residency training, an unrestricted license and passage of the relevant board examinations. Physicians then participate in continuing certification requirements. Your state board decides whether you may practice medicine, while a specialty board decides whether you meet its certification standards.

How Hard Is It to Become a Doctor?

Becoming a doctor is difficult because you must clear several independent academic and professional gates over many years. Admission comes first: as Step 3 showed, fewer than half of applicants to U.S. MD-granting schools matriculated in the most recent AAMC counts, and the students who did had high grades and MCAT scores. Those averages describe the entering group, not minimum scores that guarantee admission.

After that, medical students must satisfy their school’s academic and clinical requirements, pass a multilevel licensing examination sequence and secure a residency position. Residents then complete several years of supervised training before qualifying for unrestricted practice under their state’s rules.

The work itself also deserves consideration. The BLS reports that many physicians work long shifts that can include irregular hours, overnight work or call. Some work more than 40 hours each week. The path is achievable, but it calls for sustained academic preparation, comfort with repeated evaluation and a realistic understanding of physician schedules.

The Cost of Becoming a Doctor and the Potential Return

Application and Education Costs

Costs begin before enrollment. The AAMC set the standard fee to sit the MCAT at $355 for 2026 testing dates. Its page on the cost of applying to medical school lists a 2027 AMCAS fee of $180 for the first school and $48 for each additional school. Applying to the current average of 16 AMCAS schools therefore costs $900 in primary fees before secondaries. Most schools charge another secondary fee, and applicants may also pay for interview travel, lodging, attire and preparation materials. TMDSAS charges a flat $235 fee for any number of participating schools.

The larger expense is medical education. The AAMC reported a median four-year cost of attendance of $297,745 at public medical schools and $408,150 at private medical schools for the class of 2026. Cost of attendance is broader than tuition alone. The median education debt reported for the class of 2025 was $215,000.

Physician Pay and Whether the Path Is Worth It

The BLS reported a median annual wage of $275,930 for employed physicians and surgeons in May 2025, compared with $50,980 across all occupations. This physician figure covers specialties and career stages and is not a starting salary. The lowest-paid 10% earned less than $76,560, while the highest-paid 10% earned more than $488,320. Employment is projected to grow 4% from 2025 to 2035, with about 22,100 openings per year.

Whether becoming a doctor is worth it depends on more than comparing debt with a median wage. You must weigh years spent in training before earning full physician pay, borrowing needs, work schedules, the kind of patient care you want to provide and careers you would otherwise pursue. Our full discussion of whether medical school is worth the debt can help you organize that comparison without substituting a general verdict for your own priorities.

Other Routes to Becoming a Doctor

Combined and Dual-Degree Programs

Some schools offer combined undergraduate and medical programs lasting six to eight years. Medical schools may also offer dual degrees such as MD-PhD, MD-MBA and MD-MPH programs. Most MD-PhD students complete both degrees in seven to eight years. These structures alter how education is organized, but graduates still complete the licensing and postgraduate training stages required for practice.

Nurses, Physician Assistants and Other Career Changers

Prior healthcare training can give you useful patient-care experience, but it does not replace the physician degree. All U.S. jurisdictions require an MD or DO degree for physician licensure. A nurse considering the transition can review the path from nurse to doctor, while a physician assistant can examine what PA to MD bridge programs do and do not change. Other career changers likewise need to satisfy medical school admission requirements, earn the medical degree and complete the licensing and residency process.

International Medical Graduates

If you graduated from a medical school outside the United States, your route depends on ECFMG Certification. Whether you count as an international medical graduate (IMG) is determined by the location of your medical school, not your citizenship. Your school must meet ECFMG requirements and have an ECFMG Sponsor Note in the World Directory of Medical Schools, and you must pass USMLE Step 1 and Step 2 CK along with the other certification requirements before entering an ACGME-accredited residency.

In the 2026 Match, PGY-1 match rates were 70% for U.S. citizen international medical graduates and 56.4% for non-U.S. citizen international medical graduates who certified rank order lists. These group rates do not determine an individual IMG’s result. ECFMG Certification is also required to take USMLE Step 3, and licensing authorities impose additional requirements before granting an unrestricted license.

Your Next Step Toward Becoming a Doctor

The complete physician pathway can feel distant when you are still choosing a college course or looking for your first clinical experience. You do not need to solve every later decision at once. Identify your current gate, learn who controls it and make sure your next choice keeps the following stage open.

If you are in college, begin by comparing school-specific prerequisites and building consistent academic and clinical preparation. If you are ready to apply, assess where your record fits and choose MD, DO or both intentionally. Medical students can focus on examinations, specialty exploration and residency preparation. At every point, the next useful action is more manageable than treating the entire path as a single decision.

Frequently Asked Questions

What Degree Do You Need to Be a Doctor?

You need an MD or DO degree to become a licensed physician in the United States. Before medical school, you generally complete a four-year bachelor’s degree, but your undergraduate major does not have to be a science subject. The MD or DO degree is the professional medical degree, and earning it does not by itself provide an unrestricted license.

What Are the Steps to Becoming a Doctor?

The steps are to earn a bachelor’s degree and complete premedical preparation, take the MCAT, apply to medical school, earn an MD or DO, pass the relevant licensing examination sequence, match into and complete residency and obtain a state medical license. Board certification commonly follows residency, and fellowship is optional for physicians pursuing subspecialty training.

How Hard Is It to Become a Doctor?

It requires sustained performance across several competitive stages. About 43% of applicants to U.S. MD-granting schools matriculated in 2025-2026 based on national AAMC counts, and matriculants had mean figures of 512.1 on the MCAT and 3.81 for total GPA. Students must then finish medical school, pass a multilevel examination sequence and secure and complete residency.

How Much Does It Cost to Become a Doctor?

The largest published benchmark is medical school cost of attendance. For the class of 2026, the AAMC reported median four-year costs of $297,745 at public medical schools and $408,150 at private schools. Applicants also face MCAT, primary application, secondary application and possible interview expenses. The median education debt for the medical school class of 2025 was $215,000.

Is Becoming a Doctor Worth It?

It can be worth it if the work fits your goals and the training commitment is acceptable to you, but the figures do not produce one answer for everyone. The May 2025 median wage for employed physicians and surgeons was $275,930, while medical education can involve substantial costs and debt. Compare the work itself, physician schedules, years before full physician pay, expected borrowing and your alternatives.

How Long Does It Take to Become a Doctor?

It commonly adds up to 11 to 15 years after high school before an optional fellowship. That total consists of four years of college, four years of medical school and three to seven years of residency. A fellowship may add another one to three years for subspecialty training.

Can You Become a Doctor Without a Science Major?

Yes. No particular undergraduate major is required for admission to an MD or DO program, but you still need the premedical courses or competencies required by each school. Check individual policies because schools differ in their treatment of AP, online and community college coursework.

How Do You Become a Doctor in the US With a Foreign Medical Degree?

You need ECFMG Certification before you can start an ACGME-accredited residency in the United States. Certification depends on graduating from a medical school that ECFMG recognizes and on passing USMLE Step 1 and Step 2 CK, among other requirements. After that you follow the same road as U.S. graduates: a residency position through the Match, USMLE Step 3 and a license from a state medical board.