Physicians

Overview

Modern medicine in the United States dates back to the latter half of the 18th century when the first medical school was founded at the University of Pennsylvania. Quickly thereafter, there was a push to standardize the practice of medicine. In 1847, the American Medical Association (AMA) was established; with this came the initiation of licensing laws and accreditation standards for medical schools. The strength of the AMA was illustrated with the publication of the landmark report Medical Education in the United States and Canada, more commonly known as the Flexner Report, in 1910, which subsequently led to the closure of a number of medical schools that did not meet the AMA's criteria. Another consequence of the Flexner Report was the curtailment of the supply of physicians. Standardization of medicine continued in many ways, including the establishment of the National Board of Medical Examiners (NBME) in 1915, whose function was to administer a standardized licensing examination to physicians, the United States Medical Licensing Examination (USMLE).

Entrance into Medical School

Motivations to enter the field of medicine, while unique to the individual who pursues this path, generally include factors such as the desire to help others in a healing capacity, service in the context of science, technology, and research, and preference for an autonomous profession. Medical school admission requirements include successful completion of the Medical College Admissions Test (MCAT), a standardized test comprising three sections of physical sciences, biological sciences, and verbal reasoning, scored from 1 to 15 points, as well as two writing samples. An application is typically submitted through the American Medical College Application Service (AMCAS), which processes applications for the majority of allopathic medical schools, or through the American Association of Osteopathic Medicine (AACOM) for osteopathic medical schools.

This highly selective and competitive process draws serious and motivated students. Applicant data are collected annually and shows that most accepted applicants earned an average of 10 to 15 points on each section of the MCAT. Moreover, they have an undergraduate cumulative grade point average in science of 3.75 on a 4.0 scale. Recently, there have been an increasing number of female applicants to medical schools, and approximately 60% of students are female. Most applicants are White. Blacks, Native Americans, Mexican Americans, and mainland Puerto Ricans comprise about 12% of all medical students, while these groups together comprise about 20% of the nation's overall population.

On graduating from medical school, physicians enter medical residency programs to continue their training. These programs run from 3 to 8 years in length, and, generally, osteopathic physicians must complete a 12-month rotation prior to entry. After residency, physicians obtain a state license to practice medicine. Licensing laws are set by state boards of medicine that require graduation from an accredited medical school and passing the three steps of the USMLE to obtain a license. Furthermore, [Page 932]these boards set certain standards for physicians, such as qualifications for a license and standards of practice, and they have authority over disciplinary action.

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