The United States of America offers various prospects for Indian Medical students, practitioners and professionals who wish to embark on a professional journey in the States. Studying or Practicing Medicine in the US is considered a matter of prestige and attracts professionals all over the world. According to various studies, Indians comprise the largest non-Caucasian segment in the American Medical Communities. However, Indian Medical practitioners aspiring to pursue a career path in the US have to comply with certain procedural requirements to be eligible to practice in the USA.
This article shall be elaborating on various routes and methods that can help enhance Indian Medical Professionals establish themselves and prosper in the US. Read on!
Eligibility
To practice medicine in the US, a person must possess both Undergraduate and Post-Graduate degrees. In the US, Indian students cannot practice medicine directly after an Undergraduate degree because the basic eligibility to practice in the US is the completion of a post-graduate degree.
A person who is pursuing MBBS is an undergraduate from an Indian institution, a Foreign Medical Graduate, or has completed MD, aspiring to settle in the US, needs to appear for the United States Medical Licensing Exam (USMLE) to be eligible to practice medicine in the US. Another Route through which an aspirant can join the medical force in the US is to pursue a post-graduate degree in the US, instead of which various Indian graduates apply for Masters in Public Health in US Colleges. Job-seekers can also pursue a clerk-ship, or avail of medical fellowships while clearing the USMLE.
Procedure for Application
An applicant has to clear several rounds of eligibility examinations to be eligible to be registered as a medical practitioner in the USA. The broad steps involved in the procedure are as follows-
USMLE-Step-1:
An aspiring professional has to first appear for USMLE Step-1, the first part of the United States Medical Licensing Exam. It is a test to ascertain the competence of graduates in the application of concepts and theory in the medicinal sciences in practice. The exam has a pass/fail system as opposed to a cut-off system.
Eligibility: Indian doctors are eligible to appear for USMLE Step-1 after completion of 2nd year of MBBS in India. Graduates from Medical Schools outside the US shall apply through Educational Commission for Foreign Medical Graduates (ECFMG).
Nature of Examination: The first step is built in accordance with an integrated content framework that divides the material covered in basic science into two categories: systems and processes.
Pattern & Timing of Examination: The USMLE-Step-1 is a one-day test. It is given in a single 8-hour testing session and divided into seven blocks of 60 minutes each. A particular examination form may have up to 40 questions total, but no more. The entire examination form's total item count will not exceed 280.
The exam also includes a 15-minute optional instruction and a minimum break time allocation of 45 minutes. By completing a section of the optional instructional or a block of test items before the given time runs out, you can extend the amount of time available for breaks.
USMLE Step-2 (Clinical Knowledge):
Eligibility: The following category of test-takers fulfil the eligibility criteria to partake in the examination (applicable to Indian Nationals)-
- Medical Students either Enrolled in/Graduated from a Medical School outside US/Canada or further enlisted in the World Directory of Medical Schools as meeting the ECFMG eligibility requirements.
Nature of Examination: Step 2 CK evaluates a candidate's capacity to apply clinical scientific knowledge, skills, and understanding necessary for the delivery of patient care while under supervision, with a focus on health promotion and illness prevention. Step 2 CK makes sure that the fundamental patient-centred skills and clinical scientific principles that form the basis for the safe and competent practice of medicine under supervision are given the proper focus.
The pattern of Examination: The Step 2 CK test is conducted in one day. It is given in a single, 9-hour testing session and divided into eight 60-minute segments. A particular exam will have a range of question counts per block, but no more than 40. The total number of questions on the entire exam will not be more than 318.
USMLE Step-2 CS:
Eligibility: The following category of test-takers fulfil the eligibility criteria to partake in the examination (applicable to Indian Nationals)-
Medical Students either Enrolled in/Graduated from a Medical School outside US/Canada or further enlisted in the World Directory of Medical Schools as meeting the ECFMG eligibility requirements.
Status of USMLE Step-2 CS: Due to COVID-19 restrictions, the USMLE Step-2 CK was suspended since it involved demonstrations of clinical skills of applications. It is currently discontinued and is undergoing various changes in Step 2 CK passing standard, score reporting etc. It is expected to be re-introduced for test-takers soon.
USMLE Step-3:
Eligibility: All the following eligibility criteria must be fulfilled to partake in the examination (applicable to Indian Nationals)-
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Candidates who have obtained passing scores in Step-1 and Step-2 CK
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Candidates must possess an MD degree or the DO degree from an LCME- or COCA-accredited US or Canadian medical school, OR the equivalent of the MD degree from a medical school outside the US and Canada that is listed in the World Directory of Medical Schools as meeting the ECFMG eligibility requirements.
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Meet all other eligibility criteria as listed in the USMLE Bulletin of Information.
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The USMLE programme advises that applicants should have finished, or be close to finishing, at least one postgraduate training year in a recognized US graduate medical education programme that complies with state board licencing standards in order to be eligible for Step 3 Examination.
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Ineligibility: If any student attempts any of the steps 4 or more times, and could not pass, even by reason of incomplete attempts, shall be ineligible to apply for the USMLE exam sequence.
Nature of Examination: With a focus on patient management in ambulatory settings, Step 3 evaluates your ability to use medical knowledge and comprehension of biological and clinical science necessary for the unsupervised practice of medicine. It is the last test in the USMLE process that results in a licence to practise medicine unsupervised.
The pattern of Examination: The information in Step 3 is based on a data-driven model of generalist medical practice in the US. The test questions and cases simulate clinical scenarios that a general, still uneducated physician would run into in a particular medically stimulated environment.
Medical Fellowship: Educational Commission for Foreign Medical Graduates (ECFMG) is a comprehensive assessment program for the preparedness of Foreign Medical Graduates (FMG) to enter Residency or Fellowship programs in the US, which are duly accredited by the Accreditation Council for Graduate Medical Examination (ACGME).
ECFMG acts as the registration and score-reporting agency for Foreign Medical Graduates.
MPH in US Post MBBS in India:
Post the 1970s, various doctors aspired to practice medicine in the US by way of pursuing medical studies in the US by pursuing courses such as Masters in Public Health & Masters in Hospital Administration followed by seeking ‘Residency’. This is a viable alternative for those who wish to prepare for USMLE in the US while pursuing their Post-Graduate degree in order to be eligible to appear for USMLE Examination.
Which States Accept Indian Medical Degrees
All States of the United States accept Indian Medical Degrees for practice, subject to the person fulfilling the USMLE Exam Eligibility criteria and Degree Requirements.
A medical board issues medical licences on a state-by-state basis, therefore a doctor would apply to the state where they plan to practice. Every two years, licences must be renewed. Medical professionals are eligible to work independently in the United States once they have reached those milestones and have finished their residency training in a U.S. program. Thus, there is no distinction on a state-to-state basis for eligibility for Indian Medical Degrees.
Procedure for Immigration
If a student is pursuing MPH/MHA in the US, a Student Visa can be issued by the US Consulate for Indian Students pursuing Masters's programs. Generally, a Student Visa is applicable for 5 years, after which one may apply for a Residential Visa in the US by filling out Form I-485, including all supporting documents and fees. Travel Charges & Living Charges in the USA can be high, costing almost 8-10 Lakhs depending upon the needs of the person.
Income and Salaries
The USA is one of the best destinations in the world to practice medicine, providing competitive remuneration to various professionals practising in different branches of medicine. The salary, remuneration and benefits offered also depend on factors such as the designation of the professional, field and location of work, and whether the nature of work is temporary or permanent. The salary brackets in which professionals earn in different domains of practice are as follows-
Job Designation
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Salary Range Offered Annually
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Behaviour Specialist
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$ 107,000
|
Advanced Practice Provider
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$ 128,000
|
Diabetics & Endocrinology
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$ 236,000
|
Pediatric Specialist
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$ 238,000
|
Dermatologist
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$ 291,000
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Clinical Psychologist
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$ 292,000
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Ophthalmologist
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$ 366,000
|
Urology Specialist
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$ 408,000
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Cardiology Specialist
|
$ 471,000
|
Source: AECC Global
Best States for Indian Doctors:
While the compensation package offered to Indian professionals are at-par domestic packages, some states attract the bulk of medical professionals owing to their commercially attractive work environment and salaries offered. Some of the states are listed as follows-
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Florida: Healthcare professionals earn an average of more than $340,000 per annum, excluding bonuses and other incentives. Florida is also featured in the list of ‘Best Places to Practice-2022’, by Medscape.
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Texas: Owing to its low ‘Physicians Per Capita’ ratio, Texas offers remunerative benefits to the available practitioners, who earn in the range of more than $340,000 per annum.
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Connecticut & North Carolina: Healthcare professionals earn an average of more than $340,600 per annum, however, the state offers various incentives for professionals to practice in the state, such as a low cost of living, accessible public education and low-crime rates make it a complete package to reside at.
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Indiana: Ranked the 5th best state to practice medicine, working in Indiana can fetch an earning of $350,000 per annum.
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Missouri: Healthcare professionals earn an average of more than $357,000 per annum in the state of Missouri, earning it a spot in being one of the highest paying states for locum physicians, paying 118% of the median salary offered.
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Alabama and Tennessee: Fetching professionals $358,000 & $364,000 per annum, both the states are among the most fiscally stable in the US, offering vantage points for professionals to move and reside.
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Kentucky: In Kentucky, professionals earn around $ 364,000 per annum on average, being one of the highest paying states for locum physicians, earning more than 118% of the median salary offered in other states.
Source: Weatherby Healthcare
Conclusion
If one aspires for a competitive and career-rewarding job, the US is the place of choice for medical practitioners around the world, offering attractive salaries and providing various growth opportunities. That being said, care must be taken to make adequate preparation before considering an application to enter the country as the initial period may be characterized by challenges and hardships.
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