potentialsurgeon
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Hello, I am a year 12 student, studying A-level Chemistry, Biology, and Physics. I have started this discussion because I need some help. In the future (preferably after university) I would like to emigrate to the states to become a neurosurgery resident.

I have looked online for steps or for information on how to do this, but many of the articles that I have read don't explain things well or are really confusing. I was wondering if anyone here could maybe give me some advice?
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ecolier
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(Original post by potentialsurgeon)
... In the future (preferably after university) I would like to emigrate to the states to become a neurosurgery resident....
My advice is always study where you want to work.

Study Medicine in the US is expensive and (potentially) complicated - Medicine there is a post-graduate course; which means you have to do bachelor's degree first.

You can study here and then move to the US to practise - but you'll have to take the USMLE. There are plenty of threads on TSR about that. The long and short of it? It's not easy at all. And you'll need a really, really good score to train in neurosurgery in the US.

The US is not that accepting of international medical graduates - hence my point: study where you want to work. They have lots of IMGs, but they usually end up working in the not-so-competitive specialties like Family Medicine. I suppose you can always try to be the exception, if you work really hard.

Finally, you are way, way too early to think about a specialty.
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potentialsurgeon
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(Original post by ecolier)
My advice is always study where you want to work.

Study Medicine in the US is expensive and (potentially) complicated - Medicine there is a post-graduate course; which means you have to do bachelor's degree first.

You can study here and then move to the US to practise - but you'll have to take the USMLE. There are plenty of threads on TSR about that. The long and short of it? It's not easy at all. And you'll need a really, really good score to train in neurosurgery in the US.

The US is not that accepting of international medical graduates - hence my point: study where you want to work. They have lots of IMGs, but they usually end up working in the not-so-competitive specialties like Family Medicine. I suppose you can always try to be the exception, if you work really hard.

Finally, you are way, way too early to think about a specialty. I just shake my head everytime I see someone wanting to be a neurosurgeon in Year 10, 11, 12 or 13.
Alright, I understand where you are a coming from. But then there is this question, how does one even apply to study in the states as a pre-med? I have also researched this online but had my brain fried because the way people write those articles is laughable.
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ecolier
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(Original post by potentialsurgeon)
Alright, I understand where you are a coming from. But then there is this question, how does one even apply to study in the states as a pre-med? I have also researched this online but had my brain fried because the way people write those articles is laughable.
I don't know if these articles help, but have a look.

https://www.thestudentroom.co.uk/wik...ine_in_the_USA

https://www.themedicportal.com/appli...ne-in-the-usa/
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artful_lounger
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(Original post by potentialsurgeon)
Alright, I understand where you are a coming from. But then there is this question, how does one even apply to study in the states as a pre-med? I have also researched this online but had my brain fried because the way people write those articles is laughable.
You have to do an undergraduate degree before you apply to medicine, in exactly the same way that you can't apply to a PhD programme as a school leaver here. To begin with, for terminology, college refers to university level study in the US in general, however university usually refers to a specific type of college, namely a research based institution that offers 4 year bachelors programmes, as compared to liberal arts colleges which are not research based and community colleges which normally offer 2 year associates degree programmes.

Applications to US colleges are normally made directly to the college in question, although increasingly many now use the CommonApp, a format somewhat like UCAS. However, there is no restriction on how many colleges you wish to apply to in theory - however, you need to pay an application fee for each college you apply to, set by and paid to the colleges (via the CommonApp for those that use it). As such in practice it's usually prohibitively expensive to apply to more than about 5 anyway (application fees are usually around $50-100 per college).

Unlike in the UK, you don't apply to a specific degree programme; you are just apply to the college "at large", so to speak. You will then declare your major usually in your second year, which is essentially then what your degree is in. There are some exceptions, usually for prospective engineering majors and sometimes for people who want to major in the business school - these sometimes require you to specify what you want to major in initially (and you may be admitted to the college but not the major, although usually you can attempt to apply to the major again after you start), and sometimes have prerequisites like UK degrees.

US degree structure/format and pre-med requirements:

Spoiler:
Show


The reason you don't apply to a specific major is because the first two years are largely taken up with taking classes (i.e. modules) to fulfill the "general education" requirements for your particular college, as well as any prerequisite classes for your major. Gen ed reqs vary widely but generally you'll probably need to take at least one science class (often with lab), a social science, a humanities and/or creative arts class, a math or sometimes computing class (usually calculus), along with usually an academic writing class, attaining some minimal level of language competency (usually equivalent to two semesters of the language if you started from scratch at college) and sometimes some kind of seminar class. This is a fairly minimal example, usually you end up being required to take 2 or more in each of those areas (where usually you will take 4 such classes per semester).

"Pre-med" is not (normally) a major in the US. It's a series of classes would be medical students need to take to meet the admissions requirements of (most) medical schools - also the content of these classes is tested in the MCAT, which is also required by (most) medical schools in the US. The usual minimal requirement is two semesters each of general biology, chemistry, and physics, plus two semesters of organic chemistry, all with labs, or equivalent. For colleges where their offerings fit that pattern you normally take four classes per semester, so that's usually half of your studies for two years. They also normally expect you to have taken appropriate "college writing" classes (this is normally part of the gen ed/graduation requirements anyway).

Many medical schools have additional requirements; some modify the standard core pre-med requirements from above to fit these in, others just expect you to take them on top of it. For example, it's very common now that medical schools require one semester of biochemistry; sometimes this is acceptable in place of a second semester of organic chemistry. Likewise it's quite common for one or two semesters of math classes to be taken; usually this is one semester of calculus and one semester of probability/statistics; essentially, they expect you to have covered single variable calculus and had an introduction to probability and statistics.

However some of the pre-med requirements can be met with advanced placement credit (although usually the core science classes can't be, or they expect you to take a further more advanced class such that you still take the same number of science classes as a premed). Students applying to US colleges can, if they have taken AP exams, the IB diploma, or A-levels, get advanced placement and/or credit for the material they have covered so far. This is usually contingent on getting a particular grade/score in those exams (e.g. a 7 in IB HL Physics might place you out of the first semester of college physics).




Finance and how US colleges look at applications:
Spoiler:
Show

Circling back to application considerations, there is the important consideration of finance. You will not be funded by Student Finance England to study in the US. US college study is extremely expensive for international students (in fact, even for US citizens if they are applying to private colleges or out of state colleges). There is extremely limited funding in general for international students, and very limited offerings in terms of scholarships, which are very competitive. Most scholarships international students are eligible for are sports scholarships, and if you are not competing on at least a county if not national/international level you will almost certainly not be eligible for them.

A few colleges in the US are what is known as "need-blind" - these admit students without considering their financial need, and then they will fund any difference in their calculated financial need. The need-blind colleges are the most competitive colleges in the US, and are in fact Harvard and it's ilk. Bear in mind last year Harvard's acceptance rate was 5% - by comparison the most competitive course at Cambridge last year was Computer Science, with an acceptance rate of 11%. The average acceptance rate for Cambridge is about 20%. Also, the way "financial need" is calculated can still leave you out of pocket, because they will calculate that your family will contribute a certain amount based on their income, which is very often more than the average family can afford to pay out.

More generally, the way admissions are assessed in the US are very different to the UK. Essentially, your academics are only one small part of the picture - extracurricular activities are not only encouraged, but realistically required for admission to a good college. Crucially as well, to be competitive to the "elite" colleges (e.g. all the need-blind colleges), they are looking for you to be engaged in your extracurricular activities directly. That is, holding leadership roles, having started new clubs and activities from the ground up and raised them into actual prominence in some sense, competing on a county level for sports, captaining sports teams, etc. If you are mainly turning up to your ECs and just doing whatever it is, without directly being involved in improving, expanding, developing etc, that activity/club/team, that doesn't count for much. This contrasts with the UK, where the primary focus is on your academic performance, especially for Oxbridge where they only care about your academics that are directly relevant to the subject you're studying, and any activity outside of that is irrelevant as far as they are concerned.


About right to work in the US:
Spoiler:
Show




Revisiting ecoliers point about IMGs, although I am not 100% certain if this is the explanation for the difference, in general one major difficulty for people looking to work in the US as graduates is due to the requirements an employer must meet to support a visa application. Essentially, as I understand it, any job in the US can only sponsor an international applicant for a visa if they can prove there are no other better qualified US citizens/green card holders applying for the job. Thus, for the more "high powered" jobs (e.g. major law firms, investment banks, and, I believe, competitive medical specialties), they will have many very highly qualified US applicants already - so you need to as a minimum you need to be better than any US person applying to that job, and then you need to also beat out any other highly qualified international applicants.



Last edited by artful_lounger; 1 year ago
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ecolier
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(Original post by artful_lounger)
...Revisiting ecoliers point about IMGs, although I am not 100% certain if this is the explanation for the difference, in general one major difficulty for people looking to work in the US as graduates is due to the requirements an employer must meet to support a visa application. Essentially, as I understand it, any job in the US can only sponsor an international applicant for a visa if they can prove there are no other better qualified US citizens/green card holders applying for the job. Thus, for the more "high powered" jobs (e.g. major law firms, investment banks, and, I believe, competitive medical specialties), they will have many very highly qualified US applicants already - so you need to as a minimum you need to be better than any US person applying to that job, and then you need to also beat out any other highly qualified international applicants...
:ta: for this.

I will regurgitate this the next time this Q is asked (probably in the next few days!!).
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artful_lounger
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(Original post by ecolier)
:ta: for this.

I will regurgitate this the next time this Q is asked (probably in the next few days!!).
Thank you!

I edited in some spoilers to make the whole post a little less of a terrifying wall of text, and also break it up into semi-discrete topics, if that helps (the bit you quoted is still the last one) xD
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