An Introduction to Healthcare Educational Pathways
- Megan Helm
- 1 day ago
- 11 min read
Many students go into college and graduate school often unsure of exactly what they want to do. Especially for those who want to go into medicine, it can be really difficult to choose between the dozens of specialties and career pathways available. In this article, I hope to educate you on some common medical pathways taken by people and inspire you to pursue a career in healthcare.
Below, there are seven sections, each describing a different career pathway in healthcare. For your convenience for navigation, the sections are hyperlinked and ordered like so:
Medical School
When you hear the word healthcare, the first thought that will come to your mind is likely an image of a doctor in a white lab coat. But how does someone actually get to this role?
The first step to becoming a doctor requires you to complete a four-year undergraduate degree. As an undergraduate, you can major in anything you want as long as you complete all of the prerequisites and required courses for medical school. For example, someone could major in something like English and have just as good of a chance at medical school as someone who majored in biology. However, some of the common majors chosen by pre-med students often include chemistry, physics, biology, biochemistry, psychology, neuroscience, kinesiology, and sociology.
In order to become a doctor, you will also be required to take the MCAT (Medical College Admission Test). This is typically taken during the spring of your junior year of undergrad. It is a standardized test that is used to assess your preparedness for medical school by measuring your knowledge in areas like psychology, sociology, biology, chemistry, and physics. The MCAT score you get, as well as your GPA, play a significant role in your admission to medical school.
Once you get into medical school, you will be there for four years. Medical school typically consists of two years of preclinical education. Much of your time during these two years will be spent attending lectures and labs where you learn about pharmacology, anatomy, and biochemistry. The other two years of medical school involve clinical rotations where you rotate through a variety of medical specialties and get to work alongside doctors, residents, and other healthcare providers. This allows students to practice skills, learn from doctors, and determine what specialty they want to pursue.
There are two options for what you can pursue in medical school: you can either become a MD or a DO. Both MDs and DOs are licensed physicians and can perform the same patient care tasks. However, DOs spend about 200 hours receiving training in Osteopathic Manipulative Medicine, which gives them a more holistic approach to medicine where they have a greater focus on prevention and use their hands more (like a chiropractor would). On the other hand, MDs are more focused on diagnosing and treating diseases because they follow the allopathic model. MDs and DOs also have to take different certification exams to become doctors.
To become an MD, you will be required to take USMLE Steps 1-3 exams. Most students take the USMLE Step 1 exam after their second year of medical school, and it is an assessment of science concepts from fields like biochemistry, anatomy, pathophysiology, and pharmacology. This exam lasts about 8 hours and consists of about 280 multiple choice questions. It is graded on a pass/fail basis, requiring you to get about 60% of the questions correct to pass. During your third or fourth year of medical school, you will take the USMLE Step 2 exam. This exam is very important when applying to residency programs because you get a numerical, measurable score from it. It is a 9-hour computerized exam that tests students on applying their medical and clinical knowledge to real-world scenarios. Once you are in your first year of a residency program, you will then take the USMLE Step 3 exam, which is required for you to earn your medical license. It is a two-day computerized exam that tests you on clinical medicine. This exam is known to have a very high pass rate of around 96%
The exams required to become a DO, known as the COMLEX-USA Levels 1-3 exams, are quite similar to the USMLE exams required to become an MD. The COMLEX-USA Level 1 exam is typically taken after your second year of medical school, and it is a one-day computerized exam. The test focuses on clinical applications, biomedical sciences, and Osteopathic Manipulative Medicine (12-20% of the test). Similar to the USMLE Step 1 exam, the COMLEX-USA Level 1 exam is graded on a pass/fail scale. During your third or fourth year of medical school, you will take the COMLEX-USA Level 2 exam, a one-day computerized test where you are tested on medical decision-making and clinical knowledge. This exam is important when applying to residency programs because it gives you a numerical, measurable score. When you are in your first year of residency, you will take the COMLEX-USA Level 3 exam, which is what allows you to become licensed as a medical provider. While the COMLEX-USA exams are very similar to the USMLE exams, there is a much greater focus on Osteopathic Manipulative Medicine.
During the summer and fall of your fourth year of medical school, you will begin to apply to residency programs. After programs review your application, you might progress to the next stage where you will be interviewed. These interviews are a very important part of the application process as they are used to assess your interpersonal skills and match for the program. Once you complete your interviews, programs will rank applicants and you will rank your preferences for which program you want to attend. In March, there is a day known as Match Day where you will find out which program you will be attending for residency.
Residencies are 3-7 year programs where doctors work under the supervision of attending physicians to gain experience through hands-on training. During residency, doctors work full-time (between 40 and 80 hours a week) and are paid for their work. Throughout the course of residency, doctors begin to gain a lot more autonomy in their work as they become more skilled in their practice. Once they complete their residency, most doctors take the board certification exam as soon as possible (while their memory is still fresh). These are one-day computerized exams that test doctors on things like medical knowledge, interpersonal skills, professionalism, and procedural/patient care skills. Once doctors pass this exam, they can officially practice medicine independently. There are also opportunities for doctors to continue learning about their field by completing a 1-3 year fellowship in a subspecialty like oncology, orthopedic surgery, or infectious disease. These fellowships allow doctors to learn under senior faculty and gain clinical or research experience to become an expert in a focused specialty.
Nursing School
There are many different types of nurses that you can become, but the main three are licensed practical nurses (LPNs), registered nurses (RNs), or advanced practice registered nurses (APRNs). Below, I will explain some similarities and differences in the roles of these nurses and the education required for each of these jobs.
One kind of nurse is a licensed practical nurse (LPN). LPNs work under the guidance of healthcare providers like doctors and registered nurses. They assist with basic patient care tasks like monitoring vitals, administering medications, and helping patients with daily living needs. Additionally, LPNs have the flexibility to work in a variety of settings, such as hospitals, nursing homes, and even in schools. To become an LPN, one must have a high school diploma, complete a one-year practical nursing program, and pass the NCLEX-PN exam to become licensed.
Registered nurses conduct physical examinations, collect samples for lab work (such as blood tests), administer medications and vaccinations, care for wounds, record medical histories, check on patients by monitoring medical equipment, and provide emotional support to patients and their families. They are often working alongside other medical providers and doctors. To become a registered nurse (RN), one can either complete a two-year associate’s degree in nursing or a four-year bachelor’s degree of science in nursing. While completing a bachelor’s degree can be a little more expensive and time-consuming, it also allows RNs to have better job and leadership opportunities. After completing a degree in nursing, one must then pass the NCLEX-RN exam to officially become licensed as an RN.
The last kind of nurse is an advanced practice registered nurse (APRN). There are four main types of APRNs: nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), certified nurse midwives (CNMs), and clinical nurse specialists (CNSs). All of these nurses are very highly trained in their specialty, and they often provide advanced care with complete autonomy (meaning they are not working under other healthcare providers). To become an APRN, one must first become a registered nurse. Then, they must earn a master’s or doctor of nursing practice degree. After graduation, APRNs have to pass a board certification exam to become licensed to practice.
Physician Assistant (PA) School
Physician assistants (PAs) work closely with physicians in a variety of medical settings. They perform a multitude of tasks, such as performing physical exams, taking medical histories, creating treatment plans, prescribing medication, diagnosing illnesses and diseases, ordering and interpreting labs, and even assisting in surgery.
To become a PA, one must first earn their undergraduate degree. Similar to aspiring doctors, those who hope to become PAs can truly major in anything they desire as long as they complete the prerequisites for PA school. Many PA schools require students to have taken the GRE (Graduate Record Examination) or Casper exams during their undergraduate years. When applying to PA schools, the scores from these exams, as well as one’s GPA, play an important role in their admission to these schools. These PA schools also have a big emphasis on getting clinical hours during undergrad, with most successful applicants having gotten around 3,000 hours. Shadowing doctors is also highly recommended to get into these programs.
Once you get into PA school, there are two parts to the education system. One of the parts is the didactic phase, which is in-class and laboratory instruction in areas like clinical medicine, clinical diagnosis, pharmacology, medical ethics, pathophysiology, and behavioral science. This didactic phase typically lasts around 12-15 months. The next 12 months of PA school is dedicated to clinical studies. During this time, students will complete about 2,000 hours of clinical rotations in a variety of different specialties. Some of the major specialties covered are family medicine, internal medicine, pediatrics, psychiatry, general surgery, emergency medicine, and obstetrics and gynecology (women's health).
After PA school, students must pass an exam known as the PANCE (Physician Assistant National Certifying Exam) to become certified to practice as PAs. Every two years, PAs must complete 100 hours of Continuing Medical Education (CME) in order to maintain their certification. Every 10 years, they must pass the recertification exam known as the PANRE.
Physical Therapy (PT) School
Physical therapists (PTs) are experts in mobility, and they help patients to lessen their pain and regain movement. PTs can work in a variety of areas including orthopedic, neurological, and specialized care. On the orthopedics side, PTs help patients recover from sports injuries, regain mobility after surgery, and lessen pain in the back and neck. PTs can also work on the neurological side by helping patients with conditions such as Parkinson’s. Lastly, PTs can provide specialized care to patients, such as by helping older individuals improve their balance to prevent them from falling as frequently. PTs can work in a wide variety of settings, such as hospitals, schools, in-home health, and nursing homes. Before treating patients, PTs read through their medical histories and create treatment plans for them. While treating patients, PTs guide patients through therapeutic exercises by using hands-on techniques. This helps patients to regain mobility and increase their strength. PTs also dedicate a significant amount of time towards educating their patients and helping them to prevent future injury.
To become a PT, one must first complete an undergraduate degree. Similar to many other medical professions, you can truly major in anything as long as you complete the prerequisites for the PT programs you are applying for. However, many aspiring PTs major in things like kinesiology, exercise science, biology, and psychology. Many PT programs also require that students have taken the GRE (Graduate Record Examination) during their undergraduate years. Some other important prerequisites for PT school are having a good GPA and having accumulated about 40-100 hours of clinical shadowing under a PT.
After undergrad, aspiring PTs will attend a three-year Doctor of Physical Therapy Program (DPT). About 80% of this program is dedicated to didactic classroom and laboratory studies where students will learn about neuroscience, behavioral sciences, pharmacology, and biomechanics. The remainder of the program is focused on clinical studies, with students spending about 22-27 weeks completing clinical rotations. Once students graduate from their PT program, they must pass the National Physical Therapy Examination (NPTE) to become licensed to practice medicine.
Some PTs also decide to continue their education by completing a one-year fellowship or residency. This gives them additional training in a specific specialty such as orthopedics, pediatrics, or sports medicine. Moreover, a majority of states require PTs to complete additional training and educational credits throughout their career to maintain their medical license.
EMT/Paramedic School
EMTs and paramedics are the healthcare providers that ride in ambulances and respond to 911 calls for medical emergencies. When these healthcare providers arrive at the scene where the patient needs help, they begin by examining the person to determine what is happening and how they can best help them. On the ride to the hospital, EMTs and paramedics monitor the patient and communicate with staff at the hospital. EMTs are only permitted to perform non-invasive procedures, meaning that they are doing things like bandaging wounds and using simple airway devices. On the other hand, paramedics are certified to use invasive techniques to treat patients. For example, paramedics often intubate patients, put patients on IVs, interpret EKGs, and perform advanced life support.
To become an EMT, one must first graduate from high school. Afterwards, they must complete an EMT certification program, which lasts about 3-4 months and teaches students about how to perform emergency care to patients. This includes learning how to do things such as CPR, trauma treatment, and airway management. After EMT school, one must pass the National Registry of Emergency Medical Technicians (NREMT) exam to become licensed to practice medicine as an EMT.
The first prerequisite to becoming a paramedic is having an EMT certification, which is why many people who are EMTs eventually become paramedics. To become a paramedic, one must complete a 1-2 year paramedic program. These programs can often be found at your local community college, and you will typically earn an associate’s degree in Emergency Medical Services during this time. Paramedic programs have a focus on both in-class instruction as well as time dedicated to getting hands-on clinical experience through internships and shadowing. After one completes their paramedic program, they must pass the National Registry Paramedic exam, which is how they become certified to practice medicine.
Pharmacy School
Pharmacists review the medications prescribed by doctors and dispense them to patients. As a result, they are required to know a lot about how certain drugs work and their effects on the body. Additionally, pharmacists can give people immunization shots, conduct health screening, and advise patients on when to take their medication and its potential side effects.
The first step to becoming a pharmacist is attending college and completing the required prerequisites to get into a pharmacy program. While not all programs require applicants to have completed a full bachelor’s degree, it is highly recommended that you do. During undergrad, many people often major in science subjects like biology or chemistry.
After college, you must go to a pharmacy school to earn your Doctor of Pharmacy (PharmD) degree. These programs are typically four years long, and you typically complete a significant amount of clinical hours during this time. To become licensed to practice as a pharmacist, you must complete around 1,500 to 2,000 clinical hours. However, most of these hours are done during your time in pharmacy school. Additionally, you have to pass the NAPLEX exam (covers general pharmacy knowledge) and the MJPE exam (tests you on state and federal pharmacy laws).
Some pharmacists also decide to continue their education by attending an optional 1-2 year residency program. This allows pharmacists to specialize in areas like radiology, oncology, or clinical pharmacy in hospitals.
Dental School
Dental school is often compared to medical school for its difficulty, length, and similar educational requirements. The first step to becoming a dentist is completing a four-year undergraduate degree. During undergrad, you can truly major in anything you desire as long as you complete the required courses and prerequisites for dental school. Most people earn a bachelor’s degree in science fields like biology and chemistry as they cover the majority of prerequisite courses for dental school like anatomy and physiology. During your junior year of undergrad, you will also have to take the Dental Admission Test (DAT), which is required to become admitted into dental school.
Dental school is a four-year program with a focus on classroom and laboratory studies during the first two years, followed by clinical rotations during the last two years. Once students graduate from dental school, they will either graduate with a Doctor of Dental Surgery (DDS) or a Doctor of Dental Medicine (DMD). To become licensed to practice as a dentist, one must first pass the Integrated National Board Dental Examination (INBDE), which tests examinees on behavioral, clinical, and biomedical studies. Additionally, one must pass a certification exam (skills test on patients or mannequins) and state-specific jurisprudence exam about laws and ethics.
If a dental student hopes to specialize in a field like orthodontics or oral surgery, they must complete a 1-6 year residency.