A medical degree is a professional graduate degree that qualifies you to practice medicine as a licensed physician. In the United States, it comes in two forms: the Doctor of Medicine (MD) and the Doctor of Osteopathic Medicine (DO). Both require four years of medical school after completing a bachelor’s degree, followed by three to seven years of residency training before you can practice independently. The full path from college freshman to practicing doctor takes a minimum of 11 years.
MD vs. DO: Two Types of Medical Degrees
The U.S. has two recognized medical degrees. The MD (Doctor of Medicine) is the more widely known, while the DO (Doctor of Osteopathic Medicine) places additional emphasis on the musculoskeletal system and a whole-body approach to treatment. In practice, the differences are smaller than most people assume. Application requirements for MD and DO programs are virtually the same, and the curriculum is largely the same: students typically spend the first 12 to 24 months in the classroom and the rest of their training in clinical settings.
Both MD and DO graduates can practice in any medical specialty, prescribe medications, and perform surgery. The licensing exams differ slightly. MD students take the United States Medical Licensing Examination (USMLE), while DO students take the Comprehensive Osteopathic Medical Licensing Examination (COMLEX). DO students can also choose to take the USMLE if they wish. After residency, both hold the same practicing privileges.
How Medical Degrees Work Outside the U.S.
In most countries outside North America, the standard medical degree is the MBBS (Bachelor of Medicine, Bachelor of Surgery) or a local equivalent. The biggest structural difference is timing: MBBS programs accept students straight out of secondary school, and the degree takes five to six years, combining classroom study with clinical rotations and a year-long internship. The North American MD, by contrast, is a graduate-entry degree that requires a completed bachelor’s degree first, making the total educational timeline roughly eight years from the start of college.
Both pathways produce fully licensed physicians. International medical graduates who want to practice in the U.S. must pass the USMLE and complete a U.S. residency program, regardless of where they earned their degree.
Prerequisites Before Medical School
Before applying to medical school, you need a bachelor’s degree with specific prerequisite courses. Most programs require:
- Biology: One year with lab, covering cell biology, genetics, molecular biology, and physiology
- General chemistry: One year with lab
- Organic chemistry: One year with lab (some schools accept biochemistry in place of the second semester)
- Biochemistry: Frequently required or strongly recommended
- Physics: One year with lab
- English or composition: One year of writing-intensive coursework
- Mathematics or statistics: One year, often specifying calculus or biostatistics
- Behavioral sciences: Coursework in psychology or sociology
Your major doesn’t technically matter. English majors get accepted alongside biology majors, as long as the prerequisite courses are completed. Medical schools weigh your undergraduate GPA and your MCAT (Medical College Admission Test) score heavily. Policies on AP credit, online courses, and community college credits vary significantly from school to school, so checking individual requirements is important.
What Four Years of Medical School Look Like
Medical school is divided into two distinct phases. The first one to two years focus on foundational sciences: anatomy, physiology, pharmacology, pathology, and the biological basis of disease. You learn how the body works and what goes wrong. At some schools, like Duke, this basic science phase is compressed into a single intensive year that integrates clinical context from the start.
The second phase shifts to clinical clerkships, often called rotations. You spend weeks at a time working in different departments: internal medicine, surgery, pediatrics, psychiatry, obstetrics, and others. This is where you see patients under supervision, learn to take histories, perform physical exams, and begin making clinical decisions. Third and fourth year students also complete elective rotations in specialties they’re considering for their career, and many programs include time for research.
Throughout medical school, you sit for licensing exams in stages. The first round tests your science knowledge (typically after year two), and the second tests your clinical skills and decision-making (during the clinical years). These scores play a significant role in which residency programs you can match into.
Residency: Training After the Degree
Earning your MD or DO is not the end of training. Every physician must complete a residency, a period of supervised, hands-on training in a specific specialty. You are paid during residency, though modestly relative to the hours worked.
Residency length depends entirely on your chosen specialty. Family medicine, internal medicine, and pediatrics each require three years. General surgery requires five. Subspecialties like cardiology or gastroenterology add one to three more years of fellowship training on top of that. A neurosurgeon, for example, may train for seven years after medical school.
The total timeline from starting college to independent practice ranges from about 11 years for a primary care physician to 15 or more years for a surgical subspecialist.
Cost and Debt
Medical school is among the most expensive graduate programs in the country. Annual tuition and fees range from about $40,000 to nearly $75,000, and the total cost of attendance (including living expenses) can exceed $80,000 per year. Nationally, the median education debt for medical students who graduated in 2025 was $220,000, with $200,000 of that coming from medical school alone. About one-third of students at some institutions graduate debt-free, often through family support, military scholarships, or school-specific aid.
That debt load shapes early career decisions for many physicians. Loan repayment programs exist through the military, the National Health Service Corps, and some state programs, typically in exchange for practicing in underserved areas for a set number of years.
Career Outlook and Compensation
Physician compensation varies dramatically by specialty. According to Doximity’s 2024 compensation report, surgical and procedural specialties pay the most. Neurosurgeons average about $764,000 per year, thoracic surgeons around $721,000, and orthopedic surgeons roughly $655,000. On the other end, family medicine physicians average about $301,000, internal medicine physicians around $313,000, and pediatricians approximately $260,000.
The job market for physicians remains strong. The AAMC projects ongoing physician shortages through at least 2036, driven by an aging population, physician retirements, and growing demand for healthcare services. Primary care and rural medicine face the most acute shortages, but the gap extends across many specialties. For someone completing a medical degree today, employment prospects are essentially guaranteed, though the specific location and specialty you choose will shape how competitive your options are.