Just like the dream of passing the medical school entrance exam to obtaining the coveted diploma, becoming a doctor in the United States involves a long and rigorous process that also requires dedication, study, and planning.
To achieve this dream, it’s necessary to thoroughly understand all the steps of the process and meet a series of requirements.
For example:
Do you know what ECFMG certification is?
Do you know what Match Day is?
Do you know all the steps of the USMLE?
Do you know how to prepare for the mandatory exam?
If you don’t already have a complete Immigration Consultancy to help you with this, D4U Immigration explains everything you need to know about the process of becoming a doctor in the United States in this exclusive content. Check it out!
Requirements, Steps and Documentation: What does it take to be a doctor in the USA? (with a Brazilian diploma)
If you are currently studying or have already graduated in Medicine from a Brazilian university and wish to pursue a medical career in the United States, know that the process begins in Brazil and goes through rigorous bureaucratic steps, but they are entirely achievable and rewarding.
To practice as a doctor in the United States with a Brazilian education, it is necessary to meet the following requirements:
1. Have a Medical Degree from a Higher Education Institution accredited by CFM and recognized by WDOMS;
2. Take the (USMLE) Medical Licensing Examination;
3. Complete a Medical Residency program in the USA;
4. Apply for a State Medical License;
5. Obtain a work visa for the United States.
Below we detail each of the requirements of the process to work as a doctor in the USA.
Medical degree and preliminary assessment of the higher education institution
The first step to meet the requirements of becoming a doctor in the USA is to complete the Medical course at a Higher Education Institution accredited by the CFM (Federal Council of Medicine) in Brazil.
In addition to CFM accreditation, you should consult the World Directory of Medical Schools website (https://search.wdoms.org/) to verify if your Higher Education Institution is eligible for the USMLE (United States Medical Licensing Examination) — a multi-step exam that doctors are required to pass before being authorized to practice medicine in the United States.
To do this, simply:
1. Access the WDOMS website;
2. Select the country (in this case, Brazil);
3. Fill in the name and city of your Higher Education Institution;
4. Click on “search” to complete the search.
Tip: If you have trouble finding your university, just select the country, fill in the city and click on “Search”, as shown in the example below:
If your Educational Institution is registered on the World Directory of Medical Schools website, you can register with the ECFMG (Educational Commission for Foreign Medical Graduates) and start the exams for the diploma validation process.
When registering, there is a list of required documentation that must be sent by mail upon payment of a fee. Generally, this process takes 1 to 6 months to be validated.
After sending the documents, you must wait for the response that the documentation has been accepted to then proceed to the second stage of the process for diploma validation and medical residency in the USA.
Ensure greater practicality in the process: contact our United States immigration specialists and get a free evaluation to know if your CV is suitable for the process of becoming a doctor in the USA.
Revalidation of medical degree
To secure a position as a resident in the United States after graduating in medicine, you need to take the USMLE — United States Medical Licensing Examination.
Important: to apply and start the ECFMG process, you must have completed at least 2 years of medical school.
The process to obtain validation of your Medical degree by American authorities varies according to each state, but generally involves:
1. Online registration on the ECFMG website;
2. Payment of the Registration Fee;
3. Submission of documentation to *ECFMG;
4. Passing the USMLE (United States Medical Licensing Examination);
5. Obtaining the Foreign Medical License.
*The ECFMG Certification (Educational Commission for Foreign Medical Graduates) is an essential requirement for doctors trained outside the United States who wish to practice medicine in the country.
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To start the diploma validation process, the first step is to register online with ECFMG (Educational Commission for Foreign Medical Graduates) by paying a registration fee (currently $145).
After registering, you will receive your USMLE Number — a number that will be used throughout all stages of the process.
Then, simply send the required documents to authenticate your medical credentials.
Mandatory documentation
The full list of mandatory ECFMG documents may vary according to your specific situation, but generally includes the following items:
Medical degree: The original diploma or a certified copy of your medical degree issued by an institution recognized by WDOMS (World Directory of Medical Schools).
Academic transcript: The original academic transcript or a certified copy, with the workload and grades of all subjects taken during the medical degree.
Certificate of Completion: The original certificate or a certified copy proving the completion of the medical degree.
Medical License: If you have a license to practice medicine in your home country, send a certified copy of your license.
English Proficiency Exams: The results of an English proficiency exam, such as TOEFL, IELTS or OET, are required to demonstrate your ability to communicate in the English language at a level suitable for medical practice in the USA.
Letters of Recommendation: Two or three letters of recommendation from teachers, doctors or other professionals who can attest to your medical training, qualifications and character.
Photograph: A recent passport-size photograph.
Additional documents
In addition to the mandatory documentation, ECFMG may request some additional documents, such as:
Statement of Purpose: A written statement explaining your professional goals and why you want to practice medicine in the USA.
Curriculum Vitae (CV): A detailed curriculum vitae (in English) describing your medical training, professional experience, publications and other relevant activities.
Residency Program Acceptance Letters: If you have already been accepted into medical residency programs in the USA, please submit copies of your acceptance letters.
Other information: ECFMG may request additional documents according to your specific situation.
Curriculum adaptation
D4U Immigration offers a free CV analysis to verify if it is suitable for the immigration process to the United States, as well as job placement consulting.
Medical Licensing Examination (USMLE)
Those who wish to become doctors in the United States must take the exam and pass all stages of the USMLE.
The USMLE (United States Medical Licensing Examination) is a mandatory exam divided into 3 steps for doctors who wish to practice Medicine in the United States:
Step 1: assesses basic knowledge in medical sciences.
Step 2 Clinical Knowledge (CK): focused on clinical medical knowledge.
Step 3: tests knowledge in evidence-based medicine.
To help you know how to prepare for these stages, we detail below each of the three Steps of the USMLE.
Step 1: Basic sciences
Focus on Basic Sciences: Covers knowledge of anatomy, physiology, biochemistry, pathology, pharmacology, microbiology, immunology and human behavior.
Purpose: To assess whether the candidate has a solid foundation in the basic sciences that are essential for practicing medicine.
Format: 7 blocks of 60 minutes each, with 40 multiple-choice questions per block.
Duration: 8 hours and 45 minutes, including a 45-minute break.
Taken: Usually at the end of the second year of medical school.
Step 2 CK: Clinical knowledge and skills
Focus on Clinical Knowledge: Assesses the candidate’s ability to apply medical knowledge in real clinical situations.
Objective: To verify that the candidate has the ability to reason clinically, formulate diagnoses and make appropriate treatment decisions.
Format: 9 blocks of 60 minutes each, with 40 multiple-choice questions per block.
Duration: 9 hours, including a 45-minute break.
Carried out: Generally after completion of the third year of medical school.
Step 3: Advanced Clinical Skills
Focus on Clinical Skills: Assesses the candidate’s practical skills in a simulated clinical setting.
Purpose: To verify that the candidate possesses the interpersonal, communication and physical examination skills necessary for the practice of medicine.
Format: 16 stations of 10 minutes each, where the candidate interacts with standardized patients and performs clinical tasks.
Duration: 2 days, with a total of 160 minutes of assessments.
Taken: Usually after completion of the fourth year of medical school or during internship
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Each Step charges a fee for taking the exams. After completing the three steps, the student is directed to The Match (National Resident Matching Program), the stage where they select the hospitals where they wish to complete their medical residency and await the result.
Important: Since 2021, Step 2 CS (Clinical Skills) has been permanently discontinued due to the COVID-19 pandemic and its functions have been integrated into Step 2 CK (Clinical Knowledge). The Step 2 fees cost around $1,175 + $1,580.
For more information or to apply for the USMLE Steps, visit the website: https://www.usmle.org/step-exams/.
If you still have questions, contact the Immigration Specialists for the United States through D4U Immigration’s WhatsApp.
Medical residency and match day
To practice as a doctor in the United States, you need to complete an accredited medical residency program in the country, even if you have already completed residency in Brazil.
Important: Medical residency in the United States is valid for Brazil. The opposite is not true (because the programs have different curricular structures, durations, and requirements).
After obtaining ECFMG Certification and passing the USMLE exams, it’s time for the Residency Program selection stage. This stage includes:
Match Day: Annual resident selection process, where candidates apply to residency programs and are “matched” based on their rankings and available positions.
Requirements: Each program has its own specific requirements, such as USMLE scores, letters of recommendation, previous experience, and curriculum.
Applications: You will need to apply to various residency programs using the ERAS (Electronic Residency Application Service) system.
Interviews: Candidates selected for interviews will be invited to participate in interviews with the directors of the residency programs.
Entrepreneur (Doctor) approved for EB2-NIW – Visa to the USA
Match Day
Match Day is a crucial and exciting day for medical residency applicants in the United States, marking the moment when they find out which residency program they’ve been approved for, or “matchaed”, as applicants popularly refer to it.
How the match day works
1. Applicants and Programs: Thousands of medical residency applicants apply to various residency programs across the country, ranking them in order of preference. The programs, in turn, also rank the applicants according to their selection criteria.
2. Centralized Algorithm: A centralized algorithm, administered by the National Resident Matching Program (NRMP), analyzes the rankings of the applicants and programs and tries to find the best possible match, taking into account the preferences of both sides.
3. Results Revealed: On Match Day, usually held in March, applicants gather at their respective medical schools or designated locations, anxiously awaiting the unveiling of the results. At the same time, across the country, envelopes with the results are opened simultaneously.
4. Match or No-Match: Candidates find out which residency program they have been matched to. If the candidate is matched with their first choice, it’s a great success! If it’s not their first choice, but it’s still in one of their preferred options, it’s also a positive result. However, some applicants may not be matched with any of their choices, which means they will need to participate in the Resettlement Match process or look for other options.
With dedication, hard work and the professional support of a Complete Immigration Consultancy, you can achieve your goals and fulfill your dream of working in the medical field in this country.
State medical leave
After successfully completing medical residency in an accredited program, you can apply for a medical license to practice medicine in the state where you resided during residency.
The process of obtaining sick leave includes:
1. Applying for a License: After completing your medical residency, you can apply for a medical license in the state where you resided during your residency.
2. Additional Exams: Some states may require you to take additional exams, such as the medical jurisprudence exam (MBE) or specific exams according to your chosen specialty.
3. Background Check: The state will conduct a background check on you, including criminal history, credentials verification and an assessment of your moral fitness.
4. Approval: If you meet all the requirements, the state will issue your medical license, allowing you to practice medicine within its jurisdiction.
Work visa
Finally, the last step in how to become a doctor in the United States is to obtain a suitable work visa. The type of visa you choose depends on your individual situation, but the American EB2-NIW and H-1B visas are the most suitable for foreign medical professionals.
D4U Immigration Success Story: Doctor approved for EB2-NIW visa in 8 months – Check out the testimonial about the whole process:
EB-2 NIW visa: Everything you need to know
The EB-2 NIW visa is the easiest path for highly qualified professionals to obtain a Green Card in the USA.
D4U Immigration has numerous success cases with doctors approved for EB-2 NIW. Learn all about the EB-2 NIW American visa in our content:
EB2-NIW VISA: WHAT IT IS, HOW IT WORKS AND ITS ADVANTAGES. CHECK IT OUT!
CRITERIA FOR ELIGIBILITY FOR THE EB2-NIW VISA
EB2-NIW VISA REQUIREMENTS: FIND OUT WHAT THEY ARE AND HOW TO GET ONE
EB2-NIW DENIED: FIND OUT HOW TO PROCEED IN THIS COMPLETE GUIDE
Don’t hesitate to contact our specialists in immigration to the United States for a free analysis to see if your CV is suitable!
Glossary of acronyms and bodies
The process of becoming a doctor in the USA involves a series of specific organizations, as mentioned in this exclusive D4U Immigration content.
We list below the main acronyms and what they refer to:
ECFMG (Educational Commission for Foreign Medical Graduates): American organization responsible for validating medical diplomas through the evaluation of qualifications of foreign doctors who wish to practice medicine in the United States.
ECFMG ID: Registration Number created from the registration on the ECFMG website. It is through this number that you are identified on the platform.
WDOMS (World Directory of Medical Schools): World Directory of Medical Schools (a kind of list of all medical schools around the world).
USMLE (United States Medical Licensing Examination): Mandatory exam to obtain a medical license in any state in the USA. Administered by the Federation of State Medical Boards (FSMB), the exam is conducted in 3 stages (or steps, as they are called) that doctors wishing to practice in the United States must complete.
TOEFL: Test of English as a Foreign Language.
IELTS: International English Language Testing System.
OET: Occupational English Test.
Acronyms and/or organizations not mentioned in the content, but which correspond to the process of becoming a doctor in the United States:
Sponsor Notes: Recognition that the Higher Education Institution receives when meeting certain criteria required by ECFMG. In other words: the Sponsor Note is what makes your college recognized in the United States. Without this recognition, you cannot take the USMLE steps or even compete for medical residency positions in the United States and Canada.
IES (Higher Education Institution): Corresponding to a university center, college, university, or any higher education institution eligible for the diploma validation process.
IMG: acronym for “International Medical Graduate” (previously known as foreign medical graduate), which refers to doctors trained at a medical school outside the country where they intend to practice. The term is commonly used to refer to individuals trained in medicine outside the United States, Puerto Rico, or Canada.
For more information on how to become a doctor in the USA, check out all the services of D4U Immigration, the complete Immigration Advisory that helps you get closer to your dream!
Main questions about becoming a doctor in the United States
Despite this Complete D4U Guide for those who want to know how to become a doctor in the United States, the complexity of the process may still generate some questions.
Therefore, we have selected the main questions from our clients on the subject and listed them below:
I’m a doctor in Brazil. Can I work in the USA?
To practice as a doctor in the United States with a degree in Medicine from Brazil, it is necessary to meet all the stages of the diploma validation process outlined in this exclusive D4U Immigration content.
In summary, to practice as a doctor in the United States with a Brazilian diploma, it is necessary to complete the Medical course at an accredited university recognized by WDOMS, register with ECFMG, take the mandatory USMLE exams upon payment of fees, complete medical residency in the United States, and secure an appropriate American visa.
Is it possible to become a doctor in the USA without residency?
The answer is yes. Since 2024, it is possible to practice as a doctor in the USA without necessarily completing a medical residency in the country. However, this condition is only valid for the states of Tennessee and Alabama.
In May 2023, the state of Tennessee approved law HB 1312, which grants provisional licenses to international medical graduates to practice without the need for medical residency in the country.
Also in May of the same year, Governor Kay Ivey signed a law allowing licensed physicians from other states to practice medicine in Alabama without the need to obtain a full state license.
However, it’s important to note that both cases are exceptions and specific conditions must be met.
Important: In Tennessee’s case, the program is only available for physicians in certain specialties, such as radiology, pathology, and anesthesiology.
Finally, it’s worth mentioning that even with the new laws, medical residency is still the most common path to becoming a doctor in the USA.
Is it worth becoming a doctor in the USA?
Living the American dream in the land of opportunity can bring various advantages and benefits to the professional careers of Brazilian doctors.
The 5 main advantages of being a doctor in the USA are:
1. High salary and good quality of life
2. Professional recognition and prestige (plus the possibility of working in renowned medical centers)
3. Research and innovation opportunities
4. High demand for professionals
5. Diversity of specialties
Check out below the map of salaries for doctors in the United States (in each state) according to The Economist website:
How long does it take to become a doctor in the USA?
The total time to become a licensed physician in the USA for an international student can vary significantly, depending on various factors such as academic background, country of origin, exam performance, choice of specialty, and other variables.
In general, the process can take between 11 and 17 years or more:
1. Medical degree: 4 years
2. USMLE exams: 2 to 5 years
3. Obtaining ECFMG Certification: 1 year
4. Medical Residency: 3 to 7 years
5. Obtaining a Medical License: 3 to 6 months on average
6. Work Visa (optional): 3 to 8 months, depending on the situation
Unrecognized diploma: What to do?
If your university is not accredited by international medical bodies, your degree will not be recognized in the United States. This means that you will not be able to obtain a medical license to practice in the country.
Alternatives:
Retake your medical degree: One option would be to retake your medical degree at an accredited school in the USA or in another country that recognizes your current degree.
Complementary programs: In some cases, it may be possible to complete complementary medical training programs at American universities, which would allow you to obtain a license to practice in the country.
Other areas: You can also explore opportunities in other areas of health that do not require a medical license, such as research, administration or health education.
For more information about becoming a doctor in the United States, contact the immigration experts at D4U Immigration.
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