Since my med school days, some of the common questions I often receive are “What is your specialization?” “How long does it take to become a Doctor?” “When do you choose your specialization?” and “When do you start earning?”.
While people know it takes time to become a doctor, it seems like the exact process seems unclear to many. Admittedly, I never understood its entire process until I got to clerkship (Another concept that is abstract to many). Consultant? Fellow? Specialization? What do they all mean? So I thought I’ll write this as a crash course about becoming a doctor in the Philippines.
Before I go further, here are some disclaimers: 1) This is the most “conventional” career path for Filipino doctors, but this is not the only option for a graduate of a medical degree and 2) This process is specific to the Philippine setting, and it will also vary among different institutions. So use this as a general guide, and not a detailed know-how.
Step 1: Pre-Med (3-5 Years)
Congratulations, you’ve graduated senior high school, and now proceeding to college (or, if you’re planning to take up straight to medicine program, skip to the next step).
Which course you should be taking? Traditionally, allied-health courses have been considered as “pre-med courses”, such as Nursing, Biology, Medical technology, etc. That no longer is the case in the recent years, as graduating students of a BS or BA degree are eligible to take NMAT (see next step). Some of my med school batch-mates came from varying backgrounds, such as accountancy, music, Library science, etc. So pick a course that you will be passionate about (an article on this coming soon). However, if you are graduates of these non-allied health courses, make sure to check with the med school of your choice, if they will be requiring additional science units, as some do.
The length of this phase will depend on the course you’ll be taking up, the school you choose, and if you will be graduating on time (and if you don’t, that’s no big deal) which typically takes 3-5 years.
Step 2: NMAT (On your College Graduating Year)
National Medical Admission Test, a.k.a. NMAT is a test where you will be tested on subjects such as math, physics, biology, social science and reasoning. All med schools in the country requires this as a part of the application.
You will be qualified to take this exam on the graduating school year of your college. There are 2 testing dates, one on September-October and another on March-April every year. Make sure that you check with the med school of your choice in advance, as to when they will start accepting applicants, and therefore when you should be taking your NMAT. While this test is not a measure of how good of a doctor you will be, some schools are very particular with the qualification when it comes to NMAT score. So again, make sure that you have an idea on the score you should be aiming for.
Step 3: Med School (4-7 Years)
You apply for a med school and get in. Congrats! For the majority of med schools, you’ll be in med school for 4 years, wherein the first 3 years would be in a classroom, and the last year is where you will be working as a clinical clerk as part of your clinical exposure at the hospital which your med school is affiliated with.
There are med schools like Ateneo School of Medicine and Public Health (ASMPH) and University of Philippines Manila College of Medicine (UPCM), it would take 5 years for you to graduate, as they integrate post-graduate internship (see next step) into their curriculum.
If you opt for straight program (available at UP, De La Salle, and UST) on the other hand, you skip pre-med, and go into 6-7 years of med school. When you are done with your med school, you earn your degree. Yay!
Step 4: Internship (1 Year)
This is the one year of unpaid internship (with an exemption of monthly stipend provided by few hospitals) at your institution of choice, before you are qualified to take the board exam.
You will be once again exposed to the different medical specialties like back in clerkship, possibly the last time for most doctors, as a lot of them will pursue their specialization after the board exam.
For this, on your graduating year of med school, you will be applying for the internship program of your choice through Association fo Philippine Medical Colleges (APMC). For graduates of ASMPH and UP, this part is integrated as part of its 5 year program, so no need to worry about it.
This is where I am right now, as of writing.
Step 5: Philippine Licensure Examination
Aka the board exam. The exam spans over the 4 weekends on either March or September of each year. Since medical internship ends by the end of June, if opting to taking the September boards, you will have around 2 months to review. The exam comprises of two parts:
- Basic sciences: Anatomy & Histology, Biochemistry, Microbiology & Parasitology, Pathology, Pharmacology & Therapeutics, and Physiology
- Clinical sciences: Internal Medicine, Legal Medicine & Medical Jurisprudence, Obstetrics & Gynecology, Ophthalmology & Otorhinolaryngology, Pediatrics & Nutrition, Preventive Medicine & Public Health and Surgery
After passing it, you are now considered a generalist, and can start working as a doctor, and finally earn money! While you can stop here and continue your career as a generalist, most will eventually opt for specialization training.
Step 6: Residency (3-7 Years)
Also known as the specialization training. You will also start earning while at training in this phase.
The length of the training will vary between specializations with specializations such as anesthesiology, dermatology, internal medicine, and pediatrics lasting for 3 years, OB-GYN and orthopedics lasting for 4 years, general surgery lasting for 5 years, and neurosurgery lasting for 7 years (again, may vary depending on the hospital).
What residency looks like will vary vastly depending on the institution and the specialization. Factors include whether is it a public or private hospital? (Salary tends to be higher at public hospitals) Workload also tends to be more hectic (due to bigger patient load) with scarce resource available at public hospitals.
While you can stop here and start working as a specialized doctor, you can even further train for a sub-specialty.
Step 7: Fellowship (Few months – Years)
Also known as sub-specialization. This is when your field starts to sound even fancier with longer names like cardiology, pulmonology, plastic surgery, perinatology, developmental pediatrics, thoracic and cardiovasular surgery, etc.
The length of this period will vary anywhere from few months to few years. While this is (like residency) not necessary, but it will give you edge when it comes to finding a niche field that is not saturated (or you can just train for the heck of it). Some even go abroad to seek medical technologies and training.
Step 8: Consultant
After all those years of training, you are finally a specialist, and and expert in the field. Take note though that fellowship is not a necessary to become a consultant.
You will be working more as an on-call basis, without the overnight duties such as in residency and fellowship. Most will start opening clinics, work as consultants at a public and/or private hospital, and some will proceed to academe.
The Road Less Taken
While the above scenario is the most common career path for most doctors in the Philippines, you are not limited to that option. Some of the less common career paths includes but not limited to:
- General Practitioner (GP) – Non-specialized doctors who can work at variable settings from clinics, company, health centers, etc.
- Moonlighting – A part-time Doctor. You maybe hired by companies, clinics, or work at a hospital for short-term basis. This is a very attractive career path for many, since this usually pays a lot more than your typical residency, minus the stress and long work hours that come with it. Many of the board passers go for moonlighting before committing to a residency.
- Doctors to the Barrios – This used to be one of my dreams. In this 2-year program, you will be working as a GP at the different underserved and rural areas of the Philippines. This programs come with salary and a degree in masters of public health. Learn more about the program here.
- Health policies, research and other advocacies
I hope this very brief article clarifies some of the uncertainties you have about becoming a doctor here in the Philippines. If you have questions, comment them down below!