How to become a doctor

1. 1Earn a bachelor's degree with premed courses

   Time: 4 yearsCost: Undergraduate tuitionSources 1

   Any major works; medical schools look at whether you finished the required sciences: biology, general and organic chemistry, biochemistry and physics, along with math, English and social science. Grades in those courses matter a great deal. Schools also want evidence that you understand medicine, so clinical volunteering, shadowing physicians and research all strengthen an application. Some universities offer combined bachelor's-MD programs of 6 to 8 years that admit students straight from high school.

2. 2Take the MCAT and apply to medical school

   Time: About 1 year (one application cycle)Cost: $360 MCAT fee plus application feesSources 3, 1, 7, 8, 15

   The MCAT standard registration fee is $360, or $145 through the AAMC Fee Assistance Program. The AAMC suggests taking it in the calendar year before you hope to start medical school, which for students going straight from college means junior year. Applications include transcripts, MCAT scores, recommendation letters and essays, followed by interviews. Choose between MD schools, accredited by the LCME, and DO schools, accredited by the COCA; many applicants apply to both. Admission is highly competitive, and many people apply more than once.

3. 3Complete medical school and the first licensing exams

   Time: 4 yearsCost: About $47,525-$63,935/yr at UNMCSources 1, 4, 5, 9, 6

   The first phase is classroom and lab work in anatomy, physiology, pharmacology and clinical skills; the second is clinical rotations in internal medicine, surgery, pediatrics, psychiatry and other fields. MD students take USMLE Step 1, which has been pass/fail since January 26, 2022, and Step 2 CK, each $695 in 2026. DO students take COMLEX-USA Level 1 and Level 2-CE, which are graduation requirements.

4. 4Match into a residency

   Time: Final year of medical schoolCost: Application and interview costsSources 11, 12

   In your last year you apply to residency programs in your chosen specialty, interview, and rank the programs you want. The National Resident Matching Program's Main Residency Match pairs applicants and programs using an algorithm, and results determine where you train. Since June 30, 2020, all MD and DO residencies have been accredited by the ACGME, so both degree types compete for the same positions. Competition varies a lot by specialty.

5. 5Finish residency and get licensed

   Time: 3-9 years, depending on specialtyCost: Residents are paid a salarySources 1, 9, 2

   Residency is paid, supervised training in hospitals and clinics, with long hours and overnight call. BLS puts it at 3 to 9 years depending on specialty; primary care is at the short end and surgical fields at the long end. You take USMLE Step 3 or COMLEX Level 3 during residency. Once you meet your state board's exam and training requirements, you receive a license to practice.

6. 6Get board certified, and add a fellowship if you want a subspecialty

   Time: 1-3 more years for a fellowshipCost: Board exam feesSources 13, 1

   Board certification is not required for a license, but BLS notes it can widen job opportunities. You earn it by completing an ACGME-accredited residency and passing an exam from one of the 24 ABMS member boards, which also requires an unrestricted medical license. A fellowship of 1 to 3 years leads to subspecialties such as cardiology, gastroenterology or hand surgery. Cardiologists, for example, finish internal medicine residency first.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Diagnostic reasoning

Doctors have to turn vague symptoms and mixed test results into a working diagnosis, often with limited time.

Clear communication

Patients only follow a plan they understand, and hand-offs to other clinicians must be exact.

Stamina

Residency and many practices involve long shifts, overnight call and hours on your feet.

Composure under pressure

Emergencies and bad news require calm decisions while a team and family are watching.

Commitment to long training

Most physicians spend more than a decade in school and residency before practicing on their own.

Manual skill

Surgeons, anesthesiologists and many specialists perform precise procedures with sharp instruments.

O*NET 31.0 rates these skills as most important for the occupation: critical thinking, reading comprehension, active listening, writing, speaking.

Training cost

$194K–$254K

Before financial aid

Time

11-15 years

Typical path

Median pay

$244,180

All US jobs: $50,980

Payback once qualified

1.0–1.3 yrs

Pay above the all-jobs median vs. cost

Medical school tuition and fees only, using the University of Nebraska Medical Center's 2026-27 MD charges as a public-school example. Years 1-4 add up to $192,460 for residents ($48,845 + $47,840 + $48,250 + $47,525) and $252,540 for nonresidents ($63,935 + $62,930 + $63,340 + $62,335). Both add the MCAT fee of $360 and USMLE Step 1 and Step 2 CK fees of $695 each ($1,750 in all). Not included: undergraduate costs, application fees, Step 3 ($955), living costs and licensing fees. Private schools usually cost more. The median federal loan debt for medical graduates in College Scorecard is $208,644.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Cardiologist$496,010 median

  After an internal medicine residency, complete a cardiovascular disease fellowship and pass the board exam.

• Psychiatrist$281,870 median

  Complete a psychiatry residency after medical school; a further fellowship leads to child, addiction or geriatric psychiatry.

• Healthcare administrator$123,860 median

  Physicians often move into chief medical officer or department head roles, sometimes adding an MBA or MPH.

• Orthopedic surgeon$358,550 median

  Match into an orthopedic surgery residency, one of the longer surgical programs, with optional fellowships in areas such as sports medicine or spine.