留学美国如何成为美国执业医师

发布时间：2019-08-21 15:20

　　l 因国家与国家之间的人文环境、医疗制度等千差万别，WHO(世界卫生组织)在历史早期便意识到需要一份可靠的世界所有医学院名单，以便记录世界医生的的教育地点，这一名单于1953年出版第一版起，一直发展至今汇集了全球近180个国家及地区的医学院名单。美国作为全球经济第一的发达国家，其医疗领域的实力也是首屈一指。那么，作为美国以外的外国医学生如何成为美国的职业医师呢?

　　众所周知，在中国成为一名医学工作人员需要具备医师资格证——上岗证，拿到此证需要通过执业医师考试。，美国医生也不例外。美国的执业医师资格考试USMLE，英文全称United States Medical Licensing Examination，是通往美国临床执业的一种途径。由美国国家医学联合会(Federation of State Medical Boards，FSMB)和美国国家医学考核委员会(National Board of Medical Examiners，NBME)主办。

　　满足USMLE考试需要具备以下条件：

　　官宣条件：Officially enrolled in, or a graduate of, a medical school outside the US and Canada listed in the World Directory of Medical Schools as meeting ECFMG eligibility requirements; and meet other ECFMG criteria正式注册或毕业于美国和加拿大以外地区的医学院且位列符合ECFMG资格要求的世界医学院名录，及符合ECFMG的其他标准。

　　简单来说：

　　第一：首先要确认自己的医学院是否具备考试资格，查询方式：https://search.wdoms.org/

　　目前中国有194所院校具备考试资格，如下图：

　　If there is no information provided by ECFMG on the Sponsor Notes tab of the school’s World Directory listing, students and graduates of this school are not eligible to apply to ECFMG for ECFMG Certification or examination.如果在WDMS中没有ECFMG提供的Sponsor Notes信息，那么该学校的学生及毕业生将不具备申请ECFMG认证或考试资格。

　　There are a number of reasons why a school’s entry might not have an ECFMG note. For example, ECFMG may not yet be aware of the school. For more information, please contact ECFMG at MedSchoolReview@ecfmg.org.没有收到ECFMG认可的学校或许有非常多的原因，比如，ECFMG之前就没有了解过一些学校。如需了解更多信息，请通过MedSchoolReview@ecfmg.org联系。

　　第二：医学学位/学历资格审核。一般临床医学专业本科学历的学生或别隐身都可以报考，其他非临床医学专业的需要进行申诉。

　　第三：向ECFMG提出认证申请。申请通过后便可参与USMLE考试。

　　关于USMLE考试

　　一、简介：USMLE was created in response to the need for one path to medical licensure for allopathic physicians in the United States. Before USMLE, multiple examinations (the NBME Parts examination and the Federation Licensing Examination [FLEX]) offered paths to medical licensure. It was desirable to create one examination system accepted in every state, to ensure that all licensed MDs had passed the same assessment standards – no matter in which school or which country they had trained. Today all state medical boards utilize a national examination – USMLE for allopathic physicians, COMLEX-USA for osteopathic physicians.[信息来源USMLE官网]。USMLE的创建是为了满足美国对抗疗法医生通往医疗执照之路的一种途径。在USMLE之前，有多种考试(如NBME部分考试和联邦执照考试FLEX)提供医疗执照的途径。建立一个在每个州都接受的考试制度是可取的，以确保所有获得许可的MD都通过相同的评估标准 - 无论在哪个学校或他们接受过培训的哪个国家。今天，所有州医疗委员会都使用国家考试 - USMLE用于对抗疗法的医生，COMLEX-USA用于整骨疗法的医生。

　　二、考试内容：

　　USMLE考试分为三个步骤4次考试完成：

步骤	考试内容	考试分数
STEP 1	Basic Medical Science Exam 基础医学科学考试 specifically in anatomy, behavioral science, biochemistry, microbiology, pathology, pharmacology, and physiology. Interdisciplinary areas such as genetics, immunology, and nutrition are also tested解剖学，行为科学，生物化学，微生物学，病理学，药理学和生理学。还测试了遗传学，免疫学和营养学等跨学科领域 350 questions / 7 hours + 45 minutes break time350道题/7小时+45分钟的休息 Average Question Length: 60 to 70 words平均问题长度：60-70个词 It is a one-day computer exam taken by medical students at the end of completed second year of medical school这是医学院学生在医学院二年级结束时进行的为期一天的计算机考试	The minimum passing score on the three-digit scale is 194. To achieve a passing score, you typically need to answer between 55-65% correct (it can vary based on the calculated difficulty of the exam you took as each candidate takes a different version of the exam). 最低及格分数为194.要达到及格分数，回答正确率续在55-65％之间（因美国考生参加不同版本的考试，它会根据考试的计算难度而有所变化）
STEP 2-CK	CK = Clinical Knowledge 临床知识 USMLE Step 2 CK is a multiple choice computerized USMLE examination that tests clinical subjects learned during the last years of Medical School USMLE Step 2 CK是一个多项选择的计算机化USMLE考试，用于测试医学院最后几年的临床知识。 Basic clinical problems assessing preparedness to practice under supervision. 评估监督实践准备的基本临床问题 370 questions / 8 hours + 45 minute break time 370个问题/8个小时+45分钟休息 Average Question Length: 100 to 110 words平均问题长度：100至110个词 Primary Care focus with emphasis on Internal Medicine (60% of more of the exam)主要的治疗关注点是强调内科（60%以上的考试） A good background in Basic Sciences essential to do well	目前最低分是209，正确率如step 1.
STEP 2-CS	USMLE Step 2 CS is a “practical” live exam using standardized patients that is meant to test a doctor’s interpersonal, communication and clinical skills. The Step 2 CS USMLE exam tests how doctors take a patient history, perform a physical exam, and write up the appropriate patient note. It also evaluates “bedside manner”, patient interaction, and spoken English skills。 USMLE第2步CS是使用标准化患者进行的“实用”实时检查，旨在测试医生的人际关系，沟通和临床技能。Step 2 CS USMLE考试测试医生如何记录患者病史，进行体检并撰写适当的患者记录。它还评估“床边方式”，患者互动和英语口语技能 One day exam with 12 simulated patients (11 scored, 1 experimental)一天考查12名模拟患者（11分，1个实验） Can only be taken in the US (Atlanta, Chicago, Houston, Los Angeles and Philadelphia)只能在美国的亚特兰大，芝加哥，休斯顿，洛杉矶以及费城参加。 25 minutes per encounter (15 minutes per patient / 10 minutes for clinical note)每位患者25分钟（每名患者15分钟/诊疗记录10分钟）	No score – Pass/Fail 没有分数-通过/失败
STEP 3	USMLE Step 3 combines multiple choice questions and free-form clinical cases on computer, and also tests patient management skills at the level of the 1 st year of Residency. USMLE Step 3结合了多项选择题以及电脑上的自由形式临床案例，测试居住1年以上的病人的管理能力。 Two day exam (16 hour examination)两天的考试（16个小时的测试） 480 multiple-choice questions and 9 clinical case simulations (computerized)480个多项选择题以及9个临床案例 Assesses capacity for independent medical practice评估独立医疗实践的能力 Complex issues/patients复杂问题/患者	The minimum passing score in 2013 for Step 3 is 190。2013年通过的分数是190.正确率可参考step1.
备注： Step1, Step 2CK and Step 2CS 的成绩7年有效。最好一次性通过，补考会留下记录，影响以后申请住院医师岗位。且建议高分通过。