How Foreign Physicians Can Work as Healthcare Practitioners in the US

The trend of globalization has made it easier for professionals in many fields to find employment opportunities abroad, but this does not necessarily apply to the medical field, particularly when it comes to foreign physicians in the United States. Foreign medical graduates, commonly referred to as FMGs in the American healthcare sector, are often required to take quite a few educational courses that may not have been part of their medical school curriculum overseas.

Where you earn your education as a physician will impact where you can practice medicine. For instance, the education needed to become a practicing physician within the United States (US) requires years of education and clinical hours. For foreign-trained physicians living in the US, they will need to undergo an additional amount of education on top of the degree that they’ve already earned.

The Physician Formation and Education System in the United States

In general, students who wish to practice medicine in the U.S. must first earn a college degree that includes at least three years of what is known as pre-med education. Bachelor of Science degrees in chemistry and biology usually fit into the pre-med mold, and some schools offer programs that are straight pre-med with an eye towards gaining admission into medical school. Once admitted into medical school, the next four years will be spent in pre-clinical and clinical education periods that culminate with graduation and the granting of a Doctor of Medicine degree before heading into internship and residency. How Foreign Physicians Can Work as Healthcare Practitioners in the US

Why Additional Education?

It said that the US has high-quality standards when it comes to medical licensing. While foreign physicians may have gone through an exceptional amount of quality training overseas, the American medical industry has taken extra strides to confirm that foreign physicians looking to practice medicine in the US go through the educational training that’s set by American standards.

If you are a foreign physician interested in practicing medicine in the US, then you’ll need to prepare yourself to pass the US Medical Licensing Exams, get certified by the Educational Commission for Foreign-Trained Medical Graduates, enroll in a residency program, and then take a third licensing test.

Foreign physician, Abdelsalam Elshaikh of Sudan, reported to MPR News that all of the first year pre-med courses such as physiology, biology, etc. weren’t taught to them. This is because the curriculum for some overseas education usually focuses on what the physician will actually have to deal with when treating patients—fieldwork. US standards require that physicians are fluent in the English language and have a basic understanding of the science field in general along with understanding the core requirements set by accredited universities such as:

  • Introduction to Chemistry
  • General Biology
  • Anatomy and Physiology
  • College Algebra
  • Physics
  • Calculus
  • Molecular and Cell Biology
  • Human Embryology
  • Epidemiology
  • Biochemistry
  • Research Writing
  • Principles of Genetics

Educational Differences in the American Physician Training System

Unlike physician training programs in other parts of the world, there is no foundation training in the U.S. because medical students can choose to specialize, or not, upon getting their M.D. degree. The Bachelor of Medicine and Bachelor of Surgery programs often taught in Asian colleges, for example, are unheard of in the U.S. It is not uncommon for an American pediatrician to have earned a Bachelor of Arts in Sociology plus a Master of Health Sciences before qualifying for medical school.

US Medical Licensing Exam Requirements

With the above in mind, it is more likely for an American doctor to be able to practice overseas than for a foreign counterpart to work in the U.S., and this is a matter of licensing and education. FMGs in the U.S. must deal with the Educational Commission for Foreign Medical Graduates.

So how can foreign doctors practice in the US? These are the US medical exam requirements for any for foreign medical graduates and practicing physicians to obtain ECFMG Certification:


  • Certifying that the FMG obtained a degree listed on the World Directory of Medical Schools
  • Completing missing education requirements
  • Medical Science Requirements – You must pass both the USMLE Step 1 and USMLE Step 2 CK (Clinical Knowledge)
  • Clinical Skills Requirement – To practice medicine in the US after graduating from med school in another country, you must also pass the USMLE Step 2 CS (Clinical Skills)
  • Going through a residency program
  • Obtaining final ECFMG certification


Once you pass all three of these US medical licensing exams, you’re eligible for ECFMG certification. You don’t have to wait until you graduate from medical school to apply. Feel free to apply as a med student. However, you won’t receive confirmation until you provide graduation confirmation.

After you receive ECFMG certification, you can begin your residency in the US. But be sure to apply for your residency long before graduation and certification. The application process may take some time.

While it is true that many foreign physicians work and train at U.S. hospitals, they are often enrolled in special cooperation programs that may be sponsored through diplomatic exchange channels or the U.S. Agency for International Development. FMGs who may have already worked at an established practice in other countries will find the equivalency, licensing and certification program to be particularly arduous.

Starting All Over

So, while many foreign physicians will have years of experiences diagnosing, treating patients, and administering medicine, in order to practice as a US doctor, it essentially requires them to start all over again academically, especially when the curriculum differs from overseas qualifications.

FMGs whose medical education is deemed to be insufficient in areas such as algebra, biochemistry, physics, molecular biology, and research writing are bound to feel as if they have to start all over again in the U.S. Many become disillusioned and end up taking other jobs totally unrelated to the medical field, and this is when the movie trope of highly skilled professionals driving cabs in the U.S. becomes an unfortunate reality.

However, experts expect a shortage of both primary-care doctors and specialists to continue in the coming years. By 2025, the American Association of Medical Colleges projects primary care shortfalls ranging from 12,500 to 31,100 doctors, and shortages of non-primary care doctors between 28,200 and 63,700.

Foreign-trained doctors are critical to addressing these shortages, accounting for important shares of primary-care physicians in the United States. Nearly a third (31.8%) of all physicians specializing in family medicine, internal medicine, and pediatrics—three specialties associated with primary healthcare—are foreign-trained.

These 128,099 foreign-trained physicians are among the primary-care doctors recognized by fellow healthcare professionals as “the first line of defense in the healthcare system.” As a result, primary-care physicians deliver most of the country’s preventive and routine services, such as checkups, initial acute-care, and initial diagnoses guiding patients to the appropriate level of care.

For a model of how this would work, in Canada, the government only requires an estimated half of its foreign-trained doctors to get fully retrained. The other half can be rapidly certified to practice medicine by proving that they received their medical training from a list of vetted medical schools in countries such as Algeria, Nepal, Argentina, and Macedonia.

Thankfully, FMGs have better career options to keep them connected to the healthcare industry while pursuing their dream of becoming American doctors.

What Type of Specialties Can Foreign Physicians Practice?

BioExplorer reports that there are approximately 44 different types of doctors, but as the medical industry continues to evolve, more specializations arise. As a foreign physician, this gives you at least 44 different career options to pursue as a US healthcare practitioner. Here is a short list of just a few of these specialties:


  • Family Medicine Physician – This type of doctor is most general type of practice that can treat a wide range of patients of all ages. If this kind of doctor finds anything too serious, he or she usually refer their patient to a specialist.
  • Gastroenterologist – This kind of doctor focuses on the health of the stomach, the small and large intestines as well as the pancreas and liver.
  • Endocrinologist – Studies internal medicine related to the human body’s hormone levels.
  • Neurologist – Studies the brain.
  • Ophthalmologist – Specializes in the surgical treatment of the eyes.
  • Orthopedist – This type of doctor will specialize in the disease, injuries, and treatment of the foot that involve the muscle, nerves, bones, etc.
  • Pediatrician – Pediatricians treat children. Since these patients are still developing and growing, this kind of doctor not only focuses on the physical health, but also the emotional and mental well being of children.
  • Periodontitis – Studies the health of the mouth.
  • Surgeon – While most of these kinds of doctors may be involved in surgical procedures, to pursue a career as a practicing surgeon will keep you heavily involved with removing and/or transplanting body parts and organs.
  • Veterinarian – Not all doctors are involved with treating human beings. Veterinarians specialize in treating animals. In this profession, you can specialize in treating farm animals, domestic animals, or exotic animals. Some veterinarians treat all kinds!

Options for Foreign Doctors at Florida National University

Whereas many American doctors can practice in Europe and other places abroad with fewer hurdles, many foreign physicians come to the US on a working Visa. They work as Patient Care Technicians, Medical Assistants, or Registered Nurses. Some might even cross over onto the technical side of the healthcare industry and work as a lab technician. Even with these jobs, a certain amount of education is required.

Most foreign physicians are determined to practice medicine in the US, so the first thing they have to do is earn their pre-med degree. While it is possible to earn your undergraduate degree in Nursing and go on to become a licensed US physician, Florida National University (FNU) challenges you to enroll in our Bachelors of Natural Science program.

We also have a Bachelor of Science in Nursing (BSN) program. While our BSN program will certainly guide you toward a rewarding career in the healthcare industry, the Bachelors in Natural Science will better prepare you to pass your exams and get your physician’s license. You’ll study under the instruction of the professional board of faculty members who have years of experience in the field. The wide variety of courses offered also prevents you from pigeonholing yourself into one particular field of study. With the undergraduate program in Natural Science, you’ll earn a well-rounded degree in a variety of subjects that can catapult you into a licensed doctor practicing in a specialty of your choice.

When the ECFMG determines that a foreign physician living in South Florida must complete the equivalent of a pre-med degree before challenging the USMLE, a smart option is to keep those healthcare skills sharp by means of getting a suitable job within the industry. Florida National University is a private college duly accredited to grant health sciences and technology degrees such as:

  • Nursing
  • Advanced Respiratory Therapy
  • Medical Laboratory Technology
  • Physical Therapy
  • Radiology
  • Patient Care Technician
  • Echocardiography

The accreditation entities that recognize FNU as a degree-granting institution include:

  • Accreditation Commission for Education in Nursing
  • Florida Board of Nursing
  • Southern Association of Colleges and Schools
  • Florida Commission for Independent Education

FNU recognizes diversity in its student body and the South Florida community; for this reason, the school has an agreement with the National Accreditation and Equivalency Council of the Bahamas. As a school that truly cares about the professional development of international students, FNU recommends the following paths for FMGs:

* Enroll in a healthcare certificate program and work as a technician in this sector. A radiology technologist, for example, can earn an average of $56,000 per year in Miami. This is better than driving a taxi and will allow FMGs to continue working with the ECFMG for final certification or licensing. For more information on this program, contact one of our counselors today.

* Complete the Bachelor of Science in Nursing program, which can be turned into a graduate degree without leaving FNU. The scope of registered nurses in Florida has greatly expanded in recent years, and a few choose to become nursing practitioners and even doctors because of their advanced knowledge in healthcare.

* Complete the Bachelor in Natural Science program, which has many similarities to a straight pre-med degree, and continues to work in the health sciences sector as a skilled FMG. The South Florida region is home to a thriving and very lucrative health sciences industry where employers are constantly looking for job applicants with medical experience. This degree will make it a lot easier for FMGs to pass the USMLE and obtain ECFMG certification.

The Choice Is Yours!

In the end, FMGs should not feel dispirited by the ECFMG process. With FNU as an education partner, you have the peace of mind of an accredited institution that offers financial aid and scholarships to qualified applicants. With plenty of good jobs for foreign doctors in the USA in the healthcare sector, our certificate programs can pave the way; if you are already working, you can take advantage of our online and blended education modalities. For more information about how FNU can help foreign doctors in the U.S., get in touch with an admissions counselor today.

If you are a foreign physician, earn your Bachelors Degree in Natural Science at Florida National University. Contact one of our advisors today to start the enrollment process now!