With great interest, I have read many posts on this subreddit about attending European medical school. Many of you think this is an easier route than studying in the United States.

I am here to tell you that it is not easier but much harder. The American system is built for US graduates and not for foreign graduates. American medicine is extremely conservative, and foreign medical graduates of any type, whether American citizens or not, have a more difficult time getting into residency training and/or completing residency training. There is academic discrimination, which is not hidden.

You must consider your motivations for going to medical school in Europe. If you go to Europe to shorten your training time, you are making a big mistake. The European and American systems of training are different in almost all aspects. Each country’s program is developed to fit that specific country, and there will always be dissonance.

If you have tried to get into an American medical school and have not been successful, and you still want to be a physician, then I would recommend that you go abroad. However, go through the US system if you have high grades and good undergraduate scores. This system is seamlessly integrated with postgraduate residency training, and there is more support for examination preparation but most importantly for the residency MATCH. All foreign medical graduates are out of synchronization when they apply for the MATCH, and thus lose precious time. The more time there is between medical school graduation and the start of internship or residency, the more difficult it is to acquire a position.

A European medical graduate is looked at more stringently than an American graduate. You must fulfill many more requirements to be competitive for a residency position, and still, the fact that you have graduated from a “foreign” medical school is heavily counted in the evaluation process. In many residency programs, applications from foreign medical graduates are disqualified immediately without further consideration. You must be better than American graduates or equally competitive with American graduates to gain a residency position. In many residency programs, applicants who have trained overseas are disqualified immediately, decreasing the size of your availability pool for training. As an American medical graduate, you are not subject to such discrimination.

I am a foreign medical graduate. I went to medical school in Kraków, Poland, between 1979 and 1983. I chose to go to Poland for training because I did not believe in myself nor in my abilities to gain access to American training. In retrospect, this was a mistake. Several years after graduation, I met with the Dean of the well-known medical school in California, whom I had known for years prior to my training in Poland. He told me, “You know, if you had tried, we would have admitted you.” My response was, “Why did you tell me”? And his response was that it would not have been ethical to tell me.

I was an exceptional medical student. I worked hard and had very high grades. I integrated well with my colleagues in Poland and, after graduation, was offered residencies there in general surgery and dermatology. I decided instead to return to the United States because it is “better”. This started a cascade of uncertainty regarding postgraduate training. I took the FLEX examination in 1982 and was in the last or next to the last group prior to the changeover to USMLE. This was a tremendously difficult two-day-long examination on which I scored reasonably well. The examination was also written to be more difficult for foreign medical graduates. I scored reasonably well, but not well enough. I went through the first round of residency MATCH, trying for general surgery. I applied to 25 programs and got two interviews, and no position. The post-MATCH scramble was useless for me because, as an individual, I was notified later than American medical students who did not match, and also did not have a Dean who could contact colleagues to help. I lost the year. The next year, I decided to try radiology because, at that time it was less competitive, and I enjoyed the specialty. This time, I applied to 50 programs, received three interviews, and was matched to a very substandard program. Let it suffice to say that I was also discriminated against in this program because of my status as a foreign medical graduate and also because I was a sexual minority.

The point of this all is that it took me many years to complete my residency and fellowship training with the help of several extremely powerful radiologists in the United States who were completely supportive. I was repeatedly told that if I had not been a foreign medical graduate, I would have gotten into a top radiology program.

I now work outside the United States in an English-speaking country as an associate professor of radiology, writing, lecturing, and publishing, but it was very painful, much more painful than it should have been, to get here. It would have been much easier if I had gotten over my anxiety and applied in the United States.

In summary, if you are going to train in a European country because you feel that it will shorten your training time, this is not true. Always try at home first.