TY - JOUR T1 - An insider's view of the American and UK medical systems JF - British Journal of General Practice JO - Br J Gen Pract SP - 60 LP - 62 VL - 56 IS - 522 AU - Jennifer S Marsden Y1 - 2006/01/01 UR - http://bjgp.org/content/56/522/60.abstract N2 - The similarities between UK and American medicine are greater than the differences but not quite as interesting. This article will describe the US medical education system, some of the differences between UK general practice and US family medicine, US health insurance and doctors' compensation, and discuss some of the shortcomings and advantages when compared to the UK system.American children finish high school at 17 or 18 years old. They get a diploma rather than A and O levels. Only those planning on further education take national exams and most of these are general rather than subject specific. Those who become doctors complete a 4-year general programme to get a Bachelor of Arts or Sciences (BA or BS) prior to attending medical school, which is a further 4 years including 2 years of classroom sciences and 2 years of ward-based training in most of the specialties. They graduate with the Doctor of Medicine (MD) degree at 25 or more years old.During and after medical school, US doctors (and doctors emigrating to the US) take the US Medical Licensure Exam (USMLE) in three parts. During the 4th year of medical school they apply to their desired residency training programmes and learn their assignment for the next 1–6 years at ‘Match Day’. Any candidates not selected participate in a mad scramble for unfilled posts. Few doctors start or end a programme at any time other than 1 July of each year and in most residency programmes a doctor remains in the same programme until completion, performing most training at the same hospital or complex of hospitals in one town.However, there are some pyramid systems. Some specialties such as anaesthesia otolaryngology (ENT) or urology do not provide an integral post-graduate year 1 (PGY-1) or internship so applicants are expected to do … ER -