If you are a biology, chemistry or health sciences major with a pre-med mindset in college and then changed your mind, you might feel a bit lost right now. Colleges report that between 45%-65% of entering pre-med freshman are no longer pre-med at the time of graduation.
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Physicians need to complete at least one year of training in a certified residency program and must pass all three parts of the USMLE to become qualified to apply for a medical license. Residency entails a 3-7 year minimum commitment of training to attain clinical skills and board eligibility. Residency is highly sought after, and there are hundreds of candidates who do not match each year.
I want to drop out
But what if, after finishing medical school, matching, and starting your training, you decide that you hate residency and want to leave before finishing? What if you decide that you want to pursue another avenue? You will most likely receive a number of different messages from various people. I have received this question over a hundred times, and I have heard over one hundred different stories of why residents want to drop out, including:
The answer of whether or not you should leave residency depends on how you visualize your future. You can decide by asking yourself the following questions.
If you answered yes to any of the above questions, then you need to stay in your residency to become qualified.
Your discouragement is understandable, but dropping out will not help you get where you want to go.
If you answered no to all of the above questions, then move on to the following questions.
If you answered yes to either of those questions, then you need to develop good relationships with your program directors and transfer into a different residency. You deserve to practice the specialty you want to- and even if you waste a few years of training to get the specialty you want- you will find the extra training well worth it. If you answered no to all of the questions so far, then move on to the next question.
I am sure you don't want to hear this, but, completing your residency actually puts you on par with non-physicians who are qualified in their own areas. If you have still answered no to every question so far, then move on to the next question.
If you answered yes, then leaving residency is probably in your best interest. Residency, board eligibility and board certification will not help you attain these types of positions any more than just having a graduate degree. In fact, this is the only instance in which you will waste time professionally by remaining in your residency. But, be aware that your medical school and your residency will not be helpful in getting you the job you are looking for, and that you will have to start at the bottom and work your way up. For more information on how to find a non-clinical job, see Careers Beyond Clinical Medicine. Find out more about your specific career options without residency here. You can also see a resource dedicated to quitting residency here. 
In medicine, the top 3 measures of a physician's value lie in certification, certification and certification.
This is especially true in the United States. I have heard from doctors throughout the country who want to know if the United States Medical Licensing Examination (USMLE) is a necessary pre-requisite for non-clinical positions. The answer to this frequent question is - sometimes the USMLE helps and sometimes it doesn't. What is the USMLE? You are required to pass parts 1 and 2 of the United States Medical Licensing Examination (USMLE) in order to get your MD degree from a US medical school. Most DOs trained in the United States also take it. And you cannot receive a medical license without passing parts 1, 2 and 3 of the USMLE. The tricky part is that it is recommended to take part 3 of the USMLE after your internship- and it has been getting harder and harder for foreign medical graduates, international medical graduates, and some US medical graduates to match into residency programs in recent years. More doctors can't match into an internship than ever before, and thus they cannot get a medical license. And some doctors-in-training already know that they want to get out of clinical medicine early in the medical training process. This is where the question of how to succeed without taking the USMLE comes up. To find out more about 'dropping out' of residency, see here.
Success without USMLE?
There are numerous success stories of non-clinical doctors who have reached high salaries and attained prestigious professional appointments in jobs that are outside of patient care. And some did not rely on licensure or certification. But, your choices without a medical license are limited, so if you have an opportunity to take licensing exams- don't walk away from the opportunity just so that you can more quickly apply for an entry level non-clinical job. If you are a doctor, you know how to pass exams and you know how to score well. Just do it. If you have a solid non-clinical offer on the table that you don't want to pass up, then it is understandable that you would want to jump at the chance to build your non-clinical experience if your long-term goal is to become a leader or an executive in the non-clinical arena of healthcare. When you have a solid contract in front of you, if you want to take a break from tests and prove your worth in the non-clinical world, by all means go with your gut. Nevertheless, if you have time to study for your board exams while working that non-clinical job, it is best to do both. (I know, this is not what you wanted to hear.) You can only achieve success without the USMLE if you become distinguished enough that companies want to recruit you. However, it takes some time to build such a stellar resume to be recruitable - and sometimes the entry-level and mid-level work that builds your resume does require medical licensure. Why take the USMLE? Whether you are an entrepreneurial minded foreign graduate with years of clinical experience overseas under your belt or whether you are a recent graduate from a medical school in an exotic tropical location or whether you are a U.S. graduate who didn't match- the unpleasant truth is that state licensure and specialty certification opens some doors that your MD or DO does not, even if your goal is in non-clinical work. So the short answer is- if you don't have a non-clinical offer in place, continue to make yourself the most qualified candidate that you can possibly be. And the USMLE is the most recognized way to do that, even for non-clinical jobs. A medical license is required for most non-clinical positions that require chart review or litigation review. If you have your foot in the door to a non-clinical opportunity, follow the path that best matches your long term goals, but keep in mind that most non-clinical positions are not known for being secure.
What if I can't take the USMLE?
If you absolutely cannot take the USMLE, but still want to work, you have to really decide whether you want to stay in the medical field or not. There are other ways to work in the medical field, and becoming an expert in regulatory matters is one of the most powerful steps you can take. Fortunately, even without the USMLE, there are a number of non-clinical entry level positions which require some form of official specialty certification. For example, a clinical research associate can earn about $75/hr without residency, and must take a specialized training course. Learn more about jobs for doctors without residency or licensing here.
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