'Pre-Med' Major Decision (Foreign Degree)

Very long post, but thank you in advance for your help and input!

I’m in a dilemma about what major to choose for ‘Pre-Med’ and want some advice and other opinions, especially since my case is a bit complicated and even after extensive research I’m still undecided.

I’m a U.S. citizen, but doing my undergrad abroad.

My calling and passion is medicine, but if I was going to school in the U.S., I would probably major in something other than Biology as a ‘backup’, since U.S. schools offer ‘pre-med’ advising and programs (Although I love Biology, I just have a lot of other interests too!).

However, ‘pre-med’ is not really available at my university, students would usually major in clinical medicine from the beginning, which is customary in many countries outside of the U.S., Canada, etc. Even if I did major in Biology, the courses don’t quite match-up with a typical ‘pre-med’ track, e.g. Bio 1/2 with labs, Chem 1/2 with labs, etc. With that being said, I go to a top research university, so our access to opportunities even from undergrad is excellent and the quality of faculty and facilities is top-notch, but the major is just structured differently and perhaps more specialized (although the clinical medicine major, not open to international students, is very similar to a typical U.S. pre-med track).

However, the other problem I’m facing is having a foreign degree - the majority of U.S. med schools, from my research, would not accept a bachelor’s degree not completed in the U.S., or they at the very least won’t accept prerequisites done abroad. I have found a few schools, like NYU and Duke-National University of Singapore, that not only will accept a foreign degree (accredited)/international student, but also don’t have set prerequisite courses and require an MCAT, recommendations, and preferably research and related experience (which I have a lot of access to).

This is where I hit my dilemma – Aside from the foreign degree and lack of ‘pre-med’, I am confident I have access to everything I need to be a great candidate for a VERY SMALL pool of med schools in the U.S. and abroad. I’m considering majoring in Biology, taking advantage of this, and going full speed ahead to maybe get accepted. However – med school is expensive! And aside from NYU’s ‘tuition free’ program, I’m very concerned about financial aid/loans and I’m not sure I could even afford med school in a few years if I did get in. I think the best option, which I do really like, is an MD/PhD – however, again, I would have a shot at maybe 2-5 schools, and I have no lab/research experience yet, so I’m not 100% sure about a PhD.

This is when, I honestly get cold feet about the Biology major, because despite my immense, sickening passion for medicine and all things biology, I have other interests too – I’ve participated in quite a few innovation/entrepreneurship competitions, and I really like business and engineering. If I were in the U.S., I probably would be doing BME as a pre-med, but the program at my school is extremely difficult, and it’s majority taught in a foreign language (which I’m nearly fluent in, but there’s still a barrier).

This is why, I’m considering my second choice, Environmental Engineering, as I’ve found it combines my passions for the sciences, engineering, as well as environmental and human health – but I also know it’s not the same as medicine, though it involves many of the same chem/physics classes as Bio, and I can still select others such as genetics, microbiology, etc. I also feel like I could do a lot with this major in terms of public/global health (I’m interested in environmental health and toxicology). But, again, it’s not exactly medicine, and although I’m patient, I realistically don’t want to be just getting started in medicine at 50…(I’m already starting school late after a gap period)

In an ideal world, I would do Environmental Engineering, take additional bio courses, take the MCAT and then apply for the MD/PhD programs. But can Environmental Engineering majors do a PhD in Biology/Medicine? Does anyone know? (Which is why I’m still considering the Bio major, as it would qualify.) I also considered just doing a Bio BS and Bio PhD first then applying for med school, but would my foreign bachelor’s degree still be a problem?

If I don’t get into the 2-5 schools the first shot, I’m still willing to try again and apply, or I could also work for a few years, try to save for med school, but then I may also have to do a post-bacc, which is also very expensive.

I think in many ways I’m leaning towards Environmental Engineering, but I am concerned that it hurts my chances at an MD/PhD program when my research interests are actually all health and biology related, I would just be coming at it from a different perspective. I hear so much about the lack of biology-related jobs that I am concerned about having that degree and then struggling to have a job that could both pay for a post-bacc and then for medical school as well.

Is the Environmental Engineering a good route that would still lead to perhaps a chance at a biology MD/PhD? And, if not, is a biology major that bad in the workforce?

I’m also curious if a Bio BS can lead to an Environmental Engineering MS or PhD? In case I decide to go the other away around and not pursue medicine. I would most likely be able to apply for a direct graduate program at my university regardless of which major I choose.

I think the bottom line is that I have one goal, which is medicine. But I’m trying to make a realistic and smart decision if I need to take a non-traditional path, and still be innovative along the way.

Also, if anyone has other suggestions for med schools, please let me know.

Thank you so much!

If you really want to go to medical school in the United States, you need to do your medical school Pre-requisite IN the United States. There is no way around that.


May want to look into schools such as St. George’s University School of Medicine, American University of the Caribbean School of Medicine, Saba University School of Medicine, and Ross University School of Medicine. These medical schools may be more flexible with you.

Do not pin your hopes on a small list of schools just because you’re a “great candidate”. Even great candidates for med schools in the US apply to dozens of programs and are thrilled to get admitted to one or two; and many “great candidates” get accepted to zero. I’m not sure I understand why you are studying overseas if the plan is to attend a US med school??? You’ve kind of boxed yourself in… forget the finances for a minute, you just haven’t left yourself many options. Worrying about what to major in is really a tertiary concern given the roadblocks you’ve put in front of yourself…

It’s a tough process if you’ve got a degree from a non-US college:


This student is a US citizen. Frankly, if he wants to attend a U.S. medical school, and eventually practice medicine in the U.S., it would be in his best interest to attend and receive a degree from an undergrad college here.

That way…all requisite courses would be taken here…and the degree would be from a U.S. college. Less issues.

Graduating from branches of US universities located abroad (NUS Duke Singapore, NYU Abu Dhabi or Shanghai) is not the same as graduating from the US parent university. You will still be considered as a having a foreign medical degree and face long odds in matching into a US medical residency. (Completion of a US medical residency is a requirement to get US medical license. Without a license you cannot practice medicine in the US.)

There are a couple of overseas medical schools that have strong track records of placing their grads into US residencies. Sackler SOM at Tel Aviv University in Israel, and Oschner SOM at University of Queensland in Australia. Both schools follow the US medical education curriculum, have US based clinical rotations sites where their student do much of the clinical education (Sackler in NYC, Oschner in New Orleans) and have established track record for placing their students into US residencies. Attending either of these programs is much less of a risk than other non-US medical schools (like the Caribbean schools)

Sackler. http://www.sacklerschool.org/admissions/application-process/

Oschner. https://ochsner.uq.edu.au/admissions/admissions-criteria

Both programs require a MCAT score, plus an interview for admission. Both programs are eligible for the federal student loan program. (I’m not sure about the Grad Plus loans though.)

Re: financing med school. You’re getting way ahead of yourself, but as a US citizen you’re eligible to borrow up the $45,500/year in unsubsidized federal student loans and up to the school published COA in Grad Plus loans . This is how most US students pay for their medical education. So if you’re looking MD/PhD programs just because they offer a free education, then you don’t need to do so.

Environmental engineering is not a great route to a PhD in biology. It can be done, but you will judged as deficient in many areas of basic biological knowledge and be expected to remediate your deficiencies before starting your PhD program. This means you would be a very long shot candidate for a MD/PhD program.

MD/PhD programs are super competitive for admissions, and require higher MCAT scores and GPAs than do regular MD admissions. You will be additionally disadvantaged because you don’t have a home state and many MD/PhD programs offered at public medical schools preferentially admit in-state residents.

AAMC data for MD/PhD applicants and matriculants here: https://www.aamc.org/data-reports/students-residents/interactive-data/2019-facts-enrollment-graduates-and-md-phd-data

Biology doesn’t have good job prospects even at the PhD level. For the last 50 years universities have used graduate students as “free” labor in research labs. Consequently the US graduates approximately 3-4x as many new Bio PhDs each year as there are academic positions. Even private industry cannot absorb the number of PhDs graduated every year. A survey of bio PhDs done by (I think) the National Academy of Sciences revealed that at the 5 years post graduation mark, 1/3 remained either unemployed or severely underemployed. Many worked as part-time adjunct instructors at community colleges and colleges. (Pay for adjunct instructors is pretty low. Adjuncts are paid by the class and because they are part-time, non-tenured employees receive no benefits and have no guarantee they will be rehired at the end of the term.)

While the job market for BA/BS bio isn’t completely terrible, many jobs are low paying, dead-end research assistant/lab manager positions. Bio major have to make themselves marketable by doing internship in bio/pharm/ag-based businesses and developing skills and proficiencies that are in demand with these businesses. (computer coding/programming skills, data analysis, management)

If you like selling, pharma and medical device sales can be a lucrative job for bio majors.

It can, but… you will be judged as having knowledge deficiencies in areas like geology, soil science, wetlands ecology, GIS, resource management, engineering processes & systems. These are areas where you will need to remediate before you can be accepted into a EnviroE MS or PhD program.

My friend who owns enviro engineering firm hires engineers, not biologists. Chemical, systems and environmental engineers (at all levels from BS to PhD) because biologists can be hired as consultants to do one-off assessment reports while he needs engineers to design, build and maintain environmental remediation systems.

But honestly, if your goal is become a physician in the US, the simplest, most direct path is to do your undergraduate degree in the US or Canada. 

It depends.

If your PhD is earned at US or Canadian university, then your grad degree may be an acceptable substitute for a US undergrad degree at SOME medical schools. Every medical school in the US has its own admission requirements and processes. You will need to research this on your own.

If your PhD is earned at a non-US institution, then your foreign undergrad (and doctoral degree) is going to be the same obstacle you’re facing right now.

BTW, the odds of getting accepted to a US graduate program with a foreign undergrad degree are not good unless you have a substantial research CV from a well known foreign university.