Including undergraduate studies, becoming a practicing physician takes a minimum of 11 years and is very expensive. Starting at 38 would not allow you to be a fully practicing physician until at least 49, with significant debt. Be sure medicine is really the career for you before starting the process.
Complete medical school prerequisites. In addition to a bachelor's degree, which can be in any subject, the following courses are required for admission to most medical schools: one year each of biology, physics, organic chemistry, inorganic chemistry and English literature, and one semester of calculus.
Take the Medical College Admissions Test, or MCAT. This is a standardized exam required by most American medical schools. It tests verbal reasoning, writing skills and knowledge of the physical and biological sciences.
Apply to medical schools. Only 42 percent of medical school applicants, on average, are accepted, so increase your chances of acceptance by applying to as many schools as possible. In the 2008 application season, there were 42,315 applicants applying to an average of 13 schools each, according to the Association of American Medical Colleges. Increase your chances by graduating with a high grade point average, score well on the MCAT and participate in relevant extracurricular activities.
Attend and graduate medical school. Four years of medical school are required to become a medical doctor: two years of classroom courses such as anatomy, physiology and biochemistry, and two years of clinical rotations that provide exposure to the various medical specialties. Medical students must successfully complete the first two steps of the United States Medical Licensing Examination (USMLE) to graduate.
Concentrate on your chosen specialty. Medical students must apply to training programs in their fields of choice. As with applying to college and medical school, the applicants must go on interviews. In addition, above-average grades, high scores on the USMLE and relevant extracurricular activities ensure the highest chances of admission.
Complete residency and fellowship training. After graduation, new physicians must undergo a minimum of three years of postgraduate training in a medical specialty. The length of training varies between specialties but can be anywhere from three years for primary care to nine years for neurosurgery and surgical sub-specialties.
Pass board certification examinations. Board certification is a demonstration of a physician's abilities in her chosen specialty. While not mandatory, most physicians undergo a certification process.