Although training is entered after obtaining from 90 to 120 credit hours of university level work (see second entry degree) and in most cases after having obtained a Bachelors Degree. In other countries, such as the United Kingdom, Germany and India, the MD is an advanced academic research degree similar to a PhD or a higher doctorate. The DO degree is not offered in those countries. Admission to medical schools in the United States is highly competitive, with about 17,800 out of approximately 47,000 applicants receiving at least one acceptance to any medical school in recent application years. Before entering medical school, students must complete a four year undergraduate degree and take the Medical College Admission Test (MCAT). Before graduating from a medical school and achieving the degree of Medical Doctor, most schools require their students to take the United States Medical Licensing Examination.