US doctor moving to Australia

[C.P.]

Moving from one country to another, permanently, is a big undertaking.
Moving careers can be even more daunting.
Moving your home, your career, and trying to become licensed as a medical practitioner is about 5 times the work.

I'm almost done with the whole process, and thought I'd just throw out a line to see if anyone had any questions I may be able to answer. There wasn't anyone else to really help me through the details, so I thought I'd try and help anyone else considering it.

To save a bit of trouble, I'm:

A US born citizen.
Married to an Australian.
Have already established permanent residency in Australia.
Am a US board certified Anesthesiologist.
Have my credentials verified by the AMC.
Have already undertaken evaluation by the ANZCA and am on the Specialist pathway.
Have already applied and interviewed for a job.
If accepted, and the details work out, I'll likely be moving this July.

The process is not easy, and it is not entirely clear how things will settle out until I actually get to Australia and start working and investigating things further, on the ground, in person.


That being said. . . ask away.

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[BlueToothHunter]

Moving from one country to another, permanently, is a big undertaking.
Moving careers can be even more daunting.
Moving your home, your career, and trying to become licensed as a medical practitioner is about 5 times the work.

I'm almost done with the whole process, and thought I'd just throw out a line to see if anyone had any questions I may be able to answer. There wasn't anyone else to really help me through the details, so I thought I'd try and help anyone else considering it.

To save a bit of trouble, I'm:

A US born citizen.
Married to an Australian.
Have already established permanent residency in Australia.
Am a US board certified Anesthesiologist.
Have my credentials verified by the AMC.
Have already undertaken evaluation by the ANZCA and am on the Specialist pathway.
Have already applied and interviewed for a job.
If accepted, and the details work out, I'll likely be moving this July.

The process is not easy, and it is not entirely clear how things will settle out until I actually get to Australia and start working and investigating things further, on the ground, in person.


That being said. . . ask away.

Congratulations! What was your deciding factor in moving from LA to Australia? (Are you moving to Sydney?)

I've also considered moving (easier for me as I am already licensed there) but my wife needs to go through the whole registration... so we're taking it slow. How long did it take to get your qualification recognized in Australia?

Good luck!

 

[C.P.]

I'm ultimately moving because my wife is Australian, but there are a lot of other factors that make it a favorable one.
Pay is not one of those factors though.
Lifestyle (and the sanity that comes with it) is a big plus.
Professionalism within the system is another big plus.
The general population's views on their own health and health care are a welcome change.
The smallest factor is a slight concern over the future of the US infrastructure and our health care system.
I'm not a doom and gloom conspiracy kinda guy, and I'm more than willing to throw in my part to make whatever changes are necessary to make things work, but I'm also on the first few steps of establishing a solid career and laying down roots, which begs the question: how stable do I think things are going to be long term?

It's not really a factor in me choosing to go, but it is something I use as a motivating factor and way of convincing myself I'm doing the right thing.

I've been applying slowly, so it's not fair to really judge my speed as the average.
I've been in the process for about 5 years, but that's because I thought I might want to go this direction and started making enquiries and applications a loooong time ago.
I'm sure things could be done faster, but it was fairly frustrating doing it over 5 years, so I can't imagine what it'd be like trying to push things.

Overall, I'm looking forward to the change and hoping things work out in the end.
I genuinely enjoy what I do and like to teach, so hopefully I won't get stuck in woop woop (Australian for "the boondocks") teaching first aid classes to boy scouts, but if that's the way the cards fall, I'll make the best of it.

In our profession, flexibility is a key to contentment.

 

[Mordecai]

Best of luck. What state are you moving to?
I'm just coming to the end of an overseas elective in Trauma in Chicago. Been good.
I am thinking seriously about doing a fellowship the US when I'm through in Aus.

 

[nopockets]

I might be in the same boat in 6 years. I'm 1 year from graduating from my MBBS programme in Singapore, but have to serve a 5 year bond, during which I can, and am expected to complete my MRCP (MRCPCH for me) within 3 years of graduation, and work towards getting qualified as a consultant.
I just recently found out my family might be migrating to Australia on their own terms, so I might join them a few years after they settle down.
However, I hear there will be a flood of medical students graduating in 5 years though hopefully I can go the specialist route by then, rather than fight it out in the general AMC route.

 

[karkatvantas]

Is it true that you'll have to work for the first 10 years out in the boonies, or can you skip/shorten that period because you're a specialist?

How long have you been practicing in the US already?

I'm asking mostly because I'm a US citizen hoping to move to Australia or New Zealand after doing med school here in the states, and I'm trying to figure out what I'm in for. As far as I can tell, I'll need to complete my residency here before I can move there, is that right? It's hard for me to figure out exactly what the requirements are since the terminology is slightly different here and there.

Any info would be helpful. Thanks!

 

[omniatlas]

Am a US board certified Anesthesiologist.
Have my credentials verified by the AMC.
Have already undertaken evaluation by the ANZCA and am on the Specialist pathway.
Have already applied and interviewed for a job.
If accepted, and the details work out, I'll likely be moving this July.
That being said. . . ask away.

Hm, I'm kind of interested in the differences practicing gas in Australia vs. in the USA. All I hear is a consistent whine in the SDN Anaesthesiology forums.

 

[pitman]

Is it true that you'll have to work for the first 10 years out in the boonies, or can you skip/shorten that period because you're a specialist?

It can be shortened down to 5 years, as for any field, depending on how rural you go. So no, you don't have to be boonies, just wherever there's a shortage, in which case you may be doing the full 10 years.

If you come out before your training is done, then the years you take to complete your training (in a training hospital, so not in the boonies) also counts towards your moratorium, which starts as soon as you get generally registered (accredited by the AMC for your equivalent of internship here).

 

[Lokhtar]

You don't have to re-do the residency?

 

[kolombi]

Wow you've come such a long way, Congrats and i wish u the very best.
I'm in a dilemma about Australia and would really appreciate some help. I'm from Africa, 2 years post medical school, have started my residency program in Internal Medicine. I just passed the 1st AMC exams and am applying for a job online. I'm interested in getting into the residency program in Australia, however I'd like to know wot the chances are for getting into the program for a foreign doctor and wot the steps to go through are??

 

[karkatvantas]

It can be shortened down to 5 years, as for any field, depending on how rural you go. So no, you don't have to be boonies, just wherever there's a shortage, in which case you may be doing the full 10 years.

If you come out before your training is done, then the years you take to complete your training (in a training hospital, so not in the boonies) also counts towards your moratorium, which starts as soon as you get generally registered (accredited by the AMC for your equivalent of internship here).

Oh, awesome! When you say "training" I assume you mean what we call "residency" here? What is the process for IMGs to apply for training programs? Ideally I would like to be able to move to Australia as soon as I graduate from med school and do my residency down there, but I've heard that they're getting scarcer by the year. Is that true?

 

[cosycatus]

I might be in the same boat in 6 years. I'm 1 year from graduating from my MBBS programme in Singapore, but have to serve a 5 year bond, during which I can, and am expected to complete my MRCP (MRCPCH for me) within 3 years of graduation, and work towards getting qualified as a consultant.
I just recently found out my family might be migrating to Australia on their own terms, so I might join them a few years after they settle down.
However, I hear there will be a flood of medical students graduating in 5 years though hopefully I can go the specialist route by then, rather than fight it out in the general AMC route.

Hmmm...how come u are so sure u will get into a pediatric residency in Singapore?
anyway, i'm a singaporean student studying in Australia. Getting ur MRCPH will not get you specialist accredition here; u need to have finish a fellowship. By and large, if ur fellowship is from UK, it will be looked upon favorably. If u are male, you will not make it in 5 years, since 2 years will be serving NS. Else, u have to come here as a registrar and wait for a chance to enter AST ( which, given that u are not indigenous, even if u have PR or citizenship, u will wait and wait and with a flood of local indigenous australian student, who do u think will get priority? )

But seriously, if u are looking to migrate to Australia, be a GP!! M.med family medicine just take 3 years and u can sit for the FRCGP straight. Contrary to Singapore, GPs here make a lot ( easily 250K), whereas a specialist in the hospital make ~150K for non surgical specialties as an associate consultant, and have a flexible lifestyle and mode of practice. Some rural areas are paying 10K per week for a GP with housing and a car thrown in.

 

[C.P.]

Best of luck. What state are you moving to?
I'm just coming to the end of an overseas elective in Trauma in Chicago. Been good.
I am thinking seriously about doing a fellowship the US when I'm through in Aus.

I'm moving to NSW.
Starting out on the central coast, and then planning on heading to sydney for more specialized training.

 

[C.P.]

Is it true that you'll have to work for the first 10 years out in the boonies, or can you skip/shorten that period because you're a specialist?

How long have you been practicing in the US already?

I'm asking mostly because I'm a US citizen hoping to move to Australia or New Zealand after doing med school here in the states, and I'm trying to figure out what I'm in for. As far as I can tell, I'll need to complete my residency here before I can move there, is that right? It's hard for me to figure out exactly what the requirements are since the terminology is slightly different here and there.

Any info would be helpful. Thanks!

the ten year moratorium. It's something every international in Australia knows very well.
In the US, we have a system to help protect our local students. It has to do with government reimbursements for residency training. This significantly favours local grads over internationals. It's there to avoid all the US spots being taken up by the best and brightest from other parts of the world.
Australia has their own version.
It's the 19aa and 19ab amendments to the 1973 helath insurance act:
http://www.health.gov.au/internet/otd/publishing.nsf/Content/work-s19AB+factsheet

This rule dictates that an IMG cannot receive a provder number (which gives you the ability to bill and ultimately work anywhere) until ten years after you've achieved residency AND gotten your AHPRA license/registration.
EXCEPT if you work in an area of need or in a training position, which then allows you a hospital specific lmited license.

The point of the rule is this. Australia needs international grads. In fact I've read that upwards of 30% of their medical workforce is international.
What they don't need is for all of them (us) to settle in downtown sydney; causing a gluttony of docs in one area and a paucity in another.
This rule basically helps staff the "areas of need."

An "area of need" is not always in the middle of nowhere, some of them are large cities, and the need varies by specialty too.

the "ten year moratorium" also is less dependng on the population size.
This is classified by the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system.
RA1 - Major Cities of Australia (10 years)
RA2 - Inner Regional Australia (9 years)
RA3 - Outer Regional Australia (7 years)
RA4 - Remote Australia (6 years)
RA5 - Very Remote Australia (five years)

Here's the webpage describing it:
http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/program-otd

. . . and here's a map that will actually show you what ares fall into what category:
http://www.doctorconnect.gov.au/internet/otd/Publishing.nsf/Content/locator

For those in practice, the new regulations not only shorten the moratorium, but increase the payments the more rural you go:

"The new ASGC-RA classification system is based on 2006 Census data and was developed by the Australian Bureau of Statistics. The use of ASGC-RA and the introduction of scaling will help ensure that workforce incentives and rural health programs are targeted to areas of need – ‘the more remote you go, the greater the reward’.

Scaling is an incentive applied to a range of existing programs that will commence from 1 July 2010. The concept of scaling means that benefits derived will be significantly greater for doctors that chose to live and work in more remote areas as described in the ASGC-RA system. "

For GPs, there's also the 5-year overseas trained doctor scheme:
http://www.health.gov.au/internet/o...nt/work-5+Year+Overseas+trained+Doctor+Scheme

 

[C.P.]

Oh, awesome! When you say "training" I assume you mean what we call "residency" here? What is the process for IMGs to apply for training programs? Ideally I would like to be able to move to Australia as soon as I graduate from med school and do my residency down there, but I've heard that they're getting scarcer by the year. Is that true?

what's your training in?
I have my own thoughts on what you should do, but let me know what your specialty is first and I'll weigh in.

 

[C.P.]

You don't have to re-do the residency?

It depends on how you are "assessed."

Most will have to complete some part of a training scheme, unless you're an internationally recognized specialist who wrote the textbooks.

There is an Area-of-need pathway that goes from assessment to getting you into the workplace, but it isn't a guaranteed path to licensure, it's just a way of getting you working while the rest of the details are being looked at.

 

[pitman]

For those in practice, the new regulations not only shorten the moratorium, but increase the payments the more rural you go:

"The new ASGC-RA classification system is based on 2006 Census data and was developed by the Australian Bureau of Statistics. The use of ASGC-RA and the introduction of scaling will help ensure that workforce incentives and rural health programs are targeted to areas of need – ‘the more remote you go, the greater the reward'.

Just to tagteam C.P.'s excellent summary above...

Here's the incentive amounts for GP registrars like myself, which is the same for all specialties (one of the chief stated reasons for the new RA system was to standardize the incentives):
http://www.health.gov.au/internet/otd/publishing.nsf/Content/program-registrar-factsheet

Note the 10 Year Moratorium is a confusing misnomer for historical reasons, 'cos it was originally a fixed period of ten years (starting from the later of full registration [internship completion] and the gaining of Permanent Residency). I prefer to call it The Moratorium. Also, as of last year, the period starts from full registration (and is retroactively applied for all current moratoriumees who got their residency after registration). In other words, it's been relaxed significantly since the original Act. Probably the one smart thing Labor has done (via Minister of Health Roxon in response to considerable lobbying).

 

[Racer77]

C.P.

I am in somewhat of the same position as you are, but just not there yet. My girlfriend is Australian. The ultimate goal for us is to live in Australia after I finish either med school or residency. I am concerned with the issue of there not being many training spots for IMG's and that is one reason why I would prefer to wait till after I complete residency in the states. My specialty is trauma surgery. What is your opinion on fininding a job in Australia if you are already a liscensed physician in America? Would it be better to go through residency in Australia?

 

[C.P.]

C.P.

I am in somewhat of the same position as you are, but just not there yet. My girlfriend is Australian. The ultimate goal for us is to live in Australia after I finish either med school or residency. I am concerned with the issue of there not being many training spots for IMG's and that is one reason why I would prefer to wait till after I complete residency in the states. My specialty is trauma surgery. What is your opinion on fininding a job in Australia if you are already a liscensed physician in America? Would it be better to go through residency in Australia?

Finish your training in the US

Debate where you really want to live

Make sure you know what you want to do.

Coming to OZ to do residency after med school in the US has two HUGE downsides: one. . . you have to pay off med school. two . . . you'll have international training and have to completely redo this in the US if you ever want to return. Another downside; your training in Australia, while often less stressful, will be much longer.

If you train in the US and then Australia, you'll be licensed in the US, have to do some amount of retraining in Australia, but likely, the amount of time to complete your training in both, will be the same as if you just did it in Australia. Plus, you'll now be dual licensed.

The other downside? If you're considering trauma surgery in Australia, it's nothing like in the US. You'll likely be doing random ex-laps while anything truly interesting will be done by other specialists (liver lacs by the transplant guys, etc). Trauma surgery here is a totally different ball game.

I'm in Anesthesia, and while there's a lot of differences between the two countries, the transition looks like it should work out.

 

[omniatlas]

C.P.

I am in somewhat of the same position as you are, but just not there yet. My girlfriend is Australian. The ultimate goal for us is to live in Australia after I finish either med school or residency. I am concerned with the issue of there not being many training spots for IMG's and that is one reason why I would prefer to wait till after I complete residency in the states. My specialty is trauma surgery. What is your opinion on fininding a job in Australia if you are already a liscensed physician in America? Would it be better to go through residency in Australia?

I would complete your training in the US first before coming over here. I was an international student, graduating from an Australian medical school -- jobs were hard to come by, and you were lucky if you got a spot. The way Interns (PGY1) get allocated depends on the state you are applying to -- in QLD, residents come first, then interstate Australians, then NZ, then International students from the local medical schools. As an IMG, you will rank last.

Australia needs senior doctors, but junior docs? Nope, too many medical schools and graduates now, and not enough training positions. Even some of the local graduates don't have jobs!

 

[Racer77]

Thanks for your advice C.P. and omniatlas. I appreciate it. I dont like to hear about how Trauma surgery works there! But the information you guys gave definately helps in the decision process. I just feel like it would be to much of a gamble at this time to get a residency over there. I suppose someone could still apply for both US and Aus. But it still sounds like too much of a hassle and would be much easier once I am licensed to make the move.

 

[Leforte]

But it still sounds like too much of a hassle and would be much easier once I am licensed to make the move.

It will not become any easier once you have finished your US training - you will just be able to practice the field that you want. As a US trained surgeon, you will still be required to sit their exams, which are very different from US Board exams and have around a 50-70% first time pass rate for LOCAL graduates. It is lower for IMGs due to "technique" issues as well as knowledge issues - i.e. in the oral vivas do you approach the question in the way that they want you to - the only way to know this is to have sat in on their clinical tutorials that are part of the Aussie training programs. You may not have access to these as an IMG, especially if in an area of need position.

You will also be required to be supervised for 2 years and will have to serve up to 10 years in a public position in an area of need in order to attain a Medicare rebate for your services. There is a question if this 10 years is AFTER you have attained Fellowship in whatever College you apply to, so in fact if it takes you 4 years to get FRACS, FRACP, FRANZCA, etc, you may need to be in an area of need for 4+10=14 years (although I am not sure if it from when you have specialist recognition, general registration or if it starts when your limited license first becomes active).

Also, unlike the USA where there is often ample opportunities for professional growth in most communities and you can move most any place (for most surgical specialties, anyway) - such is not the case in Australia. It will be very difficult to find a position in a capital city as an IMG surgeon unless you have been invited in. It is not unheard of to be blocked from entering the area as an IMG until you have met the moratorium requirements. Seriously.

Something to think about before making the move. Take a look at how many US trained physicians/surgeons have made the move over (this information is in each Colleges annual reports). There is a reason the number is low.

 

[cool jas777]

Hello Sir,
This forum is very useful to collect the information required for getting registed as MPs in Aus. Sir I am a final year medical student. My internship is going to start soon. I am studying in China but going to do my internship in India and soon will get final degree. I want to know about Post Graduations in Aus. I know like we need to clear AMC exams. But still its not enough information.I heard its tough but i guess still not impossible atleast.But i don't exact procedure for it.
what is the procedure if i want to get admission in any speciality field like for MD/MS? what are the exams i need to clear? Can i work in aus as MPs?
I will very thankful to U for clearifying my doubts Sir .

 

[DrIng]

Is it true that you'll have to work for the first 10 years out in the boonies, or can you skip/shorten that period because you're a specialist?

How long have you been practicing in the US already?

I'm asking mostly because I'm a US citizen hoping to move to Australia or New Zealand after doing med school here in the states, and I'm trying to figure out what I'm in for. As far as I can tell, I'll need to complete my residency here before I can move there, is that right? It's hard for me to figure out exactly what the requirements are since the terminology is slightly different here and there.

Any info would be helpful. Thanks!

Often you will need to work in an "area of need" if you're coming from overseas to work in Australia. That said in my speciality, psychiatry, there are area of need positions in every major metropolitan city so no, depending on speciality, you don't need to be in the middle of nowhere...

 

[omniatlas]

Racer77 and all the other pre-meds,

If you really wanted to practice in Australia have you thought about the Ochsner clinical school? http://www2.som.uq.edu.au/SOM/OURSCHOOL/CLINICALSCHOOLS/Pages/OchsnerClinicalSchool(NewOrleans).aspx

You graduate with a UQ (Australian) degree, practice some of your clinical years in New Orleans, and are eligible to sit for the board exams in the US, or complete your Internship and subsequent training in Australia.

Perhaps someone else can fill you in with the details, I graduated from UQ when the program was still in its early stages.

 

[Leforte]

Racer77 and all the other pre-meds,

If you really wanted to practice in Australia have you thought about the Ochsner clinical school? http://www2.som.uq.edu.au/SOM/OURSCHOOL/CLINICALSCHOOLS/Pages/OchsnerClinicalSchool(NewOrleans).aspx

You graduate with a UQ (Australian) degree, practice some of your clinical years in New Orleans, and are eligible to sit for the board exams in the US, or complete your Internship and subsequent training in Australia.

Perhaps someone else can fill you in with the details, I graduated from UQ when the program was still in its early stages.

Not sure what you mean by eligible to sit the US Board exams. You can only become US Board Eligible by completing a Residency in the US that is accredited by the ACGME (or the DO equivalent for the DO boards). There are a few exceptions, but attending a certain medical school is not one of them.

If you mean that you the Oscher graduates are eligible to sit the USMLE - so is anyone in any medical school.

Regardless, if anyone is not an Australian Permanent Resident/Citizen or New Zealand PR/citizen when they commence studying at an Australian medical school, then they are subject to the moratorium. I know a few people who started out as on a study visa as first year med students in Oz, married and got PR/citizenship. Despite now being Aussie citizens who graduated from an Aussie medical school, are still subject to the moratorium.

 

[rayjay]

I'm almost positive (unless things have changed) that the UQ Oschner program is ONLY available to US citizens/PR. I'm just pointing that out because I think there is some confusion there; I've come across a lot of people who think they can apply to it.
Once again, things may have or may be changing but last I checked that was the case...unlucky for me I suppose, I love New Orleans!

 

[dkndys]

H CPi,

I read your posts about working moving to australia as an anesthesiologist with great interest. A quick question, does the 10 year moratorium affect you as an anesthesiologist working over there? I would imagine that an anesthesiologist practicing would not have much need for a practitioner number as they do not have a private practice they are billing for. Is that correct?

 

[C.P.]

H CPi,

I read your posts about working moving to australia as an anesthesiologist with great interest. A quick question, does the 10 year moratorium affect you as an anesthesiologist working over there? I would imagine that an anesthesiologist practicing would not have much need for a practitioner number as they do not have a private practice they are billing for. Is that correct?

yeah, it affects everyone. the setup here is different than how the US works. Private vs public insurance is like upgrading with frequent flier miles. The private insurance in australia is your frequent flier miles. If you want to upgrade, then you throw in your card and say "I wanna go private on this one." Why is this an issue? because you're constantly going to be seeing a mix of patients using public, public and private, or only private insurance. Even if you work at an academic place, if the patient says they only want attendings, then they use their private insurance. If an academic hospital employs me and I treat a patient who's using their private insurance, then the hospital collects nothing, but is still paying my salary. Not too many of them would employ me as a result. I could do all private work, but I wouldn't be able to collect anything at all in that situation since all of the patients are there using only their private insurance.
it sucks.

 

[Tiercelet]

C.P,
Thanks so much for doing this. You're doing a great service to those of us who've not been able to weed through the confusing, poorly documented, or out-of-date information out there on the Web.

Two quick questions: First, I'm more in the non-trad category -- if I go to med school in the States, I'll be in my 40s when I'm done with residency. That starts to make it tough to get PR in Australia, doesn't it? Are there issues there to be aware of?

Second, I think I understand correctly that if you are not a PR by the time you start medical school, you will be considered an IMG, even if you became a PR before you started your second year. Now if you have your permanent residency before you start med school, are you considered same as native for residency purposes?

Thirdly, how are non-trads viewed in Australia? Level playing field, or forget it?

Thanks for your input!

 

[Leforte]

Two quick questions: First, I'm more in the non-trad category -- if I go to med school in the States, I'll be in my 40s when I'm done with residency. That starts to make it tough to get PR in Australia, doesn't it? Are there issues there to be aware of?

Unless you are married to an Aussie (like myself and CP), you will need to get temporary residency first. This is generally done via the 457 subclass pathway for physicians now (there used to be other ways, but it seems to be going this way). After a few years, you can apply to be sponsored for permanent residency. If you become a PR, however, you are subject to additional requirements as an IMG - i.e., if you do not have Fellowship with one of the colleges within 4 years, you can no longer practice medicine since you cannot get a license.

Second, I think I understand correctly that if you are not a PR by the time you start medical school, you will be considered an IMG, even if you became a PR before you started your second year. Now if you have your permanent residency before you start med school, are you considered same as native for residency purposes?

If you are not a PR on the day that you matriculate, you are considered an IMG even if you do all of your med school in Australia and got PR on day 1 after matriculation. That's the way that it is. Moreover, let's say that you get accepted as an international student, and for some reason get PR prior to starting - your position may be withdrawn since there are so many allocate to full fee paying IMGs. If you are a PR, you no longer qualify for that position. The only exemption, that I am aware of, to the IMG moratorium are New Zealanders. The fact that IMGs who do their medical school in Australia are still subject to the moratorium has been brought up multiple times to show how the policy is inherently prejudice to people who are form other countries and not necessarily a reflection of lack of an Australian medical education (since the full fee paying IMGs in Aussie medical schools would then NOT be subject to the moratorium) - but in the end, it is simply ignored. When the arguments are made, no real answer is given and the powers that be simply ignore any objections. The fact is even worse when IMGs get citizenship and are still subject to the moratorium.

At the end of the day, it is not going away, and if you are an IMG and wish to practice in Australia, it is an inevitable fact that you will have to either learn to accept and adjust your career goals, or stay in your home country.

As far as being considered a native (I would assume you mean non-IMG) - no if you were not in a PR/citizen med school slot on day 1 of medical school, you are considered an IMG and are at the bottom of the allocations for postgraduate training.

Thirdly, how are non-trads viewed in Australia? Level playing field, or forget it?

Non-trads are viewed well. Level playing field I would say, and I would say maybe even at an advantage in certain circumstances.

 

[pitman]

As far as being considered a native (I would assume you mean non-IMG) - no if you were not in a PR/citizen med school slot on day 1 of medical school, you are considered an IMG and are at the bottom of the allocations for postgraduate training.

I keep hearing this, and it may be true in some states (NSW?) but has not been in Queensland -- as long as you have your PR when you apply for the internship Ballot (in 4th year), you'll be priority 1 for internship. Unless this has changed in the past year, in which case someone please post a reference..

 

[Leforte]

I keep hearing this, and it may be true in some states (NSW?) but has not been in Queensland -- as long as you have your PR when you apply for the internship Ballot (in 4th year), you'll be priority 1 for internship. Unless this has changed in the past year, in which case someone please post a reference..

Here is the reference -

http://www.health.qld.gov.au/medical/intern/Priority_Groups.pdf

I would agree with you that the QLD health statement is a bit ambiguous. Notice that many of the PR priority categories are based on where you were in Year 12 - as if where you where in high school has any importance on how well you'll be as an intern.... I would find it very difficult to believe that QLD would accept a IMG who obtained PR after matriculation over an Australian Citizen who attended U Sydney or other Australian universities.

Also - as the ratio of intern applicants to positions increases and eventually becomes > 1, I would anticipate this to change.

Moreover, this has nothing to do with the moratorium requirements. Simply internship placement priority groups. It is the moratorium issue that sucks in the end.

In addition - I would ask you, since you are in QLD and in the post-graduate training culture - how many of your non-Aussie born classmates have progressed into competitive specialties (opthalmology, etc)?
-----------------------
Priority Groups
As part of an agreement between the Commonwealth and State Governments in 2006, the Queensland Government has agreed to provide an internship offer to medical graduates of Queensland universities who are Australian citizens, Australian permanent residents or New Zealand citizens. The Queensland Government and Queensland Health are meeting that commitment and have continued to progressively expand the number of intern places with the growth in domestic medical graduates.
Planning for further increases in intern positions to meet projected Queensland universities' domestic medical graduate numbers is underway. This includes ensuring that all internship terms are accredited by the Postgraduate Medical Education Council of Queensland, as per the requirements of the Medical Board of Australia.

ALLOCATION OF PRIORITY GROUPS
Applicants eligible for an internship in Queensland will be considered for available intern positions in the following order of priority:

Priority Category

Definition of Applicant Priority

1 - Medical graduates of Queensland universities who are Australian citizens, Australian permanent residents or New Zealand citizens.

2 - Medical graduates of interstate or New Zealand universities who: completed Year 12 in Queensland, and
are Australian/New Zealand citizens, or
are Australian permanent residents.

3 - Medical graduates of interstate or New Zealand universities who: completed Year 12 outside of Queensland, and
are Australian/New Zealand citizens, or
are Australian permanent residents.

4 - Medical graduates of Queensland universities who:
are overseas permanent residents or overseas citizens, other than New Zealand citizens, and are permitted to remain in Australia for internship.

5 - Medical graduates of interstate or New Zealand universities who:
are overseas permanent residents or overseas citizens, other than New Zealand citizens, and are permitted to remain in Australia for internship

6 - Medical graduates of international universities who have successfully completed the Australian Medical Council (AMC) written and clinical exams and have obtained the AMC certificate who:
are Australian/New Zealand citizens, or
are Australian permanent residents, and
require a year of supervised training to meet general registration requirements of the Medical
Board of Australia.

7 - Medical graduates of international universities who have successfully completed the Australian Medical Council (AMC) written and clinical exams and have obtained the AMC certificate who:
are overseas permanent residents or overseas citizens, other than New Zealand citizens, and require a year of supervised training to meet general registration requirements of the Medical
Board of Australia.

 

[pitman]

Here is the reference -

http://www.health.qld.gov.au/medical/intern/Priority_Groups.pdf

I would agree with you that the QLD health statement is a bit ambiguous. Notice that many of the PR priority categories are based on where you were in Year 12 - as if where you where in high school has any importance on how well you'll be as an intern.... I would find it very difficult to believe that QLD would accept a IMG who obtained PR after matriculation over an Australian Citizen who attended U Sydney or other Australian universities.

That's the same wording (with some minor tweaking, e.g. Kiwis now on the same level as Australians) as usual, with the 2006 reference a response to our lobbying.

So it remains that so long as you get PR before the Ballot, you get bumped up higher than P4. In other words, if you go to a Qld med school and get PR at anytime, you do indeed become P1.

In addition - I would ask you, since you are in QLD and in the post-graduate training culture - how many of your non-Aussie born classmates have progressed into competitive specialties (opthalmology, etc)?

Most of my non-Aussie classmates went to Canada or the US. A few others I've lost contact with. I only know the progress here of three of us -- one is in radiology (very competitive), one (internal) medicine, and I'm GP. There really isn't any bias against non-citizen PRs that I've seen, though it's possible there might be in surgery -- not that I've seen it, but surgery is hell to get into, with only one classmate (now 4th year out) an official registrar, while at least 8 or 10 are PHOs (senior junior docs who have reg responsibilities but who haven't been accepted to the college).

 

[pika p]

Hi C.P. I am currently in medical school as of now (year 2 to be exact), and I am planning on moving to australia to do the exact same thing. I wanted to first finish my residency in anesthesiology here in the states, and then go over to australia to practice. I was wondering if you could tell me more about the process. My partner will be coming from the UK to australia and they wanted to go after their foundation years. So here are a couple questions I had during my research:

1) How would you go about finding a job? I know they have recruitment websites and whatnot, but I am not sure which ones are legit.
2) Do you have to go through the process of registration before you find a job?
3) Do you know anything about junior doctors going to australia through the competent authority pathway and the process involved in that? I know they have to do a year of supervised hospital work. Do you know how you would go about finding hospital placements that would be willing to supervise for that pathway?
4) last but not least, how easy is it to find a job as a foreign doctor?

Thanks in advance for all your help

 

[C.P.]

Finish your training in the US.
Here's why.
Training in Australia takes longer (in calendar time but not in hours worked).
Right now there is an abundance of medical students finishing up after a push was made to create more medical practitioners. Unfortunately, there wasn't an increase made in the number of residency spots so the competition is getting fierce, as of this year.
For some of the people (australian) who've approached me about the idea of training in the US and then returning to Australia, I've given cautionary support, but encouraged them to give it a try.

Complete your US training, maybe work a couple years even, then come to Australia. You'll be assessed and likely have to do 1-2 years of "bridging time," which will most likely be spent as a senior resident equivalent position, and then have to sit they're final exams.
There is a possibility you may not have to do the exam, but currently it seems that's what they'd like from a US grad (there's only two of us over in Australia right now, by the way).

What does this mean?
For less or about the same time as doing your training from the start in Australia, you can become board certified in Australia and the US, and then work in Australia.

It's beneficial on your end to have dual certification, and it's really beneficial to the local Australian system as you're bringing in new skills from a different system and not trying to compete for one of the local training spots.

So, to answer your specific questions:
1) Getting a job.
There are two types of jobs here, public jobs and private jobs. Public jobs all get advertised through the government website. Private jobs are usually like in the US, mostly word of mouth. Don't stress about it too much though, you'll have time to figure it out while you are in your "bridging" period.

2) Registration.
Before you can start any kind of medical work here, you'll have to go through some basic registration hurdles; getting your medical credentials validated is one of them.
After that, when you finish your assessment time, you'll have about 6 months where you're getting paperwork filled out and all your registrations finalized. This also isn't a worry as you can do this while you're working. Most places are fine if you're in the process of getting things sorted out. This can be different for private work though, but there are options while you're waiting for things to come through. Again, it's definitely something you need to take care of, but I wouldn't worry about it till after you've gotten here as there's nothing you can do about it ahead of time.

3) It would be my last recommendation to come here with only part of your training completed. you're getting the worst of both worlds then; not completing a US training program, and likely being assessed as having to do an extensive part if not all of our Australian training. It is possible to do, and the pathway is the same; apply for medical certification through the AMC (Australian Medical Council) and then to the college of anaesthetists. This would be if you're just going for the specialist pathway.

4) Finding a job depends entirely on your skills. Everyone told me it is a rough job market (which, to be fair, it is), but I came in with a solid skill set and had several positions made available to me.
The point being, you can get a job. The more flexible your needs are the more options you'll have. That's not unique to Australia though.

So, here's the key point. All the things you asked are important, but the only one you need to focus on is getting registration and getting assessed.

Work for a year or two afterwards, just to build up some cash to help with the transition and moving costs.

I took care of the paperwork slowly, and started it during my last year of residency (it's a lot easier getting things signed and records collected when you're still at your training hospital), and then finished things up over the next couple years.

Overall, it's a pain to do, but just because of the logistics of moving continents, recertifying in a medical specialty, and learning/struggling with the nuances of a different medical system.

I am very happy being here, but never would have gone through the struggle if it weren't for family.

Does that help?

 

[pika p]

Thank you soooo much CP for your reply! It really does help sort out this process in my head. I apologize... if I seem a bit slow in understanding this whole process, but there are just a few things I'd like to clarify.

So you said finish up my residency in the US and then afterwards go to australia to get assessed. I understand that going through the specialist pathway you have to get assessed by that college to make sure your credentials are the same as australia's and if not you'll have to do some more training and then take an examination. I was wondering if you could tell me more about how the specialist college goes about assessing you. As I've read from the ANZCA website, they have an interview panel that reviews your credentials and afterwards there's a "period of 12-24 months of upskilling or supervised practice", which I think is the same as what you're referring to as the "bridging time". My questions are:

1) How was this interview process? Could you give me a quick idea of what you had to do in this interview panel?
2) Will they place you in a hospital workplace for your "bridging time" or would you have to find a place yourself to do that time?
3) During this time, will they pay you for this "supervised practice", or is it out of your own expense?

Just so I get this correct, without any misconceived perceptions, I have listed what I took out of your reply. Please do correct me if I'm wrong.

1) Do some paperwork during residency (or the year before you plan on going)? (I'm assuming online application for the specialist pathway)
2) After finishing your training in the US, either work for a year or two to get money to go to australia or just directly go through the interview process get assessed for your medical credentials/more training if necessary to meet up to australian standards. (bridging time)
3) After your training/assessments are completed, finish the registration process and find a job (public or private: have a better idea while working there in your "bridging period")

One last question: Do you have a rough estimate for how long each part of the process took?

I apologize for flooding you with soo many questions. Once again, I am incredibly grateful that you're taking the time to help people like me ease the process of going to australia!!

 

[C.P.]

Don't worry. It's taken me a couple of years to begin to really feel like I understand the system here. That's the biggest challenge when applying too: you need to express how you are as compatible as possible to this system, but you don't know their system yet.

I refer to it as "bridging time," but you're officially working as a senior resident. The only difference is that you have little to no requirements for meeting case load requirements or ensuring you've completed certain rotations, because you've already done all that.

1) start applying to the AMC to get your medical credentials approved. Start the paperwork in the last year of residency (don't start now). You don't want to do it too early, as their certification does expire (I'm not sure how long it's good for, but it's a few years at least). You can start getting familiar with the paperwork ahead of time so you can keep track of the documents they'll want at a later date. Applying for the Specialist pathway; same thing. Get the paperwork ready, but don't send it in till you're finished. If you haven't been board certified then you may not meet the same levels of competence they're looking for.

2) That's the main reason I mentioned taking a year or two after your residency to work. Your board exams don't start till you've finished residency and take 14 months to 2 years at a minimum to complete. Plenty of time to get paperwork done, save up some cash, and start looking into residency spots.
*** just so you can feel a bit more relaxed, residency here is a LOT easier in terms of pace and stress. Your work weeks are short, your pay is 3-4 times higher than what you'll make in the US as a resident, and you get lots of holidays.

3) I had a job lined up before I officially received my board certification here. It was an easy choice for the places I was applying to. They were getting a dual certified, experienced attending (consultant here) at entry level pay.

The time of the process is a bit deceptive, because I casually went through the paperwork. I started the paperwork in my final year of residency, got my AMC (medical credentials) verified after about a year (no interview required), then started applying for an Anesthesia specialist pathway about a year later. That took about a year and change to finish. You have to apply to be accepted on the specialist pathway. Once you've been accepted, then you get invited for an interview, which you have to do in person, in Melbourne. After that, you get a reply a few weeks later. Based on that, you can start applying for training spots right away.

If you do it the way I did, you won't be waiting for paperwork to catch up for you to move over.

The important part you really need to figure out is getting permanent residency here.
That's a limiting factor.

I'm married to an Australian, which is what allowed me to work here. Without a work visa of some sort, you're put much lower on the interview list and can only be offered a spot if no other local candidates filled the position.

Any chance you're an Australian or permanent resident?

 

[pika p]

Okay I think I am getting a better idea of the process, but it's still a bit confusing to me.

1) You stated that you work a year or two after your residency (US)... are you working in australia or in the US? ( or is this the bridging time? ) I guess I'm a bit confused about what happens between your residency in the US and board exams for australia. I thought you would go to australia for residency/training and then take the board exams or are you talking about the time between you finish your australian residency and your board exams? I don't know if what I'm thinking is correct.
2) In terms of the permanent residency, does that play a role in getting residency/training spots in australia?
3) Unfortunately, I'm not an australian or permanent resident, however if I were to work as "senior resident" during the bridging time over there, would I be able to obtain a permanent residency/work visa during that time, or like I asked above, does it affect the residency spots given to me?

Thanks again CP for your quick responses!!

 

[C.P.]

Good questions.
After residency (in the US), I worked for two and a half years while I was taking the boards. During this time you're known as Board Eligible (BE). Once you're done, you're then known as Board Certified (BC).
After becoming board certified in the US, and after being evaluated (assessed) by the Australian Anesthesia College (ANZCA), you can hen apply for a job as a resident.

The terminology gets really confusing at this point, because they have different training levels: intern, resident, registrar, provisional fellow, etc.

The easy way to summarize it is that you interview for jobs at different levels as you become more senior. Instead of the US system, where you're getting accepted into a complete training program, you work you're way up from job to job. There are packaged training jobs, called "scheme positions," which guarantees they'll keep you till you're done, but even these only cover your specific training in Anesthesia, no the multiple years beforehand while you're learning the ropes and getting a resume built so you can apply to an Anesthesia program.

So:
1) finish your anesthesia training in the US (you're now B.E.). Work in the US (as an attending) while studying for, taking, and passing (most important part) your American boards.
2) apply for, accept, and start a job in Australia.
3) complete the time and whatever other requirements (likely they're final exam) they ask of you.
4) you're now dual certified in the US and Australia.

Permanent Residency. It plays a big role. You NEED to have a visa situation (permanent residency is one way, but there are multiple others) that allows you to work there. Not having Permanent Residency does not mean you can't apply or interview, but what it does mean is that those jobs can only consider you for the job if they can reasonably say they had no, qualified, local applicants to fill the spot.

Getting a work visa is foreign territory for me. My wife is Australian, so I had permanent residency applied for before I got here.
I know it's achievable though, as I'm surrounded by other people who don't have permanent residency here.

Does that help?

 

[thomas pynchon]

To C. P. I think you'll encounter a lot of difficulty in getting into the main hospitals in Australia and will have a very tough time staying in Australia if you do even get a position there. Your prospects of being able to stay long term are not very good either.

 

[C.P.]

The point you're raising regarding how competitive positions are at main hospitals is an important one, but nothing unique to australia.
Positions in large institutions are always going to be, whether the US or in Australia.
If you're a strong applicant (and being dual boarded is very desirable) you'll get a job .
If you're more flexible in where you're willing to live and work, your options proportionally increase (which, again is like the US).

In regards to staying here longterm, it has absolutely nothing to do with the job market and everything to do with getting a visa or perm residency.

Just to reiterate. I work at one of the of the largest hospitals in Sydney and was being head hunted by several others when I finished my credentials in oz.
Again this is as a consultant.
Coming as a resident/trainee would not be my recommendation.

 

[pika p]

Thanks CP! it definitely clarified a lot of things! I didn't realize that boards in the US took about 2 years to complete! It makes a lot sense now then.

If I have more questions as the time draws near, would you still be open to answering questions? I won't be starting the process for a couple years down the road.

 

[C.P.]

Not a problem.
I'm happy to help out however I can.

 

[dally1025]

The point you're raising regarding how competitive positions are at main hospitals is an important one, but nothing unique to australia.
Positions in large institutions are always going to be, whether the US or in Australia.
If you're a strong applicant (and being dual boarded is very desirable) you'll get a job .
If you're more flexible in where you're willing to live and work, your options proportionally increase (which, again is like the US).

In regards to staying here longterm, it has absolutely nothing to do with the job market and everything to do with getting a visa or perm residency.

Just to reiterate. I work at one of the of the largest hospitals in Sydney and was being head hunted by several others when I finished my credentials in oz.
Again this is as a consultant.
Coming as a resident/trainee would not be my recommendation.

Just to clarify, you have to complete a residency even after you're board certified? How long does this last? I also married an Aussie and am just trying to figure how feasible it is to work in oz. I am in an emergency medicine residency and will be board certified before we would think about moving. Thanks!

 

[neulite30]

According to the Australasian College for Emergency Medicine (ACEM):

https://www.acem.org.au/getmedia/cd.../OCC_flow_diagram_v2_June_2013_FINAL.pdf.aspx

Depending on the assessment by the college, you may have to undergo supervised training. Being board certified in America or Canada does not necessarily make a physician comparable in Australia. The degree of this comparison is done by the college's assessment of your qualifications.

 

[C.P.]

neulite is correct.

There is no reciprocity between the US and Australia.
Essentially, what happens is you first apply to Australia to have your medical qualifications recognized.
Once that is done, you choose one of two pathways to have your EM skills assessed.
General pathway
Specialist pathway

Going down the general pathway means you want all of your qualifications recognized, which allows you to get credit for all your training, including EM training. This opens the door for you to retrain in something else later on, if you decide to switch fields.

The Specialist pathway means you only are applying to work in EM (or whatever speciality you're applying for), and aren't requesting the ability to do anything else.

There are advantages to both pathways, but in my case it was much simpler to go down the specialist pathway, as I was only being assessed to work in Anesthesia.

You'll apply to the college of emergency medicine (eventually) and they'll have you jump through their hoops, eventually deciding on what they'd like you to do to be considered up to the same standards in Australia, and essentially be board certified there.

Understand that they are likely to require you to do some repeated training, but not because they view your training as inferior, but because they need to fill in any training differences and also introduce you to the australian system.

Cardiac disease is cardiac disease, no matter what side of the equator you're on.
Hospitals and health systems aren't though, and spending some time in a structured environment while you learn the new ropes is invaluable and essential for patient safety.

I had to do 2 years of "supervised" time. I got a position as a senior resident and just worked for two years. No specific rotations or numbers of cases I needed to show. I just had to prove I was competent and not crazy. . . which is debatable, via an evaluation form every six months. This form was only one page long and had only boxes to check. Nothing too onerous.

Anyway.

You first priority is getting permanent residency.
Your wife is Australian, you're eligible for it, so start the paperwork if you haven't already.

You really don't have much of a chance at getting into the system otherwise.
Being international, without any visa status, puts you very far down the line of people that are able to be considered for training positions.

Think about the jobs you're applying for like applying for a post-training fellowship in the US.
That's kind of the situation you'll be in here.

Any idea what part of the country you'd like to be in?
Do you have a timeline for moving over?

 

[neulite30]

You first priority is getting permanent residency.

While I think all of C.P.'s advice/experience is invaluable, if you're going to heed any of it I would place emphasis on getting Australian permanent residence.

Many specialist colleges will require you to do some supervised training (like C.P. mentioned). The hospitals and labs preference Australian citizens and holders of PR. In fact, it's a governmental policy.

Get this first and foremost, period. full stop.

 

[fuyulee]

First of all, awesome thread. Glad I found you guys.

I am an international student (from Taiwan) currently waiting to hear back from both US and Australian (University of Queensland) MD programs. In either country I would be considered a foreigner so I am not sure where should I am for. You guys have made it sound like getting a good job after graduating from UQ would be very difficult without becoming an Australian PR first, but on the other hand, here in the US it is really hard to even get into a MD program if you are not a PR. Alternatively I could apply to DO programs in the US but that would be another year down the drain. So here comes my questions:

How can one get a Australian PR, besides marrying an Australian? In the US I can apply for the diversity visa lottery and as a Taiwanese, I have a good shot of getting one within 3-4 years.

My chances of getting into an US MD program as a non-US citizen/PR seems slim right now but I have a good shot of getting into a DO program. Do you guys think that would be better, long term career wise, than going to UQ MD as a foreigner and then facing all the problems once I graduate?

I really wouldn't mind practicing in either country but I am not sure where I would have better chances

 

[C.P.]

wow. . . that's a tough question.
I'll try and simplify it down to some key points. My perspective is as someone who's gone through training systems in both countries, and has also worked as an academic/trainer in both systems too.
1) both systems are going to be difficult to get into as a foreign grad. I'd apply to both and see what happens. If you only get one, reasonable, option, then that's pretty much decided the debate for you.
. . . but, if you're lucky enough to get both options open, then the complexity starts.

2) where do you want to live, long term. If it's back in Taiwan (or wherever it may be) find out how they accept the US and Australian medical degrees. If one of them is poorly accepted or has limited reciprocity, then that should also be a big factor to consider. Again, this is if you have the option of being accepted by both programs.

3) DO vs MD. You can do well as a DO, but being an international (in terms of visa status), and having a DO, will make your options for getting into a good residency program a lot harder unless you're a rockstar and/or have some good connections. This isn't a reason not to go this route, but these are the hurdles you'll face, and you should, likewise, see how a DO would be accept where you're planning on living long-term. Additionally, if you're just looking at your medical training in the US, but not residency training, then you need to see how a US med degree transfers to where you're planning on doing advanced training.
Med school/DO school is a lot easier to get into as a foreign grad than getting into a residency program. Part of this is because you're going to be paying for the med school, but residency, they're hiring and paying you. If you need to be sponsored for a visa, you'll need an institution who's willing to do the sponsoring.

4) Australian PR. I married an Australian, and had PR before I started working here. I also completed my medical school and all my training in the US before I came over, which made the transition a lot easier than if I was planning on doing my training here and then trying to get a job too. I'm not the best one to guide you through that process, but here's the link to the Australian website regarding getting a visa to study:
http://www.immi.gov.au/Visas/Pages/...25&Stay=All&Length=All&Family=All&Sponsor=All
You don't need PR to go to medical school, but if you want to stay afterwards and do your training, you'll be at a large disadvantage if you don't have it.
My understanding is that you should be able to qualify for a visa if you can document you've been accepted into an Australian medical school.
I'd look at just going this route first and then trying to figure out PR once you're actually here.

I've a lot more I can tell you, but why don't we start with this and see what you think.