Americans working in Europe?

[pod2be]

I hope this thread is not redundant, I have not found a direct answer to my questions here so I will start a new thread. Any help from you European medical people will be greatly appreciated!

I am a PGY-1 in an orthopedic surgery residency in the U.S. Obviously I have five years to go, but I'd like to start gathering info now while I have the time to do so.

My wife and I spent a month in Europe between my Ms1 and Ms2 years of medical school and absolutely loved it there. We both would like to go back and spend much more time there, enough to get immersed and learn about a culture and to also be able to take trips all over europe on weekends/holidays. We think we'd like to spend at least one year there after I finish my residency training. I'm interested in France, Germany, and the UK most but I would look elsewhere as well. My questions are:
1. can an American educated and trained surgeon work in any european countries without re-doing residency years?
2. how much money could one earn in a one to two year locum tenens job in orthopedic surgery? (I'm not money hungry or anything but as soon as residency ends I have to start paying those monstrous american medical school loans you've heard so much about)
3. are there internet or by-mail sources of information about such things? I haven't been able to find anything after hours of searching the net.

I know an American orthopod that did a fellowship in scotland after residency, and that would be great except that I want to subspecialize in spine surgery and in the states you have to have accredited american fellowship training to be certified in spine.

Any suggestions, comments, etc would be greatly appreciated! I know this is rather counter to the usual FMG going to the US, but frankly American culture leaves much to be desired so I'd like to experience the world a little before I get completely tied down to an established practice and family ties to the U.S.

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[Winged Scapula]

I cannot speak of the conditions/regulations in France or Germany but in the UK, outside of fellowship training, you usually have to be "registered" as a House Officer. Registration usually involves doing 1 House Officer year - generally as an intern, if you are not trained and registered.

You can find more information on registering and the exam (PLAB) from various medical sites, including <a href="http://www.bmj.com." target="_blank">www.bmj.com.</a> Perhaps there are loopholes?

 

[BellKicker]

Hi.

I had similar questions, which I addressed in a thread called "back-and-forth docs" a while ago. There was some useful answers although nothing clear cut.

The problem is that every country (or region, at least) has different rules. In my own region (Scandinavia), I know for a fact that you have to have taken your post-grad training here to get the "full certification". Now, there are many loopholes but I'm not sure how they work.

When you say Europe, I guess you could mean Great Britain and Ireland, but if you're talking continental Europe you have to consider the language. In fact, that seems to be the biggest barrier for IMGs here. Also, every region has different tests (if they have tests at all). Here (and by that I mean the Nordic countries) I've heard it's like a harder CSA along with a little medico-legal test.

As for money...... Again I can only speak for my own region. Doctors make peanuts here. We're what you might consider socialists. We have the highest minimum wages in the world but also (and I love telling people this) what must be the lowest maximum wages in the world. I guess an orthopeadic surgeon would make maybe 80.000 here and then come the highest taxes in the world to steal 2/3 of your income.

I don't know, I think doctors in Europe make considerably less than in the US. This might make some Brits or other residents of big countries very mad but that's my general impression.

Good luck.

 

[ApacheIndian]

I can relate. I actually want to live in Budepest, Hungary, but the fact of the matter is, I'm not gonna take a 90% pay cut for it. I'm planning on finishing residency here, and then after that, work for a few months here, go to Budapest for a few months, work here for a few months... I've heard of other docs doing this... an OB attending was telling me about a friend of his who fulfills his monthy licensure maintenance requirements (minimum 144 hours/month) by working 12 straight days, 12 hours a day. The remaining 18 days? He's off to join his wife and kid in the Bahamas.

 

[Peeshee]

These are very interesting ideas. I am curious to know where you can find a job as a physician in the US working a few months and then taking a few months off to go to another country to also work as a physician. Are you talking about your own practice?

 

[ApacheIndian]

Actually, I don't intend to work as a physician while outside of the U.S. The money outside of the States just isn't worth it... my time's more valuable. There are actually tons of good investment opportunities in Europe... businesses and ideas that are flourishing here in the States, but haven't quite yet made it to Europe. THAT'S how one becomes wealthy/successful in Europe... that or join the Mafia.

 

[Stormreaver]

Now this maybe be partly inaccurate, but if you clear the MRCS (Member Royal College of Surgeons) Exam and fulfil certain other requirements (not sure exactly) you can be exempt from the PLAB and be allowed a post as a registrar (equivalent to a fellow/junior faculty).

As I said, I'm not fully sure.

 

[Winged Scapula]

•••quote:•••Originally posted by Stormreaver:
•Now this maybe be partly inaccurate, but if you clear the MRCS (Member Royal College of Surgeons) Exam and fulfil certain other requirements (not sure exactly) you can be exempt from the PLAB and be allowed a post as a registrar (equivalent to a fellow/junior faculty).

As I said, I'm not fully sure.•••••That may be true - that said, only 10% of people pass the darn thing on their first try! <img border="0" title="" alt="[Eek!]" src="eek.gif" />

BTW, it was always my understanding that a registrar is not equal to a fellow/junior faculty but rather to a senior resident (ie, you become a registrar after you complete RMO [registered medical officer] year which comes after your intern year = so equal to a 3rd year resident on the US system (but bearing in mind that residencies in the UK are much longer than in the US).

 

[pod2be]

Thanks for the info everyone.

I have found some info in the british medical journal and from links to other sites. The info is rather confusing because the terms are all so different. Like they say Americans and Brits are separated by a common language.

In the US I'll do an internship year and four years of surgical residency training. I want to do a fellowship year as well. I might do a fellowship in the US, get board certified (which I think is the equivalent to the British consultant) and then cross the pond to do locum tenens work for whomever will have me. Or I could do my fellowship over there, or do two fellowships. Lots of options apparently. Hopefully my residency coordinator will be able to help me seek out my best option.

Just for mine and other yanks' information, can someone translate all the resident designations of Britain's national health system?

I've seen pre-reg, registrar, senior house officer, specialist registrar, consultant, hospital staff. Very confusing.

Over here we just say pgy-# and specialty. Fellows are above residents and attendings are the top dogs.

Oh yeah, and for reference info, Orthopaedic surgeons in the US average income is around 350k. Spine surgeons sometimes approach 1M per year. Big difference, but I'd still like to give Europe a try!

 

[Stormreaver]

•••quote:•••Originally posted by Kimberli Cox:
• •••quote:•••Originally posted by Stormreaver:
•Now this maybe be partly inaccurate, but if you clear the MRCS (Member Royal College of Surgeons) Exam and fulfil certain other requirements (not sure exactly) you can be exempt from the PLAB and be allowed a post as a registrar (equivalent to a fellow/junior faculty).

As I said, I'm not fully sure.•••••That may be true - that said, only 10% of people pass the darn thing on their first try! <img border="0" title="" alt="[Eek!]" src="eek.gif" />

BTW, it was always my understanding that a registrar is not equal to a fellow/junior faculty but rather to a senior resident (ie, you become a registrar after you complete RMO [registered medical officer] year which comes after your intern year = so equal to a 3rd year resident on the US system (but bearing in mind that residencies in the UK are much longer than in the US).•••••It IS kind of confusing; from what I know, you start of life as a pre-reg (pre-registration House officer) then do several years of basic surgical training as a SHO (senior house officer), then a registrar. After completing the MRCS you get appointed as a specialist registrar, where you go for higher surgical training to get a CCST (certificate of completion of specialist training). I'm not sure about that 10% pass rate-- our recent graduates have been doing much better than that!

The confusing thing is that in Pakistan, the senior resident is called registrar and the fellow, a senior registrar!

So, basically, in my understanding:
Pre-registration HO: Intern
Senior House officer: PGY 2- through whatever (open ended, but usually around 2 yrs)
Registrar: Senior Resident
Specialist Registrar: Fellow
Consultant: Attending

Correct me if I'm wrong!

 

[Stormreaver]

OK, I found the website for you: <a href="http://www.rcseng.ac.uk" target="_blank">www.rcseng.ac.uk</a> and apparently I was pretty much on target with the above designations. Their residency is more open-ended and requires passing the exam rather than a specific time frame.

•••quote:•••Mediated Entry to the Specialist Register
Overseas qualified specialists whose training and qualifications are assessed as equivalent to either a CCST, or the skills consistent with practice as an NHS consultant, can apply for mediated entry to the GMC's specialist register. Entry to the specialist register allows doctors to work as consultants in the UK.

Doctors wishing to have their surgical experience and qualifications considered for entry to the specialist register should contact the Joint Committee on Higher Surgical Training (JCHST) on 020 7312 6654 for further details.

••••

 

[nychick]

This is a link to the Association of German Doctors that details some of the requirements for those looking to practice in Germany. It's in German, but you'll need to know German anyhow to practice in Germany, I reckon, so I'm not going to bother summarizing or translating.

http://www.bundesaerztekammer.de/30/Auslandsdienst/20FAQ/

 

[BellKicker]

nychick, I KNOW you're bored when you start digging up ancient threads..... Last post was 7 months ago!

I think someone needs a hobby until July first...........