attn: Dr Kimberli Cox

[robin1]

Hi,

I've been reading through alot of the posts on the forum and I have a couple of questions that I hope you can help me with.

1. How exactly did your fellow interns/residents and especially attendings react to your having held a degree from Australia? Since I know Carribean grads often face alot of IMG stigma, I'm curious if you were considered as being more "on par" with the US grads having attended med school in Australia?

I'm asking because I am now giving serious thought to going abroad (either Australia or the UK) for med school. As I have done considerably well in my undergrad (biochem major), I'm already having to answer questions about why I want to go abroad for education and I've realized how hard it for some close-minded people to understand that I genuinely just want to experience a different culture and environment rather than having spent my entire life in a protected existence and then regretting it. Hope that makes sense.

2. I assume that you probably took Step 1 of the USMLE directly after having completed the basic science portion of your course, but can you (or anyone else) tell me how much harder the test would be for someone who takes this exam after completion of medical school? I know that alot of non-US citizen IMG's do this as they have already practiced in their home country, so based on the content of the exam, is this terribly more difficult than taking it directly after the basic science portion of a medical course?

3. I have read here of carribean grads who say that some fields are simply "out of bounds" for them in terms of ever getting a place (regardless of their USMLE score). Would you say that having gone to medical school in Australia automatically eliminated you from consideration for entering certain medical fields or not?

4. Do you feel that being a)an Austrlian grad (as opposed to Carribean or 'thrid-world' grad) and b)a US citizen helped you in getting the residency that you did?

5. Have you ever regretted your decision to go abroad and study medicine? (feel free to ignore this question if it's too personal)

I'm really sorry if I have repeated questions you have answered before, but even following the links you have provided in other posts I still wasn't completely clear on these issues. Thanks so much (in advance) for your response.

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[KungFuMaster]

Sorry for intercepting Dr. Cox reply but just let me share one little comment.

There was a paper on 'Australian doctors going to America and practice' and perhaps you should read that. It was a paper written by University of Michigan people. You can find it on Pubmed on the NIH website. There is one interesting way they differentiate aussie docs from the rest going to america. They separate countries that primarily "export" doctors from countries that primarily "import" doctors. One very interesting point which can roughly reflect the standing of aussie educated doctors in the united states is the place where these docs are located. The finding shows that these docs are more likely to practice in major cities and occupy academic position than U.S. graduates. Although the sample size is exceedingly small and there are many more factors that can contribute to this trend than mere "ausse-graduated", I believe it sheds a good light on your possible career path in medicine.

 

[leorl]

Hi, I just wanted to say...it's nice "meeting" someone with my exact same feelings . I too want to do med studies in Oz for experiencing a new culture and meeting awesome people, seeing magnificent things. But I could probably get in to a US med school, so balancing out a sense of adventure with career security is turning out to be a pain in the arse . Here's to doing what we want and following what's best for us, regardless of what everyone else thinks !

Originally posted by robin1:
•

I'm asking because I am now giving serious thought to going abroad (either Australia or the UK) for med school. As I have done considerably well in my undergrad (biochem major), I'm already having to answer questions about why I want to go abroad for education and I've realized how hard it for some close-minded people to understand that I genuinely just want to experience a different culture and environment rather than having spent my entire life in a protected existence and then regretting it. Hope that makes sense.

.•••

 

[KungFuMaster]

Yeah, if I were you, I would still choose U.S. med school. But now I have no choice but to look on the brighter side of things.

 

[Winged Scapula]

Originally posted by robin1:
•Hi,

I've been reading through alot of the posts on the forum and I have a couple of questions that I hope you can help me with.

1. How exactly did your fellow interns/residents and especially attendings react to your having held a degree from Australia? Since I know Carribean grads often face alot of IMG stigma, I'm curious if you were considered as being more "on par" with the US grads having attended med school in Australia?

I'm asking because I am now giving serious thought to going abroad (either Australia or the UK) for med school. As I have done considerably well in my undergrad (biochem major), I'm already having to answer questions about why I want to go abroad for education and I've realized how hard it for some close-minded people to understand that I genuinely just want to experience a different culture and environment rather than having spent my entire life in a protected existence and then regretting it. Hope that makes sense.

2. I assume that you probably took Step 1 of the USMLE directly after having completed the basic science portion of your course, but can you (or anyone else) tell me how much harder the test would be for someone who takes this exam after completion of medical school? I know that alot of non-US citizen IMG's do this as they have already practiced in their home country, so based on the content of the exam, is this terribly more difficult than taking it directly after the basic science portion of a medical course?

3. I have read here of carribean grads who say that some fields are simply "out of bounds" for them in terms of ever getting a place (regardless of their USMLE score). Would you say that having gone to medical school in Australia automatically eliminated you from consideration for entering certain medical fields or not?

4. Do you feel that being a)an Austrlian grad (as opposed to Carribean or 'thrid-world' grad) and b)a US citizen helped you in getting the residency that you did?

5. Have you ever regretted your decision to go abroad and study medicine? (feel free to ignore this question if it's too personal)

I'm really sorry if I have repeated questions you have answered before, but even following the links you have provided in other posts I still wasn't completely clear on these issues. Thanks so much (in advance) for your response.•••

Hi...

Sorry it took me so long to reply. I had the weekend off and was away from internet.

1) I haven't personally noticed any stigma and since I have little to no contact with caribbean grads here cannot compare as to whether I am treated better. I would say that I have heard faculty and staff say negative things about IMGs, including Caribbean grads and when I remind them that I'm one too...they say that I "don't count". I was always lead to believe that commonwelath grads aren't given the same stigma as caribbean and other IMGs. I think most people are curious about my experiences but I don't know what they think about my knowledge base in comparison to US grads.

2. I didn't take Step 1 and 2 until my 4th year. Some of my classmates took it earlier but gfrankly since we are taught so little basic science (or at least were when I was there) it seemed to make little sense to me to take it after 2nd year when I had so little foundation. Seemed to make more sense to do it during 4th year when I had elective/vacation time to study. You should take the exam whenever it best suits you.

3. I don't know if some fields are "out of bounds" for me, but I am pretty sure that some schools wouldn't interview me because I'm an IMG with average scores. Had I had stellar USMLE scores the situation might have been different. Being a grad from Australia will still not confer you the cachet that being an American grad will. I would not go abroad thinking I wanted to get into a highly competitive field - it can and does happen but you might be the needle in the haystack.

4. I'm sure it was interesting - most programs said I was "outside of the box" and found my essay interesting. Did it make a difference that I was NOT from the Caribbean or other less prestigious schools? Perhaps - but I'll never know. Would they have preferred me over a Caribbean grad with stellar USMLE scores? I don't know.

5. I have regretted my decision only because the curriculum under which I studied medicine did not adequately prepare me for basic science knowledge. You use it a lot more than you think you would in residency (and of course on USMLE Step 1). I was lucky in that the popularity of Gen Surg declined substantially last year and was in teh right place at the right time. I had a wonderful experience in Australia but the PBL format did me no favors.

Hope this helps and please feel free to contact me should you have further questions.

 

[Soupbone]

Kimberli,


I remmember when you were a pre-med posting on the old Chrononet site (...only about 5 or 6 years ago ). It is good to see that you are still the same candid and insightful person that were then.

I hope all is well with your training @ Penn State and to all those considering training abroad.....do what you must to achieve your dreams. Life is way too short have any regrets about the road not taken


peace,
S0up0ne
MS-IV
UAB

 

[KungFuMaster]

Hey Kimberli,

I think if there's stigma for Aussie grad, it applies only to AMERICAN CITIZENs going to aussie school, not exactly the REAL AUSTRALIANS studying medicine in their own country and going to America.

 

[Purifyer]

But then there's the stigma of trying to get a residency in the US when you aren't an American citizen or don't hold a green card

 

[Purifyer]

Out of curiousity, What degree do you get from an Australian medschool? MB ChB or MD? Actually now that I think about it, A doctor of medicine is a post grad doctorate isn't it.. whereas a Bachelor of Medicine is an undergrad. Does this mean doctors with a bachelor degree aren't technically 'doctors'? Thats amusing.

 

[KungFuMaster]

Purifyer,

How do you define stigma? Not having a greencard is NOT a stigma. Guess some people are just too pro-American. But yes there might be stigma without a greencard in the context of workforce. Professionally not much of a problem. And yes, I am an American citizen.

Actually the origin of the term 'doctor' refers to DOCTOR OF PHILOSOPHY(PHD). And only those who can complete and defend their thesis paper deserve the title, "DOCTOR", before their name. In terms of tradition, American MDs SHOULD NOT deserve "Doctor" of Medicine because their curriculum do not require them to complete a thesis paper on medical topics. Post-grad or not is absolutely irrelevent. In fact, non-medical PHds deserve to be called doctor more than medical "doctor". This mixed-up of name-calling started when most doctors in the 19th century had completed both medical training(primarily clinical) and lenghty thesis paper as part of their medical learning experience. And since obviously these intellectual physicians had the most contact with layman patients(since when was the last time an average person met Dr. of mathematics) the term "doctor" slowly transformed into meaning, although not quite accurate nowaday especially in the U.S. given their nature of training, "a person who treats my ailment."

And so "technically" the U.S. is giving out the MD based solely on social perception on what a doctor is.

 

[leorl]

Purifyer, as far as I know, only Americans and Canadians and maybe other North American countries (I do not know about Latin america) title the degree as MD. We're on a completely different system than the rest of the world in that medical school is technically a graduate school.

In Australia, I believe graduates get an MBBS, like in Great Britain. Other places in the UK or other past-UK involved countries get an MBBChBAO (medicine, surgery, obstetrics). Both of these are equivalent to a US MD.

 

[The Pill Counter]

MB,ChB,BAO is exclusively an Irish and Northern Irish degree: Bachelor of Medicine, Bachelor of Surgery and Bachelor of Obstetrics. Northern England, New Zealand, South Africa use MB,ChB, using Latin exclusively: Bachelor of Medicine, Bachelor of Surgery (latin:Chirurgica, hence the Ch abbreviation) London and South England schools, plus Australia, India and others use a combination of English and Latin, MBBS: Bachelor of Medicine and Bachelor of Surgery. Flinders is exclusively English, hence BMBS. It's just jargon- MD, MBBS, MBChB, MBChBBAO,BM, BMBS are all primary medical qualifications- all the same

 

[Purifyer]

Originally posted by KungFuMaster:
[QB]Purifyer,

How do you define stigma? Not having a greencard is NOT a stigma. Guess some people are just too pro-American. But yes there might be stigma without a greencard in the context of workforce. Professionally not much of a problem. And yes, I am an American citizen.
[QB]••

From what little I know about applying for residency in the US, there are alot more hurdles for non-US citizens than US citizens, independent of IMG status. With the limitations of visa's et cetera. I also presume that to get a visa, you have to prove that no American could do what you can.

Honestly I don't know however and this is only an impression I have formed from reading this board. If you are accusing me of being pro-american... heh.

To sum up I think that the lack of US citizenship makes it harder to enter residencies in the US. I mean this when comparing an IMG American and an IMG [as far as the US is concerned] Australian. If I am wrong, 1) I would be delighted to be told so, 2) I freely admit I don't _know_ anything.

 

[KungFuMaster]

Purifyer,

Oh you are right though in a general sense, in that img/non.US citizens do have a more difficult time getting residency and STAYING after residency. However, since MOST of the imgs in America are from countries that mostly "export" physicians, the general "rules" and attitude of img that you might have heard over this forum apply mainly to them. Over last few decades or so, these doctors have decided to stay after residency and have supposedly(as have been suggested by AMA or workforce related group)threatened the balance of MD in the U.S. In fact, over 70% of imgs from these countries have stayed in the U.S. after residency. And their primary reason for staying in the U.S. is clearly opportunity-related, whether financially or professionally. Imagine making barely 500 a month in China versus the potential to earn over 10,000 in the U.S., and that does not include the fact that the U.S. offers a lot more in terms of living standard and professional promotion. Anyhow, since these doctors have somehow found a way to stay in this country, the AMA has frowned upon their entry for residency in recent time. And so residency has become more difficult for IMGs to enter, especially IMGs coming from countries that historically would prefer to stay. And so started all the obstacles and hurdles that people have been discussing about in this or other forums. If you are coming from a country that primarily "import" doctors, like NZ and AUS, and has historically been shown to go back after residency, many programs could welcome you with open arms. The reasons are 1) you are not going to stay and stuff up their workforce 2) they can bring their skills back to their country and spread the "glory" of American medicine. Now this differs from U.S. citizens attending AUS or NZ schools. Because as U.S. citizens, WE ARE GOING TO STAY. And so AMA has become quite disappointed over the years that MOST IMGs would not go back, and thus, has tried their best to restrict entry. One interesting fact to note is that if your are from a third-world country and you have shown your desire to go back through governmental sponsorship and legal contract(rarely happens), you are probably the BEST candidate. Perhaps more likely to make the big name places more easily than american grads. Though this is rarely the case. But please keep in mind that this is generally the case. Not all PDs dive into these issues, and some don't give a **** . And so if your are from NZ, you DO have a better odds of residency, perhaps the best ever, over U.S. citizens attending NZ medical schools. Although the drawback is after residency, you might have difficult time staying in America and practice medicine because you are not a citizen of U.S. It seems that all the Australians(auss citizens born and raised in Australia) graduate of Sydney University have gone to BIG name places with unbelievable specialities. Almost all of them are at some IVY-leagues programs or the best of west coast california programs, almost none of them had done electives for "connective purposes." As for U.S. citizens, it doesn't seem to measure up to that degree without proper connections and respectable usmle score. And so the things you have heard about IMGs do not apply to you as a Kiwi. You are lucky to be an exotic, NZ graduates, at least to many residency programs. Thank god for that.

 

[Ange]

Australians graduate with a MBBS (Bachelor of Medicine/Surgery)

 

[Winged Scapula]

Originally posted by KungFuMaster:
•Hey Kimberli,

I think if there's stigma for Aussie grad, it applies only to AMERICAN CITIZENs going to aussie school, not exactly the REAL AUSTRALIANS studying medicine in their own country and going to America.•••

Did I imply otherwise? If so, I didn't mean to. Obviously there is little to no stigma attached to native Aussies attending a medical school in their own country. It may still be difficult to get a US residency because of preference for US citizens, but it isn't the same as for a US citizen who goes abroad.

 

[KungFuMaster]

Yeah you are right too. Perhaps it's just too complicated of an issue.

 

[The Pill Counter]

gee, thanks ange, i guess i didn't cover that

 

[castaway]

Dr Cox--howdy

Can you give me an idea of how long the Australian embassy takes to grant student visas? I have read 3 months somewhere, but was wondering if one month was enough (assuming you submitted everything they ask for). Also, please tell me when in Jan the classes start. Thanks, again. AJ

 

[Winged Scapula]

TO be honest I cannot remember how long it took the Embassy to get me my visa - you should be able to get one on short notice provided you have a plan ticket (or is that a passport). its been so long I cannot remember how long I applied before I got the visa.

I also cannot tell you exactly when classes start. I am 15,000+ miles away in Pennsylvania and the class schedule at Flinders changes every year. Traditionally, first year students need to be there for orientation in late January. Please contact either a current Flinders student or Dr. Jillian Teubner or the CAU for exact information on start dates.