Aussie doctors practicing in the States

[neb]

So I have been searching on and off for a few weeks now for information about Australian doctors (aussie citizens such as myself) practicing medicine in the US, I cant seem to find anything relevant.

I know the US process would be p1,2 and 3 of the USMLE, but do we then just apply for positions as a standard IMG into internships after medical school or what? whats the deal?

PS. Can someone please put me in the right direction if you know of such a forum that has information on this topic? (I have searched this forum too!)

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[Raigon]

So I have been searching on and off for a few weeks now for information about Australian doctors (aussie citizens such as myself) practicing medicine in the US, I cant seem to find anything relevant.

I know the US process would be p1,2 and 3 of the USMLE, but do we then just apply for positions as a standard IMG into internships after medical school or what? whats the deal?

PS. Can someone please put me in the right direction if you know of such a forum that has information on this topic? (I have searched this forum too!)

If you're an Aussie med student then most likely you know the site paging drs. A very useful site.

To put it simply, yes you take the 3 steps of the USMLE then you apply for the "match" which is a huge application program that sorts you to the residency program that will accept you. To even STAND a chance you have to be ECFMG certified BEFORE you apply for the Match. If you don't know what ECFMG is, please google it and there will be hoards of information.

But remember, IMGs (American students who studied medicine abroad) and FMGs (non-US citizens who studied medicine in a foreign country) are people who compete for the leftovers of what American medical school students don't get. And the vacancies are getting less and less because America wants to train its own doctors.

And residency program directors actually DISCRIMINATE against FMGs and IMGs (though if they must they will accept IMGs over FMGS slightly because they are Americans). Which means there are a lot of residency programs that will NOT accept non American medical school graduates, which sucks for IMGs like me and FMGs like others. And because of this, IMGs and FMGs will not get into extremely competitive specialties (like neurosurgery) or non-competitive specialties in competitive residency programs like the Mayo Clinic. (Not that it's impossible, but it's near the rate of hitting the US lottery).

And for IMGs and FMGs now, it's an uphill climb. Which is why IMGs and FMGs are likely want to stay in their country. But that doesn't mean all hope is lot. You need to score HIGHER than average (which is in the 200s) on the USMLE step 1 than others. You NEED to arrange clinical rotations (8~12 weeks) in US hospitals before you are eligible. You NEED ECFMG ceritification to verify you are a good quality medical school student from a good quality foreign medical school.

And above all, you need good letters of recommendations.

But prepared for an uphill climb with bullets and cannonballs raining down on you with the enemies screaming, "Go back to your own country!" (I'm not exaggerating)

 

[neb]

Thank you very much for the reply Raigon.

Ah, so I am a foreign medical grad (or will be!) fair enough. So do you think the discrimination is mostly because of the language gap with most FMG's wanting to enter the states? (excluding Australians & Brits etc), or is it simply people would rather keep Americans in American jobs?

I was already aware that to even stand a slight chance you have to be better than the average by a big gap. I guess it makes sense really, apparently its hard for FMG's to get internships in Australia too (hell even internationals training here are finding it hard to get internships after med school).

I can see the leg work required even for a small chance is quite high, I guess this is why I can find no information on Australian doctors actively practicing in America right from internship day.

 

[Raigon]

Thank you very much for the reply Raigon.

Ah, so I am a foreign medical grad (or will be!) fair enough. So do you think the discrimination is mostly because of the language gap with most FMG's wanting to enter the states? (excluding Australians & Brits etc), or is it simply people would rather keep Americans in American jobs?

I think it's the latter for FMGs. For IMGs, they think that many IMGs go to medical schools abroad to study medicine because they couldn't make it to an American medical school (which is NOT true, there are plenty of Americans who studied abroad for a fun international experience).

But I guess the main reason is because they don't know how to assess applicants who come from an educational system they're not familiar with. And plus they probably don't have any means of verifying your credentials, because foreigners can just make things up and they won't know if it's true or not as they don't know how to contact the source since it's from a foreign country, unless there are special programs that have affiliations like Columbia University with Israel medical schools and Flinders University in Australia in which faculties will know each other and be familiar with each other (and can call them up to verify your credentials). Or Mt. Sinai with Queensland. Or some programs with the University of Sydney, etc.

I was already aware that to even stand a slight chance you have to be better than the average by a big gap. I guess it makes sense really, apparently its hard for FMG's to get internships in Australia too (hell even internationals training here are finding it hard to get internships after med school).

Yeah, vacancies are getting less and less for internationals in Australia. Same with the United States. It sucks, but it's realistic. And here are the statistics:

For FMGs who matched last year: 37%
For IMGs who matched last year 41%

And those are for less competitive specialties like Internal medicine or family medicine.

Here are the rough stats for say... a slightly more competitive specialty emergency medicne: 10%. That means you have to hit the 90% percentile. You have to beat 90% of all the FMGs!

And that speaks volumes about even MORE competitive specialties like anaesthesia, surgery, etc. I think the amount who matched into orthopedics or neurosurgery out of the tens of thousands of IMGs are in the single digits. I don't think any FMGs matched into those, I'm sorry to say. The reason is probably because FMGs require hospitals to sponsor you so they can get permanent residence to work there (which means aside from paying you, they have to worry about legal issues and hospitals are constantly getting sued by patients in the US, they don't need another legal issue to bug them). And also, to even apply for permanent residence or a VISA, you need to hire a lawyer and pay an application fee of 1200 dollars. And there's no guarantee THEN for entry. If you need help with VISA, visit the VISA orientation thread here:

http://forums.studentdoctor.net/showthread.php?t=450230

Harsh reality, because I will be considered an IMG, too ==". So I will face discrimination. But at least I'm an American citizen so I don't need to worry about the Visa status.

I can see the leg work required even for a small chance is quite high, I guess this is why I can find no information on Australian doctors actively practicing in America right from internship day.

Not just Australia. Any FMGs from a medical school outside the United States. And most people from Australian universities who make it to US residencies are internationals originally from America, all 13 of them.

And now I'm not even sure if I want to go to the US to practice medicine. With the health care bill just passed, doctor salaries will be slashed down by a large amount. And plus, free health care = more patients = overworking doctors getting underpaid.

 

[neb]

Thanks once again for the extremely informative post.

It most certainly not only looks like an uphill battle but I think I see a few back flips in there that may very well defy gravity!

The statistics are staggering, I thought that this new healthcare bill would produced more demand for IMG+FMG's to enter the US though? hmm I must have miss read that one. (I think I read something like USA would need at least 100,000 more doctors in the next decade)

EDIT: I forgot, they also increased medicare coverage to 13 million more people or something in the bill.

And now I'm not even sure if I want to go to the US to practice medicine. With the health care bill just passed, doctor salaries will be slashed down by a large amount. And plus, free health care = more patients = overworking doctors getting underpaid.

Would the salaries really decrease by that much? the bill only insures everyone, it doesnt give them government subsidized medical care? From what I have read it also gives you insurance if you have a pre-existing illness too.

I was under the impression these big insurance companies will still run the system in the USA?

Australia has a hybrid of public and private healthcare yet most of our ''specialist'' doctors earn a fair bit.

 

[Raigon]

Thanks once again for the extremely informative post.

It most certainly not only looks like an uphill battle but I think I see a few back flips in there that may very well defy gravity!

The statistics are staggering, I thought that this new healthcare bill would produced more demand for IMG+FMG's to enter the US though? hmm I must have miss read that one. (I think I read something like USA would need at least 100,000 more doctors in the next decade)

EDIT: I forgot, they also increased medicare coverage to 13 million more people or something in the bill.

True that they do need more doctors, but what they need is general practitioners, internists, and family doctors and not specialists. They are less competitive specialties and over 50% of all IMGs (perhaps up to even 60 or 70) match into one of the three areas. If you enjoy one of the three, then you have a pretty decent chance. If not, then it's an uphill climb.

Would the salaries really decrease by that much? the bill only insures everyone, it doesnt give them government subsidized medical care? From what I have read it also gives you insurance if you have a pre-existing illness too.

I was under the impression these big insurance companies will still run the system in the USA?

Australia has a hybrid of public and private healthcare yet most of our ''specialist'' doctors earn a fair bit.

Well, it probably still looks like a lot to most people. But Aussie specialists can make at most up to 200~300k (if that much) as specialists (after years and years of work as an intern, junior office, all the way to consultant - that equals about 10 years of training!). Cardiovascular surgeons, neurosurgeons, pediatric surgery, etc can make up to 600~800K, with neurosurgery even going into the millions. It's a general calculation that those big bucks may be slashed down into 200~300k. And those in the 200~300 range may be slashed down into the 100k range (like my favorite specialty - emergency medicine =(!!!). So imagine what happens if your original salary goes from 100k (and that's considered high as a general practitioner) to 70k, which is about the same as a teacher. That's a pretty hard hitting blow. Because of the new health care bill, instead of the hospitals charging you all they want, it's government sponsored, which means they will get limited funds a year. So there have been posts that medical students will want to start accepting bribes.

AKA: Something like this

"Well, Mr. Johnson. It looks like you have XXXXX. You have three options. Surgery 1 is covered by basic heal insurance and it sucks. Plus you have to wait a few months but by then you may have died (like in Canada, heheh, that's what happens when you have health care). Surgery 2 is a private surgery with okay odds at the cost of 3 grand. And Surgery 3 is the best surgery, private of course, and it will cost up to 50 grand. However, it will leave you feeling best and has the best chance of recovery."

That's what's happening in Taiwan, where our universal health care is f_cked up. Haha. Except we tell sweeter words and patients know what we're talking about. But that may not necessary be the case anymore.

And let alone the fact that there are now nurses that make as much money as doctors. And there are even some courses offering to teach SURGERY to nurses, which I find is a another pretty big blow. I mean, if you want to do surgery, go to medical school! The only reason they're doing that is because nurses get paid less and they're cheap to hire. If you teach them a bit more, then the hospital can rely more on nurses than on doctors. Doctors are plunging downwards in both respect and salary by the public. That just puts salt on the wounds.

Sorry, I'm ranting now. Heheh... A lot of problems America has to sort out. But who knows? Maybe our speculations are wrong. But I know one thing is certain, residency is looking bleak for IMGs/FMGs and it's not going to improve anytime soon, unless you want one of the three low-salary doctors I mentioned.

 

[Winged Scapula]

A couple of points worth mentioning:

- residency training positions have been frozen in the US since the Clinton Administration while new US medical schools have increased their enrollment; thus there are simply fewer excess positions to go around

- the US government funds residency training with US tax dollars; thus some discrimination against FMGs is the belief that US tax dollars should not be used to train someone who has never paid US taxes, especially while US citizens, even those trained in the US, are going without a residency position

Some bias exists because of difficulties programs have had with certain FMGs in the past - whether its language, cultural differences, differences in training, etc. They are just not willing to take another chance.

There is also the perception that training outside of the US means an inferior education. Now, we know that's not the case and most medical faculty know this as well. And as much as its not a popular opinion, while you are still an FMG, there does exist a difference in the minds of most US physicians between training in Australia, Sweden, the UK and training in the Caribbean, Mexico, Russia, etc. Fair or not (as the USMLE should be the great leveler), it exists.

Finally, many are currently upset about the hundreds of thousands of dollars loaned to US students (studying here and abroad) that end up not matching into a residency. Is it fair to give a position to an FMG over a US citizen, especially when you've saddled them with 200-300K USD in debt? That's a heated debate - protectionism vs taking the best regardless of nationality. I'm not sure the US has the requirement to train the world, when their own citizens can't be trained.

 

[Raigon]

A couple of points worth mentioning:

- residency training positions have been frozen in the US since the Clinton Administration while new US medical schools have increased their enrollment; thus there are simply fewer excess positions to go around

- the US government funds residency training with US tax dollars; thus some discrimination against FMGs is the belief that US tax dollars should not be used to train someone who has never paid US taxes, especially while US citizens, even those trained in the US, are going without a residency position

Some bias exists because of difficulties programs have had with certain FMGs in the past - whether its language, cultural differences, differences in training, etc. They are just not willing to take another chance.

There is also the perception that training outside of the US means an inferior education. Now, we know that's not the case and most medical faculty know this as well. And as much as its not a popular opinion, while you are still an FMG, there does exist a difference in the minds of most US physicians between training in Australia, Sweden, the UK and training in the Caribbean, Mexico, Russia, etc. Fair or not (as the USMLE should be the great leveler), it exists.

Finally, many are currently upset about the hundreds of thousands of dollars loaned to US students (studying here and abroad) that end up not matching into a residency. Is it fair to give a position to an FMG over a US citizen, especially when you've saddled them with 200-300K USD in debt? That's a heated debate - protectionism vs taking the best regardless of nationality. I'm not sure the US has the requirement to train the world, when their own citizens can't be trained.

Well, she's right on the dot on that one, filling in points that I didn't mention. My post perhaps was a bit too pessimistic, I'll edit that later when I have time. But yeah, that's the reason why there's bias against FMGs.

The one reason I hate most is that they think any medical school outside the US is inferior when there are patients who to, say, Japan to get treatment. (That's true, actually, one of my teachers back in high school returned to Japan for surgery because she was put on a 3 month waitlist and boy was she pissed).

 

[Mordecai]

what about if I opted to go to the US to do a fellowship as an aussie with Aussie specialisation?
I assume I would have to do USMLE Step1-3, but would I also have to do specialist exams?

 

[Winged Scapula]

what about if I opted to go to the US to do a fellowship as an aussie with Aussie specialisation?
I assume I would have to do USMLE Step1-3, but would I also have to do specialist exams?

It depends on what field you're talking about.

For example, I've known several Aussies who've come over for Anesthesia fellowships. But there are other fields/programs in which you are not allowed to do a fellowship without having done a US residency/being US Board Eligible.

 

[redshifteffect]

It depends on what field you're talking about.

For example, I've known several Aussies who've come over for Anesthesia fellowships. But there are other fields/programs in which you are not allowed to do a fellowship without having done a US residency/being US Board Eligible.

I think Rads is one such field. GP is another (not that there are many options in GP fellowships but there are a few)

 

[redshifteffect]

Well, it probably still looks like a lot to most people. But Aussie specialists can make at most up to 200~300k (if that much) as specialists (after years and years of work as an intern, junior office, all the way to consultant - that equals about 10 years of training!).

I think your salaries for Australian specialists is only true if you talk about staff specialists. Most specialists who work a combo of private/public (VMOs) or pure private make more then that. Surgeons make way more then that.

 

[pitman]

Hell, some GPs here make more than that (locum proceduralists in particular).

Can't believe you bailed, Red

 

[Raigon]

I just dug up a thread from like... 2007~2008 which talked about Aussie salaries. Dunno how I found that one ==".

So yeah, I was talking about staff specialists. I completely forgot there was such thing as private practice. Doh!

 

[redshifteffect]

Hell, some GPs here make more than that (locum proceduralists in particular).

Can't believe you bailed, Red

Don't worry I didn't I'm sticking with this one

 

[jaketheory]

i would like to point out that i have been in contact with several residency programs which stated specifically they were seeking to attract the best doctors, regardless of where they studied medicine, or their nationallity. admittedly, these were not residencies at Harvard, blah, blah, blah, but they were respectable programs either at a university hospital or a university affiliated hospital. not all programs will discriminate. some university hospital residencies have large numbers of FMG's simply because they do not receive that many competitive local applicants. it does not necessarily mean that they provide bad training;i doubt any accredited program does.

 

[Raigon]

i would like to point out that i have been in contact with several residency programs which stated specifically they were seeking to attract the best doctors, regardless of where they studied medicine, or their nationallity. admittedly, these were not residencies at Harvard, blah, blah, blah, but they were respectable programs either at a university hospital or a university affiliated hospital. not all programs will discriminate. some university hospital residencies have large numbers of FMG's simply because they do not receive that many competitive local applicants. it does not necessarily mean that they provide bad training;i doubt any accredited program does.

Yeah, actually I've been meaning to say that it's not as bad as I originally said. I've just been hanging out at the Caribbean thread a bit too much and I got brainwashed. Bleh.

Although I still do believe there are some programs that discriminate, it's not actually completely discriminatory. There are some that are still internationally friendly, although probably not the top of the top, but still some well known ones.

The match rate for FMGs are falling and probably still fall. However, it will never completely disappear, because the day America does not open its arms to people from other countries whether it's to work or to study there is the day America ceases to be America.

 

[jaketheory]

Yeah, actually I've been meaning to say that it's not as bad as I originally said. I've just been hanging out at the Caribbean thread a bit too much and I got brainwashed. Bleh.

Although I still do believe there are some programs that discriminate, it's not actually completely discriminatory. There are some that are still internationally friendly, although probably not the top of the top, but still some well known ones.

The match rate for FMGs are falling and probably still fall. However, it will never completely disappear, because the day America does not open its arms to people from other countries whether it's to work or to study there is the day America ceases to be America.

fmg match rates are highly misleading. there are many applicants which lack basic communication skills in english which highly skew these numbers. there is an enormous number of applicants from india and other countries and when many of these applicants are unsuccesful it highly influences the stats.

until accurate data reflects both the citizenship status and country of medical studies ill the stats be very useful for img's/fmg's. and the us govt is working on this. in late 2009 regulation was passed requiring submission of an mcat score and consent to allow medical schools to report usmle scores in order receive US federal studen loans to study medicine overseas.

lydnal at Uni Wollongong has mentioned to me that a considerable number of applicants to the Uni of Wollongong graduate entry medical program do not even meet the minimum criteria, many because of poor english skills. there is nothing stopping a non english speaking medical grad from applying to a US residency program when they are totally unqualified.

 

[Raigon]

fmg match rates are highly misleading. there are many applicants which lack basic communication skills in english which highly skew these numbers. there is an enormous number of applicants from india and other countries and when many of these applicants are unsuccesful it highly influences the stats.

until accurate data reflects both the citizenship status and country of medical studies ill the stats be very useful for img's/fmg's. and the us govt is working on this. in late 2009 regulation was passed requiring submission of an mcat score and consent to allow medical schools to report usmle scores in order receive US federal studen loans to study medicine overseas.

lydnal at Uni Wollongong has mentioned to me that a considerable number of applicants to the Uni of Wollongong graduate entry medical program do not even meet the minimum criteria, many because of poor english skills. there is nothing stopping a non english speaking medical grad from applying to a US residency program when they are totally unqualified.

I suppose that there is a large amount of non-qualified applicants mixed in with the qualified applicants. However, America opened fair amount of medical schools and places at medical schools with no increase in residency spots.

In fact, residency spots haven't increased since the 1990s and with more AMGs and probably even more IMGs, it'll be more people trying to secure a match in a limited number of residencies. I suppose that's what I'm more worried about.

 

[jaketheory]

I suppose that there is a large amount of non-qualified applicants mixed in with the qualified applicants. However, America opened fair amount of medical schools and places at medical schools with no increase in residency spots.

In fact, residency spots haven't increased since the 1990s and with more AMGs and probably even more IMGs, it'll be more people trying to secure a match in a limited number of residencies. I suppose that's what I'm more worried about.

there has always been a considerable surplus of spots in specialties such as family medicine and internal medicine, even including the fmg applicants. this is unlikely to change much with more amg's. obviously more competitive specialties will likely become more of a challenge for img's/fmg's. and what reasons suggests there will be more IMG's? and as i have noted, img/fg stats are highly skewed by unqualified applicants. so what if the number of img/fmg applicants increases by 8% when 60% of them have no chance anyway?

 

[Raigon]

there has always been a considerable surplus of spots in specialties such as family medicine and internal medicine, even including the fmg applicants. this is unlikely to change much with more amg's. obviously more competitive specialties will likely become more of a challenge for img's/fmg's. and what reasons suggests there will be more IMG's? and as i have noted, img/fg stats are highly skewed by unqualified applicants. so what if the number of img/fmg applicants increases by 8% when 60% of them have no chance anyway?

I understand that there are definitely a lot of leftover spots for family medicine and internal medicine and less competitive residency programs. But there are leftover spots for those specialties for a reason - they are obviously not as desired and thus we have the majority of the people trying to compete for the more desired specialties like surgery, EM, orthopedics, etc, which is my main concern. With the increase of AMGs and okay, suppose like you said, there is no decrease nor decrease in IMGs, then like you said, the more desired specialties that most people want (including me) might get cocky from the new influx of AMGs and soon start post signs saying, "No FMGs allowed" like quite a few residencies have already started doing. I certainly hope (and I have no basis to speculate) that this trend won't won't reach IM or FM.

I understand that America wants to train its own doctors, but even discriminating against IMGs or overseas trained Americans like you or I is a tad bit ridiculous IMO. I wish America would put in more effort in giving its own citizens a more clear cut advantage than the true FMGs, as they've done with AMGs vs IMGs/FMGs.

That being said, however, FM and IM isn't that bad probably. The US will probably still be my first option, being home to me and I have family there. However, if I for some reason can't even match into even IM or FM with good qualifications, I'll stay in Australia and see if I can't get PR or citizenship and work there.

 

[jaketheory]

I understand that there are definitely a lot of leftover spots for family medicine and internal medicine and less competitive residency programs. But there are leftover spots for those specialties for a reason - they are obviously not as desired and thus we have the majority of the people trying to compete for the more desired specialties like surgery, EM, orthopedics, etc, which is my main concern. With the increase of AMGs and okay, suppose like you said, there is no decrease nor decrease in IMGs, then like you said, the more desired specialties that most people want (including me) might get cocky from the new influx of AMGs and soon start post signs saying, "No FMGs allowed" like quite a few residencies have already started doing. I certainly hope (and I have no basis to speculate) that this trend won't won't reach IM or FM.

I understand that America wants to train its own doctors, but even discriminating against IMGs or overseas trained Americans like you or I is a tad bit ridiculous IMO. I wish America would put in more effort in giving its own citizens a more clear cut advantage than the true FMGs, as they've done with AMGs vs IMGs/FMGs.

That being said, however, FM and IM isn't that bad probably. The US will probably still be my first option, being home to me and I have family there. However, if I for some reason can't even match into even IM or FM with good qualifications, I'll stay in Australia and see if I can't get PR or citizenship and work there.

if someone were hellbent on doing a competitive specialty residency then they shouldnt be going to medical school abroad. you accept you may not get that position in going abroad. there are ways to get into a US med school. take more undergrad classes (wouldnt bother doing postgrad as they calculate seperate postgrad gpa's and that will never completely overshadow a crappy undergrad gpa), retake the mcat, volunteer, do some research. yes, it will take time, but if you are bent on being the next best neurosurgeon in the US, you best to be prepared to train for well over a decade anyway and one or two extra years wont be a big deal. you are incredibly unlikely to become that neurosurgeon by going to med school abroad. then again, you are pretty unlikely even going to a US med school.

all this talk about i being hard to get into competitive residencies as an img/fmg. . . these residencies are competitive for amg's too. if you make the decision to study abroad, just accept the consquences of that decision and move on. worrying about them will only make your life hell.

 

[Raigon]

if someone were hellbent on doing a competitive specialty residency then they shouldnt be going to medical school abroad. you accept you may not get that position in going abroad. there are ways to get into a US med school. take more undergrad classes (wouldnt bother doing postgrad as they calculate seperate postgrad gpa's and that will never completely overshadow a crappy undergrad gpa), retake the mcat, volunteer, do some research. yes, it will take time, but if you are bent on being the next best neurosurgeon in the US, you best to be prepared to train for well over a decade anyway and one or two extra years wont be a big deal. you are incredibly unlikely to become that neurosurgeon by going to med school abroad. then again, you are pretty unlikely even going to a US med school.

all this talk about i being hard to get into competitive residencies as an img/fmg. . . these residencies are competitive for amg's too. if you make the decision to study abroad, just accept the consquences of that decision and move on. worrying about them will only make your life hell.

Haha, yeah you're right. I'm getting way too worked up over these petty things. I'm not trying to be a neurosurgeon, but I would like emergency medicine and even if it's an uphill climb an IMG/FMG should still have somewhat of a chance. But yeah, I better accept the fact that it will be a hard climb rather than b*tching about it; I chose international route of Australia than going back to America or taking the Caribbean route for a reason.

Better start remembering the reason I wanted to go abroad was to enjoy the international experience and fulfill the dream of traveling around the world to work and study and Australia's always been on my list of must-travels. Going to Australia does have its fun and good sides, like being able to stay in Australia possibly if I choose to, even if it's a long route to PR and citizenship.

 

[redshifteffect]

Haha, yeah you're right. I'm getting way too worked up over these petty things. I'm not trying to be a neurosurgeon, but I would like emergency medicine and even if it's an uphill climb an IMG/FMG should still have somewhat of a chance. But yeah, I better accept the fact that it will be a hard climb rather than b*tching about it; I chose international route of Australia than going back to America or taking the Caribbean route for a reason.

Better start remembering the reason I wanted to go abroad was to enjoy the international experience and fulfill the dream of traveling around the world to work and study and Australia's always been on my list of must-travels. Going to Australia does have its fun and good sides, like being able to stay in Australia possibly if I choose to, even if it's a long route to PR and citizenship.

I'd be carefully optimistic about being able to stay in Australia as even if the US isn't going to get harder to match into, Australia certainly will, and we already know from what hospitals have said here that they do discriminate against IMGs. This doesn't matter even if your English speaking skills are good, because they have a legal obligation to provide Australians with jobs first.

 

[Raigon]

I'd be carefully optimistic about being able to stay in Australia as even if the US isn't going to get harder to match into, Australia certainly will, and we already know from what hospitals have said here that they do discriminate against IMGs. This doesn't matter even if your English speaking skills are good, because they have a legal obligation to provide Australians with jobs first.

I know that. It's obviously the same in America, too, which is why IMGs and FMGs in America have a harder time than the local AMGs.

I'm not going to say this is exactly the case, but I suppose you can try to put it to scale, theoretically (and if you try not to argue where I get the numbers from, I'm only giving a rough estimate).

Suppose local Americans who only try to get a US residency get 9/10 (perhaps not that high, but let's suppose it's so) chance of matching. And local Australians who only try to get internship in Australia will also get a 9/10 chance of getting internship in Australia. And to simplify things, they each only compete with the locals only, they obviously do not try to cross over (Australian to America or American to Australia).

An American (or US citizen, whatever you want to call us) with decent grades and decent clinical rotations and skills who studies in Australia may have a 6/10 (let's suppose it's so; because even if it's not, it's close enough) chance in both America and Australia, which is lower when compared individually, but better overall because 6/10+6/10 is better than 9/10. Although it is longer route if you want to swing both ways, and perhaps it may be worse for internationals in the future in both USA and Australia, as I've said before, IMGs and FMGs will never completely disappear and there should always be at least some room for IMGs and FMGs even if they're not as high as in the past.

And besides, we do need Australia as a backup, not because we're greedy and trying to put one foot on each boat, but because we have to accept the fact that match rate for IMGs and FMGs are not as high as AMGs and AMGs will get preference, thus we may not be able to match into a specialty we want. Even if Australia does discriminate against IMGs and FMGs like in the US, at least it's not worse.

 

[redshifteffect]

Even if Australia does discriminate against IMGs and FMGs like in the US, at least it's not worse.

I'm not sure about that. These are the numbers I've gotten from the AMA:

By 2014 there will be about 2900 Australian graduates (not including international students) and about 1200 GP jobs and 900 Specialist jobs. There is a large question mark over how many internship jobs there will be, but most estimates are that we'd be lucky if we created 2500-3000.

So as you can see if Australians aren't even going to get jobs, internationals certainly shouldn't be getting them.

 

[Raigon]

I'm not sure about that. These are the numbers I've gotten from the AMA:

By 2014 there will be about 2900 Australian graduates (not including international students) and about 1200 GP jobs and 900 Specialist jobs. There is a large question mark over how many internship jobs there will be, but most estimates are that we'd be lucky if we created 2500-3000.

So as you can see if Australians aren't even going to get jobs, internationals certainly shouldn't be getting them.

That would actually depend on the state and location and place of need. Even you wrote that in your recent blog post this year. I'm not trying to be optimistic and I certainly know the risk, which was why I spammed about America's situation all over the thread, but there's always light no matter how dark a place seems.

Even if it's bad, so what? I'll try anyway. And even in your blog you've told us ways on how to survive even with this medical crisis. So what if internationals aren't getting jobs? If I choose to stay in Australia, will I not attempt to get permanent residence and even citizenship? Because it's a long road to being a consultant.

Well, whatever you say, my determination is firm. I don't care how bad the crisis is and I don't care how negative you're making it sound, my decision stays the same. America first, if not, then Australia. Nothing will change that. (I'm NOT returning to Taiwan). What I will do, however, is try to adapt to the condition however best I can by strengthening my Australian network of friends. I will read around, ask around, and do everything in my power to secure a job, even if it means swallowing a lot of pride.

And to succeed, means to stop b*tching around and use my time to make the best of the situation however bad it is. That's not being overly optimistic, is it? That's just being logical.

 

[pitman]

And to succeed, means to stop b*tching around and use my time to make the best of the situation however bad it is. That's not being overly optimistic, is it?

Nope, just be informed, as Red is helping assure. If you're further doing what you want to do, because it's what you want to do, figuring out how or adapting along the way, it's also romantic in the classical sense. There's nothing wrong with that.

 

[Raigon]

Nope, just be informed, as Red is helping assure. If you're further doing what you want to do, because it's what you want to do, figuring out how or adapting along the way, it's also romantic in the classical sense. There's nothing wrong with that.

I understand and I appreciate the informing, as I've said about his awesome and extremely helpful blogs. (They're REALLY helpful actually. What happened to Ani, though? Guess he's busy at Flinders right now.)

I guess what you say about me sums up what I want to do in life. Rather than going for the easy path, I want to go for a path that I believe in and I will love, and as for how I'll survive, I'll figure it out and adapt along the way. I have a dream, I want to follow it, and I'll stick to it to the end.

And to do that, we need to believe in ourselves and see that it will work. Believing in yourself won't necessarily make you succeed, but I know that NOT believing yourself will doom yourself to failure. And so I need to look on the more positive side and so rather than looking at the darkness, I'll use what light I have left. =)

 

[Mordecai]

It depends on what field you're talking about.

For example, I've known several Aussies who've come over for Anesthesia fellowships. But there are other fields/programs in which you are not allowed to do a fellowship without having done a US residency/being US Board Eligible.

I was thinking OMFS or craniofacial / Trauma.

 

[Mordecai]

That would actually depend on the state and location and place of need. Even you wrote that in your recent blog post this year. I'm not trying to be optimistic and I certainly know the risk, which was why I spammed about America's situation all over the thread, but there's always light no matter how dark a place seems.

Even if it's bad, so what? I'll try anyway. And even in your blog you've told us ways on how to survive even with this medical crisis. So what if internationals aren't getting jobs? If I choose to stay in Australia, will I not attempt to get permanent residence and even citizenship? Because it's a long road to being a consultant.

Well, whatever you say, my determination is firm. I don't care how bad the crisis is and I don't care how negative you're making it sound, my decision stays the same. America first, if not, then Australia. Nothing will change that. (I'm NOT returning to Taiwan). What I will do, however, is try to adapt to the condition however best I can by strengthening my Australian network of friends. I will read around, ask around, and do everything in my power to secure a job, even if it means swallowing a lot of pride.

And to succeed, means to stop b*tching around and use my time to make the best of the situation however bad it is. That's not being overly optimistic, is it? That's just being logical.

Keep up that attitude and you will go far. For me, it's Australia 1st and US second. I would love to have US work/study experience simply because they are the best in the world in my field of interest. I would then like to translate that into improving the situation in Australia. Even if you get slapped down, get up and try elsewhere. The history of great achievements is chockers with those who were repeatedly slapped down.

 

[jaketheory]

I know that. It's obviously the same in America, too, which is why IMGs and FMGs in America have a harder time than the local AMGs.

i think img's and fmg's in the US have a harder time because in general (but certainly not universal) US residency directors think AMG's are superior than their IMG/FMG counterparts, IMG's/FMG's generally have lower USMLE scores, and because they have much less experience in the US health care setting as compared to their AMG counterparts, not because the US has a legal obligation to provide Americans with jobs first.

Suppose local Americans who only try to get a US residency get 9/10 (perhaps not that high, but let's suppose it's so) chance of matching. And local Australians who only try to get internship in Australia will also get a 9/10 chance of getting internship in Australia. And to simplify things, they each only compete with the locals only, they obviously do not try to cross over (Australian to America or American to Australia).

An American (or US citizen, whatever you want to call us) with decent grades and decent clinical rotations and skills who studies in Australia may have a 6/10 (let's suppose it's so; because even if it's not, it's close enough) chance in both America and Australia, which is lower when compared individually, but better overall because 6/10+6/10 is better than 9/10.

assuming your probabilities were correct (I don't know if they are even remotely accurate), the probability of getting a place in an Aussie program or a US program would be the sum of each probability minus the probability of both occurring or 6/10 + 6/10 - (6/10 x 6/10), which is 0.84 and actually less than your hypothetical probablity of 9/10.

please be sure to update us where you end up practicing so i can avoid a fatal dosage calculation error. just f'in with you mate.

 

[Raigon]

i think img's and fmg's in the US have a harder time because in general (but certainly not universal) US residency directors think AMG's are superior than their IMG/FMG counterparts, IMG's/FMG's generally have lower USMLE scores, and because they have much less experience in the US health care setting as compared to their AMG counterparts, not because the US has a legal obligation to provide Americans with jobs first.

If you've read Winged_Scapula's posts, you'll know that there are other reasons other than just because they think AMGs are superior. In fact, there are many directors that know better than judging it by that.

assuming your probabilities were correct (I don't know if they are even remotely accurate), the probability of getting a place in an Aussie program or a US program would be the sum of each probability minus the probability of both occurring or 6/10 + 6/10 - (6/10 x 6/10), which is 0.84 and actually less than your hypothetical probablity of 9/10.

please be sure to update us where you end up practicing so i can avoid a fatal dosage calculation error. just f'in with you mate.

My statistics are probably wrong because I wasn't thinking of the venn formula and didn't think about substracting the extra ground in between. But if you assume my statistics are true, then why do you want to try to swing both ways, mate?

Just wanting to hear your opinions. You've already read mine.

 

[jaketheory]

If you've read Winged_Scapula's posts, you'll know that there are other reasons other than just because they think AMGs are superior. In fact, there are many directors that know better than judging it by that.

as even i have noted as well. and there is a reason why i included in parentheses that it certainly is not universal. but many will still feel that way. and who is to say where the majority lies?

My statistics are probably wrong because I wasn't thinking of the venn formula and didn't think about substracting the extra ground in between. But if you assume my statistics are true, then why do you want to try to swing both ways, mate?

it seemed to me that your hypothetical probabilities were there to make a point, and that point was that it put you in some perceived good/better position than some other scenario. just pointing out that the logic was flawed. not swinging both ways. i said assuming the individual probabilities were accurate; i was not assuming your calculation was accurate. i was pointing out that it was not.

 

[Raigon]

as even i have noted as well. and there is a reason why i included in parentheses that it certainly is not universal. but many will still feel that way. and who is to say where the majority lies?

it seemed to me that your hypothetical probabilities were there to make a point, and that point was that it put you in some perceived good/better position than some other scenario. just pointing out that the logic was flawed. not swinging both ways. i said assuming the individual probabilities were accurate; i was not assuming your calculation was accurate. i was pointing out that it was not.

Okay.

 

[Canuck07]

Yeah, vacancies are getting less and less for internationals in Australia. Same with the United States. It sucks, but it's realistic. And here are the statistics:

For FMGs who matched last year: 37%
For IMGs who matched last year 41%

And those are for less competitive specialties like Internal medicine or family medicine.

I'm not sure about that. These are the numbers I've gotten from the AMA:

By 2014 there will be about 2900 Australian graduates (not including international students) and about 1200 GP jobs and 900 Specialist jobs. There is a large question mark over how many internship jobs there will be, but most estimates are that we'd be lucky if we created 2500-3000.

Hey guys, do you mind posting a link to your sources? I'm trying to find out additional matching stats in the States and Australia but can't find info on the numbers you posted. thanks

 

[redshifteffect]

My quotes are from some powerpoints I received from the AMA, but unfortunately do not have permission to post them online. Perhaps if you contacted them directly they could provide you with them as well.

*Edit*
Here is a public article where they commented with those figures:
http://www.ama.com.au/node/5404