Australia Doctor Lifestyle vs US Doctor Lifestyle

[Jazkio]

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[Domperidone]

It's been discussed before in the other parts of the forums.
Have you considered asking in the IM forum? Internal Medicine and IM Subspecialties. Because you won't find many American attendings in here (the Australian forum, ahem).

Have you tried a search? US lifestyle and work hours has been discussed extensively before.

For starters, Australia has no 24+ hrs shifts. That's not the case in the US.
Hours off after 24-30 hour resident/med student shift?.

Intern hours discussions:
Intern Hour Restrictions

Lifestyle discussion:
IM Subspecialties with good lifestyle
IM subspecialities for IMGs with decent weekly work hours?
Residency Programs with best work-life balance
Work Hours
Average Hours Worked In-Patient - a Poll
List goes on..

I would suggest that you do a rotation or elective in the US if it's a serious option. Among other reasons - like needing LORs - it would help address your questions more fully. It just.. isn't something you decide on the fly based on talking to other people about - at least not on it's own. Granted, talking about it and researching it would be a valid place to start, which you're doing. But moving or transitioning into that system is a such massive undertaking. You probably should 'visit' properly and get immersed as a student first. Or is that already in the plans? For example, maybe 24 hours + shifts don't look so bad on paper. But the actual experience of working 24 hours may not be what you think it is - you wouldn't know unless you tried.

I don't know how much value there is in dropping thousands of dollars into the Steps if you don't intend on going either. Another option is going there for fellowship, which also requires the steps. If you intend to move back to Australia, it would be better if you went away for fellowship rather than residency.

 

[Domperidone]

Yes, I'm intending on doing a rotation in my final year in the US (which probably entails sitting the Steps to get into somewhere competitive).

Not all of them require the Steps. Actually.
How far along are you in your studies for Step 1 even?
Where are you in your med school training? I know you mentioned clinical, but are we talking final year? Penultimate year?

Yeah, I'm aware that it's a massive undertaking! But on paper, it looks as though it'll save me a few years in the long run if I'm not mistaken?

Why do you think they can get away with fewer years in the US?
The hours on average are longer in the US for residents. Experience and exposure has to come from somewhere after all.

If your main intent is returning to Australia, it may not be worth the 'short cut.'
I wouldn't underestimate the value of having familiarity with the healthcare system you intend to be an attending or consultant in. Or having a network built up around your career. It's much harder to move once you have roots laid. It would also be challenging to return where no one knows you, no one's familiar with your work etc. It's harder to appreciate this as a student, but you realize how important this is later. Working in medicine can be gruelling - well, hospital based specialties anyway. Having good supports at work is so critical sometimes. Mental health is a huge topic lately.

Physicians training in Aus is: Intern + RMO (1 or 2 years) + 3 years BPT + 3 years advanced + (1 or 2 extra years in case of fails), whereas
US: Intern (to get Aus licensing) + 3 years residency? Sub-specialty probably 2 or 3 more years.

Idk the Australian system is scaring me out a little. Surgical registrars getting kicked out of training, and college fail rates are pretty high. It feels as though American residencies actually try to push you for a pass but also pushing working hours ofc, whereas in Aus it's chiller, more dragged out, but at the end of the day you're moreso alone.

The Australian training system scares a lot of students. Myself included when I was student, the length of training looked daunting.
It's much less scary once you're in the system as a resident or registrar. Rather, time goes by much faster, you don't notice it as much. If you have time to even notice it at all.

I remember attending a medical/surgical career fair for final year students.
One interventionalist who needed 10-12 years to train in their field told us not to choose a specialty based on the number of years required to train. But to pick the one that suited us or that we enjoyed. Either way, you're actually doing work relevant to your chosen field or related to your destination. It's not like the job starts when you become an attending or consultant.

The US isn't any different in expectation of its trainees.
Have you had a look at the residency & internship forums?
Terminating residents
Dismissed from Residency Program 3rd Year
IMG PGY-1 Terminated from residency - SERIOUS HELP NEEDED
It's a minority group in either Australia or the US that gets terminated. Generally, it takes a long time to accumulate enough problems for a program to terminate someone. In the few experiences I've witnessed, a solid year minimum. Which means, anytime in that year, affected trainees or residents have time to improve.

With regards to support for exams, it really depends on the hospital you choose to work for.
You have to find out for yourself as you shadow junior doctors/registrars, or as you start working for teams. Which hospital has the better pass rates or better support systems for their registrars? Everyone works a bit differently, some like more support, others prefer independence. There's a huge array of board resources now.

Very generally, lifestyle balance during training is relatively 'better' in the Australian system.
That's why so many UK residents are leaving the NHS for Australia after their foundation years.
Subscribe to read
BMJ Careers - Why I’m coming back from Australia to work as a junior doctor in the NHS
Doctors who left NHS for Australia: ‘More cash, fewer hours, less pressure’
The trade off is that training is longer in years.

Also, this is where I'm a little confused: In Aus, general physician is a specialty (3 more years on top of BPT), whereas the American counterpart seems to have just done 3 years of residency? Surely this is a niche circumstance - how would RACP categorise a US hospitalist? Probably somewhere between post BPT and finishing advanced training?

It's like asking how to fit a square peg into a circular one.
Don't over think it. Training however it goes still means you are working in the field you want to work in.
I wouldn't think of it as means to an end. It's much more sophisticated than that.

Again, best to do your American rotation or elective if you can arrange one. Then decide which one is more suited to you.
You have to live with that system for residency.

If you never intend to return to Australia, you could consider applying for residency in the US directly after med school. If you're able to get your application together by that time.

However, if you want to come back to Australia, I would suggest completing your Australian intern year before you go.
Get general registration out of the way first, otherwise you make your life so much harder to return.