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Hi everyone, hopefully this post does not come across the wrong way. I come from a place of wanting to understand and possibly inform other North American premeds looking into Australian medical schools. I started looking into Australian medical schools for the same reasons many North Americans do: I don't have a competitive GPA for MD schools and don't want to go DO. Initially what I read was very exciting, but as I read more and more...I feel like a lot of people are being tricked if they don't do significant research. It is important to note that much of this post does not apply to UQ-Ochsner because that program solely focuses on getting students to match in the US and has been quite successful at doing that. With more US MD and DO schools opening literally every year...we will see if that trend continues but for now it looks like a decent option. I am concerned of the predatory behavior of 4 year programs that take place mostly or entirely in Australia. I write from the perspective of an American but I believe most of it is true for Canadians as well.
At first, these schools seem very appealing. What draws us in is simple: these schools are easy to get into compared to US MD schools. They do not require a long list of "soft" requirements like a dozen extracurriculars to "check boxes", essays, and letters of recommendation. If you have the GPA and MCAT (and the cutoffs are very forgiving) and don't completely bomb the interview, it seems like they will accept you. Furthermore, Australian medical schools are located in a Western, English-speaking country at respected universities and have rotations at respected hospitals. The programs are not cheap but they cost about as much as a private MD school in the US: $320-360k in the US vs $350k-400k in Australia (both in USD). They give you the option of matching back home or if you fall in love with Australia/are disillusioned with the medical system back home, you can become a physician in Australia and live your life there.
Staying to work in Australia seemed especially appealing to me. Pay is more or less at par with pay in the US. Work-life balance seems much better. The Australian healthcare system is public with a private system superimposed and it is established that physicians are still well paid--if we move to medicare for all in the US, we have no idea what will happen to physician salaries. In the mean time, many patients in the US have a lot of animosity towards the healthcare system because it is so expensive. On the physician side, it is frustrating to know you are bankrupting people by doing your job. Australian post-grad training is about twice as long, which for some people is a downside, but as an intern/resident/registrar you are paid a much more reasonable wage and work hours are actually humane and conducive to starting a family and having a life. Personally, I would much rather work 40-50 hours of week for 10 years than work 80-90 hours a week for 5 years. Like most humans, I need sleep, have hobbies, and want to be around my kids when they are little.
Unfortunately...the reality half way across the world does not seem so bright the more you get into the specifics. The first problem for North American students is that, in terms of matching back home, Australian medical schools are really not that much different from the other "island medical schools," except they might have slightly less stigma than Caribbean medical schools. Their match rates might be slightly better but sample sizes are small and publicly released statistics are nonexistent. Ok...that isn't ideal, just stay and become a doctor in Australia then! It really does seem like a great place to work because of reasons I listed above.
So, you finish Australian medical school and then need to apply for an internship. Since you trained at the same schools as your Australian peers, that shouldn't be a huge problem...except it is. Australian and New Zealanders get priority over you (which is fair) and there aren't enough, if any, internship spots left over for foreigners. And thus the predatory nature of these programs begins. This already seems grim, but let's say you excelled in medical school, have top grades and scores, and a competitive CV. You are able to squeeze into a rural internship and are on the top of the world. Ha, it isn't that easy though. Next, you need to find a hospital that will hire you for residency. It probably wouldn't be a top hospital since your internship was not at a public, tertiary hospital and you just don't have the connections. This unfortunately carries forward and limits the connections you will need in terms of being accepted to a college for fellowship/specialty training (this part about reputation and connections based on your training sites is the part I am least sure about and would love to be corrected here). Then comes what is in my opinion the biggest and most well-hidden trap of this entire process: visas, permanent residency status, and how this affects your future training. The visa system in Australia changed in 2017 so the vast majority of advice on this forum and others is dangerously out of date. In the new system, being an intern or resident is no longer sufficient for a visa that provides a path to permanent residency. Instead, you can get a temporary two year visa that allows a one-time extension for two more years. After that, you are kind of screwed. You can't join most of the specialty colleges as a fellow if you aren't a permanent resident so it seems like you are stuck if you want to specialize. You have invested at least 8 years into learning about and working in the Australian healthcare system and you don't have much to show for it. Again, I would love to be proven wrong on this by someone more informed (I am sure there are many).
Finally, even though the pay in Australia is quite good, the job market seems abysmal compared to the US. Being a physician in the US is probably the best job when it comes to job security, salary, and being able to move to any region in the country. Of course, you will probably have to take a pay-cut and/or have a subpar lifestyle if you are very picky about location, or vice versa if you care a lot about pay and/or lifestyle, but by and large, physicians are in high demand in the US. The reports I have read estimate that Australia will have thousands of excess physicians within the next decade. Anecdotally, consultants (attendings for Canadian and Americans reading) can't even find jobs anywhere in the country when they graduate. That is a terrifying possibility. The lengthy training has its advantages, but those are all moot if you are 40, have been in school or training for literally 30+ years, are still in some debt, and can't even find a job.
I know a lot of these issues have been discussed piece by piece on this website. However, I hope that other premeds can read about the pros and cons in one place with this post and the responses it might generate. Even better, I would love to be proven partially or completely wrong and be told that a few members of this board are just too pessimistic when it comes to international medical students in Australia. Thank you for anyone who read this entire post and I look forward to hearing everyones experiences and opinions.
At first, these schools seem very appealing. What draws us in is simple: these schools are easy to get into compared to US MD schools. They do not require a long list of "soft" requirements like a dozen extracurriculars to "check boxes", essays, and letters of recommendation. If you have the GPA and MCAT (and the cutoffs are very forgiving) and don't completely bomb the interview, it seems like they will accept you. Furthermore, Australian medical schools are located in a Western, English-speaking country at respected universities and have rotations at respected hospitals. The programs are not cheap but they cost about as much as a private MD school in the US: $320-360k in the US vs $350k-400k in Australia (both in USD). They give you the option of matching back home or if you fall in love with Australia/are disillusioned with the medical system back home, you can become a physician in Australia and live your life there.
Staying to work in Australia seemed especially appealing to me. Pay is more or less at par with pay in the US. Work-life balance seems much better. The Australian healthcare system is public with a private system superimposed and it is established that physicians are still well paid--if we move to medicare for all in the US, we have no idea what will happen to physician salaries. In the mean time, many patients in the US have a lot of animosity towards the healthcare system because it is so expensive. On the physician side, it is frustrating to know you are bankrupting people by doing your job. Australian post-grad training is about twice as long, which for some people is a downside, but as an intern/resident/registrar you are paid a much more reasonable wage and work hours are actually humane and conducive to starting a family and having a life. Personally, I would much rather work 40-50 hours of week for 10 years than work 80-90 hours a week for 5 years. Like most humans, I need sleep, have hobbies, and want to be around my kids when they are little.
Unfortunately...the reality half way across the world does not seem so bright the more you get into the specifics. The first problem for North American students is that, in terms of matching back home, Australian medical schools are really not that much different from the other "island medical schools," except they might have slightly less stigma than Caribbean medical schools. Their match rates might be slightly better but sample sizes are small and publicly released statistics are nonexistent. Ok...that isn't ideal, just stay and become a doctor in Australia then! It really does seem like a great place to work because of reasons I listed above.
So, you finish Australian medical school and then need to apply for an internship. Since you trained at the same schools as your Australian peers, that shouldn't be a huge problem...except it is. Australian and New Zealanders get priority over you (which is fair) and there aren't enough, if any, internship spots left over for foreigners. And thus the predatory nature of these programs begins. This already seems grim, but let's say you excelled in medical school, have top grades and scores, and a competitive CV. You are able to squeeze into a rural internship and are on the top of the world. Ha, it isn't that easy though. Next, you need to find a hospital that will hire you for residency. It probably wouldn't be a top hospital since your internship was not at a public, tertiary hospital and you just don't have the connections. This unfortunately carries forward and limits the connections you will need in terms of being accepted to a college for fellowship/specialty training (this part about reputation and connections based on your training sites is the part I am least sure about and would love to be corrected here). Then comes what is in my opinion the biggest and most well-hidden trap of this entire process: visas, permanent residency status, and how this affects your future training. The visa system in Australia changed in 2017 so the vast majority of advice on this forum and others is dangerously out of date. In the new system, being an intern or resident is no longer sufficient for a visa that provides a path to permanent residency. Instead, you can get a temporary two year visa that allows a one-time extension for two more years. After that, you are kind of screwed. You can't join most of the specialty colleges as a fellow if you aren't a permanent resident so it seems like you are stuck if you want to specialize. You have invested at least 8 years into learning about and working in the Australian healthcare system and you don't have much to show for it. Again, I would love to be proven wrong on this by someone more informed (I am sure there are many).
Finally, even though the pay in Australia is quite good, the job market seems abysmal compared to the US. Being a physician in the US is probably the best job when it comes to job security, salary, and being able to move to any region in the country. Of course, you will probably have to take a pay-cut and/or have a subpar lifestyle if you are very picky about location, or vice versa if you care a lot about pay and/or lifestyle, but by and large, physicians are in high demand in the US. The reports I have read estimate that Australia will have thousands of excess physicians within the next decade. Anecdotally, consultants (attendings for Canadian and Americans reading) can't even find jobs anywhere in the country when they graduate. That is a terrifying possibility. The lengthy training has its advantages, but those are all moot if you are 40, have been in school or training for literally 30+ years, are still in some debt, and can't even find a job.
I know a lot of these issues have been discussed piece by piece on this website. However, I hope that other premeds can read about the pros and cons in one place with this post and the responses it might generate. Even better, I would love to be proven partially or completely wrong and be told that a few members of this board are just too pessimistic when it comes to international medical students in Australia. Thank you for anyone who read this entire post and I look forward to hearing everyones experiences and opinions.
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