Better to study in USA or EU

[ftrotter]

Hello,
My wife is Finnish and I am a United States Citizen. After lots of time and paperwork, she will soon be a United States Citizen as well. Despite this, she is still an EU citizen (dual US/EU). My wife has almost finished all of the courses in a United States undergrad program that would help her to pass the Finnish or other EU Medical School entrance exam. We estimate that she would be able to start medical school in Finland immediately but that it would take two more years of undergraduate study to qualify for a US medical school. As a result we are almost at the point where we would need to commit to one system or the other we have several questions.

First, is the process for graduating from Finland/Sweden system and coming to the United States? How hard/time consuming is it? Are there any specialty limitations that we should be aware of? Does the residency have to be repeated?

Second, does anyone have any experience going the other way? It is important to us to be able to Practice Medicine in the EU as well as in the United States. Does anyone have experience graduating from Medical School in the United States and then going to practice in the EU. How well does a US degree transfer within different countries in the EU?

Generally we would appreciate any insights as to which system would further our overall goal, to be able to practice medicine in both the US and the EU.

We really need help with this quickly, thanks!

Fred Trotter

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[Miklos]

First, is the process for graduating from Finland/Sweden system and coming to the United States? How hard/time consuming is it? Are there any specialty limitations that we should be aware of? Does the residency have to be repeated?

Simply said, medical licensure (both in the EU and the US) suffers from protectionism. This means that there are significant advantages in graduating from a local school to get a local residency.

Generally (with only very minor exceptions, see below), the US licensure jurisdictions do not accept residencies outside the US as a path to full licensure. This effectively means that a US residency is a must to full US licensure. (There are the following very minor exceptions; 1) A Canadian residency can substitute for a US one, but not in all states. 2) Licensure by appointment to a medical school faculty or eminence in medicine. See http://www.ama-assn.org/ama/pub/category/10257.html )

Second, if she intends to practice medicine in the US, she would best be served by getting into a US medical school. The reason is simply that by going abroad (even as a native of Finland), she will be considered an international medical graduate (IMG). Opportunities for IMGs are again generally, limited in the US, as the US system prefers its own graduates (as do countless other countries, no doubt). By going abroad, she will in all likelyhood be limited to less competitive/less lucrative residencies.

How can you tell, which these are?

Simplest way, is to look at FREIDA's training statistics. The average number of IMGs in the system overall today is roughly 25%. Representation above that indicates that the residency is currently IMG friendly, below that means it is competitive and 'unfriendly' to IMGs.

Very roughly, this means the following today:

Family Practice, Internal Medicine, Pediatrics, Neurology and Psychiatry are IMG friendly.

Surgical subspecialties of all types are unfriendly with the possible exception of Ob/Gyn (which US students are avoiding thanks to malpractice problems).

Other high paying specialties, such as Radiology, Dermatology, Anesthesiology, Emergency Medicine can also be considered unfriendly.

Further, even among the IMG friendly specialties there is a very significant amount of competition among IMGs. The US is to my knowledge, the only place where there a lots of residencies up for grabs for IMGs.

See the ECFMG for much more info: http://www.ecfmg.org/2007ib/ibfaq.html

Second, does anyone have any experience going the other way? It is important to us to be able to Practice Medicine in the EU as well as in the United States. Does anyone have experience graduating from Medical School in the United States and then going to practice in the EU. How well does a US degree transfer within different countries in the EU?

Depends on the local medical jurisdiction (there is no such thing as an EU license). In my view, this is really not realistic. High EU taxation and relatively low pay for physicians (as well as too few residencies) are often a deciding factor for EU physicians to come to the US.

 

[segaBOY]

How hard would it be to gain admission into a US med school with an Irish degree in pharmacy? I presume I'll have to go down the road of MCAT results. I'm Irish by the way so it'd be a degree from my home country.

 

[neurodoc]

How hard would it be to gain admission into a US med school with an Irish degree in pharmacy? I presume I'll have to go down the road of MCAT results. I'm Irish by the way so it'd be a degree from my home country.

If you completed the required US premed courses and take the MCAT (a few schools don't require the MCAT, but most do), and you can get the appropriate Visa, you can apply for admission just like everyone else. As you know, US med school admission is very competitive. As a non-citizen, it will be even more competitive for you. But you could succeed. Good luck.

 

[segaBOY]

If you completed the required US premed courses and take the MCAT (a few schools don't require the MCAT, but most do), and you can get the appropriate Visa, you can apply for admission just like everyone else. As you know, US med school admission is very competitive. As a non-citizen, it will be even more competitive for you. But you could succeed. Good luck.

Thanks for that, I might give it a shot

 

[Slowmo214]

Hello,
My wife has almost finished all of the courses in a United States undergrad program that would help her to pass the Finnish or other EU Medical School entrance exam. We estimate that she would be able to start medical school in Finland immediately but that it would take two more years of undergraduate study to qualify for a US medical school.

Sounds to me like she hasn't completed the required premed courses in the US. If this is the case then I fail to see how she could pass the Finnish entrance exam with absolute certainty: the exam is heavy on physics and chemistry and if one wants to gain admission to the more competetive schools (namely University of Helsinki) it is no joke. She could very well fail the first time and need to retake a year later. I've heard of cases like this (ugrad in the US as a science major then applying to a Finnish med school) and not all made it on the first try.

Then again, if your wife is fluent in the Swedish language getting in isn't that hard...there is a special quota for Swedish speaking students. Those eligible do not need to do as well in the entrance exam.

 

[fred cago]

Is there any statistic or any anecdotal (or other) knowledge out there concerning which country an IMG got his medical degree from? In other words, the residency directors rank US medical schools, do they have something like that for international medical schools?

 

[Miklos]

Is there any statistic or any anecdotal (or other) knowledge out there concerning which country an IMG got his medical degree from? In other words, the residency directors rank US medical schools, do they have something like that for international medical schools?

It is not that simple.

Obviously, if PDs have positive experiences with graduates of certain schools or countries, they may be more likely to interview them, etc... (The opposite obviously also applies.)

Some schools have better or worse reputations either deserved or undeserved. A PD might, for instance be more likely to look at a Oxford grad rather than a State University of (insert your unknown European city name here) grad, if all things are equal.

(Also, if your school has been banned by licensing authorities in several states that might have a real negative effect on your application.)

However, simply in order to get to the PDs attention, one must have decent USMLE scores. I doubt that in most instances, a 'better' off-shore school would compensate for a relative deficit in USMLE scores. Why? Because the ERAS system allows PDs to set up score filters to sift through applications. This means that in order just to receive a second look (never mind an interview), a competitive score is often a must even in so-called non-competitive fields.

The one method of comparison of off-shore schools that could potentially be available to everyone is not published by the ECFMG, though they have that data: the first time pass USMLE pass rate by school.