Hey there,
So, I'm a grad/ex-international student and now working in Australia. I'll try to help out with your questions. But don't use the answers as the end all be all, rather, they serve as place to start.
Try the search function too, a lot of your questions have been addressed in other forums and threads over the last 10 odd years now. It's worth exploring.
Look through the other international threads too, while not identical there's often a common theme to having an off-shore medical degree. it's good to know sometimes, just as a sort of off-label warning. Also as option, have a look at DO schools in the US, some people don't like DO (and that's fine, to each their own), but grads of those schools have a 99% match rate with American residency programs no matter their background. If that's the sort of reassurance you're after.
I would really encourage reading more and researching thoroughly. I wouldn't take this decision lightly or spend little to no time considering whether it is appropriate for you and your situation. It is a huge commitment which will affect the rest of your life.
Everyone is going to be different, so read as many stories as you can, from the uber negative to the extremely positive. Weigh them out. Ask questions.
🙂 within a balance, perhaps try not to expect too much spoon-feeding where you can easily look something up.
It's learning out of a hose, a lot of information being thrown at you in a very condensed amount of time. You have to be able to handle the pressure. For instance, you may get 1-2 days to cover cardiac physiology on your own, cardiac pathology may be 3-4 weeks tops. In an undergrad course, cardiac physiology is covered over an entire semester. I would not call this "easy". Personally. It was hard work. Whenever someone says it's easy, either they're brilliant, they're lying or they're doing it wrong and it may come back to haunt them. I've known people who've failed medical school in Australia or have had to repeat the year. Have also known people who have graduate degrees in human physiology or anatomy - needless to say, it was much easier for them. Pathology could be a bit of an equalizer, but a background in pharmacy, physiology, or anatomy gives you a head start.
Generally speaking, the minimum requirements are there (at least in North America) to select the students who will be able to adapt to this environment. It's not meant to create competition necessarily nor is it always a result of competition that selection criteria becomes so 'high'. That said yes, medicine is (perhaps overly) competitive and popular. So you have to stand out to get in as a domestic student anywhere vying for a domestic spot. It's a bit different when you're a full-fee paying international student. Try to separate the two groups out in your mind. The rules are different for the two groups. Then you have to kinda ask why, and be comfortable with the conclusions you make for yourself.
For off-shore schools such as those in Australia and Ireland, the government unfortunately does not fund them well. Actually, federal budget for medical schools is 2-3x less than that of the UK, the US and Canada and that is according to a report by the Medical Deans of Australia and New Zealand.
Hence the massive reliance medical schools in Australia has on full-fee paying international students, for whom they have no obligation to provide jobs for. Selection criteria is lower and schools like UQ have no interview at all, Some schools do not select students at all, as long as your entrance exam scores or GPA meets their minimum cut off then you get in. A couple of schools only require a high school diploma, they tend to be 6 year programs, so yea... I feel bad saying it, but if you pick the right Australian school, they will actually take just about anybody, so long as you can pay their fees.
Also, the medical schools in Australia do not manage the "residency programs" at all. They have no control over programs or have any say in resident positions, numbers or recruitment. So, students are a wholly unregulated market for the schools, and there generally isn't any planning done ahead of time for full-fee paying students. Usually it's an after thought. Despite the fees and under budgeting by governments, the university overseeing the schools take away a substantial portion of tuitions and none of this trickles to the hospitals. Again, this according to government reports to this effect, happy to link them - just ask.
Whether this is sustainable..
It's open to debate.
Who controls residency and vocational training? The hospitals themselves and the royal colleges. Which again, do not see any of your tuition.
Depends on the school.
Typically, there's lectures and PBLs, and perhaps some exposure to clinical medicine about once or twice a week (skills labs) during MS1 and MS2. I'll defer to the students to respond to this, as it's been a while for me. Expect generally 8-5 days of contact hours.
There's
no USMLE step 1 equivalent in Australia, so bit less stress if you're not preparing to go to the USA.
Don't entirely know what you mean by this either. Opportunities specifically in what?
Research?
If you pick a research-oriented school or a school with more research opportunities such as those in the big cities, then you have more research opportunities.
Networking with doctors is more accessible to you as an MS3 and MS4, even then, they're less excited about medical student networking as you do not go directly into vocational training after medical school.
I.e. you don't go into "IM" training directly after medical school. you do at least an intern year +/- 1-2 or more resident years (where you work as a resident, but are not dedicated to particular field yet).
Networking for internship is doable, but will not help you with vocational training so much if you're attempting this as a student. As stated before.
I think your question is more about how do you apply to Australian hospitals and optimize getting an internship? PGY1 only, is that correct?
Usually a lot of premeds come to these forums asking that, 'how hard is it to get an Australian internship and what do I need to do to get one.' which is a fair enough question.
One option is to do rotations and electives with rural hospitals that may or may not hire you. Caveat is, they don't always accept international students for rotations. If you go to UQ, you won't be able to rotate at any rural hospital. If you go to say, JCU which is a rural medical school, you will because they have a near exclusive partnership with the surrounding rural hospitals they do send their international students to. UQ is a primarily metropolitan based school. While it has some rural schools connected with it, they accept domestic students only to these programs only.
The other alternative is that many final years (highly variable on the state however) will travel or fly to rural hospitals and spend a day visiting the recruitment officers or admin there. Particularly in states like QLD, the rural hospitals expect international students to make contact with them directly. You just can't blindly or passively apply.
Like the real or rest of the world nowadays, looking for jobs as a very junior doctor means calling around, visiting hospitals you're interested in working with (and will realistically consider you) and asking if they have vacancies, would they be interested in your CV etc. People complain about the match in the US, but I don't know, it can be even trickier in Australia because there's no nationalized system.
Try to think beyond 'attaining' an internship.
I mean, research the hospitals you want to work at a bit more, do they offer rotations in what you need or have an interest in? Will it allow you to progress in the field you want and help you apply for vocational training later?
it remains to be seen how this will pan out. Everyone has different opinions, outlooks and predictions or speculations on this. It's a hot topic.
What I can say is that there is a government report out that has stated that we are now in doctor oversupply. What has not changed yet is that the rural areas are still chronically short of doctors. Whether this will continue to be the case in 4 years. Who is to really say? Also, you can argue perhaps the government is wrong. Doesn't matter, because the government will respond to its own reports accordingly, currently it's led to adjustments in the VISA process which are still evolving. Certainly, none of the current medical students could have foreseen this before they started. Similarly, it's becoming increasingly competitive to get into some fields of medicine. etc.
Generally, you have to accept risk. Have back-up plans. Like, do your away rotations back home or in the US, and at least prepare to do board exams even if ultimately by final year you find you don't have to go overseas. Be at least ready in a way that is reassuring for you. Because in 4 years a lot can change, some people adjust well, others simply don't.
Rural in Australian terms refers to catering a population of between 10 000-100 000. Regional is sometimes in need of doctors too, the farther they are from cities anyway, and these are areas of <100 000. There's also remote medicine for populations < 10 000. Hopefully i've got that right, my internet is currently having issues or I'd pull that up for you.
You could consider Rural Generalist - which is FM on steroids, it allows you to work as rural/remote FM with upskilling in Emergency for example, so you independently run a rural outpost in an under-resourced area. Unfortunately if you transfer from this to a city again, you have to practice only within the limits of FM. Pitman is currently a rural generalist, somewhere in this forum.
Oopps, hit reply before intended.
To finish -
Bit confused by this question. You are paid for all them, in all fields.
Also, there is no such thing as "EM only" or "IM only" internship in Australia. Going back to what I said earlier, you do not go directly into vocational training after medical school in this country. Some schools have a sub-internship year, which tries to be similar to the sub-I in the US, and you aren't paid for that as you're technically a student without a medical degree.
Have a look at the AMA website -
Becoming a Doctor.
This is also a fabulous resource by the NSW government:
Map My Health Career
FM will take at least 4-5 years in Australia on average. There's an entrance exam now, which they introduced last year. increasingly they're favoring those with more experience (so intern year + PGY2 or even PGY3 years who have done hospital rotations in OBGYN and Pediatrics for example).
IM minimum 7 years, longer if you wish to subspecialize. You can only apply to this after you've done at least an internship year.
Pure EM also 7 years minimum. You cannot apply without sitting an entrance exam and have two resident years after intern year under you belt.
Hard to answer this for me personally anyway.
I mean, it's still work at the end of the day with degrees of repetitiveness, lot of paperwork, politics etc. I get good and bad days.
I've come to recognize and appreciate over the years, that there's
no one size fits all answer to this type of question. At least, not when you're asking in order to see if it will be suitable for you. There's so much variation in the international students that come out here (there's that many). On whether you'll be happy and have no regrets coming out here, it really depends.
For instance.
Rural medicine is noble, rewarding and respected, but is not for everyone. If only it were, we wouldn't have an issue recruiting doctors there universally (not an Australia only issue). Just like saying, off the top of my head, psychiatry is not for everyone.
Similarly, working in Australia is not for everyone.
Studying medicine in Australia is not for everyone either in the sense that I've known people who have loved it but also those who hated it, and those who had no opinion at all. Were just blase about it.
Training in Australia after medical school is almost certainly going to be different to North America. I had some classmates solely focus on returning home partly because they were dissatisfied with what Australian training could potentially offer them. One thing that puts people off is that the number of years of 'residency' or training is double that of North America. Also again, you cannot go directly into vocational training in Australia the way that you can in the US and Canada. If you can't live with some degree of uncertainty, fair enough, this may not be suitable for you. Others loved the potential for flexibility, if you look at it another way. It's great if you're indecisive. Hours and lifestyle are relatively better than North American counterparts, but it means the years will be longer to make up for lost time.
Responsibilities are more gradual in Australia etc, which is not everyone's cup of tea.
To stay in the cities now, it's increasingly difficult and subspecialty training is getting harder to obtain every year. It's also becoming harder for finishing trainees to find attending or consultant positions, depending on their vocation.
I'm throwing that out there, because a lot of premeds or even med students start out thinking they are happy to take a job anywhere, even if it means rural. (how do you really know until you've tried working in it?) Undeniably it's an important thing - being employed particularly after medical school. But if you later find out your personality is not suited for this type of medicine, you don't want to realize you've entrapped yourself later. You may not come out happy at the end of it, despite having a job. As touched on earlier.. there are great things to this career, but it is still work. You have to be able to envision yourself doing the mundane parts to it everyday and still be able to enjoy even the most repetitive things.
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TL
😀R Things are fluid and changeable. Rules that apply to today, maybe different in a year or 4 years' time. You can plan, but there's always going to be something that comes up that you couldn't foresee. By going off-shore under any circumstances, you have to accept a level of risk and live with this. Be flexible, be un-entitled.
