Ever contemplated practicing outside the US post graduation?

[JohnnyMath]

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Sometimes I fantasize about what I'll do after medical school, if I make it in. I have a huge case of wanderlust, and I wouldn't mind working in a Nordic country like Sweden for a year or two, just to see what it's like. I'm perfectly fine with taking a huge dent in pay in exchange for lifestyle experience.

How does it work in terms of equivalency, and are US doctors really sought out internationally?

Also, be sure to mention if you ever contemplated practicing outside the US, where, and why! 😛

 

[link2swim06]

You should train where you will practice.

Yes a US doctor can always work in 3rd world country on a mission trip....but in another 1st world country like Sweden you would show up and have zero experience with their healthcare system.

 

[JohnnyMath]

Hmmmm.....so I guess I should just "visit" if I hopefully matriculate as a doctor? Because, to be honest, my heart is in the US, and I don't think I could imagine living permanently anywhere outside of my home state, to be honest. I just love travel, but visiting seems limited, I always thought living for a year or two would actually help you absorb certain vibes.

 

[dap]

I think about this often. In many countries, MDs from the US can get great jobs, but might not actually be licensed practitioners. This is the case here in Turkey--I know an American guy who works for the big Hopkins-affiliated hospital here but is technically not an attending. I think he's seen as a consultant or something. Basically I think he is there for marketing purposes more than anything else (the Turkish physicians at this particular hospital don't really need 'consultation' as many of them did residencies/fellowships in the states at pretty prestigious programs). He does get paid well though, has great hours and gets to travel.

If you want to practice, the situation is going to vary depending on the country. I'm really interested in coming back and working in this area of the world, both Turkey and more needy areas--but you have to pass a Turkish proficiency exam to get licensed in Turkey (fortunately I've passed that level already). You are also going to need some knowledge of the healthcare system, but from my experience in different healthcare systems both in Turkey and Iraq this knowledge is really not that hard to pick up.

I don't know specifics on Scandinavian countries but I imagine you are going to have a much harder time finding work there. Most countries want to hire their own people if they are well trained. The knowledge of the healthcare system is probably not going to be your biggest obstacle--language, licensing, and competing with native citizens for jobs will be.

But in places that have more serious shortages of physicians ("third world"), as well as in places with developing medical infrastructure, some portion of well-off citizens and/or medical tourism (big cities in Turkey, UAE, Qatar, Caribbean, some S. American countries, etc) you could probably find a pretty good job. Again, even if you can find a job in these places whether or not you are actually going to practice is going to be country-specific and depend on things like language and possibly even citizenship.

If you are really interested in this you can find some pretty sweet gigs in the world of international medicine--but they're probably not going to be in western Europe.

 

[JohnnyMath]

I think about this often. In many countries, MDs from the US can get great jobs, but might not actually be licensed practitioners. This is the case here in Turkey--I know an American guy who works for the big Hopkins-affiliated hospital here but is technically not an attending. I think he's seen as a consultant or something. Basically I think he is there for marketing purposes more than anything else (the Turkish physicians at this particular hospital don't really need 'consultation' as many of them did residencies/fellowships in the states at pretty prestigious programs). He does get paid well though, has great hours and gets to travel.

If you want to practice, the situation is going to vary depending on the country. I'm really interested in coming back and working in this area of the world, both Turkey and more needy areas--but you have to pass a Turkish proficiency exam to get licensed in Turkey (fortunately I've passed that level already). You are also going to need some knowledge of the healthcare system, but from my experience in different healthcare systems both in Turkey and Iraq this knowledge is really not that hard to pick up.

I don't know specifics on Scandinavian countries but I imagine you are going to have a much harder time finding work there. Most countries want to hire their own people if they are well trained. The knowledge of the healthcare system is probably not going to be your biggest obstacle--language, licensing, and competing with native citizens for jobs will be.

But in places that have more serious shortages of physicians ("third world"), as well as in places with developing medical infrastructure, some portion of well-off citizens and/or medical tourism (big cities in Turkey, UAE, Qatar, Caribbean, some S. American countries, etc) you could probably find a pretty good job. Again, even if you can find a job in these places whether or not you are actually going to practice is going to be country-specific and depend on things like language and possibly even citizenship.

If you are really interested in this you can find some pretty sweet gigs in the world of international medicine--but they're probably not going to be in western Europe.

You mentioned the UAE and Qatar. A lot of my premed friends are Jordanian or Palestenian. and I've picked up a lot of Arabic from them. I'm proficient, but not fluent. I can't get down some pronunciations of hard t or hard s as opposed to a softer t or a softer s. Don't get me started on the hard kh sound and the gh sound....but excluding that...is life in the middle east really that bad as what it's made out to be in the media? Jut curious.

 

[Omppu27]

You mentioned the UAE and Qatar. A lot of my premed friends are Jordanian or Palestenian. and I've picked up a lot of Arabic from them. I'm proficient, but not fluent. I can't get down some pronunciations of hard t or hard s as opposed to a softer t or a softer s. Don't get me started on the hard kh sound and the gh sound....but excluding that...is life in the middle east really that bad as what it's made out to be in the media? Jut curious.

You're proficient in Arabic by hanging out with some Arab premed friends? Having grown up with half my family being from the Middle East and taking over a year of Arabic myself, I'd love to hear what you're definition of proficient is... Regardless, you don't need to even know Arabic in the UAE. A close relative of mine works in Dubai and many of his colleagues are 100% American. Having been there a couple times myself, I can personally say that if you were to only know one language, either Arabic or English, in the UAE, you'd be better off with English. This is because many of the people working the blue collar jobs there come from close by non Arabic speaking countries. That said, I don't think finding a job as a physician, albeit with probably some experience, would be too difficult. Also, to comment on your worries about what you see in the media, Qatar and the UAE are nothing like Syria, Egypt, Libya, etc. They are very modernized areas and are in no threat to any kind of Arab spring revolution that you've seen in other countries.

 

[AnalisCanalis]

Sometimes I fantasize about what I'll do after medical school, if I make it in. I have a huge case of wanderlust, and I wouldn't mind working in a Nordic country like Sweden for a year or two, just to see what it's like. I'm perfectly fine with taking a huge dent in pay in exchange for lifestyle experience.

How does it work in terms of equivalency, and are US doctors really sought out internationally?

Also, be sure to mention if you ever contemplated practicing outside the US, where, and why! 😛

If you are a EU citizen and speak Swedish fluently, no problem. Otherwise it might prove difficult. Though, I don't really understand why any physician from a western country would want to practice medicine in Sweden.

 

[deleted500612]

You could just come to Canada... same climate as Sweden, but similar pay to the US and you already know the language. Also, it is very easy to switch between Canadian/American medical practice as there is a streamlined process for accrediting each other's doctors. Although I guess Canada is not quite as adventurous as Sweden haha.

 

[dap]

Basically everything Omppu27 said. It will take you many years to reach a reasonable proficiency level for practicing in Arabic. Fortunately in Dubai, Doha, Abu Dhabi, etc. you don't need that for a lot of these medical jobs.

Depending on who you ask and what they think the "Middle East" means you will get very different answers from life is horrible to life is wonderful. I loved Iraq and I love Istanbul, though these are on opposite ends of the spectrum in most Westerners' minds. There are some cultural differences and frustrations even in Istanbul, but most Westerners find it a pretty easy city to live in. Cities in the UAE and Qatar are a little different, as a upper-class white collar westerner you are going to live a pretty separate life. You'll probably live in a gated community, have a driver, be treated royally by your employer, and make a lot of money. Some people love that--personally, I don't have any desire to work in a situation like that, but I would gladly work in Turkey or Iraq after school and residency. But I also am fascinated by this part of the world, love Arabic and want to get good at it, love the people here, enjoy studying the history of Islamicate civilization, love anthropology, etc.

If you just have a travel bug and want to do some adventurous stuff you may be better off looking into jobs in the Caribbean, South America, or other medical tourism places. If you don't necessarily care about practicing you can look into places like Turkey where you can get a job as an MD without Turkish proficiency (but not practice) and make decent money. I imagine there are similar situations to this in places trying to develop private medical sectors and hang their "American Physicians" out as advertisements for their hospital group. Probably eastern Europe? Places in south Asia?

 

[Kahreek]

Doing all the required certification to practice in sweden for only 2 years is unreal. You may need 2 years to enter the "system", alone.

 

[Postictal Raiden]

I am originally from Saudi Arabia. Western trained physicians are paid very high salaries in SA. You don't need to be able to speak Arabic to work there. Despite how modernized and "westernized" the country has become, living there will require one to be very adaptable.

In regards to the person who said they are proficient in Arabic, you must be a genius. I know several American citizens who have been living in Saudi Arabia for years who still don't even elementary level Arabic.

 

[AnalisCanalis]

I know Sweden has a bridge program to bring foreign doctors there, giving them Swedish classes and assistance to pass their national exam to get a license. If you are from a country like Mexico where there are 7,000 people fighting for 700 residency slots in Internal Medicine, then if your ultimate goal is to get an IM residency license, going to Spain or Sweden which have plenty of residency slots are a good option if you have enough cash saved for the plane tickets. Most mexican MD's that wish to train in Europe go to Spain because there is no language barrier, residency slots for FMG's are still plentiful and half of the process of getting your degree validated can be done at their embassy in Mexico City. The big issue is affording the plane ticket to get to Spain just to do their MIR exam which cannot be done abroad like the USMLE can.

This is just not true. Residency slots in Sweden are scarce. There is however a need for trained specialists in FM and psychiatry, but that need will soon be gone considering the massive expansion of Swedish medical schools.

That being said, I would not consider Mexico a western country.

 

[JohnnyMath]

You're proficient in Arabic by hanging out with some Arab premed friends? Having grown up with half my family being from the Middle East and taking over a year of Arabic myself, I'd love to hear what you're definition of proficient is... Regardless, you don't need to even know Arabic in the UAE. A close relative of mine works in Dubai and many of his colleagues are 100% American. Having been there a couple times myself, I can personally say that if you were to only know one language, either Arabic or English, in the UAE, you'd be better off with English. This is because many of the people working the blue collar jobs there come from close by non Arabic speaking countries. That said, I don't think finding a job as a physician, albeit with probably some experience, would be too difficult. Also, to comment on your worries about what you see in the media, Qatar and the UAE are nothing like Syria, Egypt, Libya, etc. They are very modernized areas and are in no threat to any kind of Arab spring revolution that you've seen in other countries.

I could Skype you and you could hear me speak Arabic. I'm mostly White European, but I have Lebanese and Turkish in me, and before you get on the rant of how Turks don't speak Arabic, the Turkish in me is around the Aleppo and Latakia area, so my relative have established a Syrian background, being so close to the border and being so far away from the metropolitan areas like Ankara and Istanbul. Then again, I could easily Skype you and end all doubts. Just because I haven't lived there doesn't mean I don't know Arabic. It won't let me upload the sound recording file I had recorded of just screwing around, talking Arabic and making fun of the "tasweer tab3un al samakeh ya abu OMPPU-sab3o 3shreen. La t5af, b7akee 3arabi 2dak wa 3shra marat."


I'm trying to be a polyglot working on Arabic, Spanish, and French. My friends have old French brooks from their curriculum in the Middle East, and I've picked those up fast. Languages are like math, follow the rules and know when you use the rules in certain contexts. Conjugation is like memorizing theorems. I love math, therefore I love language.

 

[Omppu27]

I could Skype you and you could hear me speak Arabic. I'm mostly White European, but I have Lebanese and Turkish in me, and before you get on the rant of how Turks don't speak Arabic, the Turkish in me is around the Aleppo and Latakia area, so my relative have established a Syrian background, being so close to the border and being so far away from the metropolitan areas like Ankara and Istanbul. Then again, I could easily Skype you and end all doubts. Just because I haven't lived there doesn't mean I don't know Arabic. It won't let me upload the sound recording file I had recorded of just screwing around, talking Arabic and making fun of the "tasweer tab3un al samakeh ya abu OMPPU-sab3o 3shreen. La t5af, b7akee 3arabi 2dak wa 3shra marat."


I'm trying to be a polyglot working on Arabic, Spanish, and French. My friends have old French brooks from their curriculum in the Middle East, and I've picked those up fast. Languages are like math, follow the rules and know when you use the rules in certain contexts. Conjugation is like memorizing theorems. I love math, therefore I love language.

Haha, well I apologize if I offended you in any way... In your post you didn't mention that you have any Arabic origins. Also didn't say that one had to live in an Arabic speaking county to be able to speak Arabic. Also, if it makes you feel any better, I have no idea what you wrote at the end of that post. My Arabic is poor and I can't read transliteration to save my life. You win???

 

[Etorphine]

I am very interested in doing mission work in the future. I have specific locations in mind in developing countries where the majority speak english, and I'll be able to get by on a day to day basis. My long term plan is to get my debt squared away ASAP after becoming an attending, and moving toward a positive net cash flow. Once I have a decent amount tucked away in the bank, I feel like I will have more lee-way toward more service-centered mission trips.

 

[ferning]

Australia all the way

 

[Fox800]

If the PPACA turns out to be a complete boondoggle and medicine in the US continues to become more complicated and less appealing by the day, I'm packing my bags and heading for New Zealand. Also eyeing Australia, Canada, and Sweden.

 

[notbobtrustme]

If the PPACA turns out to be a complete boondoggle and medicine in the US continues to become more complicated and less appealing by the day, I'm packing my bags and heading for New Zealand. Also eyeing Australia, Canada, and Sweden.

Maybe New Zealand is feasible as I can't find much info on how foreign physicians are recruited. All other countries require a long waiting list, additional testing, additional training, language certifications and on top of all that, you will never be more than house staff regardless. You're going to be stuck serving in rural areas/small towns under the conditions of your visa. This isn't the US where you can just get up and move anywhere. You will be obligated to serve in those areas for the terms of your visa and if you violate them, say good-bye.
And even the worst case scenario for US doctors still involves them earning 1.5x more than their foreign counterparts.

Don't get your hopes up about practicing outside the US. It's a very long, very difficult road to traverse even if you do have a US medical degree.

 

[dap]

Maybe New Zealand is feasible as I can't find much info on how foreign physicians are recruited. All other countries require a long waiting list, additional testing, additional training, language certifications and on top of all that, you will never be more than house staff regardless.

This is not true. Many countries require language certifications, many countries require bureaucratic hoop-jumping, some countries require additional testing, few require additional training and wait lists. Not only are all of these barriers not present in all other countries, all of these barriers are not even present simultaneously in most countries. Perhaps if we are speaking exclusively of Europe these are present much more frequently, but not even close when talking about the world as a whole.

You're going to be stuck serving in rural areas/small towns under the conditions of your visa. This isn't the US where you can just get up and move anywhere. You will be obligated to serve in those areas for the terms of your visa and if you violate them, say good-bye.

This is also not always true. Again, maybe for many European/high-income countries, but it can be the opposite for many developing (and especially "upper-middle income") countries, where much of the demand is in large cities at (often for-profit) high quality medical centers and places seeking to build medical tourism industries. For more low-income countries, yes much of the opportunities are both low-pay and in rural or severely under-served areas. But that's okay for some people that just want to do something different for a while. The part you say about not being able to just get up and move anywhere is usually true, but I would argue more often because you will be an employee and not have as large a variety of potential other employers. Especially if your employer is sponsoring/helping with your work visa (common).

And even the worst case scenario for US doctors still involves them earning 1.5x more than their foreign counterparts.

True for the most part. Earning ceilings are typically highest in the US. But there are places where you can make much more per time worked than in the US, with many benefits you wouldn't necessarily have in the US. (These could include anything from lower taxes some places, to more vacation time, to a certain number of paid flights back home per year, a car and even housing, etc.)

Don't get your hopes up about practicing outside the US. It's a very long, very difficult road to traverse even if you do have a US medical degree.

It's not easy but it is definitely doable. Especially if you are flexible about location. And if you are just trying to do something adventurous and get out of the states for a while, and aren't looking to make a lot of money or move to a particular area, then it can be quite easy (the finding a job part at least). I would also mention again that there are a lot of international job opportunities for US DOs/MDs that don't necessarily include practicing. So if you just want to use your degree in some way to get a decent job out of the country, you can definitely do this in a variety of roles where you are not practicing/independently treating patients.

You bring up some really good concerns that anyone considering international medicine should pay attention to, but these concerns are not as universally true as you make them sound in your post.