A lot of doom and gloom re: difficulty in getting in to training programs. And deservedly so, however it's not as hard as you might think.
Yes, it's going to be very difficult to get what she wants. But, that is the case globally. As an international graduate, the best way to avoid miles of **** is to get in early so you don't have to double up on as much training.
If she comes across as a PGY2 and works in ED on a 12-month international contract, then she's in the system before she gets far behind. This is very easy to organise form Europe - there are locum agencies/career agencies that organise this completely as moving from Europe to Australia as a medicine career pathway is quite common.
During this PGY2 year she will be able to apply for mid-year intakes into Surg RMO positions/other training positions. From there she is in the system and good to go. At most she loses 6-12 months in an ED contract... And how much of this is really lost? She gets a lot of experience, finds out how medicine operates in Australia in the most highly supervised environment available, and makes some contacts and referees... Plus she's in close contact with other doctors who can tell her how to gain entry to specific training pathways.
Lol Doom and Gloom is one way to see it.
I'm not going to rob anyone of their own philosophy to life, to medicine, training or perspective.
Anything is open to interpretation. but you have to live with the path you choose, at the end of the day, not by how someone else tells you how to feel.
Personally, I wouldn't be able to sleep at night if I told someone it was easy and they didn't find it that way. I would actually feel guilty. I would actually blame myself. We've acknowledged challenges, and i'd rather share what they are than go sure they exist. but don't worry. Not everyone is built the same. Some don't care and will take things as they come, but that's not something I would apply to everyone. Not when things aren't risk free.
It's not entirely the case as it seems globally with regards to challenges. every country has their own. OP was specifically inquiring about Australia.
Yes, things are more competitive now (for various reasons) in many Western countries to get into 'residency'.
however. looking at it specifically. Some countries follow early streaming. in that you graduate from medical school, you get into a post graduate vocational training program. And then you're done. There's no separation of residency and registrar training. "residency" refers to the whole damn thing. It goes medical school --> residency --> (option of fellowship) --> attending/consultant. Australia it goes medical school --> residency --> registrar training via a royal college (+/- fellowship) --> attending/consultant (which isn't necessarily widely known, or what's desirable to IMGs used to early streaming in their own respective countries). It's important to make that distinction before moving offshore. It's a common assumption made that somehow we all share the same approach to training. But it's not actually the case.
within Australia, every state and even city (even hospital) approaches hiring of RMOs differently. There are common things, that said.
If you go rural or regional, where the workforce gaps actually exist, then yes. Good chance you do a PGY2 year in random stuff the hospital gives you. could be ED. Could rehab, could psych. etc. etc. then you re-apply towards something more 'desirable' to end goals the following year. it is not a guarantee. But hospitals try to be loyal to their own and reward loyalty with preferred rotations. I can't promise this will lend itself to allowing you to get into a subspecialty - if that's the end goal. the rural/regional hospitals can't offer things like neurosurgery. and if you don't neurosurgical referees, not a huge chance you'll get into say the neurosurgery training program as a registrar. you would have to move onto another hospital eventually in this case. It's harder to get hired by a hospital that knows you less, the higher you go, impossible no.
If you want to look at cities. It gets dicier as a resident - it's more competitive to get into a big hospital.
And emphasis dependent on particular hospital and state.
I.e. QLD - there's no such thing as RMO streaming. or it's very rarely done. everyone signs up for a 'general year' house officer contract. then you preference what rotations you want. if lucky, you get the rotations you preference. if unlucky you don't. that's not even anecdotal. it's on the QLD RMO applications each year. Most QLD hospitals don't even have interviews. Other states are different. there may actually be surgical streams from PGY2 and above or medical streams etc. alongside general streams, for which they will hold interviews. to be clear - streams doesn't mean you're on any training program via a college to be a registrar. you still have to reapply every year (they're annual contracts) to stay a resident in a particular stream, with the aim of applying to a program as a registrar later. Depending on the stream and hospital, they may come to expect things like research - if it's a hospital that values research and wants everyone to do research.
with regards to getting onto other training programs after PGY2, that would apply to select things. psych for example. I would not say all things. OP is asking about ED and RACS..i forget what else - I've already linked to official websites. Selection requirements for RACS for even interview consideration is based on a hefty points system - good luck having enough points accumulated after having only done PGY 2 or PGY3 in Australia. This is why it can take you up to PGY5-6 to actually get on the program. I'm not saying it's good or bad. Just saying, if you're from a country not used to this, you're probably going to be less open to this idea. you'd probably go why spend 10 years trying to be a fully qualified surgeon if you could finish training in 5 years in your home country. If you're used to the longer pathway, then who really cares. As an example.
Or let me put it this way.
we're on anonymous forum. it's the internet.
If you're really serious, to prepare (if that's the type of person you are), call the hospitals of interest AND contact the state resident medical officer campaigns. contact the colleges. Ask questions. What your chances of getting a surgical year with them as a resident etc. Or whatever it is you so desire. Then the advice you're getting isn't from randoms on the internet. Workforce personnel at a particular hospital are often pretty frank. Sometimes too frank.
For any offshore IMGs reading this, do the AMC exams - we can talk it to death, but none of it's really worth a thing until you've gotten general registration via the medical board or ahpra.
