IM vs GP FOR AN IMG IN AUSTALIA & NEW ZEALAND

[Linky Hamza]

Hey,
I'm an IMG who's applying for the US residency match this year. My end goal is to move to Australia or New Zealand to practice and settle there permanently.
My issue is that I'm still confused about which to choose between general medicine (IM) or FM (GP).
So, could a general medical specialist work in an outpatient setting only, with no calls as a PCP?
I prefer no calls and a good lifestyle. Which of these specialties has better working conditions and opportunities, is in my best interest?
Thanks all.

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[lymphocyte]

There is no outpatient "IM" equivalent per se with that level of training. An IM attending, without fellowship, would not be a consultant in Australia; they would be on par with a basic physician trainee who has yet to complete advanced training and would therefore have no employability apart from low-grade locum or niche jobs. The market for physician consultants is getting saturated, and it might be difficult to get a visa in the next few years. You will also have to contend with the ten year Medicare moratorium.

Between the two, general practice is by far the most flexible option, where you can set your own hours and practice pattern. My friend decided she really liked seeing kids, told the receptionist to only book kids, and viola, she's booked out seeing only kids. Another friend loves inpatient and outpatient work. He works at rural hospital doing three days of call every week and then nine to four at the GP clinic with two hour lunch breaks. He makes around 280K/year with great benefits. RACGP also has a reciprocal licencing agreement with ABFM, so your board certification would likely be transferrable if you pursued family medicine.

I'm using the words "maybe and "likely" because policy and circumstances change pretty quickly in Australia. You absolutely need to check with the respective colleges (RACP for IM and RACGP for GP) before making any kind of major decision. But I think the most sensible answer to the question asked, and based on what you seem to value, is that family medicine would be the best option.

 

[Linky Hamza]

There is no outpatient "IM" equivalent per se with that level of training. An IM attending, without fellowship, would not be a consultant in Australia; they would be on par with a basic physician trainee who has yet to complete advanced training and would therefore have no employability apart from low-grade locum or niche jobs. The market for physician consultants is getting saturated, and it might be difficult to get a visa in the next few years. You will also have to contend with the ten-year Medicare moratorium.

Between the two, general practice is by far the most flexible option, where you can set your own hours and practice pattern. My friend decided she really liked seeing kids, so she told the receptionist to only book kids, and viola, she's booked out seeing only kids. Another friend loves inpatient and outpatient work. He works at a rural hospital, doing three days of call every week and then nine to four at the GP clinic with two-hour lunch breaks. He makes around 280K/year with great benefits. RACGP also has a reciprocal licensing agreement with ABFM, so your board certification would likely be transferrable if you pursued family medicine.

I'm using the words "maybe" and "likely" because policies and circumstances change pretty quickly in Australia. You absolutely need to check with the respective colleges (RACP for IM and RACGP for GP) before making any kind of major decision. But I think the most sensible answer to the question asked, and based on what you seem to value, is that family medicine would be the best option.

I didn't know the issue with IM.
I like the flexibility of GP and I'm more into it. I also love primary care and I'm not that much into doing a subspecialty after finishing IM. At the moment, I'm still thinking and weighing the pros and cons of each option, but I'm pretty sure I'll go for FM! and I'll double check with colleagues when the time comes.
Thank you for your input.

 

[mcat_taker]

There is no outpatient "IM" equivalent per se with that level of training. An IM attending, without fellowship, would not be a consultant in Australia; they would be on par with a basic physician trainee who has yet to complete advanced training and would therefore have no employability apart from low-grade locum or niche jobs. The market for physician consultants is getting saturated, and it might be difficult to get a visa in the next few years. You will also have to contend with the ten year Medicare moratorium.

Between the two, general practice is by far the most flexible option, where you can set your own hours and practice pattern. My friend decided she really liked seeing kids, told the receptionist to only book kids, and viola, she's booked out seeing only kids. Another friend loves inpatient and outpatient work. He works at rural hospital doing three days of call every week and then nine to four at the GP clinic with two hour lunch breaks. He makes around 280K/year with great benefits. RACGP also has a reciprocal licencing agreement with ABFM, so your board certification would likely be transferrable if you pursued family medicine.

I'm using the words "maybe and "likely" because policy and circumstances change pretty quickly in Australia. You absolutely need to check with the respective colleges (RACP for IM and RACGP for GP) before making any kind of major decision. But I think the most sensible answer to the question asked, and based on what you seem to value, is that family medicine would be the best option.

@lymphocyte I always thought a U.S. board certified IM physician would be equivalent to a general physician in Australia. General physicians in Australia I interacted with functioned like U.S. hospitalists with some clinic time. There are no registrar years in the U.S. Why would a board certified IM physician be treated any differently than say a U.S. board certified vascular surgeon or urologist or pediatrician (3 years in the U.S.) - you can argue the training time for those is also compressed in the U.S. compared to Australia.

 

[lymphocyte]

@lymphocyte I always thought a U.S. board certified IM physician would be equivalent to a general physician in Australia. General physicians in Australia I interacted with functioned like U.S. hospitalists with some clinic time. There are no registrar years in the U.S. Why would a board certified IM physician be treated any differently than say a U.S. board certified vascular surgeon or urologist or pediatrician (3 years in the U.S.) - you can argue the training time for those is also compressed in the U.S. compared to Australia.

I can't say why RACP has this policy.

I will say that general medicine in Australia is a three year fellowship on its own.

General and Acute Care Medicine | RACP Advanced Training

The Royal Australasian College of Physicians

www.racp.edu.au

If you know any IM attendings who've earned a FACP with only three years of training, I'd be interested to hear their story.

 

[sean80439]

@lymphocyte I always thought a U.S. board certified IM physician would be equivalent to a general physician in Australia. General physicians in Australia I interacted with functioned like U.S. hospitalists with some clinic time. There are no registrar years in the U.S. Why would a board certified IM physician be treated any differently than say a U.S. board certified vascular surgeon or urologist or pediatrician (3 years in the U.S.) - you can argue the training time for those is also compressed in the U.S. compared to Australia.

That's because an internal medicine physician is 6 years training in Australia (plus the resident years). The other pathways you suggested have completion of similar requirements and timelines. There is an internal medicine fellowship on it's own that's 3 years.

 

[mcat_taker]

That's because an internal medicine physician is 6 years training in Australia (plus the resident years). The other pathways you suggested have completion of similar requirements and timelines. There is an internal medicine fellowship on it's own that's 3 years.

Peds and EM training is 3 years in the U.S. Would it be considered equivalent ? There is no pediatrician or EM physician practicing in Australia after PGY3.

 

[lymphocyte]

Peds and EM training is 3 years in the U.S. Would it be considered equivalent ? There is no pediatrician or EM physician practicing in Australia after PGY3.

Paeds, no. They fall under RACP with a similar training scheme to adult physicians.

EM, maybe, especially with a year of supervision. I know a few who made the leap okay.

 

[sean80439]

EM - I've worked with 2 consultants, one who trained in EU and one who trained in the US, both completed residencies in the US. Nil issues converting over to FACEM. Not sure if they did 3yr or 4yr residencies though, however, one did a few fellowships in the US.