IMG, struggling between the choice of pursing a career in Australia vs China

[Sweet/Sour Kiwifruit]

Hello, everyone.
I am not sure if anyone will be interested in my thread.
I would post my thoughts, concerns and struggles with the choice of pursuing a medical career in Australia vs. China.
My background is I have a bachelor's degree in medicine, a master's degree in internal medicine (both obtained in China) and will graduate next year with a doctor's degree in biomedical science issued by Australia.
I have two choices, either going back to China and start working as a resident at a city-based tertiary hospital with a heavy workload or staying in Australia preparing for MCQ (I mean both written and clinical tests in my context), and hopefully finding an internship job afterwards, then hopefully being able to continue working as a resident, then GP training, then becoming a GP.
I have already got my qualifications certified(cost me a total of $940) and could go straight for the MCQ tests after proper preparation.
I have learned both from government reports and some threads posted in this forum that the job market for IMG is becoming very unfriendly. We are ranked at the bottom priority in only one or two states for internship opportunities and not even considered in the rest of states.
This is what makes me hesitated.
I will not say that I can pass MCQ tests very easily, but it will largely depend on my efforts. However, the compulsory 12-month internship for general registration largely depends on luck. I know the internship is not guaranteed for the domestic medical graduates, either. But they have higher chances to be accepted than IMGs like me.
So I start to wonder whether it worths years' studying, preparing for tests and only ends up nowhere.
I know this is my own life and no one can decide for me. But what I am looking for is if anyone could share their experience if they successfully found an internship after the MCQ tests during the past 3-4 years. Or if not, what kind of jobs are available for IMGs?
The reason I do not tend to go back to China is that I am afraid that I could not handle the complex working environment in Chinese hospitals. The workload is heavy, the patients are impatient and some might even use violence to hurt the doctors, the promotion system is not friendly to doctors who are good at clinical practice but suck at medical research.
But, eventually, I might have to go back and face all these, too.
Anyone who is considering pursuing a medical career in Australia especially those from China is welcome to discuss the hurdles we are encountering.

And thanks for reading my thread.



"If there is a good will, there is a great way"

--- William Shakespeare

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[Domperidone]

Hello, everyone.
I am not sure if anyone will be interested in my thread.
I would post my thoughts, concerns and struggles with the choice of pursuing a medical career in Australia vs. China.
My background is I have a bachelor's degree in medicine, a master's degree in internal medicine (both obtained in China) and will graduate next year with a doctor's degree in biomedical science issued by Australia.
I have two choices, either going back to China and start working as a resident at a city-based tertiary hospital with a heavy workload or staying in Australia preparing for MCQ (I mean both written and clinical tests in my context), and hopefully finding an internship job afterwards, then hopefully being able to continue working as a resident, then GP training, then becoming a GP.
I have already got my qualifications certified(cost me a total of $940) and could go straight for the MCQ tests after proper preparation.
I have learned both from government reports and some threads posted in this forum that the job market for IMG is becoming very unfriendly. We are ranked at the bottom priority in only one or two states for internship opportunities and not even considered in the rest of states.
This is what makes me hesitated.
I will not say that I can pass MCQ tests very easily, but it will largely depend on my efforts. However, the compulsory 12-month internship for general registration largely depends on luck. I know the internship is not guaranteed for the domestic medical graduates, either. But they have higher chances to be accepted than IMGs like me.
So I start to wonder whether it worths years' studying, preparing for tests and only ends up nowhere.
I know this is my own life and no one can decide for me. But what I am looking for is if anyone could share their experience if they successfully found an internship after the MCQ tests during the past 3-4 years. Or if not, what kind of jobs are available for IMGs?
The reason I do not tend to go back to China is that I am afraid that I could not handle the complex working environment in Chinese hospitals. The workload is heavy, the patients are impatient and some might even use violence to hurt the doctors, the promotion system is not friendly to doctors who are good at clinical practice but suck at medical research.
But, eventually, I might have to go back and face all these, too.
Anyone who is considering pursuing a medical career in Australia especially those from China is welcome to discuss the hurdles we are encountering.

And thanks for reading my thread.



"If there is a good will, there is a great way"

--- William Shakespeare.

Disclaimer: some of this is 2nd hand info from working with IMGs. It's not going to be universal. Obviously. Of the IMG's I've worked for or with, most migrated 5-20 yrs ago and are/were from the middle east (as in did both med school and residency there) or Malaysian with no language barriers. However, I knew a handful of recent honorary interns or residents working the last 3ish yrs. as in... they did all the AMC stuff and then worked for free for a yr to get general registration. Paid positions are harder to come by now, if you want internship.

To sit the AMC takes up to two years as the demand is high just to get a spot to write them. you have to get in and register very fast. it's also not just hard to find a hospital to treat you as an intern, it may not be easy to survive it.

Even if you get an intern spot, if you haven't practiced clinical medicine in years it's harder to adjust. they will never really give you much time to either. you're always compared to locally trained grads fresh from med school who know the hospitals well from 2-3 clinical years as students.

None of this is fair, but there's so much demand for intern spots, there's no incentive to keep you if you struggle. If you do well they may keep you and support you. but if you cant keep up it's pretty cut throat. They can and will fail your intern rotations or your whole year if you're not on par with Australian trained interns. There's no leeway just because you're an IMG or have any difficulty with English language comprehension. While I've seen successful IMGs, I've also seen IMGs fail or just..never get hired again anywhere after a year. Again this is not based on any reports, just from me working with or around IMGs. And they're not many, at all. They're vastly outnumbered by grads with Australian degrees (whether domestic or international students originally). So grain of salt here.

It's not like..your problems are over just because you get an internship. And you also then have to apply and pass the GP entrance exams and interviews etc. You don't just..simply become a GP trainee.

there's also demand for resident positions from UK trained doctors now - they are easier to hire and follow very roughly the same medical training structure. many Australian guidelines are based on the UK's. so it's a seamless transition for them. most migrate after working 1-2 yrs at home without a break in training.

it's not so much that it's IMG unfriendly, more that there's more interns than there are actual paid traditional state internships graduating from Australian medical schools. in every Western country locally trained grads are always preferred to foreign med degrees (because they're accustomed without much further training to local systems, medical culture etc. it's a much easier transition for hospitals, they don't have to invest as much time or energy on you). The job market has changed, because of the way Australian schools work now in recruiting large numbers of international students for their tuition fees. Also in the way the job climate has changed in the UK, it changes the IMG landscape.

there is a new set of internships but they're meant to send and keep you working as a rural GP.

there's oversaturation of city GPs. there's also a 10 yr moratorium on Medicare which will affect or limit you for GP practice.

have a read of CP's thread, Australasia and Oceania, it's become a broader IMG Q&A.

There's opportunities to work rural. but that might not be what you want.

Medicine is viewed as a public resource and to a degree, a public service. Most healthcare and it's services is done through the publicly funded system. The government is going to be stingy when taxpayer money is involved. If there's zero need to send IMGs to work in a city, they're not going to fund your training with Australian tax payer dollars in a city hospital for internship or GP training for instance. They would rather send you where there is a workforce gap, like in rural communities. It's about justifying allocation of government resources. I can say this to anyone looking to work somewhere where universal healthcare exists. you're at the mercy of things greater than you.

So, it is indeed tough for IMGs of non-Western backgrounds.
which means you have to decide if it's worth the risks, of which there are many.
It's tough to get through the AMCs, but..
it just remains high stakes should you get a position. Great if you succeed. But if you struggle in it, you just become completely unemployable after or you end up working free or delay things by a few more years.

It's not easy on the teams/hospital either, but ultimately it's about patient care and they're uncompromising about this. it's so much more than about..the considerations for one member on a medical team or in a hospital.

 

[BigPikachu]

This topic has been discussed repeatedly and essentially it boils down to two main points:

Firstly, and perhaps most importantly, decide where you (and your family) want to live -- if it's Australia, just be prepared to have to work and live in the rural country townships for several years to a decade. Migrating to a new country is as much as a professional decision as much as it is a personal-familial one; and I would say the latter takes precedence. That said, Australia is a wonderful place to live and practice medicine; and, personally coming from a Singaporean-Chinese background myself, I would prefer Australia any day over China.

Secondly, having your credentials approved (which looks like you already have done), sitting exams and doing the necessary re-training is just a matter of motivation and commitment that is unavoidable and inevitable; tedious as it seems, it's just a hurdle you have to get over and done with. If you only have your basic medical degree and no post-graduate specialist qualification as of yet, then there's a bit of work for you ahead; that is, you'll have to redo a provisional year effectively as an intern in a state public hospital supervised by senior clinicians, pass that year and sit the AMC exam, before going on to apply for a specialist training program. Once you're a specialist, because you're a IMG, you'll have to do your time in an area-of-need before been able to access unrestricted Medicare billings in the case of private practice; hence, the predicament of having to spend a proportion working in country practice.

As for job prospects, like most countries, Australia will 'protect' its own Australian born-and-bred medically trained graduates by giving them preferential treatment when it comes to applying for junior doctor positions in state public hospitals and with regards to specialist training programs. It is already competitive enough for Australian graduates who appear to be 'fighting' over limited training positions at metropolitan teaching hospitals and urban-GP training positions. That said, if you did want to maximise your prospect of acquiring a job, then applying directly to the rural generalist program and/or RVTS is the best option; these country towns are desperate for doctors, they'll pay you generously and train you well; you'll get to practice good medicine, but it's still hard work and you'll have to live in the country.

Otherwise most of this information is available on the AHPRA and AGPT or RACGP / ACRRM / RVTS websites.

Good luck!