In what countries can doctors expect comparable lives to American counterparts?

[Jabronimus]

A

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[Winged Scapula]

I am an American citizen, and I am going to an American medical school - University of Michigan, to be exact. However, I'm seriously considering emigrating to another country once I finally get done with medical school and/or residency, for a lot of reasons.

Regardless of your reasons for the move, you should extensively investigate where your US education and training will allow you to practice as a physician. And if it requires more training or testing. You simply cannot rock up to any country with a US medical school and residency education and expect to start working.

You also have to bear in mind that if at any time you wish to return to the US, you will also face some difficulties. Therefore, if you complete a residency here, you should get a medical license and keep it current, along with US CMEs, etc. while working abroad. If you should change your mind and want to come back, it will be a whole lot easier if you are still licensed in the US.

Its easy to say now that you're going to leave because of the political situation, but what if your mother gets ill and needs you, or you don't care to live abroad, or the political situation improves here. Think about the long term consequences before making such a rash move.

However, having not lived in any country besides the USA, I have no idea about the living conditions or the working conditions for doctors in other countries. For example, everyone says that doctors don't get a lot of compensation in Canada (and other countries with socialized medicine), but I have no idea if that's actually true or not.

So, can anyone tell me:

1) Is socialized medicine really that bad for doctor's lifestyles? Like, can you point me to any resources that have actual data on this stuff?

Depends on what you mean by lifestyle.

You will work less in most cases.

You will make less in most cases.

If you wish to make the kind of money you can make in the US, you generally have to stay in the US or accept a position in an area of need.
These tend to be very rural, very unsophisticated places.

You can make a lot of money, for example, doing rural GP work in Australia.

Whether or not that impacts on your "lifestyle" depends on what you need to be happy.

2) In what countries do doctors live comparable lifestyles to their counterparts in the United States? Are there any resources (online or otherwise) where I can do some research on this topic?!

Thanks so much in advance!

I'm not aware of a lot of resources. Each country will have their own requirements regarding training, licensure, pay scale, cost of living, etc. Perhaps if you narrowed down your country choices it would be easier to advise you.

 

[Jabronimus]

A

 

[Winged Scapula]

Perhaps you have thought about this for a considerable amount of time.

However, without ever having lived abroad, or at the very least in the country(ies) you might consider, it does seem rash to me to not only contemplate such a move but to consider doing your medical education there. Doing so, effectively, in many cases, means you have decided to spend the rest of your life there or to give up your career if you want or need to move back to the US.

Being a physician is not like being a German auto mechanic where you can train in Germany or the US and work in either country; or a petroleum engineer, etc. Licensure of physicians is very strictly controlled. You cannot train somewhere and then expect to easily pick up and move to another country if you don't like where you are living.

I'm not assuming that the US is the best place for you. It may very well not be. But your parents are here and presumably your friends and perhaps other family members. Train outside of the US and you will find it difficult to come back to US and work if you changed your mind about living abroad or if family circumstances necessitated you doing so. These boards are full of posts from foreign trained physicians doing menial jobs or non health care related things because they cannot enter the US medical field with their training. I'm simply pointing these things out because it was not clear to me whether or not you were aware of these issues (that medical training is not accepted internationally and that you need to train where you live).

Alright...I'll get off my soapbox.

As far as things that you might look for in a country to live in, well that would really be up to you. Does it need to be English speaking? How about weather - is snow ok, or do you prefer warm weather year around? You should consider political stability, medical environment (ie, in some countries doctors are poorly paid and not well respected). And then there is the all important "feel"...without having ever lived somewhere else, its hard to say whether or not you would like it. I had the advantage of having visited Australia numerous times before moving there but many of my classmates did not and consequently, found they hated it.

I am pleased that you came to SDN looking for some assistance and I'm sorry if you thought my original response was unkind but I'm not sure you have considered all the ramifications of your plan.

 

[Jabronimus]

A

 

[Winged Scapula]

I'm a little confused about why you think that I've made up my mind to emigrate out of the USA. The fact of the matter is this: I haven't made up my mind about this, and I need to learn a lot more about this before making a decision. That's why I'm on SDN, asking these questions. (Hence, this isn't a "rash decision" because no "decision" has yet been made.)

I'm sorry if I appeared to have assumed that you had made up your mind; I assumed you were thinking seriously about this decision, hence you inquiry but had not made up your mind. And as I noted before, I see this is not a "rash" decision although I find your reasons for considering the decision somewhat ill informed.

One factor that I'd like to know more about is how tolerant different countries are of racism, as I am brown (i.e., from the Indian subcontinent), which very well might be a problem in certain countries. As for countries that have interested me - though, again, I really know nothing about them and need to learn more about each - are England, Canada, and Australia.

Not being an ethnic minority, it would be somewhat disingenuous for me to comment in detail about racism. However, it was my experience that Australia and the UK are *more* racist than the US. Both of these subforums have threads about racism in these countries so you would be well advised to read them and get a sense from others about their experiences. This is not to say that the US isn't racist...far from it, but you may be suprised to find that other countries are often far less PC about it.

You mentioned something about medical licensing and how different it is from country to country. I do know something about this (as my mother is a medical doctor who was trained outside of the States, and had to redo her residency and fellowship when she came to live in the US), so perhaps you could tell me more about this. Obviously if I were to leave the states, I wouldn't do so before I finished getting my M.D. at the University of Michigan. However, how does residency work in other countries? Will other countries accept a US graduate and train them in their residency programs?

It depends on the country. In Australia, for example, a non-Aussie citizen, trained at a non-Aussie school is last in line for residency placements. With the recent upsurge in medical schools, it is predicted that the number of students will exceed the number of training positions. Therefore, as someone educated outside of Australia without Australian citizenship, you would be offered last choice of positions. Currently, it is not difficult to get an internship, alhough generally in more rural or less desirable areas, it remains to be seen what happens over the next several years with regard to placement.

As you know from your mother's experience, the US does not look kindly upon training obtained abroad. You may be given *some* credit, but if you ever wish to work in the US again, you are making it very difficult if you train elsewhere. As most of us here say, train where you plan on living for the rest of your life or accept the possibility of never working as a physician again in another country.

I cannot comment on the ease of moving to other countries for postgraduate training with a US medical education. Please check the relevant forums for threads on this topic.

Also, will other countries accept a US graduate who has completed residency here in the states, and allow them to start practicing there (without having to redo any part of their residency)?

It is usually somewhat easier to do although you may have to take an exam or do some additional training (ie, residencies in the US are generally shorter than they are abroad). Again, it depends on what country you are talking about...there are no hard and fast rules about this.

Overall, which of these two paths allows for less headache and hassle?

Less hassle: train in the US and stay in the US
More hassle: train abroad for medical school, come back to US for residency
Even More hassle: train in US for medical school, go abroad for residency
Most hassle: train abroad for medical school and residency and try to come back to US

Furthermore, how much is a foreign residency "worth" in the United States? I seem to remember from reading Dr. Ben Carson's biography that he did his residency (or something else) in Australia, and didn't seem to have any problem when he decided to come back and practice in the states.

Ben Carson did *some* advanced training in Australia. He went to Michigan for medical school and Hopkins for residency. He did not do any basic training in Australia but rather spent a couple of years working as a senior registrar. Neurosurgery and microsurgery are pretty advanced in Oz, so this training, for him, was just additional work he was interested in and not required by any means. So he didn't have a problem coming back to the US because all of his foundation training was done here, and he is a US citizen. It is not uncommon to go abroad for a specialty fellowship that may or may not be offered in the US. Besides, Ben Carson trained abroad decades ago (when it was much more common and the US much more open to such things), is a special case and his experiences should not be expected to be replicated by others.

One big reason I'm thinking about emigrating is because of how political medicine has become. Insurance companies seem to have taken over medicine, and seem to me to be more interested in making a profit than in helping out their clients. Over and over, we hear stories of people who get screwed over because they don't have insurance, or are denied even when they do have insurance. That's why I was interested in hearing about socialized medicine.

Having lived in a country with socialized medicine, let me tell you its not all that its cracked up to be. That's not to say that the US has it figured out either. Despite the socialized medicine in Australia, people who wish faster, better service often purchase private insurance in addition to what the government provides. Wait times are long, and trips to foreign countries for needed tests and surgeries are not uncommon.

Surely you've heard of Canadians coming to the US for CABGs because they did not want to wait 6 months for their surgery. Care is rationed in other countries. Feel about the US as you desire, but the fact is that everyone is entitled to care and will eventually get it, ability to pay or not. Don't get me wrong...I think insurance companies are evil, but we do not ration care or decide who gets it or not in this country.

Nor should you believe the AMA propaganda that 47 million are without insurance in this country. 47 million are without insurance but the vast majority of those can afford it, but choose not to purchase it. My own family is one of these...they prefer to spend their money on Mercedes and other such luxuries but think health insurance is too expensive. Never mind who is going to pay if they have a medical catastrophe...that is someone else's problem. People like this are everywhere.

At any rate, there are problems here and there are problems with socialized medicine. I'm not sure its a valid reason to leave the US especially considering what might happen with our health care system with a Democrat in the White House.

 

[daki]

Interesting post, as I am considering something similar. I am a US citizen, and I'm looking to practice outside the US. My family lives abroad, I grew up abroad (Africa) and I'm seriously considering moving back after being done with residency.

Naturally, I've yet to meet anyone who has done this, or who can give good direction or advise about realistic ways in which moving back can be done. This has also caused me to seriously reconsider my initial specialty choice, surgery, for specialties that may potentially offer me a little more flexibility to at least spend extended periods of time working abroad (anesthesia or EM, maybe?) if I'm 'permanently' based in the US.

WS brings up some very good points.

 

[dragonfly99]

Emergency medicine or family practice would probably be the ideal specialties if you wanted to spend part of the year in the US, and part working abroad.
I'm sure they need surgeons and anesthesia folks in Africa too, though.