I assume that by "Middle East" you're referring to the rich Gulf Coast countries, since that's what people generally mean when they talk about that. Dubai has a large medical district and they're actively recruiting Western-trained doctors to provide Western-quality medicine at salaries comparable to what you'd get in the US, except that there's no tax and they'll generally give you a place to live and a car to drive... but as a foreign national, you cannot get permanent residency there and you cannot buy property there. I don't know about the rest of the UAE, but I'm sure it'd be similar. The same is true for Kuwait, except that they're not as Westernized as a country, they don't have a specific medical district, and they don't pay quite as much as you could earn in the US (but it's tax-free and you still get a car and probably an apartment), since their culture is less Westernized and places less value on patient-centered medical care. I don't know about Qatar and Bahrain, but I'd imagine they'd also be similar. Oman is far less Westernized, they pay quite a bit less, and their medical system is largely staffed by people who were trained in Pakistan and India... but they might offer higher-paying positions for people trained in the West.