Leaving US

[karling]

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The problem you will have as a doctor, even as a US trained and educated physician is that it won't be easy to get practice rights in another country. The most likely foreign country that would grant a US physician practice rights would be Canada and I have heard horror stories about getting a license to practice there. There is also the issue of language and culture in another country, things will be very different overseas, you might feel like you are on another world.

I have been to Japan numerous times because that is my parent's homeland, its a nice place but its impossible for US physicians to practice medicine there. Also Japanese physicians earn on average less than half their US counterparts. Also factor in that the cost of living there is much higher than the US, a bowl of Ramen can cost 10 bucks outside the largest cities.

If you were keen on working outside of the US, maybe you should have received your education and training overseas as well. Your financial burden would have been much lower.

I've seen this repeated on here a few times. It's easy to say "you should've studied there" but it's not always (ever?) that simple. For example, the country where I'm considering practicing has too many qualified students (perfect grades, perfect SAT scores) than there are spots, so getting accepted is literally done via lottery. Thus, some people go to other countries for medical school instead, or they just re-enter the lottery every year until selected (I've personally never heard of it taking longer than 3 tries). For me to get into school there, I would need to first become completely fluent in the language, then get a perfect SAT score, and then get put into the lottery pool and hope I get picked. In other words, not easy. To add to this, I needed to take my pre-med courses anyway (they have prerequisites in this country as well, but students take those courses in high school). By the time I was ready to move there and begin another 3 years or so of language acquisition and SAT prep and everything else needed, I was already done with my preparation to apply to school here. This choice was a no-brainer.

Having spoken to medical students there, they have told me that there are plenty of foreign physicians working in this country (including Americans), but they have never heard of an American studying there. Not that it's not possible or that it has never happened, but the reasons I talked about above pretty much means (at the very most) very few of them choose to it. It's easier to get practice rights than it is to get accepted into medical school as a foreigner.

I do know that getting practice rights in Japan is damn near next to impossible, though. It definitely varies by country.

 

[coffee-doc]

The Singapore approved schools list is ridiculous. There are nearly as many UK schools on it as American schools, despite the UK being only slightly more populous than the state of California and not exactly a research powerhouse. Singapore be like it's still the 19th century.

not one osteopathic school. slightly triggered.

 

[LLCoolK]

you guys have to remember... in other countries they don't get their salaries taxed as much as we do. In Hong Kong, physicians get taxed 15% of their salary TOTAL. Their total salary is lower, but the money that they get to keep is comparable/better.

 

[WingedOx]

let's not forget that if you want to keep this, you still will have a debt to pay to Uncle Sam.

 

[gbwillner]

This is a crappy time to be practicing medicine... relatively. All the pressures the OP states are real, but we are still paid better than anywhere else, all things considered. that said, as reimbursement is lowered, it is strongly felt by those accustomed to higher salaries, and they respond by working more to maintain a similar lifestyle. Those of you without experience in this field are unlikely to notice much impact when the dust settles. Of course, the other elephant in the room is the cost of training; in most other countries it is free.
Bottom line is that in medicine you will have a comfortable lifestyle, but you will not likely be rich. In the 70's and 80's most docs were rich.

 

[Stagg737]

The problem you will have as a doctor, even as a US trained and educated physician is that it won't be easy to get practice rights in another country. The most likely foreign country that would grant a US physician practice rights would be Canada and I have heard horror stories about getting a license to practice there. There is also the issue of language and culture in another country, things will be very different overseas, you might feel like you are on another world.

This somewhat depends on the country and what you're trying to practice. If you go to a country with a shortage or are licensed in a field where they have a shortage, I'm sure it would be easier to practice there than in a country that is saturated. There may also be other factors which play into it, for an example see my earlier post about gaining citizenship/practicing rights in Australia.

you guys have to remember... in other countries they don't get their salaries taxed as much as we do. In Hong Kong, physicians get taxed 15% of their salary TOTAL. Their total salary is lower, but the money that they get to keep is comparable/better.

Another point that's highly dependent on country. Some countries may be lower than the U.S., but there are also plenty where income tax can be over 50%. Plus many countries have VAT rates (basically sales tax) over 20%. So not only do you keep less of what you earn, you get taxed more when you spend money as well.

 

[cabergoline2]

I don't understand why religion would play a role in how doctors are paid. If that's the case then must be the same with Christianity in the US.
P.S. If you think you know "sharia law" by what you see in social media then you have got it all wrong. Islam is the religion of peace! Quran teaches respect to every religion. For example India has the largest amount of people practicing Islam but it produces some of the best doctors in the world and I don't see any of them leaving the country because of " sharia law"!

That is because India is a secular country that has no Sharia law . About 15% of the Indian population is Muslim. But they form the poorest portions of the country. And not many end up in a med school ,in spite of extensive affirmative action and scholarship programs. There are some Indian muslims who are internationally renowned physicians . Abul Abbas ,the editor of robins pathology and chief of pathology at UCSF is an Indian muslim and was born and attended med school in India. But he is not representative of the Indian muslim population. The reason for their backwardness is not because they are discriminated against. But because they want to stick with medieval ideology and send their kids to Islamic schools and not to schools that teach math/science.Consequently their per capita income and educational attainment is much lower than the Indian Hindus/Christians.

 

[YF786]

That is because India is a secular country that has no Sharia law . About 15% of the Indian population is Muslim. But they form the poorest portions of the country. And not many end up in a med school ,in spite of extensive affirmative action and scholarship programs. There are some Indian muslims who are internationally renowned physicians . Abul Abbas ,the editor of robins pathology and chief of pathology at UCSF is an Indian muslim and was born and attended med school in India. But he is not representative of the Indian muslim population. The reason for their backwardness is not because they are discriminated against. But because they want to stick with medieval ideology and send their kids to Islamic schools and not to schools that teach math/science.Consequently their per capita income and educational attainment is much lower than the Indian Hindus/Christians.

I would like to disagree with you on this. Fair enough India doesn't practice sharia law but Pakistan does so does many other middle eastern countries. They have great practicing physicians too. you are saying that Muslims in India like to stick to their "medieval ideology" and that's the reason for their "backwardness". But I completely disagree, Islam has only one ideology and it has been the same foreve and its peace. The religion promotes knowledge for everyone. We cannot say that because they practice their religion they are backwards. All of Pakistan follows "sharia law" and they have some of the best physicians, their schools are great. Students from there study the higher level of math and science that not even private schools in U.S. teach. Also there is Islamic schools everywhere in Middle East and it's not "madrasas" that the media talks about and portrays it as negative.

 

[WilliamofOckham]

I don't understand why religion would play a role in how doctors are paid. If that's the case then must be the same with Christianity in the US.
P.S. If you think you know "sharia law" by what you see in social media then you have got it all wrong. Islam is the religion of peace! Quran teaches respect to every religion. For example India has the largest amount of people practicing Islam but it produces some of the best doctors in the world and I don't see any of them leaving the country because of " sharia law"!

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[TedStark]

Screw compensation. I'm going to where I'm appreciated.

 

[Crayola227]

at some point I don't care if my salary is higher, I want better working conditions

also, accents make me hawt so I'd love to go practice somewhere else

 

[Brahnold Bloodaxe]

One more reason to leave. Disgusting.

 

[68PGunner]

The problem you will have as a doctor, even as a US trained and educated physician is that it won't be easy to get practice rights in another country. The most likely foreign country that would grant a US physician practice rights would be Canada and I have heard horror stories about getting a license to practice there. There is also the issue of language and culture in another country, things will be very different overseas, you might feel like you are on another world.

I have been to Japan numerous times because that is my parent's homeland, its a nice place but its impossible for US physicians to practice medicine there. Also Japanese physicians earn on average less than half their US counterparts. Also factor in that the cost of living there is much higher than the US, a bowl of Ramen can cost 10 bucks outside the largest cities.

If you were keen on working outside of the US, maybe you should have received your education and training overseas as well. Your financial burden would have been much lower.

Dude, we're not talking about instant noodle here. A bowl of ramen costs about $12 in major metropolitan areas in the West Coast. Sen yen for a bowl of ramen is pretty solid. Cost of living isn't really that high. You can get a 3LDK used condo 2-3 stations away from the downtown Osaka for about $250-270K. It's a different deal when you're talking about Tokyo. However, who the hell wants to live in Tokyo? In Tokyo, you can rent a 80-90 m2 apartment for about $1,200-1,400/month. This is very affordable.

 

[Seth Joo]

Dude, we're not talking about instant noodle here. A bowl of ramen costs about $12 in major metropolitan areas in the West Coast. Sen yen for a bowl of ramen is pretty solid. Cost of living isn't really that high. You can get a 3LDK used condo 2-3 stations away from the downtown Osaka for about $250-270K. It's a different deal when you're talking about Tokyo. However, who the hell wants to live in Tokyo? In Tokyo, you can rent a 80-90 m2 apartment for about $1,200-1,400/month. This is very affordable.

Salaries for doctors are low, and apartments in Japan are small. Most Americans are accustomed to living in houses with front lawns and backyards. I watched quite a few video blogs about Americans living in Japanese apartments, was real interesting to see how people adjust to tighter spaces. I know the Ramen is not the instant stuff, but its noodles. The only country with the American lifestyle is our neighbor to the north, Canada. Everywhere else life is going to be a huge adjustment for most Americans.

Most people I know feel paying 8 dollars for the Burrito bowl at Chipotle is a lot of money. In this country people love meat and potatoes. Give someone a bowl of noodles, they are not going to be happy.

There is a big difference between visiting another country and having a good time and living there and dealing with the reality of the place.

 

[bannie22]

Ramen is awesome. Can someone with real facts about the working conditions (hours, career advancement, application process) in Japan enlighten us?

To be honest, I do not have the mastery of the language to pass medical boards in Japanese, and probably will never be able to attain it. However, what about doing a fellowship for 1-2 years. That would be ample opportunity to experience Japan and decide if it is any value focusing additional effort in mastering Japanese.

 

[Seth Joo]

Ramen is awesome. Can someone with real facts about the working conditions (hours, career advancement, application process) in Japan enlighten us?

To be honest, I do not have the mastery of the language to pass medical boards in Japanese, and probably will never be able to attain it. However, what about doing a fellowship for 1-2 years. That would be ample opportunity to experience Japan and decide if it is any value focusing additional effort in mastering Japanese.

Japan is a closed door unless you complete your medical education in Japan and speak fluent Japanese. My parents are from that part of the world. That being said doctors are better off in the US.

The only way you could possibly work as a physician as an American citizen in Japan is for the US military. The only civilian American physicians I have met over there have only found administrative work, not clinical medical practitioner jobs.

I knew quite a few people I went to college with who wanted to go the expat route, live overseas, most of them wound up returning home after a few years, its always the little things that will make you miss home.

I did a year abroad in Europe, I found the most irritating thing about that place was that you had to pay to use public restrooms in fast food places even if you bought food there.

 

[TorMed]

I think living abroad might not be the picnic you think. A lot of countries are built around ideas of freedom and democracy but the balance between freedom and responsibilities and your neighbors rights are a lot different than the USA.

I don't know another country that has a basic right to handguns. Certainly not Canada or Europe.

In Canada we have single payer and there is no ability to see someone outside the system. Physicians have no ability to charge more than the single payer (the provinces) allow. All this has been found to be constitutional by the courts.

In Canada most of the other rights are the same - voting, free speech, right to leave and enter the country, right to life, liberty etc. but the limits to the rights are different.


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[futuredoc331]

I'd like to get out of here after graduating. I'm not as worried about my pay as I am quality of life for myself and my family. My paycheck is one thing, but then y ou have to consider the cost of health care for a family, the cost of higher education, so on and so forth. Plus, I'd much rather practice in a country that views health care as a right and provides it for its citizens.

 

[Pawn]

I am curious, as many people have actually proposed to move to Australia if given the chance, why Australia? What is so special about practicing there? Given what I see on Animal Planet and the Discovery Channel, literally everything can kill you when you walk outside your door haha.

 

[xffan624]

I am curious, as many people have actually proposed to move to Australia if given the chance, why Australia? What is so special about practicing there? Given what I see on Animal Planet and the Discovery Channel, literally everything can kill you when you walk outside your door haha.

Incorrect misperception. It's a beautiful country with lots of english speaking people and fun places to visit. Honestly, having visited it, it's pretty much like the US, only a little more exotic. Easy to see the appeal.

 

[Seth Joo]

I think living abroad might not be the picnic you think. A lot of countries are built around ideas of freedom and democracy but the balance between freedom and responsibilities and your neighbors rights are a lot different than the USA.

I don't know another country that has a basic right to handguns. Certainly not Canada or Europe.

In Canada we have single payer and there is no ability to see someone outside the system. Physicians have no ability to charge more than the single payer (the provinces) allow. All this has been found to be constitutional by the courts.

In Canada most of the other rights are the same - voting, free speech, right to leave and enter the country, right to life, liberty etc. but the limits to the rights are different.


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Europe is not the paradise it used to be, many college students dream about living in Europe, particularly after the financial crisis, things have changed over there. The economies of several European nations have been devastated. Several European countries suffer from near Depression like conditions such as Spain, Greece, and Portugal. Countries like Ireland and France are in serious economic crisis at the moment.

Not to mention Europe now has a serious problem with terrorism, and has reacted very harshly in response, several cities experienced lockdowns in response to the Paris attacks last November. So the Europe people think about no longer exists.

 

[cabergoline2]

Europe was never the utopia people imagined it to be. Even scandinavian countries which people imagine as paradise , there was a messed up social system..Sweden always had very high rates of rape ,which further increased with immigration from middle east/north africa...The anders brevik massacre , the german wings pilot purposefully crashing the airline etc should not be seen as isolated events ,but manifestations of a deeply messed society... No place can possibly be utopia..if a person is not satisfied in the US ,most likely he won't be anywhere else...no other country attracts the best and the brightest from all over the world or has such diversity...

 

[futuremdforme]

No place can possibly be utopia..if a person is not satisfied in the US ,most likely he won't be anywhere else...no other country attracts the best and the brightest from all over the world or has such diversity...

American egocentrism much? The US is great, but there are lots of great countries. And I totally agree that there's no utopia, but many people prefer to live places other than the US, just like many people prefer to live in the US. I personally know many people who lived in the US for several years, and chose to move to new countries or to their countries of origin due to preferences in lifestyle, politics, etc.

I hate this attitude because the US suffers from it - refusing to acknowledge that some countries perform better in some regards means that the US won't be able to improve in those areas, and that's a shame.

 

[nonick123]

Europe was never the utopia people imagined it to be. Even scandinavian countries which people imagine as paradise , there was a messed up social system..Sweden always had very high rates of rape ,which further increased with immigration from middle east/north africa..

I believe Scandinavian countries are best for practicing medicine in Europe. Many people think it is Germany but the junior doctors there work ridiculously long hours and the pay is low. That's why the local medical graduates migrate to scandinavian countries and their places are filled by doctors from Eastern Europe(ex-communism countries). Besides rape, these countries have a very high percentage for suicides.
Many people actually don't really understand how bad is the situation for doctors in some Europe countries. For example, in the Eastern block(where I am from) residents have the same salary as a bartender. After residency they get as much as a bodyguard and that's why they usually flee.

 

[Seth Joo]

Europe was never the utopia people imagined it to be. Even scandinavian countries which people imagine as paradise , there was a messed up social system..Sweden always had very high rates of rape ,which further increased with immigration from middle east/north africa...The anders brevik massacre , the german wings pilot purposefully crashing the airline etc should not be seen as isolated events ,but manifestations of a deeply messed society... No place can possibly be utopia..if a person is not satisfied in the US ,most likely he won't be anywhere else...no other country attracts the best and the brightest from all over the world or has such diversity...

A lot of college students who backpack in Europe have an idealized view of life there based upon casual observations of the place. I lived there for a year almost 10 years ago when things were relatively better, before the world financial crisis started ravaging the economies over there. It was not a paradise back then, but it was considerably better than it is now. Right now things are getting bad over there given the terrorist attacks and the refugee crisis, also the European countries that suffered the worst from the global financial meltdown are still struggling. Spain, Greece, and Portugal, are still economically weak and show no signs of any major recovery. France and Ireland are also economies in terrible shape, France earlier this year declared an economic state of emergency.

Many countries can barely provide basic opportunities for their own citizens, so for a someone who is not a citizen, who has no ties to the country, does not speak the language, its going to be extremely hard to find suitable employment to stay there.

Given what happened in Paris and Brussels its hard to argue that one has better personal safety in a European city than an American one. Its highly unlikely that such a tragedy will happen in the US.

 

[futuremdforme]

Given what happened in Paris and Brussels its hard to argue that one has better personal safety in a European city than an American one. Its highly unlikely that such a tragedy will happen in the US.

With all of the shootings in the US, I feel significantly safer in Europe than I do in the US. I like living in the US, even living near an area with a really high murder rate, but it's a real concern.

That said, I agree 100% that it's somewhat delusional to think about packing up for a country that has poorer pay, where you don't speak the language, and where opportunities are limited for its citizens is a good option. I think that practicing medicine in the US is probably the best professionally, but not due to safety concerns.

 

[WingedOx]

Given what happened in Paris and Brussels its hard to argue that one has better personal safety in a European city than an American one. Its highly unlikely that such a tragedy will happen in the US.

this is full potato.

 

[Seth Joo]

this is full potato.

Look at the geography of Europe and its proximity to the Middle East, it does not take a rocket scientist to figure out that they will be a likely target for terrorist attacks for many years.

That being said if you cannot speak the language you are not going to get a job in an field where communication is essential. How are you going to function if you cannot even communicate with your patients? The major licensing authorities in Europe will expect that you can speak, read, and write in their language. If you are an English speaking American, the only countries you would be able to practice would be the UK and Ireland, but since those countries are part of the EU, physicians from EU countries take precedent over US trained ones. I found this kind of interesting because a British tourist I met recently believed that an American physician would be more suitable to work in the UK than one from France or Italy.

 

[PlutoBoy]

Incorrect misperception. It's a beautiful country with lots of english speaking people and fun places to visit. Honestly, having visited it, it's pretty much like the US, only a little more exotic. Easy to see the appeal.

Australia has lots of english speaking people, folks! 🤣

(I agree with your post but that sentence made me lol)

 

[cabergoline2]

Look at the geography of Europe and its proximity to the Middle East, it does not take a rocket scientist to figure out that they will be a likely target for terrorist attacks for many years.

That being said if you cannot speak the language you are not going to get a job in an field where communication is essential. How are you going to function if you cannot even communicate with your patients? The major licensing authorities in Europe will expect that you can speak, read, and write in their language. If you are an English speaking American, the only countries you would be able to practice would be the UK and Ireland, but since those countries are part of the EU, physicians from EU countries take precedent over US trained ones. I found this kind of interesting because a British tourist I met recently believed that an American physician would be more suitable to work in the UK than one from France or Italy.

I am not really sure one can say that US is safer than Europe. I mean even doctors in Brigham and women are not safe. You might remember the BWH cardiothoracic surgeon who got shot by his former patient last year. It does not matter whether a bullet is fired by some crazy schizophreniac or some syrian guy shouting allah o akbar..we end up dead either ways. Even without the ISIS both the sides of atlantic have had significant terror issues. One might remember Timothy Mcveigh who blew up the federal building in Oklahoma. ...Europe had Anders Brevjik and the german wings pilot who crashed the airliner on purpose killing all 150 on board last year...but overall the odds of dying in a terror strike are not all that high anywhere in the world. I am more likely to die in a car crash..

 

[Seth Joo]

I am not really sure one can say that US is safer than Europe. I mean even doctors in Brigham and women are not safe. You might remember the BWH cardiothoracic surgeon who got shot by his former patient last year. It does not matter whether a bullet is fired by some crazy schizophreniac or some syrian guy shouting allah o akbar..we end up dead either ways. Even without the ISIS both the sides of atlantic have had significant terror issues. One might remember Timothy Mcveigh who blew up the federal building in Oklahoma. ...Europe had Anders Brevjik and the german wings pilot who crashed the airliner on purpose killing all 150 on board last year...but overall the odds of dying in a terror strike are not all that high anywhere in the world. I am more likely to die in a car crash..

From most reliable data sources, large numbers of foreigners involved in ISIS and Al Qaeda have come from Europe, and those are only two of the world's largest terrorist organizations, there are others. The geography and the demographics of Europe make it easier for extremists to hide among the civilian population. By comparison, its much harder for such individuals to hide in the United States.

 

[futuremdforme]

From most reliable data sources, large numbers of foreigners involved in ISIS and Al Qaeda have come from Europe, and those are only two of the world's largest terrorist organizations, there are others. The geography and the demographics of Europe make it easier for extremists to hide among the civilian population. By comparison, its much harder for such individuals to hide in the United States.

I don't really care if I get killed by a foreign terrorist or some kid with an entitlement problem...

 

[Seth Joo]

I don't really care if I get killed by a foreign terrorist or some kid with an entitlement problem...

Well if you are eager to work and live in Europe, then its probably better to get your education over there, find some way to get legal residency status and a work permit, you will as a result save thousands of dollars in tuition. From what I heard medical school tuition is very low, even for non citizens.

Every place on Earth these days has its risks, no such thing as a sure thing these days. However if you are unhappy in America, might as well leave and go somewhere else.

 

[cabergoline2]

Talking of Australia , I have a friend who is working as a PCP there..from what he tells me it is paradise for docs..he works like 40 hours a week or less and makes an obnoxious amount...(more than twice an american pcp makes)..and they have lower taxes than the US..he always seems on a vacation..i stopped looking at his facebook feed out of jealousy.. his back story is quite interesting...he was an ER doc in India and never had any real plans of moving out of India..he practiced 1 or 2 years in Bangalore..he met an Australian girl working in the Bangalore campus of google...they got married and he moved to AUS... he did not have to work much to get a license there...i think it is even easier if you are ACGME certified...

 

[Dr Nicholas Riviera]

anyone else find it a bit distressing that the OP hasn't even started DO school yet and this is their perception of the US medical field?

 

[futuremdforme]

Well if you are eager to work and live in Europe, then its probably better to get your education over there, find some way to get legal residency status and a work permit, you will as a result save thousands of dollars in tuition. From what I heard medical school tuition is very low, even for non citizens.

Every place on Earth these days has its risks, no such thing as a sure thing these days. However if you are unhappy in America, might as well leave and go somewhere else.

Agreed. 🙂 Like I said, I like the US and I think it's the best place to practice medicine, and the idea of leaving the US to go to Europe due to bureaucracy is quite absurd. I just would not choose the US because of safety. I would choose it for many other reasons.

 

[cabergoline2]

if op is going DO school he would not be able to practice medicine anywhere outside the US. no other country permits alternative medicine people to practice regular medicine...i don't know if things would change following merger...

 

[Stagg737]

Talking of Australia , I have a friend who is working as a PCP there..from what he tells me it is paradise for docs..he works like 40 hours a week or less and makes an obnoxious amount...(more than twice an american pcp makes)..and they have lower taxes than the US..he always seems on a vacation..i stopped looking at his facebook feed out of jealousy.. his back story is quite interesting...he was an ER doc in India and never had any real plans of moving out of India..he practiced 1 or 2 years in Bangalore..he met an Australian girl working in the Bangalore campus of google...they got married and he moved to AUS... he did not have to work much to get a license there...i think it is even easier if you are ACGME certified...

Does he work for a private company/on his own then? Because according to Australia's gov website PCPs from public institutions make far less than most PCP's in the U.S.

if op is going DO school he would not be able to practice medicine anywhere outside the US. no other country permits alternative medicine people to practice regular medicine...i don't know if things would change following merger...

This is flat-out wrong. There are very few countries that prohibit U.S. DOs from working there, and several of them are in places most people would choose not to leave the U.S. for anyway (Indonesia, Zimbabwe...). In most countries, a US DO = US MD in terms of practice rights and certification. Also, US DO's practice the same forms of medicine as US MDs, some just choose to practice OMM in addition.

Also, be aware that DOs in Europe are very, very different from DO's in the U.S. In Europe, they ONLY learn OMM and do not go to actual medical school like DO's in the U.S., which is why some European countries like Norway or France have restrictions against them.

 

[cabergoline2]

In the US , DO=MD.. but most foreign countries including Australia/UK etc don't permit DOs at all...

it was discussed here..

http://forums.studentdoctor.net/threads/can-dos-practice-internationally.322218/

even canada at one point did not permit them...now it has changed...

 

[Stagg737]

In the US , DO=MD.. but most foreign countries including Australia/UK etc don't permit DOs at all...

it was discussed here..

http://forums.studentdoctor.net/threads/can-dos-practice-internationally.322218/

even canada at one point did not permit them...now it has changed...

Once again, that is wrong. I personally know DO's who got their degrees in the U.S. that (did) practice in both of those countries. Look at the updated responses in that thread. Here are two that summarize it well:

Here's a graphical representation from the AOA website. Most of Africa says no, which is funny because they need all the physicians they can get.View attachment 203003

Yeah, I looked extensively into this in the past.

As Cubsfan10 said, the grey doesn't indicate necessarily that they said no, but rather that no DO has been licensed in those countries. It's very possible that no DOs ever wanted to move to those countries. Only really Zimbabwe and South Africa have explicitly restricted DOs to OMM only, but this is more due to the non-US DO degrees being nothing more than an OMT degree in many countries.

One thing to keep in mind is that with regards to aid organizations the individual must be licensed by their home country (i.e. US), and with that they can work freely under those organizations in most countries (not all). These maps and such are more for people who want to physically move to those places and set up their own practice there.

It's important to recognize that in many countries you have plenty of hoops to jump through regardless assuming you even become a citizen. Even in the US you have to take the whole series of licensing exams and attain/repeat residency training here. Other countries have similar or even more stringent requirements.



They can't. I explicitly looked into this a few years so when I was applying. There's a handful of countries that recognize the SGU MD degree that do not recognize the DO degree, and another handful that recognize the DO degree but not the SGU MD degree. Most of the countries overlap, and I believe there are in fact numerically more countries that recognize the US DO degree than the SGE MD degree.



There is a very clear difference between US MD and Carib (or any foreign) MD. In fact recognition has more to do with the country of medical education than the actual degree. Although the MD degree is better known globally, a Carib MD has significantly less recognition globally than a US MD.



Anyone who starts med school this year and later will be ACGME trained. Even now the majority of DOs are ACGME trained. Also, most AOA residencies don't sponsor/accept Canadian citizens, so they'd have to go ACGME (or Canada). Also it varies by province whether you're viewed as an IMG in the Canadian match (but the provinces with the most residencies do view DOs as IMGs). That said, if you're ACGME trained in the US as a Canadian, you don't even have to worry about the Canadian match, you could just go there after training (but most don't want to).

To be more specific Quebec and BC require 1 year residency in the US (AOA or ACGME) and 1 yr in Canada (for Quebec that year has to be in Quebec). Nova Scotia and Ontario requires an ACGME or Canadian residency. The others vary, but most (including those above) require passing of licensing exams and some require 2 yrs of GME (AOA or ACGME).

Basically with the exception of Quebec and BC, you just need to do an ACGME residency and then you should be fine. Even with those provinces you just need to add a 1 yr residency in Quebec and you could practice anywhere in Canada provided you pass the licensing exams.

What you may be thinking of is not the degree but the residency training. Some countries only allow U.S. physicians who went to an ACGME residency to practice there (so AOA residencies wouldn't count). However, now that the merger is making every residency ACGME licensed, this won't matter and US MD and DO will be the same in terms of licensing and practice rights in those countries. I've actually done a decent amount of research on this as I am strongly considering moving to another country to practice after paying back my loans and building a decent nest-egg. Most countries that a U.S. doc would reasonably want to practice in are not off-limits to most DOs. Saying otherwise is just a lack of insight into foreign medical licensing.

 

[hallowmann]

Once again, that is wrong. I personally know DO's who got their degrees in the U.S. that (did) practice in both of those countries. ...

Yeah, it wasn't the case previously though. For the last 20 years or so, the AOA has actively been working to expand recognition, which is why places like Canada, India, Australia, and the UK have changed their policies to universally recognize the DO degree in the last decade. Some countries also have a policy of it being a strictly individual process, so no one would know without a DO actually trying to apply.

...Look at the updated responses in that thread. Here are two that summarize it well:





What you may be thinking of is not the degree but the residency training. Some countries only allow U.S. physicians who went to an ACGME residency to practice there (so AOA residencies wouldn't count). However, now that the merger is making every residency ACGME licensed, this won't matter and US MD and DO will be the same in terms of licensing and practice rights in those countries. I've actually done a decent amount of research on this as I am strongly considering moving to another country to practice after paying back my loans and building a decent nest-egg. Most countries that a U.S. doc would reasonably want to practice in are not off-limits to most DOs. Saying otherwise is just a lack of insight into foreign medical licensing.

That's a very subjective statement. I'm sure there are countries I would want to practice in that you wouldn't.

Actually, what I found was both. There certainly are countries that recognize DOs provided they were trained in ACGME programs, but there are also countries that flat out don't recognize the degree. This is usually because of 1 of 2 reasons, either (1) the laws in their country do not identify or mention the DO degree and as such the medical boards don't feel the need to change laws in order to accommodate the handful of DOs that would want to practice there independently or (2) they have provisions in their laws for non-US DOs (i.e. DOs that only practice OMT) and because of that they don't recognize the degree.

 

[Crayola227]

are you sure the places that didn't recognize to DO *degree* weren't then willing to license you if you did ACGME residency?

what the degree does for you without that training vs with dramatically affects employment here, I wouldn't be surprised if that was the case elsewhere

 

[hallowmann]

are you sure the places that didn't recognize to DO *degree* weren't then willing to license you if you did ACGME residency?

what the degree does for you without that training vs with dramatically affects employment here, I wouldn't be surprised if that was the case elsewhere

Based on the reports of people that applied around the time I researched it (2013) training didn't matter, because training had to be repeated in many of those countries. The issue was even recognizing the DO degree as a medical degree vs. a manipulation degree equivalent to a chiropractic degree. Again there were places where ACGME training completely changed the issue, and DOs with ACGME training were free able to go through the same process as MDs, but at the places I was looking at, this was not the case.

EDIT: Also to be clear, its not many countries where this is the case. A handful at most.

 

[Stagg737]

That's a very subjective statement. I'm sure there are countries I would want to practice in that you wouldn't.

Actually, what I found was both. There certainly are countries that recognize DOs provided they were trained in ACGME programs, but there are also countries that flat out don't recognize the degree. This is usually because of 1 of 2 reasons, either (1) the laws in their country do not identify or mention the DO degree and as such the medical boards don't feel the need to change laws in order to accommodate the handful of DOs that would want to practice there independently or (2) they have provisions in their laws for non-US DOs (i.e. DOs that only practice OMT) and because of that they don't recognize the degree.

It is subjective, but I meant countries where an English speaking individual could move to and reasonably practice without spending years trying to learn the basics (language, interactions, etc.). Not necessarily individual desires.

From most of the places I've looked into there is typically no barrier unique to U.S. DOs who go through an ACGME residency. Even in the countries where the law explicitly states MD, it can be possible for a U.S. DO to practice provided they are able to prove their licensure is equivalent to a US MD (ACGME training, USMLE, state licensure here, etc.). In some cases institutions have even granted their country's MD equivalent from a local institution to a US DO so that he/she could practice there. I've seen a few places in Europe (UK, Norway) which I don't think recognize US DO's because osteopaths there are a common entity completely separate from physicians.

Sure there are some countries that a U.S. DO wouldn't be able to practice in as a physician, but generally speaking that isn't true for most countries and MDs would face similar barriers simply for being a foreign physician.

 

[hallowmann]

It is subjective, but I meant countries where an English speaking individual could move to and reasonably practice without spending years trying to learn the basics (language, interactions, etc.). Not necessarily individual desires.

From most of the places I've looked into there is typically no barrier unique to U.S. DOs who go through an ACGME residency. Even in the countries where the law explicitly states MD, it can be possible for a U.S. DO to practice provided they are able to prove their licensure is equivalent to a US MD (ACGME training, USMLE, state licensure here, etc.). In some cases institutions have even granted their country's MD equivalent from a local institution to a US DO so that he/she could practice there. I've seen a few places in Europe (UK, Norway) which I don't think recognize US DO's because osteopaths there are a common entity completely separate from physicians.

Sure there are some countries that a U.S. DO wouldn't be able to practice in as a physician, but generally speaking that isn't true for most countries and MDs would face similar barriers simply for being a foreign physician.

Yeah, I generally agree.

Norway, France, and Japan are big ones that don't, the former 2 because of the established presence of DOs. It did actually use to be the case in the UK, but they've made an exception for the US DO degree (Ireland was still a holdout last I checked). A number of Middle east countries don't recognize the degree at all, including Egypt which flat out shut down the app the last time someone I know tried, but people haven't really tried to apply in some of those countries for a while. Not really sure about Spain and Portugal, but it would be nice if things adjusted slightly. That said, without dual-citizenship trying to get training in the EU as a non-citizen is practically impossible regardless of degree.

 

[Stagg737]

Yeah, I generally agree.

Norway, France, and Japan are big ones that don't, the former 2 because of the established presence of DOs. It did actually use to be the case in the UK, but they've made an exception for the US DO degree (Ireland was still a holdout last I checked). A number of Middle east countries don't recognize the degree at all, including Egypt which flat out shut down the app the last time someone I know tried, but people haven't really tried to apply in some of those countries for a while. Not really sure about Spain and Portugal, but it would be nice if things adjusted slightly. That said, without dual-citizenship trying to get training in the EU as a non-citizen is practically impossible regardless of degree.

Yep. I do know a DO that practices in Spain, but he was also born there and holds dual citizenship, so I'm sure that played a large role. Either way, for 99.9% of U.S. physicians it's pretty much nothing more than a talking point, and will likely remain as such unless the U.S. goes full-blown single-payer universal with massive cuts to reimbursement (which I don't see happening too soon).

 

[lymphocyte]

I've dabbled in Australia and the US. Multiple Sub-I's in both countries (speciality and primary care). Close mentors in both countries. Strong likelihood that I'll match okay in either country for my prefered specialities. That being said, for primary care...

Australia. It's unreal. ABFM Certification transfers. Here's my growing collection of Australia posts: http://forums.studentdoctor.net/threads/reciprocal-licensing-agreement-with-australia.1203527/

PCPs make about the same as the do in the US, much more if you're willing to practice rural or do some advanced procedural training. (And "rural" in Australia can literally be only 50 miles away from Sydney or Melbourne... or all the way up to Fly-In/Fly-Out outback clinics, which are a whole other level of awesome). Here's a calculator to play with: https://gpra.org.au/gp-earnings-calculator/

But this calculator is strictly for outpatient work.

One of my rural GP mentors rounded at hospital in the morning, did outpatient for 4 hours, went home for an hour or two to diddle around with his farm, and then came back for some surgeries/procedural stuff in the afternoon (cholyes, colonoscopies, tonsillectomies, etc.). He did admin on Fridays and saw private patients on Saturday. He also did a handful of shifts in the ED every month (in a country where people can see GPs for free--so no bogus nothing). Made a few nursing home visits too. Pulled in north of $700,000/year and skied all around the world Dec-Jan.

And don't forget: free healthcare for life, 8% of salary/year extra gets socked away in a pension fund, kids go to university for free, no insurance dramas, you can always do what's best for the patient (as long as it's reasonable and evidence-based), minimal paperwork, and Australians tend be very, very pragmatic people--even as patients, which I absolutely adore. "Why's my BP high"? "Cuz you're getting fat mate. Knock off the chips." "Yeah. Fair enough."

It's not all sunshine and puppies, but most of the discontent is over the length and availability of training (which can be 8-12 years for some specialities). But if you've already trained in the US and want to move... seems like a no-brainer (at least for FM).

 

[cabergoline2]

I've dabbled in Australia and the US. Multiple Sub-I's in both countries (speciality and primary care). Close mentors in both countries. Strong likelihood that I'll match okay in either country for my prefered specialities. That being said, for primary care...

Australia. It's unreal. ABFM Certification transfers. Here's my growing collection of Australia posts: http://forums.studentdoctor.net/threads/reciprocal-licensing-agreement-with-australia.1203527/

PCPs make about the same as the do in the US, much more if you're willing to practice rural or do some advanced procedural training. (And "rural" in Australia can literally be only 50 miles away from Sydney or Melbourne... or all the way up to Fly-In/Fly-Out outback clinics, which are a whole other level of awesome). Here's a calculator to play with: https://gpra.org.au/gp-earnings-calculator/

But this calculator is strictly for outpatient work.

One of my rural GP mentors rounded at hospital in the morning, did outpatient for 4 hours, went home for an hour or two to diddle around with his farm, and then came back for some surgeries/procedural stuff in the afternoon (cholyes, colonoscopies, tonsillectomies, etc.). He did admin on Fridays and saw private patients on Saturday. He also did a handful of shifts in the ED every month (in a country where people can see GPs for free--so no bogus nothing). Made a few nursing home visits too. Pulled in north of $700,000/year and skied all around the world Dec-Jan.

And don't forget: free healthcare for life, 8% of salary/year gets socked away in a pension fund, kids go to university for free, no insurance dramas, you can always do what's best for the patient (as long as it's reasonable and evidence-based), minimal paperwork, and Australians tend be very, very pragmatic people--even as patients, which I absolutely adore. "Why's my BP high"? "Cuz you're getting fat mate. Knock off the chips." "Yeah. Fair enough."

It's not all sunshine and puppies, but most of the discontent is over the length and availability of training (which can be 8-12 years for some specialities). But if you've already trained in the US and want to move... seems like a no-brainer (at least for FM).

is their any way a US board certified IM /IM sub spec can practice in Aus ?

 

[lymphocyte]

is their any way a US board certified IM /IM sub spec can practice in Aus ?

Yes, we actually have two at our institution (large, academic, tertiary). I've only researched the process for FM, but, anecdotally, you'd probably only have to do a year of "supervised practice"--not at all like residency, and the remuneration is fair. I very much doubt that you'd have to resit any examinations coming from the US:

https://www.racp.edu.au/become-a-ph...ia/specialist-assessment-of-otps-in-australia.

I would get in touch with one of the locums agencies. They should handle licensing, insurance, etc. I cannot vouch for any of them, but this one is just an example of the kind agencies are available: http://ochrerecruitment.com/doctors/locumjobs/

I wish you the very best. Feel free to PM if I can ever be of help.

 

[animando]

Several European countries suffer from near Depression like conditions such as Spain, Greece, and Portugal. Countries like Ireland and France are in serious economic crisis at the moment.

The only country with the American lifestyle is our neighbor to the north, Canada. Everywhere else life is going to be a huge adjustment for most Americans.

Most people I know feel paying 8 dollars for the Burrito bowl at Chipotle is a lot of money. In this country people love meat and potatoes. Give someone a bowl of noodles, they are not going to be happy.

Dude, I understand you're a proud citizen of the US and it's fine but seriously, you need to adjust your view on the world. You can eat plenty of meat in Japan, French and Spanish people don't line up for soup kitchen and having a nice house with a big backyard and a green lawn is totally affordable for MD in most developped countries.

Given what happened in Paris and Brussels its hard to argue that one has better personal safety in a European city than an American one. Its highly unlikely that such a tragedy will happen in the US.

From most reliable data sources, large numbers of foreigners involved in ISIS and Al Qaeda have come from Europe, and those are only two of the world's largest terrorist organizations, there are others. The geography and the demographics of Europe make it easier for extremists to hide among the civilian population. By comparison, its much harder for such individuals to hide in the United States.

Not even one week later...