Practical specialties for international work

[makesomerheum]

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Just wanted to know thoughts on what is the most practical specialty for international work.

 

[calot's 3angle]

my bet would be on either family medicine, emergency med, or ob/gyn...

 

[IlianaSedai]

I know a general surgeon who works in Sudan....

He is his own pathologist. Don't know who does the anesthesia. Oftentimes he is also the primary care. And although I don't remember if he mentioned this or not, I wouldn't be surprised to see him delivering the babies too.

The lines can blur between specialties if you're out in a country that lacks medical care and on your own. You probably wouldn't be getting many CT scans or MRI's (radiology) but I think family/internal, EM, or gensurg are easily versatile enough. I don't know about OB -- they seemed to get so little *medicine* training when I did my rotation, they couldn't read a simple EKG and would probably flounder with complicated medical patients. But you can probably still go abroad with an OB residency. Everyone has to learn as they go anyway.

 

[BigBadBix]

I have a few classmates who are planning to work internationally.They are all going the med/peds route.

 

[GenSurg]

As far as surgical specialties go:

Plastics-Can do clefts, burns
Gen Surg-Can take care of most surgical problems, esp helpful if has some orthopedic training and can pin hips. Can also do some gyn procedures.
ENT-Some can take care of clefts
Ortho-Broken bones occur everywhere
Urology-Repair botched female circumcision

http://www.freeiPods.com/?r=20049323

 

[makesomerheum]

At my school, it appears that many of the profs involved internationally are in ID. I am also interested in heme/onc. does anyone know someone in this area that is working overseas?

 

[supercut]

If you look at the web sites of organizations that doctors work for overseas (which you should do instead of asking here) you will see that they are always advertising for surgery.

However, you should NOT, I repeat NOT pick your specialty just so you can spend a few weeks a year working for a volunteer agency. You should pick a specialty that you like. Then figure out a way to go overseas. It may very well mean stepping out of your specialty.

I know a few folks who have gone, and what the did depended to a large degeree on the setting they were in. My OB friend who went with a church group for 2 weeks wound up basically doing a peds clinic.
My gen surg friend who worked with Doctors Without Borders for several months worked as a surgeon/orthopod/ophtho/OB/ED/ID doc and was in charge of the whole hospital, supervising the equivalent of residents. He did operations that he never saw in residency.

 

[IlianaSedai]

You should pick a specialty that you like. Then figure out a way to go overseas. It may very well mean stepping out of your specialty.

Agreed. Better to spend a few years doing something that you can tolerate / appreciate / enjoy and then go overseas where you can LEARN the primary care and obstetric stuff you missed out on during your training AS YOU GO, than to train in something that makes you miserable so you can spend the rest of your life doing it overseas.

 

[gwen]

in my opinion, Infectious Disease is definitely one of the best ways to go if you are truly devoted to international work. ID docs not only have ID, but also general medicine in their background.

Gen surg, Internal Medicine, Peds, Plastics, Gyn, and even Pathologists are helpful for international work. That is one of the reasons I chose to do Internal Medicine over PM&R (what I initially started out with). Its good to have the basics of medicine or surgery to do this kind of work. i just didn't see myself being as helpful if i had become a physiatrist (although i'm sure its still possible to do that work but you wouldn't just have as much medicine experience).

there are so many places that need our help.

also, what is the general opinion on the "learn as you go" idea as proposed by the last poster?!?

 

[EMApplicant]

From the MSF-USA (doctors without borders) website:

"MSF is particularly seeking emergency medicine physicians, general practitioners, family practitioners, internists, pediatricians, obstetricians/gynecologists, and infectious-disease specialists.

Requirements:

Valid degree and current license
Completion of a residency program
Current or recent practical experience
Assets:

Training in tropical medicine and/or infectious disease (especially TB and HIV/AIDS)
Minor surgical and obstetrical experience
Training skills
Ability to work with a diverse group of professionals "​

also FYI - emergency medicine is very supportive of international work. In fact, there are a growing number of fellowship positions in international emergency medicine.

 

[makesomerheum]

Very helpful posts. I did not know about EM. Thanks.

 

[EMApplicant]

Very helpful posts. I did not know about EM. Thanks.

As an EM resident, i'm biased. However, here are some of the reasons why I chose EM, knowing that I want to work internationally for my career.

1. Breadth of skills
2. New specialty that is expanding around the world - i.e. there are lots of EM opportunities in DEVELOPED countries in addition to developing countries. For example, Beth Israel in Boston sends their senior residents to Italy where they are involved in developing EM.
3. International EM fellowships
4. Flexibility of specialty - it is feasible to work 6 months a year in the US, 6 months abroad if you want
5. Many prominent names in humanitarian relief work are EM docs
6. A lot of enthusiasm and support for international EM work
7. etc!

 

[IntlMed]

3. International EM fellowships
4. Flexibility of specialty - it is feasible to work 6 months a year in the US, 6 months abroad if you want

Would be able to expand on these two items please ?

Thank You,
IntlMed

 

[DOCTORSAIB]

I think everyone is forgeting Ophthalmology. I just came back from an eye expedition in India. We were doing mostly free cataract surgeries on the poor. The experience was amazing! In one city, in just 6 days, we did 228 free cataract surgeries! These people went from hand motion/light perception to almost 20/20 or 20/30 vision...🙂

The ophthalmologists in India (Aravind Eye Hospital) have perfected a surgical technique called Small Incision Cataract Surgery (SICS). It's suture-less and with great visual outcome. An experienced surgeon can do the surgery in 3-5 minutes! 😱 Now that's a great field for international work.

 

[atsai3]

Just wanted to know thoughts on what is the most practical specialty for international work.

I think "most practical" is what you make of it. Some specialties may be useful for overseas work, e.g., psychiatrists who go overseas to train mental health workers.

-AT.

 

[EMApplicant]

As an example of what an international EM fellowship looks like, check out the Johns Hopkins International Emergency Medicine Fellowship HERE.

Other great international emergency medicine fellowships are GWU, Harvard (both EM programs), Loma Linda, etc. There's about a dozen such programs already established. As I said, there is A LOT of enthusiam within EM for international work!

 

[EMApplicant]

Complete list of current International EM fellowships here.

 

[atsai3]

Complete list of current International EM fellowships here.

Also, here is an article from Prehospital Disaster Medicine on international emergency medicine fellowships by Greg Bledsoe and colleagues:

http://pdm.medicine.wisc.edu/20-1%20PDFs/Bledsoe.pdf

Cheers
-AT.

 

[I-eye]

Teleradiology -- i.e. "nighthawking." Work from home anywhere in the world you choose. Move every year if you want. 50-60 hours/week, 2 weeks on, 2 weeks off. 350K tax free. Virtual Radiologic Consultants. Not a bad gig if you ask me. Flexibility in location/travel was a big selling point for me with radiology back when I applied.

If you are a US citizen no income you earn, regardless of where you earn it, is tax-free. You are still taxed at your normal US rate and are basically given a credit for any taxes you pay on the same income in another country. Now it might be easier to hide it from the IRS if you earn it overseas, but that is still tax evasion.

Good luck with the nighthawking!

 

[EMApplicant]

Teleradiology -- i.e. "nighthawking." Work from home anywhere in the world you choose. Move every year if you want. 50-60 hours/week, 2 weeks on, 2 weeks off. 350K tax free. Virtual Radiologic Consultants. Not a bad gig if you ask me. Flexibility in location/travel was a big selling point for me with radiology back when I applied.

or those films might get read in bombay by a doctor charging a fraction of what rads pays in the states... the ability to consult "virtually" could be a double-edged sword.

 

[makesomerheum]

Would any of the EM responders/advocates mind explaining what international work as an EM doc would look like?