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Practicing in Asia

Discussion in 'Anesthesiology' started by anesapp2014, Mar 15, 2015.

  1. anesapp2014

    2+ Year Member

    Oct 14, 2014
    Likes Received:
    Just wondering if anyone has firsthand experience or knows of a colleague who is practicing anesthesia in Asia, such as China, Hong Kong or Taiwan. I tried doing a search on google and sdn but nothing really came up. My wife is from there and I was just curious if it's doable, especially if one works with the expat population who say they prefer US trained physicians. Although, I'm not sure what anesthesiologists trained in US can provide, unless we're talking about some pain management clinic.

    What would be the working lifestyle, environment (CRNAs?) and salary be like overseas? I don't mind making less, since some areas might have lower cost of living and less taxes. What's more important to me is that compensation is somewhat comparable, i.e. lower salary but also fewer working hours. Obviously I wouldn't want to work 80 hour weeks as an attending making considerably less than I would be in the US.

    Or is it not even worth considering given the amount of training it requires in medical school and residency in US, debt, on top of recertification abroad?
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  3. bashwell

    Classifieds Approved 5+ Year Member

    Mar 20, 2013
    Likes Received:
    Resident [Any Field]
    I don't know about Asia. But I know a little bit about Australia (Australasia). Check out ANZCA for accurate details though. ANZCA has affiliations with some but not all Asian nations. Hong Kong and Singapore are Asian nations (cities) which would currently be recognized by ANZCA though (and vice versa), I believe. Again, just check out the website to make sure though.

    Anecdotally, what I do know is there are several Hong Kong and Singaporean anaesthetic fellows working in Sydney, Australia. They did all their anaesthetics training in Hong Kong and Singapore, but are doing a fellowship year in Sydney hospitals. I believe they can stay and work here if they like, but only if they have PR/citizenship. So the barrier is PR/citizenship, not residency training. In other words, if you trained in Hong Kong or Singapore, and you have Aussie PR/citizenship, I think you should be able to work in Australia without any significant problems. At least that's my understanding, but just check out ANZCA to be sure.

    Also anecdotally I know of Aussie physicians (e.g. a cardiothoracic surgeon) who travel to China (Shanghai) regularly and work there. They don't seem to have any issues, even though they were trained in Australia. But I don't know how it works in China. Some of the stuff that happens in China sounds dodgy to me, but that's another story.

    Currently, though things are changing, I believe ANZCA would recognize US residency training in anesthesiology or at least most of your training. You might have to be observed for a year or so and take the college's final exams. But otherwise you should be good, assuming Aussie PR/citizenship, at least from what I know. And even during this year of being observed to make sure your knowledge and skills are up to snuff, and while you're studying for the college's final exams, you should still be able to work at the senior registrar (aka resident) level and thus get paid at that level (which would be well over $100k and maybe for some approaching even $200k per year including overtime pay etc, depending on how much you work). As an attending level anaesthestist/anesthesiologist, my understanding is starting salaries are equivalent to US starting salaries (though in Aussie dollars, which could be better or worse depending on the exchange rate at the time). However, it's very hard to find a staff specialist job in a capital city like Sydney. You can do locums which pay like $2000 per day for attending level + accommodations, travel expenses, etc. And yes lifestyle in Australia is generally better than in the US (e.g. you will generally work far less hours, you get paid overtime for working anything more than 37.5 hrs which is full-time in Australia, you get paid more for working holidays, there's long-service leave, etc.). See here for example to get an idea of what jobs are like in Australia.

    In Australia and New Zealand there are definitely no issues with CRNAs. The closest there would be "anaesthetic nurses" but they definitely do not have the authority independence and scope that CRNAs in the US have. Rather, anaesthetists/anesthesiologists are highly respected physicians in Australia. Not at all treated like anesthesiologists are often treated like in the US. In fact, it's very difficult to become an anesthesiologist/anaesthetist in Australia. One of the most competitive specialties.

    At any rate, unless you're absolutely personally committed to Asia and need to be there due to your wife (but it sounds like you're open to working in different places since you mentioned more than one Asian nation), I'd recommend working in Australia as an anaesthetist (aka anesthesiologist). Not only can you find a lot of what you find in the US in Australia (e.g. the lifestyle and culture are very similar and much more similar than the lifestyle and culture in Asia), but you can also find a lot of what you find in Asia in Australia! Heaps of Asians in Australia, which includes good food, shopping, cultural events, etc. Plus, Australia is not really that far from Asia. You can fly from Australia to Asia pretty quickly, depending on where you are coming from and where you are going. Perth to Singapore is something like 4 or 5 hrs. Brisbane to Hong Kong is something like 8 hrs. Sydney to Hong Kong is something like 9 hrs. So you should be able to visit your wife's family in Asia relatively easily if needed, or they can visit Australia pretty easily. In comparison a flight from Los Angeles to Hong Kong is about ~15 hrs, a flight from NYC to Hong Kong maybe ~18 hrs or so. However the single biggest barrier is you need to get Aussie PR/citizenship but speak to an Aussie immigration lawyer or agent as that's how many people do it from what I hear.

    Hope that helps, but please feel free to ask any more questions. Hopefully others who know better than I do can weigh in as well.
    #2 bashwell, Mar 16, 2015
    Last edited: Mar 16, 2015
    nimbus and repititionition like this.
  4. Happy doc05

    Sep 7, 2017
    Likes Received:
    Hi i am looking for residency training in singapore after acquiring a few years of clinical experience in hong kong.
    Would anyone kindly advise me the steps required and whether it is difficult to get into anaesthesia residency training?


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