Practicing outside the US

[a_student]

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if i wanted to practice abroad (eg canada, netherlands, third world), could i use my md from an allopathic US medschool?
do i need to complete residency?

how does it all work?

 

[descartes]

I don't know about specific locations per se, but I do know that an MD from a US allopathic school will allow you to do just about whatever you want. There may be some sort of board-like examination for the developed countries, but in my experience you can work in the third world without anything but an MD and fondness for strange food.

 

[ericdamiansean]

YOu would need to sit for the entrance exams of the respective countries, though in actual fact, a US MD degree should be a license to practice anywhere..

It's more of formality sake, you should have no problems passing it

 

[brightblueeyes]

if i wanted to practice abroad (eg canada, netherlands, third world), could i use my md from an allopathic US medschool?
do i need to complete residency?

how does it all work?

...a US MD degree should be a license to practice anywhere..

I think your degree makes you eligible to apply for equivalency in all countries but it's misleading to say that it's a "license to practice anywhere".

I think it would be easy for you to practice in a third world country. I don't know the details but I would guess you would still need to have done some postgraduate training somewhere. (Although descartes may know something I don't.)

And due to agreements between Canada and the US, it should be easy to practice in Canada. One detail you would want to watch out for, though, is that some American specialty training is shorter than its Canadian counterpart and isn't treated as equivalent. So you would have to do further specialty training in Canada. But since your degree is from an LCME school, I think you can take part in the Canadian match and this would avoid any complications.

In the Netherlands and Europe in general, it can be difficult for an American doctor to get a license. The most obvious barrier is language. You would have to prove you were fluent in Dutch to be considered for a Dutch license. You would also have to get the appropriate work-visa. Since most Western European countries attract many Eastern European doctors who already have EU citizenship, the need to get a work-visa puts you at a disadvantage.

Also, unlike for American degrees, new EU regulations require that most (but not yet all) of the other EU medical degrees have to be treated as equivalent. In practice what this means is that unlike most EU doctors you would have to take an extra exam to show equivalency. (One example of this is the PLAB in the UK.)

Another barrier is that even if you do an American residency and it is recognized as equivalent by a European country, I think they would ask you to sit a board exam. And even though I'm not sure about the Netherlands, the boards in several European countries are supposed to be extremely difficult. Just ask someone who has taken specialty exams in both France (or the UK) and North America and see what they have to say.

So as you can see it's not automatic. But if you do speak Dutch, then the Netherlands is a great place to do primary care. (It'd probably be my first choice...if only I spoke Dutch. 🙂)

If you have any more questions let me know.

 

[ericdamiansean]

I think your degree makes you eligible to apply for equivalency in all countries but it's misleading to say that it's a "license to practice anywhere".

What I meant was, in paper and knowledge wise, a US graduate should be able to perform pretty well in another country, without taking into consideration other factors such as language etc

 

[brightblueeyes]

What I meant was, in paper and knowledge wise, a US graduate should be able to perform pretty well in another country, without taking into consideration other factors such as language etc

I agree. 👍

 

[brightblueeyes]

What I meant was, in paper and knowledge wise, a US graduate should be able to perform pretty well in another country, without taking into consideration other factors such as language etc

I just remembered there's at least one big exception to this: Japan. Even if you speak fluent Japanese, I don't think your American MD would enable you to practice there. Among other things, I think their doctors also function as pharmacists so their training and responsibilities are a little different from European and American doctors. Also, Japanese medical terms are completely unrelated to the Latin/Greek derivatives used by pretty much the rest of the world. So, speaking Japanese wouldn't be enough, you'd have to master a huge, new medical vocabulary.

 

[doc05]

also keep in mind that even though you might speak fluent Dutch (or another European language), taking a board exam in another language is completely different than having even the most intelligent conversation. Those exam questions are not straightforward, time is limited, and you must appreciate the nuances of written language that can be lost on those who aren't native speakers.

 

[brightblueeyes]

also keep in mind that even though you might speak fluent Dutch (or another European language), taking a board exam in another language is completely different than having even the most intelligent conversation. Those exam questions are not straightforward, time is limited, and you must appreciate the nuances of written language that can be lost on those who aren't native speakers.

It looks like this can be a problem even for non-board exams. I did some further checking on Japan and found out about an American trained dentist Tom Ward who practices in Tokyo. He mentions that any American doctors who prove fluency in Japanese can request to take their licensing exam. But he adds that he only know of three Americans who have passed it in the last thirty years.

He also made this curious comment: I now realize that virtually everyone thinks that his country's medicine is the best in the world, just as he thinks that his culture is the most advanced, and his soldiers are the bravest.

 

[a_student]

also keep in mind that even though you might speak fluent Dutch (or another European language), taking a board exam in another language is completely different than having even the most intelligent conversation. Those exam questions are not straightforward, time is limited, and you must appreciate the nuances of written language that can be lost on those who aren't native speakers.

does a person have to be board certified (by a US residency program) to practice in a non-industrialized country, or would simply the american MD be enough?
Another question: According to the posts above, a person has to be board certrified by the industrialized countries' residency program to be able to practice there (e.g. to practice in england I'd have to be board certified by a residency program in england), does this also apply if I want to be a family practitionar in England, or any other european country? Would I still have to complete a residency program and take usmle equivalents there?

i'm an ms1 so my knowledge of both us residency programs and programs abroad is limited, thx in advance for answering my questions.

 

[KatieJune]

I don't know about specific locations per se, but I do know that an MD from a US allopathic school will allow you to do just about whatever you want. There may be some sort of board-like examination for the developed countries, but in my experience you can work in the third world without anything but an MD and fondness for strange food.

Well Mexico is a developing country and they require that you practice for 5 years under the direct supervision of a physician licensed there....that's a long time!

 

[brightblueeyes]

does a person have to be board certified (by a US residency program) to practice in a non-industrialized country, or would simply the american MD be enough?
Another question: According to the posts above, a person has to be board certrified by the industrialized countries' residency program to be able to practice there (e.g. to practice in england I'd have to be board certified by a residency program in england), does this also apply if I want to be a family practitionar in England, or any other european country? Would I still have to complete a residency program and take usmle equivalents there?

i'm an ms1 so my knowledge of both us residency programs and programs abroad is limited, thx in advance for answering my questions.

I'm not sure about developing countries but I think all European countries require postgraduate training to do any type of primary care. Each European country can set its own regulations (up to a point). But I know you need specialized training for the UK, France, Germany, Switzerland and the Netherlands, and I think it's like this for the rest of Europe too.

Belgium is a slight exception in that you can work in one or two fields without postgraduate training, but not in Family Medicine (or any sort of primary care). In fact, the only "fields" open to you are areas like Public Health. And I'm pretty sure that's not what you're looking for.

 

[MeowMix]

Going into Canada as an FMG (US = foreign) is extremely difficult. You have to take their licensing exams and do a Canadian residency. Since there are about 1.01 residency slots per Canadian grad, there are very few to spare. You are competing with e.g. surgeons from eastern Europe with 20 years' experience who are willing to drive cab and volunteer at hospitals to get a foot in the door.

The doctor I know who most recently returned to Canada after practicing 20 years in the US (Canadian med school, US residency) has had enormous trouble getting licensed.

It's a lot easier to get a US residency as a Canadian med school grad.

 

[brightblueeyes]

Going into Canada as an FMG (US = foreign) is extremely difficult. You have to take their licensing exams and do a Canadian residency. Since there are about 1.01 residency slots per Canadian grad, there are very few to spare. You are competing with e.g. surgeons from eastern Europe with 20 years' experience who are willing to drive cab and volunteer at hospitals to get a foot in the door.

The doctor I know who most recently returned to Canada after practicing 20 years in the US (Canadian med school, US residency) has had enormous trouble getting licensed.

It's a lot easier to get a US residency as a Canadian med school grad.

You're right, it doesn't look easy for an American doctor to practice in Canada; but it may not be as bleak as you describe. Degrees from American LCME schools are treated as equivalent to Canadian schools and USMLE exams can be counted as equivalent to the MCCQE exams. Below is a snippet from the web site of the College of Physicians and Surgeons of Ontario.

The examinations that the Registration Committee will treat as equivalent to the MCCQE, include:

The USMLE (United States Medical Licensing Examinations), Steps 1, 2 and 3 as long as the sequence includes an assessment of clinical skills as demonstrated by successful completion of either:
USMLE Step 2 CS (Clinical Skills)...

Also, if it's possible to take part in the first Canadian match, then an American grad would have no problem getting a Canadian residency.

On top of this, many (most?) American residencies are treated as equivalent to Canadian residencies. The only criterion I know of which rules this out is a shorter period of training. I don't know why the doctor you mentioned had so much trouble returning to Canada. Perhaps there are other factors we're overlooking.

 

[johnny_blaze]

if i wanted to practice abroad (eg canada, netherlands, third world), could i use my md from an allopathic US medschool?
do i need to complete residency?

how does it all work?

This is for if you want to practice in the UK.

It depends on what position you want to apply for. In the UK, a doctor that has completed his/her medical training and attained a fellowship is called a consultant. Finishing your residency in the US may mean that you are fully capable of practicing independently in the US but UK post graduate training is longer and it might not be possible to attain such a post (also because you’d be competing against UK postgrads also wanting the post) even thought the royal college of surgeons/physicians of England say you can.

However, it is possible to apply for a staff grade post whereby you are removed from the whole post graduate training scheme at given responsibility and paid according to the experience you currently hold. These types of positions may also be available in other European countries as well… I’m not really sure.

Another option is to apply for a junior doctor/senior house officer post, which you should get without trouble… but then you are just as low as an intern and this may not be appealing after you’ve just finished your residency!

Hope this helps anyone. 🙂

 

[UT_mikie]

It looks like this can be a problem even for non-board exams. I did some further checking on Japan and found out about an American trained dentist Tom Ward who practices in Tokyo. He mentions that any American doctors who prove fluency in Japanese can request to take their licensing exam. But he adds that he only know of three Americans who have passed it in the last thirty years.

He also made this curious comment: I now realize that virtually everyone thinks that his country's medicine is the best in the world, just as he thinks that his culture is the most advanced, and his soldiers are the bravest.

Concerning Japan, American MD's are allowed to practice there but unless you take their boards you are not allowed to accept Japanese national health insurance which virtually everyone in the population has. Therefore you would get almost get no patients. Sometimes doctors go over there and treat specifically foreigners, probably not a huge pool of people so I don't know why you would want to do this. Also I don't think many Japanese patients would feel comforatable with a non-native speaking (and esp looking) doctor when there are already so many qualified physicians over there.

I had several friends in medical school in Japan, and I would often sit in on some group study sessions. Their terms are completely different from their English equivilants, either of Chinese or German origin. What was amazing is that despite that they were pretty comforatable using latin terminology as well. They seem to learn both (or maybe it was just the group I was with because I think they are an especially bright bunch).

 

[IlianaSedai]

My understanding is that it is NOT hard to practice in a third world country with severe medical shortages.

First world countries with established medical systems that lend preference to their own graduates, however, are another matter. There are hoops to jump and it can prove to be a long process. Some require re-training in addition to passing exams. You'd have to look it up for the individual country.

There are also immigration issues. Sometimes that is even harder than medical licensing issues.