immy, that's really hard to say because each country has different regulations. I'd say with an American degree, you won't find it very difficult to practice elsewhere, but you may need to repeat qualifications before you can do so. For instance, I think if you tried to work in the UK, you may need to repeat some of the residency training (house officerships and all that). I'm not sure on this, but it's hard to find some place that will just accept you on the spot unless your work is really in demand. You really need to notify the countries of interest first and find out directly.