Medical Should I join Match 2022 or do Internship for an Australian license and join Match 2023

[MusicDOc124]

I have the option of permanently foregoing a general Australian license (it lets me practice family medicine and pursue specialty training) for Match 2022, or alternatively doing Australian PGY-1 and joining in Match 2023.

Option 1: Match 2022 = foregone AU license + US residency
Option 2: Match 2023 = registered AU license + US residency

The drawback of option 2 is I might only get 3 weeks leave for interviews during Intern year. I fear this is not enough time to go on sufficient interviews as an IMG.

I intend on practicing in the US post-residency.

Stats: step 1 239, step 2 254, 4 months USCE. Applying less competitive specialties.

I am an Australian citizen with a US partner.

What would be the point in obtaining an australian license if you plan on practicing in the US? Especially if obtaining something you're not going to use will push you back 1 year and potentially limit your availability for interviews.

While yet to be determined, I imagine many, if not most - or all, interviews next year may remain virtual unless more people get vaccinated than currently are and the virus becomes truly controlled, in which it may not be an issue anyway to do both.

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[TheBoneDoctah]

What benefit would it give you to have an Australian license?

 

[AlteredScale]

1. Sentimental reasons: I see so many FMGs in Australia desperate for a license, spending thousands of hours and dollars every year trying to pass AMC exams, and here I have a license handed to me on a plate (Interns work ~50 hours a week in Australia), and I’m thinking about forfeiting it.

2. It’s a good backup in case the US doesn’t work for whatever reason. My main concerns are residency termination (I know, it’s rare) and visa laws. J1 has a home residency requirement.. what if I need go home, and I have no license to practice with? There is ONE pathway that enables me to get license in Australia actually, but it’s contingent on me finishing PGY1 in the US, and undertaking a ‘provisional year’ in AU.

3. There’s lots of US doctors who’ve migrated to Australia. Actually, my first preceptor of the year is American born/trained/licensed, and he’s enjoying life down here.

4. Intern year runs from January - January in Australia. US residency starts in July. So if I commit to Match 2022, I’ll be working 7 months as an Intern before I resign.

5. I don’t know if I’ll marry my US partner yet. That being said, I really can’t imagine practicing in Australia in the future. I guess I love American people/culture too much. The only time I’ve ever truly felt happy was stateside.

Also, if I wait for Match 2023, I’ll probably have to take Step 2 CS, which if I have to fly to the States for will detract from my annual leave even further.

Are these pros worth the risk of only having 3 weeks for interviews? I mean, I could always negotiate for more, but I won’t have that chance until I actually start internship.

Also, I understand if I decline a Match I’m banned by NRMP for 3 years. So it seems like I really have to commit to one way or another.

That’s a tough situation. But sounds like pursuing Australian license would not fair well with you applying and interviewing for positions here. Honestly, it will depend on how bad you really want to practice in the US and if you’re willing to commit 3-7 years, uninhibited to do your residency.

I feel like you should just commit to one or the other. Either go ALL IN toward the australian license, complete your residency and fellowship. Or pull out of the license and apply to the US.

Yes if you match and you do not get a waiver of the match by NRMP granted, and you still say you aren’t going to commit the NRMP can ban you for 1-3 years or even permanently from ever participating in the process and you have now barred yourself from training in the US.

Sounds like you are more worried about having to come home while training in the US and have cold feet in terms of committing yourself to being able to stay in the US. I wouldn’t be worried about termination from residency at this stage (unless for some reason you feel significantly deficient in clinical domains?) and I would be more focused on finding and searching residency programs that support J1 visas in the specialty of your choice and reaching out to them to ensure your situation won’t get hairy in the middle of training if you match there.

 

[TheBoneDoctah]

100% agree with @AlteredScale here. The chance of you being terminated from a residency program is super small and don't think it warrants the other hassle of the Australian license. If you thought the chances were great that you would practice in Australia, then yeah, but you are saying that those chances are small and are just getting cold feet to not committing to US residency programs.

 

[lord999]

There's actually an E-3 and J1 visa problem with Australia right now as Australia has suspended reciprocal entry for professionals from the US and requires an exemption process that is legally arbitrary (meaning that the same criteria do not apply depending on when and how). You might have a much harder time than usual even with the ECFMG. We have had to rescind offers this year due to USCIS's issues at the moment.

I'd honestly speak with the Embassy in Canberra about this it's not a foregone conclusion that even if you interview, you will receive the normal treatment for visas depending on both our government's stances. This might actually delay you a year anyway depending on how open both borders are going to be.

 

[lord999]

Thank you so much for your honest response.

Are you saying that the US is actively delaying E3 and J1 visas to Australians as a result of the Australian government’s blanket inbound travel ban?

Is this affecting Australians in the current match cycle?

This saddens me because at the very least I was hoping to get a business/tourist visa to squeeze in an additional 4 months of USCE late this year (which my government appears to be ok with).

Yes with the 2020 entering class which should have entered in summer 2020. Australia relaxed somewhat during the fall and made medical staff exceptions with an invitation, but the treaty does require reciprocity and not trying to sound like a nationalistic pig, but the US Department of State does not view the situation with grace (you also have to understand that the current government that has a more nationalistic view will transition out next week). The H1B is also in major flux in the US right now over tech workers, but this also affects postgraduate medicine as well.

In other years, I agree with the above that if you don't intend to practice in the ANZ area, you should immediately bolt for the US like my other colleagues said. It's trickier now, and I think you need to get a read on the visa situation as it's much more complicated. If this is another wasted COVID year, completing your license is a good use of time if that window does not shape up for living in the US. If you think you can get here and stably stay (this is not a question about residency dismissal as it is rare, but is a question of whether you have visa bureaucracy issues given the fluid government situations), then come on in and compete.

You do realize that a three week stay here is a problem for the Australian side (we don't care for the moment although that is changing)? I hope you budgeted some downtime as you would be expected to quarantine upon reentry.

But, if you do take the visa, you're not going back to Australia as getting back is apparently a real problem. We had at least one faculty member were denied entry to Australia (and also return to the US though they were Australian permanent and an NZ citizen) and had to stay in the US for Christmas and do not plan on returning as coming back to the US is not guaranteed.