I have visited a couple times at length and I really enjoyed the country. I do have a slight idea of how the training works as I have talked to a doctor currently working there (although she is not an foreigner, so I know things may be a bit different job wise). Is work as a foreigner hard to find in or around the capital cities? Also what are the hours generally like in most training schemes? What state would give me the best chance at finding a job? We have been looking at going out to Western Australia and Queensland.
Thank you so much for the help!
Visiting is not really the same, nor is talking to one doctor once.
To put it harshly.
I visited London once and know more than few brit ex-pat junior doctors and exchange medical students from there. Doesn't mean I know their immigration policies and how to apply for jobs there. i know they do foundation years after school, but I don't know much else after. It's a black box for me.
So, hence, it's a whole other story if you've lived there or have family/married to an Australia. It's means you have some strong tie. Maybe Australia was actually home and the US was temporary. But that's not your case. How much research and how much time have you thought about this?
For what it's worth, in case you haven't considered it for long - I'm going to be very blunt about this. Because I really want you to think about this seriously and be scared. It's long and arduous path and life you sign up for in medicine, and even more so as an off-shore student. If you've made up your mind, then you've made up your mind.
I don't recommend this path. I've repeated myself quite a few times in other threads. Going off-shore should never be anyone's number one choice, it should only be your last option should not get into any MD or DO school at home.
Sure, like the premed said above, some states have better outcomes for grads. But that only applies to today, not 4-5 years from years from now. Policies and job markets change on an annual basis. And his advice only extends to a single intern year, you need 5+ years of training somewhere to finish and be a fully qualified a doctor. Every premed and student just obsesses over that one year, and can't seem to think beyond it. It's not the end all be all a single prelim or intern year. You still have to continue applying for jobs after that. Not everyone likes this.
When you graduate from med school in the US, you apply directly into 'vocational training' or residency, which could be FM or Surg. And after 2-5 years you finish and become a fully qualified doctor. That is not how it works in Australia. You apply for jobs every year. The trend now is after rotating as a house officer (similar to a TRI or Prelim year in the US) for 2-3 years, then you can apply to vocational training at royal college. with surgery, it's more like. after 5-6 years.
I would forget capital cities as an IMG or international student. Are there exceptions sure, everyone thinks they will be that exception. But as it is, we're in junior doctor oversupply, that's been in official government reports. Every state trains its own batches of domestic students and they are guaranteed a job and have first round pick of where they want to work. only after they decide and have accepted offers, are left overs (essentially) given over to international students to apply and pick up.
Training for IM, Surg and subspecialties has to date been best at the tertiary metro public hospitals. Because they have the breadth and sufficient consultants/attendings to train you. Small sites simply won't have the capacity. The bigger sites also have higher pass rates for board exams. This is why metro spots fill up with domestics first. As in, in-state trained domestics. And generally everyone tends to stay in the hospitals they do internship in.
So, the vast majority of graduates will end up rural. then you have to be highly competitive to make it back to the city after intern year. It's near impossible as an international to get an internship in the city. Unless you do it via the mixed private and rural/remote scheme, but everyone in there has to move onto a new hospital after 2-3 years. Private hospitals are sufficient to train you as an intern, but not for finishing off your training necessarily.
How vocational training works in the US again - you apply once in the match and get a program at a hospital. In Australia - it's different and less straightforward. You apply to a hospital, not a program. The hospital has it's own program to various levels of quality - important to know for passing your boards. Then when you've accumulated enough points of expeirence on your CV (could be research, could be other degrees, they like masters of public health - after you've done med school), then you apply to a royal college that will allow you to finish your training. Meanwhile, you still have to re-apply each year to hospitals. They're 2 separate entities. Not only this, but many royal colleges actually require that you have PR/green card to even apply.
Hours of training are variable depending on hospital and depending on what you decide to do. Largely it's shift work in Australia, with no 24 hours rostered hours on site. intern year hours are highly protected. obviously, on busier rotations like surgery or medicine, your hours could be 10-12 a day. On weekend shifts 16. No on calls that are 24-72 hrs.
As you go higher up it gets busier, hours are longer or "worse". PGY2 is not terrible. but if you end up doing surgery or cardiology for instance, easily you'll be 72 hours on call for a weekend for instance if you're more senior. Which means, you only phyisically needed to be there for a few hours. Then have to answer calls on your phone the rest of the time. If you're in cardiology let's say, on a bad day with lots of code AMIs (heart attacks), you could be working the entire 72 hrs. It really depends on hospital site policy and what vocation. Surgery hours as a trainee is also long, 6-7 am to 10 pm easily, or midnight if emergency cases roll in. Some days you could be leaving earlier at 5-6, but it's not everyday. They try to balance it out or alternate it. but someone has to be around after hours. I suppose it's marginally better than the US where it's start work at 4-5 am.
FM has the best lifestyle. But you aren't likely to get city FM. For one there's a moratorium - you can't bill patients for medicare for 10 years after finishing school. And they also require PR before you can even apply to the city FM college.
So that leaves rural FM. Where most international students and IMGs end up.
Not everyone mind you, but most.
When you become an off-shore student, long story short, it limits the options you have for applying for residency. Maybe you're okay with this as a premed who hasn't gone through school yet. But you can't predict what you will find out as you go through rotations - maybe you thought FM was great as a premed. Then you do as a clinical student and work in as an intern (some states allow this) and decide it's not for you. You're more suited to be a neurosurgeon.
that's a one in a million thing to get whether as a domestic or international, but it is even harder for internationals.
You'll want to ensure you have the best opportunities open to you from the moment you apply to med school. Just in case you decide you want something competitive later. So only go off-shore, if you know you have no other options. You've applied and been rejected at home. Then indeed - off-shore and it's options are the only opportunities left to you. but you are picking the harder path, it's not something to go into casually. Can you be successful, yes, if you work hard and are willing to make some sacrifices. But I can't guarantee you'll be happy with what you get.
I'm going to stop here, as I've rambled way too long.
