US vs Australian Undergrad and then Medical Schools

[Med-Hopeful]

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Hi,
First time posting--Kind of excited

I am in a debate on whether to attend my undergrad in the USA then do my medical school in the States or do my undergrad(3 years) and medical school in Australia. I am a US citizen. Primary reasons of considering this are

1. cost: medical school costs might be similar in both countries but undergrad is cheaper in Australia even as an international. So overall it might be cheaper in Aus
2. Family is considering moving to Aus and already applied for visas. Processing times are are a few years, but if it works out, I will be a permanent resident and could get subsidized medical school.
3. Australia has some nice nature and lifestyle.

Concerns:
1. If I go to Aus and the permanent residency paperwork doesn't work out, I will be an international there and I've read that it is hard to match into a residency after graduating medical school as the spots are reserved for locals. How hard is it to get a residency or "intern" in Australia as an international graduating from Australian undergrad and medical school.
2. If residency spots are hard to get in Australia, will I be looked down upon if I try to come back to US. Can I still match to competitive US medical residencies as an Australian graduate?
4. If I study in US, can I practice later in Australia?
3. If I become a dual citizen, will I have to pay a ton of taxes? Also, which is better for lifestyle and pay?

 

[Isoval]

Hi,
First time posting--Kind of excited

I am in a debate on whether to attend my undergrad in the USA then do my medical school in the States or do my undergrad(3 years) and medical school in Australia. I am a US citizen. Primary reasons of considering this are

1. cost: medical school costs might be similar in both countries but undergrad is cheaper in Australia even as an international. So overall it might be cheaper in Aus
2. Family is considering moving to Aus and already applied for visas. Processing times are are a few years, but if it works out, I will be a permanent resident and could get subsidized medical school.
3. Australia has some nice nature and lifestyle.

Concerns:
1. If I go to Aus and the permanent residency paperwork doesn't work out, I will be an international there and I've read that it is hard to match into a residency after graduating medical school as the spots are reserved for locals. How hard is it to get a residency or "intern" in Australia as an international graduating from Australian undergrad and medical school.
2. If residency spots are hard to get in Australia, will I be looked down upon if I try to come back to US. Can I still match to competitive US medical residencies as an Australian graduate?
4. If I study in US, can I practice later in Australia?
3. If I become a dual citizen, will I have to pay a ton of taxes? Also, which is better for lifestyle and pay?

1) No idea, but probably easier to do that than to get a spot in the US as a I/FMG.
2) Yes, you will be, in your words, "looked down upon". Technically, yes, you can still match competitive specialties, but statistics say no. Attending a school in Australia gives you odds that are about as good as if you had attended a Caribbean school instead. In fact, I actually think you would have a better chance matching in the US if you attended a Caribbean medical school instead of an Australian medical school.
3) Yes, both US MDs and DOs have full practice rights in Australia, but there may be concerns about difficulty in acquiring a license to do so. My understanding (a basic understanding, as I've only looked once out of curiosity some time ago) is that you really would only be able to get a license and practice in a place of relative medical need.
4) No idea on taxes. However, US physicians make some of the highest paychecks of any physicians in the world. Realistically, it doesn't really matter which (first-world) country you end up as a physician in as the standard of living will be high regardless.

Bottom line: if you want to practice in the US, you need to go to a school in the US.

 

[WOWM]

1) how difficult it is to get an intern year partially depends on which state you live in Australia. In Australia, matching isn't a national process, but a state level process. Internationals are at the very bottom of the pecking order for getting a position--citizens are guaranteed a internship, then any Australians IMGs get next dibs. Internationals get anything that's left over. In NSW, only about 1/3 of international grads of Australian med schools get placed. Additionally, international grads of Australian med schools are no longer guaranteed a work visa that will allow them to train in Australia. Visa approval is done on a case-by-case basis.
Specialist residencies are an entirely different process in Australia. After an intern year, a new grad first spends several years (3-5 is typical, but surgery can be longer) as a junior registrar on one of three pathways (hospitalist, general medicine or general surgery) before you can apply for a specialist training position. Specialist training positions are extremely competitive and generally out of reach for internationals.

2) Yes, you will be a IMG and will need to take the USMLEs, register with ECFMG and apply as a IMG. IMGs are strongly disadvantaged in the US Match.

3) In the past, the answer would be yes; however the rules changed 2 years ago and it has become much more difficult to get approval from AMC for medical licensing. If you haven't received a US board certification, you will be considered only for the generalist pathway and will be expected to repeat several years of clinical training (registrarship/residency) in Australia. If you have US BC plus attending experience, you can apply via the specialist pathway. To apply as a specialist, you must first have a job offer in Australia, then you apply to the Australian licensing board for your specialty to review your credentials. The review process can take up to a year. It can be done, but the process is cumbersome. The specialist pathways is designed for immigrants from Commonwealth countries and speciality boards seem to be less comfortable with granting US physicians full practice rights without requiring some Australian re-training.

4) If you are dual citizen, you will be required to file taxes every year in both the US and Australia. Australian tax rates are higher than those in the US and the tax structure is completely different. (There is no such thing as filing a joint tax return with a spouse, for example.) D says lifestyle is better in Australia where physicians by law cannot work more than 40 hours/week--even during residency. All physicians work for Medicare (national health service) and physician is a salaried position w/ no monetary incentives for physicians for ordering tests or hospitalizations. There is much less pressure in Australia for high put-through (patients-seen-per-hour). Salaries/physician income is significantly higher in the US.

 

[Med-Hopeful]

Thanks for the help!!

 

[Guessman]

I did my undergrad in Australia and medical school in US.

From my experience and some stories from friends back there, their medical schools seem to have relatively lower requirements on MCAT/GAMSAT (I had a friend from Indonesia who got in w/ MCAT 31 to USYD years ago), however the matriculation rates of international students are lower. Not clear if it changes recently. Regarding residency pathway, please refer to the above post.

If you choose to do undergrad in Australia and come back to US (like me), you will find yourself in a very disadvantageous position: your GPA will be recalculated and would be much lower than it's supposed to be (and it's very hard to get "high distinction" in class), some classes not recognized and need to be re-taken, which means another several years back to school and lot more money.

 

[LizzyM]

I did my undergrad in Australia and medical school in US.
<snip> some classes not recognized and need to be re-taken, which means another several years back to school and lot more money.

Please tell me more. It is my understanding that US med schools don't recognize foreign transcripts. Did you need to take 90 credits in the US to get over that hurdle?

 

[Guessman]

Please tell me more. It is my understanding that US med schools don't recognize foreign transcripts. Did you need to take 90 credits in the US to get over that hurdle?

I did take a post-bac course to compensate the low calculated GPA. The transcript needs to be accredited by a facility (WES, etc); in that case, it will be recognized.