Want to practice in another country

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GustavSwart

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I'm a first year (5yr MBChB course) medical student in South Africa. I know I worry most of the time way too much about the future, but there are many reasons people like me want to leave South Africa. Many of them politics, safety and racism related. So I do want to be able to get my close family out of a bad situation as well and I want my future family (future wife and children) to be safe and have a good live. But I also grew up in America (New York State) and I have grown up to enjoy the climate of the northern hemisphere, particularly lots of snow in the winter, and it is just my dream to live in a snowy country.

Now because language is going to be important in this, some background: I guess you can consider English my "main language". I am fluent in Afrikaans, I speak it with many family and friends. But growing up in America, I've always went to school and now medical school, in English, and I am noticeably better in English than Afrikaans.

This has convinced me that I would need to specialise (in EM) and subspecialise (in Critical Care) most likely in an English country like the USA, Canada, the UK, Ireland, New Zealand and Australia. Since studying in a language I did not grow up with, especially in a medical field will near to impossible.

Both America and Canada are also near to impossible for me to specialise in. Given I want to do EM, that is my passion, but I heard you need a "Standard Letter of Evaluation" to be considered for an EM residency. One that comes from apparently doing an EM rotation at an institution that provides an EM Residency. Not to mention the whole procedure for immigrating to America is a pain in the neck and they heavily, almost to an unfair degree, favour American medical graduates.

So if there is anyone that can tell me how it is possible for a foreign medical graduate to be accepted at an American EM or even EM-IM combined residency, please, please enlighten me. Or give me tips, or advice.

I also looked at Canada and what REALLY confused me is one site saying that if a foreign medical graduate wants to apply for a Canadian residency, then they should hold a Canadian permanent residence permit or Canadian citizenship...I do not exactly know how that is possibly if I am a foreign medical graduate, except if I needed to be born there or even live there doing another job for a few years before I can apply. Can someone who is from Canada or has done this please explain?? Is it at all possible for a foreign medical graduate to get into an EM residency in Canada.

If not Canada or America, I would have to go with UK, Ireland, New Zealand or Australia and I have already done some extensive research on immigrating to those countries as a doctor. And it seems that quite a few American medical students or doctors did not believe me on this but it is a known fact that other countries are easier to get in to than America or Canada.

Next question, one of my dreams is, especially if I have to specialise in a country like the UK to eventually move to another European, snowy country. Like Germany, Sweden or Switzerland. I especially favour Switzerland as it is essentially my favourite place on earth (I have travelled there with family when I was younger). The only thing stopping me is the language barrier. As I mentioned I already speak Afrikaans fluently, and it is a daughter language to Dutch so quite similar to an Germanic (and as I have experienced, Nordic) languages. So I have no doubt I will pick up German or even Swedish in no time to be at least level of A1 or A2. And I have quite a few years to practice and get up to the level even of B1 or B2. I know in Switzerland a B2 level Swiss-German is needed to practice in a German Canton. I am most certain I can reach that at least before the time comes that I want to immigrate.

But if there are in doctors currently working in Switzerland who are form Switzerland or not, who can answer some questions I have regarding language I would much appreciate that. You see even though I consider myself fluent in Afrikaans, English is still my main academic-professional language. Even talking to someone in Afrikaans about medicine, I have to switch into English especially concerning heavy jargon or explaining something well. So I worry about how good I will ever become at communicating with colleagues or patients on that level in a language I did not even grow up with. So my question is, in Switzerland is it acceptable to talk to my colleagues in English especially when it comes to medical jargon. How much medical English would a Swiss doctor know? And can I ask a patient if they understand and speak English if I want to talk to them about something particularly important or complex in a consultation? Or will that be seen as unprofessional and unacceptable?

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EM is not a pathway for Critical Care in the US. Usually, IM then fellowship in CC or Anesthesia then fellowship in CC, or Pulmonology then fellowship in CC.

I'm with you there wanting to see other places and it's difficult for you because if you ever plan on coming to the US, you will NOT be able to practice unless you train with a US residency program. EM will be a reasonable field for you to match if you do well on Step exams and interview well. It isn't unfair, in our view, to favor us US grads, but it is definitely favored, nonetheless. You can certainly go IM then do a fellowship in a specialty and wouldn't have much issue there.

There are few IM-EM residencies. You probably wouldn't need or even want to do one anyway. Just go for what you want. IM has spots every year that are taken by many foreign grads. Do well on Step exams and maybe do a few publications or take a job as a research assistant at an institution and you'll be able to match no problem. Basically surgery and radiology are going to be very tough but IM or EM isn't impossible, at all, with good scores.

I'm interested in practicing in Switzerland but it just seems impossible due to their strict immigration policies and being that I didn't train at a European med school.

Good luck.
 
EM is not a pathway for Critical Care in the US. Usually, IM then fellowship in CC or Anesthesia then fellowship in CC, or Pulmonology then fellowship in CC.

I'm with you there wanting to see other places and it's difficult for you because if you ever plan on coming to the US, you will NOT be able to practice unless you train with a US residency program. EM will be a reasonable field for you to match if you do well on Step exams and interview well. It isn't unfair, in our view, to favor us US grads, but it is definitely favored, nonetheless. You can certainly go IM then do a fellowship in a specialty and wouldn't have much issue there.

There are few IM-EM residencies. You probably wouldn't need or even want to do one anyway. Just go for what you want. IM has spots every year that are taken by many foreign grads. Do well on Step exams and maybe do a few publications or take a job as a research assistant at an institution and you'll be able to match no problem. Basically surgery and radiology are going to be very tough but IM or EM isn't impossible, at all, with good scores.

I'm interested in practicing in Switzerland but it just seems impossible due to their strict immigration policies and being that I didn't train at a European med school.

Good luck.

Not entirely true, EM can go on to crit care fellowships. Though I agree it isn't quite as common as IM or anesthesia. But it is a viable option.
 
EM is not a pathway for Critical Care in the US. Usually, IM then fellowship in CC or Anesthesia then fellowship in CC, or Pulmonology then fellowship in CC.

I'm with you there wanting to see other places and it's difficult for you because if you ever plan on coming to the US, you will NOT be able to practice unless you train with a US residency program. EM will be a reasonable field for you to match if you do well on Step exams and interview well. It isn't unfair, in our view, to favor us US grads, but it is definitely favored, nonetheless. You can certainly go IM then do a fellowship in a specialty and wouldn't have much issue there.

There are few IM-EM residencies. You probably wouldn't need or even want to do one anyway. Just go for what you want. IM has spots every year that are taken by many foreign grads. Do well on Step exams and maybe do a few publications or take a job as a research assistant at an institution and you'll be able to match no problem. Basically surgery and radiology are going to be very tough but IM or EM isn't impossible, at all, with good scores.

I'm interested in practicing in Switzerland but it just seems impossible due to their strict immigration policies and being that I didn't train at a European med school.

Good luck.
EM doctors can do surgical critical care, neuro critical care and medical critical care in the US. I think all pathways add 2 years to EM.

while EM-IM exists as a combo, you can do critical care as pure EM.
 
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