What other countries are US doctor friendly?

[snoozer]

Let's say I decide w/ all this healthcare crap and malpractice, that I want to practice medicine in another country after completing my MD and residency. What's a good place to go where I don't have to redo the residency? Maybe just take the boards over there? Anyone?

Just thinking bout it... cause I'm not going to stay in the US and provide care if I'm going to get sued AND taxed for it. It's not like I don't have enough debt already.

---

Members don't see this ad.

 

[dutchman]

New Zealand comes to mind. Honestly the growing BS in the American system is making me consider practicing in my homeland(netherlands) or in some other system where physicians are at least willing to protect themselves. BTW, if your residency programm is the same length as the one in Canada, I think you can can take their boards and practice there too.

 

[snoozer]

New Zealand comes to mind. Honestly the growing BS in the American system is making me consider practicing in my homeland(netherlands) or in some other system where physicians are at least willing to protect themselves. BTW, if your residency programm is the same length as the one in Canada, I think you can can take their boards and practice there too.

Hot d*mn, I'm moving to New Zealand or Canada, whatever.

 

[braluk]

Do you even need to a country's exam again to practice in their country? Ive read up on many students who go away during residency for training without having to take exams all over again. I dont know if the American MD is the gold standard but I can't imagine most countries out there would make you do your residency all over again- maybe their versoin of the boards so that you can get a license there. I heard Australia tends to be a great place to practice, as well as any of the westernized nations.

 

[78222]

New Zealand looks quite nice. Australia would be nice but their reimbursement for non-citizen physicians needs to be reworked before I would ever consider practicing there.

 

[deleted77919]

Hot d*mn, I'm moving to New Zealand or Canada, whatever.

Be careful . . . NZ doesn't automatically recognize US physician qualifications. Their residency system is based on the British model. So, say you are an EM physician. You completed a 3 year residency in the US. In NZ to be an EM physician you need to complete 2 years of general residency, then an additional 5 in emergency medicine specifically. Thus they only automatically recognize physicians who have undergone similar residency training (think UK and Australia). They will, however, examine individual circumstances and give credit for years of experience in the field, etc.

It's not nearly so hard just to do a year or two, but if you want to become a permenant resident and do it for the long haul it can be done (probably) but isn't as simple as just hoping on a plane and taking an exam.

Obviously I've been thinking about the same thing, I love the natural beauty of NZ but immigration restrictions are frusterating (as is the significantly lower pay). If you have a lot of medical school debt, the pay issue might prevent you from going. I was reading in an EM journal about EM in NZ and they quoted an average salary of NZ$140,000 a year, which is USD $95,000. On the other hand there's a lot less malpractice BS. It's all def a trade off.

 

[deleted77919]

I heard Australia tends to be a great place to practice, as well as any of the westernized nations.

As an OTD, an overseas trained doctor (yes, even US grad), the first thing you need to do is take (and pass) the AMC, which is the Aussie equivalent of the USMLE. Then you have to try to get them to recognize your US residency credentials, which may or may not happen depending on the specialty and years of practice. Then you need to meet immigration requirements, basically they need to consider your specialty as an area of shortage. Then if you meet all of these requirements you generally have to agree to practice in an area of need for 5 years in order to qualify for a medicare reimbursement number (which is basically a requirement unless you want to work for free), so forget living in Sydney, Brisbane, Melbourne, etc. These are general rules, and it is possible that exceptions can be made on an individual basis. It's much easier just to get a locum position for a year.

Having said all of this I still think Australia is a nice place.

It's also worthy to note the Oz has a fair number of OTD's so somebody is managing to get through all this. There traditionally hasn't been much interest by US physicians in immigrating to Oz because of lower pay compared with the US. However, this might change and regulations become more accomodating to US grads if more want to immigrate based on increased medmal headaches and lower reimbursements due to a socialization of medical care.

 

[Mayhem]

I think every country has some form of exam for foreign trained doctors. Medicine is regulated everywhere. Most times it's just a simple USMLE-like exam (some with a clinical skills component) but if the medical school is different or longer or if there's an abundance of doctors then it get's a bit harder to break in. And of course the nicer the place the harder to get in. So, Canada and AUS, doable but not so easy. Sudan and Iraq, turn up with a degree.

 

[OncoCaP]

As far as I know, the U.S. has the highest physician salaries in the Western world (and probably the world overall as well). Our salaries would need to come down quite a bit before the salaries in Australia or New Zealand are going to look attractive. What do physicians there make anyway? The equivalent of $80K maybe? Dutch physicians do no better. If they are so protective, what do they have to show for it ... nothing compared to U.S. physicians. It would seem really silly to dump a $200K wage in the U.S. for an $80K wage in Australia. Basically U.S. physicians have nowhere else to go. We need to be part of the political process here and do the best we can.

 

[NonTradMed]

I think most countries that are comparable to the US in terms of standard of living for doctors will require multiple hoops to jump through to become licensed physicians (just as foreign docs have to do the same here).

From what I can tell, most Western European countries plus Canada and Australia have a more socialized form of medicine than the US which has their own set of issues. I'm not sure it's a better environment in those countries to practice medicine than it is here. By trying to escape the medmal headaches, you may end up inheriting a new set of headaches.

Also, immigrating to another country is not as easy as moving to another state. The culture shocks, even in Westernized countries with a common culture, may take a long time to adjust to. Better to just switch to another career than move out of the country.

 

[dutchman]

As far as I know, the U.S. has the highest physician salaries in the Western world (and probably the world overall as well). Our salaries would need to come down quite a bit before the salaries in Australia or New Zealand are going to look attractive. What do physicians there make anyway? The equivalent of $80K maybe? Dutch physicians do no better. If they are so protective, what do they have to show for it ... nothing compared to U.S. physicians. It would seem really silly to dump a $200K wage in the U.S. for an $80K wage in Australia. Basically U.S. physicians have nowhere else to go. We need to be part of the political process here and do the best we can.

Primary care physicians in Holland earn more than their U.S counterparts. Money aside, how about the ability to practice medicine the way it really should be praciced. An OB/GYN in Holland is not constantly sweating in fear of lawsuits. Not to mention that those countries have stability in their healthcare system, something the U.S is no where close to having. BTW, they will never tax their doctors to provide Universal coverage.

 

[MWK]

Primary care physicians in Holland earn more than their U.S counterparts. Money aside, how about the ability to practice medicine the way it really should be praciced. An OB/GYN in Holland is not constantly sweating in fear of lawsuits. Not to mention that those countries have stability in their healthcare system, something the U.S is no where close to having. BTW, they will never tax their doctors to provide Universal coverage.

They might gross more but the Holland has notorious tax rates. 52% base income tax as well as 25% on your investments, 7% on for health care, etc.

Plus everything costs more over there.


Id take a chance on a few lawsuits to stay in America, take home 2x+ as much and have a MUCH MUCH lower cost of living.

 

[deleted77919]

They might gross more but the Holland has notorious tax rates. 52% base income tax as well as 25% on your investments, 7% on for health care, etc.

If you live in NYC and have a physicians income you fit in the highest tax bracket. This is subject to a federal, state, and city (yes, city) income tax. Totalling these results in very nearly a 50% tax rate on income. This does not include personal property tax, etc, etc.

The moral here, perhaps, is not to live in NYC.

My point is that taxes can be pretty high in the US as well, depending on location.

It is worthy to note that NH is the only state in the union without a general sales tax or income tax. Perhaps I will consider relocating there.

 

[Chulito]

It is worthy to note that NH is the only state in the union without a general sales tax or income tax.

Really? Where does the government of NH get its money?

 

[OncoCaP]

Primary care physicians in Holland earn more than their U.S counterparts. Money aside, how about the ability to practice medicine the way it really should be praciced. An OB/GYN in Holland is not constantly sweating in fear of lawsuits. Not to mention that those countries have stability in their healthcare system, something the U.S is no where close to having. BTW, they will never tax their doctors to provide Universal coverage.

From what I've read, Holland isn't a bad place to practice medicine. However, every place has some rough edges. For starters, most of us Americans would have to learn the language. Immigration isn't exactly troublefree either. Not everyone cares for the weather there. Cost of living can be very high as well (along with taxes). I'm not sure I would be too excited about Dutch justice either ... not exactly know for being "tough" on criminals. There are a lot of personal preference issues here, no doubt. For what it's worth, average pay for American physicians is still higher than for the Dutch (althought there are certainly cases where the Dutch system would compare very well).

 

[NonTradMed]

Primary care physicians in Holland earn more than their U.S counterparts. Money aside, how about the ability to practice medicine the way it really should be praciced. An OB/GYN in Holland is not constantly sweating in fear of lawsuits. Not to mention that those countries have stability in their healthcare system, something the U.S is no where close to having. BTW, they will never tax their doctors to provide Universal coverage.

You mentioned you had a dutch background and you seem to find the current US medical climate extremely distasteful....seems to me you should think about relocating to Holland to do your med school years. If the Netherlands are anything like the US, going to school there may make it easier to get licensed and eventually practice there than going to school here. And I really think if a person isn't happy with their future career at the start of it, their chances of being happy in it in the future will be rather slim.

 

[78222]

I'm personally considering NZ. For me it isn't really about the salary, money isn't so important to me so long as I pay off my loans and can do the things I want to do. I hope to do an elective rotation there 4th year to get a feel for it.

 

[sirus_virus]

Let's admit it, the only thing better about practicing in the U.S is the higher pay. Once that disappears(already happening), practicing medicine in the U.S will officialy become worthless, and the foreigners and midlevels can have this junk for all I care.

A lot of people will give up an extra 80K a year to practice in NewZealand's no-fault system. How about Germany? The lowest payed doctors in the world($64K)? What you guys don't know is that they don't work more than 32 hours a week and they don't have any liability overhead, so they actually earn as much as our primary care physicians per hour. Actually, the worst case of lack of continuity of care I have ever seen was in Germany when a doctor handed me over to another doctor within a span of 10 minutes because his shift was done.

 

[deleted77919]

Really? Where does the government of NH get its money?

New Hampshire has modest property taxes as well as a lumber and gravel tax (sort of random, leftovers from way back in the day) and they do tax earnings on dividends, there is an inheritance tax, a business profits tax, etc. However, all of these taxes are still relatively low. Basically NH is as libertarian as state governments go. Low taxes, and few extra services. The have schools. They build roads. That's about it.

See this website for more NH tax information. http://www.nh.gov/revenue/gti-rev.htm

 

[sirus_virus]

BTW, for those that like NZ

http://www.mcnz.org.nz/Registration...eddoctor/Beforeapplying/tabid/84/Default.aspx

For those that like Canada

http://www.medhunters.com/articles/licensingMDsCanada.html

 

[Miami_med]

Let's admit it, the only thing better about practicing in the U.S is the higher pay. Once that disappears(already happening), practicing medicine in the U.S will officialy become worthless, and the foreigners and midlevels can have this junk for all I care.

A lot of people will give up an extra 80K a year to practice in NewZealand's no-fault system. How about Germany? The lowest payed doctors in the world($64K)? What you guys don't know is that they don't work more than 32 hours a week and they don't have any liability overhead, so they actually earn as much as our primary care physicians per hour. Actually, the worst case of lack of continuity of care I have ever seen was in Germany when a doctor handed me over to another doctor within a span of 10 minutes because his shift was done.

This isn't entirely true.

Also, some of us like medicine enough to WANT to do it more than 32 hours a week, which is illegal in many countries in Europe.

Go to med school in the country you want to practice in. If that fails, try to do residency in that country. As a word of caution, the grass isn't always greener. Atleast in New Zealand, most jobs that American grads get are the leftovers undesired by the local grads. If you want to practice as a GP in the mountains, treating natives, with a government contract, this will probably work. Of course, you could just do the Indian Health Service and do exactly the same thing in the US for more money and a lower cost of living.

 

[Chulito]

New Hampshire has modest property taxes as well as a lumber and gravel tax (sort of random, leftovers from way back in the day) and they do tax earnings on dividends, there is an inheritance tax, a business profits tax, etc. However, all of these taxes are still relatively low. Basically NH is as libertarian as state governments go. Low taxes, and few extra services. The have schools. They build roads. That's about it.

See this website for more NH tax information. http://www.nh.gov/revenue/gti-rev.htm

Thanks, Dakota. That's really interesting. Can I assume that you are from there or live there now?

 

[NonTradMed]

Go to med school in the country you want to practice in. If that fails, try to do residency in that country. As a word of caution, the grass isn't always greener. Atleast in New Zealand, most jobs that American grads get are the leftovers undesired by the local grads. If you want to practice as a GP in the mountains, treating natives, with a government contract, this will probably work. Of course, you could just do the Indian Health Service and do exactly the same thing in the US for more money and a lower cost of living.

I think that's very true for anyone, in any country. Most countries will gear their medical education to the education of their respective countries. The best way to serve the local needs is to attend classes in the local country. Remember, a US medical education isn't a ticket to practicing in any country of your choice.

And yes, the grass always seems greener on the other side. When I was in IT, people kept on saying how 'lucky' I was to get out of IT and go into the 'lucrative' field of medicine.

 

[deleted77919]

Thanks, Dakota. That's really interesting. Can I assume that you are from there or live there now?

Neither, actually. I visited some, but the reason I know about NH is that I have an interest in things like state/local tax laws and cost of living because those both seriously impact quality of life.

 

[LJDHC05]

Neither, actually. I visited some, but the reason I know about NH is that I have an interest in things like state/local tax laws and cost of living because those both seriously impact quality of life.

The problem with NH is that there is ONE major medical center in the entire state. If you want to do anything academic/specialty related you're going to have to try to get a job at Dartmouth-Hitchcock (about 2 hours north of Boston on I-89) or one of its affiliated smaller community hospitals scattered throughout NH/VT.

The skiing/hiking/fishing is decent, the no/low-tax deal is sweet and the state liquor store right off of I-93 is nice and cheap. Two more drawbacks are that the public schools aren't super (relate it back to the low taxes) and the job market is kind of small (for spouses who aren't going to rest on their laurels, and a little more blue collar than white).

The locals also don't really like flatlander-yuppies invading their turf, though they're not as vehement about it as Vermonters. But what do you expect from a state with "Live Free or Die" stamped on the license plate. If you're from outside New England, you might be put off by the kind of gruff, self-reliant attitude that alot of us have (as compared to the mid-west/southern hospitality). For those of you who've never lived in New England, I'll also warn you that winter is pretty cold/unpredictable weather-wise. And then there's those darned Red Sox fans.

I'm from central MA, but I've spend a ton of time up in the hillier parts of New England...PM me if you've got questions.