Working as psychiatrist in US without US residency?

[DrIng]

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I'm curious, I saw a position advertised recently for a psychiatrist in private ractice which ststed that the position was J1 or H1B eligible. Are you able to work as a psychiatrist in the US without having done a US residency program?
(If for example you are the equivalent of board certified from say the UK or Australia?) Thanks for info.

 

[tennreb]

I'm curious, I saw a position advertised recently for a psychiatrist in private ractice which ststed that the position was J1 or H1B eligible. Are you able to work as a psychiatrist in the US without having done a US residency program?
(If for example you are the equivalent of board certified from say the UK or Australia?) Thanks for info.

No.

 

[DrIng]

I'm curious why the visa listing then? It's also interesting if you can't employ overseas trained psychiatrists how workforce shortages are made up? I know that in australia there are significant numbers of overseas trained (many UK, SA, Canada or US) who work in Australia in 'areas of need'. How is this issue of underserved areas addressed?

 

[BabyPsychDoc]

I'm curious why the visa listing then? It's also interesting if you can't employ overseas trained psychiatrists how workforce shortages are made up? I know that in australia there are significant numbers of overseas trained (many UK, SA, Canada or US) who work in Australia in 'areas of need'. How is this issue of underserved areas addressed?

As someone who once considered going through longer (but less stressful and better paid) UK residency in psych and then relocating and practising in the US, I can tell you what I have learnt.

1. you definitely cannot practise in the US as a psychiatrist without completing the US AGME-approved residency programme.

2. J1 and HB1 visas are there for those who completed their residency in the US but do not have a Green Card or US passport.

3. you could do residency on either J1 or H1B visa, depending on what your residency programme sponsors. Then, if you did your residency on J1, you will be required to leave the US for a minimum of 2 years. BUT, if you agree to work in "underserved areas", and got a job in one, then you could get a waiver for the 2years foreign residence requirement and stay in the US. This is how the issue of underserved areas is addressed.

Hope it helps.

 

[DrIng]

Thank you that explains it well.
I'm currently doing residency in Australia but have been curious about working in the states, hence the question.

For people who are interested I thought I'd share how the system works here (which also explains why I decided not to do a residency in the US).
During residency which is 5 years after a general internship (all Australian doctors do a year of a little bit of everything- medicine, surgery and EM) so it's 6 years post graduation. However, typically is a 50 hour week at worst.
During training we get paid a basic wage for the 40 hours a week that are standard (for a PGY2 this would be about $65,000) and then overtime at roughly time and a half so $60-$80p/h for overtime. When we graduate you can start a private rpactice, in most areas you can fill your books quickly as there is a 2-3 month wait to see a private psychiatatrist. The standard hourly rate for outpatient psychiatry is $265p/h (of which the government will rebate to the patient $130 and their insurance will mostly cover the rest) or you can take a job in the public health care system and get paid around $130K upwards first year out. (Did I mention that most Australian doctors graduate from medical school with a debt of at msot around $30,000 or so...)
Oh, and the Australian system does allow psychiatrist trained overseas to work here without doing our training program, as long as you work in "an area of need" (which is basically everywhere...) Just in case anyone wants a well paid holiday to Australia.

 

[Caffeine]

I think that all you need to practice any kind of medicine is just a medical license. If you treat mental disorders without specialized training in mental disorders, you are opening yourself to a lot of liability if you are sued, but I think you are legally allowed to practice. Maybe you can't call yourself a "psychiatrist", but I imagine you might be able to have a sign that says "specializing in the treatment of mental disorders". I moonlight in a job taking care of psychiatric inpatients, but I haven't completed psychiatric residency yet.

 

[BabyPsychDoc]

I think that all you need to practice any kind of medicine is just a medical license. If you treat mental disorders without specialized training in mental disorders, you are opening yourself to a lot of liability if you are sued, but I think you are legally allowed to practice. Maybe you can't call yourself a "psychiatrist", but I imagine you might be able to have a sign that says "specializing in the treatment of mental disorders". I moonlight in a job taking care of psychiatric inpatients, but I haven't completed psychiatric residency yet.

Of course, you are legally allowed to practise if you have a medical licence. no, you do not to complete any kind of residency to do that - just an internship year, and off you go. But... who would ever cover your malpractice insurance? What private patient would want to see "a specialist in mental disorders"? and what state-funded facility would hire you?

Moonlighting as a resident is a completely separate issue, and I am not sure why you are bringing it up here. You do not mention in your post what your moonlighting job entails and what year of residency you are in.

 

[Danica]

Of course, you are legally allowed to practise if you have a medical licence. no, you do not to complete any kind of residency to do that - just an internship year, and off you go. But... who would ever cover your malpractice insurance? What private patient would want to see "a specialist in mental disorders"? and what state-funded facility would hire you?

The OP is obviously a Foreign Medical Graduate and as everyone should know, different strokes for different folks.

This option "to be able to practice with one year of internship" is no longer available to FMG's, but is still an option for AMG's.

All FMG's must complete a residency in order to be fully licensed and practice medicine in the US.

 

[chocomorsel]

Thank you that explains it well.
I'm currently doing residency in Australia but have been curious about working in the states, hence the question.

For people who are interested I thought I'd share how the system works here (which also explains why I decided not to do a residency in the US).
During residency which is 5 years after a general internship (all Australian doctors do a year of a little bit of everything- medicine, surgery and EM) so it's 6 years post graduation. However, typically is a 50 hour week at worst.
During training we get paid a basic wage for the 40 hours a week that are standard (for a PGY2 this would be about $65,000) and then overtime at roughly time and a half so $60-$80p/h for overtime. When we graduate you can start a private rpactice, in most areas you can fill your books quickly as there is a 2-3 month wait to see a private psychiatatrist. The standard hourly rate for outpatient psychiatry is $265p/h (of which the government will rebate to the patient $130 and their insurance will mostly cover the rest) or you can take a job in the public health care system and get paid around $130K upwards first year out. (Did I mention that most Australian doctors graduate from medical school with a debt of at msot around $30,000 or so...)
Oh, and the Australian system does allow psychiatrist trained overseas to work here without doing our training program, as long as you work in "an area of need" (which is basically everywhere...) Just in case anyone wants a well paid holiday to Australia.

This sounds darn sweet. So if you guys are making comperably what psych docs make here, why the heck is medschool soo damn expensive for us here in the U.S? Damn, I need a vacation. Does the government help pay for your medical education over there? I need to get the heck outta here.

 

[BabyPsychDoc]

All FMG's must complete a residency in order to be fully licensed and practice medicine in the US.

Technically, you are wrong. you do not need to complete the residency to be fully licensed and practise medicine in the US, even as an FMG. You do need to complete a certain number of years of PGME, ie residency. Some states allow you to get a licence after only one year; most require at least 2 or 3. Once you do get a licence, you can legally practice any medicine anywhere in the US... whether it's worth it without completing a residency programme, is up to you to decide...

 

[Danica]

Technically, you are wrong. you do not need to complete the residency to be fully licensed and practise medicine in the US, even as an FMG. ...

Well you are entitled to voice your opinion!

However, it's wrong.
ALL FMG's MUST complete residency to be FULLY licensed.
I'm not talking about those who have been here in the country practicing for 10, 15, 25 years.
I'm talking about IMG's who entered residency the last 4 years.

 

[BabyPsychDoc]

Well you are entitled to voice your opinion!

However, it's wrong.
ALL FMG's MUST complete residency to be FULLY licensed.
I'm not talking about those who have been here in the country practicing for 10, 15, 25 years.
I'm talking about IMG's who entered residency the last 4 years.

Boy, it is dangerous to respond to Danica's posts... I should have learnt from Adam_K's experience. 🙄

Here is a link to FSMB website for general perusal:
http://www.fsmb.org/usmle_eliinitial.html

Just to make sure, I clicked on a few random links to the individual state's medical boards. Minnesota's medical board, for example, only requires 2 year of PGME; same for say, Wyoming... Alaska, on the other hand, needs three years of PGME in order to grant you your initial medical licence. South Dakota wants you to complete your residency.

Have a good day.

 

[DrIng]

It's off the topic but in answer to your question...I think med school is cheaper for Australian citizens in Australia because all our training takes places in public hospital systems and we have a really good socialist health care system (with a private system as an adjuvant). I heard someone say that the cost of our education is something like $300,000 but obvious the government pays for a lot of it. (The problem is that our universities charge a lot more to foreign nationals who want to study here- about $30K+ pa). So that's why medical school is comparatively cheap. Plus we have a system of 'welfare' which means that most students get a living allowance while studying (it's only about $200 p.w. but it means you don't need to borrow money for living expenses.) I think another factor is that malpractice suits are rare which makes the costs of everything less...

Thanks for all the responses...