The Student Room Group

Medicine in UK, working in USA

I was wondering if anyone could tell me anything about the following.. I'm currently doing AS levels (applying to a UK university in September). I want to study medicine in the UK, but my dream is to work as a Doctor in the USA. How possible is this? Would I be best moving to the USA straight after graduation, or after practising medicine in the UK for a while? Any advice or links to helpful websites would be greatly appreciated, thank you!!

PS: I want to go into the area of Paediatrics, if that would affect anything.
Reply 1
I'd say it's possible, a lot of people who want to become doctors do their education here in the UK, and then go to America once they've graduated because there is so much money to be made for doctors and healthcare experts in America. Idk about paramedics, if it'd be good or not though.
You won't be able to leave the country straight after graduation anymore, I'm afraid you will have to work in the NHS for 5 years or more after graduating from now on.
Original post by WhoDaresWins
You won't be able to leave the country straight after graduation anymore, I'm afraid you will have to work in the NHS for 5 years or more after graduating from now on.


wait what, since when, is that a rule now??
Original post by medicapplicant
wait what, since when, is that a rule now??


We'll find out how long it is after June 2nd:
https://www.gov.uk/government/consultations/expanding-undergraduate-medical-education

Will most likely be 5 years.
Reply 5
Original post by WhoDaresWins
You won't be able to leave the country straight after graduation anymore, I'm afraid you will have to work in the NHS for 5 years or more after graduating from now on.


Thank you, this is so annoying, we will have paid thousands and thousands for our OWN education and yet the government can still control what happens with our lives :smile::smile::smile::smile:
Reply 6
From what I've heard it's actually very difficult to go from being a doctor here to working in the US. For one they are actually prejudiced against IMGs (International Medical Graduates i.e. non US medical graduates) and require you to pass several exams in order to be able to practice let alone get a job. The training is also structured very differently and relies on you getting a 'residency' similar to foundation/junior doctor post in the UK. These can be very competitive to get onto and from what I hear tend to be biased towards American candidates. Plus whilst US doctors do get paid more they have to pay a lot more in indemnity insurance in case they are sued and generally work longer hours than UK doctors. Sorry to burst your bubble, I've looked into myself and from what I've seen I'd rather not go to the US.
Original post by jazz_xox_
Thank you, this is so annoying, we will have paid thousands and thousands for our OWN education and yet the government can still control what happens with our lives :smile::smile::smile::smile:


The thing is it costs £230000 to train a doctor and they want a return on investment for the tax payer as they pay for the clinical placements etc
It was extremely common before, which is why the aforementioned law was passed. You would've had to do the USMLE to apply for residency positions through the Match, but this isn't relevant with this new change.

For peds I imagine it wouldn't be too hard getting a position (if you've done 5 years of training in the UK as above, more likely a fellowship which would be slightly more selective otherwise) as it's a somewhat undersubscribed specialty as I understand, in a hospital. No idea how difficult it would be in a private clinic...however if you're willing to work in a more GP/family medicine oriented manner in a rural practice area there are many opportunities (NB rural here could range from central Maine to Hawai'i so...a fair bit of variety. You'll be far from any cities though, you can bet on that).
Original post by jazz_xox_
I was wondering if anyone could tell me anything about the following.. I'm currently doing AS levels (applying to a UK university in September). I want to study medicine in the UK, but my dream is to work as a Doctor in the USA. How possible is this? Would I be best moving to the USA straight after graduation, or after practising medicine in the UK for a while? Any advice or links to helpful websites would be greatly appreciated, thank you!!

PS: I want to go into the area of Paediatrics, if that would affect anything.


You can do this but it is tough. You need to take the US exams alongside your UK ones. This is not trivial as the UK exams tend to be theory, then clinical, whereas the US ones are combined from the beginning and tend to have heavier science content than many UK unis. Its also not cheap, and failure rates are high. I would advise trying to speak to someone who has done this to get their advice if at all possible.

You would also be allocated the worst jobs in the US as you are an 'international medical graduate', so you'd have to be willing to work in deprived or rural areas for at least a few years.

Also, I'd lose the idea of you already knowing your speciality. The vast majority change their minds, especially for paeds!

The new rule discussed above has not gone through yet. It might not apply to you, or the repayment terms may be favourable, its hard to tell.

Original post by WhoDaresWins
The thing is it costs £230000 to train a doctor


That's propaganda and a lie. The real cost is difficult to ascertain, as the NHS makes a huge profit on the money it is given to train students, but is probably closer to half that.
(edited 6 years ago)
Reply 10
You would need to do the USMLEs along side medical school exams if you want to go to USA. I'm 3rd year and two of my friends have just done their USMLE 1. Now they are working towards USMLE 2.

Plus the whole thing about making you stay in NHS once graduated is highly unlikely to happen - they might make it 2 years but that would be fair enough as you will be doing F1 F2 and you can only pick area you want at end of F2 year. You are also only a provisional doctor for F1 year.

JH also tried to force a contract on junior doctors which he then said he didn't and removed the contract as he suddenly realised the NHS can't cope without the ground level staff. Also considering that scotland and wales were not enforcing the contract anyway (so only england affected - NI can't make up its mind as usual lol) the contract was never likely to work. I think this will be the same pattern for a forced contract tbh.
Original post by ahorey

JH also tried to force a contract on junior doctors which he then said he didn't and removed the contract


If that's the case, why am I still being forced into signing that festering dog turd of a contract in August? :angry:
Reply 12
Original post by Etomidate
If that's the case, why am I still being forced into signing that festering dog turd of a contract in August? :angry:


Will you be working in England? He did say that it was up to individual trusts, but I thought majority of trusts had not agreed to the contract.

I thought the BMA had stopped the contract from happening? Wales and Scotland aren't having it, NI isn't either.

Its just such a big mess atm.
For example, I'm in NI. 30% of GPs will be retiring next year, with no one to replace them. This year 2 massive GP practices have closed, one leaving 5000 people without a GP and all other practices have closed to new patients as they are already at capacity. Guess how many GPs are trained every year in NI?

80 max.

what a great health leader JH is.
Original post by ahorey
Will you be working in England? He did say that it was up to individual trusts, but I thought majority of trusts had not agreed to the contract.

I thought the BMA had stopped the contract from happening? Wales and Scotland aren't having it, NI isn't either.

Its just such a big mess atm.
For example, I'm in NI. 30% of GPs will be retiring next year, with no one to replace them. This year 2 massive GP practices have closed, one leaving 5000 people without a GP and all other practices have closed to new patients as they are already at capacity. Guess how many GPs are trained every year in NI?

80 max.

what a great health leader JH is.


Every trust in England is implementing the contract on a rolling basis if they haven't already. They were threatened with withdrawal of funding from HEE if they didn't.

The BMA folded like a wet towel and abandoned an entire generation of junior doctors despite an overwhelming membership mandate to escalate industrial action.
Reply 14
Original post by Etomidate
Every trust in England is implementing the contract on a rolling basis if they haven't already. They were threatened with withdrawal of funding from HEE if they didn't.

The BMA folded like a wet towel and abandoned an entire generation of junior doctors despite an overwhelming membership mandate to escalate industrial action.


That sucks.

How come the welsh/scotland trusts haven't had HEE funding removed?
We were informed by our BMA person here that the contract had been removed, and that the next effort to destroy junior doctors was to enforce an NHS conscription lol.

Looks like I'll be avoiding England for F1 posts :P
Original post by jazz_xox_
I was wondering if anyone could tell me anything about the following.. I'm currently doing AS levels (applying to a UK university in September). I want to study medicine in the UK, but my dream is to work as a Doctor in the USA. How possible is this? Would I be best moving to the USA straight after graduation, or after practising medicine in the UK for a while? Any advice or links to helpful websites would be greatly appreciated, thank you!!

PS: I want to go into the area of Paediatrics, if that would affect anything.


Hi!

Bit late to this thread but I thought I would add my two cents. I am a UK medical school graduate who moved to the US after finishing F1/F2 a few years ago. I'm almost done with my residency training here and am hopefully heading to fellowship next.
Although it worked out in the end, it was a really hard journey to get here and looking back on it now, there were certainly things I wish I had know. In general, getting in to the US medical system requires you to enter during either residency (after medical school) or for fellowship. Both these processes require you to apply through a centralized process called The Match. Here are the outcomes for IMGs (international medical graduates) for the 2016 residency Match.

I applied to the residency match and my general advice for anyone looking to do the same would be:
1) Go to medical school in the US if at all possible. Obviously, US medical school graduates are at a far greater advantage than IMGs.

For those of us for whom number 1 isn't an option but still have the privilege to go to medical school in the UK:
2) Do really well at medical school. First and foremost, you are there to learn and become a good doctor, wherever you end up practicing. Also, remember, your med school transcript will be sent with your application to residency programs, as will a "Dean's letter" and they will ask the Dean to specify what percentile of your class you rank in.

3) Do the USMLEs while you are in medical school. The content is slightly different but correlates fairly well with what we learn in medical school and it is so much easier to study for the USMLE while you are studying for your own exams. (I did 1 of the USMLEs during med school and the other one while I was an FY1 - there was no comparison, definitely should have done them all at med school)

4) Do REALLY well on the USMLEs. Residency programs place a huge amount of weight on these. You cannot retake them unless you fail (and you don't want that because it will show up on your transcript).

5) Get US clinical experience while in medical school (as an elective if possible). It is pretty much impossible to get any hands on clinical experience once you are out of medical school because you will not be covered by insurance so you'll have to do "observerships" instead, which really don't offer the same experience or contact with faculty and patients.

6) Get letters of recommendation while doing your US clinical placement. Get as many as possible. You will only be allowed to submit a max of 4 for residensy applications but US rec letters carry far more weight than non-US letters (unless you get a letter from a complete superstar in the field who transcends borders).

To a certain extent, you have to be very focussed on your goal of moving to the US. I remember my friends at med school had so much more free time than I did because I would also be studying for a whole second set of exams and focussing on trying to make contacts in the US to arrange electives, or getting up early to Skype with someone in a US time zone to organize meetings etc.
In my opinion, it was worth it. I love living and working here and I am so grateful that it worked out, it definitely takes hard work and dedication but also a great deal of luck and being in the right place at the right time to grab whatever opportunities come up.
Original post by MightyMousey
Hi!

Bit late to this thread but I thought I would add my two cents. I am a UK medical school graduate who moved to the US after finishing F1/F2 a few years ago. I'm almost done with my residency training here and am hopefully heading to fellowship next.
Although it worked out in the end, it was a really hard journey to get here and looking back on it now, there were certainly things I wish I had know. In general, getting in to the US medical system requires you to enter during either residency (after medical school) or for fellowship. Both these processes require you to apply through a centralized process called The Match. Here are the outcomes for IMGs (international medical graduates) for the 2016 residency Match.

I applied to the residency match and my general advice for anyone looking to do the same would be:
1) Go to medical school in the US if at all possible. Obviously, US medical school graduates are at a far greater advantage than IMGs.

For those of us for whom number 1 isn't an option but still have the privilege to go to medical school in the UK:
2) Do really well at medical school. First and foremost, you are there to learn and become a good doctor, wherever you end up practicing. Also, remember, your med school transcript will be sent with your application to residency programs, as will a "Dean's letter" and they will ask the Dean to specify what percentile of your class you rank in.

3) Do the USMLEs while you are in medical school. The content is slightly different but correlates fairly well with what we learn in medical school and it is so much easier to study for the USMLE while you are studying for your own exams. (I did 1 of the USMLEs during med school and the other one while I was an FY1 - there was no comparison, definitely should have done them all at med school)

4) Do REALLY well on the USMLEs. Residency programs place a huge amount of weight on these. You cannot retake them unless you fail (and you don't want that because it will show up on your transcript).

5) Get US clinical experience while in medical school (as an elective if possible). It is pretty much impossible to get any hands on clinical experience once you are out of medical school because you will not be covered by insurance so you'll have to do "observerships" instead, which really don't offer the same experience or contact with faculty and patients.

6) Get letters of recommendation while doing your US clinical placement. Get as many as possible. You will only be allowed to submit a max of 4 for residensy applications but US rec letters carry far more weight than non-US letters (unless you get a letter from a complete superstar in the field who transcends borders).

To a certain extent, you have to be very focussed on your goal of moving to the US. I remember my friends at med school had so much more free time than I did because I would also be studying for a whole second set of exams and focussing on trying to make contacts in the US to arrange electives, or getting up early to Skype with someone in a US time zone to organize meetings etc.
In my opinion, it was worth it. I love living and working here and I am so grateful that it worked out, it definitely takes hard work and dedication but also a great deal of luck and being in the right place at the right time to grab whatever opportunities come up.


Thanks for the very useful insight.

Can i ask: did you get the residency program you wanted? Or did you end up in the middle of nowhere doing a job no one else wanted (if the two are different lol)?
Original post by WhoDaresWins
We'll find out how long it is after June 2nd:
https://www.gov.uk/government/consultations/expanding-undergraduate-medical-education

Will most likely be 5 years.


Just reading through that .gov document and it's worrying how leading the questions are and how strife with errors it is.

It's another example of "this is what we want to do and we'll put it up for independent evaluation to appease the masses but we don't actually care; we'll just go ahead and do it anyway lol because we monopolise health in this country".

(If the junior doctor contracts showed us anything, it's that the government can do whatever the hell they like and the public are powerless to stop them as the government controls healthcare of the country).

They state multiple times throughout it's "230,000" to train a medical student - which has been proven to be false.
Source: https://fullfact.org/health/cost-training-doctor/

And go to the section 4 - Return of Service Agreement; and see how leading all the questions are. And one statement they make in this section regarding having doctors work for a continuous period of time post-training is:

Spoiler


This is not comparable as the army medics get paid ON TOP of the government bursary which is why they are fixed to the army for a duration.

They then go onto say that if you left "early" (meaning less than say 5 years after graduating, to another country) you'd have to pay MORE on top of the normal repayments! Now I'm not saying that training a medic costs the government the same as a student studying engineering (medics do cost a bit) but surely the engineer's course is still worth more than £9k/year which the government fronts but never asks back for past the normal repayments?

This seems like one rule for medics and another for other courses...

This also isn't going to do anything to attract good quality applicants to the field, which is an ironic thought considering how half the document is about shortages filling posts in specialities in medicine in the UK.

It appears like the government can't afford to pay competitive wages for doctors and so instead are locking them into the system so they can't leave to do the same job for a better wage elsewhere (which you can't blame them for doing...).

/rant

Edit: sorry this is wildly off topic, just got a bit triggered by the document. I can make a new thread for this haha.
(edited 6 years ago)
Original post by nexttime
Thanks for the very useful insight.

Can i ask: did you get the residency program you wanted? Or did you end up in the middle of nowhere doing a job no one else wanted (if the two are different lol)?


I wanted to go to an academic, university-based program and I was initially very naive and didn't realize how hard that would be. Luckily, I landed a research position for a couple of years and managed to publish some papers so when I did finally apply for residency, I was a more suitable candidate for the kind of program I wanted. I am currently in exactly the kind of residency I had hoped for and I honestly could not be happier with the program.
Still involved a huge amount of luck though!
The £230,000 figure is nonsense.

It remains to be seen what the "return of service" will be. Frankly, even if it is 5 years, you could complete that and a residency in the United States in about the same time as it takes to train in the UK. My guess is that it will be something a little more palatable, e.g. 2 or 4 years. This will probably become more stringent over time as the government learns the hard way that medics love a target and will be actively planning their exit to coincide with whatever threshold is set by the DoH.

If you can buy yourself out of the return of service for any reasonable amount (I've known military medics buy themselves out of their commitment for around £16,000, which is much less than they were paid) then that might be worth considering, even if it means a loan. Most US doctors have about $500,000 worth of debt and their system is set up to compensate them accordingly.

There's some very good advice from MightyMousey above but I would add that it might be worth going to the US for a research year, particularly if the UK return of service is short and/or can be circumvented. A motivated medic can be a strong candidate for Kennedy, Knox, and Fulbright Scholarships. This can mean a fun year, some clinical observerships (opportunities to gain US letters of recommendation) and being in the US for residency interviews. Applicants to US residency programmes seem to have to fly all over the US at relatively short notice as programmes shortlist lots of candidates and each hold their own local selection processes. Most UK universities will also have research/experience funds available to students, which you could use to fund a number of "electives" in the US, e.g. during summer vacations.

Training in the UK followed by work in the US will always be possible regardless of the obstacles that appear along the way. It will massively help your cause if you plan far ahead.