AdamskiUK
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Hi guys,

So I was speaking with a fellow applicant who also has offers under his belt earlier on. He has a sibling who is currently studying at a London medical school and he was under a clear impression, from his sister's experience whilst doing clinical training, that many doctors who were qualifying there intended to move abroad after receiving training here.

I was wondering if that's a general trend which is increasing/fluctuating within the UK - are well-trained doctors moving to places like the US where pay can be more rewarding, taxes are less and private healthcare ensures that they will always be able to continue doing the job they love with flexible times and rates?

It's strange to me because I didn't think it was that common for UK graduates to move away because of the pretty decent job security and benefits the NHS brings us. Also, how much further training do you need when you go to places such as the States? I wouldn't discount moving abroad if (provided I actually get the grades this year) it gives me better prospects and/or better chances to develop my skills.

Perhaps my friend was exaggerating about the numbers who intend to move away, or perhaps those same people decide against it once they hit FY1.
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AnonymousPenguin
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According to the FT up to a third of F2s disappear from the system, presumably many of them move abroad. For Australia/NZ there is no additional exams to take, although there are a few hurdles. For the US you have to take the USMLEs and do a residency in the US. There are also a few visa-related hurdles.
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Helenia
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(Original post by AnonymousPenguin)
According to the FT up to a third of F2s disappear from the system, presumably many of them move abroad. For Australia/NZ there is no additional exams to take, although there are a few hurdles. For the US you have to take the USMLEs and do a residency in the US. There are also a few visa-related hurdles.
I think those numbers are fairly flawed tbh, and I certainly don't think that all of that third leave the UK/training/medicine permanently, which is what it's been interpreted as. It just means that 1/3 of people finishing F2 don't go directly into specialist training. Quite a few go to Aus/NZ for a year, I don't know many who've permanently emigrated at that stage. Then there are others like me who stay in the UK but go into a non-training post for whatever reason, and enter training a year later. There may be a few international students who go back to their countries of origin having completed the foundation programme, but I don't think it's quite the mass exodus some people have in mind!
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AdamskiUK
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(Original post by Helenia)
I think those numbers are fairly flawed tbh, and I certainly don't think that all of that third leave the UK/training/medicine permanently, which is what it's been interpreted as. It just means that 1/3 of people finishing F2 don't go directly into specialist training. Quite a few go to Aus/NZ for a year, I don't know many who've permanently emigrated at that stage. Then there are others like me who stay in the UK but go into a non-training post for whatever reason, and enter training a year later. There may be a few international students who go back to their countries of origin having completed the foundation programme, but I don't think it's quite the mass exodus some people have in mind!
Yeah, I can see how that figure can be misinterpreted. Would you, personally, consider moving away permanently from the English/UK medical system for any reasons?


(Original post by AnonymousPenguin)
According to the FT up to a third of F2s disappear from the system, presumably many of them move abroad. For Australia/NZ there is no additional exams to take, although there are a few hurdles. For the US you have to take the USMLEs and do a residency in the US. There are also a few visa-related hurdles.
Good info, thanks!

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Helenia
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(Original post by AdamskiUK)
Yeah, I can see how that figure can be misinterpreted. Would you, personally, consider moving away permanently from the English/UK medical system for any reasons?
At the moment, no. I like the UK, I like my job and I don't want to move to the other side of the world away from all my family and friends. I can see how others in other specialties and/or who have more wanderlust than me are less satisfied though.
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AnonymousPenguin
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(Original post by Helenia)
I think those numbers are fairly flawed tbh, and I certainly don't think that all of that third leave the UK/training/medicine permanently, which is what it's been interpreted as. It just means that 1/3 of people finishing F2 don't go directly into specialist training. Quite a few go to Aus/NZ for a year, I don't know many who've permanently emigrated at that stage. Then there are others like me who stay in the UK but go into a non-training post for whatever reason, and enter training a year later. There may be a few international students who go back to their countries of origin having completed the foundation programme, but I don't think it's quite the mass exodus some people have in mind!
The 1/3 leaving figure does not include people who took LAT/LAS posts. It's based on an foundation exit survey I believe.

Regardless, there's definitely fewer people than one third permanently emigrating, but I think it's fair to say there is significant brain drain. Every time I start a new rotation someone is going to Australia soon-ish in the department. The news that in the last 5 (?) years, 2-years worth of EM registrars moved to Australia is equally quite telling.
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AdamskiUK
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(Original post by AnonymousPenguin)
The news that in the last 5 (?) years, 2-years worth of EM registrars moved to Australia is equally quite telling.

So your implication would be that the Aussie system favours the EM doctors in terms of pay and benefits?

Or is it just because of a preconception/belief that you get the chance to experience a different culture (with a better climate ) at the same rate of pay/benefits that doctors decide to move there?

I know of one girl who's currently doing a year in NZ before starting proper work here and she says she loves it - I'll be sure to ask her for her reasoning.

I know it's a long way off for me but it's still something I want to consider sooner rather than later.
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AnonymousPenguin
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(Original post by AdamskiUK)
So your implication would be that the Aussie system favours the EM doctors in terms of pay and benefits?

Or is it just because of a preconception/belief that you get the chance to experience a different culture (with a better climate ) at the same rate of pay/benefits that doctors decide to move there?

I know of one girl who's currently doing a year in NZ before starting proper work here and she says she loves it - I'll be sure to ask her for her reasoning.

I know it's a long way off for me but it's still something I want to consider sooner rather than later.
1. I am not sure if this is true, but I have been told (hearsay) that EM doctors essentially have a protected 43h work week in Aus.
2. The pay is better and over-time is paid per hour (no banding).
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Spencer Wells
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(Original post by AnonymousPenguin)
1. I am not sure if this is true, but I have been told (hearsay) that EM doctors essentially have a protected 43h work week in Aus.
2. The pay is better and over-time is paid per hour (no banding).
1. It was 36 hours when I did it.
2. Yep. And you were encouraged to claim for every little bit of it.
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AcquaLife
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Also, in terms of moving to the USA, most residencies probably wont accept you. Unless you are a outstanding candidate. I don't know about the UK, but in the USA the amount of medical students is controlled by the American Medical Association. Basically, they want to have specific number of medical students because there are only a specific number of residencies. Essentially, they don't want to accept someone from another countries' medical program and take a spot away from a USA medical student.
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Kinkerz
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With this situation it might become a more pronounced issue in the years to come.
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skotch
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(Original post by AnonymousPenguin)
1. I am not sure if this is true, but I have been told (hearsay) that EM doctors essentially have a protected 43h work week in Aus.
2. The pay is better and over-time is paid per hour (no banding).
Yes, this is pretty much correct. Also in Australia the working environment is a whole lot less stressful (more consultants to junior doctors ratio and more staff in general), the EDs are much better run too with more support systems available, plus the weather is a whole lot better.

I'll post up some bbc articles about this when I get home.

I believe Canada is a similar situation to Australia in that the working environment for EDs is a lot better.

I fully intend to spend some time in Australia when I qualify and (possibly) go into EM.

Edit:
BBC article 1 - http://www.bbc.co.uk/news/health-24396884
BBC article 2 - http://www.bbc.co.uk/news/health-24432072
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skotch
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Also, I read a BMJ article about what happens to foundation doctors that don't begin specialty training straight away an the reasons for why they decide not to continue straight into CMT/ACCS/GP. Will post it when I find it.

Edit: BMJ article - http://careers.bmj.com/careers/advic...ml?id=20015263
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raveen789
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(Original post by AdamskiUK)
Hi guys,

So I was speaking with a fellow applicant who also has offers under his belt earlier on. He has a sibling who is currently studying at a London medical school and he was under a clear impression, from his sister's experience whilst doing clinical training, that many doctors who were qualifying there intended to move abroad after receiving training here.

I was wondering if that's a general trend which is increasing/fluctuating within the UK - are well-trained doctors moving to places like the US where pay can be more rewarding, taxes are less and private healthcare ensures that they will always be able to continue doing the job they love with flexible times and rates?

It's strange to me because I didn't think it was that common for UK graduates to move away because of the pretty decent job security and benefits the NHS brings us. Also, how much further training do you need when you go to places such as the States? I wouldn't discount moving abroad if (provided I actually get the grades this year) it gives me better prospects and/or better chances to develop my skills.

Perhaps my friend was exaggerating about the numbers who intend to move away, or perhaps those same people decide against it once they hit FY1.
For the states you have to do the USMLE and do pretty well in it if you are considering a competitive career like surgery. They tend to reserve their residency places to their own qualified doctors. Residency = Speciality training. Over there it matters which medical school you go to as well, so a person from Harvard/John Hopkins is instantly winning.

The USMLE is supposed to be harder than finals or on par with finals depending on what medical school you go to. You have to do a written paper (step 1) then do some clinical exam over there (step 2) to get board certified. Apparently you need letters of recommendation from already practising doctors over there, so you need to ideally do your elective there. Their system has different start times to our foundation years so you might have to risk it and leave like middle of foundation training. Its not easy to go there and if you are a consultant here it does not automatically mean you can be an attending there, they may still make you repeat training.

I got all this information when I was reading advice given from another TSR Doctor who passed the USMLE and got board certified. His name was Digitalis but I think hes inactive now!

(you probably know im just an applicant so just conveying what he wrote! )
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Kinkerz
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(Original post by raveen789)
The USMLE is supposed to be harder than finals or on par with finals depending on what medical school you go to. You have to do a written paper (step 1) then do some clinical exam over there (step 2) to get board certified.
This is less than accurate. In fact almost every single thing you've said here is inaccurate.

Step 1 is a medical science paper, usually taken after year 2 of 4 in the USA. It tests pre-clinical knowledge. Step 2 has two components, a written part and a practical part and is usually taken during the final year of medical school in the USA. Then there's step 3, which is sat once graduated and practicing as a resident.

Board certification isn't something you get from the USMLE. It is pertinent further down the career line.
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lucas13
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london is probably more international than most and so its probably not an accurate representation of the uk as a whole
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raveen789
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(Original post by Kinkerz)
This is less than accurate. In fact almost every single thing you've said here is inaccurate.

Step 1 is a medical science paper, usually taken after year 2 of 4 in the USA. It tests pre-clinical knowledge. Step 2 has two components, a written part and a practical part and is usually taken during the final year of medical school in the USA. Then there's step 3, which is sat once graduated and practicing as a resident.

Board certification isn't something you get from the USMLE. It is pertinent further down the career line.
Oh sorry, again Im just going on what others have said. Just ignore me!

But from what ive read and heard you do need to pass the USMLE and it does help with getting matched to a residency program. Ive read that prestige of your school does help too. Sorry for not being accurate. I do thing I have the general idea right.
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Kinkerz
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(Original post by raveen789)
Oh sorry, again Im just going on what others have said. Just ignore me!

But from what ive read and heard you do need to pass the USMLE and it does help with getting matched to a residency program. Ive read that prestige of your school does help too. Sorry for not being accurate. I do thing I have the general idea right.
I was talking about the specific passage I quoted (USMLE-related). The rest might be accurate, I wouldn't really know.
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raveen789
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(Original post by Kinkerz)
I was talking about the specific passage I quoted (USMLE-related). The rest might be accurate, I wouldn't really know.
Ah sorry, just ignore me on that bit!
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seaholme
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IMO if plans as described to me from the Greenaway report go into action, then there'll be considerably more of a brain drain in the future. Who would want to spend 6 years essentially just doing acute/general medicine on the wards in this country when actually you want to become an -ologist of some description and you can do that directly elsewhere?
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