Medical professionals relocating to practice in other countries is not an unusual occurrence, and there are several reasons people decide to. The BMA Poll quoted that 21% of doctors were considering alternative careers after the experience of the pandemic. Workload was found to be one of the biggest drivers and these are not surprising results considering the detrimental impact the pandemic has had on doctors' wellbeing.
Recently, it was also reported that doctors, particularly anaesthetists, will not have training jobs this summer due to a lack of available positions - leaving a lot of doctors in an awful limbo. This has now given doctors more reason than ever before to explore a non-training route. These are routes such as the Certificate of Eligibility for Specialist Registration (CESR) or Certificate of Eligibility for General Practice Registration (CEGPR) whereby to apply you must have either a specialist qualification in the specialty you’re applying in or at least 6 months continuous specialist training in the specialty you’re applying in. This can help doctors reach consultancy without the current uncertainty.
A top choice of mine at the moment is pursuing a medical career in another country. Although I have not entirely decided on a country I'd like to work in, the U.S., Australia, New Zealand, and Cuba are some of my favourites. In this blog post, I'll talk about some of the push and pull factors contributing to my decision to work as a doctor abroad. If you want more detailed information on what it takes to relocate to a range of different countries across the globe, purchase my e-book here.
Better work-life balance
This is probably my biggest driving force for wanting to practice in another country. This encompasses several things such as length of training, pay, work benefits, and the typical standard of living in the country.
For example, in Canada and the U.S., doctors ascend to the top of their careers quicker than would normally occur in the UK. They have shorter but more intense training programs and encourage you to make a choice on your specialty quite early on (e.g. at residency level). Many of the ‘Attendings’ (equivalent to UK consultants) are a lot younger but no less skilled. Trainees in North America are expected to spend almost ALL of their time attending their training (longer hours but given a lot more opportunities to provide patient care both supervised and unsupervised) and this pays off when you get to the top of your career at a ripe age of 30 something!
This is then paired with greater compensation for your time, both because of the greater hours you work but also because of how quickly you rise to seniority. It is good to remember that working longer hours is part and parcel of becoming a clinician and will be similar in every country around the world (although slightly dependent on specialty), however, compensation can vary. The average gross salary for a physician (2018-19) in Canada was around CA$347,000 (~£197,790) and in the U.S., it is $294,000 a year (£211,680). However, salaries also vary based on location and specialty. For instance, U.S. neurosurgeons make the most per year on average at $663,000 (£477,360) but by taking up locum work / extra shifts (similar to the UK), you can expect to make 30–50% on top of your permanent position. For popular destinations like Australia and New Zealand, on average, salaries are higher than in the UK. Add to that the quality of life, sunshine, beaches, and nature, and it’s easy to see why it’s a popular destination for doctors wanting to relocate.
Furthermore, most countries have benefits that physicians, because of their profession, are entitled to. In the U.S., for example, physicians can be entitled to paid vacation, holidays and sick leave, private medical and major hospitalisation insurance, prescription and vision coverage, disability insurance, and access to good-quality mortgages. In other countries, any further exams or education you need to complete can be compensated. In the UK, we simply do not offer any of this to our doctors - not even free parking!
That brings me onto the importance of the standard of living in a country. Although you can live comfortably in the UK, I personally love sun, sea, sand, and space. Having lived in London most of my life, I think it's safe to say that although I love this city, I do not see myself living here for all of my life. With an average UK specialty doctor salary and the standard 5-8 years of specialty training... I will not have the financial stability to achieve what I would like before my mid-30s. This is why many people opt for GP, especially if you are considering having a family. Although I would definitely consider joining GP land, I want to be able to practice in a location that has lots of nature and outdoor activities that I could take part in and raise a future family around.
Opportunities to be more than a doctor
With a better work-life balance will come more opportunities to focus on (and be able to financially invest in) my life outside of being a clinician. I really want to be able to give most of my time and energy to medicine and the rest to other milestones I'd like to reach in life such as property investment and expanding my knowledge in e-commerce/online business.
Exposure to tropical / endemic diseases and a new perspective on healthcare
One of the best parts of undertaking clinical practice abroad is expanding your skillset. You'll come across endemic diseases that you wouldn't see in the UK and these can be valuable additions to your medical portfolio, especially if you have interests in Infectious Diseases, Pathology, and Immunology.
Furthermore, working and living abroad will give you a unique perspective on global health and healthcare economics, policy, management, and delivery. Several countries, e.g. Canada, run a healthcare system based on the needs of the people in their province and the resources available to deliver the appropriate care. There are no layers of management in the hospitals akin to the NHS. As a result, there is no infrastructure like the National Institute of Clinical Excellence (NICE); every hospital has its own protocols/procedures and implements those. Every province is different in terms of the medical culture and how service is apportioned. If you were to return to the UK, you could bring your own innovative ideas and knowledge of how other healthcare systems are successfully working to implement here. I think we all know the NHS needs a massive rehaul - but not many people know what the 'new' shinier version of the NHS would even look like.
Getting your medical qualifications recognised and most likely, having to do extra exams
The biggest barrier to moving countries is getting your medical qualification (s) recognised by the country you wish to live in. Almost all countries will require you to take some exams or prove that you have done similar exams in the UK that are equivalent. If you are not prepared to go through this expensive and arduous process, relocation may not be for you.
Training pathways are not always quicker or a step up from your current position
The majority of countries, particularly the U.S., will require you to complete residency / the country's official training programme before you can practice there as an unsupervised, qualified clinician. This means that you need to consider what stage you want to leave your training at in the UK because whether you are fresh out of medical school or an ST5... you are likely to not only have to complete exams but undertake extra years of post-graduate training. Another caveat is then only being able to practice in a certain state or province in that country.
Having to meet countless immigration rules and regulations
This is probably the most difficult part of relocating to practice as a doctor abroad. Although doctors are well-respected immigrants, you have to jump through a lot more hoops in order to prove you are 1) a safe and qualified clinician and 2) able to live and work in the country you wish to move to. This is, again, another expensive process that takes approximately 12-18 months to complete.
I hope this gave you a bit of an insight into my reasonings for wanting / not wanting to relocate. To help you make a more informed choice about relocating, purchase one of my e-books to learn more about the following:
Healthcare system and structure
Eligibility and exams
Postgraduate training and finding a job
Immigration and visas
Checklist of the things you need to get done before relocating (with approximate time periods)
Social media account recommendations (where available)
Leave a comment below about your personal views on moving abroad as a doctor and some of your push/pull factors.