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Why I'm (hopefully) completing my foundation doctor training in the UK

It is no secret that many students are hoping to move abroad to practice medicine at some point in their careers. The reasons vary amongst different people but my core ones are: horrendous training bottlenecks (competition for specialties in the UK is similar if not worse than the US, Australia and others) and poor compensation until I'm many years into the career (and essentially, trapped).

Completing foundation doctor training in the UK before moving abroad is a strategic decision I made for my own professional development and career progression. In this blog post, I'll give a short overview of my thought process.

I got my first choice job

If this wasn't the case, I would have seriously considered whether doing F1 was worth it (although, I qualified for pre-allocation which would have meant I would have been working in London regardless - can do a blog post in this in the future). The reason I wanted to get an SFP job was for the chance to get more publications under my belt and letters of recommendation from doctors in the specialties I am going for at a well-known London hospital, with attachments to my university. I primarily wanted to stay in London so I could live near family/friends and save more money.

I'm not in a rush and the relocating process is expensive

When considering relocating as an IMG, you need to ensure you complete the necessary requirements of that country. This is undoubtedly expensive. For the US, a country I am seriously considering, for example, it costs to submit each application you make to match to a programme at a hospital in the States. I want to be a very strong candidate and try to match the first time round to a programme in a location and a specialty I truly WANT. As an IMG that is NOT easy, especially as competition increases every year.

During my final year of medical school, I've had to juggle multiple exams and plan/budget for my elective. I have learned that this is a marathon, not a sprint. For me to spend a good 2-3 months in the US (bearing in mind I have NO family contacts there), it is costing me a BOMB and was not easy to attain either. As I have had to dip into my savings to pay for exams and electives, I want to make some of this back before making the big move. Working as a doctor is a good way to earn in the meantime and give my loved ones extra time to tie up things too (as I don't plan to move alone).

I want to experience working as a doctor in the NHS for myself

The UK boasts a globally respected healthcare system and has widely recognised medical education. Completing foundation doctor training in the UK can ensure I have a good grasp on the basics of being a doctor, get used to shift patterns, and understand the true pitfalls of the NHS for myself - as I am going off of others' experiences at the moment.

I want to relocate as a competent doctor who has had a chance to get a couple of years of work under my belt. I'm also open to being swayed by opportunities that may present themselves during that time while I'm in the UK.

I may want to (or have to) come back

It's impossible to plan where life will take me in the next 10 years. For the US, in particular, returning to your home country is often a mandate of the J1 visa which most IMGs receive. The J1 visa essentially allows you to live and work in the USA during your residency - once you complete residency, you must return to your home country to apply your 'skills' for 2 years before you can apply for permanent residency/a long-term Attending job back in the US.

Some IMGs work around this by completing further training like a fellowship, working in an underserved area, or if you're going for a specialty like neurosurgery, you'll be in the States for 5+ years anyway and once you've remained in the States for 5 years continuously, you are eligible to apply for a Green card. Though most residency programmes are 4 years which is the tricky bit. The alternative H1B visa is notoriously hard to attain and often requires completion of Step 3 PRIOR to residency, so I'm relying less on this.

Overall, completing F1-2 gives me a license to practice without supervision in the UK. If I were to return and want to open up my own practice, F2 completion would help me do so. If I want to work at the level I am in the States, I could consider the Portfolio Pathway.

So that's a short overview of my reasoning. More about relocating as a doctor abroad can be found in the e-books.

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Jun 04

Can you elaborate on tranferring to a green card after 5 years on j1?


Jan 20

As usual thanks so much for this post Jess. The USA for me is also a serious consideration, but there definitely is a lot of financial investment that comes with it, and so completing F1/F2 does really make sense. when are you doing your USMLE step 1 and step 2, I’m considering doing step 1 some time in year 3 to allow me more time before it expires to qualify and work my foundation years. With step 2 I’m not as sure when to do this. your ebooks are great as well thank you have bought 2 already 🙏🏾🙏🏾

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