stay in UK or practice in US?

[matt_izett87]

Originally Posted by pretoria

I would just like to point out that free markets don't pay people what they deserve - they people what the market can bear - the two do not necessarily equate. Otherwise singers, actors and footballers would not be earning millions, while academics earn peanuts. Or do you think that Britney Spears is more deserving than people researching cancer treatments?

Also, Tony Blair doesn't pay doctors - taxpayers pay NHS doctors. So you want more money? Then either the populace need to pay more tax, or money must be diverted from other areas - welfare? treatments? street cleaning? police? take your pick.

By all means go to the US - and find a country where the free market determines that a large proportion of the population have no health insurance, where people have to mortgage their homes to pay for treatments that their HMO has deemed to be unnecessary, or outside the terms of their insurance policy. The NHS might need a lot of improvement - but at least it is free at the point of delivery to virtually all our citizens, and a lot more people besides.

no they dont, but we must also consider that academics in the US, from researchers, to lectureers get paid ALOT better there, and it is thus that many prominant british academics move to the US. Granted however that the research that is undertaken is often that which yields greatest economic benefit over what would be most useful or is most needed.
With regards to financing healthcare; no offence Pretoria, but stupid comment about Blair. you see in the way our democratic country in run, he represents (supposedly) british needs and wants, i.e. opinion, and being pm, he has the ability to focus attention (both financially and in the legislative sense) of the H.O.P., and thus if he willed it could directly influence the pay of ALL public sector employees. In terms of how, perhaps through increased taxationg, but the abolition of wasteful admin in not only hospitals but also middle-range government is something that all the parties recognise. Personally i would also propose a review of our extensive and over-generous welfare system, but i dont want to make it too political.
matt
Oh yeh, and free is great, but if you have to wait agers, free can be a long long time for sometimes life saving surgery. I wonder why an HMO would deem it unneccessary, perhaps because there islittle need for them to cover something like a boob job??!! Granted there are significant holes in the USA system, but it also promotes employment (as employers are obligated to provide cover for employees AND their families). Whether it is right or wrong, to insure the UK remains globally competitive and recruits the most capable and competent students, socialists need too look outside the box, and realise we must remain in tune with other developed countries.

[matt_izett87]

that was definatly way too political, sorry

[pretoria]

Didn't mean to come across as stupid with my Tony Blair comment - I just get very annoyed when people say 'the government should pay more/spend more for X' as if the government had some magic source of income. They often don't seem to take into account the fact that the government just redistributes taxpayers' money - and therefore any extra for one sector must either come from more taxes or from other budgets. You're obviously not one of 'those people' so apologies for being patronising :-)

Personally I do think that the Labour distribution of the income leaves a lot to be desired - the war in Iraq springs to mind (as does the welfare thing, but I'll pretend I didn't say that )

Sadly, although there are a lot of inefficiencies in the NHS, and in general government admin, I don't think improvements would yield the kind of savings you might hope for (I used to audit the NHS accounts). Besides - don't we have a better life expectancy and population health status than the americans anyway? I know Canada generally comes pretty near the top of the ranking on quality of life, and they have national health care, free at the point of delivery.

[foofighter]

Originally Posted by pretoria

Didn't mean to come across as stupid with my Tony Blair comment - I just get very annoyed when people say 'the government should pay more/spend more for X' as if the government had some magic source of income. They often don't seem to take into account the fact that the government just redistributes taxpayers' money - and therefore any extra for one sector must either come from more taxes or from other budgets. You're obviously not one of 'those people' so apologies for being patronising :-)

Personally I do think that the Labour distribution of the income leaves a lot to be desired - the war in Iraq springs to mind (as does the welfare thing, but I'll pretend I didn't say that )

Sadly, although there are a lot of inefficiencies in the NHS, and in general government admin, I don't think improvements would yield the kind of savings you might hope for (I used to audit the NHS accounts). Besides - don't we have a better life expectancy and population health status than the americans anyway? I know Canada generally comes pretty near the top of the ranking on quality of life, and they have national health care, free at the point of delivery.

i agree with you completely. here here!

[Sipadan]

Reckon I'll be off as soon as I can too. It's not just about money, the UK is an over populated small country with sh*t weather and miserable people. 6 months working in the states showed me that life can be different, not that I'd like to practice medicine over there though, may be Oz or NZ or another European country, in *theory* we can work anywhere in the EU, so why not think about that too.

[k240]

Originally Posted by matt_izett87

Oh yeh, and free is great, but if you have to wait agers, free can be a long long time for sometimes life saving surgery. I wonder why an HMO would deem it unneccessary, perhaps because there islittle need for them to cover something like a boob job??!!

As a US citizen, a 30 year old graduate student, and someone who used to have health insurance a few years ago - but doesn't now, let me just say - most people aren't having HMO denials over boob jobs.

I've had a broken tooth for almost two years. Luckily, it had already had a root canal, so there is no nerve in it (why it broke so easily), but I can either yank it out, or wait until I have around $800 to get it capped. Obviously, not happening. I have three screws in my left foot. a few years ago, it was determined that the screws were the cause of my continuing pain, and inability to run, or walk for more than a mile or two. I should have the screws removed, now that the original fracture has healed! But alas.... I'm not even lucky enough to be on a waiting list... perhaps I'd have had it done sometime in the last 36 months, if I were. Nah, either I have to pony up around $3000 for the surgery, or not. Even if I were to get new health insurance, it's a lovely little clause called "pre-existing conditions" that would exempt them from paying for it. (since there was *any* gap in my health insurance coverage)

Yeah, it's not life-saving - but I'd love to be able to run away from a mugger if I needed to. - and not be in pain after walking to the store. Even if I were on a 3 year waiting list, I'd have it done by now. But instead, I can't see being able to afford it anytime in the next several years, at least.

Waiting ages in other systems is not a good argument for the US system, because we have to wait just as long (most of us) - while we save the money to have the procedures..... if we ever can.

Originally Posted by matt_izett87

Granted there are significant holes in the USA system, but it also promotes employment (as employers are obligated to provide cover for employees AND their families). Whether it is right or wrong, to insure the UK remains globally competitive and recruits the most capable and competent students, socialists need too look outside the box, and realise we must remain in tune with other developed countries.

This was kind of funny.... I lost my job several years ago, and after losing my health insurance, I finally found another job - but it was a "contract" job - not required to provide any health benefits. Computer Programming is what I did, so I was even in the "white-collar" professions - and companies who are obliged to provide health coverage just get out of it, by hiring "consultants", "contractors", several part time people rather than full time people, and by simply "providing" a health plan that has partial employee payments required, but are so high, that most employees can't "participate in the plan". (rarely do you get an employer who is willing to pay the entirety of the employee's health insurance premium)

While I agree wholeheartedly that a lot of people need to "look outside of the box", there is a lot to learn from every system's faults.

oh my oh my... it's gotten way too political again!

[spooney]

Originally Posted by bumpy

hi,

I'm wondering if it's a better option to stay in the UK after getting the MBBS and doing GP practice or doing the USLME and try to find a residency program in the US...It appears it's really difficult to practice in the US once the medical degree is done in another country.....any advice on this?

Also is there another country where the standard of living is better than in the UK but isn't so difficult to practice medicine in?........I was thinking of possibly Australia or Canada.......any input would be appreciated.......thanks

I'm not sure whether this is totally accurate, so please don't take it as gospel but from what I've heard, there are hardly enough residencies in Canada for its own medical graduates, and so getting a residency over there as an international graduate will be very difficult.

Nat

[Anthony0987]

id love to go to canada. iremember going there to visit family and saw somthin funny. parents pay a fortune to make their kids as young as 5/6 play football there for clubs, and their parents get so into it lol, but the kids just look soo bored n the park and some little girls even start crying when theyre not allowed to sit down HAHA

[DamianUK]

Canada is a net importer of medical graduates.

They don't have the numder of medical school places required to fill all their vacancies each year and as such many Canadian med students are educated abroad.

Damian

[French Medic]

Hello Everyone,

Though I'm French, I've been living in Canada for the last few years working on a graduate degree in Epidemiology & Biostatistics at the University of Western Ontario. As it is part of the medical school, I have learned a few things which I think may be of interest to those in this sub-section of the forum.

Canada is a great country to live in with a comparable standard of living to England. Generally speaking, living costs are low (among industrialised nations) and health care for Canadian citizens/landed immigrants is indeed covered by the government (exceptions: vision/dental/cosmetic procedures).

In Ontario, Canada's most populated province, there are six medical schools, each with an undergraduate enrolment of approximately 120 students per year (not nearly enough for a province of 12 million people!). As for residency spaces, the availability is limited - currently there is something like 1 space per medical student educated in Ontario. This means that the province only has residencies available for the number of medical students it graduates. Ergo, the likelihood of getting a spot is slim. The reason there are any places for IMG's (international medical graduates) is because (at most) 3% of all students may not complete their medical degree and therefore those spots are opened for IMG's. And, to make it more interesting for IMG's, those applying with foreign medical degrees can only apply after the first round of residency spots has been filled. This means that often the most sought after residencies are taken, leaving less desirable ones up for the taking.

However, to add another level of difficulty to this mess, Canada for a long time has been accepting immigrants with professional degrees over those with no education. This has led to a number of IMG's who arrive in Canada without the ability to practise until they complete residency here. Often, these individuals are given first priority in medical training as they often come with families.

There is hope though for IMG's to come and practise in Canada. In the past few months, Ontario has been making plans to increase the number of residency spaces. In addition to this - and to ease the doctor shortage that is present in this province - the province may also make the process easier by allowing IMG's to enter at the first round of applications, thus making it more likely that the applicant will earn a place in their preferred residency.

Either way, it is worth a shot in applying. To do so, you would contact CARMS (Google it) and see what is required of you. Whatever you do, be aware of what they are offering you. While the standard of living in Canada is great, it does vary. For example, living in the Windsor-Quebec corridor (look at a map, and draw a straight line connecting these two cities together and you'll get a sense of what I'm speaking about) is really what is comparable to living in England. There is a substantial population here and plenty of services offered. You do NOT want to be sent* to Northern Ontario, or northern Quebec though. While beautiful, it is far less populated, and the standard of living might be less than what you expect. It also gets terribly cold (-40 Celsius most winter days) and many can feel isolated if they are the only doctor in a community. Good for a camping trip...not for long-term living.

Aside from Ontario, the second choice of most medical students is British Columbia (B.C.), the western-most province. The weather is more akin to England (winters aren't too cold, summers aren't too hot) and the standard of living is comparable. Alberta (specifically Calgary) is quite nice, too.

It's best to steer clear of Saskatchewan and Manitoba due to the weather. It really get's cold there in the winter time. The Maritime provinces (Newfoundland, Nova Scotia, PEI and New Brunswick) aren't bad, but can feel isolating since their 'big' cities are actually only about 300,000 people. Often times, communities are no more than just a few thousand people.

Quebec is fine, but you will likely need to be fluent in French. Like France, they even have language police to make sure that English never dominates. Again, choose cities (Either Montreal or Quebec City) rather than a smaller town to go to school. Both Montreal and Quebec City have a European feel to them. However, these residencies pay the least in the country (38,000CDN in Quebec versus about 50,000 CDN in Ontario/B.C.)

So best of luck - I hope this information helps you arrive at a decision.

*I say 'sent' because the government may make your residency training contingent upon you spending a period of time after you graduate (they never say how much, but you can bet on at least a few years) in a rural, under-serviced community in northern Ontario/Quebec. This can also be a challenge for those who aren't familiar with aboriginal culture (a group most likely to populate the northern areas) since traditional western medicine is often frowned upon or poorly understood by these people.