US citizen, UK med school, US residency, UK practice?

[Scottish Chap]

Originally Posted by AmreekiMultani

Thanks a lot for the advice!

Here's another question I'd like to throw at ya...

Being in an international medical school what should I put emphasis on? What do you notice is lacking in foreign students? Over here they stress the minute details...we spend 2 whole years on anatomy, physiology, and biochemistry! Correct me if I'm wrong but I don't believe that much time is spent on these topics in US med schools.

They say Snell's Anatomy "isn't detailed enough"... I swear they make you memorize Gray's and KLM by heart.

Are such details important in the US system, or is the general broad concept what they are looking for?

We spend very little time on the clincal aspects...I'm sure the opposite pretains in the US

My dilemma is first I gotta pass here and then I gotta pass there....2 entirely different systems to master. Phew...my heart is sinking just thinking about it haha.

In the end all I want to be is a good doctor, someone show me the way!

Humza Dasti

Studying for step 1 like your life depended on it will help; that will get you past the first screen. Get a hold of the Step 1 first aid book, BRS physiology, pathology, etc., and the Kaplan Q-bank. Practice, practice, practice. With preparation, you'll do well. International medical schools (exluding the Caribbean) do not emphasize some of the minutia on Step 1 like U.S. school and they do not 'teach to the exam'. We literally have nasty multiple choice exams every four weeks here--often on minutia--and they're taken under the conditions of the USMLE (no calculators, no talking etc.) and they're written in the USMLE format. I was actually educated in the British system (undergraduate) which is similar to your medical system and so the different thought processes required really are striking.

Keep in mind that all U.S. graduates have a Bachelors degree and many have graduate degrees. Everyone has studied organic chemistry, chemistry, and biology before medical school, and many incoming students have a working knowledge of biochemistry and physiology so they don't spend as much time on it in medical school. Also, classes are condensed into the first two years of the four-year M.D. (classes last all day at my school) and we have exams every four weeks. Contrast that to the rest of the world where a medical degree is usually 5-6 years from high school, so I think what you're seeing is another system catering to that system and working well.

Will you have elective time? If so, can you do some rotations in the U.S.? This will help you substantially - especially if you can secure a reference from a U.S. physician or two and get your name known.

You'll be fine - whatever you decide; you've come this far. Take one day at a time and focus on your immediate goal. It's not impossible to get back to the U.S., so believe it will happen. Good luck!

[londonortho]

I am an American citizen in an orthopaedic surgery residency at a competitive program. Due to possible family circumstances, there is a chance I will want to do a year of clinical "fellowship" and research in London, UK. This will likely be after my completion of PGY2, 3, or 4. I know there is a large discrepancy in the knowledge and skill base between these levels of training.

First, I am unclear about the approximate equivalent between UK and US medical training. Is SpR 4 similar to PGY4? To clarify, I have finished medical school in the US. I am in my residency. The orthopaedic surgery residency is 5 years total, including 1 year of internship (including various general surgery, ICU, 3 months of ortho, 1 month ortho radiology) and 4 years of ortho only.

Second, how should I go about finding a private based fellowship in London as a equivalent PGY 3 or 4? Have you seen/heard of such arrangements? I have excellent credentials and research experience. I am willing to purchase my own insurance and cover a good bit of the living expenses, however, I would need to be paid at least some small stipend. I do not think I will have the time to pass UK exams and get a non-private position (unless you recommend trying). I am not looking to practice in the UK, only pick up surgical tips (I would definately want to operate) and perhaps complete some research.

Thanks for your thoughts on where to look and how to convert UK medical training into US medical training (roughly).

[Scottish Chap]

Originally Posted by londonortho

I am an American citizen in an orthopaedic surgery residency at a competitive program. Due to possible family circumstances, there is a chance I will want to do a year of clinical "fellowship" and research in London, UK. This will likely be after my completion of PGY2, 3, or 4. I know there is a large discrepancy in the knowledge and skill base between these levels of training.

First, I am unclear about the approximate equivalent between UK and US medical training. Is SpR 4 similar to PGY4? To clarify, I have finished medical school in the US. I am in my residency. The orthopaedic surgery residency is 5 years total, including 1 year of internship (including various general surgery, ICU, 3 months of ortho, 1 month ortho radiology) and 4 years of ortho only.

Second, how should I go about finding a private based fellowship in London as a equivalent PGY 3 or 4? Have you seen/heard of such arrangements? I have excellent credentials and research experience. I am willing to purchase my own insurance and cover a good bit of the living expenses, however, I would need to be paid at least some small stipend. I do not think I will have the time to pass UK exams and get a non-private position (unless you recommend trying). I am not looking to practice in the UK, only pick up surgical tips (I would definately want to operate) and perhaps complete some research.

Thanks for your thoughts on where to look and how to convert UK medical training into US medical training (roughly).

Hi there!
You definitely have a situation that's not 'run-of-the-mill'. I have seen it posted elsewhere that North American M.D.'s can do fellowship training in the U.K. without having to take the PLAB exam (U.K. equivalent of the ECFMG certificate) but I should refer you to that forum where you may obtain a more complete answer: http://forums.studentdoctor.net/forumdisplay.php?f=142

Basically, an intern in the U.K. is a junior house office (PGY1). After that, there are senior house officer posts that can last a couple of years. Then, at the SpR level, you generally begin to specialize more. Keep in mind that, unlike the U.S., 99% of hospitals in the U.K. are not private and so the regulations for practicing foreign physicians are stringent. As for doing research for a year: it won't be a problem. Start contacting potential investigators now. Good luck!

[blakeish]

I am currently attending medical school in the United States and my school uses Snell's Clinical Anatomy. Last year's class scored 10 points above the national average on the USMLE Step 1, so I assume that the textbook is more than sufficient. I also find almost all of the Board Review Series books to be very helpful.


On a different note, I'd really like the chance to study in London while I'm still young and possibly consider residing there after school, but it sounds to me that the opportunities for me there are impractical at best, if not impossible.

[jurrellharrison]

this isnt really a reply more like a question, i am a US student, its my first year in college and i intend to get a BS in either chemistry or Biology, i am also doing all the premed requirements as i want to become a MD. but i want to study medicine in the UK after i do my Undergrad here in the US so i was wondering
1) how long is it going to take me to become a doctor and actually practice medicine in the UK after im finished with my undergrad here in the US
2) what requirements would i have to meet to get into med school in the UK
3) if i wanted to return to the US to practice medicine here what would i have to do
If any one has a reply to this please contact me at jurrellharrison@gmail.com

[Scottish Chap]

Originally Posted by jurrellharrison

this isnt really a reply more like a question, i am a US student, its my first year in college and i intend to get a BS in either chemistry or Biology, i am also doing all the premed requirements as i want to become a MD. but i want to study medicine in the UK after i do my Undergrad here in the US so i was wondering
1) how long is it going to take me to become a doctor and actually practice medicine in the UK after im finished with my undergrad here in the US
2) what requirements would i have to meet to get into med school in the UK
3) if i wanted to return to the US to practice medicine here what would i have to do
If any one has a reply to this please contact me at jurrellharrison@gmail.com

As a rule of thumb, it's highly advisable to attend a medical school in the country where you intend to practice. Licensing issues can be a nightmare.

To enter a British medical school, you'll need a four year undergraduate degree with a competitive GPA. Most medical schools in the U.K. do not have the rigid U.S. requirement that you complete physics, chemistry, biology, calculus and organic chemistry as an undergraduate, but few medical schools will accept you with a liberal arts degree; those that do are usually competitive graduate entry programs. Medical school in the U.K. is generally five years long. Most medical schools have an entry exam and the type of exam varies from school to school (UKCAT, GAMSAT, BMAT etc.). They are not as difficult as the MCAT. There are several four-year graduate entry medical schools in England and Wales, but most do not accept internationals.

To return to the U.S., you will need to do well on the USMLE Step 1, USMLE Step 2CK, and USMLE step 2CS exams.; CS must be taken in the U.S. and the other two are taken by computer in most countries. Matching into highly competitive specialties in the U.S. is very, very tough if you choose to go overseas for medical training - in part because your application is only considered after U.S. medical school graduates. In addition, a lot of the minutia tested on the USMLE exams is not emphasized in the U.K. and you'll be on your own for that. If you choose to do your residency training in the U.K. (there are issues with that for internationals at the moment), you would have to repeat your training if you decide to return to the U.S.

It's by no means impossible to try to do what you intend to, but go into it with your eyes open and choose wisely. Good luck!