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

[k240]

Here's a question that someone might know the answer to.

I'm a US citizen, currently finishing a Master's degree.

If I go to Medical school in the UK, and get an MBBS - take the required USMLE tests when I need to, then find a residency back here in the states....

After I am finished with residency and licensed in a State here, or if I've been practicing for a while and just fancy going back - would I be able to go back to the UK to practice medicine? If so, at what level?

Anyone have any ideas?

[jane2]

You'd have to start at exactly the same point you were at when you left medical school, i believe.

Why would you want to do a US residency to practise here, especially if you've studied at a UK medical school? The way they practise in the states is very different to here- in America it's much more based around fancy expensive technology, in the UK it's more personal and diagnosis is done involving a number of other things including technology. That's my understand anyway, although if anyone knows otherwise then please feel free to correct me

[miguel_lwms]

Originally Posted by jane2

You'd have to start at exactly the same point you were at when you left medical school, i believe.

Why would you want to do a US residency to practise here, especially if you've studied at a UK medical school? The way they practise in the states is very different to here- in America it's much more based around fancy expensive technology, in the UK it's more personal and diagnosis is done involving a number of other things including technology. That's my understand anyway, although if anyone knows otherwise then please feel free to correct me

Hi K240
Check with the relevant royal college in the specialty you want to go in (royal college of physicians etc). My understanding was that they may consider your training in the US equivalent to X years training in the UK. Medicine is increasingly becoming international (hence Polish and Czech specialist are allowed to practice as consultants in the UK even though their system is somewhat different to ours (Mainly cos of EU migration of labour laws)


With regards to what Jane2 states she doesn't seem to understand the differing circumstances in the UK and US. Yes US healthcare does appear to use more technology when compared with the UK, but this similar in France and Germany. A friend recently complained that in Germany she was able to get Ultrasound scans at every antenatal check up whilst in the UK women are offered only one scan for the whole pregnancy (my point is that on the continent a scan is offered as part of the antenatal check up screening tool as is bp measurement and urine dip sticking but in the UK you have to have a clinical need for a scan other than the routine 18 week check).

There are many reasons for this difference –

• Financial restraints in the NHS - as evidenced by the Herceptin saga;
• The need to practice defensive medicine in the states - (Yes 95% of pregnant women may have an uneventful pregnancy but if you miss a condition in one of the unfortunate 5% that ultrasound my have picked up earlier, get ready to make a claim on your malpractice insurance);
• The fact that technology is there and available - an A&E department alone in the states more often than not has a couple of MRI scanners - contrast this with the NHS where some general hospitals where only one MRI is available – Try explaining to the relatives of a stroke patient why the financial constraints in the NHS means that there loved one many have to wait up to 12 hours for am MRI scan whilst in the states it would rightly be offered on admission.

I'm not saying that health care in the states is perfect - indeed this is far form the truth as without healthcare insurance you miss out big time, but it is wrong to think that the service NHS is the best that can be delivered.

The NHS is very efficient but as my German friend put it "it's a numbers game" and quite rightly so. If a child goes to the GP with fever and a cough, the correct explanation given the parent is it's probably a viral infection, take some paracetamol and if things don't improve in a few days come back. On the continent or in the States, the same explanation is given but a few haematological/microbiological tests may be offered as back up.

I am aware of a patient who was referred to the a surgeon with recurrent piles, put on the three month appointment waiting list only to seen in the clinic and rectal ca diagnosed after just a history and PR examination. I'm not saying this wouldn't happen in the States, but it is most likely this patient would have been scoped by a gastroenteologist just to be safe.

Just my two cents worth

Mig

[jane2]

Haha, I do understand the differing circumstances, thanks !! I just didn't feel they were that relevant. It is true though that what I said the case because of what you say. My point was simply that US based training is different and is geared towards a different type of practice and if you are wanting to practise in the UK then why not train in the UK?

It's quite difficult and expensive to get a residency in the US if you are an IMG (as you are, even if you're a US citizen who qualified abroad) and presuming you could get the visa for it why not just stay in the UK and train here? I appreciate that US residencies may be perceived as 'better' but this is only true insofar as the American medical system is also 'better.' It's not really better to train in the US for practise in the UK - you're better to get used to the UK way of doing things. A lot of what you'd learn there wouldn't be of much use to you in your future career, as you'd be practising in a completely different type of healthcare system, as Miguel describes.

[k240]

Thanks everyone for the input.

I was thinking of doing a residency in the US, so that I could go ahead and get the USMLE out of the way, and not have any problems with practising here as a physician.

I also want to be able to practise in the UK (or EU) if I so choose....

I guess I'm trying to figure out the best way to have the best of both worlds.. or at least the flexibility to practise in either place.

Another point is that I'm unsure of which area of medicine I'd like to settle into. It seems that GPs are in the greatest demand in the UK, from what I've read, but I'm not sure I want to be a GP. Is that correct, or have I been reading the wrong reports?

Thanks again!

[m00ple]

You really are better off not hedging your bets indefinately. For one thing, chopping and changing countries may make people wonder how long you are likely to hang around if they give you a job. It may also mean that you have difficulty because of lack of contacts in whichever country you eventually choose to stay in because you are that much further 'behind' than your peers.

Also, while you're residency training in the US may get recognition in the UK, you won't necessarily be able to drop into the UK system as a consultant. There is usually a requirement of x number of years practice before you can be considered "equivalent" to a consultant. Often as the points in the UK and US postgraduate training programmes don't match up you will usually have to drop back a few years when switching countries.

I know it's nice to have flexibility, but perhaps it would be a better use of your time to sit down now and work out where (which country!) you think you actually want to be in in 10 or 20 years time because you would be creating difficulties for yourself by chopping and changing in an attempt to keep your options open for as long as possible.

[Scottish Chap]

Originally Posted by k240

Here's a question that someone might know the answer to.

I'm a US citizen, currently finishing a Master's degree.

If I go to Medical school in the UK, and get an MBBS - take the required USMLE tests when I need to, then find a residency back here in the states....

After I am finished with residency and licensed in a State here, or if I've been practicing for a while and just fancy going back - would I be able to go back to the UK to practice medicine? If so, at what level?

Anyone have any ideas?

As a couple of folks mentioned already, it's very difficult to move countries and expect the previous medical training in its entirety to be acceped in the 'other place'. That said, let me give you two examples of people whom I personally know that have done something similar to what you are asking about:
1. U.S. citizen. Medical education and residency in the U.S. (neurology) and attending physician. He is a consultant in Manchester without further training.
2. British citizen. Medical school in Canada and residency in the U.S. (internal medicine then pulmonary fellowship). She moved right into a consultant's post in the U.K. She was trained extesnively in research and was appointed as a lecturer, giving her hospital privileges.

Neither of the above clinicians needed to retrain in the U.K. It can be done. The U.S., however, is notoriously unforgiving if you have been partially trained overseas and want to come back. I worked beside a guy at the Johns Hopkins Hospital in Baltimore with MRCP qualification (London), yet they made him do his entire residency over and sit for the board exams out here. Unbeleivable!

[k240]

Originally Posted by Scottish Chap

As a couple of folks mentioned already, it's very difficult to move countries and expect the previous medical training in its entirety to be acceped in the 'other place'. That said, let me give you two examples of people whom I personally know that have done something similar to what you are asking about:
1. U.S. citizen. Medical education and residency in the U.S. (neurology) and attending physician. He is a consultant in Manchester without further training.
2. British citizen. Medical school in Canada and residency in the U.S. (internal medicine then pulmonary fellowship). She moved right into a consultant's post in the U.K. She was trained extesnively in research and was appointed as a lecturer, giving her hospital privileges.

Neither of the above clinicians needed to retrain in the U.K. It can be done. The U.S., however, if notoriously unforgiving if you have been partially trained overseas and want to come back. I worked beside a guy at the Johns Hopkins Hospital in Baltimore with MRCP qualification (London), yet they made him do his entire residency over and sit for the board exams out here. Unbeleivable!

Thanks so much for that advice, too. It seems that perhaps I'd be better off getting my schooling and residency here, then moving to the UK afterwards, eh?

[qtpie055]

hello. I am a US citizen with similar consideration. After spending a year abroad (well, currently abroad) here in the UK, i'm considering the possibility of actually residing here in the future. Well, it's just a thought but I like to keep my options open.

The thing is, I'm currently already accepted to medical school in the States. I got in through an early assurance program and if I do decide to accept it (which I currently intend to), I will be enrolling in it in 2 years. It would be a shame to turn down this offer since this program accepted me without taking the med school entrance exam (MCATs). I was just wondering what my options are of praciticing in the UK if I do decide to live abroad?

Should I try to apply to a UK medical school? If so, what are the entry requirements? Do UK med schools take a lot of foreigners? Most importantly, would the government provide financial loans like they do in the US?

Or is it possible to go to med school in the States and compelte residency training in the UK?

Or just complete schooling and residency in the States and see what the options are then?

Cheers!

[Scottish Chap]

Originally Posted by qtpie055

hello. I am a US citizen with similar consideration. After spending a year abroad (well, currently abroad) here in the UK, i'm considering the possibility of actually residing here in the future. Well, it's just a thought but I like to keep my options open.

The thing is, I'm currently already accepted to medical school in the States. I got in through an early assurance program and if I do decide to accept it (which I currently intend to), I will be enrolling in it in 2 years. It would be a shame to turn down this offer since this program accepted me without taking the med school entrance exam (MCATs). I was just wondering what my options are of praciticing in the UK if I do decide to live abroad?

Should I try to apply to a UK medical school? If so, what are the entry requirements? Do UK med schools take a lot of foreigners? Most importantly, would the government provide financial loans like they do in the US?

Or is it possible to go to med school in the States and compelte residency training in the UK?

Or just complete schooling and residency in the States and see what the options are then?

Cheers!

Take the U.S. school. Having gained the EA position while avoiding the dreaded MCAT you'd be insane not to. You'll also save yourself a ton of grief in securing funds, moving, and finally gaining admission.

Getting into a U.K. school: if your GPA is okay, it's possible but bear in mind that most British medical schools only reserve around ten or so places for internationals so there will be competition. Hardly any medical schools in the U.K. will ask for the MCAT. Most medical degrees in the U.K. are 5 years long. Getting into one of the 4-year 'fatstrack' medical programmes is going to be a stretch since they were initially created to relieve the acute physician shortage in the U.K.; it will be tough to convince them that you want to move there indefinitely. As a U.S. citizen, you will not receive funds from the U.K. for medical school and the FAFSA loan available to you in the U.S. cannot be used to pay the (approx. $30, 000 U.S. per year) tuiition in the U.K. because British schools are not LCME-accredited. That said, you can obtain private higher interest loans to attend medical school in the U.K. but this is not for the faint-hearted. You can apply to just 4 British medical schools each year through UCAS (http://www.ucas.ac.uk/) which is like the British equivalent of AMCAS.

If you complete your M.D. in the U.S., it is possible to work in the U.K. - with certain provisions. It would be uncommon but it's certainly not unheard of.

Good luck!