Working Abroad as a Medic

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Author: Dr. Abeyna Jones, Director of Medic Footprints, London

When I informed my family I was moving to South Africa, they thought I was mad.

A single female going to live and work in a country with one of the most notoriously prominent crime rates in the world was not something a mother could easily condone.

By then, the stigma and stereotype regarding the dangers of South Africa had already disappeared from my mind having spoken to several like-minded individuals who had worked there themselves expressing it was one of the most rewarding experiences of their career. I think this is true for most destinations, exemplified by the tribe of doctors who emigrate and simply do not return.

Reasons to work overseas

Statistics obtained from the GMC indicated that over 6000 doctors in the UK were planning a move overseas in 2013. This number is likely to increase over future years with more doctors considering alternative career options within or outside medicine, in combination with finding an opportunity to have an improved work-life balance considering the stresses and strains of the current NHS.

It is not clear how many people eventually return to the UK, however it is evident that the concept of working overseas is now widely supported amongst several institutions and organizations in the UK. The outcome of working overseas can be extremely valuable for career development; below are a few reasons why individuals would want to go;

When to go overseas

One can go at any point in their career from graduation to retirement and beyond! There are however, several natural breaks within the training system, which are quite popular for overseas travel amongst doctors;

It is also possible for doctors to work overseas during a training programme. With an National Training Number (NTN) you can either apply for an Out of Programme Experience (OOPE) or Out of Programme Training (OOPT). These are usually prospectively approved by your Training Programme Director (TPD) and Specialist College. There is also a case for having overseas experience or training retrospectively approved, which is heavily reliant on the evidence you provide. Please see the Gold Guide for further information.

Some deaneries or schemes may offer an additional year of approved training overseas in certain countries, ie. Rural posts in South Africa for General Practice trainees.

If you have more experience in your specialty, it is likely that you will be given greater autonomy in your post overseas, which can be extremely rewarding. Most places will only accept UK doctors after they have completed their foundation years, however you should check specifically with each country's requirements.

Things to consider before moving overseas

Whatever the reason, there is a substantial amount of planning that is required before booking your plane ticket.

ELIGIBILITY

PERSONAL

How to get started

Taking into account your professional and personal requirements, once you've identified a country and/or location, you have several options;

1. Contact the hospital directly

ProsCons
• Word of mouth if powerful. If you know someone that's worked there previously it may work to your advantage
• You may have knowledge of jobs before they are formally advertised
• Direct contact with medical staff to get in-depth knowledge into the advertised vacancy


• Some hospitals may prefer to work directly with agencies / organisations
• Your responsibility to keep checking to see if a vacancy becomes available
• No structured support with registration and immigration advice which you may get with an agency
• No further support for finding a placement if unsuccessful

2. Apply through a recruitment agency

ProsCons
• Specialists in overseas placements for doctors
• Usually several links to job vacancies
• Support with registration applications and immigration visas
• Ongoing support to find placement if unsuccessful
• Jobs only available in select hospitals / areas potentially limiting your choice.
• May not have medical knowledge on type of work you will perform
• Post placement support may be limited

3. Forums

ProsCons
• Word of mouth advice leading to several potential contacts
• Honest accounts of working experience
• No guarantee on vacancies
• Biased viewpoints
• Information may not be up to date

4. Check local job boards

ProsCons
• Recent vacancies for hospital / region of choice • Other potential vacancies may not be advertised
• Local doctors likely to get preference over foreign graduates


Receiving a job offer is perhaps the easiest step of the process. All that follows can be extremely time consuming and financially costly; applying for your registration and immigration documents, are usually the greatest rate-limiting factors.

Each country has different requirements depending on your nationality, where you graduated for your primary medical degree and where you gained your Specialty Training (if relevant). See below for further details.

Specialty Training overseas

If you're planning on starting or continuing your training overseas, you will need to check with the country where you're planning a move. Some destinations will require at least a year or more's experience working in the country before you can apply. Other factors taken into consideration include the level of application, citizenship and proof of previous competencies.

Popular destinations

We have expanded below on some of the most popular destinations for doctors (all of which we actively organise placements for):

  1. Australia
    Australia is one of the most popular destinations for UK doctors going overseas. Great weather, a better work-life balance, a similar culture and great pay all make it an attractive option. In terms of a woman going to work there, it is a safe destination with good career prospects for women.

    Australia is popular for fellowships in several specialties because of a paralleled healthcare system with the UK. Plenty of doctors will commonly choose to stay on and work as Consultants in this country.~

  2. New Zealand
    New Zealand is a safe destination for women and a thriving multi-cultural society, offering a mild year round climate and an excellent quality of life. You will always be close to nature (New Zealand has some truly spectacular scenery), meaning that it is so easy to spend time outdoors and lead a more active life.

    All new registrants, (all levels) must work under supervision for at least their first 12 months in New Zealand to become familiar with the culture. Specialists such as Radiologists, Anaesthetists, Surgeons and Psychiatrists are in high demand. Emergency Medicine is a competitive and popular specialty with reputable training.

  3. Canada
    Canada is a safe place to live and one of the most desirable destinations for immigrants. Since 1994, Canada has been ranked in the top ten places to live in the world. Consistently recognized for its high standard of living, low mortality rate, good education and health system, low crime rate and beauty. It is a country that welcomes ethnic diversity and has active policies to encourage immigration of skilled workers.

    Many doctors work in Canada either towards the end of their training, as part of a Fellowship or as a Consultant. There are plenty of lucrative options for doctors with excellent work/life balance.

  4. UAE
    Vacancies for international medical graduates in the UAE tend to be more popular with post CCT specialists and GPs. Whilst this may be the common trend, this doesn't mean it is impossible for more junior doctors to emigrate there.

    The standard of living and the salaries in the UAE are high. It is not unusual to receive the equivalent of GBP 8,000 – 9,000 per month. Of course, this is also tax free, making it that much easier to save money. Expats tend to live in expat communities, where accommodation is of a high standard and they can have a great quality of life. Contrary to ongoing stereotypes, cities like Dubai and Abu Dhabi cater for more of a western lifestyle in comparison to the rest of the Middle East.

    The UAE has public and private medical care but the majority of care is private. UK and EU doctors are more expensive then doctors from India or Africa, so they tend to work in the hospitals which are covered by the higher cost insurance brackets.

    The UK is on the approved physician's list, meaning that it is not necessary to undertake any further exams.

  5. South Africa
    Although South Africa cannot be classified as one of the safest countries to live in, those who choose to come and work in South Africa have an unbelievable quality of life. You can easily afford to live in a spacious house with its own swimming pool and maid on a doctor's salary in rural South Africa.

    The access to nature both in South Africa and surrounding African countries is superb. Trips can be made to the Drakensberg, Lesotho or Mozambique, and flights to Namibia, Botswana or Zimbabwe. There are plenty of unrivalled safari opportunities in the local game parks and great nightlife.

    Most foreign doctors work in South Africa to consolidate or develop their skills in either Trauma, General Surgery, Obstetrics and Gynaecology, Emergency Medicine or Rural Medicine. Majority of locally trained doctors will work in the major cities, leaving very few vacancies accessible to foreign medical graduates. Many rural hospitals are reliant on foreign medical graduates and locally trained healthcare professionals who are obliged to spend time in these areas in their third year of postgraduate training.

  6. Singapore
    Singapore is a popular destination for expats. The good weather, multi-ethnic society (yet quite westernised), good transport network and low crime rate make it an attractive choice. Accommodation is expensive but you get good value for money and apartments tend to be spacious.

    Consultants are in high demand, and many foreign doctors are employed into the highly skilled workforce. Excellent remuneration packages are available for most posts.

  7. Ireland
    Ireland is an attractive choice for UK/EU doctors that want to stay close to home but still want a change of scenery and better pay prospects than currently offered under the NHS.

Voluntary Work

There are several charitable organisations of various sizes and influences which recruit healthcare professionals on a temporary or permanent basis. Voluntary work is very popular amongst doctors requiring less commitment than a salaried post, and allowing them to work in areas of need for basic healthcare provision.

Doctors who benefit from these positions are from a range of specialties, but usually those with experience in Emergency Medicine, Trauma, General Practice and O&G are well sought-after.

Further Useful Links

Medic Footprints – http://medicfootprints.org A new organization which provides an international placement service for salaried and voluntary posts in parallel with a free resource of information about working overseas. (Website due to launch June 2014)

BMA Guide to Working Overseas - http://bma.org.uk/developing-your-career/career-progression/working-abroad . Comprehensive technical advice on working overseas including checking overseas contracts.

Medical Careers - http://www.medicalcareers.nhs.uk/ - Have a section on working abroad in developed and developing countries, plus voluntary placement advice.

Authors: Dr Abeyna Jones and Sara Sabin – Directors of Medic Footprints
Medic Footprints in a doctor-led international recruitment and placement advisory offering a range of posts and advice on working overseas. For further information please visit http://medicfootprints.org or contact us at This email address is being protected from spambots. You need JavaScript enabled to view it.