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UK Doctors Relocating To The USA: A Difficult Process

UK Doctors Relocating To The USA

Medical professionals relocating to other countries isn’t an unusual occurrence, but finding relevant, helpful information isn’t always easy. When I started looking into the process myself I was met with streams of information that seemed to assume I already had a basic knowledge of the process. I soon discovered there are many factors to be considered, rather than just gaining a visa. Working as a professional in another country can be straightforward if your qualifications automatically transfer. However in the case of Medicine and the USA this isn’t the case.

 

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Although a UK medical degree is widely recognized, in order to practice as a doctor in the US, an individual must have passed the USMLE exams (United States Medical Licensing Exams) and become ECFMG certified before they can commence employment. However, this is not an exam specifically for international medical graduates, American medical graduates also have to take the exams, which seems like a pretty fair deal to me.

 

In order for a UK Doctor to relocate to the USA they must:

 

Take Steps 1, 2CK, 2CS and possibly Step 3 (more about that later!) of the USMLE, Steps 2 must be taken in the USA.

 

Gain ECFMG certification, which includes their passing the USMLE Steps 1 and 2, and having their university transcript verified.

 

Attain some US clinical experience, usually their clinical elective when in the final year of medical school.

 

Receive letters of recommendation, preferably from US Doctors.

 

Apply for residency positions through ERAS (a portal that matches candidates to residency jobs). Residency is the initial training for a doctor in the US, it is kind of in place of the F1 F2 jobs in the UK, except you choose a speciality right away, rather than rotating.

 

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Hope and pray you are matched.

 

It is possible for International Medical Graduates to gain residency positions in Family Medicine, Pediatrics and Psychiatry most commonly, as these are the least competitive areas of medicine. Many are also matched into Internal Medicine and OB/GYN. Surgical residencies are much harder to match to, and some are near on impossible, such as Dermatology, Radiology etc. This is because there are far too many high ranking American Medical graduates applying for these positions, an IMG just couldn’t compete.

 

 

 

American medical training is very different from the UK. Medical students in the US have already completed a 4 year Batchelor’s Degree. They then complete their 4 year Medical degree, during which Steps 1 and both parts of Step 2 are sat. Residency then lasts between 3-7 years, which can either be followed by independent practice or a fellowship for further training. American Medical Graduates have an advantage in several ways. First of all there are no visa restrictions, making them cheaper and easier to employ. Secondly American Medical Graduates are taught to pass the USMLE, it is implemented into their degree, meaning they generally score higher on average. US Medical Graduates also gain much US Clinical Experience during their training, giving them an advantage on their application forms.

 

Despite this, thousands of International Medical Graduates head to the US every year to practice medicine. Visa options generally are

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J1 (easier to get) Are sponsored by ECFMG

Not allowed to “Moonlight” can only work those hours required by your residency program

Valid for 7 years but must return to the UK for two years before attempting re-entry, however this can be waived in working in an undeserved area. Green card processing cannot begin whilst on this visa.

A dependent spouse can apply for employment authorization and work for any employer in the USA.

 

H1B (More difficult to get) are sponsored by the residency program, and cost a great deal more.

Allow you to “Moonlight” to earn extra money.

Maximum of 6 years, however Green card processing can begin whilst on this visa

Dependent spouse is not allowed to work anywhere in the USA.

Will require Step 3 of the USMLE exam to be sat prior to residency application/commencement.

 

J1 Waiver jobs are offered in undeserved areas. More information about these areas can be found via http://hpsafind.hrsa.gov/

 

So there you have it! It may be tricky, but moving to the US as a doctor is very possible! This is just a basic overview, there are of course many other hurdles that must be jumped before you are a US practicing MD, but we all have to start somewhere!

 

 

 

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Medicine: A Mature Applicants Story

Medicine: A Mature Applicants Story

Hi there! I’m Sarah, I work with Medinc (my husband owns Wellesley Inc, meaning I occasionally get roped into  helping. Usually admin work or carrying products into exhibitions, nothing glamorous). This blog is designed to be “medical themed” and what can be more medical than medical school?

When I decided to take the plunge and make a career change to medicine I found there was very little advice out there for mature students. I spent hours trawling the internet trying to figure out what my options were, and made many mistakes along the way. Now i’m not claiming this post will prevent you making any mistakes yourself, but hopefully it should clarify some points. Please also bear in mind that I don’t work for any medical schools, i’m simply sharing my experience of the process. Please also remember that any information I say is based on what I have found at this point in time, things like entry requirements etc may change, so always double check facts!

The first thing I realised, but wasn’t surprised by was the competitiveness of Medicine. The bar is set high for entry requirements and the number of applicants per place quite frankly made my choke on my coffee. I guess I wasn’t surprised at all as being a doctor is a greatly respected, and let’s be honest, pretty well paid profession. It makes sense that many like minded people will be just as enthusiastic and keen on studying medicine as you, so the key is standing out… but how?

I first researched studying medicine when I was 17 and working in London as a PA. I hated my job so much but had no idea what else to do. I had stupidly quit my a levels because of personal reasons and very little sense of direction. I can’t remember what made me look into becoming a doctor but after I realised the high entry requirements and fierce competition, I gave up on the idea. I started researching other healthcare career options and saw that my local university was recruiting student nurses. Encouraged by my mum for my “caring nature” I went along and decided perhaps this could be an option. I got a job as a care assistant and started University that autumn.

I enjoyed my nursing training to some extent. It wasn’t that I disliked it but I didn’t have the kind of crazy enthusiasm you have when pursuing your dream. I still kept thinking about Medicine and loved spending time with the doctors during my training. I was often discouraged by other nurses from considering medicine and received a lot of negative comments if I mentioned the possibility of changing career track. Nurses don’t often become doctors it seemed, which surprised me.

Why did I want to be a doctor and not a nurse?

I get asked the question all the time. Before I applied, whilst applying, in my interviews and by pretty much everyone  have told what I am doing.

The simplest answer really is because being a doctor is my dream job, being a nurse isn’t.

I want to explain that I have a huge amount of respect for nurses. It’s a challenging and rewarding career that I wouldn’t discourage people from pursing. But if it isn’t for you it’s not an easy job to do. Why do some people like meat and others don’t? Or like different types of music? I am more interested in the diagnostic side of medicine, rather than care. I knew that if I didn’t at least try to pursue medicine I would regret it for the rest of my life. I would always wonder what if? I realised that it is better I try to get into medical school and fail than never try at all.

So I started researching, I found that although I hadn’t done chemistry or biology alevels I could instead complete an Access to Medicine course.

Most of the information I found was about a course called COWA (College of West Anglia), which seemed to get many students into medicine. However they changed their entry requirements for GCSE science by the time I could apply, and I was no longer eligible. I felt disheartened. After researching I found there were several other courses including MANCAT (Manchester) which were also reputable. I applied, interviewed and was offered a place, but started getting panicky about the distance. Myself and my husband had decided I would commute up to manchester, stay during the week and return for weekends. But with train fares, rent etc it was going to add up. On a last minute whim I investigated London courses and found Lambeth and CANDI. Lambeth didn’t seem too interested in helping and offered to add me to their wait list but I would have to go into London to write my name down (I live in Essex). Perhaps they were just having a bad day but they were pretty rude on the phone. CANDI (City and Islington College) however were lovely. They offered me an interview that day, plus the assessment and I was offered a place on the spot. When I asked how many students gained entry to medicine the previous year they admitted that none had, but said previously they had gotten students in and it vastly depends on the candidates.

After discussing in detail with my husband I decided to take a chance on CANDI, I could still work as a community sister, it would be far less costly and there were no guarantees either way. In the back of my mind I was nervous that if I didn’t get in I would blame myself, and convince myself I should have gone to MANCAT instead.

Once I knew I was going to do the Access to Medicine course I started to revise for the UKCAT. From my extensive internet trawling I had come to find that the UKCAT is a huge determinant of whether you are offered a place to study Medicine. I had also learnt that you shouldn’t trust them when they say you can’t prepare for it. I found this information out from the many people on student forums explaining that they increased their score as a reapplicant by more than 100 points just by practicing. As a woman who had been dreaming of studying medicine for around 5/6 years at this point I desperately didn’t want to wait another year if my UKCAT let me down. So I practiced, and practiced, and practiced some more. I bought books from Amazon, some were good, some weren’t. I used an online database which was very helpful. I used the practice questions on the UKCAT website. I won’t lie, I worked really really hard, which made me even more nervous on the day of the test. I got 690 which isn’t amazing but certainly competitive. With a weight off my mind I focused on my UCAS application.

I had started working on my personal statement at the start of summer and pretty much everyone got the “privilege” of reading and critiquing it. The college helped my finalise it and I moved on to selecting courses. This is another area that many applicants seem to trip up on. Due to the competitiveness of the courses if you apply and don’t meet or actually exceed the entry requirements you won’t stand a chance. So selecting the right programmes is incredibly important. I’m lucky and didn’t have to factor geography into my selection. My husband and I can work from anywhere, so we are very lucky. Even if geography is a more important factor for you I would definitely emphasise an open mind during the application process. After all medical school is 5/6 years long, on top of that there is foundation years. So relocating could be a more permanent change and a sacrifice you are willing to make.

Each course has it’s own set of entry requirements, such as

  • GCSE entry grades
  • ALevel/equivalent entry grades
  • UKCAT score requiement
  • Work experience

There can be other stipulations, it’s important to remember that not all Medicine programmes access access courses, and some will only accept select courses. For mature applicants there may be other factors taken into account such as gap between education and the career progression you have had in your current job.

I received interviews at all four of my selected courses. I withdrew from one and got offers from the remaining three. This was considered by the college and many people I spoke to, a huge success and i’m still on cloud nine. Something I learnt from my experience is that there are many great Access courses out there, and it isn’t necessarily the ones which are best known. CANDI’s course was fantastic, with the best teaching I have ever had. I can’t wait to start my new career and will finish on my top tips for applying as a mature/career changer

  • Revise hard for the UKCAT, it can be prepared for and can make or break your application
  • Get lots of work experience, not only will it show your commitment but will prove really useful for your personal statement and interview
  • Work on your personal statement, get everyone you can to read it, over and over until it is imprinted on your mind
  • Select your choices carefully. Apply only to places which accept your grades and other entry criteria. This is definitely more important than the Uni’s rep or where it is based
  • Be prepared to wait and wait and wait. The wait between submission and hearing back is agonising… but it is worth it in the end
  • Don’t forget to work as hard as you can on your access course!

Good luck!