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.
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.
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
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!