On The Other Side


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I think for the most part, especially in Medicine, we are so consumed by where we are and what we study that we often forget the outside world beyond the horizon. This really struck me during the Paris attacks when the sinister reality of Friday 13th put things into perspective, and highlighted how lucky we all are in every respect.

I admit I suffer from this ‘grass is greener on the other side’ syndrome, but I think now is the time to at least be aware about other opportunities after graduation.

The life experience of living in a different country is invaluable, and likewise the exposure to two distinct health care systems as a doctor.

For those of you who are curious and adventurous to know about practising medicine outside the UK, I thought I would share my brief insight to what I call:

The Big Four’ – USA, Australia, Canada & Singapore.

USA – Anyone who knows about the US medical system will know the about the dreaded ‘USMLE’ split into Step 1, 2 (CK & CS) and Step 3.

Essentially the USMLE is a conversion exam for UK graduates and is the only tool to compare UK graduates or IMGs (international medical graduates), against American medical graduates (AMGs). To practise as a doctor in the US you need to get your STEP 1 score, STEP 2 score for CK (Clinical Knowledge), pass the CS (Clinical Skills) and then enter the matching resident scheme following graduation. US residency usually requires clerkship experience beforehand and it is worth noting that many states are bias to AMGs, and so IMGs have to be aware of states that are more IMG friendly.

Once matched you go straight into specialty training where in your first year you are an intern or PGY1 (Post graduate year 1).

Australia – IMGs have to sit an assessment under the AMC (Australian medical council) composing of the CAT MCQ exam and an AMC clinical exam. Completion gives you an AMC certificate, which you can then use to apply for Australian specialty posts. Usually you will need to have completed FY1 or 12 months post graduate experience as a doctor to apply.

Canada – IMGs looking to get into Canadian residency programs have to pass the MCCEE (an exam that evaluates medical knowledge) before graduation. Next you undertake the NAC (which assesses readiness for residency programs), and then the MCCQE exam parts 1 & 2 to practise medicine independently in Canada under the LMCC (Licentiate of the Medical council of Canada).

Singapore – As long as your medical degree is recognised, there is no conversion/entry exam to sit and you apply to obtain a residency program, which will usually involve an interview. Though be aware that some programs are direct entry into specialties while others require you to take a transitional/internship year prior to specialty training.

Obviously these are all massive undertakings and it is far easier said than done, however my main point being that Medicine opens doors to so many places.

With the right attitude for any medical student – the world is your oyster.












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