Consider Working Overseas
Published on: May 7, 2018
One of the best aspects of being medically qualified is the complete portability of your skills. Wherever you are in the world, people always need doctors.
US-trained doctors are in demand in many places in the world; your choice of career and high-quality training gives you unparalleled opportunities to work overseas – whether in a paid position or in a voluntary role. There are many reasons physicians choose to work abroad: to develop a specific skill or knowledge in a prestigious world-leading center; the opportunity to experience different cultures, sightseeing and activities in another country; or perhaps for an improved work/ life balance.
Deciding which country offers the greatest potential for you to work abroad will very much depend on what your priorities are and what you are looking to gain from practicing medicine overseas. For that reason, it is important to think about what you want to achieve from working overseas before looking at the possible options available. Think about what is important to you:
- Potential for travel within the country
- Opportunities to move from job to job
- The salary you can expect
- Available technology
- The healthcare environment in which you’ll be working
- The type of care you’ll be able to deliver to patients.
Giving thought to what you want from a job will help you to narrow down the choice of countries in which you might wish to work. There are other important factors that may further influence your decision.
Speaking a Foreign Language
Things are far easier if you choose a country where you speak the language. The practicalities of diagnosing and treating patients without being able to speak their language are a difficult hurdle to get over, especially in emergency relief teams.
However, to gain employment in a national health service, a practice or hospital overseas, you’ll need to demonstrate proficiency in the local language. In most cases, this will mean a language test. For example, to work in the Netherlands as a physician coming from overseas, you will need to demonstrate language competency in Dutch to the NT2-B2 level – although the advice is that in practice you will need a level of C1 or C2.
For this reason, for US physicians, Canada, Australia, New Zealand, Ireland and the UK are the most obvious options for working overseas. If you are fluent in Spanish, your employment target widens to most of Latin America, Mexico, South America and Spain, although salaries and conditions vary considerably.
A 2016 survey featured on career addict cited the USA as the country with the third highest salaries in the world in which to work as a physician – with salaries for specialists averaging $230,000 per year, and GP salaries averaging around $161,000 per year.
On pure salary alone, only two countries rank higher: Australia and the Netherlands. Salaries in Australia average $247,000 for specialists and $91,000 for GPs. The Netherlands took the top spot with salaries averaging $253,000 for specialists and $117,000 for GPs.
Denmark, Switzerland, Ireland, France, the UK, Canada and Belgium comprise the rest of the top ten countries to work in as a doctor in terms of salary. Of course, this measurement doesn’t take into account the general cost of living in those countries – or the cost of malpractice insurance. The spiraling cost of insurance in the US would see it fall a few places in the table, were it to be taken into account.
You will also need to consider which specialties are most in demand in each country as this will have an impact on the salary you can expect to earn as a specialist. If you are thinking of staying in a country long-term, specialists will also need to consider the opportunities for private practice in conjunction with their salary. In both Ireland and the UK, experienced specialists have plenty of opportunities for lucrative private work and most specialists will split their time between public and private practice.
Bear in mind, however, that if you are an American citizen, you’ll need to pay US taxes on the income you earn overseas, as well as any local taxes accruable in the country in which you are working.
The Local Culture
Local culture is another important factor to consider. For example, in the United Arab Emirates (UAE) physician salaries are among the highest in the world. And one major benefit in the UAE is that your salary is not subject to local taxes. However, this opportunity to put significant savings away does require some compromises. Foreign workers in the UAE live in gated ex-pat communities; while they afford many luxuries, this isn’t for everyone. And while cities like Abu Dhabi and Dubai are among the most westernized in the Middle East, the way of life is very different.
By contrast, the cultural shift required for a move to an Australasian country is much less dramatic. Added to this, the work-life balance in Australia and New Zealand, with the focus on outdoor activities and the unique and wonderful sightseeing and scenery, make these countries an appealing prospect for US-trained physicians.
Meanwhile, the UK and Ireland afford easy travel access to Europe for short breaks and vacations to experience the culture and many historical cities and regions on the continent.
The local health care delivery model can also impact significantly on your experience working as a physician abroad, so it is important to do your research about the local delivery models, services and conditions before making the move.
For example, in the UK, the National Health Service (NHS) is undergoing a lengthy and serious funding crisis. This underfunding is making conditions in many facilities highly pressurized and salaries are not what they once were. The exception to this is if you go and work as a locum, filling staff shortages on a temporary basis, in which case NHS staff shortages are driving up the salaries you can expect to command. The pay-off for this is, of course, the uncertainty of income. And it does nothing to address the underfunding and diminishing morale in the state-run facilities.
Meanwhile, in Belgium, physicians are rewarded with high salaries – but their work week is one of the longest in Europe. Doctors there average a 51-hour work week. These differing conditions make it essential to do your research thoroughly before you apply. Arrange to speak with other physicians who have worked abroad.
Seeking a Position
International online job boards make it much easier to seek and find international employment opportunities today than it was just a couple of decades ago. There are many locum agencies that specialize in international placements and it is also worth investigating local Temp and Permanent agencies.
One of the best ways to find potential opportunities to work is through the local medical publications in your chosen country. For example, the BMJ in the UK, the Medical Journal of Australia in Australia, or the New Zealand Medical Journal in New Zealand.
If you need to be in a particular location (for example, to follow your partner’s job, or other family commitments), you may need to search for local facilities and hospitals and approach the appropriate specialties directly. This way, you benefit from the in-depth contact with medical staff to know when a vacancy is available and gain more knowledge of the facility and team.
If you are interested in humanitarian work, the best places to start are respected medical organizations such as Médécins Sans Frontièrs or Medical Emergency Relief International. If you are able to give your time voluntarily, Voluntary Service Overseas and Médécins du Monde are other possible routes which rely on international health professionals.
Securing a Job Offer
Online video chat makes the process of interviewing much easier but, in reality, the process of securing a position is the easy part! The hoops you will need to jump through to attain the necessary visas and demonstrate the necessary competencies are likely to take far longer.
Requirements will be, at a minimum, evidence of your primary medical degree and a certificate of good standing from your current medical board. As we’ve seen, a language test may be required, depending on where you choose to go. And some visas will require medicals as part of the application process.
One of the benefits of applying through an agency is that they are likely to help you with the visa and registration process if you are offered a position through them. If you aren’t using an agency, make the effort to investigate what support your future employer can offer in this regard.
You can find more information online with the local medical boards for the country or, in Canada, the province in which you intend to work.
For Canada: mcc.ca/
For the UK: healthcareers.nhs.uk
For Ireland: medicalcouncil.ie
For Australia: medicalboard.gov.au/
For New Zealand: nzma.org.nz/
For Dubai: dubai.ae/en/
Additional Resources to Learn About Opportunities
IRS rules on Foreign Earned Income Exclusion
BMJ careers in the UK
The Medical Journal of Australia for jobs in Australia
The New Zealand Medical Journal for jobs in New Zealand
Medecins Sans Frontiers
Doctors of the World
Voluntary Service Overseas
Top 10 Countries with the Highest Salaries for Doctors, Brendan Butler, Career Addict, Dec 12, 2016 - careeraddict.com
Procedure Working as Doctor in the Netherlands, Vereniging Buitenlands Gediplomeerde Artsen - vbga.nl
5 Best Places to Become a Medical Volunteer Abroad, Sarah Ehlers, Go Abroad, May 10, 2016 - goabroad.com One of the best aspects of being medically qualified is the complete portability of your skills.