WORKING ABROAD AS A DOCTOR - Things You Must Know

By working abroad, doctors can experience a new culture and a different medical system.
Are you always the first one to say "yes" to an adventure? Have you always wanted to immerse yourself in a new culture? Then working abroad may be for you.
If you were to ask a doctor who has worked abroad whether or not they would recommend it, you are likely to hear something along the lines of, "Absolutely! It was a great experience, but it definitely isn't for everyone."

While this statement is certainly true, it is often hard to explain exactly why it isn't for everyone. The number of reasons that doctors will give for working in another country are likely to be just as varied as the reasons that they will say not to go.

One reason that doctors go overseas to work is to experience a new way of practicing medicine. This is especially true for doctors from the United States, who are often seeking a break from the challenges of working within the U.S. healthcare system.

U.S. doctors will probably experience fewer "hoops" that they have to go through to provide patients with the medical care that they need. This can be a refreshing part of working in a new system.

Working abroad can also be an opportunity to get paid while experiencing a new culture first hand. For instance, many doctors with children find the opportunity of immersing their kids in a foreign culture to be an invaluable experience for the whole family.

Learn about the challenges that working abroad as a doctor is likely to bring, and what the best options for getting a job in another country are.

Things to consider before you sign up
Working in another country is not necessarily going to be a vacation. Many of the positions open to foreign doctors are in rural areas that have high need, so you are likely to be very busy in your new facility.

There is also a steep learning curve that comes with working in a foreign country. You will need to learn a whole new healthcare system that may have different drug formularies, unfamiliar names for surgical instruments, and new processes for getting patients through the medical system.

Living abroad also presents you with many cultural challenges. Depending on the country in which you work, you may have to brush up on your foreign language skills. And even if you are working in a country that speaks your native language, you will probably need to get acquainted with a new accent, which can take some time getting used to.

Staying connected with family and friends can also be challenging. Technology has certainly made long distance communication easy and affordable, but working across different time zones can still present problems.

Furthermore, if you are coming from the U.S., you may be liable to find that salaries are significantly lower than what you might be used to at home. In order to make it work financially, you may have to do some financial planning prior to your move, so that you can meet your financial obligations while you are away.

Another challenge you may experience is the lack of control that you are given over your schedule. Many doctors find that they are given a fixed schedule when they arrive for work that they have to adjust to. The number of patients you need to see and the procedures you must perform are also likely to be pre-set, with little room for change.

This may be especially difficult if you are coming from a private practice, where you have total control over your schedule. But if you are undeterred and ready to face your adventure, we have practical tips that will help to get you on your way.

What to know before you go
Before you decide to work abroad, it can be helpful to talk with other doctors that are already practicing medicine in the location you are considering; they can give you practical advice about both the work facility and the country. You can also get great advice about the things you should or should not bring with you once you decide to move.

If you are an American citizen, it is also important to know that you are required to pay U.S. taxes on the income you earn for the entire time you spend living overseas. You will also probably have to pay taxes in the country you are working in. It is therefore important to research this before you move, so that you know what your tax obligations are likely to be.

Additionally, returning to your home country and either going back to your practice or finding a new job can be hard. Talking with other doctors that have done work abroad to find out how they were able to transition back into medicine at home can help to prepare you for as smooth a transition as possible.

Many doctors seek employment overseas while they are between jobs in their home country. Staying in touch with colleagues while you are overseas can be a good way to find employment when you return to your home country.

If you intend to return to the same practice, it may be helpful to talk with your employer to see if you can arrange a sabbatical before you leave.

What will you need to practice abroad?
Every country will require different documentation from you before you can begin work. Some general things that you will possibly need are:

an active medical license in your home country
a current résumé
a valid passport
two or more passport-sized photos for your visa application
professional references
a complete physical exam, which may include blood work, a chest X-ray, or a bacteria culture, depending on country
a background check
The entire process can take between 3 and 6 months to complete, so be sure to start researching jobs well in advance of when you want to go.

How do you find a job abroad?
There are a number of different ways that you can go about finding a job in a new country. All are good options, so you will just need to decide which one best meets your needs.

If you are planning to go for only a short time, then using an agency may be the easiest solution. This is how Dr. Butler - an obstetrician/gynecologist (OB/GYN) who went to New Zealand for 6 months with his wife to practice medicine - found his position.

For him, the agency "just made everything so easy. They took care of all of the credentialing, visas, and passports. All [he] had to do was show up at the airport. Even [his] rental car was waiting for [him] at the airport when [he] got to New Zealand."

There are two types of agency that can help you to find an overseas job: locum tenens agencies and placement agencies.

Both will help you to find a position and assist you with completing all the necessary paperwork for credentialing and visas. But each functions differently once you start working.

If you are placed in your new position through a locum tenens agency, you will actually be employed by the agency and not by the facility at which you are working. This means that your pay checks will come from the agency.

They usually offer you additional benefits such as a car, housing, and even all of your utilities. But being an employee of the agency also means that you will probably get paid less than your colleagues employed by the facility you work at.

If you use a placement agency to find your job, you will be directly employed by the facility that hires you. Placement agencies may provide you with benefits such a car and housing for the first few weeks that you are at your new job, but you will eventually be responsible for all of your own living expenses. The benefit to this option is that your pay will be higher than if you are placed at a job by a locum tenens agency.

If you are going to be practicing medicine abroad for a longer period of time, then you may want to find a job on your own. This can be done with the help of the consulate or embassy of the country in which you intend to work.

You may be able to find more job opportunities with this method, but you will need to be prepared to do a lot more legwork than if you choose to use an agency.

Visas and medical licensing can require a lot of paperwork, and it must be done correctly or you may be denied the opportunity to work in your country of choice.

Get the most out of your time abroad
While practicing medicine in rural New Zealand, Dr. Butler did not find it any more challenging to care for his patients.

"Practicing OB/GYN is basically the same everywhere. The work certainly wasn't difficult it was just different. I went with a go-with-the-flow-attitude so I didn't really have any problems," he said.

"It was the country more than the work that was so special. The country was so beautiful and we traveled as much as possible while we were there," Dr. Butler added.

He did not experience any earth-shattering changes to his life or his approach to medicine. For him, "it was a 6-month working vacation. [He] did take [his] duties seriously but [he] did want to enjoy [him]self."

Regardless of why you choose to work overseas, it is important to bring along your sense of adventure and to remain open-minded throughout your experience.

[Source: Carrie Noriega, M.D. as published in MNT]

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