[Dr.NickRiviera]

Hi all,

As a returning Irish trained (international) medical graduate who was forced to work abroad due to lack of internship posts in Ireland (at the time) I would like to offer my experiences to any that may have an interest.

Whether its just out of curiosity or you genuinely want to hear about what its like to work outside Ireland (experience mainly of New Zealand/Australia), I am happy to share. Likewise your experiences working in the HSE would be warmly welcomed.

It's an exciting time for myself as the challenge of reintegrating into the HSE after gaining experience abroad will be very interesting. From what I gather it's an interesting time for all NCHDs as genuine efforts into resolving the issues the HSE have faced over the last few years although slow, remain a firm step in the right direction.

Look forward to some interesting discussions!

Regards,

Dr Nick

[51533823]

Hi Nick,

A few questions for you:

What are the chances of getting a training post in Aus/NZ? In relation to GP training posts I've seen something about a 10 year moratorium in Aus. Is this the same in NZ?

Would love to hear your thoughts as I hope to head that direction on graduation.

Thanks

[take everything]

Hi Nick.
Can you outline how Ireland compares with Aus/NZ in terms of:

Hours
Workload
Proper supervison/training.
Are you too busy chasing after some xray report, say, to learn anything like in Ireland, or are the roles more distinctly clinical.

You can only speak for surgery yeah?
But maybe you could comment on Medicine as well.

[Dr.NickRiviera]

Originally Posted by 51533823

Hi Nick,

A few questions for you:

What are the chances of getting a training post in Aus/NZ? In relation to GP training posts I've seen something about a 10 year moratorium in Aus. Is this the same in NZ?

Would love to hear your thoughts as I hope to head that direction on graduation.

Thanks

All the guys I know got onto the GP training scheme in NZ within 2-3 years post graduation. It is competitive but nowhere near as competitive as Ireland or Australia. I believe since there are far greater doctor shortages in New Zealand than Australia that would probably be why. A very considerable number of Kiwis emigrate to Australia for several reasons and so opportunities become available for others who would like to settle or train in NZ.
As for a period of 10 years. I am not certain if that is even entirely accurate for Australia or perhaps that only applies to certain urban districts, however as I am not sure I cannot comment. In NZ there is no such period...period.

Hope that helps

[Dr.NickRiviera]

Originally Posted by take everything

Hi Nick.
Can you outline how Ireland compares with Aus/NZ in terms of:

Hours
Workload
Proper supervison/training.
Are you too busy chasing after some xray report, say, to learn anything like in Ireland, or are the roles more distinctly clinical.

You can only speak for surgery yeah?
But maybe you could comment on Medicine as well.

Ok. I have worked in both surgical and medical rotations so I can speak about both although more about surgical. I'll try to keep it general for now.

1. Hours:
Obviously the more senior you get the more the responsibilities and hours working are needed. In Ireland there is a 48h/week work limit as outlined by EU law. This is clearly never met in most cases and we have all heard about doctors working >100h/week. Overtime is often not paid which makes it worse.
In NZ your pay scale is determined by the bracket of hours you work per week. For example <40h, 41-50, 51-55, 56-64 and 65+ Each would have a increase in salary depending on how long you worked. Every single hour above this is paid promptly without question at a pre-negotiated scale set by the Doctors Union.

2. Workload
I found that workload can be busy at times but almost never oppressive. There are always other doctors who are having a quiet day or two and they often are happy to come aid you when you are struggling. This is always reciprocated of course when the tables have turned. Suffice to say that the workload would always average out as less than you would be handling in Ireland. A 35 patient load on one House officer would be deemed 'Madness' whereas in Ireland that would be a norm. I've been lucky to have 2 whole weeks over the last year when all my bosses were off so I had no patients at all...I kept myself busy though helping others that were enjoying the 'madness'

3. Training/supervision
Excellent. If you are keen and show interest you will be trained and taught on any area that interests you. I often had private tutorials other than the official ones set by the medical council on common hospital clinical issues. Consultants are more than happy to have you scrub in with them and assist on procedures. There is protected teaching time during the week and that's not for trainee's either.
As things are usually not as busy as in Ireland you will get far more one on one chances with seniors to practice and learn new skills.

Bloods, Radiology and all general management of the patient is part and parcel of any junior doctors life. Learning to prioritize and manage the chasing of results is a very important task and in itself is a learning opportunity. As you become more senior that task is delegated to your juniors so consider it a right of passage that we all go through. I personally managed to program my IPAD to be able to access the hospital network at anytime so I had all the results at hand pretty much whenever I needed them.

In summary the general consensus from myself and my classmates that moved to NZ/OZ is that you work fair hours and loads and retain a great quality of life compared to Ireland. The money is competitive and the training is excellent if you are keen. You never chose to become a doctor for wealth or to be bitter and miserable. Balance is strongly advocated and encouraged.

Hope that helps!

[51533823]

Originally Posted by Dr.NickRiviera

All the guys I know got onto the GP training scheme in NZ within 2-3 years post graduation. It is competitive but nowhere near as competitive as Ireland or Australia. I believe since there are far greater doctor shortages in New Zealand than Australia that would probably be why. A very considerable number of Kiwis emigrate to Australia for several reasons and so opportunities become available for others who would like to settle or train in NZ.
As for a period of 10 years. I am not certain if that is even entirely accurate for Australia or perhaps that only applies to certain urban districts, however as I am not sure I cannot comment. In NZ there is no such period...period.

Hope that helps

Thanks for the great info.

I'll be coming from a graduate entry program here in Ireland and so will have a good share of debt on graduation. How are the wages in NZ for junior doctors in the first two years and then later while on a GP training scheme?

Many thanks!

[Rick Dagless]

Originally Posted by Dr.NickRiviera

Hi all,

As a returning Irish trained (international) medical graduate who was forced to work abroad due to lack of internship posts in Ireland (at the time) I would like to offer my experiences to any that may have an interest.

Whether its just out of curiosity or you genuinely want to hear about what its like to work outside Ireland (experience mainly of New Zealand/Australia), I am happy to share. Likewise your experiences working in the HSE would be warmly welcomed.

It's an exciting time for myself as the challenge of reintegrating into the HSE after gaining experience abroad will be very interesting. From what I gather it's an interesting time for all NCHDs as genuine efforts into resolving the issues the HSE have faced over the last few years although slow, remain a firm step in the right direction.

Look forward to some interesting discussions!

Regards,

Dr Nick

Hi Dr. Nick.

It's very early days but I'm giving serious thought to training in the US/Canada after intern year. Have you any experience of N. America? NZ/Oz sound appealing but would it be easier to get a residency in N. America?

Thanks

[Dr.NickRiviera]

Originally Posted by 51533823

Thanks for the great info.

I'll be coming from a graduate entry program here in Ireland and so will have a good share of debt on graduation. How are the wages in NZ for junior doctors in the first two years and then later while on a GP training scheme?

Many thanks!

Wages are competitive with Ireland especially when you factor in living costs, transport, rent etc not forgetting quality of life. The exact wages are all published online. Depending on hours ultimately and what run you are on you would be looking significantly more potential to save/pay debts etc. All the time maintaining a balanced life and negating the starts of a gastric ulcer...
Personally, I had a loan to pay back in Ireland from my college days too so I was able to pay that, pay rent for a 3 bedroom villa on a hill with ocean views, V6 3.0L car (petrol isnt cheap!), and go out for dinner 3-4 times a week and still save about 1/3 of my earnings without breaking a sweat. Hopefully that helps

[Dr.NickRiviera]

Originally Posted by Rick Dagless

Hi Dr. Nick.

It's very early days but I'm giving serious thought to training in the US/Canada after intern year. Have you any experience of N. America? NZ/Oz sound appealing but would it be easier to get a residency in N. America?

Thanks

Hey,

I'm afraid I cannot comment accurately about N.America and residency programs. Half my uni year returned back there and they all seem to be doing well. Residency programs are gonna be tough anywhere you apply. Some tougher than others.

The general feel of the N.American program is that if you can get on it you are pretty sorted and will be looking at a fast track system of getting into a specialty. The hours are crazy and the pay is very low compared to europe/nz/oz. However it does increase exponentially and you will become a consultant much faster than the other regions after which your salary would dwarf those of the rest of the world.

However from my own experiences with working with fellows from N.America vs Irish fellows...(at least 5-6) you can't compare them. Irish win hands down. Just because you become a consultant faster doesn't necessarily make you a better doctor. The whole hardship process of your junior years in Ireland/Australasia serves an important purpose, you will be far better rounded overall.

So best advice would be to create as many options for yourself eg sit USMLEs and apply for several intern programs. The Internship issue that I had when I graduated in 2009 seems to still be a huge issue for International grads in Ireland. I doubt this will be changing anytime soon...

Hope that helps!

[briankirby]

Thanks a lot Dr Nick for this thread.
Can i ask,did u average about 50 hours a week as an sho over there?I believe in the uk some weeks u do 80 hours and others u have a few days off.

Also,how old can a doctor be if they want to do their specialty training in NZ?
As in,is there a cut off age?
Thanks

[Dr.NickRiviera]

Originally Posted by briankirby

Thanks a lot Dr Nick for this thread.
Can i ask,did u average about 50 hours a week as an sho over there?I believe in the uk some weeks u do 80 hours and others u have a few days off.

Also,how old can a doctor be if they want to do their specialty training in NZ?
As in,is there a cut off age?
Thanks

Hey,

To answer your questions. On average it would be around 50-55 hours/week. Really depends on what specialty you are on. Surgical usually does more hours than medical. Pretty sure this is worldwide. ED has its own roster system so if you work over the weekly cap you are given a few days off so that you may still be within the weekly hour limit.

There is no age limit on specialty training that I am aware of. If you are interested in a particular area and show commitment in that field you stand a good chance to get on.

I just met a couple of doctors returning from NZ on the flight back to Dublin and we all agreed what an awesome deal working there was. It's almost like a paid holiday was one of the comments said. That kind of sums it all up really...

[briankirby]

Wow,sounds fantastic.
Good work hours/conditions,good pay,support,progression and sun every day.
Begs the question
Why are u guys coming back?
Cheers for your reply

[Dr.NickRiviera]

Ya I've been asking myself the exact same question since I moved back. Oh well, starting new job in 9 hours and I look forward to the 'challenge' of working for the HSE and testing my resolve and determination. NZ was a working holiday...I'm sure to find out soon enough. Will keep you posted on how the slaughter goes lol

Dr Nick

[RobFowl]

Good luck in the new post Dr Nick
hope it works out well. be interested to see how they compare!
(Never actually worked as a nchd here, came back as a trained GP)

[Dr.NickRiviera]

OH...MY...GOD...

First week done. I am too wrecked to even begin to describe. 36 hour shift on call working straight without 1 min of sleep...and in for theatre in the morning post call. I was warned...

Suffice to say...If you can hack it over here...you can hack it anywhere in the world...

Any NCHD that works here would be basically on holiday working in NZ/OZ...I really can't believe what I just experienced. And I still have a whole weekend on call to look forward to...

Interesting observation tho...almost 99% of interns are Irish...almost 99% of consultants are Irish...almost 90% of NCHDs are foreign...hmmm

All that said...This is what I signed up for and I genuinely love every second of it. Digging deep...

'I firmly believe that any man's finest hour, the greatest fulfillment of all that he holds dear, is the moment when he has worked his heart out in a good cause and lies exhausted on the field of battle-victorious.' (Vince Lombardi)

And yes...the HSE is a field of battle...