Training in the states

Dr Nic

Hi Guys,
Mind if one asks a bit about doing most if not all of your postgrad training in the States?

I plan to do my intern year here in Ireland, but after that unless i bite the bullet and go for the GP route i dont think i will stay in Ireland.


Weighing up the different countries to train in:
Ireland - crap training, crap conditions and a level of training that may or may not be recognised overseas

UK - A close friend is a very senior SpR in London, who only went there last year. He says the NHS is great for him & his equals. But not for junior docs

Canada - Return of service - F that

States - Looks very appealing. Its all predicated on doing well in your Steps, but if that was to go your way then 4 odd years of slaving and you'll be a considerable way towards being trained fully in whatever speciality you desire. Also your qualification is recognised the world over! Coming back would be a problem of course unless you want to take a major hit on your position but that wouldnt be the end of the world...

Can anyone who has experience doing their postgrad training oversea's please enlighten me? Or add in any of your thoughts?

Thank you so much!

ThatDrGuy

Hi,
I never worked in US but know a few people that have. Not so much predicated on USMLES - a high score is good though. They dont give a very high priority to non US med schools so can be very difficult to get some where good, you might have to work in middle of nowhere for a long while. Also they work 6 day weeks so bye bye weekend. Holidays are negligible. Surgery is insane, 5 am pre-rounding can be the norm. Pay is bad for first few years and hours long. Training in general is top notch as are career prospects. It helps if you have done electives in US hospitals and if you are US citizen. Make sure you get a green card, I know 2 docs who had to come home in a hurry despite having worked there for 5 years.

lonestargirl

ThatDrGuy wrote: »

Hi,
I never worked in US but know a few people that have. Not so much predicated on USMLES - a high score is good though. They dont give a very high priority to non US med schools so can be very difficult to get some where good, you might have to work in middle of nowhere for a long while. Also they work 6 day weeks so bye bye weekend. Holidays are negligible. Surgery is insane, 5 am pre-rounding can be the norm. Pay is bad for first few years and hours long. Training in general is top notch as are career prospects. It helps if you have done electives in US hospitals and if you are US citizen. Make sure you get a green card, I know 2 docs who had to come home in a hurry despite having worked there for 5 years.

You can't just make sure you get a green card. You need a sponsor and pretty much no residency programs do that any more - or at least any that you want to go to. They all do alien physician j1s and that automatically comes with the 2 year home residency rule. The only way around this is to work in an underserved area for a while. The VA in Houston is full of doctors working out their home residency rule. Marrying a citizen etc doesn't get rid of the rule either. If you want to do surgery it is insane, 6 days a week for 50 weeks of the year with one block of 2 weeks off!

Ryder

Have done a US fellowship, not residency.......NCHD life is crazy here.....70, 80+ hour weeks, and you arent paid. From what I see, the training is actually worse. The one superior aspect is a shorter duration, roughly 7 years to completion.

If you got a big name residency like Mayo, Memorial Sloan Kettering etc, it may be worth it, BUT I think it would be difficult to compete for jobs back in Ireland...ie most Irish applicants will have done fellowships (box ticked), will know the system and be known by prosepective colleagues.

Anyway, good luck whatever you choose

Dr Nic

Can someone enlighten me re the length of Irish programs eg cardiology, and how one gets onto it?
From what i can see only GP, radiology and anaesthetics have their act together re training in Ireland. You can get on them a year or two post grad, and 4 to 7 years later you're done or nearly done..

But what about the rest?
Is this written down anywhere?

Ryder

Dr Nic wrote: »

Can someone enlighten me re the length of Irish programs eg cardiology, and how one gets onto it?
From what i can see only GP, radiology and anaesthetics have their act together re training in Ireland. You can get on them a year or two post grad, and 4 to 7 years later you're done or nearly done..

But what about the rest?
Is this written down anywhere?

they're all written down, usually on the college website. I'm not a cardiologist, but the structure is....1yr intern, 2 yrs SHO, maybe none buy probably 1yr as a junior reg, competitive entry into cardiology specialist training....which itself is 6yrs (I think). All medical and surgical pathways are the same (largely)

Yes its long but at the end you're done, completely. In contrast, many European countries, and the US, with shorter training have a different career structure, with their attending equivalent to an Irish senior reg (by in large...comparing countries is always difficult)

his_dudeness

Dr Nic wrote: »

.......Weighing up the different countries to train in:
Ireland - crap training, crap conditions and a level of training that may or may not be recognised overseas.....

Thank you so much!

I'm doing post-SHO surgical research at the mo, but I'd have to disagree with some of this post related to Ireland.

As we've seen above, conditions, as bad as they are in Ireland, aren't as bad as they are in the US; over there it's a case of worse conditions but for less time than here.

And as regards training not being recognised, Irish trained trainees occupy prestigious competitive fellowship positions the world over, so I don't think that's a fair statement.

Or else I'm just being a bit niaive...

Vorsprung

his_dudeness wrote: »

And as regards training not being recognised, Irish trained trainees occupy prestigious competitive fellowship positions the world over, so I don't think that's a fair statement.

Or else I'm just being a bit niaive...

I can't comment on conditions in the States but I would definitely agree that Irish trained medics are well regarded in many countries.