Recognition of Foreign Training

Biologic

Hi all,

I've heard a few people say it's hard to get registered as a specialist in Ireland if you train abroad. How difficult are we talking, and why? I intend to go to the states for specialist training (emergency or internal medicine most likely). While I have no immediate intention to return, It'd be handy to know if there's anything I can do to make returning easier should it happen. It's probably relevant that I intend on bailing before intern year

Thanks in advance.

RobFowl

My experience is that UK, USA and Oz trained docs have little problems. The Medical council will of course make it as awkward as possible but will eventually process the registration.

opinion guy

RobFowl wrote: »

My experience is that UK, USA and Oz trained docs have little problems. The Medical council will of course make it as awkward as possible but will eventually process the registration.

Why of course ?
What is there problem with it exactly ?

RobFowl

opinion guy wrote: »

Why of course ?
What is there problem with it exactly ?

Coming back from the UK took them 2 months to put me on the general register then later 6 months to process my specialist registration. Could never get an explanation for the delays.

Biologic

RobFowl wrote: »

My experience is that UK, USA and Oz trained docs have little problems. The Medical council will of course make it as awkward as possible but will eventually process the registration.

Yeah I figured they'd be difficult about it. They'll probably have words to say about me having never completed a 6+6 month med+surg internship either. Hopefully they get a bit quicker about accepting returning graduate registrations when they run out of other docs to import.

Ryder

Biologic wrote: »

Yeah I figured they'd be difficult about it. They'll probably have words to say about me having never completed a 6+6 month med+surg internship either. Hopefully they get a bit quicker about accepting returning graduate registrations when they run out of other docs to import.

no/little problem with registration from most countries.

dissed doc

If you are registered as a specialist in any EU country you can automatically register in another. It's a simple process and quite quick. If you complete specialist training outside the EU than it is more paperwork as your training level needs to be verified. the medical council in my experience are really really good with this and are very quick. If it's taking a while, it may be because there is a question or discrepancy about your training history; that takes time to investigate.

Remember there are people with fake degrees, references and universities trying to register regularly.

RobFowl

dissed doc wrote: »

If you are registered as a specialist in any EU country you can automatically register in another. It's a simple process and quite quick. If you complete specialist training outside the EU than it is more paperwork as your training level needs to be verified. the medical council in my experience are really really good with this and are very quick. If it's taking a while, it may be because there is a question or discrepancy about your training history; that takes time to investigate.

Remember there are people with fake degrees, references and universities trying to register regularly.

I agree that qualifications within the EU are transferable.
I beg to differ though on the Medical council being good. In my experience they are slow, inefficient, unhelpful and expensive.

Xeyn

There is a document on the medical council that explains this and which foreign speciality training is recognised by the imc. Generally speaking its most fellowships from uk, Aus, us, Canada and South Africa.

HeadPig

dissed doc wrote: »

If you are registered as a specialist in any EU country you can automatically register in another. It's a simple process and quite quick. If you complete specialist training outside the EU than it is more paperwork as your training level needs to be verified. the medical council in my experience are really really good with this and are very quick. If it's taking a while, it may be because there is a question or discrepancy about your training history; that takes time to investigate.

Remember there are people with fake degrees, references and universities trying to register regularly.

So in theory, if you trained as a specialist in France/Germany/Italy/Spain that would be transferable?

drzhivago

Biologic wrote: »

Hi all,

I've heard a few people say it's hard to get registered as a specialist in Ireland if you train abroad. How difficult are we talking, and why? I intend to go to the states for specialist training (emergency or internal medicine most likely). While I have no immediate intention to return, It'd be handy to know if there's anything I can do to make returning easier should it happen. It's probably relevant that I intend on bailing before intern year

Thanks in advance.

There are significant problems with USA not identified by posters here

If you graduate here and dont do internship here that is first hurdle as you will retrospectively need to get places you worked in USA to get experiential forms signed which need to be accredited by your Medical School here - a hassle

Next to be a specialist in Ireland there are statutory requirements of a minimum time spent " in training" that is 6 years here post Internship so minimum time you can spend is 7 years in PGME in US before will be easily accredited as specialist here

A lot of residency programs are 3 or 4 years in US so don't fulfill our statutory requirements, some think they can go top US and come back after 4 years and expect to be consultant here automatically and this is not the case

Generally if someone has done residency AND 2 Year fellowship AND worked in academic institution for further 2 years the process is smooth, if worked in community practice not a smooth to get on specialist register here

lonestargirl

drzhivago wrote: »

Generally if someone has done residency AND 2 Year fellowship AND worked in academic institution for further 2 years the process is smooth, if worked in community practice not a smooth to get on specialist register here

This could be difficult given that almost all residency programs are J1s now. That comes with the 2year home residency rule before you can get another visa. Something like gen surgery + fellowship where it's all training would get you to the required experience but medical residencies generally wouldn't.

drzhivago

lonestargirl wrote: »

This could be difficult given that almost all residency programs are J1s now. That comes with the 2year home residency rule before you can get another visa. Something like gen surgery + fellowship where it's all training would get you to the required experience but medical residencies generally wouldn't.

Did fellowship with J1 and didnt have a 2 year rule, there was a stamp on it saying didnt apply

dissed doc

drzhivago wrote: »

Did fellowship with J1 and didnt have a 2 year rule, there was a stamp on it saying didnt apply

I think (and I may very well be wrong!) that that may be simply when you finish your residency you do not need to return to your sponsoring home country for two years before starting your new employment in a fellowship. From what I understood, the maximum validity is 7 years.

Exemptions are for areas of underserved need, certain states do this. Five years there AFAIR or something and you get a green card, they can wave the J1 return home requirement.

lonestargirl

drzhivago wrote: »

Did fellowship with J1 and didnt have a 2 year rule, there was a stamp on it saying didnt apply

Interesting, you don't happen to know how your fellowship was funded do you? My understanding is that once it is a US government paid for post (i.e. almost all residency positions) then the 2 year rule must apply (for example it applies to Fulbright scholars).

drzhivago

lonestargirl wrote: »

Interesting, you don't happen to know how your fellowship was funded do you? My understanding is that once it is a US government paid for post (i.e. almost all residency positions) then the 2 year rule must apply (for example it applies to Fulbright scholars).

Yes I paid for it!

lonestargirl

drzhivago wrote: »

Yes I paid for it!

Ouch!

That's why you didn't have the 2-year rule. As i said before it will apply to the vast majority of residencies and is something that should be considered.

chanste

drzhivago wrote: »

Yes I paid for it!

Can you expand on this. I'm just wondering is there possibility of earning during your fellowship in another way or is it a case of use savings/loan? Also when you say you paid for it what sort of costs were there? Any info would be much appreciated. I'm foreseeing a move after intern year if I can make it happen, if not then, then at least the following year.

lonestargirl

chanste wrote: »

Can you expand on this. I'm just wondering is there possibility of earning during your fellowship in another way or is it a case of use savings/loan? Also when you say you paid for it what sort of costs were there? Any info would be much appreciated. I'm foreseeing a move after intern year if I can make it happen, if not then, then at least the following year.

If you are going post intern you are looking as residency not fellowship. Fellowship is post specialist training, for example having completed general surgery training you might do a fellowship in breast or colorectal surgery. Residency is through the match process and I'm pretty sure you are not allowed to self fund. Any US position will come with a visa that does not allow any other work while in the US.

chanste

lonestargirl wrote: »

If you are going post intern you are looking as residency not fellowship. Fellowship is post specialist training, for example having completed general surgery training you might do a fellowship in breast or colorectal surgery. Residency is through the match process and I'm pretty sure you are not allowed to self fund. Any US position will come with a visa that does not allow any other work while in the US.

I should have been clearer. I understand that, but I am interested anyway, just as I am interested in how things are set up here for specialist schemes. Nice to know the road ahead.

Biologic

Thanks for the input everyone. It looks like it'd be wise to go over there with the aim of getting a visa waiver programme after residency given the medical council 7 year training thing. It's frustrating, the 2 year home residency rule is there because you're meant to return home trained enough to practice your specialty, but when we return home the council won't recognise it.

dissed doc

Biologic wrote: »

Thanks for the input everyone. It looks like it'd be wise to go over there with the aim of getting a visa waiver programme after residency given the medical council 7 year training thing. It's frustrating, the 2 year home residency rule is there because you're meant to return home trained enough to practice your specialty, but when we return home the council won't recognise it.

They will certainly recognise it (Category E process instead of A (Ireland) or B,C,D (EU), it is just a longer process and requires more extensive verification than an intra-EU certification. The process is to verifiy you are a trained specialist in one of the recognised categories. If you become a cardiac surgeon, then you will be easily able to justify it with both residency and fellowships.

The Irish Medical COuncil, UK GMC and *every* EU state will require the same process. It is no different than turning up in the US Canada or Aus and having to wait several weeks or even months to be processed.

The problem is not the medical council (unless you decide to specialise in Mangkukulam withcraft) but more that there is but one state employer. It's not like there are career options at specialist level in Ireland if your job sucks you can.....a) leave the country or b) stay in the job that sucks.

Your best option is to enter the green card lottery which will also open doors at many places which favour only US citizens or Green Card holders. Second best is then H1B which requires a lot more planning and money but can be automatically turned into a Green card.

The J1 is defined by it not being an immigrant visa AFAIR.

drzhivago

chanste wrote: »

Can you expand on this. I'm just wondering is there possibility of earning during your fellowship in another way or is it a case of use savings/loan? Also when you say you paid for it what sort of costs were there? Any info would be much appreciated. I'm foreseeing a move after intern year if I can make it happen, if not then, then at least the following year.

Some specialties you pay for your fellowship by working 1 clinical day per week as an attending (consultant) which then is given back to you by way of a lower salary as a fellow

If you qualify here in a specialty where you cannot get a billing privilege in teh US you have to self fund the fellowship, depending on where you go that will cost from 40,000-100,000per year. In my opinion money well spent

Ryder

drzhivago wrote: »

Some specialties you pay for your fellowship by working 1 clinical day per week as an attending (consultant) which then is given back to you by way of a lower salary as a fellow

If you qualify here in a specialty where you cannot get a billing privilege in teh US you have to self fund the fellowship, depending on where you go that will cost from 40,000-100,000per year. In my opinion money well spent

you can also get a non acgme fellowship post, which is funded by the institution.

pc11

I haven't seen a reference to training in New Zealand. Is training there as a GP or specialist readily recognised in Ireland? What's it like to train and work in NZ?

MrCreosote

pc11 wrote: »

I haven't seen a reference to training in New Zealand. Is training there as a GP or specialist readily recognised in Ireland? What's it like to train and work in NZ?

Specialist training is via the Australian colleges, and subject to the same recognition in Ireland. GP training is via the NZ college. I thought that the top NZ GP qualification (FRNZCGP) was recognised similar to the Australia one by the ICGP, but can't find it there. I suppose you'd need a certain amount of Irish GP experience first to get equivalence (6-12 months if memory serves)

FWIW I graduated in Ireland, interned there, been in NZ 10yrs plus now and did my GP training here. There was a plan to return to Ireland once this was done, but it has been shelved for the moment!

Work and training here is much more humane than Ireland, hours are set, there's a strong union- we went on strike a few years back- and no 36/58 hour shifts I remember from Ireland. The usual surgical specialties are very competitive to get on, medicine/paeds/O+G/psych less so, GP and emergency medicine relatively easy. Emergency medicine (training via the Aussie college) is well set up as a specialty here. The only other issue would be obtaining permanent residency which is required to get on the schemes, but medical grads tend to get through this pretty quickly.

As for GP it's 2 years post-grad minimum (self-selected jobs), then 1 year as a junior GP reg (placements by college), and 2 minimum as a senior reg (again, self arranged jobs) to get the fellowship. And an exam+a few visits. As a GP it's grand, I do 6-7/10, 15 min appointments, people turn up on time (mostly). The medicine itself is not much different to Ireland, there's the usual paperwork rubbish as everywhere.

Overall a great country, much better attitude to working hours and conditions. The only drawback is it's a LONG way from Ireland!

Hope that helps!

pc11

Thanks MrCreosote, very interesting. Are you based in a city?

briankirby

Am i right in saying there is an agreement between ireland and Oz/NZ that graduates can work in those countries with minimal exams?Also,may i ask if u know people who graduated from other countries in Europe who got training schemes in NZ and the process required?
Thanks

MrCreosote wrote: »

Specialist training is via the Australian colleges, and subject to the same recognition in Ireland. GP training is via the NZ college. I thought that the top NZ GP qualification (FRNZCGP) was recognised similar to the Australia one by the ICGP, but can't find it there. I suppose you'd need a certain amount of Irish GP experience first to get equivalence (6-12 months if memory serves)

FWIW I graduated in Ireland, interned there, been in NZ 10yrs plus now and did my GP training here. There was a plan to return to Ireland once this was done, but it has been shelved for the moment!

Work and training here is much more humane than Ireland, hours are set, there's a strong union- we went on strike a few years back- and no 36/58 hour shifts I remember from Ireland. The usual surgical specialties are very competitive to get on, medicine/paeds/O+G/psych less so, GP and emergency medicine relatively easy. Emergency medicine (training via the Aussie college) is well set up as a specialty here. The only other issue would be obtaining permanent residency which is required to get on the schemes, but medical grads tend to get through this pretty quickly.

As for GP it's 2 years post-grad minimum (self-selected jobs), then 1 year as a junior GP reg (placements by college), and 2 minimum as a senior reg (again, self arranged jobs) to get the fellowship. And an exam+a few visits. As a GP it's grand, I do 6-7/10, 15 min appointments, people turn up on time (mostly). The medicine itself is not much different to Ireland, there's the usual paperwork rubbish as everywhere.

Overall a great country, much better attitude to working hours and conditions. The only drawback is it's a LONG way from Ireland!

Hope that helps!

MrCreosote

pc11 wrote: »

Thanks MrCreosote, very interesting. Are you based in a city?

I'm in Wellington, been here for 8 years now (with the odd ew months back in Ireland). It's a great spot.

briankirby wrote: »

Am i right in saying there is an agreement between ireland and Oz/NZ that graduates can work in those countries with minimal exams?Also,may i ask if u know people who graduated from other countries in Europe who got training schemes in NZ and the process required?
Thanks

That's right- Ireland and the UK can get recipricol registration with the NZ medical council without exams. You do a year of "probationary registration" before getting full registration. Other countries used to have to do an exam (NZREX, sort of like the USMLE) to get registered. That could have changed though as I've not really kept up with it- the best bet would be to email the NZ medical council. They are the opposite of the Irish Medical Council- efficient and helpful.

There's plenty of non-NZ people on training schemes- in our GP group there were people originally from NZ, Ireland, UK, SA, India, Sri Lanka and Russia.