American wants to practice in the EU

[antoniost]

I have a BS in Biology from University of Connecticut, an MPH from Yale University, and an MCAT score of 30. I consider my self a competitive applicant for US schools, but I desire to live in and practice in the EU. I've already read this thread (http://forums.studentdoctor.net/showthread.php?t=185261) so I have an idea, but need more clarification.

With that in mind, I figure it would pointless to go to a US school and rack lots of debt in student loans if I want to practice in the EU.

So I believe my best option would be to apply to a school in the EU and complete my residency/internship there and subsequently practice as a licensed physician there also.

My questions are:

Would it be best for me to go to a med school in the same country that I desire to live in?

What additional requirements are there for acceptance to EU med schools as a foriegner? Is it the same for all non-EU citizens? How will my US degrees and MCAT be acknowledged by EU schools?

My top two countries of desired practice would be Spain and the UK.

I'll appreciate any info anyone can offer. Thanks.

---

Members don't see this ad.

 

[f_w]

> Would it be best for me to go to a med school in the same
> country that I desire to live in?

An unqualified 'Yes' to that question. While medical degrees within the EU are pretty much interchangeable these days, this recognition in many cases only applies to 'EU citizens and non EU nationals with EU rights (=spouses of EU citizens)'.
So, if you want to go to the UK, try to go to medschool there (or maybe IRL). If you want to go to spain, go to medschool in spain.

> What additional requirements are there for acceptance to EU med
> schools as a foriegner? Is it the same for all non-EU citizens? How
> will my US degrees and MCAT be acknowledged by EU schools?

You will find as many variations of pre-requisites as there are countries. Many european countries have 6 year medschool tracks without an undergrad degree required.
I belive the schools in IRL and UK are graduate entry programs. But for 'non developing country' overseas students, the tuition there is probably in the same range as lets say UConn.

> My native tongue is English, but I would be most comfortable with
> becoming proficient in Spanish, Italian, or Greek as I am most
> familiar with those languages, but I am open to other possibilities.

I think you should decide where in the EU you want to live and take it from there.

For spain (unless there has been a major revolution):
If I remember correctly, they have a pretty difficult admission exam. Medical school is 6 years and at the end you have one big exam the MIR. The curriculum is mostly taught in lectures which are followed by annual exams. There are some 'shadowing' type clinical courses during the higher years. The real practical training happens during internship.

 

[antoniost]

Thank you for your help f_w!

If anyone else has anything further to add, that would be great.

 

[f_w]

Why don't you go back to your alma mater. The expense of going to spain for 6 years would probably be comparable to the expense of going there. They are a primary care oriented state school, they like their alumni and are really into MPH's.

And while Spain is a great country to live in, I am not so sure whether the medical sector is so attractive. The share of goverment paid healthcare is higher than in the US and the options for enterpreneurial activity in healthcare are fewer. Have you had a chance to look into the spanish healthcare system yet ?

 

[saphenous]

Hiya,
i am an american studying med in the uk. feel free to ask any questions if needed.


Saph

 

[antoniost]

Is a US medical degree seen as an asset in Western Europe?

Also, I don't know how accurate these figures are, but according to this salary report a generalist in Spain makes on average $163,000 USD base + bonuses.

And a generalist my area makes $164,300 base + bonuses based on this salary report.

So if those figures are correct, then compensation seems to be equal between the two. There are other factors that are not calculated. I'm assuming that because Spain has a national healthcare system and in general more social programs than in the US that taxes are probably higher, but I also assume that malpractice insurance, which can be 25% of a US physician's salary, is much cheaper or handled differently in countries with a national healthcare system. Yes, I know I have a lot more research to do, and assumptions are not enough.

I would love to contact someone who is doing or has already done what I proposed.

Thanks again for your input f_w.

 

[antoniost]

Hiya,
i am an american studying med in the uk. feel free to ask any questions if needed.


Saph

Thanks.

Do you plan on practicing in the UK or going back to the US? Do you have an undergraduate degree from a US school? Can you give me the basics of the requirements of applying to a UK med school?

 

[drmanyee999]

but I also assume that malpractice insurance, which can be 25% of a US physician's salary, is much cheaper or handled differently in countries with a national healthcare system. Yes, I know I have a lot more research to do, and assumptions are not enough. :

Hey, I don't have solid numbers, but when I was in Australia two years ago (which has a nationalized health care system also), most of the docs I spoke to said they had similar malpractice rates to the US. I don't know about the UK, my dad retired more than 10 years ago so I'm sure the rates he paid are much different now.

 

[brightblueeyes]

Hey, I don't have solid numbers, but when I was in Australia two years ago (which has a nationalized health care system also), most of the docs I spoke to said they had similar malpractice rates to the US. I don't know about the UK, my dad retired more than 10 years ago so I'm sure the rates he paid are much different now.

You might want to compare actual numbers. Doctors in most Western countries seem to regard their malpractice insurance rates as high...but they're usually not aware of just how high American rates are.

I'll defer to anyone with specific figures but I doubt that any other country's malpractice insurance rates are even close to American rates.

 

[f_w]

> Also, I don't know how accurate these figures are, but
> according to this salary report a generalist in Spain makes
> on average $163,000 USD base + bonuses.

Actually, they give 74k as 'low' 110k as 'average' and 161k as 'high'.

I believe docs in spain do allright, but knowing the taxation there, 110k doesn't get you far. Otoh, your medical insurance is included and if I remember correctly tuition at state universities for your kids is free.

Also, when looking at income figures, you have to keep one thing in mind: As a foreigner coming into a system, you can't expect to have direct access to the jobs paying at the upper end of the income scale (similar to the UK where access to a lot of the private patient income controlled by lots of 'old boys networks'). So, if you want to compare the 161k figure given on monster (for whatever its worth) with the counterpart in the US, you can't look at some suffering FP in Fairfield Co, but rather a smalltown FP in the midwest who does everything from colonoscopies to C-sections...


As for malpractice rates:
In many european countries, hospital based physicians are employees of their hospital. The hospital is either self-insured (e.g. if it is owned by the county or province) or it buys some sort of 'umbrella' coverage for all its physicians. You as a physician get a monthly paycheck, you never see how much the hospital paid to cover your professional liability. The only malpractice insurance the individual doc has to buy is one that covers activities such as EMS work or locums. So, comparing malpractice rates can be very misleading. In the UK they have something called 'crown indemnity'. It is fairly affordable and if I understand the concept correctly it means that the state will cover all your 'misdeeds' outside of NHS employment (which are covered anyway).
Overall, the expenses for malpractice are far lower as your liability is limited to actual damage done, loss of income etc. The judges hearing malpractice cases are experts in it and there are guidelines on the amount of compensation. It is not left up to a jury of 12 softbrains to dream up some 'punitive damages' for something that might or might not have been a medical mistake.




I think your plan to go abroad is not unreasonable. But I can tell you, that there are many things that go into the decision to emigrate. The good thing for you is that as a physician, the way back into the US is allways open.

 

[antoniost]

>
Actually, they give 74k as 'low' 110k as 'average' and 161k as 'high'.

Those numbers are in Euros, and 129,137€ is the base (110k€) + bonus, which at the current exchange rate = $163,000 USD

 

[f_w]

I guess the currency conversion does it (there is a reason that mars lander plowed into the planet a while back. Thank god I am not a rocket scientist)

I wouldn't give too much on that monster report. If you want to look at the source data, there is a report from the OECD floating around which had looked at physician incomes a little while back.

There are many variables on how much your income is worth in buying power. If you stay in a country long term, you might want to have a look at them before you make a decision.
For europe in general, I would look at the following:

cheaper than in the US:
- subsidized education
- subsidized childcare
- subsidized healthcare
- lower property tax

more expensive than in the US:
- energy cost
- transportation (stiff taxes on purchase and owning a vehicle, 2-3x price of gas)
- real estate (there is only so much land)
- taxes

 

[saphenous]

Hi,
I plan on coming back to the us after med school, went to college in the us as well. Med school in the uk tends to be 5 years unless you get on an accelerated gep program--which I know not much about. You would have to apply by october i think(dont quite rememeber) thru ucas--the medical school and university application service. My recollection is that u can only apply to 4 schools for medicine. hope this helps--let me know if you have more questions.

cheers.

 

[deleted21609]

Though it's not your question, I'd like to point out to you that in 5 years, you may not want to work in the EU anymore. I know very little about your background, but unless you've spent a really long time there working or studying (not vacationing!), you probably don't realize what it's really like.
You may go there and just love it, but most people I know (even those who liked it there) didn't want to stay. I think it'd be a big mistake to go away if you're going to want to practice in the US -which brings us back to your wanting to work in the EU. Ah well, I guess you'll make your own mistakes. Just think about it long and hard before you pass up your chance to go to med school at home.

 

[brightblueeyes]

Is a US medical degree seen as an asset in Western Europe?.

It's probably not an asset but I don't think it's a liability either. Two more important issues would be getting a work visa and making sure your American postgraduate training is recognized. Perhaps your biggest concern should be ensuring that you're fluent in whatever language you plan to practice in since this would be crucial to your work as a clinician.

Also, I don't know how accurate these figures are, but according to this salary report a generalist in Spain makes on average $163,000 USD base + bonuses.

And a generalist my area makes $164,300 base + bonuses based on this salary report.

If compensation is your primary concern, you might want to reconsider your choices. I think physician compensation in Spain, Italy and Greece is lower than elsewhere in Europe.

Then again, I think many people choose these three countries for their lifestyles. If the figure you posted for Spain is correct (it seems high) then Spain seems quite attractive.

In any case, make sure you're familiar with and like the culture and customs of the country you choose. I think this will have a bigger impact on your future happiness than a moderate difference in compensation.

BTW, I'm doing something similar to what you're describing except I chose a different European country. (But perhaps if I'd known more about Spain and spoke Spanish... )

Good luck.

 

[antoniost]

...but most people I know (even those who liked it there) didn't want to stay.

Could you elaborate on that point. What made them not want to stay? Lifestyle? Income?

 

[antoniost]

Then again, I think many people choose these three countries for their lifestyles.

My consideration not based on compensation. If that was the case, I would not even consider leaving the US. But lifestyle and happiness are more important to me than compensation. Those figures were just to point out that I can expect similar standards of living in Western EU countries. I don't think anyone cant tell me that I wouldn't be successful as physician and live a moderate to high standard living in Western Europe?

 

[tlew12778]

To the OP, if you want to live and practice in the EU, then get your degree in the EU IMO. Why set up the extra hurdle for yourself by having an American degree? Yes, I know a few successful American drs here, but they are GPs more or less and they have a very niche clientele (expats mostly).

That said, there are a few things I wanted to point out. Mind you, I live in Italy (for the last 7 years) and this is all based on my personal experience.

cheaper than in the US:
- subsidized education agree
- subsidized childcare depends... in many EU countries, kids live at home until they get married so the overall cost is higher... many also do not get PT jobs in HS or college like American kids do, so you have to figure in that cost as well
- subsidized healthcare agree, but I can tell you that I spend more overall on healthcare annually than my US friends. Granted, I also won't be screwed if I get into a major accident or need a transplant or something... point is, it's all relative.
- lower property tax no opinion on this one since I don't own property yet

more expensive than in the US:
- energy cost Home energy you mean? My last electric bill for 2 months was 14 euro and my last gas bill for 2 months was 24 euro... we have a 1 BR apt.
[]i]transportation (stiff taxes on purchase and owning a vehicle, 2-3x price of gas)[/i] disagree and agree... vehicles are cheaper in general in Europe... the average price of a car here is probably around 9k euro... plus most cars get good mileage due to the extreme price of gas.
real estate (there is only so much land) disagree... this really depends on what geographic area of the US you are talking about... it will cost us the same (maybe a little less) to buy an apt here in Milan than it would in NYC or Boston for instance.
- taxes agree... but only overall... i currently pay 30% tax which is the same as I would pay in the US.

I'd like to point out to you that in 5 years, you may not want to work in the EU anymore. I know very little about your background, but unless you've spent a really long time there working or studying (not vacationing!), you probably don't realize what it's really like.
You may go there and just love it, but most people I know (even those who liked it there) didn't want to stay. I think it'd be a big mistake to go away if you're going to want to practice in the US -which brings us back to your wanting to work in the EU. Ah well, I guess you'll make your own mistakes. Just think about it long and hard before you pass up your chance to go to med school at home.

The first part is true. The second part, is only partly true. The OP doesn't say he wants to come back to the US at all, and I would probably consider a US education a serious liability for someone that wants to practice in the EU if only due to the enormous debt you will be paying off afterwards. It's kind of hard living on an EU resident's (extremely low) salary while paying back $200k in debt, IYKWIM. And while difficult, it is not entirely impossible to return to the US in the long run... it might involve re-doing residency but it's still possible... and without the debt. I think it's a bit presumptuous to say that an EU education is a "mistake" and that the OP is giving up a "chance".

I think physician compensation in Spain, Italy and Greece is lower than elsewhere in Europe.
Hospital salaries, yes. But most have private practices and can rake in a bundle. I was just calculating the my OB/GYN makes 1 euro a minute on average (in her private practice). I have no idea how this compares to the US, but wherever you live, I would guess that that's a good salary... My fiance just began his residency in vascular surgery and told me that the average fee for private consultations for surgeons is around 250 euro. And this is paid in cold hard cash... drs don't deal with insurance companies here. If patients have private insurance, they get reimbursed later on, but drs have nothing to do with that.

In any case, make sure you're familiar with and like the culture and customs of the country you choose. I think this will have a bigger impact on your future happiness than a moderate difference in compensation.
I cannot agree more.

 

[drmanyee999]

I'd also like to point out something which American's don't get is that the UK is very different from Europe. Ranging from culturally to cost of living. For example, gas (petrol) prices in UK are unreal compared to US. When I left UK in 2000 gas was $5/gallon and we're bitching over here that gas is over $2/gallon.

The poster who asked about foreigners wanting to leave Europe - one of my father's American colleagues (physician) wanted to move to England for a long time and when they had visited his wife had loved it. Within a few months his wife was on the phone to my mum in tears saying 'Everything's so different, I can't even turn the f***ing oven on!'

 

[antoniost]

I'd also like to point out something which American's don't get is that the UK is very different from Europe.

Did you mean very different from the US, or continental Europe?

Within a few months his wife was on the phone to my mum in tears saying 'Everything's so different, I can't even turn the f***ing oven on!'

That was his wife, who I assume wasn't as thrilled about living in UK as her husband was, but how did he feel about living in the UK?

 

[drmanyee999]

Did you mean very different from the US, or continental Europe?

Both, but my statement was referring to continental Europe.

That was his wife, who I assume wasn't as thrilled about living in UK as her husband was, but how did he feel about living in the UK?

His wife was thrilled beforehand, they had visited us a few times and thought it was great. He also ended up disliking the place and they moved back to the US not long after that phonecall.

 

[antoniost]

Thank you for your post tlew12778, it was very helpful!

Could you briefly explain the Italian medical school application procedure for a foriegner such as myself?

 

[f_w]

As I mentioned before, despite the progress in european unification, this is not the 'United States of Europe' yet (and will probably never be). While some broad generalizations are probably in order, you have to look at one individual country at a time, particularly when it comes to medical education. Two countries, side by side can have very different systems of medical education.

The first and foremost question should be: Do I intend to live in this country.

And I am not talking about the kind of stuff you find out about on vacation, or even during some sort of exchange student program. Each of the european countries has certain ways 'how they do things', many of them part of a long standing tradition. This will come up mainly when you are dealing with the authorities, or when you get into areas like property ownership. And living in the dorms (or even your own little rented pad) as a student is very different from living in a country and/or doing business there (e.g. having to navigate the spanish civil court system, or dealing with some quirks in spanish labor law if you have employees).

(Otoh: If you can't switch on the oven, you are either pretty dense, or it reflects on your lack of motivation to adapt to a different environment. It is almost as idiotic as the people who complain about the absence of rounded door-knobs.)or

 

[barczech]

Hi, There are my two pennies...
I am from EU, now working in US as an postdoc (2 years) and doing observeship, before I had been practing neurology for 11 years in EU. So, I think I can compare...

Contras to go for an American to EU to practise medicine:
The healthcare system in EU is more socialistic
the salaries are much lower
the research is badly funded
the unemlyement rate of doctors differs from country to country (f.i. in Italy there is 17% unemployement rate, high is also in Greece, Spain, Slovakia, low in UK, Ireland, Germany, CZech Republic).
the system is more rigid ( especially in Germany and central Europe)
Language barrier

Pros:
better lifestyle than in US
no medical malpratice costs (or rare- europeans do not do that)
more open access to health care and social security
Lower costs for the education (which is better up to high school level in Europe than in US, but the US Universities are in general better and of higher standard than european ones- just my opinion and experience).
short distancies
great culture and history

So, think more about UK or Ireland, but everythink is possible if you really want it.

P.S. I am going the other direction- just passed Step 1, 2CK, waiting for 2CS.
Try to work hard in US and then to retire in Europe...
Hopefully it helps. Any qs?

 

[antoniost]

the unemlyement rate of doctors differs from country to country (f.i. in Italy there is 17% unemployement rate, high is also in Greece, Spain, Slovakia, low in UK, Ireland, Germany, CZech Republic).

tlew12778 can you comment, since you live in Italy?

 

[deleted21609]

Could you elaborate on that point. What made them not want to stay? Lifestyle? Income?

Lifestyle- You go to a place on vacation and everything seems new and interesting and great. You live in that place for a while and that great thing is now very very old and possibly annoying. In the US, when you get tired of one scene there are hundreds of other things to do. In europe, there is generally far less variety. What seems like fun loving at first becomes lazy & unprofessional after a while. You go to an office and the schedule on the door says they'll be back from lunch in 5 minutes, but 3 hours later no one is there. You don't have to tip at restaurants and bars, but the service is awful. You go on vacation an get stranded because the lazy b**t**d bus drivers or baggage handlers or taxi drivers are on strike again. You wait for a bus to take you home from your weekend trip to the country and the bus doesn't come, you wait for the next one on the schedule and it doesn't come either, again, then 4 hours later when you should be at home a bus finally rolls up. Lifestyle? I just don't see it.

You walk around on tours and stare at the beautiful buildings, but after living by them for a while you stop even looking.

Culture- Europe is dead. The culture is regurgitated stuff from hundreds of years ago. It's great when your a tourist, but why can't they come up with something new? Listen to their music, it's almost uniformly horrible. The only exception is that a lot of good music comes from England. I mean I like to go to museums, but A- you can do that here and B- you could do it on vacation.

Income-An OB making 1 Euro and hour would be the worst paid OB in the country in the US, and that guy above thinks that it's great. Not only that, but as a foreigner, you'll be excluded from advancement in medicine unless you do something extraordinary or go into a field or location with a doctor shortage (which isn't likely). And the taxes, both income and VAT, are huge.

 

[barczech]

Student.ie,

Your comments on the different lifestyle in Europe are very useful but I do not agree with them completely.
You are right that from the professional point of view, U.S. is the best (that's why I am trying at my age of 36, with at least 30 published papers, completed residency and fellowship, to enter the US medical training). No question about it.

Of course, if you go for vacation anywhere, you are impressed and after a while it becomes boring, or the same. It happened to me, too ( here in US).

The train or bus delays- it depends on the country. In Netherlands, for instance, they depart on time in seconds.

I don't agree that european culture is dead, if you think that US culture is better, OK, it is your opinion, but I can't accept it. Americans don't enjoy the life, don't go out for a couple of beers with collegues (I mean at the workplace), the sport fans are actually not so excited about the match result, going by car everywhere, "fast food " culture.... At every minute you need to look happy, although your are not- it is not natural-I don't see the culture here, in US.

Beautiful buildings, history etc.- yes, you are right, they are not for everyday living, but this is the history!!! Not american houses made from fake wood where antiques are everything what is more than 50 years old. Because our future lies also in our past, so everybody needs to appreciate the history.
Taxes- again, you are right, they are huge, salaries are much lower. But on the other hand, I don't need to pay my mortgage on education, I don't need to pay significant amount of money on health care (45 mil. of Americans can't afford to have one)..., and I have, at least some, social security. I don't need to take vacation when I am sick. And here in US, about 25% of people don't take any vacation- is this the culture of the 21st century? It is like of Zola's romance.

Overall, it depends on everyone's preferences, mine are: to work in US, to live in Europe. That's it.

BTW, Nice discussion!!

 

[antoniost]

student.ie,

In which coutries have you had these bad experiences as you described in your previous post?

barczech,

I agree with your response.


But I don't understand when many people say work in the US and retire to Europe, because you'll end up spending the most important years of your life in a country you don't want to live in. I have spoken to many European immigrants here, who came 40-60 years ago, many of them said they would want go back but they can't because of children, grandchildren, friends, unfamiliarity with advancements of their native land, etc. And the older one gets, the less he can adapt to radical changes. If I don't leave now, I have a feeling I will get tied down here and never make it out.

 

[deleted21609]

I don't agree that european culture is dead, if you think that US culture is better, OK, it is your opinion, but I can't accept it. Americans don't enjoy the life, don't go out for a couple of beers with collegues (I mean at the workplace), the sport fans are actually not so excited about the match result, going by car everywhere, "fast food " culture.... At every minute you need to look happy, although your are not- it is not natural-I don't see the culture here, in US.

Beautiful buildings, history etc.- yes, you are right, they are not for everyday living, but this is the history!!! Not american houses made from fake wood where antiques are everything what is more than 50 years old. Because our future lies also in our past, so everybody needs to appreciate the history. :

I have yet to hear about European culture. Just saying something over and over doesn't make it so. You're living in the past. Living near where events occured in the distant past is not culture. All I see is ridiculous movies and repetitive techno crap music or impersonations of hip-hop translated into French or German. I can count the number of good Czech movies I've seen on one finger- Kolya. The rest of Europe doesn't do any better.
The houses I know are wood or brick not cinderblocks like in Europe. I've heard this fake wood comment before from an Eastern European. What? Do they sit you down in your childhood to teach you lies about America? or did you learn that at your Pioneers meetings? There may be lots of fast food in the US (and in the EU), but at least the US has some other new things to go along with it. Not the same dishes they've had in each location for hundreds of years. Goulash is delicious, but so are a million other things. Try some. America produces most of the bad music, movies, trends, etc., but it also produces most of the good stuff. Europe offers nothing these days. What are you so proud of anyway?

 

[f_w]

Culture- Europe is dead. The culture is regurgitated stuff from hundreds of years ago. It's great when your a tourist, but why can't they come up with something new?

This blanket dismissal of european culture is about as ******ed as the blanket dismissal of US culture you will occasionally encounter in european or asian expatriates (in the US). I am not sure where in europe you are, but you don't seem to be there by your own free will, or why are you so bitter ?

 

[brightblueeyes]

...All I see is ridiculous movies and repetitive techno crap music or impersonations of hip-hop translated into French or German...

If this is all you've noticed then maybe this just means that you wouldn't be happy living in these countries. Besides, most people need time to adapt to a different culture. I know I do.

BTW, I like many things in American culture and I suspect I'd be amazed by New York (yeah, I'm one of the few people who haven't been to this cultural mecca) but among the American cities I'm familiar with (some of which I like a lot) there are none I'd prefer to Paris.

 

[barczech]

Student.ie,
You are lost guy. OK, you started to shoot first...
Ridiculous movies- what is real american movie? Most of them are made by other nations, directors, actors (BTW the governor of the biggest state here in is Austrian... ), etc.... For american money- that is true.
Techno crap- I can't agree more with you! But there is a little more in Europe than techno crap. have you ever been in Amsterdam, Prague, Vienna, London or Paris, or other cities? You can find very good rock, blues or jazz music.
Movies in different languages- maybe here is the problem for ya...(not only English spoken in the world...).
Czech movies- f.i.Milos Forman is Czech director, at least 4-5 of his movies (Amadeus, Larry Flint...) are treated among the best movies ever made. BTW, U can't compare the absolute numbers (Czech nation of 10 million of people vs. America- 300 million of people).
You are kidding me- almost of of the houses here in US are wood (fake), and only minority of houses are cinderblocks. I don't know where you got lost In Europe, but.. Have you ever left one area in that particular city which are you talking about? All the american cities look the same! In Europe, it is completely different story. If you don't appreciate it, that is very bad....
Pioneer meetings- I've got the son here, the american propaganda is much more persuasive than the "old communistic" one. And, what is more dangerous- you believe it! (which was not our case).
Fast food as a "new" culture- poor culture and poor world! And do not forget to eat with plastic utensils.... on the paper plate (in a better case). This is real progress....And that dishes stuff- here you made me laughing.
You self confidence is something what should be admired, really. Good job! Do not forget your burger with diet coke and the stroh...
Final word- stay in US, smile, be cool, ...and do not study only medicine, try some history, too. Or, forget it.... Living example of american ignorance...

I have yet to hear about European culture. Just saying something over and over doesn't make it so. You're living in the past. Living near where events occured in the distant past is not culture. All I see is ridiculous movies and repetitive techno crap music or impersonations of hip-hop translated into French or German. I can count the number of good Czech movies I've seen on one finger- Kolya. The rest of Europe doesn't do any better.
The houses I know are wood or brick not cinderblocks like in Europe. I've heard this fake wood comment before from an Eastern European. What? Do they sit you down in your childhood to teach you lies about America? or did you learn that at your Pioneers meetings? There may be lots of fast food in the US (and in the EU), but at least the US has some other new things to go along with it. Not the same dishes they've had in each location for hundreds of years. Goulash is delicious, but so are a million other things. Try some. America produces most of the bad music, movies, trends, etc., but it also produces most of the good stuff. Europe offers nothing these days. What are you so proud of anyway?

 

[tlew12778]

Could you briefly explain the Italian medical school application procedure for a foriegner such as myself?

Well... it's actually my fiance that's the dr not me . And he's Italian so he didn't have to take any extra tests. But I know that as a foreigner you most definitely need to take a language test. In addition, you will need to take the regular entrance exam for med school, plus provide your HS transcripts and college transcripts I guess, all translated and certified by your local Italian consulate. I know there is more information on this if you go to the University of Milan's website (http://www.unimi.it/engl/fs_handbook.htm). Each school is separate though so you would need to visit each school's website and contact their foreign student office.

As I mentioned before, despite the progress in european unification, this is not the 'United States of Europe' yet (and will probably never be). While some broad generalizations are probably in order, you have to look at one individual country at a time, particularly when it comes to medical education. Two countries, side by side can have very different systems of medical education.

The first and foremost question should be: Do I intend to live in this country.

And I am not talking about the kind of stuff you find out about on vacation, or even during some sort of exchange student program. Each of the european countries has certain ways 'how they do things', many of them part of a long standing tradition. This will come up mainly when you are dealing with the authorities, or when you get into areas like property ownership. And living in the dorms (or even your own little rented pad) as a student is very different from living in a country and/or doing business there (e.g. having to navigate the spanish civil court system, or dealing with some quirks in spanish labor law if you have employees).

I agree with this TOTALLY and entirely.

Lifestyle- You go to a place on vacation and everything seems new and interesting and great. You live in that place for a while and that great thing is now very very old and possibly annoying. In the US, when you get tired of one scene there are hundreds of other things to do. In europe, there is generally far less variety. What seems like fun loving at first becomes lazy & unprofessional after a while. You go to an office and the schedule on the door says they'll be back from lunch in 5 minutes, but 3 hours later no one is there. You don't have to tip at restaurants and bars, but the service is awful. You go on vacation an get stranded because the lazy b**t**d bus drivers or baggage handlers or taxi drivers are on strike again. You wait for a bus to take you home from your weekend trip to the country and the bus doesn't come, you wait for the next one on the schedule and it doesn't come either, again, then 4 hours later when you should be at home a bus finally rolls up. Lifestyle? I just don't see it.

You walk around on tours and stare at the beautiful buildings, but after living by them for a while you stop even looking.

Culture- Europe is dead. The culture is regurgitated stuff from hundreds of years ago. It's great when your a tourist, but why can't they come up with something new? Listen to their music, it's almost uniformly horrible. The only exception is that a lot of good music comes from England. I mean I like to go to museums, but A- you can do that here and B- you could do it on vacation.

Income-An OB making 1 Euro and hour would be the worst paid OB in the country in the US, and that guy above thinks that it's great. Not only that, but as a foreigner, you'll be excluded from advancement in medicine unless you do something extraordinary or go into a field or location with a doctor shortage (which isn't likely). And the taxes, both income and VAT, are huge.

So many things to comment on here...
the first paragraph - These are the things you learn to eventually love about Europe. You need to take things with a grain of salt here. The reason the bus is late is bc the bus driver puts a higher value on his friendships than his job... he's probably chatting with the other bus driver and left 3 min late or whatever. Yeah, it's annoying... you get a scooter to resolve the problem. Yeah, lunch lasts a while... it's bc Europeans place a high value on food and on mealtimes. What's so bad about that? When was the last time you really appreciated your homecooked, hot lunch?

second paragraph - Culture is dead? The two best movies I have seen in the last 10 years are La Vita e' Bella and Mar Adentro... Italian and Spanish respectively. Modern music - how much do you want to bet that 50% of the stuff you hear in clubs is some remix from Europe? Avventura is Puerto Rican and as removed as I am from American culture now, I know they were a hit in NY a couple summers ago. U2 is Irish. Museums - Let's see... you want to see some original Klimt pieces you need to go to Austria to the Klimt musuem. Yeah you can wait till they tour the US if they ever do... Or what about the Picasso Musuem in Amsterdam? The Tate in London or the Prado in Madrid or Bilbao? You're not going to see the Venus de Milo unless you take a trip to Paris.

third paragraph - No offense, but read better... I said 1 euro a minute, not an hour. Yeah you can make more in the US, you can make more in Italy too... but you also do Q3 and work 100+ hr weeks in the US. My fiance is a resident in surgery and I can tell you he has no pager, he turns off his cell phone at night and he eats dinner at home more often than not. He's only in the OR maybe 3-4 mornings out of the week and even at that, surgery starts at 8AM so he has to be there at 7:30. Oh and he can take vacations... in the US people don't take vacations bc they want to appear professionally "responsible" or "motivated"... well here in Europe people think you are not appreciating your own life enough if you don't take your allotted 30+ days a year. Remember you work to live, you don't live to work.

If I don't leave now, I have a feeling I will get tied down here and never make it out.

There might be some truth in this. Last time I was in the US with the fiance, we went to talk to my dad's cardiologist about the pros and cons of residency in the US vs residency in Italy. He flat out said that wherever you start your residency is where you will end up in life, bc once you get on that track, it's hard to get off. That said, and despite everything else I have said in this thread, we are still debating whether we want to move to the US for a couple years to test the waters... BUT, the ONLY reason for that... and I mean the ONLY reason... is bc my family is there and my dad has heart problems so I want to spend time with him before he dies (sad but true). There is no doubt about it, our lifestyle in Europe wins hands down in the quality competition. And I can say that bc I grew up in the NYC suburbs so I've got 21 years of US experience to compare it to.

 

[tlew12778]

tlew12778 can you comment, since you live in Italy?

17% unemployment overall or in the medical field in particular? If overall then I agree with it. If in the medical field, then I don't know... in Milan, I do not know any dr that has not been able to work as a dr upon graduation/licensing. Granted, that does not mean one enters into residency easily and is gainfully employed as a resident; I know a few people that did not match for 1-2 years and therefore worked for insurance or pharmaceutical companies, private labs, or nursing homes.

 

[deleted21609]

"Student.ie, have you ever been in Amsterdam, Prague, Vienna, London or Paris, or other cities? You can find very good rock, blues or jazz music."

I've been to all of those. Everyone of those music types is AMERICAN!
Club music sucks. U2 is old and hasn't produced anything good since the Joshua Tree. I'm sure people could name lots of exceptions to my rule, but it's still generally true.

"Movies in different languages- maybe here is the problem for ya...(not only English spoken in the world...).
Czech movies- f.i.Milos Forman is Czech director, at least 4-5 of his movies (Amadeus, Larry Flint...) are treated among the best movies ever made. "

Saw them. Not impressed, but that's just me. I have seen good Euro-movies. They're just rare.


"All the american cities look the same! "
Have you ever been to NY, Miami, Chicago, New Orleans, San Antonio, Santa Fe, Seattle, San Francisco, San Diego, Denver. The same he says. That's the typical lie that you're all taught.

 

[antoniost]

student.ie and others,

I appreciate your responses, but it's getting a little bit off topic. We could spend all month extolling or deprecating European culture and not get a definitive answer.

It's really a matter of personal taste, there is no absolute. From my experience in the US and my experience in Europe, I'd rather be living there instead of here for the many positive reasons said by others here. And I'm willing to accept the negatives in exchange for what would be a better life IMO.

You've all been great with your constructive information, and I would love to hear more especially about med school, the application process, residency, health care system of the UK and Spain.

PS-Another great Milos Forman movie: "One Flew over the ****oo's Nest" starring Jack Nicholson

 

[deleted21609]

PS-Another great Milos Forman movie: "One Flew over the ****oo's Nest" starring Jack Nicholson

That is a good movie (from 1975).

I didn't join the discussion to Europe bash. I wanted to warn you that it's not all it's cracked up to be and that you won't have equal opportunity there. I've done that, so good luck wherever you end up.

One last point though. Lifestyle is a choice. I rotated through an office where 2 pediatricians each worked 3 days a week and probably made as much as a full time doc in Europe. They had plenty of time to enjoy life. 3-4 days a week is the norm in EM. You don't have to move a way to get quality of life. You just have to choose it.

 

[Miklos]

I think that the cultural argument (either way) is meaningless.

I've chosen to come back to the U.S., though I enjoy many of the cultural amenities Europe has to offer (in addition to family connections), I just don't see a long term future for Europe.

I think that the continent has literally turned into a museum. In my view, European governments seem to exist mainly to protect the rights of the status quo (bread and circuses) without any thought to the future.

This almost single-minded defense of socialism (e.g. in the news lately, the 48 hour work week) has its costs. Just to mention a few: higher taxes (income, value added and consumption), much slower growth rates (e.g Germany), higher consumer costs, etc..

I am convinced that current demographic trends (notwithstanding the IMO overly optimistic French figures of last week) predict the death of European socialism, as it will soon become unsustainable.

As it is, the system is creaking at a 50% (a bit less for more liberal countries) marginal tax rates (seen budget deficit and debt figures?).

What will happen when the baby-boomers retire?

Who will finance the social costs, at current birth rates (which are well below population replacement) as immigration does not appear to be a politically acceptable solution?

Further, I suspect that the brain-drain from less developed countries will continue in favor of the U.S. and other liberal (in the classic economic sense) countries (c.f. barczech above).

Why would a hardworking, well-educated immigrant from a less developed country choose much higher marginal tax rates and higher consumer prices?

Miklos

 

[barczech]

Student.ie,
Your response is nice, I appreciate it. And I agree with others, it is everyone's choice.
As Miklos wrote, America has a big advantage, no question about it and I never claimed anything else (otherwise I would be hypocritical, I have been living in US for last couple of years, with my family). The postgraduate training is very well organized, research great (but in research, U do not see a lot of Americans, but I'll stop here...). My only point was to explain and to correct (maybe not very wellly and maybe too offensive) the better (in my eyes) living standard in Europe than in US. But otherwise, economically, technologically, etc. America is still Nr. 1 (the question is for how long when I see the asian expansion), and the braindrain from Europe to America is gonna continue. Although, the classical immigration from Europe is gone. But hopefully you agree with me, the roots of America lies in Europe.
So, that's it, and now it is the time to move to the original topic.

BTW, I was in all of those american cities, but San Antonio, downtown is the same for me, I am sorry for that. San Diego is my favourite.

I have not personal experience with the UK or Italian healthcare system. But being American I would prefer UK/Ireland. Here are some useful links:
www.gmc-uk.org
www.jobs.nhs.uk
www.doctors.net.uk
www.rcplondon.ac.uk
www.dh.gov.uk/Home/fs/en
www.medicalcouncil.ie (ireland)


Hopefully it helps. I' ve got collegues who left to Germany (mixed experience), UK/Ireland (mostly good experience), France (bad experience), Sweden (very good experience), and actually to Australia (very good experience). And of course, to US (mostly very good experience).

Take care.

E=student.ie]"Student.ie, have you ever been in Amsterdam, Prague, Vienna, London or Paris, or other cities? You can find very good rock, blues or jazz music."

I've been to all of those. Everyone of those music types is AMERICAN!
Club music sucks. U2 is old and hasn't produced anything good since the Joshua Tree. I'm sure people could name lots of exceptions to my rule, but it's still generally true.

"Movies in different languages- maybe here is the problem for ya...(not only English spoken in the world...).
Czech movies- f.i.Milos Forman is Czech director, at least 4-5 of his movies (Amadeus, Larry Flint...) are treated among the best movies ever made. "

Saw them. Not impressed, but that's just me. I have seen good Euro-movies. They're just rare.


"All the american cities look the same! "
Have you ever been to NY, Miami, Chicago, New Orleans, San Antonio, Santa Fe, Seattle, San Francisco, San Diego, Denver. The same he says. That's the typical lie that you're all taught.[/QUOTE]

 

[tlew12778]

But being American I would prefer UK/Ireland.

This is interesting. Can I ask why in particular? I don't have much experience with the English system, but I've got good friends from there and they've mostly complained about the level of service they have been provided. Granted, this is not saying that it's any worse than any other EU country, but why is the UK considered "better"? The level of care in the UK is not really something that most Italian drs (that I know at least) acclaim.

antoniost - One other thing, IMO, it's easier to become acclimated to a new culture whilst a student... it would give you enough time to decide if the EU is indeed where you want to stay. If you change your mind after 6 years of med school, you could always take the USMLE and try to match as an FMG. But I assume you've considered that already.

 

[barczech]

This is interesting. Can I ask why in particular? I don't have much experience with the English system, but I've got good friends from there and they've mostly complained about the level of service they have been provided.

tlew12778,
Missing the language barrier, some common cultural and historical background. But it is my personal opinion. I've also heard that the standard the healthcare system is lower to the standard of my country. My collegues are going there to earn more money, but do not want to stay there for the longer appointments.
I must point out- being American I would stay in US, if being thinking to move to Europe - than UK/Ireland. But I can be wrong.

 

[DocteurMarion]

The best quote in your post : " Culture- Europe is dead. "

I was born in Europe and thanks for this good LAUGH...

I am sure the town of Malibu California has more culture than any European countries right?


LOOOOOOOOOOOOOOOOOOOOOOOOOOL

 

[brightblueeyes]

This is interesting. Can I ask why in particular? I don't have much experience with the English system, but I've got good friends from there and they've mostly complained about the level of service they have been provided. Granted, this is not saying that it's any worse than any other EU country, but why is the UK considered "better"? The level of care in the UK is not really something that most Italian drs (that I know at least) acclaim.

I've never heard anyone try to claim that UK/Irish healthcare was better than the rest of Western Europe. I think the best someone could claim is that with recent increases in funding it now might be as good as the rest of Western Europe. I don't know much about Italy but a WHO report rated its healthcare system quite highly so they're probably doing something right.

I think the reason the UK and Ireland come up so often is that these are English speaking areas. Personally, there are four other European countries I'd rather work in.

 

[f_w]

I think you have to separate two things here.
- Is a healthcare system 'good' for its consumers.
- Is a healthcare system 'good' for its providers.

And for the UK, the answer to question #1 is probably no. While primary care is readily available, access to advanced diagnosis and treatment is fraught with waiting lists and red tape. (the WHO global numbers like infant mortality and life expectancy are comparable to other countries in the EU space, so if you look at this very limited picture the UK system is 'good' for the UK citizens. But if you look at the likelihood of certain cancer patients to receive timely and up to date treatment, it doesn't look so rosy.) The brits are acutely aware of this and with some of the recent changes and the influx of money, they are trying to correct it.

The answer to question #2 ? I don't know from personal experience, but the UK docs I have run into so far were fairly happy with their situation. Many of the specialists have an NHS appointment to pay the bills, and some private practice arrangement to take care of retirement (and the 36ft boat berthed in Greece).

 

[antoniost]

During my research I came across the Educational Commission for Foreign Medical Graduates, and more notably, the International Medical Education Directory (IMED).

The ECFMG is the organization charged with ensuring that physicians who have graduated from foriegn medical schools are qualified to pursue a medical license in the United States. Being certified by the ECFMG is a pre-requisite to applying for the USMLE Step 3 exam, and a pre-requisite for entering an ACGME-accredited residency program.

The IMED provides a list of international medical schools where the earned degree is recogonized as the equivalent of the M.D. in the USA.

Only students who attended medical schools listed in the International Medical Education Directory (AKA IMED) are eligible to apply for ECFMG certification. The standards are even more strict than simply being listed: a student's year of graduation must also be listed in the IMED database. That is, if you graduated from a medical in a year that your school was not accredited by IMED, you cannot apply to the ECFMG.

This may have been posted elsewhere in the SDN forums, but I find it of use because the IMED search gives a me list of potential schools to apply to.

 

[f_w]

The IMED list essentially parrots the WHO list. Although they would like to evaluate the schools for their authenticity, I don't think they have done so so far.
As a result, you will find some of these fly-by-night private enterprises on there. You know, the ones with a 'charter' in guinea bissau, an 'affiliation' with a medical school in india and a physical location next to some prestigious college in the UK.

IMED is an information resource for the state medical boards. But in the end it is up to the states to decide what they accept or not. You won't have any problems if you go to a regular medical school in europe, most of the problems are with the for-profit schools (essentially glorified Kaplan courses for the USMLEs that issue a diploma in the end).

 

[Miklos]

The IMED list essentially parrots the WHO list. Although they would like to evaluate the schools for their authenticity, I don't think they have done so so far.
As a result, you will find some of these fly-by-night private enterprises on there. You know, the ones with a 'charter' in guinea bissau, an 'affiliation' with a medical school in india and a physical location next to some prestigious college in the UK.
.
.
.
IMED is an information resource for the state medical boards.
But in the end it is up to the states to decide what they accept or not.

Agreed.

You won't have any problems if you go to a regular medical school in europe, most of the problems are with the for-profit schools (essentially glorified Kaplan courses for the USMLEs that issue a diploma in the end).

Disagree. The maze of IMG licensure is much more difficult to navigate than the above statement implies, especially if you do clinical rotations in North America (among other problem states: California, New York, Texas).

Miklos

 

[f_w]

Miklos
antoniost wants to stay in spain or the UK, he wouldn't be doing any US rotations then.

Except for CA which has their minimum hour requirements for different specialties, there is no medical board that puts up particular hurdles for FMG's who did their training entirely abroad. (NY requires US citizenship or permanent residency for full licensure: not a problem for antoniost. TX used to require proof of legal status. LA requires proof of legal status.)

 

[Miklos]

Miklos
antoniost wants to stay in spain or the UK, he wouldn't be doing any US rotations then.

Except for CA which has their minimum hour requirements for different specialties, there is no medical board that puts up particular hurdles for FMG's who did their training entirely abroad. (NY requires US citizenship or permanent residency for full licensure: not a problem for antoniost. TX used to require proof of legal status. LA requires proof of legal status.)

Good point, as long as one does all of one's clinical training abroad (at the home institution).

 

[efex101]

I grew up in Madrid until I was 21, now I am in medical school here and would *never* chose to go back and practice medicine in Spain. The whole Spanish system is in terrible need of some major revamp and "most" doctors that "can" (note: you may want to have your own private practice but this is easier said than done) will work long hours into the night to make some $$ because they make peanuts under the "socialized" umbrella. Until you have lived there for a substantial amount of time you have NO clue of what living in Spain or any other European country is. I know that when you visit it is great but the whole way of life is totally different and not that glamorous as you may thing. Folks here say the quality of life is better and I ask what do you mean by quality of life? if you mean tons of bars/restaurants/night clubs/etc.. at every corner then sure it is better but if you mean opportunities to excel in whatever, nice highways, homes, etc...then hell no! Spain (and many other European countries) have tiny tiny apartments that is very difficult to get used to once you have experienced the massive homes here..same with vehicles. If you think that you will be living la vida loca and having tons of time off as a physician think again! they tend to work a lot there for nothing *and* again there are many many unemployed physicians there so beware! the medical care is awful and it *is* discriminatory, do not assume that socialized healthcare mean healthcare for all this is a huge misconception. If you are elderly (over 55 or so) or the very young...there are tons of procedures and options that WILL NOT be available for you. Again think that this is a government run system so somewhere the line is drawn. Please do yourself a favor and go there for a year or more and see for yourself what it is like before you embark on this. The hospitals for the most part are subpar (think a la communist style) and most folks that can opt for private insurance...