Australian Schools

[skypilot]

Yeah Pitman, at least we kept the debate relatively clean which is better than a lot of the threads I've seen on this board.

I've applied to U of Sydney. I am very intrigued and excited about attending med school in that city. I think I also have a good shot at the schools in the US so it would be an "abroad by choice" decision. I am a little torn. On one hand I know it is a good school. On the other hand I also know I would be at a slight disadvantage come residency time especially if I wanted a very competitive specialty (which I doubt). My sister is an internal medicine doc and she manages to travel the world and never has a problem finding a job. She thinks I should go for it. She said that so many docs are foreign grads anyway (40% in her field) that it won't make any difference at all. She manages to split her time between Hawaii in the winter and Alaska in the summer. She also spends quite a bit of time in California and quite a bit of time doing charity work in South America. On the other hand she went to USC so it is not like she is speaking from personal experience as an FMG. I have another friend who is a Psychiatrist in Texas. He trained in England. He also said I should go to Australia but warned me that I won't want to come back! Add that to the fact that I could definitely afford to go to Sydney without going bankrupt (since this is my second career) and have a slight dilemma. But I will not have to make the final decision till Sydney asks for a deposit in October.

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[Apollyon]

We get 3 electives in our residency (in a 3 year program!), and I want to do international EM in Oz in the worst way...

Good luck to you. You have your head on straight. Wherever you go, it will work out.

 

[pitman]

skypilot -- Similar "decision by choice" for me, but already made it (er, the choice for the non-choice?): I only applied to Australian schools (3). GPA is good, MCAT is excellent, just decided f* this country for at least four years (incidentally, decision was made soon after 9/11 when I spent that week a couple blocks from Ground Zero...then also had current "career" to contend with, yada yada here I am finally applying).

I like the story about your sis, I plan to practice in 3rd World and/or disaster relief +/- small tropical island(s), *sort* of taking after what my mom does, but minus the 25 years she spent in private practice, and definitely not peds (more like ER, IM, or FP).

And you're right, it's not like we called each other's mom's crack ho's or anything.. then again, I do claim you need to brush up on your stats . Maybe we'll get the chance to duke it out on the Sydney soccer field.

Apollyon, you're at St. G's, right? You want to do an elective in Australia/Sydney, or practice there?

-Pitman

 

[pitman]

BELOW QUESTION HAS BEEN "MOVED" TO NEW THREAD:
http://www.studentdoctor.net/forums/showthread.php?s=&threadid=76776
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Aussie students/grads (hopefully some from each Aussie PBL school):

I do like the sound of roundtable discussions, Socratic method, etc. in PBL. But since the schools don't go into it much on their web sites, I'm very curious about the tutors and their effectiveness -- who are they, from what pool do they come? what are they trained to do, and do they do a good job of "guiding" the discussions?

Also, how are groups assigned, how often do they change, and do you wish they were more or less dynamic than they are?

Tanks.

-Pitman

 

[ALTorGT]

Hi Fellas
Im trolling these boards becasue I'm an Australian looking to fix up an elective for myself in USA.
Im from University of New South Wales. We have an undergrad 6 year course.

There is a lot of rivalry and mud thrown around between U Syd and U NSW about their respective teaching methods.

UNSW course is seen as archaic by the USYD types. We get a solid grounding in the basic sciences, including biology and chemistry is a lecture, tutorial format (although the course is currently undergoing a significant revamp - due in next year for a module based approach).

UNSW complains that USYD and U Newcastle grads graduate with a far less thorough grounding in basic sciences and as they're 4th year is spent in rotations doing Psych, O&G etc. etc.. they dont have confidence or acumen to work well as interns. Doctors know of wide disparity between quality of grads....But this is true of any school I suppose.

To each his own I suppose. But in the long run (seeing as it is that you don't want to get a Ph.D. in protein spectrometry and its application to screening for amyloid plaque deposits in liver disease), it prolly matters more that you get a good grounding in clinical medicine around a vast patient base. So yeah, AUSSIE programs will do the job. And if you work hard from the outset to ace your USMLE, I suppose you shouldnt have problems going back for residency.

Incidentally, I myself was considering US for residency. Rite now planning to do an elective there - perhaps in emergency or trauma. I know its tough for FMG, especially non citizens to get residency and then visa/green card. Can you tell me more about your perspective. Sure we have great weather and more laidback, but I just felt like a change at least after graduation for 10-15 years - USA - more money? more cutting edge stuff - hi tech? Why did your english doc say he wouldnt come back if he came here?

Thanx.

 

[skypilot]

Originally posted by ALTorGT

UNSW course is seen as archaic by the USYD types. We get a solid grounding in the basic sciences, including biology and chemistry is a lecture, tutorial format

I know its tough for FMG, especially non citizens to get residency and then visa/green card. Can you tell me more about your perspective.

Sure we have great weather and more laidback, but I just felt like a change at least after graduation

Why did your english doc say he wouldnt come back if he came here?

Hey great to hear an Australian perspective. What I have heard about Australian medicine is that it is less dependent on technology and less like a factory than the U.S. Do you perceive U.S. medical education as being of better quality from Australia? From patients I have heard that in general U.S. educated physicians sometimes are not as well trained in the basics of clinical medicine although if you need brain surgery this is the place to be!

Sounds like UNSW might be a better choice for a US student who is facing the USMLE since you have a more traditional lecture based curriculum.

My friend who trained in England got the highest grade in the state on the flex exam (old exam before foreign grads took the USMLE) so I know the training in England is good. He had a heck of a time getting permanent visa status. It took years. I think if you have some incredible specialty to offer other than general medicine it might be easier. I think it was relatively easy to get the temporary visa to train over here. He's now a professor at one of the med schools in Dallas Tx as well as a psychiatrist.

I have heard that for a US citizen, coming back to the states for residency after training in Australia is relatively easy since the visa is the main obstacle.

So I would like to hear more about your perspective. Do you have American students doing rotations over there? Is U.S. training perceived as being of higher quality? What do you think is the downside of training in Australia? What do you think of a student from the U.S. making the reverse journey and wanting to train in Australia despite having an acceptance in the U.S.?

Thanks.
Sky

 

[ALTorGT]

Hey

I don't have first hand experience of USA medical system. But heres the deal:

In UNSW, we have full grounding in basic sciences and we use the standard textbooks. Yes, from all the elective reports I read, American medical education places the clinical examination textbook in the waste paper basket of medical curricula. Whereas a patient who presents with a headache is asked for a full history and then examined for signs of systemic or local disease in Australia, US students I read were quick to order an expensive MRI to rule out any intra cranial pathology before formulating a list of DDx.

The Australian medical system is structured around the General Practitioner. We had an American Pharmaceutical rep come in to give us a drug presentation. She shared some insights into the cost structures of our respective medical systems:

Case example: Asthmatic - 3 yr history. Acute exacerbation of breathlessness, wheeze and cough

Australian approach: Visits general practitioner. Is billed on her medicare card by the G.P. (Govt. reimburses fee which is approximately $25 per short visit). He refills her script for ventolin whihc costs $8 to purchase and off she goes. In Australia, patients can't self refer to specialists. Everyone has a G.P. who manages their overall health and write referrals to specialists. You can receive a Govt. rebate for a specialist consult only if you see him with a referral. - All figures are in Aus Dollars. G.P.s are the gatekeepers.

US approach: Patient visits Respiratory physician. Charged USD 100. Provides script for ventolin for only 1 month as opposed to 5 months in Australia. And patients needs to pay USD 42 for a metered dose inhaler. If she develops a headache, she will self refer again to a neurologist when perhaps she needed a cardiologist to manage hypertension. So you can see, how this adds up costs, is wasteful and inefficient.

However, if you develop a rare form of astrocytoma which inhabits the cerebellopontine angle of your brainstem and it needs to be resected with gamma knife therapy, then best place in the world to do it with (If you have the dough) would be Hopkins or Mayo or Harvard.

Teaching: Students in Australia, while in their clinical years are not given as much responsibility or the gruelling hours of med students in USA. From my reports I read that you guys are treated as interns. We don't have that culture here. We get mainly teaching and act more as observors of treatment being dished out. Also, the clinical teaching is probably not as organised as your programs and we are more self oriented and organise tutorials with consultants informally. Patient base is not as vast as LA or New York. Emergency does not have the trauma load as you guys will have. Nevertheless, preclinical extends for 3 years with a solid emphasis on Anatomy, Physiology, Micro, Pharm, Pathology (for 3 years) and if you study for your USMLEs 1 and 2 from the outset, should have no probs RIPPIN IT TO SHREDS!

Just my 2c.

 

[Winged Scapula]

While there is some truth in what ALTorGT writes, it somewhat generalises the US experience. Having seen both sides of the medical frontier, I can state the following:

while the US does rely less on clinical medicine and more on technology, I know of no decent student, resident or consultant who would order a study without properly doing an H&P; besides, who orders an MRI for initial headache workup?

secondly, most US insurers still require that patients have a referral to specialists. Patients cannot wily-nily see specialists and expect to have their visits paid for if they do not have a family physician refer them for said visit.

In addition, many US insurance plans REQUIRE patients to get a 90 day prescription to cut down on dispensing costs for scripts.

However, as with all new prescriptions, especially those for new diagnoses, it would be foolish IMHO to prescribe a patient a large number of doses and refills without assessing whether or not the medication works. Patients will often ask for a small supply because they cannot afford the co-payment for a multiple month supply, and need to pay for it on a paycheck to paycheck basis.

Anyway, just my 2 cents...

 

[skypilot]

I know those were generalized responses to give us an understanding of the differences in approach between the two systems. Thanks!

 

[Winged Scapula]

Originally posted by skypilot
I know those were generalized responses to give us an understanding of the differences in approach between the two systems. Thanks!

I'm glad you realised it was an over-generalisation - however, others may not have.

 

[Dr.Magic]

Just thought I should correct something ALTorGT said. In the system here in Australia, Newcastle and Sydney Grads are considered to be EXCEPTIONAL as interns, because they do so much Medicine at a much earlier stage than UNSW. And because the Medicine is linked to the basic sciences in a clinical sense, it makes it more meaningful and you remember and apply it better.

The most common phrase you will hear in hospital corridors from consultants and registrars is "You can always tell a Newcastle graduate, they are simply better prepared and on the ball!" After hearing this from several consultants, surgeons, physicians in three different states, I decided to attend Newcastle. And 5yrs is definitely better than 6yrs (if you look through the 6 year program outlines, there is a lot of useless stuff taking up the time).

 

[ALTorGT]

UNSW Upper Limb Anatomy: The arm is divided into flexor and extensor compartments, with muscles attaching superiorly to the shoulder joint region and inferiorly to the bones of the forearm


Newcastle ANAT 101: The hand bones connected to the wrist bones, the wrist bones connected to the long bones, the long bones connected to the shoulder..........Sing along.

hehe

Not to belittle, I personally have spoken to Newcastle grads who talk about how little anatomy they know.

 

[Dr.Magic]

You obviously are basing your statements on what you have heard from certain Newcastle grads. It is after all a PBL course and if certain students don't want to spend the time doing anatomy on their own and want regular spoon feeding sessions in anatomy, then the fault is their own.

Just a correction:

"....compartments, with muscles attaching superiorly to the shoulder joint region and inferiorly to the bones of the forearm.."

Not all muscles of the arm attach to the bones in the forearm. (does Coracobrachialis ring a bell?)

 

[pitman]

Originally posted by Dr.Magic
Just a correction:

"....compartments, with muscles attaching superiorly to the shoulder joint region and inferiorly to the bones of the forearm.."

Not all muscles of the arm attach to the bones in the forearm. (does Coracobrachialis ring a bell?)

Actually, the original statement was factually correct -- "muscles" (i.e., some) do attach the way described. Therefore, your response is an elaboration, not a correction.

-Pitman

 

[Dr.Magic]

Oh!! so now we are moving onto english lessons are we?!!

 

[pitman]

Hey Dr. Magic, you made the contrary assertion (burden is on he who asserts disagreement from status quo and all that). But grammar itself wasn't the issue, was used only to point out that your assertion (the categorical "correction") was WRONG, ALL WRONG!

 

[Dr.Magic]

Bless us with more of your teachings, Sensei !!

 

[pitman]

How flattering...you think of me as master.

Just a humble philosopher, grasshopper. But I do have a Japanese girlfriend, if that helps.

 

[ENTSteven]

HI THere,

I am from australia and i think Sydney is a great place to live and work!! especially want to be a doc

I am a surgical trainee in Oz, however I like adelaide, the training in adelaide is even better than Sydney.

I get to do things that my sydney counter parts dont get to do.

I am in PYG2, I have done 35-40 tracheosomies + 20-30 tonsillectomy, as you have noticed that ENT is something that I wanted to do. People in Syndye only gets to write up drug charts and also put drips in, too boring!!

anyhow welcome to Oz, if you are coming, great place to live!!!! You will love it!

 

[tl47]

So, anyone from the States who studied/studying at OZ? Can please share what were the things that we should purchase in US? I was wondering about textbooks, and possibly also USMLE stuff. Do the school library and campus bookstores generally have all the books?

Specifically, I'm looking at Flinders. Not sure of admission, but it's good to know in advance. Any electronic stuff I should bring (I know about the tax, which stinks... btw, how strict are they, really? Say, I have a personal use laptop, will they really check and make sure it is 12 months old, etc. etc.? Will they ask for receipts for my $7 walmart watch to make sure it's 12 months old too? Or my 3 year old MP3 player which I have since lost the receipt?) ?

 

[Winged Scapula]

I agree with flindophile (and not only because I'm a former Flinders bookstore co-manager). I wouldn't purchase books the US to bring to Oz - you can get them there, reasonably cheaply and why waste the space and cost to ship them? Obviously if you already have some texts bring them with you, but don't buy anything new.

I don't know anyone who was actually taxed on electronic goods so I wouldn't worry too much about it.

 

[bgeez]

hello all, i was wondering which one of the Aussie med schools does a better job of preping for USMLE. or is it all self studies?
Please shade some light.
thanks

 

[Winged Scapula]

IMHO none of them does a particularly good job - after all, these aren't schools DESIGNED for those taking the USMLE (typically Americans) but rather are schools that accept a small percentage of international students (of which a smaller number are interested in taking the USMLE). They have little reason to do so - after all, the students pass (at least most of them) without the schools offering any help, so why invest the extra effort (extra effort hardly being an Aussie trait)?

If you attend an Aussie school, regardless of which one, plan on doing a lot of self-study. None of them have formal review courses or teach "to" the exam.

 

[bgeez]

thank you for your responses. 2 mre questions.
i heard as a foreigm med grad, you need a very high or more than average score on step1 and step2. how is high is high? some of the folks i know say it needs to be over 90%. is that true?

also, i heard u can do the fourth year clinical rotation in US. are there any med centers in particular that are affiliated with Aussie med schools? or its basically anywhere?

need some enlightenment.
thanks in advance.

 

[bgeez]

thanks for the reply flindophile.

i heard there is a gap between graduation (in december?) and start of residency. whats the best way to utilize this time?
thanks again.

 

[Winged Scapula]

Originally posted by bgeez
thanks for the reply flindophile.

i heard there is a gap between graduation (in december?) and start of residency. whats the best way to utilize this time?
thanks again.

Have fun. There is no reason why you need to be studying or working in a health related field during this time unless you want to. It will be the last lengthy vacation you'll have until retirement.

 

[bgeez]

Thanks flindophile and Dr. Cox.

i heard about the core clinicals rotations and elective rotations.
what includes the core clinicals and what are the electives? does assie schools have similar core clinicals as in US?
thanks one more time.

 

[Winged Scapula]

Originally posted by bgeez
Thanks flindophile and Dr. Cox.

i heard about the core clinicals rotations and elective rotations.
what includes the core clinicals and what are the electives? does assie schools have similar core clinicals as in US?
thanks one more time.

The Cores in Australia are basically the same as in the US: Family Med (called Gen Practice), IM, Surg, Ob-Gyn, Peds, Psych.

Electives are sort of up to you - you are given categories in which you need to complete 4th year rotations and choose from the available rotations. You have some time to do away electives and you can tailor these to your future career goals.

 

[bgeez]

i heard flinders and most other aussie school tend to accept mostly candaian students in their international quota? does that mean other non US citizens dont have much chance??

 

[MD1088]

Flindophile is normally spot on but I must add that the international quota of 1/3 N American to 2/3 Aussie is not entirely accurate. My class (yr 2 of 4) has a couple European students, a couple UK students, several Hong Kong students, an Indonesian student and quite possible others that have kept there nationality a secret...The Canucks and Yanks do make up the bulk though...