Beware after PLAB

[Rajshah]

I am a UK graduated doctor, but my roots lie in Bangladesh.
I know of the plight of overseas doctors in the NHS.
I have a worked for the NHS, didn't like it so passed my USMLE and am going to USA.
Here is my experience.

I found it diffcult to get a job even though from UK. When i did work as a locum I overheard many conversations between a whole variety of people from nurses to pofessors and consultants even domestic staff. They all complained that overseas doctors deliver suboptimal "third world care". Other consultants loved forcing non career posts on foreigners. They tell me a foreigners should work but never be allowed to progress as they would take over the system.
I got more and more frustrated as preference was given to caucasian colleagues for holidays and invites to social events - I was left doing oncalls. I have seen coroners cases where the consultant have openly pointed fingers at innocent foreigners.
Just look at the recent court cases in the BMA ( a group said to protect doctors) on racism.
A nurse once told me all indians smell disgusting and all her colleagues laughed. I reported her and she only got a reprimand.
another phrase - PLAB= Pretty Lousy Asian Bastards.
Hold hope for the few people who share the plight of foreign doctors and maybe you will finally get that career to feed your family or maybe you'll be stuck with public transport working 7 days a week while a fat consultant drives his Jaguar.
The future of the UK is bleak - a small country with limited resources and a growing population.
If you wish to come here by all means do, but 99% of foreign doctors i meet are unhappy with the way they are being treated in the UK and would give anything to turn back time before they have to rely on their now bosses for references.
Am I saying that the country is discriminatory? I will leave that for you to decide.
As for me i leave the country soon, and I will not look back - except to check on petrol prices, house prices, fire brigade strikes, tax brackets....
Good luck to all who read this. Feel free to copy this advice to other message boards so the information is passed on.

Dr Raj Shah (now MD)

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[Apollyon]

What you say, I've heard over and over...as one Indian doc told me (who had worked in the UK, before coming here to the US), "Anyone who says they liked it there (the UK) was lying".

One thing different between the US and the UK is that, in the US, if you do your work and bust your butt, no matter where you're from, you can move up the ladder, and be whatever you aspire to. You won't spend your entire career as an SHO or senior registrar.

Best of luck.

 

[KaliforniaDoll]

Smart FMGs dont stay in the United Kingdom for long. They use it as stop over to make some money and get the basic training to improve US residency chances. I have worked as SHO for few years to get my fellowship. I still regret for wasting my time in the UK.

UK sucks. PLAB test is the unfair and worst examination i have taken in my life.

 

[Calypso]

Hi everyone,

As a Canadian visible minority who's considering going to the UK to earn my MBBS, then working on up through the NHS, I now have serious concerns over the challenges faced by those wishing to earn consultant status there. I understand how ridiculously difficult it is for FMGs to place in PRHO spots, but I was wondering what the situation is like for international, vis. minority students who do earn the MBBS in the UK itself? Is it a similar challenge to make it as a consultant? Is it more worthwhile to do a US residency, then certify in the UK as a consultant?

Also, I recently came across this article which was originally researched by a BBC Health correspondent and published in the BMJ. Does it hit the nail on the head:

http://careerfocus.bmjjournals.com/cgi/content/full/328/7451/219

Thank you for your input, and best of luck to you!

 

[IlianaSedai]

If you're wanting to work your way up to consultant in the UK, I would think that your best bet would be to do your MBBS there, even though you'll have to figure out your immigration issues as you go. I think it's always best to get your medical degree in the country where you intend to stay -- that saves a lot of trouble in the long run. If you want to work in the UK permanently, you're better off getting your degree there because then you don't have to take the PLAB examination in order to be qualified to apply for SHO, SpR etc posts to work your way up to consultant.

My observation is that there is, admittedly, something of an institutional prejudice against South Asians and people from the Middle East in particular (i.e. India, Pakistan, Bangladesh, Arab countries) in the UK. That said, those minority groups are not so rare in the UK, they're easy targets because their communities are very large yet not well assimilated into British culture, medicine is a huge "thing" in those cultures, and there are a lot of foreign doctors specifically from those countries practicing in the UK. There also seems to be a myth among those countries that the UK is some sort of gold mine, hence a lot of disappointment after immigrants land there. To an extent, I think many Britons view these very visible ethnic minorities as an immigration "problem" for the country. With all due respect to the original poster of this thread, Dr. Shah probably had a number of things working against him -- ethnicity, language, cultural assimilation, and possibly (jumping to conclusions from other threads) some cultural conflict of values.

Thing is, not all of those will be issues that YOU face as a Canadian, first language English speaker, etc. There's a big difference between the situation with Indian doctors (immigrants with all of the nasty politics involved in immigration issues) and that with Canadians ("expats"). I wouldn't know what you'll find. You might find you have the benefit of being able to decide how to identify yourself ethnically (Canadian or whatever your other background is), and people then go along with what you tell them. Declare yourself as whatever you wish, and people will remember you as such. Some backgrounds are, sadly, more persecuted than others. Whatever the case, as a graduate of a UK medical school, you ought to do fine in landing an SHO post.

If you want to stay as a consultant in the UK, my personal opinion is that it is most definitely NOT worthwhile to do a residency in the US. If you got your MBBS in the UK, you'd have to USMLE into the US. If you got your MD in the US and wanted to go to the UK, you'd still have to PLAB. It is not guaranteed that you will receive "credit" for your US training. (To get an idea of this, check out the statistics at the Specialist Training Authority web site http://www.sta-mrc.org.uk/ ). Might as well go where you want to go from the start.

 

[Miklos]

If you're wanting to work your way up to consultant in the UK, I would think that your best bet would be to do your MBBS there, even though you'll have to figure out your immigration issues as you go. I think it's always best to get your medical degree in the country where you intend to stay -- that saves a lot of trouble in the long run. If you want to work in the UK permanently, you're better off getting your degree there because then you don't have to take the PLAB examination in order to be qualified to apply for SHO, SpR etc posts to work your way up to consultant.

My observation is that there is, admittedly, something of an institutional prejudice against South Asians and people from the Middle East in particular (i.e. India, Pakistan, Bangladesh, Arab countries) in the UK. That said, those minority groups are not so rare in the UK, they're easy targets because their communities are very large yet not well assimilated into British culture, medicine is a huge "thing" in those cultures, and there are a lot of foreign doctors specifically from those countries practicing in the UK. There also seems to be a myth among those countries that the UK is some sort of gold mine, hence a lot of disappointment after immigrants land there. To an extent, I think many Britons view these very visible ethnic minorities as an immigration "problem" for the country. With all due respect to the original poster of this thread, Dr. Shah probably had a number of things working against him -- ethnicity, language, cultural assimilation, and possibly (jumping to conclusions from other threads) some cultural conflict of values.

Thing is, not all of those will be issues that YOU face as a Canadian, first language English speaker, etc. There's a big difference between the situation with Indian doctors (immigrants with all of the nasty politics involved in immigration issues) and that with Canadians ("expats"). I wouldn't know what you'll find. You might find you have the benefit of being able to decide how to identify yourself ethnically (Canadian or whatever your other background is), and people then go along with what you tell them. Declare yourself as whatever you wish, and people will remember you as such. Some backgrounds are, sadly, more persecuted than others. Whatever the case, as a graduate of a UK medical school, you ought to do fine in landing an SHO post.

If you want to stay as a consultant in the UK, my personal opinion is that it is most definitely NOT worthwhile to do a residency in the US. If you got your MBBS in the UK, you'd have to USMLE into the US. If you got your MD in the US and wanted to go to the UK, you'd still have to PLAB. It is not guaranteed that you will receive "credit" for your US training. (To get an idea of this, check out the statistics at the Specialist Training Authority web site http://www.sta-mrc.org.uk/ ). Might as well go where you want to go from the start.

IMHO, anyone who is not "lilly white" and does not speak received pronunciation stands a good chance of being a victim of discrimination in Britain.

 

[IlianaSedai]

IMHO, anyone who is not "lilly white" and does not speak received pronunciation stands a good chance of being a victim of discrimination in Britain.

Sure -- there is racism in Britain and there is also little to no awareness or interest in issues of racism in Britain, so what goes on, goes on, and nobody pays attention or raises much ruckus about it.

But if you think there's no racism in Canada or America, then I can't agree with you there. A visible minority is a visible minority and sometimes gets picked on in all three places. It does NOT necessarily mean that you won't be able to get a job in Britain. The issues surrounding immigration (and PLAB-ing doctors) from the Indian subcontinent are very specific, and being from there is a major disadvantage that, for lack of a better word, truly sucks in Britain.

But you cannot generalize the plight of that immigrant population to everyone. Americans and Canadians in the NHS are so few that there isn't much data available to tell you how they perform career-wise; but it is probably fairly certain that it's not nearly as ugly as the immigration problems from the Indian subcontinent. These countries are much more similar to the UK in outlook and culture, and they don't draw the same type of negativity. As a person with an already at least somewhat Western background, you also possess better "people smarts" and language skills. You are better prepared culturally, you have a similar background, and you won't be so completely "lost" as a new arrival. You're therefore not nearly as vulnerable to getting "lynched" as an immigrant or recent arrival from the subcontinent.

If you're concerned, I think it's worth visiting, spending time in the country, getting to know a few people and asking questions to figure out whether you really want to stay there long term. There are ethnic minorities in medical school in the UK. And successful doctors. It's not like you're going to med school in India and trying to PLAB your way in -- that's totally different.

 

[Rajshah]

I agree that UK medicine is not alone in discrimination. It constantly happens everywhere in all walks of life.
However there is a point where it becomes silly, and you find people "less able" than yourself getting further with their career, because of their origin.
The UK has a very bad track record of judging ability and as a result you could be a multiple prize winner, lots of research etc... but no good job to show for it.
I found with my experience in the US that people still do discriminate, but if you have the ability they will reward you for it.
One other word of warning - do not accept trust non-career grades in the UK. It leads to dead end as the consultants in charge will try to keep you there usually through downgrading letters of reccomendation.

 

[Calypso]

Thank you all very much for your input!

For sure, racism and prejudices unfortunately still persist everywhere, both inside and outside of health care. So, it sounds like if I earn my MBBS in the UK I'll at least be able to secure a PRHO spot, maybe even SHO. But as a visible minority, I'm greatly concerned that I won't be given an equal opportunity to work my way up to consultancy status.

What are my options, then, if I do the MBBS in the UK, do the specialty in the States, then return to the UK? I'm with you, Iliana, on doing the MBBS instead of the MD. But for my residency, I'm okay with having to do the USMLE's if it means that I can become whatever I wish. Will I still have to do the PLAB though? And I wonder what hiring practises are like when it comes to consultant positions, given that the NHS said there's specifically a shortage in consultants.....

*sigh* So much politics to consider

 

[IlianaSedai]

What are my options, then, if I do the MBBS in the UK, do the specialty in the States, then return to the UK? I'm with you, Iliana, on doing the MBBS instead of the MD. But for my residency, I'm okay with having to do the USMLE's if it means that I can become whatever I wish. Will I still have to do the PLAB though?

If you get the MBBS in the UK you should not have to do the PLAB (although you still have to do the USMLE). The danger in doing your residency in the US, however, is that you are not guaranteed that your training will "count" toward being qualified as a consultant. You might end up getting bumped back a few years down the training hierarchy, which is not desirable at all. The link I put in the previous post, for the Specialist Training Authority, has some helpful data under their "Statistics" section that might be of interest to you. How overseas postgraduate training is evaluated and what percentage of applicants are successful in getting full "credit" for their residency depends on the specialty (note, for example, that anaesthesia and radiology are "shortage" specialties). They also tell you what percentage of applicants from specific countries are approved and what percentage are denied. However, your UK degree might give you some advantage against those numbers (which are for people who did not graduate from a UK medical school).

In short, life is always easier if you can pick one country and one medical system, and stick with it. It's a work-intensive process but very possible to move countries and re-qualify once, but bouncing from UK to US to UK is actually moving twice -- when you get to this point, you'll most likely be too lazy and also in your early 30's by then, and wanting to stay in one place.

However, I would not worry much about any of this beyond applying to medical school there, for now. It is a bit too early to be worrying about postgraduate training, and a lot happens in the 5 - 8 years between now and your graduation from medical school. Just sit back and relax and the answers to your postgraduate concerns will become more apparent over the course of years. The most important part of this process is really just location. If you like the UK, why leave for training when it's not guaranteed it will count? (The exception might be a one or two year fellowship after UK postgrad training.) And if you don't like it, go home or go to the US. I don't think the race issue needs to play a huge role in your decision-making-- you can just do your training where you want to live, and I think that you should do fine, regardless of how you look.

 

[kim222]

hi rajshah...

i appreciate your frustration with the UK system
but given ur experience in having graduated from a uk med school
would like to hear from you

1. how difficult are the plab exams

2. ill be studying in an irish med school so when is the best time during med school to take the plabs if i want a prho place in the uk

3. are the plabs more imp or ur academic transcript more imp in detremining whether u get selected for a particular prho post

 

[DrIng]

my understanding is that if you graduate from an EU school you may not have to take the PLAB- you'll need to check this though...

 

[CSI Miami]

There is no excuse for racism, but some overseas trained doctors who speak terrible english, give the good guys like you a bad name.

I wish you luck, but can't see why we should allow people who can't speak English, to work in the US or why they should let you work in the UK, if you can't speak English.