working as an international physician

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Dire Straits

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is it possible to be a full-time physician working in different countries that are in need of physicians? is there enough money in it to live off? nothing major, just enough money to buy a home in the U.S. and spend most of the year practicing in different countries that are in need of doctors. I'm hoping to complete a general surgery residency in the U.S. and then practice general surgery in countries that are in need of surgeons. but i'd like to know if there is enough money in this kind of work if i do it full-time to support myself.

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Dire Straits said:
is it possible to be a full-time physician working in different countries that are in need of physicians?
Yes, there's a number of organizations that actually desires to "employ" that type of physicians, but:
Dire Straits said:
is there enough money in it to live off?
...that's exactly the problem:
Usually, you'll be sent to absolutely underserved areas/countries where the population (and thereby ultimately the aid organizataion) isn't able to actually pay (you) reasonably for treatments, so there isn't any type of significant money either.
For example, look at organizations such as MSF: you'll only get about 500-700 USD a month for your services, compare this to the income that you could make as an attending in the US in the same time.

However, there are a few organizations that actually pay a bit more than just ~1000 USD a month.
I've recently heard something about a help organization that would pay about 4000-5000 USD a month (for physicians from required specialities).

I'm not sure how this exactly works (I guess there will be some sort of UN/government funds involved) - but generally, even if you're lucky, you can hardly expect to get much more paid than a (senior) resident in your speciality when volunteering.
Even though there may be a few positions with the really big organizations (i.e. WHO ?) where one might make some more money for that type of work </speculation>.

I'd recommend to check out the webpages of the various help organizations and look into the possibilities:

http://www.ama-assn.org/ama/pub/category/3345.html

Dire Straits said:
nothing major, just enough money to buy a home in the U.S. and spend most of the year practicing in different countries that are in need of doctors.
If that's what you want, your best/safest bet would probably really be to simply work part time in the US for as long as you deem is necessary, and afterwards volunteer the rest of the year with your preferred organization.

Dire Straits said:
I'm hoping to complete a general surgery residency in the U.S. and then practice general surgery in countries that are in need of surgeons. but i'd like to know if there is enough money in this kind of work if i do it full-time to support myself.
I think all this sounds very noble and certainly rewarding and fullfilling, but I'm not sure whether it's really feasible to do this full time - because of the lack of money.

The above mentioned approach is actually what most regular volunteers seem to do: work for a couple of months (i.e. 2-6) in their country and then go abroad as soon as they have made sufficient money.

Anyway, I'll try to get the name of that 4000-5000 USD/month organization for ya.
 
wow, thanks a bunch medwiz. really appreciate all that info. and i would definetly like to know the name of that organization you were speaking of.
 
Dire Straits said:
wow, thanks a bunch medwiz. really appreciate all that info. and i would definetly like to know the name of that organization you were speaking of.
Sorry, haven't yet found the name again - unfortunately, I also emptied my browser
cache & history yesterday, so that makes things a bit more complicated.

But I seem to recall that it was an organization that's somehow related to activities
in central/south america ( as if that'd narrow it down :) ).

Well, I'll keep looking for it during the next days.



Apart from that, several volunteer organizations seem to offer a somewhat better
"reimbursement" for people who are willing to make long term commitments, so this
may already be a small positive factor for the plans that you described.

But I still doubt that you'd ultimately be able to actually conveniently purchase estate
or pay of loans based on such a salary, after all the majority of these organizations are
really based on volunteer work and donations - it's actually not all that uncommon that
volunteers actually have to pay for some of the costs (i.e. transportation, food, living).

Also, if you are intending to do this full time and hence need to make a certain amount
of money minimally, you are probably not really looking for "volunteer" organizations in
the closest sense.
Rather, some sort of "staffing" organization for 3rd world medicine/developing countries (i.e. underpaid jobs for physicians :) ).
I think that "staffing" was actually the term that was used with the aforementioned organization.

Basically, this seems to work like some sort of "network" where a staffing organization
collaborates with dozens of different volunteer organizations and dispatches specialists
to underserved areas, whereas finances really seem to stem from humanitarian aid funds.
Much like what's suggested at this webpage: http://www.vistastaff.com/physician/volunteer.php

Depending on how long you hope to do such work, you may be really better off contacting
some of the big humanitarian aid organizations (i.e. international red cross, unicef etc.)
and ask them about feasible ways to achieve your goals, even if they should not be directly
able to help you, they may be able to forward your inquiry accordingly, I'd guess.

Also, you didn't say when exactly you'd be finished with your residency and when you are
hoping to do such work, but I'm pretty sure that these things will need to be planned
carefully in advance if you intend to actually do this fulltime and get paid for it.

So depending on how seriously you hope to do such work, it might be a good idea to simply
set up a simple standard letter that provides a general insight into your background, motivation,
goals and requirements, so that you can simply send this general letter to the various help
organizations by email, it should be pretty straight forward to get your hands on some contact
info via the various volunteer directories, i.e.:

http://www.msf.ca/overseas/medlinks.htm
http://www.imva.org/Pages/orgdb/wblstfrm.htm

Some of these directories are even searchable:
http://www.amsa.org/global/ih/ihopps.cfm
http://www.serveyourworld.com/categ...r-Organizations-by-Type/Medical-Volunteering/


There wouldn't be any costs involved and you could always ultimately also ask each organization to
simply forward your inquiry to possibly more appropriate organizations if they deem it appropriate.

Alternatively, you could also consider sending such a general inquiry to the American College
of Surgeons, they'd certainly also be able to get back to you with some basic information,
there's even a small brochure about volunteer services available at their website:
http://www.acponline.org/college/membership/volunteer_brochure.htm

On the other hand, one of the more common issues amongst regular volunteer physicians
seems really to be the lack of a permanent job, so considering to work part time in the US
might still be a good compromise in that regard, that way one would keep having a foot in
the door, so you wouldn't necessarily have to actually give up on your job - also, that route
seems to be significantly more feasible - even without careful planning in advance.

Also, I'm not sure whether you read that other volunteer thread, but a friend of mine
served with MSF for about a year and he keeps telling me that while this experience was
certainly extremely rewarding and fulfilling, it's also been horribly challenging and
stressful at times, particularly in the beginning.

For example, as a surgeon, you'll not rarely be the only surgeon on a mission, so you'll have
to take care of a rather broad area of presentations/cases without any sort of surgical/speciality
backup, i.e. if you take a look at the requirements for surgeons with some of these volunteer
organizations, you'll notice that general surgeons are usually not only preferred over their
sub speciality counterparts, but are preferably also able to do most of the common stuff of
those disciplines that have turned into sub specialities in the Western world.

For example, general surgeons will preferably be able to do ortho, ob/gyn, plastics, trauma
and even some basic opth and ENT stuff.

Also, experience dealing with dental issues seems often to be really a plus (i.e. tooth extraction).

Of course, this is also likely to extremely depend on the scope of the actual missions that you
are interested in, but it's still likely to also cover a variety of cases that wouldn't usually
be within the scope of a general surgeon in the US - on the other hand, that seems also part of the
reasons why some physicians feel really attracted to such missions.

So, even after G/S residency, one would probably be well advised to take some extra rotations to actually
feel somewhat more comfortable with the most common procedures in either speciality if you don't have any
really rural experience under your belt. Maybe, the part time approach is also a good idea in this regard,
as it'd allow to accumulate sub speciality experience during the US stay.

Also, as you indicated an interest in doing this hopefully primarily for some time, there's often
another signifcant difference in the policies between the various organizations regarding
friends,spouses/family accompanying a mission:
While many of the smaller NGOs usually don't allow any friends deployed (or even just visits),
some other organizations (i.e. MSF) do allow some of their most regular volunteers to take people
with them after some time - others even have a strong emphasis on going abroad in groups/with
friends or family - the latter usually having a religious background, this may be another factor-
I'm personally not particularly religious (at least as long as my family is healthy ;-)), so I could
personally not identify particularly well with the majority of really religios organizations.

On the other hand, another problem that seems also somewhat common amongst long term volunteers
is also mentioned on the MSF webpages: the most regular (i.e. fulltime) volunteers may experience
troubles fitting into the hierarchy of a Western hospital again, where your colleagues have stepped
up the career ladder, whereas you usually don't have made any significant money or actual career
progress, but will often have much more (and broader !) operating experience accumulated meanwhile.

Given the incredible autonomy and freedom that volunteer physicians often experience, it seems quite
understandable that the beaurocratic necessities of the Western world (i.e. careful documenting etc.)
are likely to be perceived as hindering and maybe even frustrating.


So, if you really want to do something like this for some time, I'd definitely recommend to set up
some sort of standard inquiry that you can easily send out, this should be a no brainer and you
would probably keep getting responses for quite some time after having sent out such an inquiry
to the different organizations - even without having to care for all this by yourself.

Also, it may probably not hurt if you purchase some books/DVDs about this kind of work if you haven't yet
really looked into it, so that you get a better understanding of the requirements and type of work.
 
another thing to consider is working for a military branch and being stationed overseas. pay is adequate but you will be treting mostly americans and it can be quite boring at times, i imagine. not sure your reason or lure of working overseas (the patients, the diseases, or the chance to live abroad) but depending on what you want, the military may be the perfect answer for you.
 
That reminds me of a tshirt a friend of mine had when we were kids.....

"Join the army............
travel to exotic places.....
meet exotic people.........
and kill them."
 
MedWiz said:
Sorry, haven't yet found the name again - unfortunately, I also emptied my browser
cache & history yesterday, so that makes things a bit more complicated.

But I seem to recall that it was an organization that's somehow related to activities
in central/south america ( as if that'd narrow it down :) ).

Well, I'll keep looking for it during the next days.



Apart from that, several volunteer organizations seem to offer a somewhat better
"reimbursement" for people who are willing to make long term commitments, so this
may already be a small positive factor for the plans that you described.

But I still doubt that you'd ultimately be able to actually conveniently purchase estate
or pay of loans based on such a salary, after all the majority of these organizations are
really based on volunteer work and donations - it's actually not all that uncommon that
volunteers actually have to pay for some of the costs (i.e. transportation, food, living).

Also, if you are intending to do this full time and hence need to make a certain amount
of money minimally, you are probably not really looking for "volunteer" organizations in
the closest sense.
Rather, some sort of "staffing" organization for 3rd world medicine/developing countries (i.e. underpaid jobs for physicians :) ).
I think that "staffing" was actually the term that was used with the aforementioned organization.

Basically, this seems to work like some sort of "network" where a staffing organization
collaborates with dozens of different volunteer organizations and dispatches specialists
to underserved areas, whereas finances really seem to stem from humanitarian aid funds.
Much like what's suggested at this webpage: http://www.vistastaff.com/physician/volunteer.php

Depending on how long you hope to do such work, you may be really better off contacting
some of the big humanitarian aid organizations (i.e. international red cross, unicef etc.)
and ask them about feasible ways to achieve your goals, even if they should not be directly
able to help you, they may be able to forward your inquiry accordingly, I'd guess.

Also, you didn't say when exactly you'd be finished with your residency and when you are
hoping to do such work, but I'm pretty sure that these things will need to be planned
carefully in advance if you intend to actually do this fulltime and get paid for it.

So depending on how seriously you hope to do such work, it might be a good idea to simply
set up a simple standard letter that provides a general insight into your background, motivation,
goals and requirements, so that you can simply send this general letter to the various help
organizations by email, it should be pretty straight forward to get your hands on some contact
info via the various volunteer directories, i.e.:

http://www.msf.ca/overseas/medlinks.htm
http://www.imva.org/Pages/orgdb/wblstfrm.htm

Some of these directories are even searchable:
http://www.amsa.org/global/ih/ihopps.cfm
http://www.serveyourworld.com/categ...r-Organizations-by-Type/Medical-Volunteering/


There wouldn't be any costs involved and you could always ultimately also ask each organization to
simply forward your inquiry to possibly more appropriate organizations if they deem it appropriate.

Alternatively, you could also consider sending such a general inquiry to the American College
of Surgeons, they'd certainly also be able to get back to you with some basic information,
there's even a small brochure about volunteer services available at their website:
http://www.acponline.org/college/membership/volunteer_brochure.htm

On the other hand, one of the more common issues amongst regular volunteer physicians
seems really to be the lack of a permanent job, so considering to work part time in the US
might still be a good compromise in that regard, that way one would keep having a foot in
the door, so you wouldn't necessarily have to actually give up on your job - also, that route
seems to be significantly more feasible - even without careful planning in advance.

Also, I'm not sure whether you read that other volunteer thread, but a friend of mine
served with MSF for about a year and he keeps telling me that while this experience was
certainly extremely rewarding and fulfilling, it's also been horribly challenging and
stressful at times, particularly in the beginning.

For example, as a surgeon, you'll not rarely be the only surgeon on a mission, so you'll have
to take care of a rather broad area of presentations/cases without any sort of surgical/speciality
backup, i.e. if you take a look at the requirements for surgeons with some of these volunteer
organizations, you'll notice that general surgeons are usually not only preferred over their
sub speciality counterparts, but are preferably also able to do most of the common stuff of
those disciplines that have turned into sub specialities in the Western world.

For example, general surgeons will preferably be able to do ortho, ob/gyn, plastics, trauma
and even some basic opth and ENT stuff.

Also, experience dealing with dental issues seems often to be really a plus (i.e. tooth extraction).

Of course, this is also likely to extremely depend on the scope of the actual missions that you
are interested in, but it's still likely to also cover a variety of cases that wouldn't usually
be within the scope of a general surgeon in the US - on the other hand, that seems also part of the
reasons why some physicians feel really attracted to such missions.

So, even after G/S residency, one would probably be well advised to take some extra rotations to actually
feel somewhat more comfortable with the most common procedures in either speciality if you don't have any
really rural experience under your belt. Maybe, the part time approach is also a good idea in this regard,
as it'd allow to accumulate sub speciality experience during the US stay.

Also, as you indicated an interest in doing this hopefully primarily for some time, there's often
another signifcant difference in the policies between the various organizations regarding
friends,spouses/family accompanying a mission:
While many of the smaller NGOs usually don't allow any friends deployed (or even just visits),
some other organizations (i.e. MSF) do allow some of their most regular volunteers to take people
with them after some time - others even have a strong emphasis on going abroad in groups/with
friends or family - the latter usually having a religious background, this may be another factor-
I'm personally not particularly religious (at least as long as my family is healthy ;-)), so I could
personally not identify particularly well with the majority of really religios organizations.

On the other hand, another problem that seems also somewhat common amongst long term volunteers
is also mentioned on the MSF webpages: the most regular (i.e. fulltime) volunteers may experience
troubles fitting into the hierarchy of a Western hospital again, where your colleagues have stepped
up the career ladder, whereas you usually don't have made any significant money or actual career
progress, but will often have much more (and broader !) operating experience accumulated meanwhile.

Given the incredible autonomy and freedom that volunteer physicians often experience, it seems quite
understandable that the beaurocratic necessities of the Western world (i.e. careful documenting etc.)
are likely to be perceived as hindering and maybe even frustrating.


So, if you really want to do something like this for some time, I'd definitely recommend to set up
some sort of standard inquiry that you can easily send out, this should be a no brainer and you
would probably keep getting responses for quite some time after having sent out such an inquiry
to the different organizations - even without having to care for all this by yourself.

Also, it may probably not hurt if you purchase some books/DVDs about this kind of work if you haven't yet
really looked into it, so that you get a better understanding of the requirements and type of work.


hi medwiz, thank you again for the insightful post. it's really helpful. you are right that i couldn't probably do it fulltime and still make a decent living and pay off my loans. so i was thinking after gsurg residency i'd work as a locum surgeon in the states. i figure working as a locum would allow me to make reasonable money and will importantly give me greater flexibility to go overseas. i figure if i worked as a salaried employee for a hospital or even joined a private practice, they wouldn't be pleased with me taking off for months at a time to go work overseas and leaving them to pick up the extra work left behind. i'm entering msIII in a little while, so i got some time ahead of me. by the way do you know any international volunteer organizations that will take med students over the summer for a few weeks? thanks again for your help.
 
dbiddy808 said:
That reminds me of a tshirt a friend of mine had when we were kids.....

"Join the army............
travel to exotic places.....
meet exotic people.........
and kill them."

i'm so going to hell for laughing at that.
 
See you there.
 
I haven't read that giant post earlier. I am sure it has excellent info. Briefly just my two cents: having a strong interest in HIV and having married a Thai national, I have looked into practicing in Thailand. The general problem that most expat US docs state is that unless they are earning a Western salary (through WHO, UN, CDC, etc) you fall into an income trap. You can earn enough to live quite comfortable there, but not enough to save for retirement (or pay off student loans) in the US. Loans by the way can be waived by the US govt (something like $35,000/year for research programs).
 
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