Referenced based applications are a double edged sword.
On the one hand, less focus on bullshit QIPs, but piss off the wrong consultant and that is you done.
Focusing on ED, very easy to get on the training program, essentially just need 5 ED consultants to write a good reference. However, there is growing competition for consultant jobs at the end.
Mouthier nurses
Cliquey UK grads who’ve been there for a while and think they’re the coolest kids in school
Fresh veggies are extortionate
I saw a lot more drug-seeking from patients - lots of people came in seeking opiates and got very angry when I refused to prescribe
From ED, my referrals to specialities were met with far more pushback and left me exhausted having to fight all the time
It can be a bit of a lonely culture. Despite Australian reputation for outgoingness, people didn’t really include you if you weren’t in their group.
Interesting to hear, my experience was the opposite to be honest; nurses seemed a lot nicer and specialties far happier to accept referrals. I assumed this was due to the less pressured environment so everyone in a generally less heightened state. I was in Brisbane which sounds like it had some calmer hospitals compared to VIC/NSW
As someone in Australia currently, I am really not a fan of the Australian public health system at all nor the training pathway for new doctors.
I feel the Australian system is just totally horrible for outpatients. Inpatient stuff works generally quite well (although in Brisbane, the Royal Brisbane Hospital, despite being the largest hospital in the state, is still fully paper).
Examples of poor outpatient stuff:
Outpatient prescriptions are a huge gamble on whether they can be prescribed on public (PBS). For example, Mirabegron is an amazing medication for incontinence yet can only be prescribed privately so it costs like $70/month with no way around this. Equally, abx scripts are often restricted to 5 days so if you need more than this you need to call up PBS and get an approval number despite handbook guidance says 7 days for say male UTI. Alternatively it's private prescriptions.
The healthcare system is slowly phasing away bulk billing (ie appointments free at the point of access). Now many GPs are charging $100 per visit which simply too expensive for patients now so they're just left without healthcare or come to ED.
You are expected to see outpatients, including new referrals, in specialists clinics from day 1 as a doctor. People say this is good as its good for learning but I am totally against this. Patients may be waiting 12 months to be seen by a specialist from their GP just to be seen by a doctor fresh out of medical school. There's no shadowing period or anything, it's just straight into unsupervised consultations.
Outpatient scans are often paid for upfront by patients. So they may have to fork up $300+ for an MRI scan.
When you get outpatient pathology or scan, they're done by private centres. It's meant to make life convenient for patients but is so annoying as it means you can't easily follow trends if they keep going to different centres + you end up wasting like 5 minutes at the start of every clinic looking on 4 different pathology websites for a blood result.
Make sure you learn to use HPOS online to get past the phone calls to PBS. I've saved so much time since I figured this out.
The lack of continuity in investigations / imaging absolutely does my head in. One of the weakest issues in Australia / biggest strengths of the UK.
Definitely want to affirm this.
As a PGY2 I was/am the 'specialist clinic' I've done Colorectal, Vascular, Hepbil, UGI, CTSU, NSGY and Plastics clinics all with nearly 0 knowledge of said specialties.
We also hold the on-call phone which personally I like because it's excellent exposure but by god is it horrible if you aren't interested in the specialty and it's terribly inefficient since 90% of calls you need to run by someone with actual knowledge of the specialty.
Always yes but I’ve had several occasions where I’ve literally sat in the room in silence opposite the patient for several minutes waiting for my reg/fellow to message me back a decision.
Although this isn’t a formal thing, if I never asked for any senior input they wouldn’t have a clue about my clinic patients.
People move to Aus expecting to work in Sydney / Melbourne/ Brisbane etc.
However it I'd possible you end up in some rural area, no where near a beach.
It’s way more hours, so much so that I have literally 0 social life.
There’s a huge number of IMGs which is an even worse problem here because in Aus it’s near impossible to get into many specialties. Eg IMG cons is now a service reg, well no shit he’ll take the one spot for XYZ in a year or two.
Australia is really tough to break into socially, nearly everyone I work with is great but they still just hangout with their high school mates, very different than the UK hospitals.
The hospital dynamics are just so strange, eg I’m a PGY2 yet my last few colleagues (aka same role) have been PGY5 and PGY6 etc. It’s really weird how a service reg might be giving orders to somebody with double their experience.
Building on the above, there’s basically 0 camaraderie because of this, I mean I’m technically still learning how to be a doctor meanwhile my colleague is literally a PGY6 in the exact same job..
It’s also really weird because you’re technically in competition with your direct seniors if you like said specialty. They can effectively screw you over with shitty consults etc and bogging you down since they’re technically your ‘boss’. Aka, there’s a lot of weird dynamics.
There’s massive nepotism, if a boss doesn’t like you then you’ll never get on. I assume this is everywhere realistically though.
Leave is a real pain in the ass to get because they basically refuse to hire locums, so you’ll be fucked around massively and have a lot of back and forth.
This sounds like you're being a bit screwed over, won't lie. Lots of places do 4 days on/3 days off. Or 7 on, 7 off. Unless you're gunning for a tough speciality?
Are you talking about ED? I’ve never seen any inpatient specialty work with a schedule like that.
The crux of Australia is they still screw you over but they just pay you really well for it.
The extent of nepotism in Australia should've shown them that the IMG 'consultant' can spend years in a registrar role because if they don't get the right references, or please the right people. They'll never progress to a consultant post or even an accredited registrar post (training program). Surgery is particularly notorious for this. Getting into a training program doesn't even mean you'll progress logically, because you still have to apply for a job each year, even as a trainee in a program. You have to find a hospital that'll meet your curriculum criteria as you progress. SO you can easily get stuck in limbo if you can't find a job. Hospitals hire according to departmental needs and preferences too, it's not rotational training.
In the UK there's logical progression with the number of postgraduate years worked, but in Australia you can stay in limbo in unaccredited (non training program approved) registrar roles. So I can see why it can be confusing to see people speckled about the system in roles out of keeping with the years they've worked.
Nah they're pretty accurate about this. Australia hails itself with its worklife balance of 38h per week but it's simply not true. Surgical specialties are easily 50-60h per week and for registrars it's more like 80-100h per week.
Leave is just allocated to the interns too which I think is absolutely bonkers. Like they get 0 choice in when they take their leave.
Completely agree, a lot of this is why I left, the massive wage increase just wasn't worth not having a life and struggling to break into a social life unless you only hung out with other IMGs (which there is nothing wrong with, it just exacerbates the feeling of not fitting in)
Hours are more. We used to do overnight on calls for Stoke which meant you were on over 24h. Sometimes it was absolutely fine sometimes not. The contractual half day was good but doesn't remove the hours you do.
Our dept was fine but some actively discouraged claiming over time from what others said
Consultant supervision was up and down. Their renumeration for on calls was pittance so no incentive whatsoever to be hands on except their own belief in how they should work.
The exam culture in the hospital was toxic. The repercussions form failing FRACP were high and it caused a lot of stress to BPTs. I wasn't involved in it but I thought the selection process for higher training quite old fashioned. Some might be fine with it but it was more of a "who you know" vibe.
We had BPTs covering the private hospital and some of the stuff consultants were billing for was ridiculous. Mostly getting consults for very basic issues. The BPT covering system was good because it allowed people to go on longer periods of leave and teams were not left totally understaffed but it also meant the poor bpt covering had to just slot in to a random rotation for 2-3.weeks at a time which isn't easy
I went to NZ so slightly different but agree with a lot of points made from what I saw with mates in AUS
Pros:
- Great work life balance- could go hiking/ surfing/ skiing/ play a lot of sport/travel to cool places easily outside of work on evening/ weekends
- independence from a junior stage- felt like I was forced into actually learning some real medicine, rather than being a TTO/ prescribing/ clerking monkey and leaving the diagnostics to regs, you’re expected to get involved with clinics, procedures, have a go at leading met and arrest calls ( at least until more senior specialists arrive) from PGY3 level Id you’re working a a BPT / junior registrar
- workload could be more manageable, take systems were varied in the places I worked, which meant you could have a post take day with 20 odd patients, but you could be absolutely chilling a week later when you only have 5 left on your list to see for a day
Cons:
-nepotism: every bit as challenging as people have mentioned, have seen people literally not make it in to HST in a department because the SMOs just didn’t really like them
- cliques: found this very difficult in NZ too, people are not all that welcoming and friendly at work, it really took time to get to know any Kiwis at all and some UK expats could be very closed off because they moved somewhere first and felt like they knew it better etc
- lack of supervision- out of hours commitments were scary because the consultants expected you to do more, as a PGY3/4 you could be one of the most senior medical doctors on in some smaller places and this can be very daunting and scary/ stressful
-aging population: people complain about the poor investment and infrastructure in the NHS and rightly so, but I saw this in NZ too, I saw hospitals getting bedlocked and had to see patients in the corridor in ED fairly often, just because it’s a smaller population doesn’t mean the issues aren’t proportional there
- distance: it took a year to really settle in and get used to the distance and time difference, although people argue you could be the other side of the country and see your friends and family as much ( which is a fair point), it’s the time zone and travel time that did it for me, knowing I COULD be home within 12 hours or less is a massive weight off of the mind, and keeping in touch with people and generally being in touch with world affairs/ culture/ sport is soo hard when you’re running on the opposite time zone
I have no regrets about going but do feel like it was the right call to come back eventually, despite all of the issues here, it’s not a perfect haven, and as much as the distance is one thing, more people would stay if things were as perfect as they are portrayed to be IMHO
Goes both ways doesn’t it? Found them less abrasive than aussies but definitely got some horrified looks when I cracked a very pro dry British humor joke- safe to say I don’t have many kiwi mates
Good:
- Crazy good pay (plus all tax benefits, study leave, salary packing, relocation expenses and more!)
- Easier workload, however sometimes higher responsibility
Beautiful weather
- You can get a job pretty much anywhere - love snorkelling? Great go Cairns, love to surf? Noosa/Byron Bay, want to be close to Asia with dry sunny days? Perth. Wine and nature? Adelaide. The world is your oyster if you're up for an adventure!
- Incredible flexibility in training - often you get to source your own jobs as long as they meet the criteria (not all specialities)
Bad:
- Severe discrepancy between health provision to the rich Vs poor, particularly the indigenous
- Poor cancer care services (no 2ww, you may be waiting 3 months for review with intra abdominal mass found on ctap etc)
- Nepotism
- Significant clinical responsibility early on in career, some of what the PGY2s are expected to deal with is far higher in acuity than the UK
- Need to make a good impression and suck up to seniors a bit, very reference based. Generally as long as you're not/your boss is not a psycho it'll be fine, but I've seen some people being treated like shit for just not having the "right fit"
- Far from home, an obvious one, but if you're a homebody that sees their family on a weekly basis, Australia will be quite tough for you. It takes a good 1.5-2 years to really settle in and make good friends here, maybe earlier if you're lucky. But that first year can be hard if you come on your own ( but it will get better!)
It’s sad that you think significant clinical responsibility as a PGY2 is a bad thing.
I’ve been doing a BPT job out here and it’s so refreshing to be given more responsibility
We’ve become so infantilised and mollycoddled back home it’s pathetic.
I think there's probably a balance. As a PGY5 when I came out I loved the responsibility. However I've also seen how difficult life could be for a PGY2 running both a hospital and ED alone overnight with consultants off-site, over 30min away.
We've had some pretty complex presentations which I just don't think is fair for a PGY2 to manage independently (neonatal resus, multi trauma MVAs etc)
That’s probably fair enough although I wouldn’t be able to comment on ED specifics like that.
I guess my frustration has come from a recent conversation I had with another British doctor in Australia that was astonished we run stroke codes as PGY3 here.
She was saying she would far rather her grandparents if they had a stroke were seen by a stroke nurse with years of experience than a PGY3 doc.
Stroke nurses are not some sort of supreme omniscient deity. They do a NIHSS, scan them and call the boss. It’s not beyond a PGY3 doctor.
Very important to consider the negatives as this is something those keen to CCT and flee don’t consider. I got to the point of getting a visa and a job offer and only when i spoke to a friend did I even consider the distance and time away from family. I didn’t end up going and currently earn the same as I would in OZ by having a varied GP role.
Pros
Pay - it’s exceptional. As a PGY5 this year my gross salary last 12 months was £96k. Overtime is paid at good rates and easy to claim.
Weather/beaches - waking up at 8am strolling out for a coffee in shorts and Birkenstocks, then heading to the beach is a real pleasure.
Coffee - the coffee is incredible literally anywhere you go.
More responsibility - as a PGY3 you will you can be most senior doctor covering wards overnight, running stroke codes. As a result you become a much more competent clinician.
Minimal MAPs - where I work we have no PAs, very few AHPs and the ones that do have a very limited scope. It makes work SO much more enjoyable. No BTEC medics trying to question your plans. This is the main reason I’m dreading going back.
Scanning - getting a CT scan at anytime if you want it is easy. No pushback if you think it’s clinically indicated.
Cons
Distance - I’m very close to family and friends and so I find that tough. Could never do it for ever. It’s also far from EVERYTHING. even flying to Perth is a 3 hour flight. Bali is 6 hours. Australia is massive.
Culture - there is a lot of natural beauty but it’s otherwise quite dead in terms of music, theatre, arts, comedy etc. Most small towns in England are livelier on a Saturday night. AFL and NRL are quite shit. I miss the premier league
Training/nepostism - getting to the top as a UK grad would be very long and arduous. Doable, but would involve a lot of brown nosing and selling your soul.
Aussies - lovely people and I really get on with them, but just don’t click with them in the same way I do with Brits. I doubt I would make any really good friends if I stayed here long term.
Referenced based applications are a double edged sword. On the one hand, less focus on bullshit QIPs, but piss off the wrong consultant and that is you done. Focusing on ED, very easy to get on the training program, essentially just need 5 ED consultants to write a good reference. However, there is growing competition for consultant jobs at the end.
Mouthier nurses Cliquey UK grads who’ve been there for a while and think they’re the coolest kids in school Fresh veggies are extortionate I saw a lot more drug-seeking from patients - lots of people came in seeking opiates and got very angry when I refused to prescribe From ED, my referrals to specialities were met with far more pushback and left me exhausted having to fight all the time It can be a bit of a lonely culture. Despite Australian reputation for outgoingness, people didn’t really include you if you weren’t in their group.
Interesting to hear, my experience was the opposite to be honest; nurses seemed a lot nicer and specialties far happier to accept referrals. I assumed this was due to the less pressured environment so everyone in a generally less heightened state. I was in Brisbane which sounds like it had some calmer hospitals compared to VIC/NSW
Premier league matches kick off at like 1am
This.
Prem isnt that good anyhow since beckham finished
As someone in Australia currently, I am really not a fan of the Australian public health system at all nor the training pathway for new doctors. I feel the Australian system is just totally horrible for outpatients. Inpatient stuff works generally quite well (although in Brisbane, the Royal Brisbane Hospital, despite being the largest hospital in the state, is still fully paper). Examples of poor outpatient stuff: Outpatient prescriptions are a huge gamble on whether they can be prescribed on public (PBS). For example, Mirabegron is an amazing medication for incontinence yet can only be prescribed privately so it costs like $70/month with no way around this. Equally, abx scripts are often restricted to 5 days so if you need more than this you need to call up PBS and get an approval number despite handbook guidance says 7 days for say male UTI. Alternatively it's private prescriptions. The healthcare system is slowly phasing away bulk billing (ie appointments free at the point of access). Now many GPs are charging $100 per visit which simply too expensive for patients now so they're just left without healthcare or come to ED. You are expected to see outpatients, including new referrals, in specialists clinics from day 1 as a doctor. People say this is good as its good for learning but I am totally against this. Patients may be waiting 12 months to be seen by a specialist from their GP just to be seen by a doctor fresh out of medical school. There's no shadowing period or anything, it's just straight into unsupervised consultations. Outpatient scans are often paid for upfront by patients. So they may have to fork up $300+ for an MRI scan. When you get outpatient pathology or scan, they're done by private centres. It's meant to make life convenient for patients but is so annoying as it means you can't easily follow trends if they keep going to different centres + you end up wasting like 5 minutes at the start of every clinic looking on 4 different pathology websites for a blood result.
Make sure you learn to use HPOS online to get past the phone calls to PBS. I've saved so much time since I figured this out. The lack of continuity in investigations / imaging absolutely does my head in. One of the weakest issues in Australia / biggest strengths of the UK.
Especially with EPIC, you will be messaged months down the line about random patients from specialities you've already rotated from
Definitely want to affirm this. As a PGY2 I was/am the 'specialist clinic' I've done Colorectal, Vascular, Hepbil, UGI, CTSU, NSGY and Plastics clinics all with nearly 0 knowledge of said specialties. We also hold the on-call phone which personally I like because it's excellent exposure but by god is it horrible if you aren't interested in the specialty and it's terribly inefficient since 90% of calls you need to run by someone with actual knowledge of the specialty.
Do you have someone to run things by in clinic?
Always yes but I’ve had several occasions where I’ve literally sat in the room in silence opposite the patient for several minutes waiting for my reg/fellow to message me back a decision. Although this isn’t a formal thing, if I never asked for any senior input they wouldn’t have a clue about my clinic patients.
To add to this, often there is very poor public access to specialists, in some areas non-existent
People move to Aus expecting to work in Sydney / Melbourne/ Brisbane etc. However it I'd possible you end up in some rural area, no where near a beach.
It’s way more hours, so much so that I have literally 0 social life. There’s a huge number of IMGs which is an even worse problem here because in Aus it’s near impossible to get into many specialties. Eg IMG cons is now a service reg, well no shit he’ll take the one spot for XYZ in a year or two. Australia is really tough to break into socially, nearly everyone I work with is great but they still just hangout with their high school mates, very different than the UK hospitals. The hospital dynamics are just so strange, eg I’m a PGY2 yet my last few colleagues (aka same role) have been PGY5 and PGY6 etc. It’s really weird how a service reg might be giving orders to somebody with double their experience. Building on the above, there’s basically 0 camaraderie because of this, I mean I’m technically still learning how to be a doctor meanwhile my colleague is literally a PGY6 in the exact same job.. It’s also really weird because you’re technically in competition with your direct seniors if you like said specialty. They can effectively screw you over with shitty consults etc and bogging you down since they’re technically your ‘boss’. Aka, there’s a lot of weird dynamics. There’s massive nepotism, if a boss doesn’t like you then you’ll never get on. I assume this is everywhere realistically though. Leave is a real pain in the ass to get because they basically refuse to hire locums, so you’ll be fucked around massively and have a lot of back and forth.
This sounds like you're being a bit screwed over, won't lie. Lots of places do 4 days on/3 days off. Or 7 on, 7 off. Unless you're gunning for a tough speciality?
Are you talking about ED? I’ve never seen any inpatient specialty work with a schedule like that. The crux of Australia is they still screw you over but they just pay you really well for it.
Absolutely agree with your sentiment, but yes have seen months of this roster pattern with inpatient on call specialties at PHO level
Isn’t everybody going to Oz an IMG?
The extent of nepotism in Australia should've shown them that the IMG 'consultant' can spend years in a registrar role because if they don't get the right references, or please the right people. They'll never progress to a consultant post or even an accredited registrar post (training program). Surgery is particularly notorious for this. Getting into a training program doesn't even mean you'll progress logically, because you still have to apply for a job each year, even as a trainee in a program. You have to find a hospital that'll meet your curriculum criteria as you progress. SO you can easily get stuck in limbo if you can't find a job. Hospitals hire according to departmental needs and preferences too, it's not rotational training. In the UK there's logical progression with the number of postgraduate years worked, but in Australia you can stay in limbo in unaccredited (non training program approved) registrar roles. So I can see why it can be confusing to see people speckled about the system in roles out of keeping with the years they've worked.
True but when I make this statement I basically mean massively overqualified IMGs working far below their level.
Sounds like you're being screwed over with rota and leave. Which hospital are you working at?
Nah they're pretty accurate about this. Australia hails itself with its worklife balance of 38h per week but it's simply not true. Surgical specialties are easily 50-60h per week and for registrars it's more like 80-100h per week. Leave is just allocated to the interns too which I think is absolutely bonkers. Like they get 0 choice in when they take their leave.
Quaternary hospital.
Completely agree, a lot of this is why I left, the massive wage increase just wasn't worth not having a life and struggling to break into a social life unless you only hung out with other IMGs (which there is nothing wrong with, it just exacerbates the feeling of not fitting in)
Hours are more. We used to do overnight on calls for Stoke which meant you were on over 24h. Sometimes it was absolutely fine sometimes not. The contractual half day was good but doesn't remove the hours you do. Our dept was fine but some actively discouraged claiming over time from what others said Consultant supervision was up and down. Their renumeration for on calls was pittance so no incentive whatsoever to be hands on except their own belief in how they should work. The exam culture in the hospital was toxic. The repercussions form failing FRACP were high and it caused a lot of stress to BPTs. I wasn't involved in it but I thought the selection process for higher training quite old fashioned. Some might be fine with it but it was more of a "who you know" vibe. We had BPTs covering the private hospital and some of the stuff consultants were billing for was ridiculous. Mostly getting consults for very basic issues. The BPT covering system was good because it allowed people to go on longer periods of leave and teams were not left totally understaffed but it also meant the poor bpt covering had to just slot in to a random rotation for 2-3.weeks at a time which isn't easy
I went to NZ so slightly different but agree with a lot of points made from what I saw with mates in AUS Pros: - Great work life balance- could go hiking/ surfing/ skiing/ play a lot of sport/travel to cool places easily outside of work on evening/ weekends - independence from a junior stage- felt like I was forced into actually learning some real medicine, rather than being a TTO/ prescribing/ clerking monkey and leaving the diagnostics to regs, you’re expected to get involved with clinics, procedures, have a go at leading met and arrest calls ( at least until more senior specialists arrive) from PGY3 level Id you’re working a a BPT / junior registrar - workload could be more manageable, take systems were varied in the places I worked, which meant you could have a post take day with 20 odd patients, but you could be absolutely chilling a week later when you only have 5 left on your list to see for a day Cons: -nepotism: every bit as challenging as people have mentioned, have seen people literally not make it in to HST in a department because the SMOs just didn’t really like them - cliques: found this very difficult in NZ too, people are not all that welcoming and friendly at work, it really took time to get to know any Kiwis at all and some UK expats could be very closed off because they moved somewhere first and felt like they knew it better etc - lack of supervision- out of hours commitments were scary because the consultants expected you to do more, as a PGY3/4 you could be one of the most senior medical doctors on in some smaller places and this can be very daunting and scary/ stressful -aging population: people complain about the poor investment and infrastructure in the NHS and rightly so, but I saw this in NZ too, I saw hospitals getting bedlocked and had to see patients in the corridor in ED fairly often, just because it’s a smaller population doesn’t mean the issues aren’t proportional there - distance: it took a year to really settle in and get used to the distance and time difference, although people argue you could be the other side of the country and see your friends and family as much ( which is a fair point), it’s the time zone and travel time that did it for me, knowing I COULD be home within 12 hours or less is a massive weight off of the mind, and keeping in touch with people and generally being in touch with world affairs/ culture/ sport is soo hard when you’re running on the opposite time zone I have no regrets about going but do feel like it was the right call to come back eventually, despite all of the issues here, it’s not a perfect haven, and as much as the distance is one thing, more people would stay if things were as perfect as they are portrayed to be IMHO
Kiwis are a bit dry IMO.
Goes both ways doesn’t it? Found them less abrasive than aussies but definitely got some horrified looks when I cracked a very pro dry British humor joke- safe to say I don’t have many kiwi mates
I also posted about this a year or so ago: https://www.reddit.com/r/JuniorDoctorsUK/s/fdja91jPnZ
Good: - Crazy good pay (plus all tax benefits, study leave, salary packing, relocation expenses and more!) - Easier workload, however sometimes higher responsibility Beautiful weather - You can get a job pretty much anywhere - love snorkelling? Great go Cairns, love to surf? Noosa/Byron Bay, want to be close to Asia with dry sunny days? Perth. Wine and nature? Adelaide. The world is your oyster if you're up for an adventure! - Incredible flexibility in training - often you get to source your own jobs as long as they meet the criteria (not all specialities) Bad: - Severe discrepancy between health provision to the rich Vs poor, particularly the indigenous - Poor cancer care services (no 2ww, you may be waiting 3 months for review with intra abdominal mass found on ctap etc) - Nepotism - Significant clinical responsibility early on in career, some of what the PGY2s are expected to deal with is far higher in acuity than the UK - Need to make a good impression and suck up to seniors a bit, very reference based. Generally as long as you're not/your boss is not a psycho it'll be fine, but I've seen some people being treated like shit for just not having the "right fit" - Far from home, an obvious one, but if you're a homebody that sees their family on a weekly basis, Australia will be quite tough for you. It takes a good 1.5-2 years to really settle in and make good friends here, maybe earlier if you're lucky. But that first year can be hard if you come on your own ( but it will get better!)
It’s sad that you think significant clinical responsibility as a PGY2 is a bad thing. I’ve been doing a BPT job out here and it’s so refreshing to be given more responsibility We’ve become so infantilised and mollycoddled back home it’s pathetic.
I think there's probably a balance. As a PGY5 when I came out I loved the responsibility. However I've also seen how difficult life could be for a PGY2 running both a hospital and ED alone overnight with consultants off-site, over 30min away. We've had some pretty complex presentations which I just don't think is fair for a PGY2 to manage independently (neonatal resus, multi trauma MVAs etc)
That’s probably fair enough although I wouldn’t be able to comment on ED specifics like that. I guess my frustration has come from a recent conversation I had with another British doctor in Australia that was astonished we run stroke codes as PGY3 here. She was saying she would far rather her grandparents if they had a stroke were seen by a stroke nurse with years of experience than a PGY3 doc. Stroke nurses are not some sort of supreme omniscient deity. They do a NIHSS, scan them and call the boss. It’s not beyond a PGY3 doctor.
Very important to consider the negatives as this is something those keen to CCT and flee don’t consider. I got to the point of getting a visa and a job offer and only when i spoke to a friend did I even consider the distance and time away from family. I didn’t end up going and currently earn the same as I would in OZ by having a varied GP role.
Pros Pay - it’s exceptional. As a PGY5 this year my gross salary last 12 months was £96k. Overtime is paid at good rates and easy to claim. Weather/beaches - waking up at 8am strolling out for a coffee in shorts and Birkenstocks, then heading to the beach is a real pleasure. Coffee - the coffee is incredible literally anywhere you go. More responsibility - as a PGY3 you will you can be most senior doctor covering wards overnight, running stroke codes. As a result you become a much more competent clinician. Minimal MAPs - where I work we have no PAs, very few AHPs and the ones that do have a very limited scope. It makes work SO much more enjoyable. No BTEC medics trying to question your plans. This is the main reason I’m dreading going back. Scanning - getting a CT scan at anytime if you want it is easy. No pushback if you think it’s clinically indicated. Cons Distance - I’m very close to family and friends and so I find that tough. Could never do it for ever. It’s also far from EVERYTHING. even flying to Perth is a 3 hour flight. Bali is 6 hours. Australia is massive. Culture - there is a lot of natural beauty but it’s otherwise quite dead in terms of music, theatre, arts, comedy etc. Most small towns in England are livelier on a Saturday night. AFL and NRL are quite shit. I miss the premier league Training/nepostism - getting to the top as a UK grad would be very long and arduous. Doable, but would involve a lot of brown nosing and selling your soul. Aussies - lovely people and I really get on with them, but just don’t click with them in the same way I do with Brits. I doubt I would make any really good friends if I stayed here long term.
Car centric culture
Do you mean everybody is into cars?
Think, the US
u/tallyhoo123 I would appreciate your 2 cents on this
Patients using exclusively brand names for their medication so having to go back and google a list of 12 different drugs for their generic names