Although you may graduate with a medical degree from the UK, you may not want to work here for your entire career. Even if, right now, you are committed to living in the UK and working in our fantastic NHS, your mindset may change in the future. Therefore, it is worth considering what your options are outside of the UK with an entire world out there to explore!
This is the first of a series of blog posts we are writing outlining how graduates can work abroad within popular destinations. In this post, we will try and briefly discuss the process of working in Australasia, i.e. in Australia or New Zealand. Ultimately, the decision of moving abroad to work is a personal one and there are several factors to consider such as finances, lifestyle, family and work-life balance. But hopefully, this blog will help you understand the logistics of working as a UK trained doctor in Australia and New Zealand.
The simple answer is yes! In fact, the majority of international doctors in Australia come from the UK, making it a particularly popular choice. This is because the undergraduate and postgraduate training process is quite similar in both countries which allows easier transferring. As a graduate, you can scout for jobs across the country, and once you have a job offer, you will need to apply for provisional registration with the Australian medical council as well as a visa to work (most commonly a temporary skill shortage or TSS visa). Both the registration and visa could become permanent depending on whether you choose to stay in Australia on a long-term basis or not. If you, however, plan to come back to work in the UK then you need to think about whether you should maintain your GMC registration whilst working abroad, with or without a licence to practise in the UK. As a general rule, if you work abroad for less than three years and return to the UK then it is cheaper to remain on the GMC register whilst working abroad rather than withdrawing and re-applying upon return. However, you should keep the registration without a licence to practice as this will save money annually and the licence can then be restored upon return with paperwork from your foreign employer as evidence of medical good standing.
There was a 17% rise in UK doctors working in both Australia and New Zealand from 2014 to 2016, with numbers working in the US dropping within that same time period - perhaps from destinations like Australasia having more aligned medical training pathways with the UK. This particular increase in these years had also coincided with the dispute in the UK over the conditions of the junior doctor contract, which has convinced several doctors to move away from the UK, potentially on a permanent basis.
However, it is important to note that recently (pre-COVID), Australia had made plans to cut the number of overseas trained doctors coming into the country by about 10% and are encouraging foreign doctors to work in remote communities instead of large cities. But this will be a slow process that will take place over several years and COVID has increased the demand for healthcare staff which may have changed their approach.
Australia is a popular ex-pat location in the 21st century, particularly for reasons such as an improved quality of life, work-life balance, finances, and weather amongst others. Several of these reasons like work-life balance, often carry through in medicine which attracts doctors from around the world. Furthermore, the UK medical degree is well recognised by the Medical Board of Australia which makes the transfer easier than in other nations.
There are two distinct pathways to apply for as a UK doctor: the competent authority pathway or the specialist pathway. We will first focus on the non-specialist competent authority pathway as it is more popular and provides more job opportunities. To enter this pathway, you must have graduated with a medical degree from the UK and have completed at least 12 months of internship or FY1 which will enable you to apply for house officer jobs around the country. Once you have secured a job offer you must apply for registration to the Australian Medical Board which will grant you provisional medical registration, so you are legally able to practice. After completing 12 months of supervised practice with this provisional registration you can then request general registration (and permanent residency) which lets you apply for speciality training.
Although you can work in Australia after completing just FY1, it is more common for UK doctors to complete both years of the foundation programme and undertake what is known as an ‘F3’ year as a house officer upon arrival in Australia which is essentially an equivalent job to FY1/FY2. Even though this means you may take a year longer to specialise, doing an F3 year allows doctors to explore other countries and specialties which can influence what type of doctor they want to be and where they want to work.
If you do choose to leave the UK after FY1 to work abroad in a non-training post and then return to the UK, you will need to re-join the standalone F2 programme where you will be competing for fewer places with mostly international graduates who are in a similar position.
The specialist pathway is mainly for doctors who are qualified specialists (consultants or GPs) although there is a small quota of places available for specialists in training (SpR). Qualified specialists are assessed by the relevant specialist medical college who usually deem UK doctors as comparable to Australian specialists and so will grant provisional registration meaning they can practice under a degree of supervision for 12 months. After this has been completed they will receive general registration. Due to the paperwork and assessments required for this process, costs can amount to around $10,000 AUD.
This is perhaps the all-important question for some people. Generally, doctors are paid better in Australia compared to the UK but finances are more complicated than just salaries because we need to consider costs of taxes, accommodation, insurances, transport etc which can vary. Salaries differ depending on the state, but generally, a house officer or intern, which is where you will begin post F1 (or as an F3), earns an average of $80,000 AUD annually. After completing an internship, a couple of years of residency will earn you $80,000 - $100,000 AUD annually and after residency, registrar salaries vary between $100,000 to $160,000 AUD depending on the year of training. Post-training consultancy or GP earnings can vary from $170,000 to $450,000 AUD depending on the location, experience and specialty.
Not too far away from Australia, both geographically and training system wise is New Zealand which is also a popular destination for international doctors. Similarly to Australia, it is popular for doctors to apply for a F1/F2 job (house officer) in an F3 year in New Zealand after completing the foundation programme in the UK. Doing this gives a flavour of life in New Zealand as a doctor as well as time to build up points towards a specialty application. To work as a junior doctor in NZ, doctors need to apply for jobs advertised by individual hospitals/district hospital boards (deaneries) or through locum agencies which can be popular as they help sort out the paperwork in return for the sporadic success of a job. Once the job and visa are secured you will work with a provisional license for 6 months before being granted a full medical license.
Doctors often choose to work abroad in countries such as New Zealand after completing an element of training e.g. foundation programme, temporarily and then return to the UK and continue specialty training without too much difficulty. However, it is also common for doctors to initially travel to New Zealand for a temporary job such as an F3 year but end up emigrating permanently. For example, in a survey conducted in 2012, out of hundreds of UK doctors in NZ, only 30% of them had initially planned to emigrate permanently compared to 89% at the time of surveying wanting to live there permanently with common reasons such as lifestyle, job satisfaction and better work-life balance justifying the move.
The salary varies depending on the stage of career but an average house officer will earn $85,000 NZD gross whereas a registrar can earn around $140,000 NZD and senior doctors/consultants closer to $200,000 which increases with experience. Salary also depends on the number of hours that you work. For example, a 40-45 hour work week as an F3 is likely to earn you around $65,000 NZD whereas 55-60 hours can earn $94,000.
Overall, Australasia is a common location for international doctors to work in, particularly for doctors educated in the UK as the degree is regarded with high esteem. As discussed earlier, it is most common for doctors to travel to foreign locations after finishing the foundation programme as a way to explore the world and perhaps earn some extra money at the same time. Many doctors have travelled to Australia and New Zealand in their F3 year and haven’t looked back since, so if you are considering working outside of the UK, life down under has lots to offer, you’d be naïve to not consider it.
Author: Dhillon Hirani
Editor: Allegra Wisking