International Medical Graduate Reveals His Top Tips For Securing a Residency Position Abroad

My Journey as an International Medical Graduate

My medical school training took place in the UK, and towards the end of our course, lunch time conversations would turn to where everyone wanted to go for their foundation training (the first 2 postgraduate training years in the UK system). London was, of course, very popular. Some were taken with Scotland, some wanted to stay closer to home, some had decided based on proximity to renowned training hospitals for certain specialties. I, on the other hand, had my attentions drawn away from British training.

Will postgraduate training abroad make you a 'better' doctor?

If you have your heart set on postgraduate training abroad, you have to first think very long and very hard about your reasons. There are many valid and reasoned arguments – proximity to family, cost of living, opportunities for further training, civil or political unrest in your current home. Yet, there is only one argument guaranteed to predict dissatisfaction – the perception that the postgraduate training elsewhere is of higher quality than anywhere else. I could spend days writing entire essays on what makes postgraduate training good or bad, but suffice it to say that training programs develop within the context of their own healthcare system and social landscape. Just because you train in the USA doesn’t necessarily mean that will make you a better physician if you practice in Brazil, for example. However, what overseas training can do is give you a broader experience in how to practice.

So, you’ve decided to move abroad to train? Then let me take you through what to expect.

First off, you need to ensure that your medical school is recognized by the WHO in the International Medical Education Directory (IMED) kept by the Foundation for Advancement of International Medical Education and Research (FAIMER). You can search for your medical school here.

If they don’t list your medical school, you can e-mail them to inform them of the omission, but it will be extremely difficult for you to even apply anywhere, as this is one of the most common prerequisites any countries’ medical authority will have in verifying your credentials.

The licensing exams

The next step to consider is exams. Despite the multitude of tests you have likely already passed as part of your medical school curriculum, most countries have at least one exam you’re required to pass before you can apply for postgraduate training – this can be verified with the medical licensing authority of the country you are applying to. They will also be able to inform you of any other requisites they have for international graduates applying for a license (e.g. criminal background check, Immigration status, etc). Applying for licensure for training programs can be a lengthy process so it definitely pays dividends to start the ball rolling as early as possible – the last thing you want is to be accepted into a training program, only to be unable to practice due to licensing issues.

Immigration

Immigration status is of equal importance to any other part of the process – you can’t interview anywhere if you can’t get into the country! Every country has its own requirements for doctors applying to train and work, most require you to be, at the very least, a landed immigrant. There are also numerous ways to obtain the appropriate immigration clearance – applying via family routes, professional routes, special circumstances VISA, etc. As with medical licensing, these application processes can go on for months so the sooner you can submit them, the better.

So now you’ve passed your entrance exam, obtained the correct immigration clearance and ensured that you are eligible to apply for a medical license in your country of choice. Now comes the hard part – finding and applying successfully to a training program.

Applying for a residency training program as an international medical graduate (IMG)

Tip #1: The easiest way to find out if training programs even take International Medical Graduates (IMGs) is to contact the co-ordinator for that training program directly. Remember, training programs are often limited in the number of overseas graduates they can accept by either local or national health authority policy, national legislation or government mandate. Once you know that the training program does accept international applications, it’s useful to know if your application will be read alongside domestic graduate applications, or whether the IMGs have their own separate stream (this is the case currently in the Canadian application process) – will you have to be the best candidate there, or just the best international candidate there?

Tip #2: Although every program you apply to will be looking for slightly different things from their trainees, overall you as an IMG represent a unique entity in the eyes of the admissions officers – you possess an experience that your interviewers don’t necessarily know about, so be prepared to detail that experience to your panel in a concise but engaging way. Highlight how keen you are to broaden your medical education and build upon what you’ve already learned with a fresh perspective on those things, and the new things you are yet to learn. The most attractive IMG from an admissions perspective is one who is self-aware, motivated and pragmatic about where he/she has come from and how this will shape their learning in their future training, but also juxtapose with it and how this juxtaposition provides opportunity for self-reflection and overall improvement of both medical knowledge and critical thinking of said knowledge.

Tip #3: Finally, wherever possible (and if your medical school curriculum allows for it), try to undertake observerships or electives with the program you’re looking to apply to. This not only allows you to get a good sense of what being a trainee in the program entails and whether it is truly for you or not, but it also gives the program the opportunity to see what kind of trainee you would be if they accepted you. Be respectful, grateful and courteous to those who take time out of their day to teach you or involve you in some way – chances are at least some of those people will be involved in the program admissions process, so its important that they have a positive impression of you if you are to stand a chance of being accepted. You have a limited amount of time to impress, so take advantage of every opportunity offered to you and always be pro-active in finding clinical activities to get involved in (don’t be pushy about wanting to participate in certain areas, offer to help wherever needed and be grateful of the opportunity). Although it is beneficial to spend time around those who possess the greatest influence within the program, do not pursue them excessively as this can actually be detrimental to your cause – your motives may become transparent and your reputation can sour quickly. If those with whom you would be working alongside see that your only interest is to buddy-up with the program director, it will not only harm your chances of being accepted, but could potentially make your life more difficult if you were to be accepted – everyone wants a hard-working and respectful colleague, nobody likes a suck-up.

There’s no denying it – applying for postgraduate training as an IMG is hard work. It is a serious commitment in both time, money and effort and can often feel like a hopeless endeavor. Trust me, the rewards you reap if and when you are successful make every second, penny and ounce of energy worth it. If you can steady your ship through the often tumultuous seas of the application process, your prize awaits you on the other side – your new life.

About the author:

Dr. Sebastian Heaven is a graduate of Cardiff University medical school in the UK which, as of 2015, is ranked 3rd in the country behind Oxford & Cambridge in medical education and has successfully navigated his way to the orthopaedic surgery residency program at McMaster University. Dr. Heaven is currently a senior admissions expert at BeMo.

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