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The downside of being down under.

Posted Feb 13 2011 5:28am

This blog, and many others are full of the joys involved in a move to Australia and New Zealand. A region where work/life balance is (usually) possible, and where we don't have to routinely watch patients die while they wait for outpatient appointments, or operating theatre slots.

The weather is decent, there's lots to do, and our political masters don't seem to exist purely to screw up our education. Most doctors who come here never regret it.

But there must be a downside, right? Of course, and many of them. So, here is the Dr Thunder MD official "Downside of being down under" list:

1) Trying to get here: NIGHTMARE to get registered as a doctor. Very slow process, and they've outsourced the verification of medical qualifications to the USA!! This, of course, only prolongs the process.

2) Patient expectation is higher: In my opinion (and I've been disagreed with on this topic on the blog before) Australian patients are more aggressively demanding than those in Ireland or the UK, often to the point of being unrealistic. Having said that, I think it's because they're used to a health service of a high standard. Whereas in Ireland, especially, we accept that we'll wait in A+E for 16 hours before seeing a doctor.

3) Residents often rotate every 4 months: As opposed to 6 months in the European model. I don't think they get a good grasp of some of the specialties in 4 months. In fact, 6 months often isn't long enough for these junior doctors to get enough experience.

4) Cost of living: In my experience, it's higher than in most places in Ireland and the UK. Though I found New Zealand much more reasonable. There will obviously be some regional variation here.

5) It's a long way from home: Don't underestimate that side of it, especially if you're not used to living away, or if you're coming out for a long time. One of my grandparents passed away not so long ago, and I didn't get to say goodbye or go to the funeral.

6) There's a craziness about cross-recognition of exams: We have a lot of very highly qualified paediatric doctors who come to Oz, and they have to re-sit all their specialist exams, because Australia won't recognise the UK/Irish ones (and vice versa), which is madness. We're all developed countries, and someone who has their postgraduate paediatric exams in the UK should be given exemption from those exams in Australia (and, again, vice versa).

7) The place is full of GAMSAT course students: We won't go into this, as it's been covered to death on this blog, but we probably need to make the medicine course longer, not shorter, and I personally think that's reflected in the quality of many of the medical students. Though this is almost as much of an issue in Ireland too, as of recent years.

8) Primary care: In contrast to the UK, primary care here is basically a business model. GPs can (and usually do) charge more for a consultation than the government pays. They also usually insist on patients paying cash up front and then reclaiming the money themselves. I'm not having a go at GPs. Anyone who reads this blog will know I have much love for GPs. But they are forced into becoming business people, and the financial realities of that inevitably mean that our poorer patients often can't afford to see their doctor, and get poorer follow up. It also means paediatric A+E is like a GP surgery, with a huge amount of "primary care types" of problems showing up. This will come as a bit of a shock to UK doctors in particular, who are used to a free-at-the-point-of-care NHS.

9) Patients?: Not over here. Seems every second person is now referring to them as "clients". I heard some psych person call a patient a "consumer" the other day. I don't know why, but it boils my piss.

10) The bloody chocolate: it's DISGUSTING!

So, leave your comments below for the benefit of the hordes of UK and Irish docs fleeing their jobs. Remember, no positives. We've done them to death. This is all about the misery :D

Dr T


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