Need Advice! Ending my Medical Career?
PICK A PATH!
Basically, when people want to study medicine, they go through two paths. When you’re 17 – still with your hands in your pants from being turned on by girls with acne, and don’t know the full story on governmental policies, Chambers of Medicine, healthcare policies and systems, structure of medicine, payments that you have to make TO BE ABLE to practice medicine and all other mind-crunching idiocy that has come about to put endless bureaucratic if-then’s into the Hippocratic Oath – this is what I was faced with:
1. You can study at home.
2. You can study abroad.
The medical education system has two major types:
2. Rest of the world
The American system has a 4 plus 4 year system where you MUST obtain a Bachelor’s degree in pre-med (any subject can be done, plus basic medical courses). After your Bachelor’s degree, you must attend 4 years of medical school after passing GRE (optional), MCATs and an interview. Depending on the medical school, the curriculum is usually divided into 2 years theory and 2 years clinical rotation. After the first 2 years, you do USMLE Part 1. After the clinical rotation, you do USMLE Part 2. If you pass both of them and all your classes in the 4 year medical college, you sign up for your 1 year internship and then take USMLE Part 3, which then qualifies you for 1 year residency at the hospital that is usually anywhere close to your first choice (you are licensed at this point!). You can then continue work as a resident OR you can specialize. Depending on the specialization, you work and train for 4 years to 5 years, earning only about 90,000 – 120,000 USD per year.
The other system is a 6 year system straight from high school. You get 3 years of theoretical and 3 years of clinical, ideally. Most everywhere in the world is like this so people graduate young at 24 and then do their 1 year internship. After that, they usually do a one part test (two parts of PLAB) and then get licensed. Then if they find a position, they specialize for 4-5 years and THEN start work for an average of 72,000 Euros annually in Europe. That’s why people usually try to go private or move to the USA.
THE STORY CONTINUES
So I did pre-med/Biochemisty in the US and then 6 years of FULL medical school in Zagreb. That means I repeated two years even though I didn’t have to go to class for most of the first two years, as I did most of them in the strenuous Biochemistry course at NC State University. University of Zagreb WAS under Harvard Medical International, which allowed us to follow the curriculum to do the USMLE (USMLE Included was in the brochures) in preparation for the US internship and residency programs. Then they dropped the Harvard Medical International name.
Now following the possibility tree. If you study at home and then do your internship (which is technically work) at home and then have to do your specialization (which is also work at home), then everything aligns. You are a citizen of that country, thus not having to fulfill quotas, not having to deal with immigration and your University is recognized by the country hosting that University. Most schools also integrate their internships into their educational programs.
In the US, when you study, you get a 4+2 visa allowing you to WORK +2 years, allowing time for internship AND residency. In Croatia, you have to apply for a work permit for your internship and specialization, theoretically.
Let’s move on. In countries that are not WESTERN EUROPE, internship is NOT integrated under the Ministry of Education, but under the Ministry of Health. Thus, it is considered work despite technically being educational training. Therefore, you need a work permit from the Ministry of Interior and Immigration. Then these countries have a quota for immigrant workers. Usually educated workers are needed more, but in Croatia there are 15 spots for golf instructors and animators and 5 spots for doctors.
Moving on, you might ask, “Why haven’t I moved out then?” Like I said, most of the countries integrate their internship into their education, thus it is nearly impossible to move after JUST getting your diploma, since you are not a licensed doctor. In the US, you can do the USMLE and go straight into the residency program if you find a spot in a hospital. From there, you can apply for a specialization.
Here in Croatia, I had to be licensed. Unfortunately, the Croatian Chamber of Medicine has stated that for FOREIGNERS, the license only lasts as long as your career in Croatia, making your education, once again, invalid if you were to move out. According to WHO, the Croatian license should last until you are 75 years of age (or retirement), but they don’t seem to follow regulations.
What else? MUP (Ministry of Interior) has changed the laws making it easier for EU citizens to work here, but not “Trecha Drzhava” (Third Country), which includes America also. This is because they require workers to get a ONE YEAR contract, which the healthcare system hardly does unless you are a Specialist. On top of that, the Croatian Chamber of Medicine does not allow foreigners to do their specializations in Croatia unless you pay for it yourself.
LET’S MOVE ON?
1. Do the USMLE and apply to residency and specialization in the US?
– The total cost of the USMLE is around 10,000 to 15,000 dollars depending on how many hospitals you end up applying to and how long it would take you to pass the USMLE. I would need one year to study for it, but in the meantime, I wouldn’t be able to work because the USMLE is listed as one of the hardest exams to take in the world AND it takes time for me to read, since I’m not naturally book-smart. The plus side? After that, I would be earning minimum 70,000 starting annual pay and will be able to specialize and will have a chance to apply for a green card.
2. Stay and try to find a job in Croatia?
– I would be unemployed indefinitely UNTIL I can get a job. Right now I’m a General Practitioner, which only allows me to work in the field as Team 1 Emergency Medicine OR in Primary Health Care. This will change soon, since the EU requires specialization, which I am not allowed to do. I CAN also do my specialization because of a loophole in the rules of the Croatian Chamber of Medicine, but will have to pay for it (250,000 Kuna). In order to do this, I would have to re-stamp my passport out after this job, then move back and stay here without work as a tourist and hope I find something within 3 months. I have 2 days to know if DZ Rijeka can prolong my contract (didn’t happen).
3. Further my education?
– At the age of 33, I am too old to qualify for any type of scholarship and would rather be a General Practitioner with a PhD in Alternative Medicine, so I can use alternative therapies in my practice. The program is in India and is recognized internationally and is relatively cheap. However, I won’t be able to work and will be researching/writing my 300 page dissertation over a period of 2 years (if I’m fast and have time).
4. End my medical career.
If anybody has any other suggestions or loopholes out or if you won the lottery, then I would appreciate ANYTHING. I’m tired of living out of a suitcase.