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Advice on working overseas

Written by JuniorDr.

airplanes-globe-squareFor adventurous junior doctors there are plenty of opportunities to work overseas - from locum placements in the coastal towns of Australia to volunteering in remote villages in Africa.

One of the greatest benefits of being a doctor is that it gives you an easy passport to work around the world. Wherever you have been dreaming of escaping to we offer some advice to help you get there.

Each year hundreds of junior doctors leave the UK with their passport in one hand and stethoscope in the other to experience healthcare overseas. It's not just for the sunshine; working in another health system can develop new learning and practical skills which you can bring back home with you.

But before you start booking those flights here are three key things you should consider first -

Choosing a placement

Be prepared to do plenty of research. Many doctors rank location as their primary concern but it is important to accept a job which is appropriate to your clinical experience and career needs. Ending up in a post which is significantly different to your grade and competence in the UK can lead to a stressful experience.

One of the first decisions you will need to make is whether you want a salaried post in a developed country, or a voluntary position working in a developing country with a charity.

For voluntary posts you can browse the opportunities at Voluntary Services Overseas (www.vso.org.uk) or the websites of overseas medical organisations, such as Médecins Sans Frontières (www.msf.org.uk). Be aware that most of these organisations do not accept doctors in their foundation years and require clinical experience relevant to the post.

For locum clinical posts you can find a large selection in BMJ Careers (www.bmjcareers.com) or by browsing the numerous locum agency websites. Be aware that visa requirements have changed in recent years and countries, such as Australia, have tightened up their requirements for overseas doctors.

Both developed and developing country placements offer different experiences but bear in mind that you may need to make additional financial arrangements if you work for a charity as these only pay a living allowance in most cases.

Whichever post you choose do make sure to check the terms and conditions in detail and ask for a copy in writing. It is highly recommended to speak to another doctor who has been on a similar placement with your proposed organisation to learn of their experience.

You can also read diaries and experiences of doctors who have made the move at www.juniordr.com.

Getting permission

If you've got a National Training Number (NTN) you'll want to ensure you don't lose this when you take a placement overseas.

Speaking to your postgraduate Dean early is essential. Most are supportive but you may find difficulty if you're in your foundation years or in the first year of a specialty training programme.

You'll need to apply for an Out Of Programme Experience (OOPE) which can take some time, so starting the process before you've confirmed your plans is advisable. Try also to ensure the timing coincides with finishing a rotation when you leave the UK and that you return in time to start another.

Overseas posts will only count towards training if permission is granted prospectively so ensure you have this agreed before you leave. Placements in English speaking countries with a similar training programme and health system to the UK are more likely to be accepted.

Bear in mind that if you will be applying for a new post when you return that this may be difficult to do from overseas and attending interviews may need plenty of planning.

Before you leave

Once you have a post confirmed you'll still have a number of things to organise. Make sure you start long processes like visa applications early. You can find current requirements on the website of the relevant country - a full list can be found at the Foreign and Commonwealth Office website (www.gov.uk/foreign-travel-advice).

You will also likely have a number of financial arrangements to make before you leave. Depending on your current financial arrangements you may also have to notify Inland Revenue, and if you have a mortgage you will need to apply for permission to let if you plan to rent it out.

Once your overseas placement is confirmed you should inform NHS Pensions (www.nhsbsa.nhs.uk/pensions) as you can make arrangements for this break from contributions.

It is essential you arrange medical indemnity insurance before you leave. Most UK providers offer cover either within your existing policy or for a supplement. Additional cover may be required for some countries, such as the United States.

Health and travel insurance cover is also essential. Remember that if you are planning winter or risky sports to ensure that your cover is sufficient for this.

Finally, enjoy it. Working overseas can bring a new perspective to your professional and personal life. With a little planning your medical degree can be a passport to that destination you've always dreamed of going to.

If you want to find out more about working overseas and get further information visit the careers section at JuniorDr.com.

Useful resources

BMJ Careers - www.bmjcareers.com
MedicsTravel - www.medicstravel.com
Support4Doctors - www.support4doctors.org.uk
Health Professionals Abroad: A Directory of Worldwide Opportunities
Tim Ryder, Vacation Work Publications (2000)
The Medic's Guide to Work and Electives Around the World (2nd Edition)
Mark Wilson, Hodder Education (2009)