{"id":34786,"date":"2016-05-13T03:00:47","date_gmt":"2016-05-13T07:00:47","guid":{"rendered":"http:\/\/quotulatiousness.ca\/blog\/?p=34786"},"modified":"2016-05-12T10:11:48","modified_gmt":"2016-05-12T14:11:48","slug":"british-doctors-and-the-attraction-of-moving-to-australia","status":"publish","type":"post","link":"https:\/\/quotulatiousness.ca\/blog\/2016\/05\/13\/british-doctors-and-the-attraction-of-moving-to-australia\/","title":{"rendered":"British doctors and the attraction of moving to Australia"},"content":{"rendered":"

Scott Alexander<\/a> talks about the dispute between the junior doctors and the British government:<\/p>\n

A lot of American junior doctors are able to bear this [the insane working hours] by reminding themselves that it\u2019s only temporary. The worst part, internship, is only one year; junior doctorness as a whole only lasts three or four. After that you become a full doctor and a free agent \u2013 probably still pretty stressed, but at least making a lot of money and enjoying a modicum of control over your life.<\/p>\n

In Britain, this consolation is denied most junior doctors. Everyone works for the government, and the government has a strict hierarchy of ranks, only the top of which \u2013 \u201cconsultant\u201d \u2013 has anything like the freedom and salary that most American doctors enjoy. It can take ten to twenty years for junior doctors in Britain to become consultants, and some never do. […]<\/p>\n

Faced with all this, many doctors in Britain and Ireland have made the very reasonable decision to get the heck out of Britain and Ireland. The modal career plan among members of my medical school class was to graduate, work the one year in Irish hospitals necessary to get a certain certification that Australian hospitals demanded, then move to Australia. In Ireland, 47.5% of Irish doctors had moved to some other country. The situation in Britain is not quite<\/em> so bad but rapidly approaching this point. Something like a third of British emergency room doctors have left the country in the past five years, mostly to Australia, citing \u201ctoxic environment\u201d and \u201cbeing asked to endure high stress levels without a break\u201d. Every year, about 2% of British doctors apply for the \u201ccertificates of good standing\u201d that allow them to work in a foreign medical system, with junior doctors the most likely to leave. Doctors report back that Australia offers \u201cmore cash, fewer hours, and less pressure\u201d. I enjoy a pretty constant stream of Facebook photos of kangaroos and the Sydney Opera House from medical school buddies who are now in Australia and trying to convince their colleagues to follow in their footsteps.<\/p>\n

Upon realizing their doctors are moving abroad, British and Irish health systems have leapt into action by\u2026ignoring all systemic problems and importing foreigners from poorer countries who are used to inhumane work environments. I worked in some rural Irish towns where 99% of the population was white yet 80% of the doctors weren\u2019t; if you have a heart attack in Ireland and can\u2019t remember what their local version of 911 is, your best bet is to run into the nearest mosque, where you\u2019ll find all the town\u2019s off-duty medical personnel conveniently gathered together. This seems to be true of Britain as well, with the stats showing that almost 40% of British doctors trained in a foreign country (about half again as high as the US numbers, even though the US is accused of \u201cstealing the world\u2019s doctors\u201d \u2013 my subjective impression is that foreign doctors try to come to the US despite barriers because they\u2019re attracted to the prospect of a better life here, but that they are actively recruited to Britain out of desperation). Many of the doctors who did<\/em> train in Britain are new immigrants who moved to Britain for medical school \u2013 for example, the Express<\/em> finds that only 37% of British doctors are white British (the corresponding number for America is something like 50-65%, even though America is more diverse than Britain). While many new immigrants are great doctors, the overall situation is unfortunate since a lot of them end up underemployed compared to their qualifications in their home country, or trapped in the lower portions of the medical hierarchy by a combination of racism, language difficulties, and just the fact that everyone<\/em> is trapped in the lower portions of the medical hierarchy these days.<\/p>\n

If Britain continues along its current course, they\u2019ll probably be able to find more desperate people willing to staff its medical services after even more homegrown doctors move somewhere else (70% say they\u2019re considering it, although we are warned not to take that claim at face value). I work with several British and Irish doctors in my hospital here in the US Midwest, they\u2019re very talented people, and we could always use more of them. But this still seems like just a crappy way to run a medical system.<\/p>\n

I don\u2019t know anything about the latest dispute that has led to this particular strike in Britain. Both sides\u2019 positions sound reasonable when I read about them in the papers. I would be tempted to just split the difference, if not for the fact several years of medical work in the British Isles have taught me that everything that a government health system says is vile horrible lies<\/em>, and everybody with a title sounding like \u201cMinister of Health\u201d or \u201cHealth Secretary\u201d is an Icke-style lizard person whose terminal value is causing as many humans to die of disease as possible. I can\u2019t overstate the importance of this. You read the press releases and they sound sort of reasonable, and then you talk to the doctors involved and they tell you all of the reasons why these policies have destroyed the medical system and these people are ruining their lives and the lives of their patients and how they once shook the Health Secretary\u2019s hand and it was ice-cold and covered in scales. I don\u2019t know how much of this is true. I just think of it as something in the background when the health service comes up to doctors and says \u201cHey, we have this great new deal<\/em> we want to offer you!\u201d<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Scott Alexander talks about the dispute between the junior doctors and the British government: A lot of American junior doctors are able to bear this [the insane working hours] by reminding themselves that it\u2019s only temporary. The worst part, internship, is only one year; junior doctorness as a whole only lasts three or four. After […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[331,4,66],"tags":[33,95,162,519],"class_list":["post-34786","post","type-post","status-publish","format-standard","hentry","category-australia","category-britain","category-health-science","tag-ireland","tag-jobs","tag-socializedmedicine","tag-stress"],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p2hpV6-934","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/34786","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/comments?post=34786"}],"version-history":[{"count":1,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/34786\/revisions"}],"predecessor-version":[{"id":34787,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/posts\/34786\/revisions\/34787"}],"wp:attachment":[{"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/media?parent=34786"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/categories?post=34786"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/quotulatiousness.ca\/blog\/wp-json\/wp\/v2\/tags?post=34786"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}