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Applying for US residency

Applying for US residency

Old Nov 25th 2020, 9:05 pm
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Default Applying for US residency

Hey,

Am a final year medical student in London applying for US residency in preferably Internal Medicine. So far have got 18 interviews and will start interviewing soon. Its going to be most virtual interviews this year due to obvious reasons. I need an H1 visa but I only applied to places that sponsor. Most of my interviews are for places on the East Coast mostly around Philly and New York city like Long Island and Westchester etc

Looking for general advice as I wont be able to see most of these places in the flesh. The starting salary is $65k which dont sound much but its more than what a new medical grad pays in the UK surprisingly.

Grateful for any general pointers or tips as to what to look for generally.

Thanks
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Old Nov 25th 2020, 11:26 pm
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Default Re: Applying for US residency

It very much depends where on the east coast you go. $65k won't last a day in New York, Philly, D.C. or similar big cities. Have you ever been to the US before? These cities are going to be a reality shock if not!
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Old Nov 25th 2020, 11:50 pm
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Default Re: Applying for US residency

Originally Posted by notaclue View Post
It very much depends where on the east coast you go. $65k won't last a day in New York, Philly, D.C. or similar big cities. Have you ever been to the US before? These cities are going to be a reality shock if not!
Assuming he sleeps at the hospital when on shift and stays in hostels when he is off he could probably do it, but $65k gross before tax would probably mean living in a shared house further out in NYC metro. At least he is likely to have much lower student loans if he has qualified in the UK... a 5 year MBCHB, vs a 4 year UG premed and then MD in the US. The resident years are not really for earning money, it’s more like paid training.
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Old Nov 26th 2020, 2:07 am
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Default Re: Applying for US residency

Originally Posted by tht View Post
Assuming he sleeps at the hospital when on shift and stays in hostels when he is off he could probably do it, but $65k gross before tax would probably mean living in a shared house further out in NYC metro. At least he is likely to have much lower student loans if he has qualified in the UK... a 5 year MBCHB, vs a 4 year UG premed and then MD in the US. The resident years are not really for earning money, it’s more like paid training.
Yes of course I have been to Philly and NYC etc!! I did my electives on the East Coast! One of the main reasons I wanted to move to the US was the training is only 3 years and you are a Consultant. In the NHS it takes anything from 8-9 years minimum if not longer.

I only have 2 interviews at Manhattan hospitals and they both have subsidized housing at around $1200 for a 1 Br which to me is dirt cheap for Manhattan. I have no student loans either thanks to relatively low tuition fees in the UK.

My Philly interviews are all in the suburbs of Philly pretty much and some are in the suburbs of Pittsburgh too.
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Old Nov 26th 2020, 2:34 am
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Default Re: Applying for US residency

I thought J's were more common for Hospitals?
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Old Nov 26th 2020, 3:39 am
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Default Re: Applying for US residency

That's easy - you'll have subsidized housing, it's only for a year or two as your salary will increase rapidly and by a lot, and you'll be working all hours God sends anyway, so your decision should be based only on the career enhancing potential of the role and the reputation of the hospital.

Last edited by Pulaski; Nov 26th 2020 at 3:41 am.
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Old Nov 26th 2020, 12:45 pm
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Default Re: Applying for US residency

Originally Posted by ukmd View Post
Yes of course I have been to Philly and NYC etc!! I did my electives on the East Coast! One of the main reasons I wanted to move to the US was the training is only 3 years and you are a Consultant. In the NHS it takes anything from 8-9 years minimum if not longer.

I only have 2 interviews at Manhattan hospitals and they both have subsidized housing at around $1200 for a 1 Br which to me is dirt cheap for Manhattan. I have no student loans either thanks to relatively low tuition fees in the UK.

My Philly interviews are all in the suburbs of Philly pretty much and some are in the suburbs of Pittsburgh too.
Did you already do your USMLE?

I worked at medical school down in NZ which has a program more similar to the UK than US and we got US students coming because it was shorter/cheaper even with international fees, but recall they had to go through an additional step back home.

Is the H1 your future employer will apply for cap exempt or do you have to do the H1b lottery next spring?

As part of my job I had to look at different models of medical education and the differences were pretty big. You could start at 18 in the UK/NZ and be in a hospital doing TI at 22 in year 4. In the US at 22 you would have done done a 4Y UG and then still have a 4 year MD ahead of you and not seen a patient yet. Some of the things I read were crazy, students doing a MD and MBA at the same time, so they would be prepared to manage their practice later on in their career. The most interesting part of my job down in NZ was setting up rural medical schools / electives. We put about 12 students in each and rather than doing “rounds” at a hospital with 15 other medical students they were seeing patients who came in to ER etc and they were the first diagnosis of the patient (check after by a Doctor). The idea was to encourage people to consider careers in places with shortages of Doctots (most aim to be a high paid specialist).

Having moved to NYC as single professional I highly recommend it, I had a great time although did not get to experience single life all that long. Aside from rental that can be a significant expense if you are actively “dating”.



Last edited by tht; Nov 26th 2020 at 1:14 pm.
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Old Nov 26th 2020, 1:42 pm
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Default Re: Applying for US residency

Originally Posted by ukmd View Post
Hey,

The starting salary is $65k which dont sound much but its more than what a new medical grad pays in the UK surprisingly.
I know it’s not the question you asked but I just wanted to say never compare salaries between the UK and the US without also comparing cost of living. Most, if not all, jobs here pay more than the UK equivalent would pay. But that’s meaningless without considering that the cost of living here, even in subsidized housing, is much higher. Groceries, mobile phones, nights out, clothes, utilities...it’s all more expensive. I think the biggest shock for me, even though I’ve been here for several years, is still the difference in cost in food between the UK and here. And food is the only thing you cannot go without.
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Old Nov 26th 2020, 5:34 pm
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Default Re: Applying for US residency

Originally Posted by Pulaski View Post
That's easy - you'll have subsidized housing, it's only for a year or two as your salary will increase rapidly and by a lot, and you'll be working all hours God sends anyway, so your decision should be based only on the career enhancing potential of the role and the reputation of the hospital.
I'd agree. This is a fairly unique scenario.
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Old Nov 26th 2020, 9:17 pm
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Default Re: Applying for US residency

Originally Posted by tht View Post
Did you already do your USMLE?
Yeah course I did buddy am ECFMG certified I wouldnt have got any interviews without USMLE!! All H1s for docs are cap exempt and also exempt from any proclamations as clearly we are needed for Covid so that helps a lot!
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Old Nov 26th 2020, 9:21 pm
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Default Re: Applying for US residency

Originally Posted by Boiler View Post
I thought J's were more common for Hospitals?
Most of the places that sponsor do both J and H depending on what the candidate prefers. Wont get into details but some prefer J for career reasons.

I only applied to places that sponsor the H, its cap exempt so no wait or any issues with that.
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Old Nov 26th 2020, 9:28 pm
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Default Re: Applying for US residency

Originally Posted by steph0scope View Post
I know it’s not the question you asked but I just wanted to say never compare salaries between the UK and the US without also comparing cost of living. Most, if not all, jobs here pay more than the UK equivalent would pay. But that’s meaningless without considering that the cost of living here, even in subsidized housing, is much higher. Groceries, mobile phones, nights out, clothes, utilities...it’s all more expensive. I think the biggest shock for me, even though I’ve been here for several years, is still the difference in cost in food between the UK and here. And food is the only thing you cannot go without.
I see your point but its all checks and balances. A doc starting out in the UK gets $35k and wont get past perhaps $90k even after decades of training. Sure some things are more expensive in the US but other things are way cheaper like electronics (e.g iPhone 12 pro max is 300 quid cheaper there which is nuts!), petrol, cars etc etc. Clothes? I found stuff like Ralph Lauren and other brands much cheaper in the US. So its pros and cons. For sure the opportunities are way more diverse particularly for medical professionals.
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Old Nov 26th 2020, 10:48 pm
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Default Re: Applying for US residency

Originally Posted by ukmd View Post
.... Sure some things are more expensive in the US but other things are way cheaper like electronics (e.g iPhone 12 pro max is 300 quid cheaper there which is nuts!), petrol, cars etc etc. Clothes? I found stuff like Ralph Lauren and other brands much cheaper in the US. So its pros and cons. For sure the opportunities are way more diverse particularly for medical professionals.
Take it from those of us who live here, there are certainly things that are obvious to the visitor to the US that are cheaper - restaurant meals, electronics, and gasoline, but those are are small part of your ongoing living expenses and they are considerably outweighed by the higher cost of many other things including food and household consumables, half-decent appliances, such as fridges and laundry appliances, which are commonly priced at over $2,000 (per set in the case of the laundry appliances), and any savings on gasoline will be largely if not entirely taken up by the very high cost of car insurance. IME the most significant "hidden cost" (hidden from visitors, that is), is the tax on homes, which in the New York area, whether NY, NJ, or CT, starts at around $1,000/ mth for an unremarkable 3-bed family home, and for a new, larger home of the sort befitting a doctor, you could easily be paying $5k/ month in property taxes!

Then there are other costs of running a home in the US that have likely never even occurred to you, like the fact that the roof on a home in America only typically lasts 15-20 years, and sometimes less if damaged by storms or winter weather, and forced-air heating and airconditioning systems that last about as long. In both cases you are looking at $10k for low-end replacement, but a fancy roof/ heating system on a larger home in New York or the North East, could easily run $20k-$30k.

There are plenty of good reasons to love living in America, but low cost living is not one of them, and especially in the North East anywhere between the greater DC area and Boston.
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Last edited by Pulaski; Nov 26th 2020 at 11:23 pm.
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Old Nov 26th 2020, 11:12 pm
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Default Re: Applying for US residency

Originally Posted by Pulaski View Post
Take it from those of us who live here, there are certainly things that are obvious to the visitor to the US that are cheaper - restaurant meals, electronics, and gasoline, but those are are small part of your ongoing living expenses and they are considerably outweighed by the higher cost of many other things including food and household consumables, half-decent appliances, such as fridges and laundry appliances, which are commonly priced at over $2,000 (per set in the case of the laundry appliances), and any savings on gasoline will be largely if not entirely taken up by the very high cost of car insurance. IME the most significant "hidden cost" (hidden from visitors, that is), is the tax on homes, which in the New York area, whether NY, NJ, or CT, starts at around $1,000/ mth for an unremarkable 3-bed family home, and for a new, larger home of the sort befitting a doctor, you could easily be paying $5k/ month in property taxes!

Then there are other costs of running a home in the US that have likely never even occurred to you, like the fact that the roof on a home in America only typically lasts 15-20 years, and sometimes less if damaged by storms or winter weather, and forced-air heating and airconditioning systems that last about as long. In both cases you are looking at $10k for low-end replacement, but a fancy roof/ heating system on a larger home in New York or the North East, could easily run $20k-$30k.

There are plenty of good reasons to love living in America, but low cost living is not one of them, and especially in the North East anywhere between the greater DC area and Boston.
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I agree but low cost living never factored into my decisions and neither does it for the thousands of physicians that migrate to the US every year. I was just saying to the lady above that there are checks and balances with every country comparison. I know for myself the career opportunities for my profession in the US and the diversity of them far outweigh what I could get in the UK and that is the main reason for moving not a cheap iPhone or laptop!
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Old Nov 26th 2020, 11:47 pm
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Default Re: Applying for US residency

Originally Posted by Pulaski View Post
Take it from those of us who live here, there are certainly things that are obvious to the visitor to the US that are cheaper - restaurant meals, electronics, and gasoline, but those are are small part of your ongoing living expenses and they are considerably outweighed by the higher cost of many other things including food and household consumables, half-decent appliances, such as fridges and laundry appliances, which are commonly priced at over $2,000 (per set in the case of the laundry appliances), and any savings on gasoline will be largely if not entirely taken up by the very high cost of car insurance. IME the most significant "hidden cost" (hidden from visitors, that is), is the tax on homes, which in the New York area, whether NY, NJ, or CT, starts at around $1,000/ mth for an unremarkable 3-bed family home, and for a new, larger home of the sort befitting a doctor, you could easily be paying $5k/ month in property taxes!

Then there are other costs of running a home in the US that have likely never even occurred to you, like the fact that the roof on a home in America only typically lasts 15-20 years, and sometimes less if damaged by storms or winter weather, and forced-air heating and airconditioning systems that last about as long. In both cases you are looking at $10k for low-end replacement, but a fancy roof/ heating system on a larger home in New York or the North East, could easily run $20k-$30k.

There are plenty of good reasons to love living in America, but low cost living is not one of them, and especially in the North East anywhere between the greater DC area and Boston.
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all true, but with the right specialty, once you have the experience you can also move to a much lower cost/tax state and earn a lot of money... I had a co-worker who’s wife was being offered close to $1m a year package to move somewhere in the sticks. I think she was a anesthesiologist... hard to do in finance, but they need doctors everywhere...
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