monfed

As a corollary to this post: don't forget, from that lower salary in the US we talked about, you will need to pay for healthcare, likely a higher rate of car insurance, internet and phone costs more, etc. But then again you do have 500k in the bank to play with....

I would like to add, though, that having moved from London to Los Angeles, and taken a slight drop in salary to do so, that I don't feel living standards are any worse- they're better. Weather is better, the beach is nearby, I can afford rent in a good (if not swanky) area for young people, recreation is more easily available, people are friendlier. It's true that I have less vacation time (only 2 weeks not 4 a year), but nor am I overworked. I have great healthcare through work. So it really depends. I say go for it if that is what you want....

monfed

wait... isn't early retirement at 55 great?! That's 10 years earlier than average!

jeffreyhy

My wife's cousin got his MD and did his residency in their country, then he came to the US as a J-1 and got a PhD doing cancer research at MD Anderson, University of Texas. Now he's working as a physician at the Bronx VA hospital in NYC.

Does that give you any ideas?

Regards, JEff

notshipman

jeff how is he working as a physician in the US without doing residency there? Have i missed something?

Monfed I share your thoughts regarding LA etc regarding retirement at 55 not really the reason they retire at that age is usually on health grounds probably mental illness due to the job itself!!!

jeffreyhy

I'll have to ask about that, maybe it's me who has missed something. Is it posiible that what he's doing at the hospital is a residency?

Regards, JEff

Michael

Physicians on a clinical track must agree to practice in a Health Professional Shortage Area or a Medically Underserved Area for a minimum period of three years to be eligible for a waiver. Waivers can be sponsored either by a state Department of Health, or an appropriate federal government agency. Sponsorship by the state is called the Conrad 30 Program. Although most states participate, each state has different rules, different timing and different allocation procedures for the maximum 30 waiver positions available to each state each year. Some states limit the program to primary care physicians, while others allow specialty or subspecialty positions. Most states require a significant period of recruitment to prove the unavailability of U.S. doctors. The physician must remain at the facility in H-1B visa status for three years in order for the waiver to be finalized and effective.

A limited number of federal programs are also available. They include: the Veterans Administration, the Appalachian Regional Commission, the Department of Health and Human Services and the Delta Regional Authority. Most or all have common requirements: with the exception of the Veterans Administration, all the federal programs require the physician to work 40 hours per week in a Health Professional Shortage Area or Medically Underserved Area. Again with the exception of the Veterans Administration, the other agencies require the physician to practice in primary medical care. All programs require proof of significant recruitment for U.S. workers and require the physician to be in H-1B status at the facility for three years.

http://www.klaskolaw.com/articles.php?action=view&id=56

notshipman

agree with what you say michael but with those programs you need to have done a residency in the US in the 1st place that was my query with jeff is his relative a) did a residency b) if not how did he get an exemption

customsquestion

Not entirely sure but he got the gc off the h1b situation he works at sloan kettering the cancer place. The GC lotto is the vaunted attempt to prevent illegal immigration through giving people from most countries that wouldn't get in a chance at getting a green card.

notshipman

quite bizarre considering a load of GC lottery winners are from europe, australia and other pretty wealthy places!

no wonder it is being shelved. has no effect on illegal immigration

Sally Redux

I believe it was originally meant to increase diversity.

It's pointless to think about how other people get in. There are all sorts of anomalies.

notshipman

Well really imo they should be looking at streamlining the process for those that contribute to the country skilled migrants etc

the whole GC lottery and family migration that seems to underpin the whole system undermines the attraction of talent to the country that ultimately would contribute to the economy

Michael

I suspect the main problem is primarily with the AMA. Although their charter is to primarily regulate the medical profession, it is a strong advocate and lobbying force for established doctors to keep salaries high and competition low.

Most other professions advocate for more H-1B visas and less restrictions but not the medical profession.

The diversity lottery is a small segment to give the average person a chance to immigrate. Many more on L-1, H-1B, O-1, EB1, and EB-5 visas become legal permanent residents and TN and E3 visas can work pretty much indefinately in the US.

notshipman

think its a bit more complicated to be honest there is a shortage of 'trained doctors' not people wanting to be trained. the number of residency slots are capped because of medicare funding that aint much to do with the AMA. In fact I saw something about them trying to lobby congress to increase the slots to offset a shortage caused by obamacare and increased access etc

Problem is whereas other countries like Canada will accept western residencies and appoint senior docs directly the US wont well not yet so this bottleneck remains and everyone loses out!

scrubbedexpat099

Like many things in the US, special interests have a disproportionate say.

Michael

I agree that occasionally they may make a half hearted effort but when it comes to things that will make a significant difference, they always seem to be opposed.

http://www.ama-assn.org/resources/do...by-day-gme.pdf

I agree that it is ridiculous that the US doesn't recognize western residencies and I suspect that the AMA opposes that.

Also what is ridiculous is that there are 50 state licensing boards and states don't recognize licenses from other states. Although those may be state bureaucracies, members of those boards are primarily from the AMA. The AMA is defining licensing and in my opinion, if they wanted to recognize western residencies, I suspect it would easily pass congress.