My Life as an ED Consultant in Australia
At Messly, we help young UK-based doctors find their dream jobs by providing guidance and insight into as many career options as possible, and that includes looking outside the NHS.
To give you a clear idea of what it’s like working in a hospital abroad, we recently spoke to a doctor who has successfully moved from the UK to Australia. In this interview, he shares his motivations for moving away, provides advice and tips for finding a job abroad, explains how the healthcare system there differs to the NHS, and much more. Read the full interview to discover what life is like as an ED Consultant in Australia.
Tell us a bit about you
I’m Andrew Davidson.I work as a Consultant Emergency Physician and Consultant in Pre-Hospital and Retrieval Medicine in Queensland, Australia. I live in Brisbane (where my pre-hospital and retrieval job is) and travel to Mackay in the Whitsunday region of North Queensland for two weeks a month where i work in a busy regional Emergency Department that services an area the size of some European countries…
How long have you been in Australia?
I moved to Australia in July 2012 at the end of Foundation Training in and around Glasgow. I completed all my Emergency Department speciality training in Australia (specifically on the Gold Coast and in Brisbane) between 2012 and 2018.
Why did you decide to move out to Australia?
At the time I applied for my job in Australia (along with 7 of my colleagues in the same hospital), access to specialty training in the UK had already become more about what hoops you had jumped through and less about you as a clinician.
I had been pretty disillusioned watching my colleagues in the years above me applying and having to complete pointless audits and box ticking exercises only to fail at the first hurdle because of some missing piece of irrelevant “extra curricular”.
Emergency Medicine in the UK was also becoming more about rapid referral and disposition and less time to actually look after our patients. I decided not to apply for training despite the protestations of many colleagues (both my peers and my seniors) that I was committing career suicide by going “off for a working holiday” and that I was essentially making myself unemployable in the NHS! The more I was told that I shouldn’t do it, the more I wanted to prove them wrong.
How did you find your job? What tips do you have for others who are job hunting in Australia & New Zealand?
Having spoken to one of my best friends from uni (who also worked with me as a foundation trainee at the time) we decided to give it a go. She wanted to move to New Zealand for medical jobs, I wanted to go to Australia for Emergency Department experience. Neither of us wanted to go alone if we could avoid it. She says it was peer pressure and bribery with pizzas, I say it was logic.
We chose Australia and used the Queensland Health “work for us” website and contact details found online for various Emergency Departments to send our CVs off far and wide across Queensland and New South Wales.
Now, as then, most of the jobs available are in Emergency Medicine or rotational positions.
The job situation in Australia is certainly now far far more competitive than it was. When we came in 2012, having enthusiasm and hands seemed the only requirement. Now, more desirable/in-demand places are looking for some commitment to actually work hard and not just be here for a “medical gap year”.
Be open to going to smaller centres in regional cities and towns - not everyone can get a job in a big academic centre in a state capital. There are some fantastic opportunities to be in some really interesting places and part of much smaller teams away from the larger centres.
What tips do you have for getting AHPRA registration and securing the necessary visa?
The process for AHPRA registration and visa applications was a total ball ache for want of a better description… but that is a common theme everywhere, the UK is no different!
It always takes longer than you think, so start early and be persistent with chasing things up if you are unsure or need guidance. Be organised, make sure you send the right documents first time and fill in the forms correctly.
Gather up all your documents early (med school certificates, GMC registration certificates, ID documents etc) and get multiple (at least 6) copies of each certified. This will save you time down the line when an agency asks for an officially certified copy of something and you’re left scrambling, trying to get a copy notarised with no time to spare.
Once a hospital has agreed to employ you, they will provide guidance regarding visa classes and sponsorship. The Australian government has massively overhauled the visa system and gone are the old 457 temporary skilled migration visas that I was sponsored on. These allowed you to progress to permanent residency and then citizenship easily.
The visa situation now is much more limited and you may find yourself restricted in terms of place of work or duration of the visa. I am no expert so always seek advice from the hospital employing you and the Australian High Commission / Embassy if you have any questions.
How did you settle in?
I was very lucky to move around the same time as 7 others from the same hospital so we had a ready-made support network.
We opened bank accounts before we left and transferred money to Australia to be waiting for us on arrival. Most banks (CommBank, Westpac, ANZ and NAB) have teams dedicated to helping migrants with their banking. We used CommBank and they were really helpful and easy to deal with. On Day 1 in Australia, we turned up to the branch they told us to and there were our cards and everything else waiting for us.
We rented a car and stayed in a youth hostel for the first two weeks (right above a nightclub - probably not the best plan) until we were able to sort out a car to buy and a place to rent.
Having a reference from your last landlord in the UK can be really helpful in securing a rental more quickly, so think of that in advance if it applies to you. Websites like carsales.com, realestate.com and Domain were all really helpful.
What was the hardest thing about moving out?
Moving to the other side of the world is a big deal - don’t underestimate how hard it can be once the first few weeks of “yay this is like a holiday” has worn off. Moving in a group goes a very long way to mitigate that. But remember - you are going to be well paid (very well paid in comparison to the UK) and in a very flexible work environment in terms of leave, so making plans to go home to visit is easier than you might think. Try not to book flights home as soon as you feel homesick - toughing it out for the first few months and really throwing yourself into the social life and the lifestyle is great medicine, far better than booking a ticket straight home to everything familiar! I met an Aussie a few months after arriving and here we are, happily ever after almost 8 years later!
What are the main differences between your job in the UK compared to your job in Australia?
As a SHO in an Emergency Department in Australia, I certainly found the level and availability of senior support something really new! People just did not seem as stressed or “burned out” and the assumption was that you would function to your level of comfort and then ask for help.
The departments are well-staffed, both in terms of medicine and nursing resources, the teaching tends to be well-organised and your time is protected so you can attend.
The medicine is not dissimilar, even if the nuances of the system may take a while to get your head around. First-name basis for everyone (even with interns speaking to the Director of the department) is commonplace and the working environment is far more relaxed.
What do you love most about working your job?
Overall I love the medicine that I get to do.
We do our own procedures in the Emergency Department (RSI, lines, blocks, drains etc.) and although we have to contend with the 4-hour rule and often severe bed block just like in the UK, I feel that I can actually treat my patients and sort them out in the Emergency Department before I am forced to pass them on up the chain or to other services.
I work in an Emergency Department that regularly sees marine toxinology, diving emergencies, snake bites, shark bites (a few recently), as well as all the usual Emergency Department presentations common to any other department in the developed world. The variety is great and it’s always interesting. I get to combine working in the Emergency Department with working outside, in helicopters, fixed-wing aircraft and fast cars as part of my job.
And it all just seems so much nicer when the sun shines 350 days a year and the temperature is between 25º C and 35º C most of the time! I finish work and it’s warm, so I can sit outside with a glass of wine, go to the beach on the weekend or lie by a pool.
Tell us about your ED training
I signed up to the Emergency Medicine training program very quickly after arriving in Australia. I didn’t even have to do an audit or have saved a kitten from a tree or presented posters at the regional meeting to be considered!
Look at the ACEM website for more info about the new requirements for admission to Emergency Medicine training in Australia/ New Zealand.
For those who don’t want to stay and train, there are shorter Emergency Medicine qualifications like the EMC and EMD that, although not a full fellowship CCT, do provide you with something to show for your time and effort. Again, the ACEM website has the details.
How does your rota compare?
Obviously there are still extremely busy shifts where you will be exhausted - but it all seems so much easier to deal with when it’s always sunny and you’re being well-paid and well looked after by your employer.
There isn’t the same issue of departments relying on guilt and good will to function here - something I often hear horror stories of back home!
When I first came to Queensland, we worked a 4 on / 3 off / 4 on / 3 off / 8 on / 6 off roster which was great in terms of predictability and rest days. You could go away for six days to Fiji without taking any days of leave! Obviously not all departments are the same but in general you work a 40 hour week in four ten hour shifts and then get three days off.
How does the pay compare?
The pay is significantly better than in the UK for less work.
I remember being laughed at by payroll at my first hospital because two of us went in to tell them they had paid us twice (not realising we get paid fortnightly not monthly). I was quite happy with my month’s pay….. which turned out to be only half of a month’s pay.
If you work overtime you get paid for it - no expectation to just suck it up and work harder.
What about leave?
If you want leave, you can usually get it without any dramas.
As a doctor at any level in Queensland (and Australia in general) the leave allowances are generous - both in terms of recreational leave and professional development.
You get professional development leave to attend conferences and courses, exam leave for exams (without having to arrange your own swaps and sell a kidney) and the importance of having a life outside of work is far more valued here than I ever saw back home.
Are there any other perks?
Salary packaging allows a certain proportion of our pay to not be taxed up to a given limit. I pay a decent chunk of my mortgage and bills out of my pre-tax income so I ultimately end up earning more and paying less in tax. We get tax refunds of a few thousand dollars every year (if you have a good accountant!) and other allowances such as relocation benefits etc that will vary from place to place.
Do you plan on returning to the UK anytime soon?
And finally, what tips do you have for other doctors who are thinking about making the move?
Do it. You won’t regret it. Even if you come and decide to only stay for a year or two, the experience will set you apart from others and it allows you to see how the other side of the world works!
Messly is here to help
At Messly, we help doctors like you make your next move in healthcare. We're working with hospitals and clinics in Australia and New Zealand, helping doctors from the NHS find their dream roles in Australia and New Zealand.
If you’d like to explore life as a doctor in Australia further while you consider your options, check out another interview with a junior doctor who moved to Australia as an ICU trainee.
This article is part of a wider series, supporting doctors like yourself with a comprehensive set of guides to ensure your F3 year is a success. These guides cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience. Click here to visit our F3 Resource Hub to explore the full list of guides and articles.
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