beneli: ^^

‘I am a very patriotic Nigerian and would love to practice back home. But unfortunately, whenever I go back for summer clinical hands-on practice, my disdain for our poorly-equipped hospitals (at least in the North where I live) grows. And the conditions in which the medical team works is, to put it lightly, appalling! So, I've decided not to go back home immediately until I've tried other countries for better exposure during my residency and early medical career.’

You said some very interesting things up there. I think your decision to try to get better exposure at the beginning of your medical career is a very pragmatic one.  I too was filled with a lot of naivety ‘patriotism’ when i finished medical school and returned to Nigeria, but this made me to eventually waste nearly 8 years of my life and career!

You can say that’s why i am interested in preventing others from making the same mistakes . . .

Now let’s try to address your questions. It’s a lot of information, so i will break it down into 2 – 3 posts to beat the spambot:

1. On a scale of 1-10, w/ 10 being an absolute guarantee, what are my chances of getting into a residency into the UK immediately I finish from here, assuming I fulfil all requirements (PLAB etc). I'm a bit jittery cuz I have friends here w/ a UK passport but even they complain of how competitive the UK has lately been.

On a scale of 1 – 10 I would put your chances of getting into a residency programme in the UK, immediately you finish, at less than 4!

The truth is that it’s become extremely difficult for Overseas Doctors to get into training programmes (residencies) in the UK these days. This trend started sometime around 2005 – 2006 when recruitment into the training programmes became centralised. Prior to this the different NHS trusts handled their own recruitment, and as a result of that, overseas doctors found it easier to get posts in the hospitals where they would have done a period of clinical attachment.

You see, the clinical attachment not only offered you exposure to how things are done in UK hospitals and your expected competencies as a junior Doctor, it also gave you the opportunity to get a UK Consultant to act as your referee, who would also sometimes sponsor your application to join their hospital. At least that’s how i . . . and a lot of guys i know . . . got my foot into the door here. Now everything is based on the ‘strength’ of the application alone – this would include things like what your visa status is, whether you are believed to be of the right ‘cultural mix’ etc . . . 

For a lot of overseas doctors, the truth is that their applications lack the required ‘strength’.  When they do get the interviews, their ‘cultural mix’ - the way they look, sound etc – don’t always work for them, unfortunately!

However, overseas doctors are still occasionally offered non-training posts, which leads nowhere career-wise . . . 


2. The same for USA, let's say I get 240+ in the USMLEs (wishful thinking!)

Getting 240 in the step 1 is not wishful thinking, if you give yourself 1 - 2 years to prepare - especially seeing that you’ve not too long finished the ‘basic sciences’.

Some useful resources that you may wish to explore if you consider going down the USMLE route include the following online tools;

i) Dr Najeed lectures. This includes over 400 hours of online lectures tailored specifically for the USMLE. You may find it useful for the rest of your training as well.  It’s of course not free, but people say it’s worth every cent spent. He has about 30 hours free lectures that gives a taste of the quality of material. http://drnajeeblectures.com/

ii) USMLE WORLD – this site is a very useful preparation resource for the USMLE. It’s made up of question banks for th different steps of the USMLE. This gives you a flavour of the level of knowledge expected for the different steps of the exam. http://www.usmleworld.com/

iii) The USMLE First Aid series are like your USMLE bibles!

iv) The various usmle online forums, like http://www.usmleforum.com/


You can actually get into Internal Medicine and similar specialties with less than 240 though. 220 is still considered a reasonably competitive score.

You've answered most of my questions too. I already know about the clinical attachments and elective programmes as well,which we can do in our final year. But I want to know if undergoing these trainings esp the clinical attachment gurantees one a training post with NHS. I dont mind doing locum for sometime.

PS: I follow Dr Najeed. He's simple an awesome teacher.