US vs UK Doctor Training: What’s Better? (Differences Explained)

The US or the UK? Which is better for medical school? 🇺🇸vs🇬🇧

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TIMESTAMPS:
00:00 Reaction
15:15 Final Thoughts

LINKS FROM VIDEO:

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Disclaimer: Content of this video is my opinion and does not constitute medical advice. The content and associated links provide general information for general educational purposes only. Use of this information is strictly at your own risk. Kevin Jubbal, M.D. will not assume any liability for direct or indirect losses or damages that may result from the use of information contained in this video including but not limited to economic loss, injury, illness or death. May include affiliate links to Amazon. As an Amazon Associate, I may earn a commission on qualifying purchases made through them (at no extra cost to you).

[dr.msaqibhissan]

Hi Kevin. I am a registrar in Stroke Medicine in UK. I have done 3 years of internal medicine training and still far far away from being a consultant. I would like to highlight a few things here

1. Uk training system is much longer than US. For example, if one wants to be a neurologist, he has to work 2 years as SHO, 3 years of IM training and 5 years of neurology. This is about 10 years after graduation. Whereas in US, neurology training is straightforward 4 years. However, I do realize that some specialties are equally longer in US as well.

2. In UK, many people work in non training service provision jobs rather than training jobs. In US everyone has to undergo residency.

3. Salaries for residents are almost same in both countries.

4. Compensation in US is many folds higher than in the UK for consultants. Taxes are way higher in UK.

5. Hands down, US training is the best in the world. Specially in large university hospitals.

Even though I have done MRCP UK and midway through my journey, I am taking USMLE now so I could earn better once I become consultant or attending. Personally, I would choose US any day.

[sebastianheine]

Would be nice to see a USA vs Canada video. Considering how close the countries are geographically they have very different systems, especially for IMG/FMG

[dhruvock]

In my career I have cleared both UK exams(MRCP UK +Neurology SCE- all First attempt) and finished all parts of USMLE(Step1+Step2+Step3- First attempt). I will say there is a vast difference in study approach and both are unique in so many ways. Especially Step3 USMLE is heavy biostatistics based exam on day 1 and PACES is a pure clinical skill exam on real patients with active illness. MRCP-UK according to me the best Internal Medicine exam in the world which is adequately standardized to the level of PG IM Training however USMLE is overall the toughest exam in the world due to the sheer intensity of exam stipulation such as number of questions in each single hour section of the exam as well as the length of clinical vignettes hence time plays a key role in solving a USMLE question. USMLE feels quite tough to pass or score high per se especially at later stages of career when one is already at a level of a resident or registrar as it is difficult to conceptualise other specialties like OBGY/Gynae or Peds whereas MRCP-UK can still be cleared if an individual has a very good knowledge of internal medicine specialties. I hope some basic facts could help vloggers and bloggers reading my comment post and best of luck to anyone endeavouring the hard journey of medicine.

[TechSush]

As an orthopaedic registrar (resident) training in the UK, there are vast differences between the two training schemes which haven't been fully explored in the video. Here are some of the key ones:
1. UK training is much longer in general - 5-6 years medical school, 2 years foundation programme, 5-8 years for most hospital based specialties or 3 years for general practice (family medicine). This is if you run straight through without any breaks which is very uncommon today.
2. UK trainees work on average fewer hours that their american counterparts. All training and non-training jobs are restricted to an average working week of 48 hours with a maximum of 72 hours in 1 week. This is different to most programmes in the US especially the surgical ones.
3. UK trainees are paid better per hour than the US residents, but end up with much less compensation as a full trained consultant (attending) with a starting salary that is fixed at pounds for all specialties.
4. UK training programmes are in general less competitive than american residency programmes and hence, are in general more accessible to IMGs. Many IMGs in the UK match into competitive specialties such as plastics/ENT/ortho etc. when they would have had difficulty in the US with the same portfolio.
5. UK healthcare is free to all under the National Health Service. There is much less dealing with insurance companies and issues surrounding funding.
6. UK training programmes have far more checkpoints which block progression. After foundation, doctors apply for core training and then again for further subspecialty training through a competitive national selection process. It is common for people to fail to progress at these checkpoints and need to take extra time out of training. Very few programmes in the UK are run through such as radiology, opthalmology, neurosurgery and cardiothoracics.

[aweisen]

Training in the UK seems to allow a better/easier lifestyle than US residents. Experiencing a 3rd year of med school in the NHS, it was always joked about how medicine in the UK is on banker's hours, nobody gets sick on the weekends or after 5pm. Now, this is offset by having several extra years of training. It's 5-10 years of "residency" in the UK to be "fully trained" and become a consultant "attending."

The UK timeline looks like this:
16-18 go to college (take A-Level exams to prep for university) Think of this like junior and senior year of high school and community college in the US.
18-23 go to Med school, 5 years, a medical degree is a bachelor's degree, MBBS, in the UK, it's not a doctorate level degree, MD.
23-25 2 years of Foundation Training in the NHS. This time period is like 4th year med school and intern year in the US.
25 to 28-34 it takes 3-8years of specialty or core training to become fully qualified, a consultant. (I await the comment about how one is fully qualified after medschool/fy1, no... you aren't)
28-48 one is then a consultant. It takes 14 years as a consultant to finally hit the top pay rating as a consultant which is like 130k (Just changed in a new contract from 19 years and yes there are several other/additional forms of pay that consultants get, 130k is base)

[theinsomniacmedic]

If you are talking purely on entry for IMGs; The UK has limited spots for IMGs, while the USA has a significantly more number of IMGs matching into residency programs due to their size. The "residency" IMG acceptance rate is reflected in this - in the UK its about 14% for their Foundation Programme, in the USA its around 37% for their MATCH to residency, so statistically its harder for IMGs in the UK to get a training spot. The USA has more applicants as well ~ 7, 000 vs 12, 000 (2023).

[crepiskopos]

UK emergency physician here. I think it’s worth saying that there is a different philosophy to UK medical training in that it is more pyramidal - your two foundation years after finishing medical school are designed to be like a combined medical/surgical internship, which gives you a broader knowledge and experience base than your typical doctor in the US who specialises earlier.

The UK also offers a lot more flexibility in terms of being able to work at resident (senior house officer) or fellow/junior attending (registrar) level outside of a formal training pathway, which can be good for those unsure of what specialty to pursue, those wanting to switch specialties, or even those wanting to develop a special interest in something.

There are of course downsides to this - it does mean that training is a lot longer than it is in the US and also that (unless you are in a run-through specialty) you have to re-apply for a training post as you complete your time at each tier (senior house officer and then registrar). It also wastes a lot of time if you already know what you want to do.

[feastybeasties]

Hi! Enjoyed this video! At 11:26 I will say that I think some family med residency’s can get up to the 80 hours a week Esp in those that are unopposed. Additionally, there are a lot of variations between family med residency programs with how inpatient and ob heavy they are with those being programs a lot more intense hours wise.

[pasoking]

I would say it depends on the specialty. Surgical is good to go either way. UK is a bit more balanced time wise and thus gives more time for study and academia. And the requirements to enter those programs already make sure the candidates are high quality. All of the years are creating a strong baseline for patient assessment and care.The training length can be a benefit since with more exposure and knowledge, by the time you are a consultant, you are more comfortable with the patient care and procedures. US is still quite streamlined with better pay and treatment.

[chrismcgowan]

13:26 Being a Junior doctor in the UK is not a cross b/w 4th year and intern year necessarily. I am doing a transplant fellowship 10 years after completing my medical degree and am still a 'junior' doctor. If I quit now I'd say I could call myself a former surgeon

[kainhyde]

Great video as always! However, you mentioned at the beginning that there are lots of UK medical graduates going to the US. Is this from anecdotal data or statistics? Just tryijg to gauge the competitioj lol

[mirandantorinkansah]

12:02 in the UK, we are not paid extra hours if we work overtime in training. That’s slightly incorrect. You can do something called exception reporting but that’s up to you to fill it out, each time you work extra. It’s not an automatic overtime rate that gets applied to your monthly salary.

[MNTXZZR]

I want to get General surgery residency as an FMG, it’s need research for 1 and half year and good Step2 score and some connections you get during research period to get this residency. I think it’s worth all this hard work.

[Bastakology]

I agree with 🇬🇧 dude on the dating before marraige as a person who is still deciding specialty and thankful that i didn't have to rush

[chandanpreetrao]

Please do a comparison between the us and Australia training!!

[MrMaloty]

The UK seems like a great opportunity for unmatched applicants.

[chowsta]

That's a good looking watch! Is that a black sub?

[Jay-pghw]

I’m from the UK and now in the US doing IM residency. It’s very interesting to see these comparisons but most of the time those that make it out to be a choice between UK and US never really had the choice. US is far superior to the UK as a doctor and everyone knows this. The application stats speak for themselves

[katienolan]

Training in Ireland is so different to the US, in my class we had many who matched back to the US & Canada

But overall, it's quite different. We don't 'pick' or 'choose' our specialty until many years post medical school. We are forced to fulfill time in both medicine and surgery, regardless of our interest, even as doctors. I don't think that is a bad thing though, although we are unable to earn as much, by comparison to the NHS, in Ireland you are paid for the hours you work, and overall I think we meet a much more varied patient set, which is always helpful - when we do specialise I think we have had ample opportunity to think of what we are actually interested in medically or surgically - can anyone know in MS4 exactly what they want??!

[israelvaldezarmenify]

the bad thing of the us system is that you waste a lot of years, many many years 4 pre med, 1 doing shadowing or something like that for curriculum, befoore you get into med school, in mexico we do 7 years of pure med school, starting at 18 and residency is done by a nationwide test, which we can do right away after med school or we can work as a generalist and save or pay debt or anything before commiting to something