- Postgraduate training -

Personnal accounts – United Kingdom

United Kingdom (London)

CONTROL OF INFECTIOUS DISEASES (PCI), MASTER'S IN CONTROL OF INFECTIOUS DISEASES, LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE (LSHTM)

ACADEMIC
Start	I began the process in the fall of my final year of residency (PGY-6): exploring the different options and my colleagues’ suggestions, checking deadlines for registering for both Master’s degrees and potential bursaries/scholarships. I applied for the Master’s in November of my PGY-6 year. In England, the universities use rolling admissions, starting in November and ending in July or when all places are filled. Several other elements required me to be accepted for the Master’s (for the visa, accommodation, etc.), so it was worthwhile starting early!
Support	I needed two letters of reference to apply. I asked my future department head, and my residency program director.
Choice of site/specialization	I was hesitating between a more clinical fellowship (in a hospital) and a fellowship with a Master’s program. In any case, I’d known for a long time that I wanted to do percutaneous coronary intervention (PCI). A colleague from another hospital had told me about her clinical fellowship in Switzerland. A local colleague told me about her Master’s at the LSHTM. After talking to them, I realized I preferred to apply in the UK, as it was less expensive than Switzerland, and I preferred to do a Master’s, because it was less complicated for visas and other permit applications, and easier to get certain bursaries. I also really liked the idea of finishing with a degree confirming that I had acquired knowledge and competencies! I looked at several different Master’s in the UK, and also applied as a backup to Glasgow and Dundee, Scotland.
Interview	No interview was needed.
Exams required	Each university decides whether they feel you need an English test to complete the application (otherwise it becomes a prerequisite to be met before receiving the final letter of acceptance, prior to which they send us a conditional letter). Fortunately, at the LSHTM they consider that Quebecers don’t have to take the English test, since we live in a majority English-speaking country (right!). If I’d wanted to work in England, though, to get the equivalence permit from the General Medical Council I’d have had to take a specific English test.
Pay/Bursary	I was not paid for my Master’s, but instead had to pay rather high tuition fees ($48,000!). I combined several income sources: I worked as a staff physician for two months during the summer before leaving, and that meant I could pay my tuition fees. I received the $40,000 McLaughlin Fellowship from Laval University, which was paid every two weeks all year long. I also received a London Goodenough Association of Canada (LGAC) scholarship to live in Goodenough College. And I had the £10,000 grant from the Jackman Foundation, which went directly to pay my rent at Goodenough College. I received a $500 grant from Les Offices jeunesse internationaux du Québec (LOJIQ), and the $2,500 Carolyne-Delage scholarship from Laval University. CHU de Québec’s PCI program also gave me a $7,500 grant. I applied for the Chevening Scholarship, whose deadlines fell throughout the previous fall (the fall of my PGY-6 year), and which has very tough requirements. Only one or two Canadian applicants receive it each year, and I wasn’t one of them. But, as the scholarship is for around $100,000, it’s worthwhile taking a look at it. You have to be a Master’s student to apply.
Prior rotation required	Undergraduate medical degree (MD)
Work permit/visa	I didn’t apply for the General Medical Council equivalence, as I wasn’t going to be treating patients.
Visitor’s visa	I had to choose between two visas: I took the student visa, so my partner could be my “+1” even if it costs more (you have to prove you have the funds to pay for your Master’s, and the health insurance premiums and application fees are higher, too), because we wanted him to be able to get a visa easily, as well as health insurance. The other option would have been the Youth Visa, which is extremely simple to obtain, less expensive, and valid for two years. At the time, though, the age limit for applying was 30, and my partner was 31 years old. I think the age limit now for applying is 35. And I think “+1s” (dependants) are no longer permitted for Master’s student visas. Canadians can spend 6 months in the UK without a visa, and whenever you leave the country (to go to France, for instance), the timer goes back to zero. On their official sites, though, it says you may not use that strategy to settle in the UK or in a “prolonged, repeated manner.” It’s the Border Force officer who determines what’s prolonged and repeated. Probably, doing that for one year wouldn’t have been a problem, especially because now, when Canadians arrive in England by air, passport control is carried out by machines, not humans. So, worth considering if you’re more than 35 years old!
PERSONAL
Health insurance	In England, the visa gives you access to health insurance as if you were English, and that’s really practical! With the visa, you pay an NHS fee. It’s easy to have access to a family physician (GP), you just have to register based on your address when you arrive (or later!). This insurance also covers prescription drugs. Medical drugs cost £9 per prescription, per month. You can also buy a 3-month, 6-month, or 1-year payment plan, which costs a lot less if you have more than 2-3 medications a month.
Car	We didn’t need a car.
Bank account	Online bank accounts work perfectly for fast access to a bank account, which you need for a cellphone, gym subscription, etc. I had a Monzo account, and several people went with Revolut. Both are secure, and easy to use.
Accommodation	I stayed in Goodenough College in quite a large, furnished apartment with one bedroom, bathroom, kitchen, and dining room. Goodenough College is for postgraduate students, but I also had an Australian friend who was there on a clinical and research fellowship in oncology, so I think that if you start the process early enough, and have papers proving you’re going to be on a “real” fellowship program, that could be accepted. Registrations begin in May. The deadline for the LGAC scholarship (see above) is January-March, depending on the year, and if you’re given a scholarship, you’re guaranteed a place in the College. Most people live in rooms that are more like student residences, and cost less, with bathrooms that are shared (or not), and common kitchens. Having your own space costs more, but with two sources of income (my partner and I), and the LGAC scholarship, it was really worth the extra! It’s also in a great location, and the activities and community are amazing.
Driver’s licence	We took the International Driver’s Permit from the CAA ($50, valid 1 year) just in case, but we drove only in Ireland, where our Canadian permit is recognized..
Quebec Health Insurance Board (RAMQ)	We applied for a “once every seven years” exemption so we could continue to have RAMQ coverage even if we were outside Quebec for more than 6 months. In my case, as I was going abroad to study, the exemption was automatic.
Telephone	I went with Giffgaff (there were some SIM cards at the College when we arrived, all I had to do was activate my account and pay), and my partner went with Lebara. They’re equivalent, but for the same price, Lebara’s basic package included 100 minutes a month of international calls, which proved very useful!J
Mail	Managed by Goodenough College in London, and by my parents in Quebec City!
SPOUSE
My spouse had to accompany me for the visa application process (including a return trip to Ottawa) He was also able to work remotely from London, for his work in Quebec.

United Kingdom (London)

MEDICAL EDUCATION

ACADEMIC
Start	September 2024
Other	Letters of recommendation, letter of intent, and resumé required No application fee for vast majority of programs Tuition fees between £22,000 and £26,000 in UK for international students
Choice of site/specialization	Queen Mary University of London (QMUL), London’s only full-time, in-person program Other excellent options in UK: Dundee, Scotland, full-time, in-person; UCL, full-time, online only. Other UK programs: Cardiff, Wales, in-person, full-time; and Brunel, England (not as highly recommended) Outside UK: Maastricht, Netherlands, good reputation, well known, but part-time and remote only; Chicago, USA, part-time and remote only Note that Canada’s medical education culture is closer to UK’s than USA’s.
Interview	No interview for QMUL and most universities, but interview required for other programs, such as UCL
Exams required	International English Language Testing System (IETLS) test of English language proficiency, required by all UK universities
Pay/bursary	Société des médecins de l’Université de Sherbrooke (SMUS) bursary If doing a Master’s in London, apply for the London Goodenough Association of Canada scholarship (associated with Goodenough College, probably the best place to live in central London, on your own or as a couple/family, if you’re doing a Master’s or doctorate in London) Chevening Scholarship, but applying is a competitive and challenging process Quebec Association of Internal Medicine Specialists (ASMIQ) bursary (for people in GIM) Look out for Association for the Study of Medical Education (ASME) awards and grants if you choose a UK program.
Prior rotation	N/A
Work permit/visa	N/A
Visitor’s visa	Student visa
PERSONAL
Health insurance	Health insurance coverage via the National Health Service (NHS) upon applying for the visa. Means you can have a family doctor in a few weeks once you arrive in UK, and it’s easy to have follow-up/examinations/prescriptions.
Car	Apart from the steering wheel being on the other side, it’s really not practical to drive in London . . . so take public transit! Apple Pay is cheaper than buying tickets/traditional Oyster photocard (daily price caps, depending on trips taken, rather than charging for individual trips). It’s worth getting an 18+ Student Oyster photocard, which you can apply for even if you’re over 25, by providing proof of studies. It’s very advantageous on train travel in UK (1/3 off), and can be used to apply that discount to London Underground travel when you link the National Railcard to a Student Oyster photocard.
Bank account	Most people use Revolut (online banking, lets you transfer money from Canadian banks).
Accomodation	For people doing a Master’s/PhD in London, the best thing is to apply to live at Goodenough College (ideal location, great opportunities, unique community, highly competitive cost). Options for single individual or couples and families. If you want an apartment in London, it’s essential to take the necessary steps in person, or through people on site, and via reputable agencies. There’s no July 1 moving day in UK, so you can rent at any time. Also, note that it’s tenants who pay council tax in UK, not owners.
Driver’s licence	N/A
Quebec Health Insurance Board (RAMQ)	For Quebec and Ontario, merely let the provincial health insurance authorities know you’ll be out of province for the year, for the purpose of studying. No impact on your provincial coverage, which you can still use if you return to Canada during the year you’re studying abroad. Your regular coverage resumes once you confirm you’re back in Canada following your fellowship.
Telephone	Complimentary Lebara SIM card provided by visa office once you apply for UK visa. Cost very reasonable (c. £15 for 40GB of data, with no roaming charges on trips to continental Europe). Beware of telephone theft in London
SPOUSE
N/A

Please note that there is also a Facebook Messenger group for resident doctors leaving for the UK on fellowships (available on request).

United Kingdom (Oxford)

RESPIROLOGY (CLINICAL RESEARCH)

ACADEMIC
Start	Internal Medicine R4
Support	Two mentors at University of Sherbrooke, where he will be practising They recommended three researchers to him—two in the U.S., and one in Europe
Choice of site/specialization	He wrote to the three researchers, with a cover letter, resumé, and three letters of reference The choice of specialization was intended to ensure succession in research and treatment of asthma An asthma specialist has since been hired, but on returning to clinical research the candidate will replace a retiring doctor. To ensure that physician’s succession, the candidate agreed to conduct laboratory experiments during his fellowship and to complete a Master’s (classes and thesis) at Oxford, for which he will be released from his fellowship activities
Interview	One interview for each site: two via Skype, and one at a conference In each case, he mentioned that he would be going on a fellowship with his spouse, who wanted to perform a fellowship in Clinical Psychiatry The three sites put him in touch with their HR departments, so he could see how practice permits would be considered for a research or customized clinical fellowship The researchers he met with also put them in touch with Psychiatry professors Finally, the UK proved to be the simplest choice in terms of red tape. The candidate’s dual French and Canadian citizenship facilitated the process for Europe
Exams required	International English Language Testing System (IELTS) English exam
Pay/bursary	University of Sherbrooke Society of Physicians (SMUS) guarantees the salary of any future professor going away on a fellowship This was a key element in his application process The fellowship host site has nothing to pay
Prior rotation	Not required
Work permit/visa	Aside from Diagnostic Radiology, no Royal College specialty is recognized directly in the UK You have to obtain a full licence to practise from the General Medical Council, so you can work as a resident For a fellowship of no more than two years’ duration, you can take the Medical Training Initiative (MTI) route to obtain a Certificate of Sponsorship from one of the royal colleges in the UK. This can be combined with sponsorship for a Tier visa. This is the simplest route for a Canadian doctor. BEWARE: If you apply for a permit to practise and are already on site, you will have to take the Professional and Linguistic Assessments Board (PLAB) test
Visitor’s visa	As a holder of dual French and Canadian citizenship, the candidate is an European Economic Area (EEA) National, and that simplified matters. But beware, the process took more than a year even so He had to prove that the MD took five years Also, clinical clerkships are not fully recognized. So candidates have to demonstrate that they have continued to acquire certain competencies during their years of residency You can also have your medical permit recognized by another nation that is recognized directly (e.g., a pediatrician who has done the U.S. exams may be recognized directly)
PERSONAL
Health insurance	In the UK, proof of residence provides access to the National Health Service (NHS) If you are Canadian and have a Tier visa, you will pay a Health Surcharge of around $500 and have the same access to the NHS as any UK resident You will still need good travel insurance, though
Car	NO, cost is prohibitive, at £1,500 a year per driver Cycling and public transit work very well
Bank account	The candidate and his spouse opened an account with HSBC Canada, and took steps to open an HSBC UK account remotely They can carry out no-fee account-to-account transactions It can be worthwhile taking a travel credit card with no currency conversion. While this costs a little more, it avoids any headaches Power of attorney and a mandate in anticipation of incapacity were signed before leaving Quebec
Accomodation	They used the Zoopla app to find accommodation Warning: “Fully furnished” refers only to furniture. It does not include dishes, utensils, etc. They also had to advance six months’ rent before arriving (beware of fraudsters)
Driver’s licence	They obtained International Driving Permits before they left, and use Co-wheels pay-as-you-go car hire, which recognizes their driver’s licences
Quebec Health Insurance Board (RAMQ)	Before leaving, both fellows completed the waiver application for stays outside Quebec for training
Telephone	Don’t forget to have your cellphone unlocked before leaving. In their case, they had a SIM card delivered to their home in Quebec before leaving, using the GiffGaff website. No contract, no credit check, and the phone works as soon as you get off the plane
Mail	Don’t forget to have your mail redirected by Canada Post before you leave Quebec
SPOUSE
His psychiatrist spouse was able to apply under the MTI only if she did not apply to immigrate via her spouse’s European passport She had to wait several months before her Tier 5 visa was issues (they keep the passport during the entire process). Costs can be as high as $1,000 Suggestion: Associate the MTI with a Tier 2 visa, if possible In all cases, ask for the visa to be issued for two years, otherwise you’ll have to repeat the whole process for the second year As Brexit approached, it was discovered that the candidate’s spouse could apply via a special program protecting the families of EEA Nationals already on site in the UK, at no cost

United Kingdom (Oxford)

RESPIROLOGY (ASTHMA)

ACADEMIC
Start	Autumn 2022 – first contact made with the department head who was known to a physician at Sacré-Cœur. Concrete steps to be taken after Christmas 2022, with an anticipated departure date of August 1, 2023.
Support	The easiest process for going to the UK as a Fellow is through the Medical Training Initiative offered by the Royal College of Physicians – it’s a slightly long process consisting of many steps, but it is well structured, and they provide fairly good support. In terms of requirements, not much apart from a letter from the program director and two referees who support the purpose of the training and the competencies – a document with the required competencies can be found on the UK college website; my referees simply indicated that I met all the requirements as per the document without any further details. A notarized copy of my medical diploma was required, but as part of the process, it is suggested to call upon a company that will do everything remotely. As far as the steps themselves, and the organization, I received help from several colleagues, including respirology residents – a colleague in another setting a few months before me, and a colleague in the same setting, but who had been there during the pandemic. There’s a group of resident doctors who are going on fellowship in the UK, with several of the residents who are there now, as well as alumni for people with questions.
Choice of site/specialization	Excellent recommendations from physicians in my department and from colleagues who completed their fellowship there or who know the physicians within this department.
Interview	Very basic for my department – if the candidate is receiving external funding, departments in the UK appear very keen in welcoming extra fellows.
Exams required	In theory, I don’t think the English exam (IELTS, which is quite difficult) is necessary since it is possible to apply for an exemption. The criterion is to have been trained in a country where English is the official language. In my case, I’d already completed the test, but I still applied for an exemption on principle to see if it would work, and it did. However, I am unsure if it would work for everyone, particularly in the case of a degree from a French-speaking university. If you can cope with uncertainty, you might consider it, but for your sanity, I imagine you’re better off doing it or at the very least allowing yourself ample time in case you apply for an exemption and the latter is declined, particularly given some people have had to retake the test (with the minimum passing mark being quite high).
Pay/bursary	CIUSSS-NIM bursary – irrespective of the amount, it helps to have something “on paper” that confirms you’re making at least 35,000–45,000 pounds, which makes it much easier to find housing rather than telling them you have a line of credit.
Prior rotation	Not required
Work permit/visa	If you’re under 30, you can apply for a Youth Mobility Scheme visa, valid for 2 years – as long as you come into the country before the age of 30, it will remain valid thereafter. Alternatively, the Royal College of Physicians supports the process of obtaining a Tier 4 visa in the context of the Medical Training Initiative application.
Visitor’s visa	Same as work visa
PERSONAL
Health insurance	For all people arriving on a long-term visa, there is an annual NHS fee which offers coverage for medication and hospitalization. It’s very easy to register for a family physician, who can refer you to specialists free of charge if necessary. Drug coverage is excellent, and there are no strings attached, even for biologics or monoclonal antibodies (however, these usually have to be prescribed by a specialist, so remember to have a prescription on hand while you find a family physician, have the latter refer you, and wait to see the specialist and for the NHS to process all the paperwork). As a healthcare worker, all these expenses qualify as fully reimbursable!
Car	I don’t have one, everything is done by bike, but it’s very easy to rent a car.
Bank account	It’s easy to open an account when you arrive, but otherwise I pay all my bills using a Canadian credit card with no conversion fees, so it’s almost as easy as in Canada. Some expenses require direct debits from an account, but you can usually wire money from your bank in Canada should you prefer not to open an account there.
Accomodation	More complex – there are many real estate rental agents, but it’s sometimes difficult to obtain a virtual visit, particularly if you contact the agents by email. Much higher chance of success by phone (it’s possible to use an app allowing you to make international calls by redirecting your call to a local number like Rebtel, a much cheaper option than using your own plan). Real estate agents are much less motivated than in Quebec – expect to have to chase them down frequently to get your file moving, even with the date of occupancy nearing. For my part, I only made an advance payment for the first month, but some people have been asked to pay several months’ rent in advance. Of note, the municipal tax (Council Tax) in the UK, unlike here, is paid by tenants, and via monthly instalments.
Driver’s licence	I already held an international permit, but I had no problem renting a car even with only a Quebec permit.
Quebec Health Insurance Board (RAMQ)	Simply make a request to avoid losing your eligibility during your time outside the country. Since your stay is tied to pursuing training abroad, you can ask for a waiver which will not count towards Quebec’s 7-year provision.
Telephone	Several companies offer excellent bundles, considerably cheaper than in Canada, and this goes for the Internet as well.
Mail	Have all mail redirected to family/friends, bearing in mind that you also need to do this for your bank/university (they will send you your diploma within a year of completing your training, probably during the course of your fellowship), as well as your last home hospital (for your income tax receipts).
SPOUSE
Spouse completing her fellowship in Switzerland during the same period.