- Postgraduate training -

Personnal accounts – United Kingdom

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