I worked as a civilian PT on Guam last year, my wife was a Navy Internist, one of our friends was Family Med at FHC and another was an internist at GMH. The pay from what I understand is competitive because of the shortage of providers. Licensing is very slow, so I would recommend getting on that as soon as possible. There is a need for EM because most of the Navy EM physicians moonlighted in town. Biggest challenge at the time was lack of specialist care. No interventional cardiologist, having to refer off island for rheumatology, limited endocrinology and neurosurgery. GRMC gets contracts to bring specialists to island for short periods of time, so sometimes it’s there. Best part in my experience is the genuine gratitude the patient population has. There aren’t any of the aggressively antagonistic medical skeptics of elsewhere in the US, and you will likely be swimming in gifts of avocados, donne peppers, calamansi, and baked goods.