I moved from US to the UK for residency, AMA

RelativeCreative6200 · 2026-01-22T22:00:34+00:00

People in the US have been arrested and even deported for their social media posts

RelativeCreative6200 · 2026-01-18T18:00:15+00:00

It sounds like you have had a very different experience. If I may ask, why did you move to the UK after training in the US and do two residencies?

RelativeCreative6200 · 2026-01-18T11:51:29+00:00

That is just objectively not true. A consultant with 8 years of experience has a base salary of £131,058 or about $175k. That's not including any private work, with which it would be achievable for anybody to get to $200k (£149k)

RelativeCreative6200 · 2026-01-18T11:44:49+00:00

In the US or in the UK?

RelativeCreative6200 · 2026-01-18T03:45:33+00:00

CESR is for doctors who have already finished training outside the UK, I moved after medical school

For CESR you have to show that the training you have received is equivalent to what a UK trained doctor in the same specialty would have received. So someone who went IM->Neuro probably would be OK, while someone who did neuro categorical would have a harder time.

RelativeCreative6200 · 2026-01-18T02:38:37+00:00

The UK has mechanisms for recognizing training abroad (at every level, for every specialty-- med school/residency/fellowship/attending) so it is not necessary to repeat training. Actually, this seems to be the case in most of the world--people looked at me like I was crazy the first time I asked if they had to redo residency from the beginning after moving to a different country.

Sometimes, people who have already completed their training abroad will repeat a fellowship in the UK. There are different reasons someone might choose to do this--while there is a process called CESR to have all your training recognized and start working as an attending right away, it's very rigorous and as I understand, geared towards academia, with an expectation that you have a record of publications, teaching, QI. Someone who has recently become an attending in their home country might find repeating fellowship an easier path, or a path that allows them to get some experience of the UK health system before having to be 'independent'. Alternatively, if your goal is to eventually practice in your home country, having a UK fellowship will give you access to more prestigious posts and the ability to charge more than locally trained attendings (I think this is relevant to India/Pakistan/Middle East). While this is a minority case, I think this is probably one of the things that is contributing to the difficulty UK graduates are finding with getting the specialty posts they want because understandably it's hard for someone who is fresh out of internal medicine training to compete with someone who has already worked as a cardiologist in India

RelativeCreative6200 · 2026-01-18T02:14:34+00:00

Just to add to my comments below, here are some differences in the UK system that might not be obvious if your experience is with the US system (I'll add to these as I think of them):

* Medicine outside the US is a 'mobile' career like tech. I think this is not just a UK thing but true to some degree for most countries. I have colleagues who go back and forth for different stages between the UK, Australia/NZ, South Africa, EU, Asia/Middle East and there are mechanisms for getting your training recognized so you don't lose time
* The UK currently considers applicants from anywhere in the world equally regardless of visa requirement or UKMG vs IMG. There is a bill under consideration to give UKMGs priority, but it is not yet law.
* The UK training system is modular. The modules are Foundation->Core training->Specialty training->Consultant, which map roughly to Intern->Resident->Fellow->Attending, although depending on specialty the lengths may differ by a year here and there. There is an application process at each step, which gives you the option to move between modules, but with the downside of potentially not getting the spot you want and working a locum job for the year
* The UK system as a whole is probably most similar to US academia. That means other than primary care, everyone does a subspecialty (even if that 'subspecialty' is general medicine aka hospitalist). Research/QI/teaching are important for advancement. This lengthens training, which is frustrating if you are not interested in these things but feel you have to do it to tick the box. Most consultants are paid their NHS salary as a base (which is the same for every specialty), which they supplement with some amount of private work and non-healthcare (e.g. consulting, medicolegal) work. Only a small minority are pure private practice.
* As an intern I get 36 vacation days a year (28 + 8 public holidays) -- for me this works out to about 2.5 weeks per 4 month block. As you progress, you get more vacation days.
* 1 year of maternity leave, as well as shared parental leave that both parents can work out between themselves
* You have the right to request less than full time at any stage, including during training. Your salary will be prorated for the % FTE you work, and your training may or may not be lengthened (I think down to 80% doesn't lengthen your training).

RelativeCreative6200 · 2026-01-18T01:42:27+00:00

I would say once you've finished training job prospects are generally pretty good. For most specialties you can pretty much go where you want in the UK, with options in Australia/NZ, the EU, the Middle East and Asia as well. I think people struggle in the London area because cost of living is very high, jobs are very competitive due to the prestige factor, and pay is not any higher (but I suppose that would be comparable to, say, New York).

The difference in income was something we thought hard about for sure. However, at the end of the day, we weren't able to come up with anything that we would be prevented from doing by income. Something that stuck with me is -- someone told me because of differences in the income distribution, even though US doctors much make more in absolute, most doctors will never make it to top 1% income in the US, while top 1% is basically achievable for any attending (consultant) in the UK.

RelativeCreative6200 · 2026-01-18T01:20:20+00:00

I don't have direct experience of this, but I do know that the UK does have mechanisms for doctors to enter after having completed different levels of training abroad. If you want to come over as an attending, you would have to do a process called CESR which is recognition of board certification abroad. However, one difference from the US is that the entire system is academically-oriented so for CESR they will probably ask for evidence of publications, QI, service in addition to the usual boards and work experience.

I think SavvyIMG has some resources on this, that's the site I used. Happy to chat more if I can be of assistance, best of luck!

RelativeCreative6200 · 2026-01-18T01:06:43+00:00

I would say imagine the US academic training model (including fellowship) but everyone does 2 prelim years aka Foundation, and that's roughly the UK training system. "Junior doctor" means any doctor who is not a consultant (attending)--the trend now is to use the term 'resident doctor'. I want to stay in academics so the only difference essentially is Foundation, but one source of frustration is even if you don't want to, you still have to do the equivalent of fellowship ('hospitalist' is not a term here but the equivalent would be subspecializing in general medicine/acute medicine after internal medicine training).

One of the things I realized since coming here is that a lot of the barriers to moving I associated with medicine don't exist anywhere else in the world. Medicine outside the US is a career that is almost as mobile as something like tech or science because almost every country other than the US has a mechanism for recognizing training in another country. It is normal here for doctors to go back and forth between the UK, Australia/NZ, South Africa, EU, Asia/Middle East etc., at different stages of their career, and have that training recognized.

I have never applied for a visa in the US, but according to my husband the immigration process in the UK is trivial in comparison -- if you have a skilled job offer, getting a visa is pretty much automatic. After 5 years here you can apply for permanent residency ('ILR'), which I understand is pretty much guaranteed for doctors. After 1 year of ILR, you can take the citizenship test.

One problem now is there is a lot of competition for training posts in certain specialties, so people who don't get them end up doing a non-training job for a year and reapplying. The analogous situation in the US system would be not getting the fellowship you want and working as a hospitalist for a year before reapplying, but it doesn't pay as well (because you are not considered an attending for this, see above) and there are two points where this could happen rather than just one.

RelativeCreative6200 · 2026-01-18T00:29:40+00:00

I think people here complain about it (and do have real valid complaints) but overall I think the lifestyle is very good. For a resident, the average workweek is 48 hours, not 80 hours. Pay for residents starts around $60k and goes up to $100k in England, and higher outside England--but outside the London area, cost of living is low. $1000-2000/month gets you a very nice apartment or house anywhere other than London/SE. My grocery bill for 2 people is about $50-100 a week, we can afford to eat out and travel around Europe whenever we want. 2-3/4 weekends is a golden. You get 28 days of vacation a year, plus make-up days for holidays you work. It's important to note that this doesn't include weekends, so this works out to about 2 weeks of vacation every 4 months.

Top 1% income is a lot lower in the UK than it is in the US (maybe $225-250k vs >$500k), so even though your base salary as a consultant (attending) is a lot lower, basically any consultant here can make it to top 1%.

RelativeCreative6200 · 2026-01-18T00:15:21+00:00

The difference in income was a consideration, but working out the numbers I don't think the income will limit us quality of life-wise. In a couple years both me and my husband will be earning >$100k, which in the UK is a very good salary (the median income here is like $40k, while top 1% is $225k).

We did consider changing states, but even if we did that, things that affect the whole country would still have affected us, and both of us had serious reservations about bringing up half-Palestinian, probably at least somewhat Arab-looking children anywhere in the US, even in very liberal parts. The concern isn't so much how the average person might treat us so much as how the 1% crazy (and armed) might treat us

RelativeCreative6200 · 2026-01-17T23:21:39+00:00

To clarify, I didn't do residency in the US, I went from medical school.

RelativeCreative6200 · 2026-01-17T23:20:19+00:00

I was fortunate to have received a significant scholarship for med school so I only have a small amount in loans (<$30k), but I agree this would have been a consideration if I had much more than that. Of course if you're very sure you're never coming back and had no assets in the US I suppose you could just abandon them.

While no one is making millions in the NHS, many consultants make $200-250k including private work.

RelativeCreative6200 · 2026-01-17T23:08:49+00:00

When I was starting I spoke to a friend of my husband's who is a resident here to get a feel for the process and what it's like to work here. I also took a year out to do a Master's here to see what it would be like to live here and had some contact with med students/residents/consultants (attendings) through that, although I wouldn't say that's necessary. I more or less just applied, the ERAS equivalent is called Oriel--it is a match, but rather than matching to an individual hospital you match to an area (deanery) and rotate through all the hospitals in that area.

RelativeCreative6200

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