Moving as a Doctor – UK vs Australia vs USA

1. Up-Front Costs to Get Licensed & Job-Ready

UK

• Exams: English test (OET/IELTS), PLAB 1 & PLAB 2
• Registration: GMC full registration application
• Other costs: Visa, flights, accommodation in Manchester for PLAB 2
• Typical total: £3,000–£6,000

Australia

• Exams: AMC CAT MCQ (AUD ~$2,720) + AMC Clinical Exam (AUD ~$3,530)
• Registration: AHPRA limited registration
• Other costs: Visa, skills assessment, criminal checks, flights, relocation
• Typical total: AUD $10,000–$15,000

USA

• Exams: USMLE Step 1, Step 2 CK, Step 3 (~USD $1,000 each) + ECFMG certification fee
• Applications: ERAS application, NRMP Match fee
• Other costs: Elective/observership costs, visa, interviews (often requiring US travel)
• Typical total: USD $10,000–$20,000

2. Difficulty Level of Entry

UK

• PLAB exams are straightforward compared to AMC Clinical or USMLE.
• Jobs are advertised year-round, but competition for first post is moderate — may take 3–6 months of consistent applications (GMC notes this is normal).
• NHS is used to hiring IMGs.

Australia

• AMC pathway is more expensive & time-consuming than PLAB.
• AMC Clinical exam waiting times can be long.
• Many hospitals prefer candidates with Australian or UK experience.
• Regional and rural hospitals offer more openings for IMGs.

USA

• Most competitive.
• Requires USMLEs + matching into a residency via NRMP.
• Limited visas and preference for US medical graduates.
• Observerships in US hospitals are almost essential for interviews.

3. Salary Snapshot (Base)

4. Typical Work Hours

UK

• Contracted: 40 hours/week
• Reality: 48–56 hours/week with on-calls & night shifts (European Working Time Directive cap ~48 hrs, but rota gaps may push higher)

Australia

• Contracted: ~38–40 hours/week
• Reality: 40–50 hours/week for juniors, extra paid overtime common in regional posts

USA

• Residents: 60–80 hours/week (ACGME cap 80 hrs, averaged over 4 weeks)
• Attendings: 40–60 hours/week depending on specialty and call duties

5. Lifestyle & Work–Life Balance

UK – Predictable career structure, strong training programs, lower pay, high cost of living in big cities, work intensity can be high due to rota gaps.

Australia – Higher pay, better work–life balance, generous leave, less hierarchical culture, but AMC pathway takes longer without prior experience.

USA – Highest pay potential, cutting-edge medicine, longer and more competitive pathway, more work hours during residency, limited leave.

6. Summary Table