Insights from my personal journey
Risking the judgment of being labeled x, I will start this article with some self-aggrandizement. This is just to grab your attention if you are already hooked and don’t need the academic might of the author to keep you reading, feel free to skip to the next paragraph.
As is the story with most economic migrants who come to Australia, my school days were my glory days. I completed my high school without having to know what it feels to not top an exam. Suffice it to say, that the all familiar pressure to perform and the parental enthusiasm to make me a doctor, kept me with books and I kept studying. After high school, another two years of doing the same (pretty much nothing else) landed me an admission to the All India Institute of Medical Sciences. If you are from India, you know it is a big deal, if you are not, don’t bother, you may have graduated from a medical school of similar stature in your country. From there, with the conviction that research is the way to solve biggest problems troubling humanity, I went to the U.S.A to pursue a Ph.D. program and gave up on clinical work. Making this choice, I was not aware that being an outlier from a group of outliers, I was already bordering on being labeled as ‘odd’, instead of smart.
Another year of struggle with Ph.D. and a few broken dreams later I was back in India due to certain personal challenges. It was during this time that I got married to my childhood sweetheart who would soon lead me to the great country of Australia.
“Blessed is he who expects nothing,
for he shall never be disappointed.”
The promise…the year of 2011
My wife is a nurse and many of her friends from India had moved to Australia. They all had great things to say about this country. Good pay, great respect, many job opportunities etc., etc. Constant Facebook chatter about these and the awesome pics that these friends posted online soon convinced my wife that Australia is the way to go. She came here in 2011 and was lucky to find a job with some struggle, but fairly straight forward, when seen in the light of the process we have to go through as doctors. While at work, like any good wife, she enquired about the prospect of doctors in Australia. All the doctors she talked to, genuinely (but immaturely) advised her that the prospects are great and she should convince me to come here. According to them the process was fairly straightforward just clear the AMC exams then you are all set to go. Steered by this counsel and further inspiration coming from my wife, I decided to come to Australia. I rushed to book the AMC exam and the IELTS date, picking the earliest available slots. In few months’ time, I landed in Australia, that too on a high note. I thought I had completed the toughest part, as I had cleared the AMC part 1 and IELTS. So, I was hoping that I would get a job in few weeks, as I was told that doctors were in incredible demand in Australia. In this high, I didn’t even take job hunt too seriously as I wanted to enjoy the country a bit before I started working. I was like,‘let me see what hospital I like’!!
The fall…2012 and beyond
After coming here, things changed pretty fast for me. Most conversations with potential employers started getting stalled on something small. “If only you had recent Australian work experience…, If only you had ED experience, if only you had psychiatry experience…, If only you moved to a rural town, if only you had AMC part 2, if only you had done the PESCI exam…etc.etc.”
None of the people I met or talked to was willing to help me in the current situation. You guys may not have much trouble understanding how frustrating this was to me, as many of you may be going through this painful process currently. After one negative interview, many reject letters, and some conflicting advice later, I came to the conclusion (erroneous though-will clarify that later) that nothing would happen until I cleared AMC part 2. Unfortunately, during that time there was a surplus of desperate (like you and me) candidates applying for part 2 and there was a 10-12 month wait period for part 2 exam. This period was ultimately frustrating as I felt completely helpless and felt that there was nothing that I could do that would change my job prospects for a whole year. (Looking back there were many things I could have done differently!!!)
“Tough times never last,
but tough people do.”
Robert H. Schuller
Further fall and hitting the rock bottom…
8 months or so later, when my mind was flirting with depression, I got an email from AMC that there was a cancellation and I could give part 2 exam in that slot (in 2 months time) if I wanted to. I was so confused as I had not been preparing for the part 2 and had been distracted by frustrations of surviving in Australia without a job. Anyway, I took the slot and predictably failed the part 2 exam. Looking back, this was the lowest point in my Aussie trajectory. All the hopes were hinging on the part 2 exam and all people connected to me were eagerly waiting to find out about the result. God only knows (I am sure he knows) how I survived the embarrassment and the frustration that followed. To rub salt into the wound, I couldn’t even find a part-time job at that time in Sydney. Macca’s asked for previous work experience, Coles didn’t call me for an interview, Dymocks’ stated that they would prefer students (I couldn’t convince them that I was also some ‘kind’ of a student) and with a broken heart I took up delivery driving which kept me distracted from the misery.I still remember the shock on my driver mate’s face when I told him I was a doctor. Obviously, this Irish lad would have thought that I am some quack who claimed to heal with Indian bushes.
“In everyone’s life, at some time, our inner fire goes out.
It is then burst into flame by an encounter with
another human being. We should all be thankful for
those people who rekindle the inner spirit. “
Supports that cushioned the fall…
I would not have come out of that fall, if not for the awesome support of my family and friends. I wish I could acknowledge all of them here, but I don’t think you guys need to know their details. If they happen to read this article, I would want them to know how much their help meant to me (Thank you all).They convinced me that I had been erratic in my approach and needed a systematic and long term plan. They offered me the financial support I needed and convinced me to attend an AMC bridging program. This, in hindsight, turned out to be vital, as meeting other candidates and preparing together in a study group boosted my morale and translated into increased confidence. During this time, I got another opportunity to pick a slot for AMC part 2again from another cancellation, I took the slot so that the exam date matched exactly with the course completion date. This ensured that I was fresh with all the knowledge that I had gained from the bridging program. On this occasion, the exam felt a lot different. The first time, every station was an anxiety-provoking nightmare. This time around every station was a challenge that had to be matched to a particular approach or skill that I had learned. Reflecting on the difference, it was as if initially I was navigating without a map, and after the course, I was driving with GPS support. Mistakes that I and others had made while preparing were popping up and guiding my steps. Points emphasized by trainers were providing a structure on which new OSCEs could easily be tackled. I was fairly confident that I would pass this time.
“Just when I think I have learned
the way to live, life changes.“
Some Good news but the process gets bigger than AMCs…
So then I get the good news, it had been a while and I had become accustomed to hearing bad news, so good news of clearing AMC part 2 came as a welcome break. I was so thrilled that I started applying for jobs right away. I was also eager to inform all places where I had applied earlier andlet them know that I have cleared AMC part 2 (just in case that was why you had not contacted me yet!!!). All this excitement and action only lasted few months, as there was no dramatic change in the responses I got from employers. The reject letters were doctored the same way and the responses from so called pundits only changed slightly- “If only you had recent clinical experience, if only you had a clinical reference from someone in Australia, if only you had this/that…” only difference being that the AMC part 2 got deleted from the list.
Baby steps towards recovery…
This time around I had becomebit more mature (good thing about having struggles in life and AMC is really good at ensuring that) and decided to activate plan B/C and D. I started looking beyond AMC and into ways of improving by CV. Courses, observer-ship, online certifications, Linkedin profile, part-time jobs, and networking etc. became my areas of focus. With help from a friend whom I had met during the AMC part 2 exam, I got my first break. He was working as an EEG technician when we had met during the part 2 exam and he was close to getting a job in a GP clinic. When he moved on, he helped me get this job. This was a real break as this meant I got someone to be my referee who is part of the medical workforce. Don’t forget that I had come to Australia in 2012 and this happened in 2015, so after 2 and half years of struggle. I also enrolled in a master program (neuroscienceat BMRI) in Sydney University as part of activating plan B (with some financial burden of course!).
“We must accept finite disappointment,
but never lose infinite hope.”
Martin Luther King, Jr.
Good things come to those who wait…
As I started doing Masters in Neuroscience, I kept applying for all psychiatry medical officer jobs. Eventually, I got an interview call from a reputable Health District in a regional town and the interview went really well. After few weeks of wait I discovered that I was on the eligibility list (still no job, but this was the closest I had been to a job). Few more frustrating months of staying on the eligibility list and 100s of phone calls (to check whether I am still in the list) later, when I had almost given up on the chances of getting a job, I got a call from the ClinicalDirector who offered me a job. I couldn’t believe it, I really thought someone wasplaying a prank on me, such was the sensitizing effect of hardship on me. I made sure that they would email me the same day so that I can be sure.
Few more months of waiting on AHPRA for registration, I was told by AHPRA that my IELTS had expired. I had to give IELTS again (remember I had cleared it in the first few weeks of deciding to come to Australia) as if it was matter of life and death while my application was under process with AHPRA, as I feared that the job offer would be declined if the service had to wait any longer. Anyway, after all those years of drama, my life changed for good. I did get that job, and within few months of working started getting interview calls from other services. In the following 18 months, I was successful in all the 4 interviews I had given and I have successfully jumped few jobs to suit my circumstances and training needs. So, friends please don’t be broken heartedafter your first break everything is indeed straight forward.
“You can be discouraged by failure, or you can learn from it.
So go ahead and make mistakes, make all you can.
Because, remember that’s where you’ll find success – on the far side of failure. “
Thomas J. Watson
As you would have noted by now, it took me few years and many setbacks before I could start working as a medical officer in Australia. Though some parts of this struggle are unique to my circumstances, the general nature of having to wait a year or so after the AMC examinations have become more common nowadays as more and more Australian medical graduates are competing in the same space. So, what does this mean for us and how can we be more prepared?
“Yesterday I was clever, so I wanted to change the world.
Today I am wise, so I am changing myself.”
The most important part of the process that I would like share is that we should look at coming to Australia and settling into medical profession as a long journey with multiple steps that needs parallel efforts. This is significantly different to the way we are used to back in the subcontinent (and in the neighboring countries); where it is all about clearing tough exams. Once you do that you are all set. However, in Australia, clearing the AMC exams are only part of the process, finding a job and then flourishing in a career are all equally difficult processes. And these parallel processes demand that we work on them separately while we prepare for the exam. Tactics we can employ may include, improving CV (certifications, masters, research, observerships, volunteering, steps to show acculturation), working on communication skills, becoming familiar with Australian healthcare system (IMG friends, volunteering, Cancer Council,) and culture (part-time jobs), networking, keeping yourself motivated and supported during the transition (family, friends, fun, faith ) and being ruthless in your job search (just don’t let any opportunity go by-apply everywhere-many IMGs have gotten jobs just because they showed at the right place at the right time).
Before I finish, let me say thatas a person who had struggled few years in the land down under, it is definitely worth it. Work is satisfying and manageable, pay is good. It is a stunning country especially if you are interested in travel. Once employed you get to be part of a system that is well organized and values yourgrowth. And needless to say, that doctors are indeed still in great demand in Australia. It is just matter of making yourselfinto the right kind of doctor who is in demand. All the best, friends!