What’s NEXT? - After your primary medical degree like MBBS or MD?

What’s NEXT? - After Your Primary Medical Degree like MBBS or MD?

Dr. Shaktheeswari Ravi
Article Reviewed by The Medindia Medical Review Team on Apr 15, 2021
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Graduating from medical school after years of hard-core training, battling books from various authors and publications for all the different subjects, is an exhilarating moment of pride and joy and might personally provides us with a sigh of relief and peace.


Unfortunately, stemming from personal experience, these positive emotions are short-lived before they get drowned by the succeeding question of WHAT'S NEXT!

So here are some career-options for those suffering from that very Question.

Number 1: Practise Medicine - Yes, WORK

The most popular option after graduating with a primary medical degree is to start as a DMO (Duty Medical Officer) or a Junior Resident. This provides time to think of a career path and gives a short respite from preparing for examinations. The transition is almost quite seamless from a house-surgeon to a DMO and comes with a decent pay.

Depending on your location, a satisfactory sum from 30 to 40K can be expected with about 8-12 hours of shifts and night duties as well.

What is expected of you: To be flexible and efficient in a fast-paced environment and must possess strong decision-making skills along with a sense of sympathy, empathy, and readiness to offer service to your patients.

However, this is the time to explore various specialities and introspect to know what you enjoy doing the most. Primary decision should be to choose a career between a surgical or medicine related field.

Looking for Opportunities Abroad

For those who strive for a life overseas, a promising life does await. But the path doesn’t come easy and it isn’t for everyone. Popular destinations include the US, UK, Australia, and the Gulf countries.

Every country has its own requirements to be eligible to work and specific registration process to practice medicine.

The United States of America: The United States Medical Licensing Examination (USMLE) is the one-path medical licensure program created for physicians in the US and abroad.

  • Fees: This three-step licensing examination comes with a heavy price-tag, costing a minimum of US $1000 and more for each step of the examination.
  • Preparation: It requires a meticulous work ethics, sound medical intelligence, and perseverant personage to get into a residency program in the US. The study period is a minimum of 2-3 years. It is noteworthy to mention that several countries accept USMLE scores, such as New Zealand, Qatar, United Arab Emirates, Dubai Health City, and India as well.
The United Kingdom: The General Medical Council (GMC) of the UK has the ‘Professional and Linguistic Assessments Board’ test (the PLAB tests - Part 1 and Part 2), as the standardized licensing examination, to obtain either a provisional or a full registration to practice in the UK.
  • Fees: The exams are expensive and they cost around GBP £1100 (GBP-British Pound Sterling) overall.
  • English Proficiency: To qualify for the said examination, one must present to the council standardized English test scores like IELTS or OET with a high score of 7.0 in all four bands plus a 7.5 overall. This is in addition to the PLAB-1 and 2 examinations.
  • Preparation: The overall dedicated study period is about 1-2 years and demands strong medical knowledge with an unwavering attitude.
Canada (MCC): The Medical Council of Canada grants a qualification in medicine known as the Licentiate of the Medical Council of Canada (LMCC) to physicians who have met its requirements of passing two examinations namely MCCQE Part 1 & 2 (The Medical Council of Canada Qualifying Examination). Part 1 exam has two sections with 210 multiple choice questions (MCQ) and 38 short answer questions. Part 2 exam is a series of clinical stations.

  • Fees: Both the above exams costs around CAD $4200 (CAD-Canadian Dollars).
Australia: To obtain a registration in the Australian Medical Council (AMC), one must start with the ECFMG-EPIC Verification (Educational Commission for Foreign Medical Graduates-Electronic Portfolio of International Credentials) to assess their primary medical degree, after creating an AMC portfolio. Once that is completed, candidates can undertake a pathway of their choice, the most followed being ‘The Standard Pathway’ - where candidates need to pass an MCQ plus a Clinical Examination.
  • Fees: AUD $6250 (AUD-Australian Dollars).
New Zealand: The Medical Council of New Zealand recommends to use the registration self-assessment tool to determine which pathway one might be eligible for. Needless to say, one must pass NZREX Clinical Examination (New Zealand Registration Exam), along with satisfactory English Proficiency Scores and an EPIC-Verified Medical degree.
  • Fees: This exam would cost you NZD $767 (New Zealand Dollars).
  • Preparation: One needs to bear in mind that this is an OSCE Examination which is deemed “quite-difficult” and needs arduous clinical preparation.
It is notable to mention that once a license to practise is obtained, it is financially quite rewarding.

Message for an overseas-aspirant: Choosing to practise medicine abroad is an excellent decision but has its own pros and cons. One needs to evaluate a country of choice, decide on the path to embark and requires thorough research. It is always advisable to connect with a peer or a colleague in the said country to help one with the entire process.

Number 2: Post-Graduate Options - India and Abroad

The question that is on every medico’s mind; the one that can cause sleepless nights and the one that crumples the mind - Post-Graduation ergo ‘Chase for the Specialty’.

How does one choose?

Choosing a medical specialty is one of the most significant decisions a medico will make in his/her life.

Understanding one-self and recognizing what someone wants for their future requires much thought and this complex decision has several influencing factors to it.

Identifying the said influencing factors is quite crucial in planning the road ahead.

What does this mean?

One needs to make peace with the fact that there is no magic formula in figuring what specialty to choose from; finding a good fit in simple terms means, exploring who you are, what you want from life, and pinning down options that will support those goals. It is notable to bear in mind that sometimes more often than always, multiple career options can provide you, career satisfaction.

Factors that one needs to keep in mind to aim for a specialty program entails:

(a) Personality fit
(b) Specialty content
(c) Role model influence
(d) Work/life balance
(e) Future family plans
(f) Length and competitiveness of specialty
(g) Education debt

With all that being said what paths can get you there?

As far as India is concerned, our great nation is moving towards a one-path medical licensure program proposed by the National Medical Commission called the NEXT (National Exit Exam). It is speculated to be implemented in the early months of 2022/2023.

MBBS aspirants currently have to go through NEET-PG, a highly competitive exam testing the candidates in 19 subjects with 300 MCQs to be finished in 3.5 hours. The candidates this year (2021) were in a plethora of shock when the questions were reduced from 300 to 200 but the duration remained the same, asserting the fact that India is also adapting a more clinical-oriented question pattern that is similar in nature to other competitive universal medical exams.

Aspirants can also go for the central institute exam known as INI-CET, to attain a post-graduate degree of choice.

One can also choose overseas options like MRCP or MRCS that hold exams in India held from time to time at some centers. However, this too requires planning and working in the field to gain enough clinical experience.

Number 3: The Pandora’s Box

Alternative to an MD or a clinical specialty is pursuing the path less travelled. I call this opening the Pandora’s Box, as this unfolds paths of endless, immense opportunities but brings with it several bouts of hesitancy and indecision among medical graduates.

The hesitancy, uncertainty is merely an incorrect perception and repeatedly, they have proven to be domains of excellence.

So what are these domains?

  • Masters in Public Health-Community Medicine: With the advent of the pandemic, this particular sector has received the recognition it deserves. Opportunities are endless abroad and a shift in transition for its importance in India is seen, thanks to COVID-19.
  • Masters in Hospital Administration & Management, Advanced Leadership program in Healthcare Management: These are areas of booming career opportunities. It is reserved for those who can take up and run an administrative set-up in this cutting-edge industry.
  • Aspirants can also enter areas of technology and research in Medicine (M. Tech in Bio-Medicine): This deals with bioinformatics, medical biotechnology and imaging, machines that are re-inventing medical diagnostics, per the minute.
  • Taking UPSC Exam and joining Indian Administrative Services (IAS): One occasionally finds doctors taking up IAS. At some stage you can aspire to lead the health policy of a state or the country if you are successful.
  • The Pharmaceutical Industry: This is not only a logical option for physicians, but one with a very broad range of potential positions and career paths. One can fit anywhere from early-stage research to post-marketing surveillance.
The above are merely scratching the surface of the non-clinical routes and it invites an intense discussion on its own.

Message to an overwhelmed aspirant:

“The most difficult step is to know what you enjoy doing. I would advise all fresh medical graduates to take a break from the studies and not chase post-graduation immediately after passing out” -

Dr. Sunil Shroff - Founder and Chief Editor of Medindia.net

The above said words, where the one that put an overwhelmed aspirant like me to ease, that sometimes hitting snooze on your proposed medical career time-stamp could be a good thing. This might just give you the edge you need!

Notes from the author: “Explore from within and choose what you want and remember, there are several ways to attain the career satisfaction that you crave”

Do as much research as you can; reach out to your peers and mentors for advice and mentorship-until you find something that clicks.

It is understandable that the hard work and countless hours that one needs to invest in Medicine is indeed an arduous task, but the satisfaction and potential to impact human life, as a result, is an unparalleled emotion with no bounds, that is well-worth the effort.
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