Tiago Villanueva: Does medicine cater for a truly “global” career?

Tiago_VillanuevaI was inspired during medical school by Mark Wilson’s “Medics’s guide to work and electives around the world,” which conveys the core idea that medicine can be a “passport to the world.”

But at first glance, I feel you can’t really compare a conventional medical career with the often apparently more glamourous careers in business, diplomacy, and international politics. The latter usually require extensive travelling, speaking several languages and meeting and mingling with people from all around the world. Medicine, on the other hand, seems pretty much like a “confined” profession. Doctors usually serve a particular community, city, region, or country at best. Some doctors, particularly in certain fields, may have an international reputation and even attract patients from all over the world, but those are the exception rather than the rule.

Unlike businessmen, doctors cannot change their place or country of work regularly. The medical profession is fiercely regulated, often requiring extensive bureaucracy, language, technical, and scientific assessement for a doctor to be fit to practise in a different country (getting a job is usually a different story). Even within the European Economic Area, where professional qualifications acquired in one country are recognised in all others, mobility does not happen overnight.

It is a fact that doctors often attend international conferences and train in foreign countries during part of their specialist training. Most of the time, however, doctors are not travelling around the globe, but rather looking after their patients in the same place for many years. Some people have even told me that they did not choose medicine because it limited their prospects for an international career.

But having fewer opprotunities for globe trotting and interaction does not mean that medicine should be less “globally- minded.” After all, we live in the 21st century, and more than ever, there are tools,  resources, and opportunities available for medical students and doctors to become more “globalised.” For example, I subscribe to email listservers of GP’s in Portugal, Spain, Brazil, and USA. This enables me to be in daily contact with doctors from those countries or even further afield; for instance, the Spanish listserver, MEDFAM, also attracts many doctors from Latin American countries. I find that this regular contact with doctors from other countries, even if merely “virtual,” is extremely rewarding as well as a significant boost to my professional development. It not only allows me to share and discuss doubts and cases from my own clinical practice, but also gain insight about primary care and family medicine in other countries, have access to important literature I would not have known about otherwise, learn about job opportunities being advertised, network, and even practise writing in foreign languages.

Recent networks such as doc2doc take this sort of interaction to the next level by “aggregating” doctors from all over the world. A few years ago, did you ever think it would be possible to engage in a discussion with doctors from Singapore, Australia, or the USA via an online forum? I didn’t, but it’s now happening everyday.

Here in Portugal, a colleague and I started organising listserver based virtual conferences with leading personalities from the world of international primary care and family medicine such as Professor Barbara Starfield. For a period of one to two weeks, the listserver’s participants are able to pose questions to the “speaker” of the conference, who then replies at a convenient time, usually within 24 hours.

Thus, there is massive scope for “immersion” in international environments.  But it’s the “immersion” in a cultural and linguistically different environment (be it at the physical and/or virtual level) that is the key factor in making a medical career more globalised, and that is already accessible at the touch of a mouse click.

So, doctors may not rack up so much frequent flyer mileage as savvy, globe trotting business people, but there’s no reason nowadays for them not to think globally or make the most of dynamic international (virtual) networks.

Tiago Villanueva is a newly qualified general practitioner based in Portugal and a former BMJ Clegg Scholar and editor, studentBMJ