Medical Residency in Finland

pedroh7 · Post by **pedroh7** » Tue May 26, 2015 5:45 pm

Hello, I'm a doctor from Brazil, right now in the last year of my training in clinical Neurology. My plans have been, for some time now, to study clinical neurophysiology, meaning, electroencephalography, electromyography, polisomnography and other complementary exams.

I recently visited Finland and it seems to me like the ideal place to raise children. Life as a doctor in Brazil is good, seeing as we make a quite disproportional amount of money compared to other professions, and job stability is good, in fact we get calls offering jobs, I mean, sometimes you don't need to move a muscle to get a job. However life is not just about wealthiness and I don't want my future kids living somewhere where you only walk the streets as little as necessary and only in the daylight, you never drive with windows open, and if that's not enough they have to be all black so the robbers can't see who or what is inside; people beg for money in practically every traffic light, often in an intimidating manner, they charge you to look after your parked car (it is implied that they may or may not empty your tires, scratch your car or just rob you right there if you don't pay), so on and so forth, there is just no real freedom, people are jailed inside their homes with electrical barbed wires. I may be exxagerating a bit but this is really not far from the truth.

I was impressed with not only the freedom finns have to do and go wherever they want but also how close everywhere is to real preserved nature. Nature is beautiful where I live in too, it's just pretty hard to find it.

Anyway, from what I gathered reading posts here moving to Finland and finding a job is insanely hard, especially for people who can't understand Finnish, which is everyone except for the Finns and the Estonians, and also extra difficult for non-EU citizens.

Even then, I was wondering how easy, or hard, it would be to do medical residency, which from what I understand is considered a master's degree, in Finland. I say this because it seems, from what you say, that immigration as a student is easier since it gives you time to learn the language, which apparently is close to impossible to do outside of total immersion.

Another possibility I thought of would be coming as a Neurologist for the Clinical Nerophysiology subspecialization studies. There seems to be an advantage with this option which is that a Neurophysiologist doesn't talk a lot to patients, he just writes his reports, so it would probably be easier to get by without ultra proficient, perfect conversational levels of Finnish. The problem with this is that I would have to not only validate my diploma as a doctor but to revalidate my title as Neurologist as well, which is something I don't even know how is done.

I already know that for most things like buying medicines, groceries, asking for information on the streets and whatever english more than suffices judging from my short stay there, and even if it doesn't, basic native language will, which I'm confident I'm smart enough to get a grasp on, with enough effort and time.

So, in short, which do you think is more realistic, try to redo the Neurology residency all over again (which doesn't bother me too much because I know the epidemiological profile, amount and kinds of diagnostical resources, therapeutical options and other factors are different enough from here to justify it), or try the Neurophysiology subspecialization? Or none of them?

I'm not really sure about this, not because I don't like the country, I actually loved it, it's green, clean, people aren't noisy or unpolite (actually they were pretty gentle and helpful when I was there with few exceptions). Just because of the language barrier you mention and the fact the country doesn't go out of it's way to attract immigrants, even when they are highly qualified.

Any advices regarding immigrating for residency or the subspecialization?

**Sponsor:**

biscayne · Post by **biscayne** » Wed May 27, 2015 12:18 am

Why don't you try Ireland which is actively trying to recruit specialists, as all ours went to Australia. Ireland is (relatively) clean, green, safe, good to raise families etc. On paper it might not be the Utopia Finland is supposed to be, but it is English speaking, hospital consultants earn an absolute fortune, and there is plenty of nature and coastline. People are relatively friendly and on the whole it could be an easier option for you.

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 2:10 am

Thank you for the reply, I may consider that. I didn't know Ireland was recruiting and I agree that it seems nice. I was extremely impressed with how beutiful Finland was, and also with many other things about the country, but then again the only countries I've been to except for my own were Argentina, Chile, Venezuela, and since my trip which took place in my last two weeks, Finland, Russia (St. Petersburg specifically), Estonia and Sweden (actually only the city of Haparanda in the border). So maybe my views are still a bit narrow. I was just reading, by the way, about how miserable the life of non-EU imigrant doctors is in Sweden. Endless bureucracy to get validated, difficulties to get jobs because you're a foreigner and they always choose the natives first, having to spend years unemployed waiting for the validation process to happen and having to work jobs like taxi driver and such, and that is if they don't refuse you for being overqualified. The reality makes a stark contrast to those dreams of societies of perfect equality and opportunities for everyone.

I won't discard Finland just yet and more opinions are welcome but you may be right, sometimes you are just banging your head against a wall.

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 2:15 am

Ok, I thought I had posted a reply here but it's nowhere. So here it goes, trying again...

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 2:16 am

Oh. There is moderation. Right, sorry.

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 2:47 am

I will add one more question.. since learning finnish is apparently harder than learning quantum physics while drunk, or building a rocket to another galaxy... What about learning Swedish? Doesn't that fulfill the requirements of the autorities and employers? Of course, you still run the risk of not being able to communicate with some older patients, but is that a valid option at all?

rinso · Post by **rinso** » Wed May 27, 2015 7:19 am

Forget Finland. In your specialized field the language will be an large obstical. That you don't speak with the patients themselves doesn't change the demands and tests.
Try Portugal so the language barrier is not a problem.

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 8:36 am

I see your point. Anyhow, about Swedish being an official language of the country. Can most of the Finns communicate in that language? And since it's mandatory at schools the same way Finnish is, is a Finn who can't speak Swedish considered illiterate?

Further, it intrigues me when you say the barrier is intransponible. I will quote Valvira, which is the government organ who licenses medical professionals.

From the website: "Citizens of non-EU/EEA member states need to present Valvira with an official language certificate that verifies they have satisfactory skills in Finnish or Swedish. The Finnish National Board of Education grants two kinds of National Certificates of Language Proficiency and both of them are accepted by Valvira. The tests for the Certificates are quite demanding and Valvira requires that you pass with a Satisfactory grade, at least."

Doesn't that mean I get licensed just fine with good Swedish skills even if I can't understand a word of Finnish?

Maybe that won't suffice in a few real situations envolving people who didn't actually study, maybe they grew up in less prosperous times for the country.

What I would like to know is this: is Swedish enough to communicate? It seems workable, in comparison. Can most people in the country speak and understand this language, as the government dictates?

WRT Portugal, yes, I obviously understand their somehow weird, less fluid-sounding version of Portuguese fine, besides it sounding funny it's okay really

, but then again I am fluent in English and could handle other places just as well.

Oh and by the way I have nothing against learning Finnish, the problem is that many in this board convinced me that fluency in the language in a short time of studying is impossible, and for some (and I hope I'm not one of them, in fact I don't think I'm one of them), it may even never be attainable. So I'm tryng to come up with a realistic solution. If you convince me that going to Finland is crazy regardless of how you go about it, then I'll have to accept it (maybe this forum should be called "don't come to finland"? People certainly give that advice a lot around here), you may be right, after all you know more about life there as I do.

If all fails there is always Norway or Sweden, where a normal human can still learn how to communicate, maybe even Ireland as said above, or Canada. Or, you know, Brazil, since life is by no means bad if you are a doctor here. I'm not running away from a civil war or anything, anyway.

Rosamunda · Post by **Rosamunda** » Wed May 27, 2015 9:52 am

pedroh7 wrote:I see your point. Anyhow, about Swedish being an official language of the country. Can most of the Finns communicate in that language? And since it's mandatory at schools the same way Finnish is, is a Finn who can't speak Swedish considered illiterate?

No, most Finns cannot. The Swedish speakers live in a few towns along the coast and some are scattered in rural areas in the south. There are vast swathes of the country where you won't find a Swedish speaker. In fact, there are some areas where even attempting to communicate in Swedish would alienate you from the locals! It's a political issue too. If there were a referendum on dropping compulsory Swedish, it would probably get through.

Further, it intrigues me when you say the barrier is intransponible. I will quote Valvira, which is the government organ who licenses medical professionals.

From the website: "Citizens of non-EU/EEA member states need to present Valvira with an official language certificate that verifies they have satisfactory skills in Finnish or Swedish. The Finnish National Board of Education grants two kinds of National Certificates of Language Proficiency and both of them are accepted by Valvira. The tests for the Certificates are quite demanding and Valvira requires that you pass with a Satisfactory grade, at least."

Doesn't that mean I get licensed just fine with good Swedish skills even if I can't understand a word of Finnish?

Technically, yes. I guess it would be anti-constitutional if they refused someone a licence because they spoke only Swedish, not Finnish (given that licences are given to people who speak Finnish but not Swedish). However, when I went to Swedish classes most of the students were learning Swedish because they needed it to apply for public sector jobs. Getting a licence is one thing, getting a job is something else.

My gut feeling is that Finland will soon be in position where it has to accept Swedish-speaking healthcare workers because the shortage of Finnish-speaking nurses and doctors is so chronic. My mother-in-law is in hospital and every time I visit I speak to nurses from the Far East who speak Swedish and English. And Swedish-speaking nurses from Sweden. That is, however, on the west coast in an area which is predominantly Swedish speaking. Finland recently "imported" circa 30 nurses from Spain and, if I remember correctly, only three survived the language training, found jobs and remained in Finland. The cost to the taxpayer is quite significant, I'm not sure they will renew the experiment.

WRT Portugal, yes, I obviously understand their somehow weird, less fluid-sounding version of Portuguese fine, besides it sounding funny it's okay really , but then again I am fluent in English and could handle other places just as well.

Yes, your written English is excellent which is perhaps a sign that you could do well at learning Finnish. The few foreigners I have met who have mastered Finnish with a high degree of fluency have mostly been academics and generally Finnish is not their first foreign language.

If all fails there is always Norway or Sweden, where a normal human can still learn how to communicate, maybe even Ireland as said above, or Canada. Or, you know, Brazil, since life is by no means bad if you are a doctor here. I'm not running away from a civil war or anything, anyway.

Well, if you do go to Norway or Sweden (or even Canada) you are more than likely to meet up with Finnish doctors, nurses, dentists who have expatriated!

I have met doctors here who have only basic Finnish (and only average English). Many are not fluent by any means. I'm not sure how the health centres and the hospitals deal with this. My guess is that if you have skills that are in short supply in Finland, you will find a job (have you considered teaching?). Swedish is a way in, but it's a gamble and your prospects will be limited.

I have a neighbour from Portugal and she has very good Finnish. She now teaches (in English + Finnish). Her English is also excellent.

rinso · Post by **rinso** » Wed May 27, 2015 9:56 am

Yes, Swedish only is a theoretical possibility. But you will be restricted to a very limited area. And you will compete with candidates who will speak Swedish and Finnish.

Can most people in the country speak and understand this language, as the government dictates?

Unless you're in a Swedish speaking area Finns don't like to communicate in Swedish. And certainly not about medical terminology.

(maybe this forum should be called "don't come to finland"? People certainly give that advice a lot around here)

Many people think Finland is one of the best countries to live in. Reality is that it is good for Finns, but foreigners (who don't speak the language fluently) have a serious handicap. This makes life much less comfortable for immigrants. You have to understand that before you make a life changing decision.
On the other hand, your children will adept quickly and they will not (less) experience those disadvantages.

Beep_Boop · Post by **Beep_Boop** » Wed May 27, 2015 11:07 am

I second the suggestion about moving to an English-speaking country.

biscayne · Post by **biscayne** » Wed May 27, 2015 1:59 pm

Just to confirm: my country, Ireland, has a serious shortage of hospital consultants and specialists. Our trainee consultants must go abroad for one year, and for obvious reasons they go to English speaking countries such as Australia, then, finding themselves in the sun for the first time in their lives, they quickly arrange to come back after they are trained. The Irish medical schools are well regarded and they have no trouble getting jobs abroad. The US and Aussie hospitals are full of them. We then need to recruit from Nigera, Pakistan etc. This is becoming a huge problem for us. Huge. We simply cannot get good staff. Consultants start on 150,000 per year moving up to 250,000 and can still work privately managing 2 "books" public and private, again a huge problem as the private patient comes within a week, the public within a year or more, same hosptial, tax paid equipment etc. Huge issue. If you have the qualifications you say, you would get a job, well paid, very soon and have no language issue at all. Why make life so hard? You would make enough money in Ireland to live in the top 10% of the population. You would live in the nicer areas of whichever city you want. As I said, on paper Finland might look better, but Ireland has good public schools too, and in many ways a nice quality of life. I've lived abroad for many years, but return about once per month and am in the process of moving "home", and have been really surprised at how nice the quality of life is.

Beep_Boop · Post by **Beep_Boop** » Wed May 27, 2015 2:50 pm

biscayne wrote:You would make enough money in Ireland to live in the top 10% of the population.

Your comment is gold, except this part.
That's a huge huuuge underestimate. According to the Irish Central Statistics Office (CSO), the median gross income for full-time workers is €32,000. This means that earning more than 32k per year automatically puts you in the top 50%. A household that earns (daddy + mommy) more than €75,000 a year is in the top 10% of household incomes.
Earning 150k easily puts you in the top 1%, and I'd say it's even smaller.

pedroh7 · Post by **pedroh7** » Wed May 27, 2015 3:11 pm

Ok, I guess Finland really may be way harder than necessary then. I'll look into Ireland... It sounds better and better the more you tell me. And I guess I can always spend a few days on vacation if I miss Finland too much. Someone said before that Finland makes for a great postcard, but that's it. It sure was an unforgettable place for me. And it probably has a lot to offer, especially to the students that go there all the time, brazilians included even, thanks to Brazil's own "Science Without Borders" program. Shame it apparently isn't for me. No problem, I keep my expectations low regarding mobility, immigrating is comparatively harder for doctors already and I knew that. Thanks for the suggestions, I for one never considered Ireland before; you opened my eyes to some interesting possibilities.

biscayne · Post by **biscayne** » Wed May 27, 2015 3:47 pm

Adnan, I would need to research it properly, but to me, those figures are way off. A salary before tax of 32k is extremely low in Ireland, even taking into account that the first 12k is a tax free allowance. I'm a nurse and my salary there before I left, was wayy over 32k. Now it would be about 65-70k based on what the recruitment agencies which are dealing with me are saying (as I'm just about to go "home").

A salary of 32k won't go far in Ireland for a family situation as we have the most expensive childcare costs in the OECD - we don't have a state kindergarten system. You have to pay almost 1000e per month per child for full time day care which eats into the salary. Once the kids are out of day care and in school, the family sees a dramatic rise in income.

I won't argue with you until I've done the research, but I reckon 32k is off. Aside from that - consultants make amazing money (note that I said consultants, this means a specialist physican with a HSE - Health Services Executive - contract which compels him/her to see x-amount of public patients per month/year for which he/she is well paid and they are allowed to run a private service from their office in the public hospital) But the op is saying he is a specialist and I know for a fact the hospitals are crying out for specialists, for example the entire country has 1 pediatric rheumatology specialist and the poor kids wait up to 3 years for an appointment. Shocking. Meanwhile all those we have educated at public expense have fecked off to Canada, Oz, NZ, USA etc. Shocking.

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