Dr Nav Sidhu Profile picture
Apr 15, 2023 17 tweets 7 min read Read on X
1/ Spent the last 30 min on the phone with a UK junior doc and family friend, giving advice on whether to move to NZ or Aus. They suggested I write a 🧵 .... so here goes.
#JuniorDoctorsStrikes #JuniorDoctorsStrike #juniorDoctorStrike @BMA_JuniorDocs
2/ Firstly, agree that the term 'junior doctor' is not perfect and is misconstrued to mean young. A lot of junior docs in UK/NZ/Aus are well into their 30's and have families. All are qualified and trained doctors, who happen to not be consultants
3/ In trying to compare and contrast NZ and Aus, will try to present pure facts. Both places and pros and cons, and there will be nuances and exceptions. I have worked as a junior doc in both countries as an immigrant.
4/ Everyone wants to know about pay. Aus does pay higher wages but that's not the whole picture. Both places have different tax rules and perks. A$1 = 0.54 pounds and NZ$1 = 0.50 pounds.
5/ Aus pay is different in each state. Each has its own 'award' and some are better than others. You can google these yourself.

Generally, they all have an hourly rate (or a rate for 40 hrs/week) that increases each year, and then loadings for time >40 hrs, e.g. 1.5x or 2x.
6/ In NZ, they use avg hour bands but 40 daytime hours are always included. So 4 nights 2200-0700 = 9 hrs x 4, plus the 40 base hours (that you didn't work) for that week.

This is the link to the NZRDA contract (largest junior doc union in NZ). nzrda.org.nz/wp-content/upl…
7/ When reading these contracts, note that one can be a registrar as early as PGY3 in NZ and Aus. This is different from the UK.
8/ In QLD, a PGY4 doc working 40 hrs/week earns A$118,444. Actual pay will be more as they will likely work more hours.

To get the same pay in NZ as a registrar in PGY4, one has to be in the 55-59 hr/week band, though this means actually working 45-50 hr on avg (see #6 above)
9/ Tax rates are quite similar. Nett pay of a $120k salary is $88,133 in Aus (incl. Medicare) and $87,812 in NZ (incl. ACC)

Top marginal tax rate in both countries kick in at $180k: 45% in Aus and 39% in NZ.

But, GST (similar to VAT) is 15% in NZ and 10% in Aus.
10/ The perks are quite different though. Aus has 'salary sacrifice' where a portion of your salary can be used for certain spending, tax-free.

Govt has tried to reduce this in recent years. Many stories of ppl paying for weddings using salary sacrifice back in the day.
11/ On the other hand, NZ completely reimburses you for all costs of training. And I mean all costs. College fees, exam fees, textbooks, travel & accom. for courses and exams, annual registration, indemnity insurance, etc. There is no limit, even with multiple exam attempts.
12/ For balance, the cost for items listed above are tax-deductible in Aus and they do give junior docs an annual CPD allowance.

Additional CPD allowance (over and above cost of training) is given to senior trainees in NZ.
13/ Parking monetary incentives aside, both have very similar work cultures. Almost all colleges are binational.

Both are trying desperately to attract junior docs, esp from comparable health systems.

In NZ, docs now get permanent residency on arrival. Image
14/ As places to live, the biggest cities tend to have more expensive housing, just like any other country in the world.

Other costs of living seem to be a little bit more in NZ, which I put down to economies of scale and being just a little bit further from everywhere else.
15/ In terms of geography, both are beautiful countries. Aus is so much bigger of course, and in NZ you're never more than 125 km from a beach.

Owing to its vast size, there is more diverse wildlife in Aus, but also more dangerous. This is really down to personal preference.
16/ There are other differences that are harder to quantify: political leanings, treatment of indigenous peoples, social outlooks, levels of misogyny, attitudes to climate change, levels of religiosity, etc

There are not all important to everyone to the same degree
17/end
Moving from ur land of birth is hard. Been there, done that. Some move and choose to return. Many stay. I always tell people it's a personal choice, as my reasons won't carry the same weight or meaning as yours.

We are privileged in that we have a choice - not many do.

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More from @DrNavSidhu

Jun 18
1/ So, this document just dropped today from @ANZCA, GESA, NACOS, @AUDiabetesSoc

A consensus expert opinion on what do to with patients on GLP-1 RAs presenting for endoscopy and #surgery.

Let's unpack it in this brief thread 🧵
#Anaesthesia #Anesthesiology Image
2/ Focusing on pre-surgery.

This stands out: No evidence to support stopping these drugs before surgery, except for liraglutide on DOS (because it's once-daily dosing)

Followed by: Anyone taking these in the last 4 weeks should be considered unfasted and having a full stomach
3/ Bold because it's different. The @ASALifeline recommends stopping for 1 week (weekly) or 1 day (daily dosing. 👇

asahq.org/about-asa/news…
Read 11 tweets
Nov 8, 2021
1/
Some recent chatter about single-moment-in-time high-stakes examinations. Let’s call them #SMITHSEx for short.

Here’s why I think #SMITHSEx is dirty and should be consigned to the rubbish bin, as far as postgraduate / specialty medical training is concerned.

A thread 🧵
2/
Been ruminating on this for a while, and a recent #ICRE2021 thread on #SMITHSEx got my attention. @ICREConf
3/
A few things happened soon after. A good friend didn’t pass their #SMITHSEx, by a small margin. Meant that they couldn’t take up permanent consultant / attending post that was already offered to them, in the dept they had trained in for the past 5-7 years.
Read 13 tweets

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