An i­nternational locums assignment, and the (failed) quest to find good pizza

The origin of Dr. Bryan Smith’s locum tenens career was one that began, he says, out of desperation. He found the credentialing process for his new permanent job was taking a long time, so he decided to take an assignment in Bellingham, Washington, to secure some income while waiting. He also did a brief stint in Florida.

After working a few domestic locum tenens assignments, Dr. Smith and his family decided to uproot and move to New Zealand at the beginning of 2017.

There was a confluence of reasons for taking such a leap, he says. “One, I’ve always wanted to be here, practice in another environment, where practicing medicine wasn’t too dissimilar to America. It was, of course, somewhere that is English speaking,” he notes.

They also felt after 2016 that the time was right to venture beyond America.

“To be perfectly honest, we decided at the end of the year that taking an assignment internationally was an ideal move for the family,” he shares. “My wife said, ‘If we’re going to do it, let’s do it now.’”

With some trepidation, Dr. Smith and his wife packed up and moved with their two teenage sons so Dr. Smith could begin his assignment in New Zealand. Surprisingly, he found that his wife and sons adapted quickly, and acclimated well to school there.

“They were nervous, but it worked out. The kids adapted better than we did,” he admits. “They love their school, which is a bit different, but it’s definitely a positive experience from an educational standpoint. And my wife now loves it here.”

Unsure if this would turn into a long-term assignment, and after initially planning on working for just a year, Dr. Smith and his wife discussed remaining in New Zealand beyond that.

“I was here for about three months and I was offered the clinical directorship, which is an administrative job that is essentially in charge of the medicine department, and all medicine subspecialties,” he shares. “It’s a full-time administrative clinician job which I took, and I was able to make a difference at the facility that basically changed the way the system runs.”

From the time he accepted the position, he felt he hadn’t fully fulfilled his vision for change at the facility, so he kept the permanent contract and hasn’t anchored himself with a definitive deadline for staying abroad.

“We’re not sure how long we’re going to be here, but for the time being things are looking good.”

Exploring and embracing a different culture, both personally and professionally

Dr. Smith and his family weren’t naïve – they knew this move would be an adjustment, although they were all in agreement about one condition: the assignment needed to be in an English-speaking country. “Since my foreign language skills aren’t that great,” he jokes, “we narrowed it down to Canada and New Zealand.”

“I’ve been interested in New Zealand for a long time. It’s a very small country and sparsely populated. We’d looked at Australia, but it seemed pretty pricey,” he says. “New Zealand seemed like a much better fit, and nothing appealing in Canada popped out at us, so here we are.”

He and his wife feel choosing an international assignment has been an incredible opportunity for the kids. “This is an experience they’re going to carry with them forever,” he says. “That’s huge for me.”

This move has also allowed them the opportunity to travel to places that would be much more expensive and time-consuming had they taken them from the States.

“We’re in a place where we can travel to exotic areas, areas that would be almost prohibitive to travel to if we were home in the U.S.,” he shares. “We’ve gone to Fiji, Australia, and we’re planning a trip to Thailand soon. More great experiences for the kids.”

Not only was the cultural shock to his family at the forefront of his mind, but there was also the difference in the healthcare system, and how that would impact his career and income. However, he says, “from a practice standpoint, the experience has been extraordinary.”

“The compensation in New Zealand is quite good and I can live comfortably here, but you’re not going to get rich being a physician here, which is fine by me,” he says.

Acclimating to a different approach to national healthcare

New Zealand has a health system that is heavily government funded, meaning there is virtually universal access to healthcare. New Zealand’s system frees patients from financial and other barriers, and they have an integrated and preventive rather than curative approach to care.

“This is an entirely different type of system than the U.S. in that there’s no financial or profit-based motive behind healthcare,” he shares. “There are limited resources, and the driving factor seems to be the allocation of resources so most people have access to healthcare. This is a very positive experience for me.”

Dr. Bryan Smith

The downside to international assignments? Homesickness – and pizza

“We miss our family. My father- and sister-in-law visited over summer, which is winter back home,” he says. “My mother lives in Pennsylvania and she’s not able to get down here.”

The cost to travel here is fairly prohibitive, so they haven’t been able to see family as much as they’d like. Another drawback? “I miss pizza. New Zealanders couldn’t make a pizza to save their life,” he jokes. “And I miss root beer, and ice in my drinks.”

“There really isn’t New Zealand cuisine per se. There’s a lot of lamb which I enjoy, but there are also the most bizarre food combinations,” he says. “You go to a grocery store and there’s a tenth of the selection seen in U.S. grocery stores. It’s just an adjustment, but it’s one that’s worth it when everything else is taken into consideration.”

Adaptability is key for international assignment success

Even though Dr. Smith eventually plans to return to the States and find a permanent career, he and his family are content at the moment. As a hospitalist and internal medicine physician, he’s found his career doesn’t have a direct equivalent in New Zealand, but he found that this assignment has enabled him to define himself as something more than a general physician. He does, however, miss being what he calls a “pure hospitalist.”

“The term hospitalist doesn’t translate; nobody really knows what that is,” he says. “But one thing to keep in mind is that no matter how much research you do, you have to prepare to be adaptable and flexible. This isn’t a problem for me, though. It’s thrilling.”

Dr. Smith has found his locums assignment in New Zealand has been challenging at times, but it’s ultimately been an incredibly rewarding experience.

“This is an absolutely beautiful country. It lacks a lot of the things that the U.S. has, and it has a lot that the U.S. will never have. I’m certainly not wishing to escape anytime soon.”

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