Inside Tomorrow's Pharmacist (2003)

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Work your way round the world

Work your way round the world by Sarah Marshall

Can you answer yes to any of the following?

• Do you love to travel

• Are you looking for a new challenge

• Do you fancy gaining experience of a different side of pharmacy

• Do you want to explore a new country and culture and be paid while you do it

• Is your eye always drawn to the adverts in The Pharmaceutical Journal for jobs in foreign climes

• Do you have a partner who works for a multinational company abroad and you want to go too

If you said yes to any of the above, working as a pharmacist abroad may be just what you are looking for. The good news is that with flexibility, hard work and a sense of humour, pharmacy can be a portable career.

I have just returned to the UK having spent the past nine years working in the Sultanate of Oman in the Middle East and subsequently in the Netherlands, my husband's job having taken me to these locations initially. Both experiences stretched and enriched me and broadened my outlook. In this article I aim to give you some pointers and practical tips to get you started if you want to move abroad.

Find out more

First, you need to identify the country you would like to work in and find out as much as possible about pharmacy as it is practised in that country. What would you gain professionally from working there?

Work in a Dutch community pharmacy, for example, can offer experience in sophisticated electronic prescribing and prescription monitoring, extemporaneous preparations, phytotherapy and homoeopathy. Many hospital pharmacies in the Netherlands will have their own production and quality control facilities and expertise in manufacturing a variety of items, such as IV fluids, other parenterals and solid dosage forms, all under one roof.

Useful starting points include a recently updated bibliography produced by the technical information department of the Royal Pharmaceutical Society of Great Britain¹ citing articles describing pharmacy practice and the role of the pharmacist outside the UK. In addition, the bibliography, which costs £10 (£20 for non-members of the Society), includes addresses for pharmaceutical organisations worldwide.

Finding someone who has already taken the step of working in that country is particularly useful. The best way to do this currently seems to be by networking, since it is not possible to search the Royal Pharmaceutical Society's membership list by country. You could also try contacting the local equivalent of the RPSGB for help or the author of an article covering pharmacy practice in that country.

Is it feasible to work in that country?

If you are answering an advert in The Pharmaceutical Journal then obviously your prospective employer will have looked into this in depth. But if you are trying to find work in a country of your own choosing then you will need to consider whether it would be feasible. Be aware that some countries will be easier for a British pharmacist to work in than others, perhaps because there is no language barrier or culturally the country is closer to the UK. European Union countries may be easier than those elsewhere where your hard won qualifications may not be recognised! Contacting the relevant pharmaceutical organisation is a good starting point. You will need to consider such matters as:

Registration

In order to register as a pharmacist in the country in which you wish to work your qualifications and training will have to be recognised. The Royal Pharmaceutical Society has reciprocity agreements with some pharmaceutical organisations around the world, for example Australia. This means that pharmacists registered in the UK who graduated from a UK pharmacy school do not have to sit qualifying exams once they arrive in Australia, although an assessment and other requirements (for example, a letter of good standing from the Society) may be necessary.

Elsewhere, it may be necessary for the British degree course and training to be compared with that of the country to which you are applying. Be prepared to submit copies certified by a solicitor of documents such as:

• Degree certificate

• Registration certificate

• Curriculum vitae (including details of practical training before registration, and subsequent work experience)

• Birth and, if relevant, marriage certificates

• Passport and photographs.

In addition, a full transcript of your academic record throughout the course, including marks at the end of year exams and assessments may be required and a written or oral examination as well as a letter from the Society stating that you are registered and in good standing. Depending on your destination you may have to have these documents translated. As you can imagine this process takes (a very long) time so it is worth getting on with it as soon as possible and don't discard any paper work from your degree course yet.

If, for example, the UK course is not deemed comparable to that of your destination you may have to work at a different job level to that you would be entitled to here. In the Netherlands, for example, the Dutch degree is more equivalent to a British BSc and MSc combined, rendering British hospital pharmacists less qualified than local pharmacists, unless they decide to complete the Dutch course, or work at a different level. One of the keys to working abroad is being flexible!

You should also be aware that some countries, such as Oman, do not accept newly qualified pharmacists to work in state hospitals, preferring those with a specified number of years experience. Believe me it is better to find this out before you go!

Language

If a foreign language is spoken in the country you are aiming for you may be required to demonstrate proficiency in that language before being allowed to practise. The good news is that being able to speak one foreign language may enable you to work in several countries, for example German in Germany, Switzerland and Austria, French in France, Belgium, Canada and so on.

Once again learning a language takes time so sign up for those evening classes straight away! It may not be necessary for you to speak the language to degree level since communication need not be about having a complex vocabulary but more about using well what you do have — a useful skill for a pharmacist to acquire in any language. If you can, try and immerse yourself in the language. The key is practice, practice, practice!

Work permits and visas

These are outside the scope of this article but are very important. If you are already living in the country in which you wish to work the visa allowing you to be there may have to be changed to allow you to work. In addition, a work permit may also be necessary. Bookshops stock a variety of books giving country specific advice on requirements for working abroad. The embassy of the country you are hoping to work in can advise on current regulations.

Health issues

Health issues are also not covered extensively in this article, but include such items as vaccinations and other health precautions for the country you are aiming for. As a pharmacist you will know how to access the most up-to-date information but be aware that sometimes recommendations for tourists and residents can differ. Look into who would provide health insurance for you. Make sure you are fully covered. Bear in mind that some health problems may not be easily treatable in your country of choice; does your cover allow for that?

Professional indemnity insurance

Is it necessary? Who will provide it?

Pensions and tax

Make sure you get advice on your pension contributions and tax situation while you are away.

Finding a job

The Pharmaceutical Journal carries adverts for positions abroad as does the British national press. If the country you are hoping to work in has it's own pharmaceutical publications these may also advertise posts, and some may be available online. Some Pharmaceutical Society websites (eg, Australia) also carry recruitment adverts. If you are already living in the country in which you want to work then networking with local pharmacists is fundamental to finding a job. Make it your job to find a job. Let everyone know!

Being prepared to be flexible can provide rewards. Adapt your approach to suit your circumstances. When I first arrived in the Netherlands I volunteered to carry out a free drug audit for a hospital for a couple of months, while I took Dutch classes. This enabled me to be completely immersed in the language and the professional culture, as well as to get known locally. This subsequently led to paid employment.

For those of us who find ourselves living in a new country every few years as a result, say, of a spouse's job, it is important to weigh up priorities. A salary may be less important than work experience that can go on your CV. There is no shame in working as a volunteer in a pharmaceutical role if it offers valuable experience and contacts which could even lead to paid work later. In Oman I was able to lecture and carry out research into local medicinal plants, an extension of my PhD, which took me to conferences and enabled me to write papers, while I searched for salaried work.

Another tip is to turn your disadvantages into advantages. Sounds hard? Think about where your skills could give you an advantage over local pharmacists. Being a native English speaker may be a desirable plus point, if, say, you are working in the area of international clinical trials. Persuade people that you would be invaluable to them, be brave, be imaginative and take the initiative. Plan ahead. As you can imagine all the above takes time so plan well ahead!

Enjoying your job abroad

Congratulations! You have got a foreign posting and it is your first day. Lastly, a few tips on how you can make the most of your experiences and really enjoy your time.

Keep a sense of humour and perspective

Be prepared to laugh at your own mistakes. Language gaffs can be particularly painful, but no one expects you to be perfect and strangely it can help if you laugh at things with colleagues. Remember, their English may not always be perfect either!

Respect the local professional culture

Of course the way things are done will be different to what you learned about and experienced in the UK. Don't forget that part of the reason you went abroad was to see how pharmacy is practised elsewhere. Watch, listen and learn. You may think the health system has many deficits but be cautious and diplomatic with your criticism. Disparaging comments from newcomers are rarely welcome!

Be prepared for culture shock to strike

There will be days when all your words come out wrong, people laugh at you, the climate is unpleasant and the culture frustrating beyond belief! Hang in there, it won't always be like that.

It has been said that culture shock has four phases. Initially, you may experience a honeymoon phase when everything is new, exciting and challenging, followed perhaps by a time when you become disillusioned with your new environment, everything seems difficult somehow. Subsequently, you may move into an adaptive phase when you accept the new culture's values and then finally an assimilation phase, whereby you feel that the new culture is just as valid as your own. Knowing that culture shock can take this pattern can help enormously in coping with it.

Learn as much as you can about the country you are living in

Take the opportunity to travel and get to know local people. It really helps you to feel part of the place. Make the most of your time there it will pass very quickly. j