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From what I can tell the U.K. is basically all downside - poor resources, poor autonomy, poor respect, poor pay. Great location if you don't already live there and want to get to the West. That's about it. The frog was boiled 30 years ago.
In the U.S. the frog is still being boiled - pay is down, respect is down, autonomy is down, documentation burden is up, malpractice is a joke, but pay is still fucking great (especially if you want to hustle), job security is absurdly rock solid (post-training....alarming during training), and we have the most resources and ability to do interesting shit, research, etc.
There's no doubt that almost all doctors in the world who aren't moored to a specific location would head over here in a heartbeat if given the chance.
But it's also worth considering the opportunity costs. Poor pay hurts less in Western Europe where nearly everyone's jobs are shit.
In the U.S. people in medicine feel like they are missing out on lucrative careers their peers are doing. You can argue they are overconfident in this, but it's not really arguable that doctors (at least during residency) are the hardest working professional class in the U.S., and you do frequently see them roll out into other fields like tech or consulting and kill it.
So yeah the U.S. miserable but it still has some benefits and I'm continuing to work here. If you snap your fingers and dump me in England? Shit I'm going to go farm or something instead.
Back when my dad telling me the UK was a nation in decline, my rejoinder was that it's better to move to a rotting edifice that is several decades ahead of us and only stagnating, than to sit back here.
In a similar vein, whatever problems American doctors have (I'm sure they do have problems, there's nothing perfect), they are experiencing a decline from a peak the rest of us have to crane up at in awe.
Being poor, or just mediocre, sucks, even if you don't have the same degree of unhappiness from comparison.
UK doctors make similar complaints, pointing to their friends who went into finance, consulting and so on and make double the money, in half the time. They feel the contract was broken, that the promise that as some of the most talented students who went through a rigorous training program of many years and made them highly skilled workers, they should be paid commensurately.
Some of them do jump into finance, but the sheer cramped smallness of the UK means there really aren't all that many places to go or ways to win big. The country itself constrains their options. I consider trying to apply for jobs in Pharma, as a medical lead or liaison, but my nature as a foreigner diminishes my worth to them, primarily as it stands in wrangling regulations and knowing the right people to push things through. Or I considered learning ML, but then that's become even more saturated.
And here I was talking about giving up and returning to till my ancestral farms, if the people who stole the land and genocided the village won't ask too many questions haha.
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