Can NPs and PAs work outside the U.S.? If so, under what circumstances?

Because my chances of getting into a U.S. medical school are practically non-existent, I was advised to consider to consider NP and PA.

I am most interested in health work abroad; I currently help run one urban and one rural health clinic in northwestern and western Mexico. We have four clinics total; all four are free clinics. Instead of administering such clinics, I’d like to contribute more to diagnosing and treating illness. Given the level of violence in Mexico, it is increasingly difficult to get U.S. doctor and medical students to come down to our clinics. Which is understandable given that our clinics happen to be located in areas where there is a high level of drug gang activity. (Neither provider nor patient has ever been hurt or targeted.)

If I could do some of the work myself, it would ease the burden of trying to find outside providers. We do have Mexican doctors and surgeons come in as well, but having the alternative expertise (e.g. U.S. expertise) and technology is very useful given the problems we face.

Would NP or PA work in Mexico? None of the Mexican doctors have heard of those degrees and they weren’t sure about the legality, although the suggested that someone having such a degree would only be able to work under limited circumstances due to liability issues.

Any thoughts on this?

As an addendum to the above, I have been encouraged to reconsider medical school as well as NP and PA. My colleagues point out that because my interests lie in international and rural health, having an MD would be better than a PA or NP. But I need to first convince med schools to admit me. One option is to go to a foreign medical school.

I don’t have any specific answers for you, but I do wish you the best of luck with it all.

I really don’t think you should give up. Are you not able to get into an osteopath school? I’ve been reading the message boards on people with lower gpa’s and have been admitted. Your gpa doesn’t sound too low to the point where a D.O. school will not accept you. You should still try that route. In regards to your testing skill, that is one thing you will need to figure out whether becoming a PA or NP. They all require exams. Also, I’ve been working in the alternative med. field for the past 5 years. I think you should consider altering your diet and remove gluten and dairy from it, especially if you think you may have ADD. Consider your lifestyle, exercise, yoga and diet. This may all come in to play with your thinking and anxiety during a test.

Good luck and don’t give up.

I think it depends in what capacity you want to work, organizations like Doctors without borders often employ NPs and other healthcare providers in a lot of other countries but when you are not directly working with a well known organization the local governements have different scopes of practice and may not recognize even DOs as physicians because in some places they are considered more like chiropractors and cant perform surgery etc. In short I think you will have to do some careful research with your particular goal in mind. I agree dont give up! I also want to practice in underserved national and international rural areas and have decided I must pursue MD so that I dont limit my options even though I would otherwise also consider DO. Good luck and let me know if you find anything else interesting.

PS do you speak fluent spanish? Perhaps you could get your MD in mexico or puerto rico? or even carribean might be better than NP because you could still practice internationally. Just a thought.

Good suggestions on diet. I’ve already cut out most red meat. That’s hard to do when you go to Mexico as often as I do; the locals love meat! I used to be a lactovegetarian, but lost it when I started volunteering in Mexico.

But I can cut out wheat by eating corn tortillas, eat chicken instead of beef. I never eat pork or ham.

At our clinics, the local village women cook for us, in exchange for our free services and free products.

  • en0920 Said:
PS do you speak fluent spanish? Perhaps you could get your MD in mexico or puerto rico? or even carribean might be better than NP because you could still practice internationally.

I do speak Spanish, but I am not yet fluent; however, my Spanish does get better each time I go to Mexico or Central America or when I venture into some neighborhoods in Southern California, where I now live. I learned Spanish as an adult, mostly by speaking it, so Spanish doesn't come naturally. I have been told that I have less of an accent compared to other "gringos."

I have considered the Puerto Rico programs and at least one Mexican medical school is interested in me given my work there. But since I will be a foreigner, I an unsure about loans.

As far as limitations, yes that is a factor. The organization with which I volunteer is encouraging me to pursue MD since it would be easier for me to continue volunteering for them. MD is a universally-recognized degree, whereas PA, NP, and DO are more-or-less unique to the U.S.A. While many countries recognize DO, some strangely still do not. Fortunately, Mexico is one of the ones that do recognize DO degrees.

Given the similarities between DO and MD training, I still wonder why DO schools don't confer MD as well; MD is still the recognized degree. I recently came across a reference to the initials MD after a doctor's name in a textbook from the early 1400s!


I have been reading your posts for a while now. You are the only one that can decide what you want to do. Apply to medical school, apply to be a PA or an NP, this is all up to you.

Do your research and the best thing to do is speak to the admissions office at the school that you are interested in. That way, you will have THE best advice possible. Remember that the GPAs and MCAT that you see are averages. Some people have higher GPA some have lower GPAs. Same with MCAT.

A lot goes into getting into medical school beyond GPA and MCAT. There is a lot of discussion regarding an applicant and their credentials.

Also remember that AACOMAS replaces repeat grades with better ones and the older ones are not calculated into the final GPA. If you do get an interview that would be the time to shine and be able to explain to the interviewer what you would like to do.

In the end, it comes down to what YOU want and how YOU will do it.

My best advice, get the information directly from the horse’s mouth. Call a medical school near you and see if the admissions director will make an appointment with you to discuss your credentials and then take if from there.

Good Luck.

I second gabelerman’s post. And I have something to add: If you have a compelling story (and present it well in a captivating personal statement), that goes a long way, too.

I was just at the OldPreMed annual conference this past weekend, and one of the sessions was a workshop entitled “You Are the Admissions Committee.” We got to look at real medical school applications (with the identifying details whited out) and decide (not for real, of course), in groups of 5 or 6, whether we would invite that candidate in for an interview. It was an eye-opening experience.

One candidate was rejected across the board, not so much for his grades or MCAT score (they were OK), but because he lacked motivation, initiative, and maturity. The absence of these qualities was reflected in his lackluster personal statement and descriptions of his extracurricular activities.

A second applicant - whose cumulative grades (regular and science) and MCAT were MUCH lower than the first, although the grades did show a significant upward trend - was accepted for an interview across the board because he showed the very qualities the first candidate lacked. His personal statement was incredibly compelling, and his passion for medicine was almost palpable.

This just goes to show that it’s not all about the numbers. You can do other things to set yourself apart from the crowd.

Best of luck, whatever you decide.