It is no secret that many doctors dislike the U.S. health care system. They spend four years in college preparing for medical school. They spend four years in medical school then they must spend three to seven years in a residency program. In residency they work 60 to 80 hours a week for a starting salary of $60,000 a year, rarely rising to more than $75,000. By the time they are free to practice they are roughly 30 to 35 years old with $200,000 to $350,000 in debts. Some find their specialty is highly lucrative, while others find their only options are to work for a hospital or a staffing agency. Hospitals want them to generate revenue by seeing as many patients are possible. Staffing agencies (often owned by private equity) have a business model of holding costs down by understaffing and underpaying. It can become incredibly stressful.
The Wall Street Journal wrote about U.S. doctors who decided to take drastic measures by moving out of the country:
Four years ago, Dr. Brandon Williams, an internal-medicine doctor at a hospital in La Jolla, Calif., reached a breaking point. An increase in patients, not enough medical staff, the threat of malpractice lawsuits, and distress about patients’ inability to pay for healthcare got so bad that he developed post-traumatic stress disorder. One of his colleagues died by suicide.
He didn’t want to stop practicing medicine—but he wanted to stop practicing medicine in the United States.
Dr. Williams moved his family to New Zealand, to a coastal community that is a hub for American expat doctors. WSJ reports that American physicians’ interest in moving to New Zealand has boomed in the past few years. English is the primary language. Many medical specialties require no additional training or certifications. Working for a public health system may feel quite different than working for a U.S. hospital. WSJ did not say this but whereas American hospitals expect employed physicians to see as many patients as possible to boost revenue, the opposite is often true in countries with a single payer health care system. Patient care is a cost center, not a revenue center.
New Zealand welcomes American physicians and makes it easy to work there. More from WSJ:
In 2025, New Zealand announced a series of changes to make it faster and easier for overseas-trained doctors to register and work in the country. There are currently about 530 American doctors working in New Zealand, up 29% from six years ago, according to the country’s health minister.
Interestingly, many countries do not make it so easy for foreign-trained physicians to practice medicine, even for experienced physicians. The United States requires most foreign-trained physicians to go through residency again, lasting three to seven years. When I was researching medical tourism, Costa Rica is the closest country with high quality medical care at prices one-third of those in the U.S. In my research, Costa Rica made it clear that U.S. doctors cannot just move there in retirement and put up a shingle.
New Zealand-trained doctors often want to live in major cities, whereas many of the American expats are happy to work in smaller towns that became hubs for American doctors hoping for a less stressful, slower pace of life. There are plusses and minuses. New Zealand is nearly 7,000 miles from the West Coast and nearly 9,000 miles from the East Coast. Depending on where you live, housing may be cheaper or more expensive than what you are used to. Salaries are lower. One expat physician told WSJ she experienced a 35% pay cut but works less and gets six weeks of paid vacation. Several of the physicians profiled in the WSJ article were married to attorneys, who found it less convenient to work in their profession. They will have to retrain on New Zealand laws.
Overall, the American doctors who moved to New Zealand seem happy to enjoy a slower pace of life. There is probably also an element of adventure to their relocations. New Zealand is a scenic country and it easier to navigate than one where English is not spoken. For doctors looking for a slower pace in small towns there are likely plenty of options here at home in American. Salaries are often higher since most doctors prefer larger cities. Also, opening a direct primary care practice is another way to slow down and enjoy life outside of hospital and private equity employers.
Read more at WSJ: Doctors Leave the U.S. for Timaru, New Zealand