Do you want to work in an exotic locale? In a different country every couple of years? Have the challenge of practicing healthcare with limited staff and scarce resources? Do you want to look after a small group of patients whom you see on a regular basis?
Medical personnel working as foreign service employees with the US Department of State get to do all this. And they receive paid housing (or a tax-free housing allowance), health coverage, federal retirement benefits, free education for dependent children, and paid leave. Sounds good, doesn't it?
It sounded good to Carol Dorsey back in the early '80s. All it took for the family nurse practitioner (NP), who was working in rural at the time, was a small two-line ad in a nursing journal and she was off to her first job looking after embassy staff, in Yaounde, Cameroon.
Initially, Dorsey planned to stay with the Department of State for just two years, but she found the work so fulfilling that, 22 years later, she is still a foreign service employee. Now, however, Dorsey and her husband live closer to home, in Washington, DC (where the Department of State headquarters is located), and she is responsible for recruiting NPs and physician assistants (PA) to work in embassies around the world.
On the Job: What's Involved
The Department of State hires health practitioners (NPs and PAs), medical technologists (these positions are more rare), and regional medical officers (physicians and psychiatrists). There are currently 130 medical personnel who care for Department of State employees and their families. Starting salaries for PAs and NPs range from US$55,901 to US$82,093.
New employees must serve an initial two-year tour, and he/she must be willing to serve anywhere in the world. For the first two postings, which are both two years in length, new hires have no choice in where they will work; after that, however, they can rank their order of preferences, and they have a good chance of going where they want.
Health practitioners may serve in remote locations where they are responsible for all aspects of medical care for embassy employees and their families. And, in these situations, the job can be very demanding: while they may be assisted by locally hired staff (Dorsey worked on her own in some postings; in others, she hired local nurses), they are generally on call 24/7.
In some cities, such as Rome and Paris, the Department of State does not post foreign service medical providers but utilizes local resources. But in other major cities, such as London and Cairo, where the foreign service does use NPs, the work involves primary care, coordinating medevacs, and preventive health education.
Most of the posts, however, are in medically underserved areas: "You are often practicing what I