In the summer of 2012, I left my job as an emergency medicine physician at an academic center and moved with my family to Norway. My colleagues told me I would be risking my career. As it turned out, this courageous step and a fortuitous opportunity changed my career trajectory in the most unexpected way.
A Seed Is Planted
In 1998, during my emergency medicine residency training, my eventual husband, Bjørn, and I took a vacation to Malaysia. There, we met a young man on the island of Sipadan who was midway through a one-year sabbatical, traveling the world. I asked him how he was able to take such a long leave of absence from his professional career. He shared that his boss would not allow it, so he quit his job. Shortly thereafter, he was informed that he would have employment when he returned. I always admired that.
Bjørn is Norwegian and moved to the US to start a subsidiary in 1996. He was provided with a one-year visa, which was later renewed, and eventually replaced with a green card once we married. Although we chose to remain in the US because of my job, Bjørn frequently pined for his homeland. He kept his Norwegian citizenship, and our three children are all dual citizens.
I, too, was enamored with my husband’s homeland and taught myself more Norwegian each time we traveled there to visit. I insisted that my husband read and speak Norwegian with our three children, including our middle child whom we adopted at the age of five years. Bjørn eventually became an independent contractor and cut back his work dramatically to stay at home and care for our children.
Choosing The Right Time
Being naturally debt-averse, I paid off my student loans and saved up a substantial fund that was earmarked toward taking a one-year sabbatical in Norway. We decided that “someday” should be when our children were old enough to get something out of the experience, but not too old that it would disrupt their education and social lives. In preparation, we enrolled our children in Norwegian lessons online for Norwegians living abroad.
We took the plunge in July 2012 when our children were eight, nine, and ten years old. We were fortunate to find a family relocating from Australia that rented our home in Massachusetts, inclusive of our two dogs and minivan. The decision to leave our dogs behind was not taken lightly. However, the Australian family was eager to have pets. We hired someone to manage our two rental duplexes. The rental income was enough to cover our mortgage in the US plus our rent in Norway.
We painted a picture of a great adventure for our children, but when I took a photo of them sitting on suitcases as we left the US, there was nothing but tears and fear of the unknown.
Risking My Career
I felt fearful of the unknown and wanted to keep my foot in the door at my job in the US. Initially, I had proposed to my boss that I would go down to 0.25 FTE, working two weeks every two months, but this was rejected due to concern that my colleagues would want the same, making staffing cumbersome.
“My fear of regret won over the comfort of stability…”
Instead, I was granted a one-year, unpaid leave of absence. A colleague warned me that I would be risking my career by leaving my stable academic position. My fear of regret won over the comfort of stability and I accepted the leave of absence.
I knew that I would not be able to work in Norway as a physician, as there is no reciprocity in medical licensure between the US and Europe. Nonetheless, I submitted my paperwork to start the process of obtaining a Norwegian medical license (which typically takes at least six years), just in case I decided to return to Norway in retirement. For more on licensure see The Ultimate Guide to Practicing Medicine in Norway.
An Unexpected Twist
Word soon got out that there was an American emergency medicine doctor living in rural Norway, volunteering as a swim instructor at her children’s school. At the end of December 2012, a Norwegian anesthesiologist contacted me. He had been hired to create Norway’s first emergency department at the country’s largest hospital which had the worst reputation for patient complaints and deaths in the waiting room. The Icelandic CEO of the hospital wanted to institute an American/British/Australian model that would place an attending physician in the emergency department (akuttmottak) to supervise the interns and residents. The anesthesiologist, who had prior experience working as a flying doctor in Australia, asked if I would be willing to lead a group of nine doctors for this pilot project.
I obtained a waiver for most of the requirements to obtain a Norwegian medical license given the critical need for someone with my experience. I was required to take a four-month course on the Norwegian healthcare system to gain “knowledge on Norwegian health and care services, health, social security and social rights, cultural understanding, and national focus areas.” Upon completion of this course I would obtain an unrestricted medical license. All communication at work, both verbal and written, was to be in Norwegian. In addition to leading by example in the akuttmottak, I would have the opportunity to take groups of colleagues to France and Australia to participate in international emergency medicine conferences. The salary was approximately one third of what I receive in the US, but the experience would be priceless. Immediately after receiving the job offer, I phoned my boss in the US, explaining the opportunity in Norway. He told me I would be an “idiot” not to accept the offer.
Our one-year leave morphed into two years. I converted my student visa to a work visa and renewed our tenant’s lease back in the US. I do not possess an unusual aptitude for foreign languages, but I can now say that there is nothing quite like trial by fire to acquire fluency.
Integrating Into Norwegian Society
Our children went to the same elementary school that my husband had attended. His former teacher was now the principal. Norwegian children are taught English starting in second grade. Our children became resources for their teachers.
Our oldest son, Erik, was frustrated because he could not read at the same level in Norwegian that he could in English. His request to have extra help from his teacher was denied because he had scored higher than 95% of his classmates on the standardized Norwegian language exam that was administered in the fall. While the Norwegian children were learning English, Erik learned Spanish with Rosetta Stone. He found a best friend and they hope to attend the same university in Oslo next year. Our middle (adopted) son, Nikolas, picked up the Norwegian accent better than the rest of us. He joined a local gymnastics club and easily made friends with the other boys and spent his free time biking around town. Our youngest, Annika, took horseback riding lessons over the border in Sweden and often looked after her Aunt’s horse that lived on our farm. One of her greatest worries was that she would speak English with a British accent when she moved back to the US.
We spent school vacations traveling around Europe, including England, Spain, Portugal, Croatia, Denmark, Germany, the Czech Republic, Italy, and Austria.
Repatriation to the United States
Bjørn could not reside outside of the US for more than two years without losing his green card, so we repatriated in July 2014. The Australians were renting our house until the end of August, so I took a two-week, family-friendly locum tenens assignment on Nantucket. This was followed by a five-week cross country trip, including an overnight hike into the Grand Canyon.
After returning to school, the kids noticed that they no longer had the freedoms that they had in the Norwegian school system. There was more focus on academics and less free time, outdoor activities, and recess. Erik aced a pop quiz on European geography. At work, there was a hiring freeze at my previous job, so I took a job for a contract management group one hour from home. I returned to my original job a year and a half later when a position became available.
“Contrary to risking my career, I developed my niche within emergency medicine…”
Contrary to risking my career, I developed my niche within emergency medicine: specialty implementation in Norway and importantly the pilot project helped establish the specialty of Emergency Medicine in Norway. I have had my work published, I have represented Norway on international committees, and have been invited to speak at international conferences.
Lessons Learned
My story could have had multiple endings, but with adequate preparation, courage, optimism, and flexibility, one can withstand almost any challenge. It is only by moving outside your comfort zone that you can learn what is possible. In retrospect, I am glad that I was not allowed to maintain a 0.25 FTE in the US. Doing so would have hindered my integration into Norwegian society. I have no regrets.
Dr. Gayle Galletta attended medical school at Georgetown University and Emergency Medicine Residency at Henry Ford in Detroit. Most of her two decades as an attending have been spent at the University of Massachusetts and its affiliate community hospitals. From 2012-2014, Gayle took sabbatical and moved to Norway with her husband and three children. While there she was unexpectedly recruited to help establish Norway’s first emergency department, paving the way for emergency medicine specialty recognition by the Minister of Health in 2017.
