Ultimate Guide to Practicing Medicine in Guam

Guam is where America’s Day begins!  This tropical island is a hidden gem, a place worth exploring if you want to live and work overseas but still desire the comfort of being in the United States.

Located in the Western Pacific, Guam has been a U.S. territory since the end of the Spanish-American War in 1898.  Although very American, it is also described as a melting pot of cultures due to various Spanish, Asian, and Pacific Islander influences. 

Guam’s Health Care System

Guam’s health care system mirrors that of the United States. Medicare and Medicaid are available, as are private insurance that are typically employer-based. There are 2 civilian hospitals, the public Guam Memorial Hospital, and the privately owned Guam Regional Medical City. There are also several large outpatient clinics and many small physician private practices throughout the island. 

Medical Licensure/Registration

As it is part of the United States, medical licensure is very similar to the rest of the US. Guam requires at least 1 year of US residency training. Currently, there is an online form (PDF) that has to be submitted to the Guam Board of Medical Examiners. 

Licensure can take time, but temporary licensure can be obtained in about a month, while awaiting full licensure. In an effort to improve the process, the Guam Board of Medical Examiners will soon be launching an online application. 

Finding a Job

Finding a job in Guam can be challenging as not everyone advertises, and with it being such a small close-knit community, we often rely just on word of mouth.  

So here are a couple of options: 

1. You can start by browsing the Hippocratic Adventures job board. 
2. For inpatient positions, both hospitals are always looking to hire physicians, so a good starting point would be to contact their medical staff office. Locum positions and limited-term contracts are two options worth inquiring about with the medical staff.  
3. For outpatient work, the easiest thing to do would be to reach out to any of the Guam-based physicians on the Hippocratic Adventures Facebook Group and we would be happy to help connect you to potential employers. It’s a small island, so we all know each other!

Of note, you may be eligible for public student loan forgiveness with some of the community outreach clinics within the Department of Public Health and Social Services. 

You can expect salaries to be similar to the US. The private insurance reimbursements are slightly less, but Medicare rates are the same.  

Workplace Culture

Because it’s such a small community, most of the healthcare providers know each other. It makes it so easy to communicate with each other regarding our mutual patients. We also often socialize with each other outside of work, and across different practices. If we don’t know each other, there is only 1 degree of separation so it makes it so easy to communicate!

There’s a lot of respect towards physicians, both from the rest of the team and patients. The staff will never refer to us other than “Doc” or “Doctor X.” It took a while but I finally have some long-term team members calling me by my first name outside of work (and only sometimes!). 

The patients love to show their love and appreciation. Throughout the year, patients will drop off fruit or vegetables that they grow (mango season is insane—we get huge bags of green and ripe mangoes!). They bake and bring us their goodies (totally ironic since I’m an endocrinologist and they quickly tell me they don’t eat what they bake), or they bring what they pickle or cook, or if they found something delicious and want to share. The holidays are especially amazing, with patients dropping off treats almost daily. 

The patients tend to be pretty honest, so much so that some hospitalists who originally came as locums mentioned it too. If you ask about vices, you’ll get a pretty honest answer. If the patient underestimates their consumption, their family members speak up and quickly fill in the gaps.  

There are not as many services available. Occupational therapists and speech therapists are very limited. Specialty medicine is very limited, and it’s often difficult to get an appointment or completely not available.

If you imagine what is available in a small town of 150,000 people in the middle of the mid-West, that’s what’s available, maybe a bit more. The difference is we can’t drive a few hours to a tertiary care center; we have to fly 4-20 hours to the nearest medical facility, and not everyone can afford to do so. 

Immigration

Since it’s a US territory, as long as you are authorized to live and work in the US, you can work in Guam too! There’s no hassle when it comes to immigration. 

Bottom Line: 

This would be a great opportunity for a physician looking to live and work overseas but still desire the comfort of being in the United States. Practicing medicine here is challenging, but it’s also humbling and wonderfully rewarding. 

We often stretch our abilities as subspecialty care is very limited.  But, at the end of the day, the appreciation and love from the community and the deep gratitude we receive from our patients is a heartwarming feeling that makes the challenges all worthwhile.

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Dr. Erika Masuda Alford was born and raised in Guam and left the island for her undergraduate degree. She obtained a BS and BA from the University of Pittsburgh before attending New York Medical College for my MD, followed by a residency in Primary Care Internal Medicine at the University of Connecticut and a fellowship in Endocrinology, Diabetes, and Metabolism at Baylor College of Medicine and the UT MD Anderson Cancer Center. She returned home to Guam shortly after fellowship with her husband, Andrew, and they are the proud parents of a son and daughter.

Jobs for Doctors in Guam & Other US Territories