The Hippocratic Adventures Toolkit for Physicians Working Abroad

Moving abroad is complex – here, we describe services and tools that have made the lives of fellow adventurers easier. The links to the products below are affiliate links, many of which include a discount for you, while also helping to support this website. We’ll be adding to this list as time goes on!

1. Credit Card With No Foreign Transaction Fee

On your first scouting trips abroad, bring a credit card with no foreign transaction fee. This will reduce your need to exchange cash and helps you avoid the 3% foreign transaction fee surcharge for using a credit card abroad.

Personally, we use the Capital One Venture Card, which accrues ‘miles’ that can be used to pay for travel expenses and hotel stays, at an effective rate of 2% cash-back, which quickly pays for the annual fee of 95$.

2. Managing Currency Exchange

Once you’re ready to move abroad you’ll want a local bank account in your new home country. You will also need a currency exchange service with low fees and which uses the current market rate.

Personally, we use Wise (formerly Transferwise), which allows you to hold different currencies in one account and is frequently touted as one of the most inexpensive means of converting currency, with fees being typically around 0.4%.  If you’re earning US income, you’ll transfer US dollars from your US bank account into your Wise account; convert in your desired currency; and then transfer the amount from Wise into your bank account in your new home country.

For US Citizens and residents, it is important to know that a bank account located in another country with currency other than the US dollar is considered a foreign bank account, and you *must* file the Foreign Bank Account Report (FBAR) if the aggregate balance of all your foreign bank accounts exceed $10,000 at any point during the year. This is intended to prevent tax evasion, and the penalties are steep – $10,000 for a ‘non-willful’ violation. Filing can be done online and typically only takes a couple minutes.

3.  Virtual Private Network (VPN)

A Virtual Private Network (VPN) allows you to connect to a network in another location, altering your IP address to make it seem that you are in another location. That’s right, your trusty VPN allows you to connect to your employer’s US Electronic Medical Record, many of which will block IP addresses from outside of the United States; other important websites that also block non-US users (Experian and certain banks); and of course, your US-based netflix account. As a bonus, most VPN services also provide encryption, adding another level of security to your internet usage.

While there are some free VPN services, be warned – the free services tend to monetize their services by selling browsing data. Besides, a good VPN is inexpensive, costing you only a few bucks per month for the longer-term plans.

NordVPN

These days, the most popular VPN service is NordVPN, which has received consistently high reviews for its speed, ease of use, and the fact that its servers are located in privacy-friendly Panama. Here’s an affiliate link for 3 free extra months with NordVPN.

Private Internet Access (PIA)

Personally, we use Private Internet Access (PIA). It’s simple to configure, and in 5 years of using Private Internet Access, have never run into glitches, and can connect up to 10 devices simultaneously. It’s also slightly less expensive than NordVPN. Here’s an affiliate link for 3 extra months with PIA.

4. Telephone Services

Staying on your phone plan after moving abroad and paying roaming charges to your US carrier is not financially viable; you’ll want to consider different options, based on your usage, including porting your number to Google Voice, or obtaining a new US number for your business or personal use.

Porting Your Current US Number

Going into all of your accounts to change your phone number is a lot of work, not to mention that a lot of services won’t accept a foreign number for two-factor authentication.

Google Voice

A simple solution – shortly before you move abroad – is to port your US number to Google Voice, for a one-time fee of 20$. With the free Google Voice App, you’ll be able to receive text messages (including two-factor authentication) and voice messages on your phone whenever you are connected to the internet, for free; and make calls, for free, to the US using Google Voice through an internet browser. While we’ve been able to send text messages through the Google Voice app on our phones, it threatens us with additional charges if we try to make calls, for unclear reasons.

A couple caveats about porting your number to Google Voice:

First, you must begin the process of porting your number while you are still in the United States. Despite our using a great VPN, Google could recognize that we were not based in the United States, and to circumvent this, I had to work with a family member who was stateside to help set up Google Voice.

Second, porting your number to Google Voice will terminate your contract with your current carrier, incurring any early termination fees that you may have, and can’t be easily undone. As such, I would recommend doing this only 1-2 days before your move.

Third, the process is not very intuitive – here’s a good step-by-step guide to take you through it.

Obtaining a New, Virtual US Business number

Google Workspace

If you have a business Google Workspace Account, you can obtain a new US number through Google Voice, for unlimited calls back into the US for 10$/month. Google Voice can be made HIPAA-compliant by signing a Business Associate Agreement (BAA) for your Google Workspace account.

Zoom

If you’re planning on doing telemedicine back into the US from abroad, Zoom is also a viable option and their Zoom plan – which includes both a second phone line and Zoom conferencing – is 23$/month.

5. Online Notarization

Within a week of moving to Portugal, Ashwini and I each received an email from a state medical board asking that we complete and notarize a form. We initially groaned at the idea of finding the closest US embassy and securing an appointment just to notarize a couple documents, until we discovered that we could notarize documents electronically and online. Within minutes, we had an appointment with a friendly notary from notarize.com for later that day, crossed off this new pesky task off of our long to-do list.

Dr. Emeric Bojarski is a Child, Adolescent, and Adult Psychiatrist and founder of Equilibrium Behavioral Health, a tele-psychiatry private practice. He attended Harvard Medical School, completed residency at Yale-New Haven Hospital, and fellowship at Massachusetts General Hospital and Mclean Hospital.

For a personalized approach to moving abroad, learn about our Guidance Service.

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