best state to live in
 

Hello i'm currently studying for a degree in midwifery in the UK. After gaining my degree, I would like to move to the US and work here, however I dont know how to go about this. Does anyone know how I would find information about this, and how likely it would be that I would obtain a visa.
Also, because I dont live in America, I dont really know all that much about state specifics, only what i've seen on tv/read about. If i give a basic description on what I would like out of a state, would anyone be able to advise me on what states fit this description. Thank you.

STATE IDEALS: hot weather in summer, cold in winter, friendly people, good value for money property wise, possibly near beach, and finally a low crime rate (a must).

If you find that ideal state, please let me know!

("Good value" and "near beach" usually aren't found together.)

You might want to do some research and see what certification you will need to complete in order to practice midwifery in the States.

thanks for the reply! Do you know what kind of state would fit my description minus the 'near a beach' part? Also do you have any idea how I would find out about what certification I will need? thank you

I really don't know, except we have a friend who is a midwife in Oregon.

There are beaches in Oregon, obviously, and better values to be found than in California. Weather can be difficult, I hear.

Google Midwife Certification in Oregon, and see what you find.

Thank you I'm looking into it now:) How do you mean difficult, too hot?

I'm sorry - but what you want to do is practically impossible. You will need to contact the US embassy in London to find out the process for applying for immigration - but expect it to be very time-consuming and unlikely to be successful. Typically the only chance to do this is to have a talent or training that is not readily available in the US - not true in this case.

Separately, I'm afraid that a degree in midwifery from the UK is useless in the US. You would need to meet educational requirements and pass a licensing test here. Typically here - that would be an advanced nursing degree - which means 4 years for an RN degree and then another year or two to become a nurse practitioner. (One of my cousins in a pediatric nurse practitioner specializing in neonatology - and her course was 3 years on top of her 4 year RN degree. She is now an associate director of nursing supervising obstetrics and pediatrics as well as the largest NICU in the state.) (The same is true of FMGs - foreign medical graduates - and it often takes a considerble time and additional schooling before they can qualify in the US.)

Also, here is most states nurse midwives are required to work with an obstetrics practice if they are to obtain hospital privileges (and many hospitals do not encourage NMs due to risk/insurance issues.) There are some states in which licensed NPs can set up individual practices - but they are typically rural areas that are severely underserved by physicians and healthcare practitioners in general.

As for where to liv e a lot will depends on the state's laws regarding midwifery - here this is a state and not a federal matter - and Florida - with it's very large geriatric population is not likely to be a state really in need of midwives. Separately, although summer are hellishly hot, winters are not cold, property values are low - but so are salaries - and the crime rate varies by location. Property near beaches is esepcially expensive and property taxes can be very high.

But - your first step really need to be the US embassy to find out if you wold qualify for immigration at all.

Probably every US state has different requirements.

Using Oregon as a 'for instance:

http://www.alliedhealthworld.com/bec...in-oregon.html

"Becoming a Midwife in Oregon"
By Karen Weil, allied health world contributing writer
Published: October, 21 2010


Are you interested in learning how to become a midwife in Oregon? Training includes a combination of education and practical experience. There are multiple entry points into the profession. If one is already a practicing nurse, he or she will want to look into a master’s level program in midwifery. Those just beginning their college careers may also find this to be the best option. Ultimately, aspiring nurse-midwives can expect to finish their education a couple years sooner than if they went to medical school.


Some people find direct entry midwifery a better option. Oregon does not mandate licensure for such midwives. Licensure is, however, highly recommended for several reasons. Only licensed midwives (LDMs) are authorized to administer certain medications or use devices such as IVs that may be helpful in the birth process. Furthermore, if a mother is looking for reimbursement for birth-associated medical costs through the Oregon Health Plan, a licensed midwife must assist her.

Certification as a direct entry midwife is a shorter path for some, but one still must demonstrate a high degree of professional knowledge. This includes practical experience. Before certification, a midwife must have participated in a total of 50 deliveries, 25 of them as an assistant, and must have completed a requisite number of prenatal and postnatal examinations. Aspiring midwives in Oregon must also pass a certifying exam through NARM (National Association of Registered Midwives).

Excellent point, nytraveler. Immigration could be a show-stopper for the OP.

Agree with PeaceOut Oregon is the state for you. http://cms.oregon.gov/OHLA/DEM/Pages/index.aspx
How close to the ocean you want to live is up to you.
I live on the east side of the Cascades in Oregon.
This morning when I got up the temp was 40*F. When I got back from the mountains where I saw snow, the temp was 100*F .

I looked into working as a midwife in Australia and it seemed that because midwifery was in demand there you could quite easily get a work visa- I thought it would be the same for the US as well. Is there any way that the degree and education I will have in the UK will be relevant in the USA, as I thought this type of degree would be universal.


tomfuller- What is Oregon like as a place? Is it rural or more city? And also do you know what temperature 100f is in *c? Thank you

Come on Katie- you can google to convert F to C can't you?

Q please: Why is this post just under Florida and not also under California? :)

And of course, my home state of Oregon. Double :)

Most of the large cities of Oregon are within 25 miles of the I-5 corridor. We have a couple of mountain ranges, lots of farm land, lots of high desert, a long beautiful coastline and many friendly people.
100 Fahrenheit is 37.8* Celsius.
I live about 50 miles south of Bend. Bend is a city of about 81000 with a good medical center.
My trip today took me to the top of a butte to the west of Crater Lake National Park.

Don't worry about the state, you must find out about how to go about getting licensed to work as a midwife. I assume you would be a nurse-midwife as opposed to a lay midwife? Each state has its own Board of Nursing that you need to be licensed with.

Check into the logistics of working here and the location of jobs will narrow down which states you will live in.

<i> hot weather in summer, cold in winter, friendly people, good value for money property wise, possibly near beach, and finally a low crime rate (a must).</i>

Sounds like North Dakota except that it isn't anywhere near an ocean.

HTTY

No - I wold anticipate that the education would be very different - as it is for MDs.

In the US MDs first go to university for 4 years, then medical school for 4 years, then residency for at least 2 years - and as many as 5 or 6 for the complicated surgical specialties - often followed by fellowship programs. so MDs have at least 12 years of school - and mostly 14 or 15 - after high school.

Nurse midwives would typically have the equivalent of a masters - not bachelor's degree - but licensure and the licensing exam/requirements are different in every state. And if they can practice solor or only under supervision of an Ob.Gyn also differs by state. I would suggest that in Australia NMs probably deliver a significant number of infants - whereas in the US the percentage is very small. (Some hospitals don;t allow them to practice at all based on insurance issues - that is - insurance against malpracice - not payment (although I don;t know if all insurance plans do cover NMs.)

So:

1) Find out info on possibility to immigrate
2) Determine which states have licensure requirements you can meet, allow freedom of practice and need more NMs (and you will have to take the standard tests to get a license and may well have to have additional education)

Sorry - healthcare systems in the US and Australia are completely different.

In the US most is private pay based on insurance provided as part of employment benefits - with a significant percentage for the poor provided by a variety of federal and state programs.

My understanding is that Australia provides healthcare to all citizens.

nytraveler - before moving to New Mexico, I would have also said things about nurse midwives. That was certainly the case in NY when I lived there and had children.

Nurse midwives are very common practice here in NM and most babies are delivered by them in hospitals. Unless you are high risk, a NM delivers you. And yes, insurance pays them. They are associated with ON/GYN practices, but they do the delivering.

So, this is a VERY state specific thing. I think it is far more common in less urban areas, and perhaps here in the Southwest.

Yes, it it much more common in the southwest - where there is often a shortage of MDs. It is also somewhat more common in the Pacific northwest - not for that reason - but because many women there are interested in alternative and out of hospital birthing - which MDs typically won't touch with a barge pole. So there are quite a few NMs.

And the laws do differ state by state - as do the hospital rules/regulations in terms of how NMs are allowed to practice.

Not sure of the rules in FL - but do know that the population has a high percentage of geriatrics who obviously won;t need her services.

Sorry - for more detailed information the OP should go to the website of the Nurse Midwife's Association - which will have a huge amount of information and can probably provide a lot of guidance.

American College of Nurse Midwives

http://www.midwife.org

National Association of Certified Professional Nurse Midwives

http://nacpm.org

This information from the former site on education may help:

Midwifery education programs leading to the CNM and CM credentials involve graduate education. Most programs require a Bachelors Degree for entry, but some will accept Registered Nurses (RNs) without a Bachelors Degree, providing a bridge program to a Bachelor of Science in Nursing (BSN) prior to the midwifery portion of the program. Some programs leading to the CNM credential require a BSN prior to entry, but many will accept an individual who has a Bachelors Degree but is not an RN, and will provide an accelerated nursing education prior to the midwifery portion of the program. Programs leading to the CM credential require a Bachelors Degree and specific health and science courses prior to entry.

As is the usual advice. Before you make a huge committment like this, it is prudent to actually visit the US and check out the places you would consider living in before committing to a particular place.

For example, despite all the talk about Oregon, about half of it has a climate quite similar to Scotland's and could not reliably called "hot in summer". Also "near beach" puts you in a really dismal climate.

I didn't actually realise I'd put it under Florida until I'd posted it- didn't mean to :)

Could you explain what '1-5 corridor' means please?
I'm not too sure how I would become a nurse midwife, as in the UK I do a degree to become a midwife. Its a 3 year course and afterwards I'm a fully qualified midwife. From your response I'm gathering that midwives play different roles in america then here in the UK.

Just out of curiousity, do any of you know anyone who have immigrated from the uk?

Are there many differences between North and South Dakota? And are they fairly tolerant of different people e.g aren't judgemental of a persons race/sexuality etc.

Thank you all for your responses :)

Interstate highway 5 runs about 300 miles north to south in Oregon from Portland along the Columbia River to Ashland which is near the California border.

"<i>Interstate highway 5 runs about 300 miles north to south in Oregon from Portland along the Columbia River to Ashland which is near the California border</i>"

The I-5 Corridor runs nearly 1400 miles - it starts at the Mexican border in Southern California, and ends at the Canadian border in northern Washington state. (or vice versa)

"<i>Are there many differences between North and South Dakota? And are they fairly tolerant of different people e.g aren't judgemental of a persons race/sexuality etc.</i>"

Weird question IMO. Ask the same thing about any county in the UK. >>What do folks in Yorkshire or Essex or Oxon think about race/sexuality?<< Can you generalize/generalise really?

But 'in general' those two states are less 'cosmopolitan' than many others. They also can be VERY cold in the winter.

"STATE IDEALS: hot weather in summer, cold in winter, friendly people, good value for money property wise, possibly near beach, and finally a low crime rate (a must)."

Give a temperature range for what you consider to be hot and cold. Those are very subjective terms.

Good value for money property wise - I would think you'd be best off renting rather than buying somewhere to live until you decide that you really do want to live here.

Near beach? Does that mean near the ocean or near "a beach"? If you are open to more than just the ocean beaches, you could consider places around the Great Lakes. For that matter, every state has lakes with beaches, even North or South Dakota. Probably not what you meant but saying "near beach" leaves it pretty wide open.

Not trying to be difficult here, but the ideals you list are fairly vague, a more precise definition would really narrow things down. What is a low crime rate? Everyone wants lower crime rates but what does "low" mean to you. Crime is very specific, you really can't rule out any state based on it as the crime rate varies widely from city to city and from neighborhood to neighborhood within cities.

Check into the requirements for the State of NH. I believe the state licences different categories of midwives, each of which has different educational requirements. Midwives can attend home births as well as in hospitals.

There are some areas where property values are low but since NH doesn't have a state income tax nor sales tax, property taxes are higher than in most other states. Even in a northern rural area, you would only be a few hours from an ocean beach. There are a lot of lake and river beaches.

Cold in winter and warm in summer. We have two nieces who married men from England. One who had worked here previously in the high tech field followed proper procedure and it took several years before they were allowed to move to the US. In the meantime, our niece lived and worked in England as a teacher. Our other niece's husband stayed on after his work visa expired and they eloped. They hired an immigration attorney and followed his advice. Because of the quick marriage, our niece was questioned extensively on why she got married. There was a period of time when her husband could not work.

I agree New Hampshire fits your state requirements pretty well as does Maine, western Mass and southern Vermont. Assuming you mean two to three hours to the ocean is close, at least you can do it in a day trip. Summers are hotter, winters colder and we have less rain than the UK. In most places in the US cost of living (property values) go hand in hand with income levels. My sister-in-law and I are both nurses, I'm in Massachusetts, she's in South Carolina. My property value (and property taxes) are many times what hers are, but my income is also higher.

Re being a midwife. There are lots of midwives in New England, every OB/GYN practice has at least a few and they handle a good portion of the low risk pregnancies/births. But they are CNM (certified nurse midwives) and this is a master's degree - so if you are not already a nurse and don't have any college degree of any kind it will take five years. If your course in the UK is college accredited some of the credits may transfer but you should check on it. I can assure you a three year course in midwifery in the UK will not translate to a midwife license in the US without additional course work (probably several years).

So you have three things to do if you are serious about this - one check the immigration requirements, two pick a location, three contact a college in the state you decide on and see how much you would have to do to get your nursing/midwife license.

Many of you missed the point, assuming OP meets all the qualifications to be a midwife in WHATEVER state she would like to live there's still the problem of obtaining a work visa. Before she could be hired her potential employer would first have to prove there are no US Citizens qualified to fill the position. The Department of Labor is pretty strict on this rule. On several occasion I tried to get work visas for people from UK who were very qualified for the positions I was seeking to fill and was never once successful. In each instance I was required to advertise the position nationally and in one instance the DOL even sent me a list several candidates (US Citizens) who they deemed were fully qualified to fill the position.

So, best words of advise would be for OP not to be too concerned about where she might live as there is never any guarantee she will be able to find employment. Her first priority would have to be finding an employer who is able to hire her. That is going to be a very daunting task. Once accomplished, she will be free to find a place to live near her place of employment (again assuming her potential employer is allowed to hire her).

Lastly, in most instances the potential employee is not allowed to remain in the US during the job application process.

So STEP ONE, OP should contact the US Embassy in the UK and they will explain the entire immigration/work visa process.

Yes, the corollary of RoamsAround's post is that OP would need to have a US employer. It is difficult to imagine that any physician or medical practice would hire a midwife without any experience.

So practically, OP needs to finish her degree and get several years worth of experience before searching for a US employer.

I'm British and have lived in the US for 10+ years. I moved here on a non working visa accompanying my husband who originally had a 3 year visa for his secondment.
After a year here he applied for another post and the company arranged our new visas (I know the paperwork was extensive and we had to travel outside the US to renew so we drove to Canada. It cost several thousand dollars and was valid for 3 more years.)

Another renewal cost the company more $$$ and then after another job change my husband's current company arranged our green card applications.
More paperwork, travel to UK, more $$$ and we now are legal aliens.
Green card will have to be renewed after 10 years or we can apply for citizenship (more $$$).

It was a long haul and only possible because my husband is an expert in his field so eligible for a work visa.

Bear in mind that if you do manage to get a work visa after qualifying, gaining experience and obtaining an offer of an actual job in the US then if you lose your job, you visa is not renewed or if it's not renewable or if your contract ends you are required to return to the UK immediately.
You can't apply for another job and stay in the US as your visa is specific for the original position only.

The easiest option to live and work in the US is to marry a US citizen!

Yes, you can move to Australia and get a working visa there because it is part of the Commonwealth and therefore much easier for British citizens.

As others have pointed out, it's not a simple matter to immigrate to the US. I'm always amazed when people assume otherwise. And just to keep it in perspective, this is not unique to the U.S. Other countries have similarly restrictive laws, not the least of which is the UK. So there's nothing inherently unfair about this.

But to answer the OP's original question about which is the "best" state to live in, it should be pretty obvious that there's no one definitive answer. If there were, everyone would live in that state and the remaining 49 would be empty.
:)

Ha! Good one Judy24. Also, even the most populated states (presumably the ones in which people prefer to live) have places where few people want to live.

HTTY

This much I can tell you. If you don't like the weather where you are living - you may not like the state.

I grew up with snowy winters - but plenty of sunny days and would not now want to shovel snow for any reasonable sum, and we love San Diego.

My oldest niece on the other hand - came out from McLean, VA to Stanford/Palo Alto, CA - SF Bay Area - for her Ph.D and missed having weather/change of the seasons.

She now lives in Ashland, Wisconsin - at the north end of Wisconsin next to Lake Superior - and just loves it.

So - different strokes for differrent folks.

Unfortunately there will not be any employers in the US that can hire her - since the credentials for nurse-midwifery are so different in the two countries. She could apply for a student visa - and probably have to spend 2 or 3 years here to get her certification (at a very high price) but then there is no guarantee she would qualify for a job and get to stay.

Typically with FMGs that enter based on their credentials alone they are required to work for a certain number of years in an underserved area (as defined by the federal government) before they are allowed to apply for a green card.

And I'm not sure any of the underserved areas (likely to be rural, perhaps appalachia, or southwest - or maybe the Dakotas) woulld be what the OP is looking for.. The candidate is not assigned to a specific place - but is provided with a list of options for which they can apply (and be selected by the employer or not).

If I were the OP I would contact the associations I listed and try to determine:

1) what employment opportunities look like long-term
2) realistically how much additional education wold be required and what the cost wold be (remembering that there would be no pay involved) Members of these groups are usually very collegial and willing to provide advice to anyone interested in the specialty as a career


(FYI, I beleieve universities in the US are much more expensive than in the UK - especially for graduate degrees

Thank you all for your replies. Is it difficult to gain a student visa (other then the fee's)? In the UK the tutition fee's per year are £9000 so for my course it totals £27000. Are the US fee's a lot more than this? Thanks for your help

Getting a student visa is routine - all you need is to show that you have been accepted and will be attending a credentialed university. Costs for schools in the US are all over the map - that's why I suggest speaking to someone at the association to get more details. My elder D is finishing law school - which is much more expensive than the prices you are quoting and the younger is starting to look into grad school in marine biology - which are also much higher. The costs I mentioned are tuition only - room, board and living expenses are all extra.

However, there may be programs that are not SO expensive. And coming from outside the US there might be scholarships or grants that you might qualify for. I have no idea of which schools are good or wold meet your needs - but a quick check showed that the program at the Miami School of Nursing is $9000 per semester - or $18000 per year. This isn't expensive for university in the US. State universities are often less expensive - but usual;y have different rates for residents and out of state students (since taxes support a part of the university expenses.

But do contact the organizations which can provide a lot of guidance.

If you do make it over to the US, check out Portland, Maine.

The requirements vary greatly by state. Here is an organization for all types of midwife http://mana.org/definitions.html
Perhaps you would fit the direct-entry definition? Under Resources there are links to the various state requirements.

Have you considered Canada? Part of the commonwealth so maybe easier to immigrate there.

For a wide open Q - you have received tremendous amounts of valuable advice/counseling. Hope it has been helpful.