CANADIAN IMG - prospects of returning to Canada?

raymdc-89

New Member
Hi.

So I've heard plenty of horrible stories about the Canadian policy on international medical graduates. The retaking of exams, low chances of matching for a residency spot, being forced to work minimum-wage jobs, no medical practice, that sort of stuff. But I think a lot of the stories were focused on international doctors that are NOT Canadians. I heard that the 1st iteration (of CARMS) is open to Canadian MD's as well as Canadians holding international medical degrees. While the 2nd iteration is for the less fortunate international graduates that are not Canadians in the first place.

My name's Ray. I've recently graduated from a B.C. high school in Vancouver. I have been accepted to two medical schools outside Canada (St. Andrews in Scotland, and Tasmania in Australia). I am most likely going to go to Australia for an MBBS degree. I am a Canadian citizen (I was born in Ontario), and I am a B.C. resident (lived in BC for 3 years).

I was wondering what my chances are for specialty training in Canada. Are they just as slim, or does the fact that I am Canadian helps me? Let's consider I manage to get through the MCCEE and MCCQE. Would the fact that I will be getting an Australia degree help as well (I think Canada prefers international degrees from 'favored countries').

If you've got more information, what about the US? What are my chances there?

Thanks
 
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chadtnl

New Member
Hi.

So I've heard plenty of horrible stories about the Canadian policy on international medical graduates. The retaking of exams, low chances of matching for a residency spot, being forced to work minimum-wage jobs, no medical practice, that sort of stuff. But I think a lot of the stories were focused on international doctors that are NOT Canadians. I heard that the 1st iteration (of CARMS) is open to Canadian MD's as well as Canadians holding international medical degrees. While the 2nd iteration is for the less fortunate international graduates that are not Canadians in the first place.

My name's Ray. I've recently graduated from a B.C. high school in Vancouver. I have been accepted to two medical schools outside Canada (St. Andrews in Scotland, and Tasmania in Australia). I am most likely going to go to Australia for an MBBS degree. I am a Canadian citizen (I was born in Ontario), and I am a B.C. resident (lived in BC for 3 years).

I was wondering what my chances are for specialty training in Canada. Are they just as slim, or does the fact that I am Canadian helps me? Let's consider I manage to get through the MCCEE and MCCQE. Would the fact that I will be getting an Australia degree help as well (I think Canada prefers international degrees from 'favored countries').

If you've got more information, what about the US? What are my chances there?

Thanks
The fact that you have no undergrad education may be a problem.
Good luck.
 

herpor

New Member
i am lookin for someone img preparing for the pediatrics royal college . I live in Montreal so we can practice together specially for the oral.
herpor
 

raymdc-89

New Member
The fact that you have no undergrad education may be a problem.
Good luck.
I sorta doubt that undergraduate education has really anything to do with whether you'll get a residency spot or not.

It's almost like saying a university looks at the grades I got when I was in 6th or 7th grade.

- rayy
 

chadtnl

New Member
I sorta doubt that undergraduate education has really anything to do with whether you'll get a residency spot or not.

It's almost like saying a university looks at the grades I got when I was in 6th or 7th grade.

- rayy
You may well be right my friend but it is definately an issue in the US. I can only imagine that it is a bit similar to applying with an intercal BSc or without one.
 

racheljane

New Member
I was born in Canada and although I've been in UK for most of my life I still have dual nationality so returning there to practise one day is a possibility in my mind but like the OP I'm not sure if I'd be considered an IMG or a Canadian with UK education... either way, I have a feeling that as the last poster mentioned a BSc would prove useful/essential.

Is it right that Canada won't accept IMGs who are already trained in a specialty i.e. that they'll have to go back to basics and retrain in that (or another) specialty after the MCCEE and MCCQE?

In other words, if I trained and worked in the UK as, say, a brain surgeon Canada wouldn't necessarily accept that training as equivalent to their own and I would have to spend years going through their system retraining.
 

osmosis

New Member
from my knowledge, canadian citizen IMGs are treated the same as non-canadian IMGs. correct me if i'm wrong!
 

heed

New Member
if you went through the US system then you are not considered an "IMG" either - graduates from canadian and US medical schools are exempt from the MCCEE and are able to compete on equal terms for residency posts in Canada.
 

raymdc-89

New Member
from my knowledge, canadian citizen IMGs are treated the same as non-canadian IMGs. correct me if i'm wrong!
Hello,

It used to be that way, where Canadian MD's (as well as American MD's I believe) are considered in the 'first iteration' of matching. The '2nd iteration' is for IMG's. But recently they've opened up the 1st iteration to Canadian IMG's as well. As for non-Canadians, they're unfortunately still stuck with the 2nd.

That's what I've been told about a year ago, from an anesthesiologist in Canada, a director of an Ontario hospital's anesthesia residency program.

- Ray
 

osmosis

New Member
thanks for the info. i checked it out on the canadian img site and found out that for most provinces, Canadian IMGs go through a parallel matching process, not the same one as the non-IMGs, although still in the first iteration. After finishing the residency, in most provinces you are obligated to complete a 'return of service' in an underserved area, which can't be too much fun..
 

raymdc-89

New Member
thanks for the info. i checked it out on the canadian img site and found out that for most provinces, Canadian IMGs go through a parallel matching process, not the same one as the non-IMGs, although still in the first iteration. After finishing the residency, in most provinces you are obligated to complete a 'return of service' in an underserved area, which can't be too much fun..
Thanks for posting.

Yeah, the whole deal about the 'return of service' sorta stinks, but I guess that's their way of getting back at us for not going to medical school in Canada (hmm, while at the same time they continue to restrict spots for their MD programs... DESPITE what they call a 'shortage of physicians' in the country...)

Right now I'll be heading off to medical school in Australia in February. Considering I pass each year and get my degree, I'm thinking of either staying in Australia for residency, or try Canada (hopefully things will be better in 5 years). If not, then the United States.

- Ray
 

moin

New Member
Hi

I'm a Canadian, who moved to the UK 3 years ago after finishing grade 9. Before, it was my intention to move back to Canada to do my undergrad and med. But, I decided to apply to uni in the UK, probably because I became more used to the system here. Also for the fact that it is not compulsory to have an undergrad degree to do med here. I also hope to work here as well - England has sort of grown on me.

However I am curious and I was wondering if someone could explain to me how the iteration system of CARMS works. Under what criteria are postgraduate training places matched up to doctors and why are there two rounds?
 

raymdc-89

New Member
Hi

I'm a Canadian, who moved to the UK 3 years ago after finishing grade 9. Before, it was my intention to move back to Canada to do my undergrad and med. But, I decided to apply to uni in the UK, probably because I became more used to the system here. Also for the fact that it is not compulsory to have an undergrad degree to do med here. I also hope to work here as well - England has sort of grown on me.

However I am curious and I was wondering if someone could explain to me how the iteration system of CARMS works. Under what criteria are postgraduate training places matched up to doctors and why are there two rounds?
Much of the information can be found on www.carms.ca

Well first you gotta 1.) get your medical degree and then 2.) write the MCCEE. Okay so this is what the 1st and 2nd iteration means, from what I know:

The 1st is available to all med graduates without post-grad training in North America. Depending on the province, IMG's can either compete directly with Canadian MD's (competitive stream) or compete only with other IMG's (parallel).

The 2nd iteration are positions that have not been filled after the 1st iteration. I'm guessing these will be positions in less popular specialties or locations.

Since now ALL medical graduates (Canadian, American, Australia, British, anyone else from a med school recognized by the IMED) are eligible for the 1st iteration, I'm not sure how 'much' of a difference it makes if you did not graduate from a North American med school. I was also told that being Canadian makes it easier, because some provinces require you to be 1.) Canadian or 2.) if not Canadian, then at least having lived in Canada for X number of years.

Some provinces (I think all, except for Manitoba and Quebec) require you to sign a Return of Service agreement, saying that after residency you'll have to go to some loner place in Canada to work for X number of years, and not an urban hospital setting.

The CARMS thing is actually pretty confusing to me as well, but that's how much I understand it. I haven't checked on the stats, but I think only a small %tage of IMG's get a spot...

Hope that helps.

- Ray
 
I would like to put in my two cents because there is an option, which is not necessarily written down anywhere, but which is quite common in clinical practice and that applies to anyone, Canadian citizen or not, who has completed a medical degree as well as a post-graduate program abroad: Fellowships. Although fellowship positions are fairly competitive they are a pretty sure way of getting to stay in Canada, many of the fellows that I've met, both in Neurosurgery and in Psychiatry, were not Canadian citizens nor landed immigrants and upon completion of their program they were all offered positions to work in Canada. If they decided to stay then their licenses to practice were pretty much handed over to them. There are restrictions on your license and can't just decide to quit your job at the hospital that hired you... you are obviously bound to this agreement as anyone else who has a Working Visa would (Obviously it would be different for a Canadian citizen) But, you have the same opportunity as any one else to write the License Examinations, and most people get something like 5 years to do it, so that way they can turn their somewhat limited license into a full blown Canadian License. Of course then that means one would have to stay abroad for the full residency program, but this is something to remember...

I am pretty confident that within the next few years the CMA will loosen up the restrictions for Canadian IMGs. The Canadian medical system has already started undergoing a reform and I have a feeling that Canadian IMGs who want to get residency spots, particularly in primary care areas, will have no problems doing so. Much of the recent public health and government-sponsored health research has been directed to show that our health system is only sustainable if there is a tremendous shift towards community based health services; hence, there are tonnes of advantages for people who choose to be part of this new breed of comunity health docs who work in interdisciplinary teams in the community. The fee-for-service system where GPs work in isolation is dying, and I also think that it's about time that it should die! If we want to be able to care properly for everyone we must have enough "gatekeepers" in the community. There is also huge pressure from the public to change the affair of things.

I do not think it's unfair to bind new graduates to certain areas. This ensures that the most underserved areas are getting enough docs; that people who live with chronic illnesses like cardiac disease and diabetes and who are not getting the care and maintenance that they need will eventually not have the strokes and the heart attacks that are so common and that end up costing the system a lot more in the end than if these people were properly treated and monitored by their GPs. I disagree that agreements to serve in underserved areas are a punishment for the Canadians who went abroad to study medicine. If anything, it is a testament to your commitment to serve through health care practices no matter at what cost. I mean, you must really want to be a doctor if you are leaving your country and often times your family and all your friends to go all the way across the globe into a new culture in order to learn how to doctor. THAT is a huge commitment in itself.

There are small communities in Ontario in which people enter a LOTTERY system just to see the town's GP. I mean, people with asthma and diabetes who end up miles and miles away in Emergency care because they have no primary doctor. If you want to be a doctor in Canada you have to be prepared to be useful in the most underserved areas. If you want to make loads of money then go to the US. Canada has a publicly funded system for a reason, and I like to think that most of us still believe that access to health care is not a priviledge but a right of every human being. Physicians and physican-wanna-bes should be the first ones stepping up to that line and fighting for a sustainable system that will care for the people who need it the most.

Unfortunately the CMA will never be completely open about their requirements and the specific guidelines about how Canadian or non-Canadian IMGs get their spots, it's just all part of the status quo...it's also somewhat arbitrary and I've heard mixed reviews from foreign grads.

I have also been told that doing your electives in Canada is a must for anyone who plans on coming back. Choosing an elective that is affiliated with the school you plan on doing your residence is essential; that way you can start networking and even make it clear to your supervisors that you would like letters of reference in the future.

It's all possible regardless of whether you have an undergrad degree before going into medicine or not. The US already has a few 6 year programs for high school grads, and the rest of the world has always had this 6 year program; there are loads of physicians practicing in Canada who have complete such programs.

Keep your eye on the ball and be certain that you will get what you want. Getting into Med School and then completing the course is the hardest part, after that anything is possible as long as you keep your goals in mind.
 

raymdc-89

New Member
Hey Tranpoline Laughter,

The information you've provided has been very useful, and I thank you for that. Here in Australia (we're I've just started med school), they place a lot of emphasis in underserved areas, and I now understand why. For our final two years of medical school here, I think you're only allowed to stay in the city hospital (which is a tertiary center) for only one year, and your next must be at one of two 'rural clinical schools'. As you said, it's the same situation in Canada, and my earlier comments about 'Canada getting back at us foreign graduates' was perhaps inappropriate. I guess it is reasonable for them to place priority for their own graduates over international MD's (or MBBS's!).

As a Canadian, I am certainly aiming to return to Canada or the United States. However, I do not mind staying in Australia because I actually find it very nice here. But who's to say what I'll think after 5 years?

Thanks for bringing up the issue on fellowships - I hadn't thought of that at all and my mind was just stuck on trying to get back to North America for residency, when I can indeed return for a fellowship in case I don't match.

Thanks for all your info

- Ray
 
Hey Ray,

I didn't mean to confront you or anything; I get really passionate about these issues and can't shut up sometimes.

Cheers to you and good luck!
 

Deltoid

New Member
Trampolinelaughter, I really do hope the Canadian government will open up spots to Canadian IMG's. I've been keeping my eye on this issue every since I started medical school, and in the past four years things haven't changed all that substantially.
 

raymdc-89

New Member
Trampolinelaughter, I really do hope the Canadian government will open up spots to Canadian IMG's. I've been keeping my eye on this issue every since I started medical school, and in the past four years things haven't changed all that substantially.
Deltoid,

I've been searching up on more information regarding Canadian IMG's returning to Canada for residency spots, and it just seems like there is more depressing news than optimism out there. I keep getting information on how difficult it is for us to return to our home country, the restrictions placed on us, and how so many Canadians that received their MBBS outside of Canada were basically shut-downed during the match.

I'm still just a 1st year medical student at the University of Tasmania in Hobart, Australia. I'm finishing up my 1st semester and exams start next week. I have 4.5 years ahead of me, but it sounds slightly sad that my mind is so fixed on trying to return to Canada for residency, and whether there've been any recent changes to policies regarding our chances of going back.

Perhaps something will change in the next 4 years, but it just seems there's been so much 'hopelessness' out there, that I've begun to slowly push the Canadian-residency option aside, and begin to focus more on what I need to do to get to the United States. At the same time, I am strongly considering doing my clinical training right here in Australia, which in fact may very well be the easiest thing for me to do. I don't mind Australia that much anyway. It seems nice here.

It's just that I've felt that it would be great to go back to North America and live/work there. But if it's such a hassle...

If anyone has any insightful info on this issue, post away.

- ray
 

Deltoid

New Member
Hey Ray,

Thanks for sharing your thoughts again. I met a paediatrician here in the UK who just moved to New York about a month ago to start work there. He's just underneath consultant-level in his training, but said the sheer lack of jobs for foreign-trained doctors in the UK has forced him to make a permanent move to the US.

Sadly, when I asked him whether he had considered Canada as an alternative to the US, he gave a dry laugh and said that it's pretty impossible finding a job as an IMG in the Canada.

Amidst all this hopelessness though, there are a few success stories. Just under a year ago I joined the Association of International Medical Doctors of British Columbia (AIMD BC website) and got talking to some people there. One woman very kindly offered to speak to me over the phone and told me her story of how she ended up in Canada and about her first-hand experience of trying to find a residency position.

The impression I get from her (and from the AIMD BC emails) is this: getting work in Canada is definitely hard - no doot aboot it (sorry, had to throw in the pun). But, at the same time, there is a lot of support out there for IMG's who are really keen to find work in the country. There's small groups of IMG's gathering to study together, and even OSCE training sessions to attend.

Personally, my ideal job would be to work in Ottawa, Toronto or Vancouver in hospital medicine, but I'm starting to realize that this might be too ambitious a goal to aim for seriously. It's hard enough for regular Canadian grads to get hospital jobs in the big cities, so as an IMG my chances are even lower. The question left for me is whether or not I'd be willing to compromise - either by going into family medicine or by looking to work outside the big cities.

Anyway, I've got my medical finals in two weeks so I've got enough to worry about for now. Thankfully my fifth and final year will be exam-free, so I'll have plenty of time to contemplate my future then.
 
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