Doing radonc in the US

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Dear all
I am an international radiation oncology resident in my PGY3 enrolled in a radiation oncology residency program in Canada. I have few questions pertinent to having an academic experience in the States:

1. Do I need to be ECFMG certified to be legible to set the American board exams in radiation oncology?
2. If I become certified by the Royal College of Physicians and Surgeons of Canada, can I apply for doing my fellowship training in the US? do i need to be ABR certified to do the fellowship or is the Royal College certification sufficient? Will I need to pass any of the USMLEs too? If so, which steps?
3. I am planning to do some electives in the US in the coming year. Do I need to be ECFMG certified +/- pass step 3 of USMLE to do the elective?
4. Everyone is talking about tbphe competitiveness of getting into a radonc residency in the US, but what about fellowships? Is it as competitive to get into a fellowship position in the US? and what things can one do to boost up the chances?

Many thanks

Fellowships are not competitive in the US. However by only completing a fellowship in the US you will not be allowed to practice radiation oncology. You will need to complete a radiation oncology residency in the US to practice radiation oncology.

To obtain a residency as an international graduate is very difficult (though not impossible).

Originally Posted by lazers

You will need to complete a radiation oncology residency in the US to practice radiation oncology.

He's coming from Canada though. I know there can be some reciprocity in those situations, although I am not completely sure on that.

Edit: found the thread relevant to this subject: http://forums.studentdoctor.net/showthread.php?t=284941

Canada is LCME recognized. No issue coming here to practice, generally speaking in terms of recognition at the hospital/board certification. However, visa issues still exist - still may need J1 or H1 or whatever, unless you already have a greencard or US citizenship.
S

Originally Posted by SimulD

Canada is LCME recognized. No issue coming here to practice, generally speaking in terms of recognition at the hospital/board certification. However, visa issues still exist - still may need J1 or H1 or whatever, unless you already have a greencard or US citizenship.
S

What I was surprised about, reading the thread I posted above, is that US-trained grads can't go practice in Canada. I wonder why it's not a two-way street.

It's not as simple as that. For example, if you were a rad-onc and wanted to work in a big city in Canada - Vancouver, Toronto, or Montreal, you would have to get fellowship trained to be even considered for a position. Or, you may have to work at a fellow-level in Canada for 1-2 years depending on what specialty you are in. However, in rural areas, US-board certification is allowed. Part of this is that some of our training programs are shorter, so they expect you to "top-up" by doing some additional training in Canada.

What's happened there is that they've removed caps on salary/patients seen, and the dirty little secret is that their physicians (from PCP to specialists) typically out earn their US counterparts. FPs make in the 300s, radiologists near a million (in the bigger cities). The groups are getting very difficult to join, as they are finally able to make better money than in the 90s, and so Canadian graduates are having difficulties finding positions. So, it's not that they don't want American physicians or are restricting them. It's that if you are joining their practice, you'd better have something of value to add to their practices.

S

Originally Posted by SimulD

It's not as simple as that. For example, if you were a rad-onc and wanted to work in a big city in Canada - Vancouver, Toronto, or Montreal, you would have to get fellowship trained to be even considered for a position. Or, you may have to work at a fellow-level in Canada for 1-2 years depending on what specialty you are in. However, in rural areas, US-board certification is allowed. Part of this is that some of our training programs are shorter, so they expect you to "top-up" by doing some additional training in Canada.

What's happened there is that they've removed caps on salary/patients seen, and the dirty little secret is that their physicians (from PCP to specialists) typically out earn their US counterparts. FPs make in the 300s, radiologists near a million (in the bigger cities). The groups are getting very difficult to join, as they are finally able to make better money than in the 90s, and so Canadian graduates are having difficulties finding positions. So, it's not that they don't want American physicians or are restricting them. It's that if you are joining their practice, you'd better have something of value to add to their practices.

S

Interesting. "Dirty little secret" indeed considering the assumptions many have about the canadian health system and its impact on physician compensation.

Originally Posted by medgator

What I was surprised about, reading the thread I posted above, is that US-trained grads can't go practice in Canada. I wonder why it's not a two-way street.

The whole US-trained grads not being able to practice in Canada has to do with variations in residency/specialty training length. There are a few rad onc programs in the US that are 4 yrs whereas all rad onc residencies in Canada are 5 yrs. If you're coming from one of these 4 yr programs you'll likely need to supplement with an additional fellowship year but for most US rad onc residencies ... this is not an issue being that both residencies are 5 yrs between the two countries.

Originally Posted by Eggheads

1. Do I need to be ECFMG certified to be legible to set the American board exams in radiation oncology?

are you a graduate of a US or CAD med school? IF so, then you don't go through ECFMG.

2. If I become certified by the Royal College of Physicians and Surgeons of Canada, can I apply for doing my fellowship training in the US? do i need to be ABR certified to do the fellowship or is the Royal College certification sufficient? Will I need to pass any of the USMLEs too? If so, which steps?

-in order to be RCPSC certified in rad onc .. you need to take the exam at rhe end of your 5th yr of residency. Most ppl who apply for fellowships do so early in 5th year so you don't need to be RCPSC certified to apply to fellowships.

Don't need to be ABR certified either but if you don't have USMLES 1-3 then you will need MCCQE parts 1 and 2. However, having only MCCQE parts1 and 2 will limit you on places you can apply for fellowship.

3. I am planning to do some electives in the US in the coming year. Do I need to be ECFMG certified +/- pass step 3 of USMLE to do the elective?

-generally no.

4. Everyone is talking about tbphe competitiveness of getting into a radonc residency in the US, but what about fellowships? Is it as competitive to get into a fellowship position in the US? and what things can one do to boost up the chances?

-as others have said ..fellowships in the US are not that competitive.

Many thanks

-g'luck!