Residency in UK/Canada/Europe?

terrible idea with the exception of canadian programs and even there I'm not clear on the issues of registration and licensure after residency training in canada. (as opposed to med school which is a non-issue).

Back in the day it was not nearly as difficult for FMGs to become certified to practice medicine in the US. Now it is extraordinarily difficult (excepting Canada as stephew said, but getting a RadOnc residency there is rough for Canadian citizens).

Even if you are a world-reknowned expert in field "X" you will have to redo an entire residency plus pass Step I-III to practice medicine in the US. One interesting example I have run into over the course of my training (though I know of many more):

One of my classmates was an head and neck surgeon in Vietnam and practiced for about 7 years until he emigrated here. He really wanted to practice medicine but realized he had to complete a residency and understood that it would ve virtually impossible to get an ENT residency as an FMG. So, he re-enrolled in medical school. While the rest of my classmates (and me!) were fumbling with patients during the 1st two years, he seriously had an attending level understanding (obviously) of patient care. Interestingly, he ended up going into EM.

A lot of FMG RadOncs would love to get an attending level position here. The chances of successfully doing so are very, very low. Sometimes they are "stuck" in a kind of a fellowship position for years trying to convince the powers that be to give them a residency slot. What usually happens is that the hospital is able to "farm" them for their attending-level expertise while paying them crap.

stephew said:

terrible idea with the exception of canadian programs and even there I'm not clear on the issues of registration and licensure after residency training in canada. (as opposed to med school which is a non-issue).

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Correct. The ABR does not recognize training in any program outside of the US or Canada. PGY2-5 must be spent in an ACGME/LCME approved program or a program approved by the RCPSC (Royal College of Physicians and Surgeons of Canada). Anything else and you will not be eligible to sit for the ABR examinations. The only Canadian program that is jointly recognized in McGill and McGill in return for making a very limited number of positions available to US residents has a requirement that you will not remain in Canada after training. Anywhere else in the world, and you have to repeat your residency here to be board eligible.

napoleondynamite said:

So if I were to train at McGill, it would be no problem returning to the US? Do you think that it would be difficult to obtain employment in the US after training in Canada? Thanks for your help.

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I don't think so. I think the bigger problem is getting a position at McGill. McGill uses the NRMP for peds, IM, ER, surgery and orthopaedics, and I think a few others, but I don't recall radiation oncology being in that list.

The US does recognize Canadian residencies as equivalent. The Canadians do not recognize US residencies as equivalent at present. So, a Canadian doing a US residency and desiring to return to Canada will have an issue, at least in Quebec and Ontario.

I have a good friend who used to work at Stephew's place and now works in the midwest who trained at Princess Margaret Hospital in Toronto, and he had no trouble coming back to the states. And, I'll bet if Stephew's been there for a few years he probably knows who I am talking about. This was mega-years ago, though, and things might have changed.

The bigger issue is that there are only about 10 or so programs in Canada, so bagging a position there might be harder than getting one in the US. McGill requires a pledge to return to the States when you're done with your training.