ABEM Certified Physician to Canada

[EM.EM]

I'm an EM Physician who trained in a three year residency program and have been practicing in a busy academic center in the US for the past three years.

My wife is Canadian and we have been toying with the idea of moving to Canada.

The Royal College of Physicians and Surgeons of Canada have informed me that I am unable to sit for the Canadian EM Boards. They state that you need an equivalent length of training - which in Canada is 5 years. I've been informed that when there is a one year differential, this difference can be made up by fellowship, but a two year differential would need additional residency training.

This seems insane. Does anyone know an exemption option, or a work around?

Ontario is the only province that offers a loop hole w/ Pathway 3/4 where you are "supervised" during tenure. And although it seems as though the "supervision" is minimal - this status 1. is indefinite 2. is only in Ontario and 3. is slightly demoralizing to practice under supervision.

If anyone has any experience with this please let me know. Thanks.

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[Old_Mil]

I am exploring this option right now. I should actually have an offer extended to me next week. If the written offer reflects what was discussed, I am going to accept and begin the emigration process.

After visiting and interviewing I have to say the practice environment seems very attractive compared to what has developed here. The money is about the same. A fraction of the malpractice risk. The canadian $, despite some recent weakness is much stronger than it has been in the past. If you find yourself in a high tax state, you will probably find that the Canadian federal + provincial tax burden is a bit lower than your US federal + state tax burden.

Ontario and Saskatchewan have created special provincial pathways for ABEM boarded guys to.come work without the FRCP...that's the pathway 3/4 option you mention. Supervision lasts 12-18 months and basically consists of periodic chart review to make sure everything is going OK. Your day to day life on shift is the same as it would be here in that you aren't checking patients out or anything. You can basically forget about BC or Alberta unless you are FM, they haven't chosen to make the same provincial accomodations for ABEM guys.

Health Force Ontario (http://www.healthforceontario.ca/en/Home) and Saskdocs (www.saskdocs.ca) should be able to hook you up.

If you want me to put you in touch with a medical director I spoke with in Saskatchewan about what sounds like a really good job (just not necessarily a great one for me), PM me.

 

[coachB]

I briefly looked into this as well (wife is Canadian) - originally contacting Health Match BC. They referred me to Ontario but I didn't really look any further. This is not really a practical possibility for a few more years anyway. But if you do go about it this way, once you clear the supervision period, are you then eligible to be fully licensed and move to another province? Or are limited to Ontario and Saskatchewan for life?

The Canadian system has its own issues (boarding, overcrowding), but I agree that the overall climate sounds more reasonable. And as you said, salaries and taxes seem to be fairly comparable.

So I would also be very interested in hearing anyone's experiences.

 

[Old_Mil]

As far as moving to other provinces once you have an unrestricted ON/SK license I am not sure. I really haven't looked into that because I wouldn't really have any motivation to relocate once I was established and working.

 

[DeadCactus]

Curious, are EM/IM folks eligible to practice or do you need 5 years of EM specific training?

 

[Old_Mil]

Curious, are EM/IM folks eligible to practice or do you need 5 years of EM specific training?

FM (and I believe IM?) are eligible to take the FRCP certification tests because it is a three year residency. Canada has two training paths to EM: 3 years of FM + a 1 year fellowship year.in EM or 5 years of EM. So ABEM guys can't take the FRCP test for EM certification. Ontario and Saskatchewan have set up province specific transition pathways for US physicians to go over. If I take the job I would be the third ABEM guy in the group.

 

[deuist]

3 years of FM + a 1 year fellowship year.in EM or 5 years of EM.

How does that math even make sense?

 

[D0CYAN]

It doesn't. Welcome to Royal College logic eh!

RE other provinces, the ON and SK workarounds don't get you an unrestricted license. You eventually get to practice without supervision, but it's a limited certification to practice within the specialty you've been supervised for and only within the province that did the supervising.

 

[CanadianEM]

There are probably a lot more options for places than you guys would expect. I know that certain places like Calgary are actively hiring and even specify that they are also looking at ABEM. Google it and you can search out their ad.

Other provinces also employ ABOEM or ABEM guys as well. Saint John, New Brunswick had an ABOEM employed in their tertiary centre. Nova Scotia has ABEM guys. Some BC postings (eg: Royal Columbian, which is a level 1 trauma centre) also specify that they are also looking for ABEM guys. Food for thought. Now, whether you would get a license from the provincial colleges is a seperate matter, and one I'm not entirely clear on.

The Canadian EM scene is interesting. The forefathers being GPs, wanted a training pathway for family docs, hence the 2+1 pathway (2 years family, 1 year fellowship in EM). But the royal college wanted their own pathway so they pushed for 5 years of training, to produce specialists in EM. These guys tend to be mainly in the academic centres. However, the 2+1 guys are quite accomplished in their own right and many work side by side with the 5 year guys. 2+1 guys include heavy academic people like Jeff Perry from Ottawa (he of the CT for SAH studies) or Andulfato from UBC who is the big ketofol guy... there are many other examples.

 

[NurWollen]

There are probably a lot more options for places than you guys would expect. I know that certain places like Calgary are actively hiring and even specify that they are also looking at ABEM. Google it and you can search out their ad.

Other provinces also employ ABOEM or ABEM guys as well. Saint John, New Brunswick had an ABOEM employed in their tertiary centre. Nova Scotia has ABEM guys. Some BC postings (eg: Royal Columbian, which is a level 1 trauma centre) also specify that they are also looking for ABEM guys. Food for thought. Now, whether you would get a license from the provincial colleges is a seperate matter, and one I'm not entirely clear on.

The Canadian EM scene is interesting. The forefathers being GPs, wanted a training pathway for family docs, hence the 2+1 pathway (2 years family, 1 year fellowship in EM). But the royal college wanted their own pathway so they pushed for 5 years of training, to produce specialists in EM. These guys tend to be mainly in the academic centres. However, the 2+1 guys are quite accomplished in their own right and many work side by side with the 5 year guys. 2+1 guys include heavy academic people like Jeff Perry from Ottawa (he of the CT for SAH studies) or Andulfato from UBC who is the big ketofol guy... there are many other examples.

So in Canada, is it up to the employer to decide whether their emergency physicians need to be board certified in EM, the way it is in the US? You seem to indicate that an ABEM or ABOEM-boarded physician could potentially get hired in a variety of provinces. Wouldn't they just be be licensed-but-not-board certified EP's, just like we see in the US? Or does it depend on the province?

 

[EM.EM]

There are probably a lot more options for places than you guys would expect. I know that certain places like Calgary are actively hiring and even specify that they are also looking at ABEM. Google it and you can search out their ad.

Other provinces also employ ABOEM or ABEM guys as well. Saint John, New Brunswick had an ABOEM employed in their tertiary centre. Nova Scotia has ABEM guys. Some BC postings (eg: Royal Columbian, which is a level 1 trauma centre) also specify that they are also looking for ABEM guys. Food for thought. Now, whether you would get a license from the provincial colleges is a seperate matter, and one I'm not entirely clear on.

The Canadian EM scene is interesting. The forefathers being GPs, wanted a training pathway for family docs, hence the 2+1 pathway (2 years family, 1 year fellowship in EM). But the royal college wanted their own pathway so they pushed for 5 years of training, to produce specialists in EM. These guys tend to be mainly in the academic centres. However, the 2+1 guys are quite accomplished in their own right and many work side by side with the 5 year guys. 2+1 guys include heavy academic people like Jeff Perry from Ottawa (he of the CT for SAH studies) or Andulfato from UBC who is the big ketofol guy... there are many other examples.

Thanks for everyone's input. It's amazing how there's an apparent shortage of EM Physicians in so many regions of Canada and yet the RCPSC will not allow the majority of US trained EM Physicians to practice.

I searched Calgary ABEM - and all I found was a toxicologist position. If the applicant trained at a 4 year program and then did toxicology, they would then be permitted to sit for the RCPSC EM specialty exam and thus would be allowed to practice in most provinces. I contacted the Royal Columbian - they defer to CPSBC who then defers to RCPSC... who then states that a two year difference in training cannot be made up by years in practice or fellowship and would require more residency training.

I have found EM/IM physicians and ABEM docs from 4 year programs (+ fellowship) who have secured jobs in Canada outside of Ontario - but have yet to find any ABEM 3 year program graduates who have figured this out.

It's interesting - because as far as I can see EM is the only specialty that this "no 2 year difference" rule would affect. It seems as though when comparing US/Canada w/ all other specialties there is at most a one year difference.

 

[Old_Mil]

Now, whether you would get a license from the provincial colleges is a seperate matter, and one I'm not entirely clear on.

I think that is the catch. The Provincial college of BC seems to offer no pathway for a three year EM grad to be licensed, they want five years. Alberta would allow it if you have a fellowship (3+1).

Don't know anything about Manitoba, Nova Scotia, or that little French colony in eastern half of the country.

 

[Apollyon]

I think that is the catch. The Provincial college of BC seems to offer no pathway for a three year EM grad to be licensed, they want five years. Alberta would allow it if you have a fellowship (3+1).

Don't know anything about Manitoba, Nova Scotia, or that little French colony in eastern half of the country.

What about the other end, ie, a prelim year and then EM residency (1+3)?

 

[Old_Mil]

That should be fine for ON and SK. AB should be alright, from what I recall - it's been a little while since I looked into Alberta. BC, no.

At any rate, I think it's time for a new adventure. I received the written offer from the hospital in Canada and gave notice at my present job. I'll apply for my visa this week followed by my provincial license and if all goes as planned I should be working shifts up north by fall.

I'll keep you all posted on how the process goes. I'm sure there will be a learning curve, but I think I'm going to be able to live with a situation where the entirity of physician charting is accomplished in a space 2/3rds the size of a 3 x 5 index card.

 

[NoLollipops4U]

People have mentioned ABEM or ABOEM......I was under the impression that AOA (DO) residencies were not recognized in Canada? I know quite a few Canadian students at DO schools, and this seems to be the general understanding. With the residency merger happening between ACGME and AOA over the next few years, it should be recognized but for now most DO students/residents say otherwise.

Thoughts?

 

[Birdstrike]

The answer to all of this is obvious. Canada has better doctors than us.

 

[Old_Mil]

People have mentioned ABEM or ABOEM......I was under the impression that AOA (DO) residencies were not recognized in Canada? I know quite a few Canadian students at DO schools, and this seems to be the general understanding. With the residency merger happening between ACGME and AOA over the next few years, it should be recognized but for now most DO students/residents say otherwise.

Thoughts?

Honestly, I'm not sure. Although I have a DO degree, I went to an ACGME residency and all my credentials have been through the USMLE-ABEM process.

 

[NoLollipops4U]

Honestly, I'm not sure. Although I have a DO degree, I went to an ACGME residency and all my credentials have been through the USMLE-ABEM process.

Honestly, I really hope you and whoever else is interested gets to practice in Canada as a DO. I can count on both hands the number of DOs in Canada. There are only 1-2 DO EM physicians in Canada right now. Most practice OMM or family med. I think its Alberta, that only lets DOs (regardless of ACGME residency or not) that only allows you to practice OMM. I'm not 100%, but it was that way a few years ago. Although to be honest, you won't want to live in Alberta anyways.

 

[OldBlue]

Bumping an old thread with a new question: which fellowships does Canada consider sufficient to complete the 4+1 or +2 equation to achieve reciprocity? Do these need to be ACGME approved fellowships? Thanks for any new thoughts on this subject.

 

[coachB]

Bumping an old thread with a new question: which fellowships does Canada consider sufficient to complete the 4+1 or +2 equation to achieve reciprocity? Do these need to be ACGME approved fellowships? Thanks for any new thoughts on this subject.

My understanding is that any ACGME fellowship is okay and that any non-ACGME fellowship is not accepted.

 

[FallingFromSpace]

Does it have to be a fellowship, or just 5 years of ACGME training? The reason I ask is that I did two years of residency in another specialty prior to switching into emergency medicine.

 

[OldBlue]

Just heard back from the Royal College. Here's the scoop:

Eligibility requires completion of a 4 year ACGME approved residency program, plus 1 year ACGME approved fellowship relating to Emergency Medicine.
OR
Non-ACGME approved fellowship if said fellowship is completed at the same place as your 4 year residency program.

I'm assuming 2 year fellowships would be OK as long as they meet these rules as well. I hope this helps!

 

[jayceee]

FM (and I believe IM?) are eligible to take the FRCP certification tests because it is a three year residency. Canada has two training paths to EM: 3 years of FM + a 1 year fellowship year.in EM or 5 years of EM. So ABEM guys can't take the FRCP test for EM certification. Ontario and Saskatchewan have set up province specific transition pathways for US physicians to go over. If I take the job I would be the third ABEM guy in the group.

You've got a few details wrong.

Family med in canada is a two year residency. It's the only residency program length that's shorter than its US counterpart. They're trying to change this, but for now family med training in Canada is two years long. Three year shorter than most specialties, which is part of its appeal.

Read the brief paragraph on post graduate medical education here:
https://en.wikipedia.org/wiki/Medical_school_in_Canada#Post-graduate_medical_education

http://www.cfp.ca/content/58/9/1045.full

Canada has a PGY 3 enhanced skills program for family physicians who want additional training .

The 2 year residency+1 one year fellowship is designed for family physicians living in rural areas to acquire EM skills to better serve their communities. It's not a way to work EM at a tertiary center.

You can family 2+ 1 in EM, Ob, and Anesthesiology. A few more PGY3 fellowships have been added in recent years.

https://www.google.com/webhp?source...-8#q=family+medicine++enhanced+skills+program

 

[jayceee]

How does that math even make sense?

Because it doesn't.

He had a few details wrong.

Family med in canada is a two year residency. It's the only residency program length that's shorter than its US counterpart. They're trying to change this, but for now family med training in Canada is two years long. Three year shorter than most specialties, which is part of its appeal.

Read the brief paragraph on post graduate medical education here:
https://en.wikipedia.org/wiki/Medical_school_in_Canada#Post-graduate_medical_education

http://www.cfp.ca/content/58/9/1045.full

Canada has a PGY 3 enhanced skills program for family physicians who want additional training .

The 2 year residency+1 one year fellowship is designed for family physicians living in rural areas to acquire EM skills to better serve their communities. It was never designed as a way for physicians to become EM physicians in a shorter time frame. It was just designed to improve access to EM/urgent care in underserved communities. If you want to become an EM physician in Canada, you do the 5 year residency.

You can family 2+ 1 in EM, Ob, and Anesthesiology. A few more PGY3 fellowships have been added in recent years.

https://www.google.com/webhp?source...-8#q=family+medicine++enhanced+skills+program

 

[Apollyon]

Is there a reason why you cut and pasted your response for a second post?

 

[Angry Birds]

Serves you right for marrying a Canadian.

 

[rbnsafsadgf]

So I am in a similar yet different boat.
I will have done 1 year non-EM ACGME then a 3 year EM residency.
I am a Canadian PR already.
Can I qualify for EM in BC with a fellowship? ACGME vs non?
Would it make sense to get a BC qualification via family medicine (which I think I see a route to getting via cumulative total of my training) and then apply for jobs that say they want ABEM people?
Who are the right authorities to be sending these questions to?

 

[Apollyon]

So I am in a similar yet different boat.
I will have done 1 year non-EM ACGME then a 3 year EM residency.
I am a Canadian PR already.
Can I qualify for EM in BC with a fellowship? ACGME vs non?
Would it make sense to get a BC qualification via family medicine (which I think I see a route to getting via cumulative total of my training) and then apply for jobs that say they want ABEM people?
Who are the right authorities to be sending these questions too?

Isn't that something that you should be asking of the ministry of, though? I think that it is MUCH less likely that you will find it here. I mean, I may be able to name every province and territory, but I, as an American, don't know all the rules.

 

[MasonWilliamL]

Is it not possible to apply for CCFP(EM) certification with ABEM? On the flip side, is there any route of ABEM eligibility with a CCFP(EM) (even if it requires an additional year of training)?

 

[DetroitERDO]

People have mentioned ABEM or ABOEM......I was under the impression that AOA (DO) residencies were not recognized in Canada? I know quite a few Canadian students at DO schools, and this seems to be the general understanding. With the residency merger happening between ACGME and AOA over the next few years, it should be recognized but for now most DO students/residents say otherwise.

Thoughts?


I know of 2 D.O.s who both did an ABOEM residency / board certification that cross the bridge from Detroit to work in Windsor

 

[Apollyon]

People have mentioned ABEM or ABOEM......I was under the impression that AOA (DO) residencies were not recognized in Canada? I know quite a few Canadian students at DO schools, and this seems to be the general understanding. With the residency merger happening between ACGME and AOA over the next few years, it should be recognized but for now most DO students/residents say otherwise.

Thoughts?


I know of 2 D.O.s who both did an ABOEM residency / board certification that cross the bridge from Detroit to work in Windsor

You should really use the "quote" function. Apparently, it would also be easier/quicker than the way you responded.