current Canadian DO students, pls read!

I'm a Canadian citizen who finished up at a DO school in May and began an ACGME residency in July. It's my understanding that AOA residency programs do not accept non-US citizens or green card holders - they're not at all familiar with visas.

Another VERY important piece of information of which you should be aware is that if you're planning on eventually going back to Canada to practice, you have to complete an ACGME residency program (the Royal College of Physicians and Surgeons will not recognize AOA residency programs). Also, the length of residency programs for some specialties differs between Canadian and American residencies. For instance, anesthesiology and neurology are 4 year programs in the US whereas they are 5 years in length in Canada. This means that if you plan on going back to Canada, an ACGME fellowship must be completed in order to have equivalent years of training. On the flip side, Family Medicine in the US is a 3-year residency while in Canada it's only 2 years in length.

In my case, I matched at a 4-year categorical ACGME PM&R residency and will then complete a 1-year Pain or Sports Medicine fellowship. I used the Optional Practical Training extension of my F-1 student visa for my first year residency and my program director was kind of enough to sponsor me for an H1-B visa, which will cover me for the remainder of my residency.

My school had more students match at AOA than ACGME programs. The school administrators will tell students it's because "our students were proud of the osteopathic tradition and" blah blah blah. My perspective is that the more ACGME matches a DO is able to obtain, the more competitive the crop of students that school was able to produce.

A good source of information is the Canadian Osteopathic Association website osteopathic.ca

Please feel free to PM me with any further questions or concerns.

I know of three people in my class that are Canadians. All are currently looking for ACGME programs, and all want to return to Canada at some point in time. Thus it seems its possible. Also, I seem to remember that some provinces will grant you a license even after an AOA residency, but that no AOA programs will take Canadians. I remember hearing from an American DO who did an AOA EM residency who worked in Canada. Guy said there was some hoops to jump through though.

Check the DO Match Lists threads - students will post their school's match list and it usually has the AOA or ACGME designation somewhere in there. Remember, in order to be licensed and board certified in Canada as it stands right now, you must complete ACGME training... AOA GME is NOT recognized!

Hey cbest, I'm a first year AZCOM kid from Alberta. Mind if I fire you a PM with close to a jillion questions (not at all an exaggeration )?

Fire away - always happy to help Canadians doing the DO thing!

Quick question cbest.

I'm a 1st year at KCUMB and from Ontario. If you get into a dually acredited residency I don't believe you have to write the USMLE's. Do you know if that is currently OK with the provincial medical associations (in general - I realize there will be provincial differences) or will you still need to write the USMLE's? I'm thinking the latter, but hoping for the former.

Thanks

Technically, you aren't required to take the USMLEs at all no matter what stream of residency (ACGME vs AOA) you match into. More and more provinces are accepting the COMLEX series for licensing purposes. As DOs, though, it may still be a requirement to take the MCCEE but I'm hoping they do away with that rule by the time I'm ready to make the trip back to Canada, if that's how things shake out for me personally.

Lots of DOs match into ACGME accredited residencies every year with just the COMLEX and most provinces are recognizing the COMLEX series as equivalent to the USMLE series. There will likely be an extra hoop or two to jump through to get back to Canada for DO still, but it's getting better all the time.

Thanks. I'm hoping things streamline a bit too. I was thinking I would have to take COMLEX, USMLE and MCCEE to cover all my bases. Hopefully just the COMLEX and maybe the MCCEE.

All the best.

I'm planning on taking both the Comlex and USMLE step 1 just to be safe.

As one who has been involved in osteopathic licensure in Canada for over 30 years and still involved actively let me set the record straight. To return to Canada you need to do an ACGME residency. At this time the AOA residency will not get you a license in Canada. The Federation of Medical Regulatory Authorities of Canada, an organization made up of the registrars of each province have just issued a statement in Feb. 2011 that set a Canadian standard for full licensure(http:www.amr-dim.ca/Canadian_standard_licensure.html). As a U.S. osteopathic graduate you do qualify, but you must do an ACGME residency. You will also in the future be required to have the L.M.C.C.. Today to obtain the L.M.C.C. one has two options. If one does an accredited residency in the United States(ACGME) then one only needs to do Part 1 and Part 2, the Evaluating Exam is then not required. However if one goes directly in to a Canadian residency then one must do the Evaluating Exam( see the Carms matching website who I recently clarified this position with). Currently the Medical Council of Canada is apparently reviewing its position regarding the Evaluating Exam for osteopathic graduates and this may change but for now the above is the case. The Canadian standard alluded to above is expected to be in place across the board in 2012 so this will be what most current students can expect. There are also being guidelines made for "provisional licensure" but these are not out yet. Yes in the future one can hope AOA residencies will be accepted but don't count on it as these things don't tend to change too quickly,especially since it has just been reviewed. Further if you do complete an ACGME residency remember that often U.S. residencies are shorter for specialization than their Canadian counterparts. One often has to do one further year of fellowship(not a problem) to match the Royal College requirements. In particular if one does an ACGME residency in Emergency Medicine one needs to be particularily careful in that in Canada five years are required for specialization certification through the Royal College. Alternatively one can complete a Family medicine residency in Canada followed by one year of training in Emergency medicine and achieve certification through the Canadian Family Medicine certification route. If one wishes the Canadian College of Family Physicians( I believe that is the name) will grant certification to any graduate of a U.S. family medicine program(ACGME) who passes the U.S. family practice exams. However in the future as one can see the Medical Council exams appear to be required. As for the USMLE, they are not necessarily required to gain entrance to an ACGME residency. COMLEX will suffice, however some programs you wish for may want USMLE. Comlex is accepted currently in Canada in several provinces including Ontario as equivalent, however with this new Canadian standard I wouldn't count on this to continue. Bottom line, stay tuned. Things may change, but for now anticipate doing the Medical Council exams.

Thanks Cando. I have to admit that this part is a bit murky for me so I will have to spend some time mapping out my various plans of action to make sure I don't miss anything. For now though, I am focused on just getting through all my school exams. Perhaps over Christmas I will do some more digging.

Yes, thank you. The information is much appreciated. I was under the impression that you had to take USMLE step to get an MD residency. I'm going to do a bit more research on this topic also!

Cando you're like 5 different kinds of awesome. Thanks for the massive clarifications.

drgio - how it works is that most ACGME residencies know what the COMLEX is, but they don't always have a great idea on how it is scored. For the super DO friendly residencies (IM, FM, PM&R, etc.) most of the programs will take the COMLEX, they know what it is, and it's all you need.

But - for other programs, the PD's don't really know what the COMLEX is, how the scores work and they have no care to learn. So in their mind they can't really rank you against other applicants and as such they file you app away into the round filing cabinet under the desk. It is a good idea to at least do Step I of the USMLE so that way you can apply to all of the programs and all the PD's will know how awesome your 235 is (versus knowing what a 530 is on the COMLEX).

There's a slight caveat here though, at least in my mind. If you're going to write the USMLE and only get say a 200 (average is ~225) then it may be best to not write it, keep your COMLEX and hope some ignorance on the part of the PD's works in your favor

Could I get some clarification. In Florida can one train on an educational license right out of school in an ACGME residency or does one have to obtain the prerequisite first year of AOA training first. I recognize one has to complete AOA accredited training for full licensure but can one train in Florida in an ACGME accredited residency without this one year of AOA training?