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A Canadian with a lot of questions...

Discussion in 'Family Medicine' started by DBcanada, Dec 3, 2008.

  1. DBcanada

    Joined:
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    Hi everyone,

    I'm a 3rd year med student in Canada, born and raised in Canada. My fiance is Canadian, and is currently a 1st year med student in the US.

    Initially we were thinking she would finish medical school and come back to Canada - likely the path of least resistance when it comes to our future. For a few months I've been thinking "why don't i look into medicine in the US? I like the US as a country, it's not that far from home, healthcare has problems in both the US and Canada - no escaping that, etc. etc."

    Now I'm at a point where I feel pursuing a long term goal of practicing family medicine in the US is what I want to do. I see myself having a private practice +/- hospitalist work. I like the idea of getting into sports medicine, pain medicine, emerg, or whatever I want at the time. You can do this in Canada but I get the impression the opportunities are greater in the US. As far as family vs. internal goes, I figure if I ever want to come back to Canada I shouldn't do internal since here you can't set up a private practice as a general internist the same way as in the US.

    So of course, the questions/worry/generalized anxiety kicks in. I'll start with a couple basic ones and move from there. I really just want peoples opinions, so let me know what you think.

    1. I need to do a US family medicine residency. I know this considered non-competetive, as it is in Canada, but what am I looking at in terms of requirements and restrictions?
    - Will I need to write the USMLE?
    - Do I need to start looking at setting up some, if not alot of, US electives?
    - What path did you take through medical school to get your FM residency of choice? (not-canadian specific, just generally what does it take to be a family doc in the US)

    2. Does this sound like a right move?
    - In your opinion, with the current economic climate (not like Canada is unscathed either) and the debatable outlook on primary care in the US, is now a good time?
    - I'm very very interested in practice management and I enjoy operating in the business world. While my home base is always medicine and the best care for patients, I feel like in the US I'll be more fulfilled if I can eventually start a practice from the ground up. Do you see a future in this or will reimbursement change to the point where it's not economically feasible to be a doc/entrepeneur? (ie. will i end up being hired and under someone elses control because it's the only way to pay the bills?)

    3. Any suggestions as to where else I can get some more help?
    -do you think I would be able to contact someone in the US, some administrator/dean, to get some help? I'm in Windsor, ON this year for my clinical rotations - across the river from Detroit. Think I could contact someone and drive over to meet them?
    -other routes to go?


    Thanks so much guys, I know this is alot. I didn't want to post this on some other forum because it seems everyone else is all about these competetive specialties and whatnot. and from what I've read, being Canadian and applying for a plastics residency is very different that being Canadian and applying for family medicine.

    I just want to be happy, like everyone else, and FM makes me happy. and so does America. That, unfortunately, is all I really know at this point haha..

    Thanks in advance for the help,
    DBcanada
     
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  3. MeowMix

    MeowMix Explaining "Post-Call"
    10+ Year Member

    Joined:
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    With this many specific questions about Canada, #1, you should post in the Canada forum and also look @
    http://www.premed101.com/forums/ (Can equiv of SDN)

    I like the idea of getting into sports medicine, pain medicine, emerg, or whatever I want at the time. You can do this in Canada but I get the impression the opportunities are greater in the US.
    not necessarily. The FM PGY-3 year in Canada in EM is way beyond what most FM residents get in the US.

    As far as family vs. internal goes, I figure if I ever want to come back to Canada I shouldn't do internal since here you can't set up a private practice as a general internist the same way as in the US.
    what difference would it make whether your pts have public or private ins? why couldn't you set up your own practice in Canada?

    1. I need to do a US family medicine residency. I know this considered non-competetive, as it is in Canada, but what am I looking at in terms of requirements and restrictions?
    - Will I need to write the USMLE?
    - Do I need to start looking at setting up some, if not alot of, US electives?
    - What path did you take through medical school to get your FM residency of choice? (not-canadian specific, just generally what does it take to be a family doc in the US)

    - I beg to differ that FM residency is non-competitive. You are going to be considered as a foreign medical grad (unless you have a green card or US citizenship; simply having a US fiance is not enough), and you will require an H1B or J1 visa, both of which come with a lot of complications and restrictions. Many programs will not even consider you because of the visa requirements (they have to sponsor you). Most will not sponsor an H1B. For example, in Colorado there are 9 FM residencies, only a few of which will sponsor a J, and you have to do all the footwork yourself. You do need to take USMLE Step 1, Step 2 CK and Step 2 CS. That's about $2000 US right there, and if you plan to apply in 2009 for residency in 2010, then you need to start studying and taking those exams soon. Step 1 is considerably different from MCCEE/MCCQE in its focus on basic, not clinical, sciences. Many more answers on the Canadian SDN equivalent.

    2. Does this sound like a right move?
    This is not the big question right now. The big question is how you are going to set yourself up to get a residency somewhere close to your loved one. It is easier to finish residency and then move to the US once you are board-cert. Then, you can easily go back if eventually you decide that you prefer to work in Canada. Right now it can be difficult for US-residency-trained Canadians in most provinces in many specialties (FM in Ontario is an exception) to go back home without doing extra years of residency or other hoop-jumping.

    3. Any suggestions as to where else I can get some more help?
    websites listed above. There is a wealth of knowledge in the community on how to approach these issues.

    Also, bear in mind that although your fiance is at a US med school, unless she also has green card or citizenship, she too is treated as a foreigner for residency purposes, and will have to jump through the same visa hoops in 3 years. If you stay in Canada and do a basic 2-yr FM residency, you will be out at the same time she graduates, and you will have a lot of flexibility together. Otherwise, you will be in residency until 2013, and she will have to find a residency position possibly a long way away for her intern year and your PGY3 year.
     
    #2 MeowMix, Dec 4, 2008
    Last edited: Dec 4, 2008

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