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A warning to all my North American friends considering UK & Ireland..

Discussion in 'UK & Ireland' started by Killer T Cell, Mar 25, 2012.

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  1. Killer T Cell

    Killer T Cell 5+ Year Member

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    First of all, a bit of background about myself. I'm a US-IMG who came over to England for medical school in 2007. I managed to jump through all the hoops and was able to match into a pediatric residency in America. As an IMG, I've always had my eye on the foreign graduate situation and I've been seeing a disturbing trend over the last few years. And I just wanted to take this opportunity to share my thoughts and findings.

    Ever since the onset of residencies in America, there have always been more residency spots than American medical graduates. That's why it has been relatively easy for foreign graduates to match into the 'IMG friendly' specialties (FM, IM, Neuro, Psych, Peds etc) and even occasionally sneak into the competitive fields. Foreign graduates were the ones who filled the gap.

    But over the last few years, there has been a boom of osteopathic schools + increased enrollment in MD schools + opening of new MD schools. On the other hand the number of residency spots have remained the same due to budget constraints, and financial troubles. So if you put two and two together, there is a really dark cloud looming in the horizon for foreign medical graduates. It's projected that by 2015, the number of American graduates (MD+DO) will nearly equal the number of residency spots.

    This would mean that even those five specialties will be quite challenging for IMGs (Even if you are from the UK or Ireland), unless you are an exceptional candidate with really high grades, excellent USMLE scores, research and electives at top hospitals. Have a look at this thread if you want to read more about the American situation http://forums.studentdoctor.net/showthread.php?t=858100

    I am fairly certain that highly qualified IMGs will still be able to get "a" residency spot in America even if it's 2017 or 2020 in the traditionally IMG friendly specialties. But I'm pretty sure competitive specialties will almost certainly be off-limits unless you are an absolute superstar candidate (I'm talking PhD, years off for research, multiple publications in international journals etc.)

    There are a handful of Canadians in my class, so I am quite aware of the CARMS situation as well. It's a similar type of picture, with more and more Canadians studying abroad with each passing year and a stable number of residency spots. Most of the times you are competing for a very very limited number of IMG 'quotas' or fighting for unfilled spots in the second round. I know a few people who decided to settle for Family Medicine or Psychiatry although they really wanted to do Pediatrics or Internal Medicine. The competition is getting incredibly tough and this article breaks it down quite nicely. http://www.cbc.ca/news/health/story/2011/02/22/canadian-students-medicine-overseas.html

    The UK is really strict when it comes to foreign students (not sure about Ireland). Even if you go to school here, if you are not an EU/UK citizen, it is almost impossible to find good training posts beyond 2 years after graduation.

    If you do come here, keep in mind that from the day you set foot in England/Ireland, you are walking on eggshells. You cannot afford to have even one red flag on your application. The competition for residency is going to be extremely tough in the coming years. So, no retakes during medical school and no poor scores or failures in any of your USMLEs or MCCEEs. Trust me...that is a lot of pressure, because one slip up and you have almost invariably burned off all your bridges to head back home. Even if you come out on the other end unscathed, getting into a well reputed residency program in a good metropolitan city will be tough, much much harder than getting into a north american medical school. There's a good chance that you'll find yourself in an unfortunate position where you'll have to compromise on your career choice and not be able to do what you love.

    Therefore if you are a high school student, I would strongly advice you to do your undergraduate in North America, and apply to North American medical schools in a few years time; even if it means a bit of short term pain and uncertainty. Trust me, the long term consequences of going abroad significantly dampen the short term gains.

    If you are an undergraduate student or finished your degree, try to get into North American medical schools for at least two years. In my opinion, only then should you even consider the possibility of going abroad for medical school. Do a post-baccalaureate or post graduate degree, retake the MCATs, do whatever it takes to improve your application. Europe should be your last resort after you exhaust all your North American options.

    If you are already in UK/Ireland, at least you now know what you are up against and will be better prepared when the time comes to wage that uphill battle to get back home. Do audition electives at places where you want to work, these are invaluable!! Second only to your USMLE/MCCEE scores. On top of that, do research, get published, go to conferences, present audits, volunteer, and take on leadership roles. Turn yourself into a solid, well rounded applicant!

    If I were applying right now, I wouldn't even entertain the possibility of studying in the UK, not even for a nanosecond!! Things have changed so much in the last five years and they're heading downhill with each passing year. Of course you'll hear the anecdotal success stories, but please take them with a grain of salt. Because behind every success you hear about on SDN there are stories without happy endings; struggles, hardships and regrets we never hear about. I'm the only American in my class and we had seven Canadians when we first started. Three of them failed out at different junctures of our course. Out of the four who are still here, two of them applied to Canada this year (the other two are planning to apply next year because they haven't written their MCCEE yet). Unfortunately both of them did not match despite coming from a well reputed medical school in England and possessing bachelors degrees from Canada. They're trying for round 2, but most likely they'll have to stay here and try again next year. So if this is the situation today, just imagine what's looming in the horizon? There is a category 5 hurricane brewin' in the ocean my friends.....be very very careful before you decide to swim directly towards it.

    Sorry about this epic gloom and doom message. But I really think that anyone who comes to England or Ireland should be aware of the long term consequences and be able to make an informed decision. I know how difficult and unfair the medical admission process in North America is. I've seen many qualified candidates fall through the crack time and again. And I understand the appeal of well reputed medical schools in Ireland and England, places that are willing to give you a shot at your dreams. But just make sure that you have exhausted all your options back home before you get on that transatlantic flight. That way you will have absolutely no regrets a few years down the road, and you can be at peace with your decision for the rest of your life.

    If you knew all this already, I'm sorry for taking up your time. But either way, I hope it was at least a little bit helpful. All of this is just my personal opinion based on my own experiences and observations; please don't take it as anything more. Having studied in the UK and having just gone through the match, I feel like I have gained quite a lot of insight into this process. Others might disagree with me. So please do your own research and come to your own conclusions. I wish you all the best and don't hesitate to message me if you have any more questions or need any help.
     
    Last edited: Apr 18, 2012
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  3. docs87

    docs87 2+ Year Member

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    Thanks for the insight. I was on the fence about ireland.
     
    Last edited: Apr 4, 2012
  4. jf1987

    jf1987 c/o 2016

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    Overall how did the Canadians do at the end of the day?

    How many didn't match and how many had to settle for what they didn't want?

    Is it hard to get IM residency spots as Ireland IMG?
     
  5. Killer T Cell

    Killer T Cell 5+ Year Member

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    jf1987, were you asking about the IM competition in Canada or America? I just edited my original post to include more details on the Canadians from my year.

    Outside of my year...there are two Canadians I know from the Class of 2011. One of them is working in England as a junior doctor. He never applied to Canada and is going to try for internal medicine in America next year. The other settled for a rural psych post during 2nd round of Carms (even though she didn't want to do psych).

    And I know of 2 Canadians in the Class of 2010. One of them wants to do pediatrics and has been working as a junior doctor for two years here. Like I said before, your training comes to a dead end here after two years. So he's going to go back to Canada, do a year of research, write his MCCEE and apply for peds. The other person was able to get out straight away and got into internal medicine.

    The class of 2013 has about 8-9 Canadians. Many of them came here straight out of high school or after a few years of undergrad in Canada. Most of them are studying for their exams now and are going to apply next year alongside all the Canadians from my year. So I'll have a much bigger sample size next year this time. I know for a fact that only one or two of them have a genuine interest in family medicine. The rest of them are divided amongst internal medicine and pediatrics. But almost all of them just want to get back to Canada at this point that they're willing to take family medicine residencies in rural locations. This journey just wears you down......
     
    Last edited: Mar 25, 2012
  6. jf1987

    jf1987 c/o 2016

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    I was asking about IM in Canada.

    Also, despite the increase of people studying overseas the majority of those are in Caribbean and Australia. According to a presentation from Carms posted online on the CIMSA website residency directors favor Irish grads and they are certainly considered more competitive. I am thinking that perhaps most of the increased pressure will fall on graduates from Caribbean and Australia (many of whom will stay in Australia). Also it seems that people studying in Ireland, at least that post on SDN, are more optimistic and positive about the residency situation as a whole. But I am not sure why there would be a big difference between UK and Ireland.
     
  7. Alexander III

    Alexander III

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    I was thinking the same thing jf. The number of accredited foreign medical schools has not increased significantly over the last 5-10 years which means that the major increase in foreign medical students is due to an increase in attendance in non-accredited foreign schools. You can also looked at the schools accredited for US federal loans which is based on how well students from that school do on their USMLEs meaning that a lot of these non-accredited schools do not provide sufficient medical education by U.S. standards. Furthermore, over the last 5 or so years RCSI and UCD (I am not familiar with the other Irish/UK schools) have had a consistent percentage of their NA graduates match in NA despite the constant residency spots and increase in foreign and local medical grads.

    Just out of curiosity do you know if the total number of IMGs obtaining residency in Canada has been decreasing significantly over the past years? Financially speaking its very beneficial for the Canadian government to allow qualified foreign grads because the government doesn't have to pay for their medical education.
     
  8. jf1987

    jf1987 c/o 2016

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    I believe that UCC grads have been doing good as well based on numerous testimonials. I don't know about NUIG or Trinity. But apparently Canadian residency directors don't know much about each individual school and they are often considered as about equal. I think the number of IMGs matching in Canada has slowly increased over recent years since they have increased the number of spots. Couldn't find the link but I remember reading that the government has provided funding for additional positions in recent years.
     
  9. druggeek

    druggeek Banned

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    I don't even understand why americans need to go the IMG route... Here in Canada it's so hard to get into a med school (>3.7 gpa CUTOFFS), we have and endless number of people with >3.9s/high MCATs, good extracurriculars, etc etc who don't even get an interview because:

    1) One tiny part of their application was slightly off

    or


    2) They didn't have enough luck

    The competition is so intense (ex. average undergrad gpa for those getting into uoft last year was 3.94) that it makes sense that people want to leave Canada.

    I never understand why anyone who is smart AND hard working enough to become a doctor, needs to leave the US to go IMG... you guys have so many MD schools with an overall lower standard of acceptance (lower average gpa/mcat) then add in DO schools where a 3.3 has a good shot (here a 3.7 gets laughed at).

    Barring exceptional cases, a large majority of those who can't pull off a good enough academic record to get into at least a DO school, won't even be as good as the family docs who have no clue in the world what's wrong with you.
     
  10. Killer T Cell

    Killer T Cell 5+ Year Member

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    I definitely agree, the vast majority are going to the Caribbean. But Ireland is definitely second according to that article, and Australia after that. I've seen an exponential increase in Canadians at my own University (2-3 in the class of 2010 to 13-15 in the class of 2015), and I suspect a similar trend is taking place in Ireland.

    Regardless of where the additional people are going, they will still be coming back into the same pool to compete against the Irish/UK grads and we will definitely feel the pressure. And keep in mind that Canadian medical schools are also increasing enrollment + a new medical school (Northern Ontario School of Medicine), so I am sure that will also have some sort of trickle down effect.

    As of 'now', IM is moderately competitive in Canada. I am not an expert in this field, but I have had many long chats over the last few years with my Canadian mates and have picked their brains. So in today's climate all you have to do as an Irish/UK grad is to do well on the MCCEEs and perform audition electives at places where you want to match into. These audition electives appear to be crucial in Canada, so it's important to start planning for them 10-12 months in advance and shine when you're there! Of course if you have a masters degree, research, publications, presentations etc. on top of that it's icing on the cake.

    What is it going to be like 4-5 years down the road? I suspect it's going to get to a point where you need to have a really high MCCEE score along with a lot of the 'icings' mentioned above to be competitive for IM. And there will be more and more UK/Irish grads who will never be able to get back to Canada. Unfortunately we cannot predict anything in life with 100% certainty, all we can do is speculate given the current trends and patterns.

    In regards to the optimism, I think it has to do with a few factors
    1) A very successful alumni record in the past when things were still bright and sunny for IMGs.
    2) SDN is a very very skewed representation of the real life population. I didn't know this until I came over here. The people who failed out of medical school, failed USMLEs/MCCEEs, have been trying to match for multiple years with $200,000+ debt, gave up on their dream career....you will never ever hear those stories on SDN.
    3) People who have been down this road rarely come back to post their insights, stories of how they had to jump through many hoops and whether they would do it all over again if they had a chance?
     
    Last edited: Mar 25, 2012
  11. Alexander III

    Alexander III

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    Again I don't know about all the Irish schools but, I know that RCSI has had a strong number of North American students since the 1980s. I obviously don't know the details from every year but, the graduating class in 1990 had approx. 20-25 NA grads in a class size of around 120 so roughly 15-20%. So it has increased a bit over the last 30 years but not nearly as significantly as many other schools.
     
  12. druggeek

    druggeek Banned

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    The MCCEE isn't even remotely close in importance as the USMLE is for residency matching in the US. Getting a residency spot in canada is largely dependent on reference letters/doing a rotation at that site + making a good impression/and clinical grades (unless you're at a pass-fail school).

    IM isn't that competitive in Canada unless you're aiming for the top couple programs..

    Also, the biggest problem for IMGs will be other IMGs. As an IMG you compete for IMG spots, and in 2013 I believe there will be a sharp peak in the number of IMGs who are graduating (canadian born IMGs) while residency spots are stagnated.


    The biggest issue of all right now, is physician unemployment (in Canada). While derms, family docs, IMs, psychs, and peds have distributed shortages and/or are generally in good demand (or at least a solid market).. many things like... ALL surgical specialties, cards, GI, all peds subspecialties, any specialty dependent largely on procedures have a horrible job market right now. In fact I believe there was not a SINGLE cards job in ALL of Canada for the past long while. And as for the future... you have 2 physicians retire with 6 more waiting to take those 2 jobs. And then some other specialties/subspecialties (ex. optho, path,rads) have a half-decent market.

    So why should IMGs even be allowed to practice in Canada? People who are canadian grads (or at least canadians with an american MD/DO education) are unemployed or facing unemployment with their specialty choice... and then we have IMGs demanding more spots or demanding to be treated equal to a CMG/AMG given this situation. In other words, someone who couldn't quite cut it, is asking to be equal to someone who did cut it quite well.
     
  13. jf1987

    jf1987 c/o 2016

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    Despite the article saying that the second most popular place to go abroad is Ireland the majority of the increased enrollment is in Caribbean and Australia. The class sizes at the Irish schools have been largely stagnant with perhaps a slight increase from what I have read....
     
  14. Alexander III

    Alexander III

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    The majority of IMGs only get residency spots in the specialties you specifically named as having a shortage or high demand. Also many Canadian medical schools show a lot of favoritism towards things that are out of the applicant's control. Western's MCAT cutoff for students who went to high school in south-western Ontario (SWOMEN) is 8,8,8 O = 24O!!!! Seriously! They reject tons of stellar applicants because they went to the wrong high school. Furthermore there are a handful of IMGs who study abroad because they want to, its an awesome experience and contrary to what many North Americans think, there are tons of institutions that provide an equal or even better education than they would find at home. Lastly, there is no indication that suggests that Canadian medical grads are better than foreign medical grads at their job (undergraduate grades and MCAT are a very poor method of determining what makes a good doc). If I was a sick patient in Canada, I'd want the best doctor regardless of which country he/she graduated from.
     
  15. jf1987

    jf1987 c/o 2016

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    I would say that it depends on where the IMGs are from. The stats required to get into Irish schools are higher than DO and only a bit lower than American MD schools on average. Most of the Canadians going to Ireland would likely be able to get into American schools if they were citizens of the US. I have heard many Canadian doctors admit that if they were trying to get into Canadian schools today that they wouldn't have made it. Should they be fired so that recent grads can take their spot?

    Obviously I agree with you as far as Caribbean schools are concerned. The admission stats are a joke and many of the Australian schools are letting in people with pretty bad stats. Also the quality of Irish med schools are likely just as good and in some cases possibly better than Canadian schools.
     
    Last edited: Mar 25, 2012
  16. Killer T Cell

    Killer T Cell 5+ Year Member

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    I completely agree how America is relatively so much more easier than Canada. Back when I was applying it was even easier than it is now. I had my heart set on pediatrics and knew that as a UK graduate I would still be able to get into a competitive residency. My family has always been nomadic and we used to move countries every 5-6 years, so I came here purely to pursue a romantic notion of living in Europe for a few years, studying at a world-class university, citizen of the world etc. etc. I was so enthralled with this idea that I didn't even consider the American option and completely cast it aside.

    During my time here, I went to South Africa to see the world cup, traveled to twenty different countries in Europe, did plenty of research on the side....things I might never have been able to do had I stayed in America. I honestly had the time of my life. I also worked really hard and everything worked out in the end. I never had to pay for my naive and hasty decision to come here without even giving the American option a thought. I had to jump through many hoops, but overall, I got lucky and made it out unscathed! But if I had the same mistake now, would I have gotten just as lucky in 2016 or 2017? I don't know.....but most likely not......

    If I didn't get into an MD school, I would have had no qualms going to a DO school. But I know many Americans who would rather go to the Caribbean or Ireland rather than a DO program. Why does having an MD at the end of your name matter so much to some people? No idea, it makes no sense to me. And there are many people who turn up their game too late during undergrad to salvage their GPA. And I think they should definitely be given the second chance that they deserve, which the Caribbean medical schools offer.
     
  17. druggeek

    druggeek Banned

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    This shortage situation is a temporary thing. Eventually IMGs will be in many cases "taking away" jobs/potential jobs from CMGs, even for family medicine.

    Have you considered why they show this favouritism? There's too many strong applicants from Toronto/GTA area who could probably take every med school spot around Ontario (and a large number around Canada). Now how many of those will want to move away from where they grew up and live in western ontario or north-east ontario ? Very few.... So the standard is slightly dropped to ensure that a good number of doctors will be around all over the province.
    Those cut-offs also are simply cut-offs... The average person getting accepted has much much stronger stats. A relative comparison, would be that a 3.75 would get accepted if they live there vs. someone from toronto needing a 3.90 (just to show a comparison).


    As for your statement about people studying abroad because "they want to" represents a minority of students (as shown in the latest carms study) and I'm willing to bet every single one of them has a poor knowledge base about the residency situation in Canada. (every person ive talked to about going IMG thinks it's a 100% guarantee to get accepted when you're back to Canada).

    Now as for saying IMGs are as good as CMGs/AMGs... cmon now... lets be realistic. There have been sources that have said IMGs have a poorer performance on clinical rotations (carribean students). A large number also would never be competitive enough for any moderately competitive specialty (and there's a reason for that). This is after many have failed in the first couple years...




    Canadians going IMG instead of an american school don't know about the 30+ MD schools and 7-8 DO schools in the US that accept Canadians. But yea you're spot on about the rest in general. Poor admission standards contradict a long time accepted fact that medical school is and must be competitive in order to ensure physicians are the brightest people.
     
  18. druggeek

    druggeek Banned

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    Ya it's amazing someone will take such a large percentage risk, risking >200k of debt and possible unemployment on top of 4-5 wasted years of your 20s (if things dont work out) just for 2 letters after your last name.

    So many people are rapidly weeded out in the carribean, and then you can't afford to fail a SINGLE thing or good bye all hopes to a residency spot.
     
  19. jf1987

    jf1987 c/o 2016

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    I am not sure where you get your information. Take a read through this:

    "Canada's doctor shortage is bad and is only going to get worse, concludes a new report from the B.C.-based think tank The Fraser Institute.

    The report finds that Canada has 2.3 doctors for every 1,000 people -- a ratio that ranks our country 26th out of 28 developed nations with publicly funded health care. That compares to the average ratio of 3 doctors per 1,000."

    The report looked at recent medical school enrolment and graduation rates and calculates that Canada will require between 2,200 and 2,300 new physicians each year from now through 2020.

    That figure would be just enough to maintain the current physician-to-population ratio, not to improve the ratio. Nor does that estimate account for the increasing number of doctors currently practising who will retire between now and 2020.

    "In fact, in 2010, 38 per cent of Canada's physician workforce was aged 55 or older and the projections we've made don't even account for that increase in retirement that we're likely to see over the next 10 years," Esmail said.

    Source: http://www.fraserinstitute.org/uplo...esearch/articles/canadas-physician-supply.pdf
     
  20. Alexander III

    Alexander III

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    I am well aware of the shortage of docs in rural areas and don't disagree with Westerns favoritism on those grounds. I think a 24O cutoff is still a bit low, this is southwestern Ontario, not the Carribean. However; Western does take up almost 20% of all medical school spots in Ontario which makes things more competitive even if you live in other rural areas in Ontario.

    I apologize, I should have been more specific about IMGs being as good as CMGs/AMGs. I meant IMGs from legit foreign medical schools who are able to score well on USMLEs and MCCEEs. I do not advocate for the carribean schools or other foreign schools with very low acceptance stats. The top Irish grads are still competitive for some competitive specialties, I know a UCD graduate who graduated last year and matched in radiology in the GTA.

    Also the Irish medical system puts a lot of emphasis on communication and bed-side manner which is something that is lacking with CMGs. I know this because I was talking with a doc on the weekend who is the head of a residency program in Ontario and he compared a lot of new residents who applied this year to walking and talking webMDs. With patient compliance already being a huge issue in Canada, we need docs who can communicate well with patients. I realize this is just one aspect and am fully aware that there are components of the Canadian system that are better than the Irish system and vice-versa.
     
  21. druggeek

    druggeek Banned

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    Have a look thorugh these:

    http://www.cihi.ca/CIHI-ext-portal/...spending+and+health+workforce/RELEASE_02DEC10

    http://premed101.com/forums/showthread.php?t=60302

    Generalizing all physicians together is a big mistake. Not everyone wants to be a family doctor and more so, just because there is a physical shortage does NOT mean that there are jobs to meet this shortage. When there are unemployed specialists... that says something.

    Hospitals do not have the money to have enough operating room space to support more surgeons (which are needed due to surgery waiting times). They also don't have enough money to put more resources out there for many other specialists.

    Shortage and physical demand do not equal more jobs in Canada.
     
  22. Alexander III

    Alexander III

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    +1
     
  23. Killer T Cell

    Killer T Cell 5+ Year Member

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    This is exactly where the trouble is brewing. Although schools like RCSI, UCD etc. might be taking a stable number of North Americans every year, there are more and more Irish and British schools that are opening up their doors to N. Americans (eg. the new program at St. Andrews in Scotland, Imperial in London etc.). In the face of stagnant residency spots, this will significantly increase the competition in the years to come.
     
    Last edited: Mar 25, 2012
  24. jf1987

    jf1987 c/o 2016

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    In BC, for example, they are increasing IMG spots...

    Question: What steps are being taken to improve access for IMGs, including CSAs?

    In response to a commitment to improve access for Canadians Studying Abroad (2008 and 2010 Throne Speech), the following steps have been taken:
    o 40 new entry-level positions will be added to the IMG-BC Program. At full implementation in 2015/16, 58 entry-level positions or 134 IMGs are expected to be in training at any one time. The program will be larger than a distributed medical program (which has 32 first-year students or 128 undergraduate MD students in training at any one time)
    o utilizing the Medical Council of Canada's national assessment tool
    o removing the requirement for success in the Medical Council of Canada's Qualifying Exam part 1 prior to accessing CaRMS

    Source: http://med.ubc.ca/files/2012/03/img_bc_and_canadians_studying_abroad-briefing-March-2012.pdf
     
  25. druggeek

    druggeek Banned

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    Thing is those who are accepted do much much better than the cutoff. maybe a couple will squeek through but those are outstanding in all other regards.

    And yes you're right about the TOP and the best IMGs only because they were definitely good enough to get into at least an american school but due to a lack of research, went the IMG route. But nothing at all should ever be changed to further accomodate IMGs who are canadian born... because the best IMGs will always be successful (since they only compete with each other for residency spots) so it's an irrelevant discussion.
     
  26. druggeek

    druggeek Banned

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    BC has a seperate issue and they had an increase in their seats for many reasons. This (very thankfully) will not carry over to other provinces (the worst to carry over would be Ontario).
     
  27. MonsterCookie

    MonsterCookie

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    Just to clarify, it's 8/8/8/O but your total score has to be at LEAST 30 for interview invites (along with the minimum 2-year GPA of 3.7). It's quite annoying for people like me, because I met the GPA cutoff and the MCAT cutoff by section...but was rejected because I had a total score of 29 :( ...24O would be ridiculous haha.
     
  28. Alexander III

    Alexander III

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    woops haha, forgot about that. Sorry.
     
  29. Alexander III

    Alexander III

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    I don't think its necessarily due to the lack of research. Studying abroad is most certainly an awesome experience both educationally and culturally. For example Dublin ranks as 8th best student city in the world according to the QS world university rankings. So I would argue that those capable of getting into NA schools should consider going through the IMG route at top level schools precisely because they will be successful and can be competitive in most specialties when they return to NA. I would personally rather get a world class education in city like Dublin over going to a low-tier US medical school in a random city. That's just my opinion though.
     
  30. Killer T Cell

    Killer T Cell 5+ Year Member

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    This is just a drop in the bucket in comparison to the increasing number of Canadian Students studying abroad. "The number of Canadians studying medicine outside of Canada has more than doubled in the last five years". The best and the brightest IMGs will still match. But it's just going to be an uphill battle as the bar rises higher and higher with each passing year.

    Will Irish/UK grads be immune from this phenomenon? Definitely not. Mediocre Irish/UK grads will definitely feel the squeeze. My classmates are already experiencing it. We all like to believe that we are the best and brightest (I know for a fact that I am not). However life is unfortunately a bell curve and there's not enough room for all of us at the top.

    It's a scary reality, but one that must be acknowledged and respected. It'll instill a healthy dose of fear and motivation. Only then can you start planning other avenues (research, volunteering, leadership etc.) to catch up to and compete with the IMGs at the top of that bell curve. Only then will you be prepared to accept the consequences of failure and be ready to come back stronger after each setback. The ones who I've seen fall, were usually the ones who were unaware of their fallibility, and oblivious to the fact that they were walking on a tight rope the day they set foot in a foreign medical school.
     
    Last edited: Mar 25, 2012
    Maruko likes this.
  31. Killer T Cell

    Killer T Cell 5+ Year Member

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    Physician
    I couldn't agree more!! Studying abroad has definitely been an enlightening and enriching experience for me.

    This is where our opinions diverge :) I would argue that those planning to practice in Canada or America should go through the AMG/CMG route even if it means going to a low tier US medical school in a random city. The short term gains of living in a fun city, getting a world class education etc. are not worth it in terms of the long term risks. They are -

    1) Risk of not being able to match into a specialty of your choice. No matter how prestigious your school is, certain specialties such as ENT, ophthal etc. will be out of the question unless you are an absolute superstar genius with publications in NEJM!! Even moderately competitive specialties like ER & General Surgery will require a ton more work than your Canadian counterparts.
    2) Risk of matching into a location or program that AMGs/CMGs avoid like the plague, places where you might be miserable for the next 3-6 years of your life.
    3) Risk of not being able to match at all with $250,000+ of debt.
    4) Risk of failing out of medical school with a six figure debt. I know that UK medical schools weed out so many people during the first two years. 3 out of 7 Canadians in my year failed out at various points. Whereas the fail out rate at N. American medical schools is very very minuscule. Rarely do people drop out, and mostly for personal or family reasons.

    It's hard to assess these risks at the dawn of your medical school career. But I'm coming towards the sunset and I've seen how real and devastating these risks are. Even if you make it to the other side, students from places that are far far lower on the 'world university rankings' will get significantly better interviews and match into significantly better places.

    So for me personally, give me a spot at the lowest ranked American University any day over a top 10 world university such as Imperial or UCL. It's not worth it at the end of the day unless I have exhausted all my options. The reputation and prestige does not correlate with match success as I've seen with my Canadian classmates. We'll always be second class citizens, a tier below the AMGs/CMGs, a fact that I am comfortable with. You can adjust the imbalance a bit by going to a well known uni, but the scales will never be even, and the disparity is much wider than you think. Just my 2 cents....
     
    Last edited: Mar 25, 2012
    ridethecliche likes this.
  32. Wolf11

    Wolf11 2+ Year Member

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    This thread is depressing...
     
  33. Psychologic

    Psychologic 2+ Year Member

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    +1 :(
     
  34. S0B

    S0B 5+ Year Member

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    Canada
    Its the unfortunate reality we face as International Medical Students :(
     
  35. Psychologic

    Psychologic 2+ Year Member

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    :( That's true but you've gotta stay at least a little optimistic otherwise everything can overwhelm you. No matter what happens at least we'll have some fun in the process :)
     
  36. Alexander III

    Alexander III

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    Fair enough, I agree with some of your points and disagree with others.
    1) This is a risk regardless of where you graduate from. Only the top candidates in Canadian medical schools can freely pick their specialties, the ones who graduate in the lower half of their class have to take what's remaining. Job availability also currently limits some specialties after residency regardless of how competitive an applicant is. I do agree that IMGs need to have a stronger application to beat out a Canadian counterpart and rightly so.
    2) Again a risk for Canadian grads although more IMGs are likely to be stuck in this position because the bottom half of IMGs that make it back to Canada won't be able to out compete the CMGs for better residency spots, and again rightly so.
    3) Agreed although this risk varies significantly and also depends on the individual applicants. If a IMG gets a low USMLE and MCCEE score and can't match anywhere that's mostly their fault. Study harder, prepare better or don't attend an inadequate foreign school especially if you have $250,000+ on the line.
    4) Again, even if more NA students fail out of foreign schools than local schools, I have little sympathy. It is entirely the student's fault if they fail out, a lot of good foreign medical schools have relatively competitive stats (3.6+ GPA, 30+ MCAT) so its not like these candidates are stupid.

    I completely agree that you have to assess the risks and make educated decisions. Good decision making, realistic views and a strong work ethic is essential for IMGs to make it back to NA into an acceptable residency specialization and location. So basically, don't go to a sub-par school that won't prepare you properly, work as hard as you can throughout those 4/5 years to make yourself as competitive as possible and during the summers try and make connections back in NA at places with teaching hospitals (research). Also try to remember that you are competing mostly with other IMGs and the inflated number of IMGs comes from sub-par medical schools so if you are attending a well-regarded school then you already have an advantage over them. That's my view...
     
  37. jf1987

    jf1987 c/o 2016

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    I wonder what will happen to all of the Caribbean schools. They will have to shut down once their match rates turn to rubbish because they will get hit the hardest by this. Naive people will keep going to a point.
     
  38. Salad

    Salad

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    OP thanks for posting this.

    To everyone else, I do believe a lot of the fear mongering above is a bit much. That being said, it's an incredibly important message and should be heeded in part. Becoming an IMG is not easy. Work hard and (try to) educate yourself about the match. We have a harder match situation then our AMG/CMG counterparts. Luckily we have people like the OP who are willing to share experiences so we can better prepare ourselves.
     
  39. Medstart108

    Medstart108 5+ Year Member

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    Mar 24, 2012
    Thanks for posting this, I definitely agree with your points. Make sure you do your research before considering options abroad.
     
    Last edited: Apr 21, 2014
  40. S0B

    S0B 5+ Year Member

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    If you get accepted to McMaster health Sciences, DEFINITELY Go there. However, I do not think any other science/medical related program is worth it in Canada.

    Right now I am 17 years old and I figure by the time I (hypothetically) finish medical school abroad, I will be 23 years old. Even If I take 5-6 years matching for residency (Highly unlikely considering I wanna pursue FM) I will still be on the same level as current Canadian Medical Graduates.

    If I were in your shoes, I would choose based on you acceptances, Mac Health Sci > A990 Program > NUIG. This is all assuming you have the financial situation sorted out.
     
  41. sasmadrid

    sasmadrid

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    Great response.
     
  42. Tranc3r

    Tranc3r

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    Salutations,

    The 1st post points out a very important prediction that theoretically might occur. Personally, I do think that residency matching will become increasingly more competitive as every year goes by. It's important to take note that those students who already have residency positions, this year or year(s) before, after graduating from the Irish medical schools are competing in the pool of that particular year. No doubt, with added numbers of freshly baked IMGs every year plus those who try again for residency, by the time it's 2017/2018, it's going to be a lot more difficult to get a match if the residency spots remain the same, or worse, decrease. But, take note, no one can predict what's exactly going to happen in 5-6 years. Who knows... maybe Taxes will finally be spent the proper way and hundreds of more spots open, or, government completely slices off IMG applications and opens hundreds of more Canadian/USA medical school slots. But bottom line, it's important to see and feel the reality of the situation.

    I am fairly knowledgeable of the whole process of residency matching as my brother is going through it at the moment (as an IMG) and there are tons of resources out there to inform yourself. I have been collecting as much information from everyplace I can since Grade 10. I am currently finishing off my 2nd year of my BSc. I too am applying to medical school in Ireland and I know the risks I am taking but I fear that there are many of those who don't know.

    Now to shed some light on the most important part of becoming a doctor in Canada and USA... Residency. This would generally go for ALL IMGs. I do not have direct statistics for Ireland and still wonder why ABP doesn't publicize any statistics on residency matching for students that go through them; but it's important to know too that residency matching isn't their business. (but it might just help out in getting more applicants if the residency matching is acutally what they mentioned to me on the phone: "All the graduates get residency." ABP also mentioned to me that in Canada, you're stuck with Family Medicine, and if you want to try (not guaranteeing) for specialty, you're better off at USA.

    I'm not sure if everyone here has looked at actual statistics provided by both CaRMS and NRMP, but if you haven't, the links are below. It shows why it's so much more beneficial to get into medical school of your country (USA or Canada).

    USA via NRMP: Please view page 12 & 29. You can clearly see the advantages of staying home as nearly all applicants get matched. ~40-50% IMG get matched.

    http://www.nrmp.org/data/resultsanddata2011.pdf

    Canada via CaRMS: One the second link, you can see how much more difficult it is to get a residency match if you're an IMG; ~20% get match.

    Specific stats: http://www.carms.ca/eng/operations_R1reports_11_e.shtml
    Stats that matter: http://www.carms.ca/pdfs/2011R1_MatchResults/1_Summary of Match Results R1 1st_2nd Combined_en.pdf


    Please take these facts into consideration. It really sucks how the present system is layed out in Canada and USA if you want to become a doctor. This may be for another topic, but I just ask "Why are you really becoming a doctor?" Do some soul searching and really grind it down. For me, I'm heading right down to DWB or Mercy Ship after my MD because, personally, I believe that money is important but never a priority, it's more of helping those who need it than those who expect it.

    If I do not get into Ireland this time (first time applying), I feel that it'll be worth it and I'll try within Canada. However, I also know and met others with amazing GPA + MCAT + Bachelors + research and don't get in. So, in reality, it's risky whichever path you go, but just please don't make your decision blindly.
     
  43. druggeek

    druggeek Banned

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    Oct 1, 2010
    lol hope this is not a joke..

    Let me give you a bit of advice kid and take my words very seriously.

    1) You have no idea in the world what specialty you want to do. Your first choice ir surgery? Wait until you've done enough rotations working 70-100 hour weeks doing nonstop call before you decide to dedicate your life to it. More so, once you actually do rotations your interests will drastically change... so forget about specialty choices right now.

    2) I know people with low-mid 80s in high school who are destroying university right now with >3.8 GPAs and I know people with mid-high 90s in high school who are getting 2.7-3.0s. Forget high school marks dude... if you understand the material, then youre fine. Your average could be 85 and you might end up killing your friends' GPAs in uni... so dont even let that be a factor.

    3) Having some random ECs including lots of volunteering wont make you stand out in the EC department. You need to have all that, have research, be a top athlete/artist, have some awards, have a good story, have other types of ECs, AND have a high mcat/high gpa and make sure everything else in your app. is very strong too (ref letters, essay, etc.). Oh and be socially skilled and kill the interview. The people you know who got rejected from med didnt have one (or more) of these things. Or they didnt apply to enough places...
     
  44. druggeek

    druggeek Banned

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    Oct 1, 2010
    you do understand the risks of being weeded out in med school abroad right? and you do understand IMGs may end up being selected at a very minimal level in the future right? The college is doing a full investigation on physician unemployment, and you can bet they are very strongly going to look at problems facing CMGs and will do what they can (at the expense of IMGs) to modify this issue.
    On top of that, theres an increasing number of canadian born - american grads who are considered equal to canadian grads, and they will take up more spots in the future.


    If you do take a few years for residency matching, you will be largely incompetent in your clinical skills as well as background knowledge that (likely) you'll face termination very early into your residency. Simply due to the fact that "if you dont use it, you'll lose it."
     
  45. MeowMix

    MeowMix Explaining "Post-Call" 10+ Year Member

    1,639
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    Jan 6, 2003
    Here is another option if you are 17 and brilliant: my career path. Go to university in Canada. Do well. Go to top grad school in US on scholarship. Do well. Work in US and save money. Get green card. Apply to med school in US. I was not brilliant; my university GPA was nowhere near high enough to get into Can med schools; I did great in the US application process.
     
  46. druggeek

    druggeek Banned

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    What about the 30+ med schools in the US that accept canadians and 7-8 DO schools that do as well?
     
  47. jf1987

    jf1987 c/o 2016

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    Jerusalem, Israel
    [​IMG]
     
  48. druggeek

    druggeek Banned

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    Oct 1, 2010
    lol I'd have lots of fear gambling a massive amount of money and the best years of my life for potentially getting nothing in return.
     
  49. MeowMix

    MeowMix Explaining "Post-Call" 10+ Year Member

    1,639
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    Jan 6, 2003
    I could not stomach hundreds of thousands in debt, high interest rates (over 10% at the time), and $1.30 canadian on the US dollar.

    But these are fine options for people with money, particularly now the C$ is at par. I agree with you that the DO schools should be a top choice for anyone hoping to practice in north America.
     
  50. jf1987

    jf1987 c/o 2016

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    Jerusalem, Israel
    That is why I am getting an eu passport due to my heritage ;) I can do my post-graduate training in Ireland or UK when I am done if I can't get back.

    The majority of us will be okay anyways as long as we are prudent and realistic. There is no need to incessantly fear-monger based on hypothetical worst-case scenarios.
     
    Last edited: Mar 26, 2012
  51. druggeek

    druggeek Banned

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    Oct 1, 2010
    Places like Ireland, and any useful schools in the carribean would put you in a similar situation though... 200k debt etc etc. Except your odds of getting into residency will be more like 20% lolz... vs. a near guarantee if you're an american grad looking to do primary care.

    Though many people do have parents who can chip in (paying ~10k a year + living costs) as well as some money they've saved up, etc etc So your debt could be in the low 100s (not too bad). Interest rates would probably be more like 6% and we wouldnt have a 1.30 dollar ;)
     

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