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

[druggeek]

Class Avg. of my Orgo Class: 67% (and this was the pre-med/life sci orgo class).

85% class avg for orgo? Are you kidding me? Even 76 is ridiculously high.

lol @ my uni class averages are more like 50-55. But thankfully it's cause there's a fair number of dumb people.

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[Alexander III]

You're making some assumptions dude,

1) You realize that once you're an IMG, your only 'realistic' residencies are IM/FM/Peds/Psych in the U.S, and Psych/FM in Canada? And by the time you graduate (2017 or whatever), the way the climate is going for IMGs in America, it will only be FM/Psych. And guess what, these are the lowest paying specialities....

Fact: There are family docs and psychiatrists earning 150K/year. And by coming overseas, you will have HUGE loans.

I already posted this once, but I will again, cause its 100% accurate: http://benbrownmd.wordpress.com/

Also remember, physicians' incomes in general are coming down. Long gone are the days when docs are rolling around in 500K pools of money. Those are 80s and 90s. Things have changed, and will continue to change for our generation of doctors.

Fact: My dad is a Physician in Canada, and he has said that in the past 5 years, he has witnessed a 30-40K hit in income.

Trust me man, when you're a final year medical student, as you know as an IMG you have no chance (realistically) at obtaining radiology, urology, derm, anesthetics, ER, etc., you will regret not staying in Canada. Even if you do save 400K or whatever cause you cut short 1-2 years, is that really worth the price of doing something for 40 years that you don't love?

Trust me buddy, if you don't like doing ward rounds for 5-6 hours/day (Hospitalist) or talking to depressed people for 6 hours a day in outpatient clinics (Psychiatry), saving that 400K or whatever will mean nothing.

2) Are you not reading the rest of this thread? You don't go to Queen's Life Sci or Mac Health Sci. You BEAT the rush.

Want my advice? Go to Univ. of Guelph or Univ. of Windsor or York Univ. I'm not slamming these schools at all, but the impression I get is that its easier to get a higher GPA than it is if you do Life Sci at U of T/Queen's or Health Sci at Mac or BMedSci at Western. Do an 'easy' degree or anything that interests you. Smack a 3.9. Take Organic chemistry in the summer so it DOESNT count towards your GPA. Spend 2 months of your summer between 2nd and 3rd year studying for the MCAT. And you're IN. You're a Gr.12 student and posting on SDN. By that alone you're a smart kid. I'm fairly certain you won't have any trouble getting into Ontario Meds...if you play the game.

Worst case scenario, if you don't get into meds after 4 years, you book it to the carribean. I got a close friend that went to Western, did BSc (3 years) and then booked it to SGU (4 years) and matched into Internal Medicine in Ontario. 7 years total.

and if you really play your cards right, you can do 3 years of BSc and 3 years of MD (Mac or Calgary). 6 years total.

In the words of Charlie Sheen, "Winning".

You keep mentioning the whole "do what you love" idea when it comes to medicine which is great but, many IMGs aren't sitting here pondering between a NA acceptance letter and a foreign acceptance letter. Many applicants can't get into Canadian medical school because the competition is absurd, so for a lot of candidates its FMG or bust. A lot of people are also open-minded and would rather be any kind of doctor rather than an entirely different profession. Also a university degree is hardly worth anything anymore because everyone has one. I know kids with a university degree working at McDonalds so if you have an acceptance letter to an accredited foreign medical school chances are you will be able to practice medicine somewhere, even if its not your number 1 specialty or number 1 location. There is also no rules against changing specialties, it happens all the time, so who says you have to do a job you don't like for 40 years.

 

[Blitz2006]

You keep mentioning the whole "do what you love" idea when it comes to medicine which is great but, many IMGs aren't sitting here pondering between a NA acceptance letter and a foreign acceptance letter. Many applicants can't get into Canadian medical school because the competition is absurd, so for a lot of candidates its FMG or bust. A lot of people are also open-minded and would rather be any kind of doctor rather than an entirely different profession. Also a university degree is hardly worth anything anymore because everyone has one. I know kids with a university degree working at McDonalds so if you have an acceptance letter to an accredited foreign medical school chances are you will be able to practice medicine somewhere, even if its not your number 1 specialty or number 1 location. There is also no rules against changing specialties, it happens all the time, so who says you have to do a job you don't like for 40 years.

I thought just like you man, when I was a pre-med student. I just wanted to be a doctor. But you'll soon realize, 'doctor' is a very, very large umbrella term. Sitting in a lab and cutting up specimens (pathology) is very different from chatting with patients all day (psychiatry).

After rolling through the years of med school, I've realized there is a lot in medicine I like...and a lot I dislike. The difference is, Canadian Med Students can more easily obtain what they like...whereas that scope for IMG is much smaller...

I'll be honest, I'd have more fun being a highschool gym coach (i love sports) than sit in a office all day and prescribe painkillers for back pain (Family medicine).

And of course you can 'switch' careers. But you realize as an IMG, this is almost impossible, especially with Return of Service? Also, after doing a gruelling 3-4 year Internal Medicine residency, 'switching' careers is very tough, and probably unrealistic/unlikely. You think after doing 4 years of 80 hours/week, you're gonna sign up for another 5 year residency at the age of 32? Doubt it.

But I'll admit, you're probably right, I probably am a bit more picky than the avg. med student when it comes to speciality/location.

Just my 2 cents,

Disclaimer: I'm obviously generalising FM to make a point, so before anyone starts to flame me....

 

[DoctaS]

Killjoy.

 

[Alexander III]

I thought just like you man, when I was a pre-med student. I just wanted to be a doctor. But you'll soon realize, 'doctor' is a very, very large umbrella term. Sitting in a lab and cutting up specimens (pathology) is very different from chatting with patients all day (psychiatry).

After rolling through the years of med school, I've realized there is a lot in medicine I like...and a lot I dislike. The difference is, Canadian Med Students can more easily obtain what they like...whereas that scope for IMG is much smaller...

I'll be honest, I'd have more fun being a highschool gym coach (i love sports) than sit in a office all day and prescribe painkillers for back pain (Family medicine).

Just my 2 cents,

Disclaimer: I'm obviously generalising FM to make a point, so before anyone starts to flame me....

Given the current state of teachers college it may actually be harder to become a gym teacher haha. I'm also aware of the term "doctor" and the how broad of a term it is. I happen to have a very high interest in family medicine (and yes I know what it entails because my father is GP) at this point which is why I'm not too worried about going the IMG route because even if there a few specialties I'm interested in, I won't be "settling" for an undesirable one if they are unattainable because of competitiveness or job availability.

 

[Blitz2006]

Given the current state of teachers college it may actually be harder to become a gym teacher haha. I'm also aware of the term "doctor" and the how broad of a term it is. I happen to have a very high interest in family medicine (and yes I know what it entails because my father is GP) at this point which is why I'm not too worried about going the IMG route because even if there a few specialties I'm interested in, I won't be "settling" for an undesirable one if they are unattainable because of competitiveness or job availability.

See thats my point. You know what you want, and you realize that as an IMG this is obtainable. Fair Enough.

The whole point of this thread, started by KillerT, was to say to prospective IMGs to not cross the pond and expect to get Urology in TO when coming back. And thats my point as well. Be realistic (which many IMGs are not, shockingly).

 

[DoctaS]

See thats my point. You know what you want, and you realize that as an IMG this is obtainable. Fair Enough.

The whole point of this thread, started by KillerT, was to say to prospective IMGs to not cross the pond and expect to get Urology in TO when coming back. And thats my point as well. Be realistic (which many IMGs are not, shockingly).

last year an RCSI Grad got into Ortho at Mac. . .
you just need to have connections

 

[freakeenyc]

Yay page 4. Honestly though, I'm sure a decent proportion of.students going to Ireland understand the negative repercussions. You don't just move to another country for 4 years without doing your homework. But to those who don't knoe I guess this thread will scare the crap outta them.

 

[druggeek]

You keep mentioning the whole "do what you love" idea when it comes to medicine which is great but, many IMGs aren't sitting here pondering between a NA acceptance letter and a foreign acceptance letter. Many applicants can't get into Canadian medical school because the competition is absurd, so for a lot of candidates its FMG or bust. A lot of people are also open-minded and would rather be any kind of doctor rather than an entirely different profession. Also a university degree is hardly worth anything anymore because everyone has one. I know kids with a university degree working at McDonalds so if you have an acceptance letter to an accredited foreign medical school chances are you will be able to practice medicine somewhere, even if its not your number 1 specialty or number 1 location. There is also no rules against changing specialties, it happens all the time, so who says you have to do a job you don't like for 40 years.

Well there's also the US schools which are an option, easily defeating the whole IMG thing.

Changing specialties is very difficult to do right now. It used to be much easier (like everything else in the world was) but you can only match in the 2nd round and obviously... all the good specialties will be gone in the 1st round.

What would scare me a lottttt about going the IMG route, is getting 250k of debt and having nothing to show for it after. There was one guy talked about on SDN, he's tryin to get a job as a teacher after investing 10 years trying to get into med school/going IMG route med school. He didnt get a teaching job yet, so he's teaching mcat courses...lol. Then there's the prospect of going IMG and being kicked out after 2 years. Some people think just by going to the carribean and "working hard" your step 1 scores will be amazing, ya...um... so then why didnt they work hard for their gpa/mcat ??

 

[Alexander III]

Well there's also the US schools which are an option, easily defeating the whole IMG thing.

Changing specialties is very difficult to do right now. It used to be much easier (like everything else in the world was) but you can only match in the 2nd round and obviously... all the good specialties will be gone in the 1st round.

What would scare me a lottttt about going the IMG route, is getting 250k of debt and having nothing to show for it after. There was one guy talked about on SDN, he's tryin to get a job as a teacher after investing 10 years trying to get into med school/going IMG route med school. He didnt get a teaching job yet, so he's teaching mcat courses...lol. Then there's the prospect of going IMG and being kicked out after 2 years. Some people think just by going to the carribean and "working hard" your step 1 scores will be amazing, ya...um... so then why didnt they work hard for their gpa/mcat ??

US schools are not that easy for Canadians since a lot of the small schools don't even accept international students and the large schools only take a handful of students, all of which who have competitive stats.

I can also tell you a story of a guy I talked to who went to UCD, had the best 4 years of his life and then matched in radiology at mac. Try telling him he shouldn't have gone the IMG route.

I agree that those who have very subpar GPA and MCAT should not go IMG route because frankly they may not have have the minimum academic potential. Students with >3.6 GPA and 30+ MCAT are competitive enough for Canadian and US schools. This is even more true with those who have MCAT scores around 32-33 because at that point you are literally a few questions away from 35-36 (can easily be attributed to luck or other factors).

I also have no sympathy for students who don't work hard in med school. Do your work because at that point your education isn't about passing tests, you need to know it so you don't get patients killed.

 

[druggeek]

US schools are not that easy for Canadians since a lot of the small schools don't even accept international students and the large schools only take a handful of students, all of which who have competitive stats.

I can also tell you a story of a guy I talked to who went to UCD, had the best 4 years of his life and then matched in radiology at mac. Try telling him he shouldn't have gone the IMG route.

I agree that those who have very subpar GPA and MCAT should not go IMG route because frankly they may not have have the minimum academic potential. Students with >3.6 GPA and 30+ MCAT are competitive enough for Canadian and US schools. This is even more true with those who have MCAT scores around 32-33 because at that point you are literally a few questions away from 35-36 (can easily be attributed to luck or other factors).

I also have no sympathy for students who don't work hard in med school. Do your work because at that point your education isn't about passing tests, you need to know it so you don't get patients killed.

I think 2 cycles of applying to every MD school that takes Canadians (about 30-35 I believe) and every DO school that takes Canadians (6-7) should get you in SOMEWHERE.

Even getting into an average MD school isnt that hard for a Canadian. Just beat all the average admission stats by a little. 3.60 average? Have a 3.70... 31 mcat? have a 33 mcat.

 

[Alexander III]

I think 2 cycles of applying to every MD school that takes Canadians (about 30-35 I believe) and every DO school that takes Canadians (6-7) should get you in SOMEWHERE.

Even getting into an average MD school isnt that hard for a Canadian. Just beat all the average admission stats by a little. 3.60 average? Have a 3.70... 31 mcat? have a 33 mcat.

That is an alternative to going the IMG route but a lot of people would rather get a world class education at a school like RCSI or UCD in an awesome city like Dublin. ALL the guys I talked to who went to an Irish medical school who got back into Canada (haven't actually met one who didn't manage to get back to NA, mostly cuz there has only been a handful over the last couple of years who haven't been able to) said that those 4 years were some of the best years of their life. Most of those private US schools charge around $40,000-$60,000 per year in tuition as well so its cheaper but still a lot of money.

No one is denying that there is a risk of going to a foreign medical school but, realistically if you're reasonably intelligent, have an excellent work ethic and network properly then you will not have any trouble getting back to NA. The people who don't make it back either flunk out, go to a school that doesn't prepare them for the USMLEs/MCCEE, only apply to overly competitive residency programs and don't put enough effort in making connections back in NA. As far as I'm concerned if you go to an accredited foreign medical school and can't get back to NA, then its your own fault not the medical schools.

 

[druggeek]

That is an alternative to going the IMG route but a lot of people would rather get a world class education at a school like RCSI or UCD in an awesome city like Dublin. ALL the guys I talked to who went to an Irish medical school who got back into Canada (haven't actually met one who didn't manage to get back to NA, mostly cuz there has only been a handful over the last couple of years who haven't been able to) said that those 4 years were some of the best years of their life. Most of those private US schools charge around $40,000-$60,000 per year in tuition as well so its cheaper but still a lot of money.

No one is denying that there is a risk of going to a foreign medical school but, realistically if you're reasonably intelligent, have an excellent work ethic and network properly then you will not have any trouble getting back to NA. The people who don't make it back either flunk out, go to a school that doesn't prepare them for the USMLEs/MCCEE, only apply to overly competitive residency programs and don't put enough effort in making connections back in NA. As far as I'm concerned if you go to an accredited foreign medical school and can't get back to NA, then its your own fault not the medical schools.

This has already been discussed several times in this thread.

Going the DO route is much much better than going IMG only due to the fact that statistically your odds of matching is enormously higher. If not, I dont know how it can be justified to spend 250k on something with 30-40% success rate vs. >90% success rate.

 

[jf1987]

This has already been discussed several times in this thread.

Going the DO route is much much better than going IMG only due to the fact that statistically your odds of matching is enormously higher. If not, I dont know how it can be justified to spend 250k on something with 30-40% success rate vs. >90% success rate.

You are seriously just trolling at this point.

 

[Alexander III]

This has already been discussed several times in this thread.

Going the DO route is much much better than going IMG only due to the fact that statistically your odds of matching is enormously higher. If not, I dont know how it can be justified to spend 250k on something with 30-40% success rate vs. >90% success rate.

Well fortunately the med school I'm attending has had a <90% success rate along with a few other Irish schools which has also been discussed in this thread, so careful how you apply your stats because not all foreign medical schools are the same.

 

[druggeek]

Well fortunately the med school I'm attending has had a <90% success rate along with a few other Irish schools which has also been discussed in this thread, so careful how you apply your stats because not all foreign medical schools are the same.

Well then you are well on your way.

 

[deleted21609]

Well fortunately the med school I'm attending has had a <90% success rate along with a few other Irish schools which has also been discussed in this thread, so careful how you apply your stats because not all foreign medical schools are the same.

Sure they do. Sure they do.

Don't say you haven't been warned.

Gotta love applicants ignoring the truth shared by those who've been there.

 

[jf1987]

Sure they do. Sure they do.

Don't say you haven't been warned.

Gotta love applicants ignoring the truth shared by those who've been there.

But the other half of those who have been there and are on these forums have a much more positive view of the experience as well as its outcomes. It seems that some of those of the contrary opinion are jaded about their experience. Perhaps it is because they went in with faulty expectations or got burned themselves somewhere along the road.

 

[Killer T Cell]

I got into a top 20 pediatrics program (specialty of my choice) in an awesome city and I'm the only IMG in my class of 28 interns. So no, I'm not jaded and I didn't get burned along the road or go in with faulty expectations. I love it how people always think there's an ulterior motive or undertone of resentment whenever you say something negative. It might be the case with some people, but please don't put us all in the same boat.

Very few people acknowledge that some of these posts could be the result of an objective analysis of the facts, balanced with our real-world experience. It's hard to acknowledge that, it's easier to believe that the voices of caution are the result of resentment and anger. It's easier to accuse people of fear mongering than give them even a little bit of credit. It's easier because it fits with your world view. Otherwise it means that you have to open your eyes to the possibility of an unpleasant reality.

I love how most of the skepticism and flames are geared towards the people advising to tread with caution. If you're going to be a skeptic, be skeptical of both sides of the coin.

And finally, what motive do we have for fear mongering? We have finished our journeys, we are not competing against you in any form or shape, and we have no hidden plans to bankrupt British and Irish medical schools. All of us are taking the time out of our busy schedules to write these lengthy posts, so that future applicants will have a balanced and realistic perspective on the journey that lies ahead. Whether people want to take them on-board is entirely up to them.....my conscience is now clear.

 

[druggeek]

Sure they do. Sure they do.

Don't say you haven't been warned.

Gotta love applicants ignoring the truth shared by those who've been there.

I think the problem with future-IMGs is that they fail to realize how newer schools are popping up in the US (DO/MD schools) and very soon the number of american grads will be VERY close to the number of residency spots. Obviously there will be very few spots left for IMGs... Hence why it's laughable that people quote people they know got into "hopkins neurosurgery after graduating from whatever international school." Like it gets worse every year, you need to stay with the times.

 

[freakeenyc]

Ok. How about we move this thread in another direction. For those who are going to the UK, what kind of advice can you guys give other than not go, beast the USMLEs. What should we look out for etc.

 

[jf1987]

So no, I'm not jaded and I didn't get burned along the road or go in with faulty expectations. I love it how people always think there's an ulterior motive or undertone of resentment whenever you say something negative. It might be the case with some people, but please don't put us all in the same boat.

I love how most of the skepticism and flames are geared towards the people advising to tread with caution. If you're going to be a skeptic, be skeptical of both sides of the coin.

I didn't say that all of you are jaded but simply wanted to understand why many others who have made the journey back came with a comparatively more positive outlook. Or, if you like, I could say why were those who were more positive not more pessimistic? That is all. Perhaps it did have to do with expectations? But I don't know, I haven't been there yet.

 

[Killer T Cell]

I didn't say that all of you are jaded but simply wanted to understand why many others who have made the journey back came with a comparatively more positive outlook. Or, if you like, I could say why were those who were more positive not more pessimistic? That is all. Perhaps it did have to do with expectations? But I don't know, I haven't been there yet.

I think a lot of it has to do with stepping out of your own shoes and looking at the big picture. I would have loved to use my own story as a positive example and infuse encouragement and hope. Believe it or not, I am a very positive and optimistic guy in real life just ask blitz2006.

But there's no denying that it is going to get incredibly tough for IMGs. I realize that nobody can predict the future, but trends rarely lie. I've been witnessing it over the last few years. People who come over here with unrealistic expectations will be absolutely crushed! And the scary thing is that, what's a 'realistic' expectation now will most likely become an 'unrealistic' expectation in 2017-2018!

I think there would be far less optimists if people started thinking both laterally and longitudinally, stepping beyond their personal stories. You'd have a lot more realists like me At least I think I'm a realist, some may call me a pessimist though. But someone once told me that "a pessimist is what an optimist calls a realist" haha

 

[druggeek]

I didn't say that all of you are jaded but simply wanted to understand why many others who have made the journey back came with a comparatively more positive outlook. Or, if you like, I could say why were those who were more positive not more pessimistic? That is all. Perhaps it did have to do with expectations? But I don't know, I haven't been there yet.

You cannot use some dude who graduated 3 years ago as an example because that same dude probably went overseas in like 2004. Things have changed and trends in numbers dont lie. It's like when pharmacy students in the US talk to pre-pharm students. They can tell them all they want about the exponentially increasing number of pharmacists and nearly no job positions available, but they dont care! Problem is, not caring = it biting you in the end.

 

[Killer T Cell]

You cannot use some dude who graduated 3 years ago as an example because that same dude probably went overseas in like 2004. Things have changed and trends in numbers dont lie. It's like when pharmacy students in the US talk to pre-pharm students. They can tell them all they want about the exponentially increasing number of pharmacists and nearly no job positions available, but they dont care! Problem is, not caring = it biting you in the end.

I completely agree with you dude. Things have changed so much in the last few years and it's only going to get worse. I would love to hear the thoughts and experiences of at least one Irish Grad who went through the match this year. It would be tremendously helpful for future applicants. It's very surprising that considering there are so many North American seniors over there, not even one has posted on this thread....

 

[Killer T Cell]

Ok. How about we move this thread in another direction. For those who are going to the UK, what kind of advice can you guys give other than not go, beast the USMLEs. What should we look out for etc.

It's all in my first post buddy. And somewhere on this thread, Blitz2006 wrote a very kind biography about my life - all the things I did to get to where I am right now. But the best advice I can give you....it's right here...

http://forums.studentdoctor.net/showthread.php?p=12410212#post12410212

 

[JGKT]

This thread should be stickied....a must-read for North Americans considering the IMG route.

People, listen to Killer T Cell and Blitz2006. They don't seem to have any axes to grind.

Canada, USA, UK, Australia - it seems to be getting harder for DOMESTIC students to obtain competitive residency positions (desirable location and specialty). Sometimes I read the CARMs thread on the Canadian PreMed101 site and cringe. Seems like a horrible process for CMGs....and a nightmare for Canadian IMGs.

I graduated from a London med school in 2008. I think I was the only Canadian in my graduating class. In year 1, I thought I wanted to be a GP or psychiatrist.....in the end, I hated GP and psych (not trying to offend...just not my thing). By the end of med school, I wanted to be a vascular surgeon. By the end of F1, I found my dream job - radiology.

I'm currently a radiology specialist registrar in one of the large London Trusts. I don't delude myself - I would not be in a radiology residency programme in Toronto, Vancouver, Calgary, etc. had I decided to return to Canada (I didn't bother to go through the CARMs process as I was put off by the Return of Service commitment). I was a solid all-round performer in med school, but not a superstar. I have absolutely no regrets about studying medicine in the UK, but had I known then what I know now, I probably wouldn't have even applied. Things just kind of worked out for me....through luck.

My saving grace was that I obtained British citizenship through my partner during med school so I had no visa/work permit issues after completing F1/F2 (internship years in UK). This left me in the best possible position to compete for a specialty training position in the UK. I believe non citizen graduates of UK med schools can complete F1/F2 training years without any problem....you can use this as a back up.

My advice would be to attend med school in a country where you can practise without restriction. You will have a back up in case Canada/US doesn't work out. If possible, marry/CP a Brit .

Medicine is a hard job....one has to really enjoy it. I doubt that one can survive long term in a specialty that one doesn't really love. Make sure that you don't have to settle.

On a positive note, there are many different routes to success. Good luck to everyone.

J

 

[sportsperson]

This thread should be stickied....a must-read for North Americans considering the IMG route.

People, listen to Killer T Cell and Blitz2006. They don't seem to have any axes to grind.

Canada, USA, UK, Australia - it seems to be getting harder for DOMESTIC students to obtain competitive residency positions (desirable location and specialty). Sometimes I read the CARMs thread on the Canadian PreMed101 site and cringe. Seems like a horrible process for CMGs....and a nightmare for Canadian IMGs.

I graduated from a London med school in 2008. I think I was the only Canadian in my graduating class. In year 1, I thought I wanted to be a GP or psychiatrist.....in the end, I hated GP and psych (not trying to offend...just not my thing). By the end of med school, I wanted to be a vascular surgeon. By the end of F1, I found my dream job - radiology.

I'm currently a radiology specialist registrar in one of the large London Trusts. I don't delude myself - I would not be in a radiology residency programme in Toronto, Vancouver, Calgary, etc. had I decided to return to Canada (I didn't bother to go through the CARMs process as I was put off by the Return of Service commitment). I was a solid all-round performer in med school, but not a superstar. I have absolutely no regrets about studying medicine in the UK, but had I known then what I know now, I probably wouldn't have even applied. Things just kind of worked out for me....through luck.

My saving grace was that I obtained British citizenship through my partner during med school so I had no visa/work permit issues after completing F1/F2 (internship years in UK). This left me in the best possible position to compete for a specialty training position in the UK. I believe non citizen graduates of UK med schools can complete F1/F2 training years without any problem....you can use this as a back up.

My advice would be to attend med school in a country where you can practise without restriction. You will have a back up in case Canada/US doesn't work out. If possible, marry/CP a Brit .

Medicine is a hard job....one has to really enjoy it. I doubt that one can survive long term in a specialty that one doesn't really love. Make sure that you don't have to settle.

On a positive note, there are many different routes to success. Good luck to everyone.

J

Well said

 

[Setto]

It seems like the main issue with these types of threads is that they are geared towards a) people that want competitive specialties and b) people who want/need to return to North America. So sometimes it can be frustrating when you tell someone you are going overseas for medical school and they roll their eyes and start throwing all sorts of stats at you.

In my opinion, if you want to be a doc more than anything else, then it doesn't really matter where you go or where you end up (within reason of course) so long as you enjoy it. Some may not be interested in the super competitive specialties, some have been blessed with the financial situation where it isn't that big of a risk, finally some are in a position where they have a EU passport or an Ozzy passport etc.

So much like it can be downright ignorant to group Killer T Cell in with other "hate mongers", it doesn't make much sense to clump all people going over seas in the same group either.

In the end it's all how you read this and other threads. You can read it positively ("watch out for this, make sure you do that...") or negatively ("you're never going to do this, HA! good luck with THAT"). We need to keep in mind that many Canadians who have applied/attended schools outside of Canada deserved to go to school in Canada, it just never happened to them. These are intelligent people who have most likely weighed the cost vs. benefit of moving away and leaving their lives behind in order to become a doc and I don't think we should forget that.

What's great about Killer T's original post is that he has gone the IMG rout and is sharing wisdom instead of scaring us off. It's not like he said the people shouldn't go the IMG rout, he is just telling us that it will be difficult.

Oh and as far as I know, the massive enrollment increase is still in its infancy in the US, so cheers to us being ahead of the curve.

 

[Blitz2006]

This thread should be stickied....a must-read for North Americans considering the IMG route.

People, listen to Killer T Cell and Blitz2006. They don't seem to have any axes to grind.

Canada, USA, UK, Australia - it seems to be getting harder for DOMESTIC students to obtain competitive residency positions (desirable location and specialty). Sometimes I read the CARMs thread on the Canadian PreMed101 site and cringe. Seems like a horrible process for CMGs....and a nightmare for Canadian IMGs.

I graduated from a London med school in 2008. I think I was the only Canadian in my graduating class. In year 1, I thought I wanted to be a GP or psychiatrist.....in the end, I hated GP and psych (not trying to offend...just not my thing). By the end of med school, I wanted to be a vascular surgeon. By the end of F1, I found my dream job - radiology.

I'm currently a radiology specialist registrar in one of the large London Trusts. I don't delude myself - I would not be in a radiology residency programme in Toronto, Vancouver, Calgary, etc. had I decided to return to Canada (I didn't bother to go through the CARMs process as I was put off by the Return of Service commitment). I was a solid all-round performer in med school, but not a superstar. I have absolutely no regrets about studying medicine in the UK, but had I known then what I know now, I probably wouldn't have even applied. Things just kind of worked out for me....through luck.

My saving grace was that I obtained British citizenship through my partner during med school so I had no visa/work permit issues after completing F1/F2 (internship years in UK). This left me in the best possible position to compete for a specialty training position in the UK. I believe non citizen graduates of UK med schools can complete F1/F2 training years without any problem....you can use this as a back up.

My advice would be to attend med school in a country where you can practise without restriction. You will have a back up in case Canada/US doesn't work out. If possible, marry/CP a Brit .

Medicine is a hard job....one has to really enjoy it. I doubt that one can survive long term in a specialty that one doesn't really love. Make sure that you don't have to settle.

On a positive note, there are many different routes to success. Good luck to everyone.

J

Great post. 100% real truth. I couldn't agree more.

And like Killer T, I'm a realist (even though ppl may say pessimist). For JGKT, she got married, and she even said things worked out 'by luck'. And even despite all her success here (Radiology registrar job in a London Trust is damn competitive, I'm quite impressed), she states that she would not have chosen this route.

But I commend JGKT for sticking to her dream, thats admirable.


I mean, what if (and a very viable, realistic option) JGKT didn't get married to a British citizen? What would have happened after F2? From the few stories I've heard, non UK citizens basically take a year off and go back to their home country (ie, Canada) and try to do some 'research' or study for MCCQE1 or something. And remember, it gets tougher and tougher to go back the further you apply from graduation. why?

1. Your elective experience that you do in Canada/U.S becomes more and more out of date.
2. Reference Letters also become out of date (and its also just harder to keep in touch with your preceptors)
3. Program Directors have specifically told me that they prefer 'fresh' graduates, they don't like training older people (its tougher to teach old dogs new tricks, right?)
4. Gaps in your CV (at your residency interview, you will get grilled if they see that you took a year off from clinical work, and usually goes against your application unless you are pumping papers for New England Journal of Medicine).

But again, I'm just trying to highlight the more viable option. Most of us IMGs who come to UK/Ireland won't end up marrying a local.

Not pessimism, just the reality.

 

[Setto]

Great post. 100% real truth. I couldn't agree more.

And like Killer T, I'm a realist (even though ppl may say pessimist). For JGKT, she got married, and she even said things worked out 'by luck'. And even despite all her success here (Radiology registrar job in a London Trust is damn competitive, I'm quite impressed), she states that she would not have chosen this route.

But I commend JGKT for sticking to her dream, thats admirable.


I mean, what if (and a very viable, realistic option) JGKT didn't get married to a British citizen? What would have happened after F2? From the few stories I've heard, non UK citizens basically take a year off and go back to their home country (ie, Canada) and try to do some 'research' or study for MCCQE1 or something. And remember, it gets tougher and tougher to go back the further you apply from graduation. why?

1. Your elective experience that you do in Canada/U.S becomes more and more out of date.
2. Reference Letters also become out of date (and its also just harder to keep in touch with your preceptors)
3. Program Directors have specifically told me that they prefer 'fresh' graduates, they don't like training older people (its tougher to teach old dogs new tricks, right?)
4. Gaps in your CV (at your residency interview, you will get grilled if they see that you took a year off from clinical work, and usually goes against your application unless you are pumping papers for New England Journal of Medicine).

But again, I'm just trying to highlight the more viable option. Most of us IMGs who come to UK/Ireland won't end up marrying a local.

Not pessimism, just the reality.

How many people would you actually say take a year off? It seems to me that people would prefer to match into a residency that isn't their first pick than take a year off. What I mean is, wouldn't this really only happen to people that only apply to competitive residencies?

But as I type this I guess I can understand that if someone is truly passionate about a specific calling/specialty, they would never settle for less.

 

[Blitz2006]

How many people would you actually say take a year off? It seems to me that people would prefer to match into a residency that isn't their first pick than take a year off. What I mean is, wouldn't this really only happen to people that only apply to competitive residencies?

But as I type this I guess I can understand that if someone is truly passionate about a specific calling/specialty, they would never settle for less.

Exactly, you answered your own question.

And you are also correct, most IMGs fold and will scramble into anything they get. Hence the '2nd round Scramble' madness.

 

[Setto]

Exactly, you answered your own question.

And you are also correct, most IMGs fold and will scramble into anything they get. Hence the '2nd round Scramble' madness.

I guess that just goes to show, yet again, that IMGs need to be realistic and open minded. These are normally the IMGs who did have competitive grades for Canadian med schools, they just didn't get their name picked. These people are/should be smart enough to know the odds, the outcomes and the truth.

I'm an IMG, and I'm not worried because of done the foot work and the research. I'm just getting sick of people telling me I should be worried.

 

[Poisson]

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....

Yes, this is very true, failing out of DO or MD in the US is extremely rare. Also, for folks that fail terms in the caribbean, I have researched extensively, and many many times folks can transfer to an equal or lesser school and continue their studies, sometimes in the term they want. I might have heard AUA accepts transfers, and a school like this even goes off the Cali system now, but other than that, you would be transferring to a low school that may limit residency and practice in states opportunities. However, someone I know of graduated from probably the number 3 or higher residency in the country int he field, from undoubtedly one of the worst ranked caribbean schools down there, one where probably 9 out of 10 people down there can't even get family practice, and end up becoming sales reps. I have not heard of people failing out of UK and transferring anywhere, I'm sure this happens though. I get the feeling like they wouldn't get advanced standing, but they might. A guy was posting online, and talking about how tough it was for him failing out of a UK school, and taking him over a decade to get back on track. Take all this with a grain of salt though, and I'm in no way supporting caribbean.

Anyways, I have a question though, and its pretty important. You say that UK med schools are failing out lots of students, especially in the early years. Is this true? Is this because of the 6 year program, where people just aren't cut out for med school from high school? Lets face it, every undergrad program in the states has a lot of folks with high high school GPAs that fail out of science classes, but in med school you only get so many chances. I've talked to quite a few people from Irish schools, and the idea I get is that failing out is really rare, is this true? Is there any difference in failure rate of entering a 5 year program with a bachelor's degree and entering the GEP program? Are there differences between schools, like does UCC do it different than UCD? At least in US schools, typically anything that is 6 year, the first 2 years are ridiculously tough in a program (compared to most high schools, but easier for more mature folks), and they fail people, whereas once you get more into the program, its basically pass/fail, and nobody is getting out. For instance, you start pre-pharmacy, maybe you need to maintain a 3.2 or 3.5 or whatever in the first 2 years, if you fail out, you don't get the admission to the pharm school, but if you took the test, got in, its more streamlined. However other folks that get into 6 year MD programs in states, only need to get like a 2.8 or so and can continue through the MD if admitted out of high school. I get the feeling the Ireland isn't about failing people, but there are always wash outs, just wanted some opinions.

 

[Setto]

Yes, this is very true, failing out of DO or MD in the US is extremely rare. Also, for folks that fail terms in the caribbean, I have researched extensively, and many many times folks can transfer to an equal or lesser school and continue their studies, sometimes in the term they want. I might have heard AUA accepts transfers, and a school like this even goes off the Cali system now, but other than that, you would be transferring to a low school that may limit residency and practice in states opportunities. However, someone I know of graduated from probably the number 3 or higher residency in the country int he field, from undoubtedly one of the worst ranked caribbean schools down there, one where probably 9 out of 10 people down there can't even get family practice, and end up becoming sales reps. I have not heard of people failing out of UK and transferring anywhere, I'm sure this happens though. I get the feeling like they wouldn't get advanced standing, but they might. A guy was posting online, and talking about how tough it was for him failing out of a UK school, and taking him over a decade to get back on track. Take all this with a grain of salt though, and I'm in no way supporting caribbean.

Anyways, I have a question though, and its pretty important. You say that UK med schools are failing out lots of students, especially in the early years. Is this true? Is this because of the 6 year program, where people just aren't cut out for med school from high school? Lets face it, every undergrad program in the states has a lot of folks with high high school GPAs that fail out of science classes, but in med school you only get so many chances. I've talked to quite a few people from Irish schools, and the idea I get is that failing out is really rare, is this true? Is there any difference in failure rate of entering a 5 year program with a bachelor's degree and entering the GEP program? Are there differences between schools, like does UCC do it different than UCD? At least in US schools, typically anything that is 6 year, the first 2 years are ridiculously tough in a program (compared to most high schools, but easier for more mature folks), and they fail people, whereas once you get more into the program, its basically pass/fail, and nobody is getting out. For instance, you start pre-pharmacy, maybe you need to maintain a 3.2 or 3.5 or whatever in the first 2 years, if you fail out, you don't get the admission to the pharm school, but if you took the test, got in, its more streamlined. However other folks that get into 6 year MD programs in states, only need to get like a 2.8 or so and can continue through the MD if admitted out of high school. I get the feeling the Ireland isn't about failing people, but there are always wash outs, just wanted some opinions.

Well, it looks to me like you answered your own question Think about all the people who go into university thinking they are going to get into an MD program and not make it. Well, that's pretty analogous to the 6 year program. By the time that these 6 years get to the final 4 years of med school, they need to be capable of handling the rigorous education. This capability is very difficult to measure in someone who has not attempted an undergrad degree yet or hasn't taken any science classes yet.

On the bright side though, there is a 6 year program for a reason in many European countries: it produces fantastic doctors. It's as if the kids going into that program are bred for medicine (or so I understand).

 

[Medstart108]

.

 

[clarkalim]

So how about if, as a US Citizen, I was interested in completing my medical education and residency training ANYWHERE in the UK--England, Scotland, Ireland, or Wales?

And, I intended to gain dual citizenship there and live there for the rest of my life, never coming back to the U.S. except for tourism purposes?

Would it be difficult for me to get into a residency outside of England? Is it difficult to get into postgrad training in Scotland, Ireland, and Wales?

Could I take a UK medical degree and complete my residency training anywhere within the EU, and then practice anywhere in the EU?

I would be willing to do whatever it took to learn the language.

I'd even be willing to go to medical school in a different country, like Germany or the Netherlands, if it meant that I could also complete medical residency in the EU and become a licensed doctor in the EU.

 

[Medstart108]

So how about if, as a US Citizen, I was interested in completing my medical education and residency training ANYWHERE in the UK--England, Scotland, Ireland, or Wales?

And, I intended to gain dual citizenship there and live there for the rest of my life, never coming back to the U.S. except for tourism purposes?

Would it be difficult for me to get into a residency outside of England? Is it difficult to get into postgrad training in Scotland, Ireland, and Wales?

Could I take a UK medical degree and complete my residency training anywhere within the EU, and then practice anywhere in the EU?

I would be willing to do whatever it took to learn the language.

I'd even be willing to go to medical school in a different country, like Germany or the Netherlands, if it meant that I could also complete medical residency in the EU and become a licensed doctor in the EU.

To get the best info you should ask the medical schools themselves. Make a phone call if possible, some of those responding to emails don't know for sure themselves.

If you can get into a UK medical school studying (A100 Medicine) you are pretty much guaranteed foundation year 1 and 2 as long as things don't change.

After that, i hear there is preference for UK/EU citizens in terms of specialty and location choices but most people say you can find a specialty training post. So essentially, yes if you get into a UK medical school you can eventually practice in the UK.

I don't know much about getting a degree in the UK and then going elsewhere in Europe to train, but i'm sure that if you are a fully licensed consultant, every country in the world with the exception of the US and Canada would want you. You would be another doctor with UK training and would cost them nothing to train you.

Citizenship is another issue. If you are a non UK/EU citizen with no family ties to britain, you would be placed on a Tier 4 Student visa throughout your 5 or 6 years of medicine. After that they would place you on a different visa for foundation programme. Those 5 or 6 years won't count towards gaining citizenship however.

 

[Medstart108]

repost

 

[clarkalim]

To get the best info you should ask the medical schools themselves. Make a phone call if possible, some of those responding to emails don't know for sure themselves.

If you can get into a UK medical school studying (A100 Medicine) you are pretty much guaranteed foundation year 1 and 2 as long as things don't change.

After that, i hear there is preference for UK/EU citizens in terms of specialty and location choices but most people say you can find a specialty training post. So essentially, yes if you get into a UK medical school you can eventually practice in the UK.

I don't know much about getting a degree in the UK and then going elsewhere in Europe to train, but i'm sure that if you are a fully licensed consultant, every country in the world with the exception of the US would want you. You would be another doctor with UK training and would cost them nothing to train you.

Citizenship is another issue. If you are a non UK/EU citizen with no family ties to britain, you would be placed on a Tier 4 Student visa throughout your 5 or 6 years of medicine. After that they would place you on another visa for the foundation programme.

I don't know much after that. If you want more info contact the UK Border Agency and explain what you plan on doing. They will tell you if that is possible.

That's a good idea. I'll try emailing UK medical schools to see how their other international grads that wish to stay in the country have fared...and also contact maybe even the foundation programme as well

Thanks so much for your help!!!!

 

[jenl]

Life is what you make it. The world doesn't begin and end in North America.

 

[IMG0157]

to anyone still reading this thread one year later:

i am a final year student in the UK that's just gone through the CaRMS process and am anxiously awaiting match day (march 5th). after reading all this i would have to agree 100% with what biltz and killert have said. people may have been matching back to canada in years gone by, but it is only going to get more and more difficult as more and more canadians choose to study abroad. i don't want to advise anyone on what to do as you guys have pretty much all the information, but all i can say is this- being on the other side of things now and knowing what i do now about the match & statistics, and having gone through the whole process of arranging and completing american and canadian exams, electives, interviews etc. all alongside keeping up with my university's curriculum, if i had to choose whether or not to come to the UK for med school today, i would choose not to. the reasons why have all clearly been stated by killertcell, blitz, and others in the above posts. just wanted to reiterate how right i think they are

 

[krd1025]

d

 

[Medstart108]

Just wanted to point out that there's no way US citizen IMG is favored over non-US citizen US med grads. The general consensus is that US MD (regardless of citizenship) > US DO (regardless of citizenship) > US citizen IMG > non-US citizen IMG. First of all, the average stats for international students (including canadians) to enter US MD schools is 3.8+ GPA and 33+ MCAT which is way higher than the americans choosing the IMG route. Also the visa issues are mostly towards the IMGs (confirmed this with few ProgramDirectors in the US). Most programs who don't sponser B1visas WILL sponser for us med grads even though they say they don't (this is to filter out the non-US citzen IMGs). I can provide more stats/proofs if you're not convinced. However, the rest seems fine and IMG route should be their last choice especially for the non-US citizens

Yeah. For non-US citizens attending US MD schools, their school can give them a 1 year visa extension on top of the F1 visa they use to study. During that 1 year, they write their Step 3 and then get an H1B. non-US citizens attending US medical schools won't be disadvantaged much just because they have US medical school training so their education is for sure standardized.

 

[jnuts]

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....

Just browsing this thread and I thought I'd correct this misperception. While it's correct to say that the majority of the increase in CSAs has been in Australia and the Caribbean, the Canadian enrollment in Ireland has not been stagnant. From the early 1990s to about 2005 there were no IMG spots in CaRMS and no way for a CSA to re-enter the Canadian Medical System. This strongly discouraged Canadians (other than dual citizens) from going to Ireland and the numbers were very low (1-2/year). Overall medical class sizes in Ireland have increased dramatically in the last two decades (up to 300% in some cases). Of the North Americans, the number of Americans has been steadily dropping and the number of Canadians rising due to increased domestic capacity in the US. There is a new medical school at the University of Limerick which only opened in 2007 and graduated its first Canadians in 2012.

There were no graduate entry programs in Ireland before 2006. All those spots (about half of which are taken by North Americans, the majority of whom currently are Canadian) are increased capacity on top historically increasing regular class sizes. That program has expanded very recently from RCSI and UCD to Limerick, Cork and Galway. The year-on-year number of Canadians is increasing and will continue to increase over the next 3 years at least before levelling off and possibly decreasing. All the Irish schools have a vested interest in the overall success of their international programs and have expressed a desire to decrease Canadian enrolment to avoid a situation where a substantial portion of the graduating class has no option for ongoing training.

I'm really not trying to be pessimistic. I loved Ireland and would go there again if I had to make the decision today. I'm talking about this because those original IMG spots were created after the application of tremendous political pressure. The Canadians in Ireland now really have to work together to continue expanding opportunities in Canada for CSAs or resign yourselves to a dog-eat-dog struggle for limited opportunities to continue your careers.

 

[jenl]

I can't tell you how many doctors in Canada that I know who were IMG's. Without them the good programs in Canada would look very different. I am serious. Look at the staff at your favourite hospital. Find out where they trained - undergrad medicine and residency. I guarantee that some of the most esteemed professors came from outside North America. If you train abroad there is always a way back. And remember - there is life outside North America.

 

[AStark]

Of course there's "life" outside North America. That's not the point - if you want to live and (ideally) work in the country let alone the continent that you grew up in, going to a foreign medical school is an excellent way of lowering your chances of that happening.

I would be quite leery of relying on IMG spots that appear in the CaRMS match. In many cases, programs lobby for eliminating these spots altogether and sometimes intentionally leave them unfilled. We are essentially maxed out in many areas of the country when it comes to undergrad let alone postgrad training. If there are going to be increased spots, they will go to CMGs first because provinces manage undergrad and postgrad medical education in tandem. The CSA issue has been getting some play in the media, but there is fairly minimal support for expanding IMG spaces, especially since CMG spots have increased considerably over the last decade.

It's certainly true that numerous staff physicians attended schools abroad, but I can't think of a single example where one had pursued a degree in Ireland or the UK because they were unable or unwilling to do an MD in Canada. For example, there are a bunch of German anesthetists (who of course had done their postgrad training already) in Nova Scotia because they were specifically recruited several years ago. No one is recruiting CSAs from Ireland, Australia, or the Caribbean.

For some perspective, in 2012 there were 2,156 IMGs who participated in CaRMS, of whom 1,833 were prior year graduates. Only 407 matched, including 141 graduates from 2012. I'm sure a sizeable number who went unmatched in CaRMS managed to get a US position. I suppose that's okay if you don't mind ending up in a potentially malignant community program in rural Indiana or Nebraska. I'm not being pessimistic - these are just the facts.

Regarding programs in Canada, it's important to keep in mind that most IMGs will be required to sign a Return-of-Service contract. If you match to something like IM, you will be effectively barred from subspecialty training. (Not that GIM is a bad choice - far from it - but I don't think you should like having no choice about it.)

See the following:
http://carms.ca/eng/operations_R1reports_12_e.shtml

 

[Medstart108]

You won't end up in a malignant community program in Nebraska or wherever. in the US, the most IMG friendly places tend to be on the east coast. Look the 1,833 who were prior year graduates tend to be new immigrants to Canada who studied medicine in their home country and are driving the proverbial taxi cab. Those people don't have a strong grasp of Canadian culture, don't have Canadian electives, don't have shadowing experience, don't have a strong grasp of the Canadian language and have graduated years ago (meaning their medical skills have declined). Canadian IMGs do still have a shot at Canada, but the chances are better in the US.

Stark is right about the RoS. If there is an RoS, you will be forced to work in a rural community for 5 years. Don't go overseas if you will only work in Canada. The US is just as good of a place as Canada to work and live.

 

[jnuts]

I have one correction to the post above. ROS agreements (at least the one in Ontario that I've seen) start after the conclusion of training including fellowships and subspecialty training. IMGs are certainly not barred from subspecialty training.

 

[Medstart108]

O really thats important. What if you decide to apply for a fellowship in the US? Will they allow you to do your fellowship there?