Applying to the US for specialty from Canada

[gotrumpet]

Hey guys

I'm a PGY-1 (1st year resident) in Canada, a graduate of a Canadian med school. I didn't get in my choice of specialty (ophthalmology) and ended up in another program.

If I want to transfer to the US, what is the likelihood that they will take me?

My grades weren't stellar but I am confident that I can ace the USMLE step 1 which is required by most schools in the US.

Some applicants have had it easier with P/F while others have been screwed over with the H/P/F system when they don't get lucky with subjective evaluations at the end of their rotations, or didn't get all the past exam questions from previous rotating groups.

The Canadian system is very reluctant to accept previously matched applicants, and competitive programs make it virtually impossible to match into their programs if you didn't match the first round. They are unwilling to allow people to transfer into their programs besides the regular matching, but if you matched to something else previously you are out of luck in their match. They say they'll take you in 2nd round, but that's a joke since you know there will be no spots left after 2nd round except for spots that nobody wants (it's their nice way of saying 'too bad').

So I'm wondering if there is a way to get into the US for ophthalmology where there are a lot more spots. From my understanding (please do correct me if I'm wrong),:

1. US schools recognize Canadian schools as similar to their own and different from IMG, since Canadian schools are ACGME accredited.

2. So that pretty much means that a strong USMLE step 1 should get you some chance. (Whereas if you're an IMG you need step 1, 2 and maybe 3 and be a superstar and still may not get in?)

Thanks.

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[Puppo]

Hey guys

I'm a PGY-1 (1st year resident) in Canada, a graduate of a Canadian med school. I didn't get in my choice of specialty (ophthalmology) and ended up in another program.

If I want to transfer to the US, what is the likelihood that they will take me?

My grades weren't stellar but I am confident that I can ace the USMLE step 1 which is required by most schools in the US.

Some applicants have had it easier with P/F while others have been screwed over with the H/P/F system when they don't get lucky with subjective evaluations at the end of their rotations, or didn't get all the past exam questions from previous rotating groups.

The Canadian system is very reluctant to accept previously matched applicants, and competitive programs make it virtually impossible to match into their programs if you didn't match the first round. They are unwilling to allow people to transfer into their programs besides the regular matching, but if you matched to something else previously you are out of luck in their match. They say they'll take you in 2nd round, but that's a joke since you know there will be no spots left after 2nd round except for spots that nobody wants (it's their nice way of saying 'too bad').

So I'm wondering if there is a way to get into the US for ophthalmology where there are a lot more spots. From my understanding (please do correct me if I'm wrong),:

1. US schools recognize Canadian schools as similar to their own and different from IMG, since Canadian schools are ACGME accredited.

2. So that pretty much means that a strong USMLE step 1 should get you some chance. (Whereas if you're an IMG you need step 1, 2 and maybe 3 and be a superstar and still may not get in?)

Thanks.

You can not apply in opthalmalogy with out passing all 3 steps. Yes you will get exemption of one year if you are a surgical resident.

 

[jbish]

I agree, you'll want to have completed at least steps 1 and 2 and probably have 3 scheduled or complete when you apply. Of course, this will be for next year's match (2008) as the deadlines have already passed for this year (2007). By then you'll have completed 2 years of residency training but for your best chance of matching into a position, should probably apply for PGY1 spots in the US. You also need to look into provincial rules for Visas- programs in the US are reluctant to sponsor H1B visas and you'll need your provinces permission to get a J1 visa. Quebec, I know, rarely (if ever) approves ophthalmology as a specialty that is eligible for J1 visa. So, even if you get accepted by a US school- you could still be unable to train in the US if your province says they will not agree w/ the visa. Ophtho, of course, is quite difficult to match into so you should strive for ~240 on step 1...yes, Canadian schools are considered "equivalent" to US schools, but many schools (i.e. the secretaries reading over applications "weeding out" the "not-good-enoughs" before going on to the program director) do not know this and will toss you into the FMG pile. Therefore, you should call programs if you have not heard from them by October/November to ask about your application status and gently "remind" them that you are not an FMG.

Good luck. It is not a fun process and I'm a US citizen so I don't even need to worry about the provincial J1 visa issue.

 

[gotrumpet]

You can not apply in opthalmalogy with out passing all 3 steps. Yes you will get exemption of one year if you are a surgical resident.

hi where did you get this information?

I only ask because I did contact a couple programs and all they said was you need at least step 1. Mind you, even as simple as I kept my 2/3 questions, they don't always answer your questions, as if they are too busy doing something else than to answer emails.

From my understanding, step 1 was required and step 2 was recommended.
(is it the written or clinical step 2 that's required? I heard they are thinking of scrapping the OSCE part...and do they look at the step 2 scores too or just care if you've passed?)

I was not aware that step 3 was required.

By the way, wouldn't it be easier to apply straight to PGY-2 because PGY-1 is just another year to do. Plus, I think the PGY-1 year of Canadian schools is the same as American schools in terms of equivalence.

And from your guys' experience, are Canadian schools generally considered ACGME equivalents?

 

[jbish]

Canadian schools are LCME accredited. Whether they are "generally" considered so or not depends on where you are training. New England is pretty aware of McGill being a "good school" and UofT...but "generally" people are not aware that the US and Canadian schools are accreditted by the same institution. Regardless, your education is equivalent, you just may have to make that known to people who are unaware of it.

As far as Step 2, it's the written that you should have done, not the clinical. Some programs insist on passing the clinical before starting residency- you can look up specifics on the FRIEDA website (through www.ama-assn.org).

I say it'd be better to apply to PGY-1 spots b/c there are more open to apply for. How many people drop out of an Ophtho residency to allow a PGY-2 spot to even become available? Very few. Much fewer than the total number of PGY-1 spots in the country. If you're really serious about ophtho, you'll be willing to do another year. This happens all the time in surgical specialties in the US- people that match into preliminary surgery positions spend the next year applying for BOTH pgy-1 and pgy-2 categorical positions, because some programs will not consider the preliminary pgy-1 year as equivalent to a categorical pgy-1 and don't have an opening at the pgy-2 level for the prelims to jump into.

 

[gotrumpet]

Canadian schools are LCME accredited. Whether they are "generally" considered so or not depends on where you are training. New England is pretty aware of McGill being a "good school" and UofT...but "generally" people are not aware that the US and Canadian schools are accreditted by the same institution. Regardless, your education is equivalent, you just may have to make that known to people who are unaware of it.

As far as Step 2, it's the written that you should have done, not the clinical. Some programs insist on passing the clinical before starting residency- you can look up specifics on the FRIEDA website (through www.ama-assn.org).

I say it'd be better to apply to PGY-1 spots b/c there are more open to apply for. How many people drop out of an Ophtho residency to allow a PGY-2 spot to even become available? Very few. Much fewer than the total number of PGY-1 spots in the country. If you're really serious about ophtho, you'll be willing to do another year. This happens all the time in surgical specialties in the US- people that match into preliminary surgery positions spend the next year applying for BOTH pgy-1 and pgy-2 categorical positions, because some programs will not consider the preliminary pgy-1 year as equivalent to a categorical pgy-1 and don't have an opening at the pgy-2 level for the prelims to jump into.

But the thing with the US is that PGY-1 and PGY2-4 are separate streams. PGY-1 you can do outside of eg. your ophtho school, so I was thinking that since I'm in PGY-1 in Canada now, I'll have PGY-1 already completed. (But maybe I'm not understanding the difference between the categorical and prelim PGY-1 year...sorry if that's the case.)

What do you think?

Thanks for the input btw, really appreciate it.

 

[jbish]

Ok, so I did a little research on the San Fransisco match, as this is where Ophtho does its match. Currently there are no open PGY-2 positions for 2007 or 2008 published for Ophtho (2008 will be posted after January). So, you couldn't start pgy-2 in July 2007. It also doesn't look good that you could start pgy-2 in July 2008 (as there are rarely if ever any vacancies in Ophtho after the match). This means you're looking at applying in the next cycle (starting this spring/summer) for PGY-2 positions for July 2009.

That's a long time to wait...and it'd probably be good just to doublecheck that Ophtho programs you are considering applying to will take your PGY-1 year in Canada as a valid program (most people do pgy-1 positions in internal, transitional, peds, and probably the oddball surgery spot. I assume a family med year would be pretty equivalent to a transitional year..but if you just did a year in something completely unrelated, they may not be happy with it).

Also, to start a PGY-2 position, you'll need to have completed the entire USMLE program (I, II CK, IICS, III) because you will need a license and in order to get this you need to have passed the licensing exam. This is what I can decipher from their website...but, you're looking at waiting until 2009 to start a pgy-2 spot anyways, so you have plenty of time to take all 4 exams!!

 

[gotrumpet]

Ok, so I did a little research on the San Fransisco match, as this is where Ophtho does its match. Currently there are no open PGY-2 positions for 2007 or 2008 published for Ophtho (2008 will be posted after January). So, you couldn't start pgy-2 in July 2007. It also doesn't look good that you could start pgy-2 in July 2008 (as there are rarely if ever any vacancies in Ophtho after the match). This means you're looking at applying in the next cycle (starting this spring/summer) for PGY-2 positions for July 2009.

That's a long time to wait...and it'd probably be good just to doublecheck that Ophtho programs you are considering applying to will take your PGY-1 year in Canada as a valid program (most people do pgy-1 positions in internal, transitional, peds, and probably the oddball surgery spot. I assume a family med year would be pretty equivalent to a transitional year..but if you just did a year in something completely unrelated, they may not be happy with it).

Also, to start a PGY-2 position, you'll need to have completed the entire USMLE program (I, II CK, IICS, III) because you will need a license and in order to get this you need to have passed the licensing exam. This is what I can decipher from their website...but, you're looking at waiting until 2009 to start a pgy-2 spot anyways, so you have plenty of time to take all 4 exams!!

but why will I need a coplete license ie. complete all 4 steps? That would mean I would have to do well in all 4 steps too? I thought that Canadian residents would be the same as US applicants, so I don't understand why I would need all 4 steps. My understanding was that I would only need step 1 and do well in it. This is considering that Canadian and US applicants are in the same pool, and seeing how US residents don't even need step 2 to enter PGY-1.

Not sure what their PGY-2 requirements are.

And would I need to do WELL in steps 2 and after? Or just do well in step 1 before applying, and steps 2 and after before starting PGY-2? I didn't know by the way, that to start PGY-2 that you had to have all 4 steps passed.

But as long as I only need step 1 and ace it before applying, I'm cool with that. Acing all 4 steps would be torture (that's a lot of studying! )

Thanks

 

[jbish]

All I can tell you is what I learned from the internet (groan) and for the PGY-2 positions that were available for Ophthalmology for 2006 you had to have passed all Steps in order to apply.

The reason you're a different case from US applicants is because you've already completed a PGY-1 year...and, many programs want you to have passed Step 2 CK before starting PGY-1 (this varies) or at least have written it. By the time US applicants enter PGY-2 they will have written Steps I, IICK, and IICS and probably will have scheduled step 3.

An interesting thing about the steps...once you have your medical license (after passing step III), you may not need to report your scores on your application. My mom is doing a second residency (hence already had her license) and when she was applying for this position last year (she's a first year FM resident), she didn't have to report her individual scores on the steps as she instead just clicked the box on ERAS for "enter your medical license number." I recall this because she said at one interview, an interviewer actually asked her what her scores were and she said "What does it matter? I passed, I have a license. What more do you need to know?" I'm not sure if the same is true for the SFMatch system as ERAS. And, you certainly won't be able to write all 4 exams by this summer (at this point, the first dates opening up for IICS are in April so by the time you registered, the dates will be past June I'm sure). For now, just focus on Step I, and start calling programs you're interested in applying to and specifically ask them if they want all steps passed for those applicants applying straight into PGY-2 spots. I find calling programs is much easier/straightforward as it's much harder to ignore a person yapping at you versus a random email.