canadian IMG applying for IM residency in US

[the_wiseguy]

hey all...i am a canadian who recently graduated from flinders in australia. i am in the middle of completing my application for US residency. a couple of issues are coming up for me, and while i've gotten some answers, i still feel a bit in the dark, i'm wondering if anyone can shed anymore light on these:

1) the whole visa issue seems very complex and very variable. i would prefer an H1B but i realise not all programs will give this out and i'll also need to do step 3 before that would even be considered. J1 is my only sure thing. i've read that in addition to all the US licensing tests the US also wants the Canadian equivalency exam taken and passed before giving a J1 to a Canadian. i just wanted someone to confirm this- it seems ridiculous to me since the canadians didn't subsidise my education one bit!

2)i wonder if anyone has any advice on good IM residency programs that are IMG friendly. i've done well on the USMLE's- 235 (95) on step 1 and 226 (88) on step 2, good grades, electives at columbia (ny) and maryland with good US (and aussie) reference letters. i realise many suggest university-based programs as many of these provide good teaching and better chances at future fellowships. i know the good ny-area programs- any other advice for programs around the country?


any advice would be very much appreciated.

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[Renovar]

Originally posted by the_wiseguy
hey all...i am a canadian who recently graduated from flinders in australia. i am in the middle of completing my application for US residency. a couple of issues are coming up for me, and while i've gotten some answers, i still feel a bit in the dark, i'm wondering if anyone can shed anymore light on these:

1) the whole visa issue seems very complex and very variable. i would prefer an H1B but i realise not all programs will give this out and i'll also need to do step 3 before that would even be considered. J1 is my only sure thing. i've read that in addition to all the US licensing tests the US also wants the Canadian equivalency exam taken and passed before giving a J1 to a Canadian. i just wanted someone to confirm this- it seems ridiculous to me since the canadians didn't subsidise my education one bit!

2)i wonder if anyone has any advice on good IM residency programs that are IMG friendly. i've done well on the USMLE's- 235 (95) on step 1 and 226 (88) on step 2, good grades, electives at columbia (ny) and maryland with good US (and aussie) reference letters. i realise many suggest university-based programs as many of these provide good teaching and better chances at future fellowships. i know the good ny-area programs- any other advice for programs around the country?

any advice would be very much appreciated.

Ouch, seems like you have reasonable numbers, and if you were an AMG you would be good to go. But the fact that you are Canadian IMG is gonna hurt ya.

The thing about Visa for Canadian without greencard trying for residency is this. And I have seen multiple websites on the net stating what I am saying. Just go to Yahoo and type in Canadian IMG:
http://members.tripod.com/donalda13/


1. if you are from LCME schools (CMG's or AMG's) you should be good to go at a residency that will sponsor you an H1B. You are eligible for an H1B based on the fact that you are an US / Canadian graduate.

2. if you are from non-LCME (ie. IMG) Canadian you are best with H1B. But in this case, you will need step 3 because of your IMG status. Many states wont allow you to take step 3 before med school graduation, some wont even allow you to take it until you did 1 year of residency. Your BEST OPTION would be to 1. Take a year off, find out which state(s) allow you to take step 3 after graduation before residency and apply next year. OR very unfeasible 2. Apply this year, match somewhere that will sponsor you H1B, take step 3 right after graduation and attempt to apply to H1B this year. This is very difficult because every year there is an H1B quota which is released in October.

3. The thing about Canada and J1 is that it is very circuituous. J1 is an exchanger visa, in which the home country must issue a "statement of need" for US to issue you a J1. But do Canada "need" you to be trained in the US to serve Canadians? Not exactly. That's why they are very reluctant. And you certainly need to pass the Canadian licencing examinations before they will consider issuing you the statement of need. True, Canada did not subsidize your education, but nor did it tell you or need you to go to Oz for med school, nor did it ever say it "need" you, that's why they dont issue you the "statement of need" unless you fulfill their requirement.

It is a royal pain in the A$$, to be sure. Do lots of research, and have faith. I am sure some other Canadian experts on this board would care to make additional comments.

 

[silenthunder]

Hey wiseguy,

I know I've been trying to figure out the whole deal with getting H1. I've seen this discussed a bit on valuemd. You may want to go take a look; you may also have more luck with a response on valuemd ( I know there are quite a few canadians there facing the same issues).

Sorry, that's all the help outta me. I'll keep looking around, and let you know if I find some answers.....

Cheers,

Silenthunder

 

[the_wiseguy]

thanks for the replies...i knew this visa thing was a mess. just wondering if either of you (or anyone else for that matter) can answer a query regarding the H1B. if i get an H1B from another source prior to starting residency and get it transferred over to the residency program does that alleviate the hassel or is that of little relevance as the program will still have to assume the 'sponsorship' role?

thanks.

 

[Renovar]

Originally posted by the_wiseguy
thanks for the replies...i knew this visa thing was a mess. just wondering if either of you (or anyone else for that matter) can answer a query regarding the H1B. if i get an H1B from another source prior to starting residency and get it transferred over to the residency program does that alleviate the hassel or is that of little relevance as the program will still have to assume the 'sponsorship' role?

thanks.

Not at all. As the sponsor, the program still need to fill out mucho periodic paperwork and a lot of administrative hassles that's why some programs dont want to mess with it. You may want to offer the program that you will hire a lawyer (pay out of your own pocket) to take care of all the hassles and paperwork, and all they have to do is put their name above the line, sign at the X and stamp in the square, some would be more willing to do it.

Basically, as I said, Canadian and J1 dont mix. You need H1B, and the fact that you are an IMG (who will need step 3) and dont have F1 right now is going to be trouble. I really suggest you do some research on what states allow you to take step 3 right after graduation, and contact an immigration lawyer early to have them navigate you through this mess.

 

[roo]

J1 to train in USA isn't painful at all.

You write the Canadian MCEE in the November of final year of medschool. If you wrote a Step 2, it is much the same, and the pass rate is high (about 97%). The score doesn't matter and you don't need to report your scores, you just need it for Canada to give you a J1. Then when the USA match is over, you show Canada your job offer and MCEE result and they give you a statement of need to get a J1. Note you have to go back to Canada for 2 years after residency. J1 waivers to try and wriggle out of your J1 deal is rare and difficult.

H1B is painful.

If you want start on an H1B you have to graduate, do Step 3, and get your papers done before start of residency. If Aussie school ends early in the calendar year, there may be time.

A country prefers its own citizens to fill its own jobs, which is fair. And grads from own country is also fair, since it is what is familiar, and they know what they are getting. Beyond that, a J1 visa student is okay from their end, since they don't have to do anything extra. H1B does require them to do stuff. However, if it is a non-competitive field and you are strong candidate, then some will go the extra distance.

 

[poly]

Originally posted by roo
J1 to train in USA isn't painful at all.

You write the Canadian MCEE in the November of final year of medschool. If you wrote a Step 2, it is much the same, and the pass rate is high (about 97%). The score doesn't matter and you don't need to report your scores, you just need it for Canada to give you a J1. Then when the USA match is over, you show Canada your job offer and MCEE result and they give you a statement of need to get a J1. Note you have to go back to Canada for 2 years after residency. J1 waivers to try and wriggle out of your J1 deal is rare and difficult.

Any idea what's a MD to do in Canada for the 2 year period when he can not practice medicine but still needs to keep his skills/knowledge up to date?

 

[roo]

If you don't want to work in Canada, you can do a fellowship in Canada. Go to McGill or something and tack on the extra training for some better career possibilities.

You are better off writing the Canadian exams if it is possible for you to work in Canada after finishing a US residency. Then you can work and get out of debt.
It keeps the portability open to have your exams written to work in Canada too. You will have written your US exams, you are better off writing the Canadian ones while it is still in your head, instead of doing it again later. For some disciplines this won't work since that discipline won't let you work in Canada after finishing a US residency, (the most common reason being the US residency was too short, such as anesthetics which if IIRC was 5 in Canada, 4 in USA).

Note that if you wanted to go back to US, you do need a work visa unless you are only doing a pure research or education job (physician educators and reseachers can freely move back and forth under NAFTA law, but physicians practising medicine cannot).

 

[Thewonderer]

Originally posted by roo
J1 to train in USA isn't painful at all.

H1B is painful.

For some people, it is worth the trouble to get H1B in the beginning so you have more freedom later in terms of working on either side of the border so you won't be pushed back to Canada and interrupt your career advancement in the US. I have heard of rumor that AAMC or AMA is trying to push for extending the 2-year home residence requirement for a couple more years. The laws are always changing. But one thing for certain is that once you have a J1, then there is no way out except a waiver (many VA's won't give you waivers, instead you have to spend 3 or more years in North Dakota or some truly under-served areas).

Also, 3 years of IM, peds and 4 years of psych or anethesiology in the US are all one year shorter than the resident training equivalent in Canada. That's one year of extra $130k-$250k of salary when you graduate from the an US residency program and get to stay in the US. That's a lot of money.

 

[The Pill Counter]

Hey wiseguy, did you graduate last year or about to this year?
Even if you found a residency that was willing to sponsor you, does the timeframe work out? From what I was trying to put together:
1. graduate in December
2. ECFMG certification by mid-January at best
3. register for Step 3, write it by mid-February at the earliest
4. Get your score and state licensure when?
I was told the H1-B quota runs out by the end of March, so you need to be in position to apply with a state license by match day. Can all that be squeezed in or is it impossible? What about state licensure? Are you restricted to the states that allow you to write Step 3 AND apply for state licensure without postgrad experience?
Hope someone can shed light on this...

 

[redshifteffect]

Instead of sitting an extra year out why not do your internship in Australia while finding out about the states which allow you to write the USMLE 3? - This will at least allow you to make some money to help pay your debts....!

www.carribeanmedicine.com has some good info on this topic.

Also from what I have read you are best off applying to an IMG friendly hospital. Most of these ones will be more than willing to sponsor your H1B...there are quite a few Canadians out there who have gotten in this way. You are not exactly applying for the most competitive residency so you should be okay. Do not waste time with the J1...(unless you want something very competitive)

A good thing is that with the H1B you can apply for a green card after a year or so of working there...and your chances of getting one are pretty good.

If you do have to return to Canada, why not work on a border city? Ex. there is one Canadian who is working in Detroit but living in Windsor.

 

[The Pill Counter]

Thanks redshifteffect,
But it's all information I already know. It doesn't help with the timeline I'm wondering about. I know which states allow you to sit Step 3 early etc. and I don't want to be 30 when I leave Australia.
Does anybody know how long it takes to register, sit and get your score for Step 3?

 

[redshifteffect]

Why don't you contact that administrator @ caribbean med. he had to go through the same process and he would know the process!


Sorry i wasn't much help in the other info.

 

[The Pill Counter]

So redshift, if you enter training in the States on a J-1, does that mean you can work in Detroit, but live in Windsor during those two year's home residency requirement?
Don't you need a work visa if you're working in the States, even if you're not living there? I thought during those two years you couldn't get a visa of any kind? Right, wrong?

 

[redshifteffect]

Pill Counter,

I'm not sure about the working in Detroit thing during the two years but I did read in the paper (Toronto Star) that someone was working in Detroit but living in Windsor, I'm not sure if that was during their 2 year mandatory return. I was suggesting this along the lines of if you can't get a greencard.

However there is a Canadian working at a hosptial in my state (Australia) who has the same problem, he did his J1 and was forced to come back to "Canada"...however he got a job at a hosptial in Australia and is trying to stay here now.

I know for a fact that you don't have to go back to Canada, you can go whereever you want, but whether or not you can live in Canada and work in the States I'm not sure about.