Canadian MD grads V. US ones

[Dr. Wall$treet]

When i was interviewing hte other week, i really got along well with the guy, and i posted about it before but i thought of something he told me today and i find it pretty interesting. He told me that only about 70 to 80 percent of people graduate med school in canada, v. about 99 here in the US. Dont you guys find it scary now that you see some of the poeple who go into medicine. I mean classmates that you just KNOW should not be docs etc. ANd you know once they are in, inevitebly they will be practicing medicine! I dont know. I mean i like the fact that grades arent a huge deal in med school but i really think they should have a system where you can indeed fail out of medschool unless you put a big effort in. I just hate to think they pass everyone for the sake of reputation etc. I also know canada is alot more compeitive and the standard of care there is recognized is being much better. So i kinda thought that made sense since they possibly weed out bad candidates in med school. I dunno just a thought

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[MacGyver]

Although some might consider the healthcare SYSTEM in canada to be superior (because of the guaranteed access to basic care), there is absolutely no evidence to indicate that Canadian med grads are any better (or worse) than US grads.

 

[drake.ramoray]

20-30 percent dropout rate seems awfully high.
I don't know of any school in Canada with less than 90% graduation rate (often much higher).

 

[moo]

I don't think the attrition rate is that high in Canada, otherwise transferring from one school to the next would be easy and that just isn't the case.

 

[Thewonderer]

Graduation rates for Canadian schools are in the 95+% range.

 

[brandonite]

Yes, Canadian grad rates are in the 95% + range. Not in the 70-80% range. I don't know if I agree with that completely, but still.

That said, medical admissions in Canada are much more competitive. There are far less spots per applicant up here.

And there is plenty of anecdotal evidence that Canadian med grads are valued in the US for residencies or whatever. We have the second highest match rate into US residency programs, better than DO grads or FMG's. And our schools are part of the AAMC, and are LCME accredited. I think we get a very good education up here.

 

[MacGyver]

Originally posted by brandonite
That said, medical admissions in Canada are much more competitive. There are far less spots per applicant up here.

True, but there are many other countries that have lower admissions percentages than either the US or Canada.

And there is plenty of anecdotal evidence that Canadian med grads are valued in the US for residencies or whatever. We have the second highest match rate into US residency programs, better than DO grads or FMG's. And our schools are part of the AAMC, and are LCME accredited. I think we get a very good education up here.

I believe the stat vs FMGs is accurate, but I dont believe your claim on canadian grads vs american DOs, UNLESS you are talking about DOs matching into specifically MD residency programs (instead of all residencies, MD and DO as a whole), which really isnt a fair comparison

 

[brandonite]

Originally posted by MacGyver
True, but there are many other countries that have lower admissions percentages than either the US or Canada.



I believe the stat vs FMGs is accurate, but I dont believe your claim on canadian grads vs american DOs, UNLESS you are talking about DOs matching into specifically MD residency programs (instead of all residencies, MD and DO as a whole), which really isnt a fair comparison

Yes, there are other countries that have lower admissions percentages than Canada or the US. But this post is trying to compare Canadian med grads versus American grads. I don't see how other countries are relavent to this discussion.

And second of all... I was looking at the NRMP matches of Canadian MD grads versus DO grads. It perhaps isn't the best comparison, but it is far from a bad way to look at things. Canadian grads usually participate in the Canadian match - the CaRMS, and DO grads usually participate in their own matching program. Thus, we're both a bit out of our element in the NRMP.

Listen, I happen to think that I'm going to get a great education up here. I'm not going to say that a Canadian MD is superior to an American MD, because there is just no way that you could ever prove a statement like that. Besides that, being a good doctor depends far more on what you make of it, rather than the educational system that pumped all of that information into you.

 

[relatively prime]

I think McGyver's point with the acceptance rate comment was that just because country A has a lower acceptance rate than country B... that doesn't mean that the medical students of country A are better than those in country B. Which is a good point.

But come on people... we're splitting hairs here. Canada has some great doctors... so obviously there must be some great med schools trailing them. Same goes for the U.S. I don't see any point in bickering over who is slightly better than the other.

 

[brandonite]

Originally posted by relatively prime
I think McGyver's point with the acceptance rate comment was that just because country A has a lower acceptance rate than country B... that doesn't mean that the medical students of country A are better than those in country B. Which is a good point.

Oh, right. Missed that one. Yes, it is a good point. But given that the Canadian and American systems of training medical students (both in med school and as premeds) are identical, then I think it should mean something.

But again, it's really pretty difficult to make any kind of comparison between the systems. You can't prove anything with anecdotes and half arguments.

 

[relatively prime]

Originally posted by brandonite
Oh, right. Missed that one. Yes, it is a good point. But given that the Canadian and American systems of training medical students (both in med school and as premeds) are identical, then I think it should mean something.

But again, it's really pretty difficult to make any kind of comparison between the systems. You can't prove anything with anecdotes and half arguments.

Yes, but... and this is just another anecdote/half-arguement... isn't there a cap on physician salaries in Canada? This might imply that some of the brighter Candian students are going into other more lucrative fields instead of medicine. I suppose you could argue that means Canadian med students are even better b/c they are "obviously" not going into for the money... but I think that's silly... most often in the ~real~ world smart people go where the money is... this is reflected in the fact that med school aps go up when the economy goes down.

 

[moo]

Canada trains good doctors. The deans of UCSF and Harvard trained in Canada. It's futile to compare because there are bright minds on both sides of the border.

 

[Ponyboy]

The idea that Canadian MD's are better than American MD's comes from the fact that licensing and specialty exams and training are more rigorous in Canada when compared to the US. This is partly due to the fact that all doctors who are not Family Docs are considered specialists in their respective fields. Thus, pediatricians, internists, O & G's are all trained with a focus on secondary and tertiatry care. So, while it may seem like the Canadian internist is better than the american internist, he has just been trained for a different type of practice.
Another reason for the higher standards is the relatively smaller population of doctors and how the small size lends itself to increased quality control among the residency programs. It's much easier to keep track of the quality of 15 internal medicine programs as opposed to say 150.

 

[brandonite]

I've heard that a lot, ponyboy.

In particular, in IM, where the residency in Canada is 5 years, compared to the usual 3 in the States, Canadians do very well in fellowship competitions.

I'm still curious as to how Canadian med school grads do in residency matches. Do you have any idea? My dermatologist did his derm residency at NYU after graduating from U of Manitoba, and he has told me many times that residency directors love Canadians, but then I look and see that 20 or 30 % of Canadians don't match, and I get worried. I want to do my residency in the US for family reasons, so this is pretty important to me...

 

[Thewonderer]

Is IM in Canada really 5 years? The U of T program is 3-4 years.

The following link has good info on U of T's residency offering:

http://www.library.utoronto.ca/medicine/educational_programs/postgrad/postgrad_programs.html

Pediatrics (4 years), Neurology (5 years), Derm (5 years), EM (5 years) and psychiatry (5 years) are all longer @ U of T than in the US.

However, U of T's general surgery program (5 years) is shorter than those in US academic centers (7 years) and cardiac surgery (6 years) is MUCH shorter than in the US where you have to go through general surgery residency and then CT surgery fellowship (9-10 years).

Lastly, family med only takes 2 years to complete in Canada while it is a 3 year program in the US.

 

[relatively prime]

Originally posted by Thewonderer
Is IM in Canada really 5 years? The U of T program is 3-4 years.

The following link has good info on U of T's residency offering:

http://www.library.utoronto.ca/medicine/educational_programs/postgrad/postgrad_programs.html

Pediatrics (4 years), Neurology (5 years), Derm (5 years), EM (5 years) and psychiatry (5 years) are all longer @ U of T than in the US.

However, U of T's general surgery program (5 years) is shorter than those in US academic centers (7 years) and cardiac surgery (6 years) is MUCH shorter than in the US where you have to go through general surgery residency and then CT surgery fellowship (9-10 years).

Lastly, family med only takes 2 years to complete in Canada while it is a 3 year program in the US.

Nice come back! Now it's tied again.

Here, while we're at it... we might as well keep score

Canadians: 3
United Statians: 3

j/k!

 

[Ponyboy]

A gen surg residendcy in Canada and the US is five years. The seven year curriculum factors in two extra years of research that residents do in the middle of their residency. These two years are not actually part of the residency.
The cardiac surgery (as well as some other surgery programs) is different in Canada because residents spend less time in the general surgical fields and quickly move onto their chosen fields of surgery. Thus, a resident will only spend about a year and a half in basic surgical fields before moving onto four and a half years of cardiac surgery (this is again omitting the extra time spent in research).

 

[badassy]

Hearing how hard it is to get accepted in Canada to medical school worries me about getting into one when I'm older =(

 

[Thewonderer]

Originally posted by Ponyboy
A gen surg residendcy in Canada and the US is five years. The seven year curriculum factors in two extra years of research that residents do in the middle of their residency. These two years are not actually part of the residency.
The cardiac surgery (as well as some other surgery programs) is different in Canada because residents spend less time in the general surgical fields and quickly move onto their chosen fields of surgery. Thus, a resident will only spend about a year and a half in basic surgical fields before moving onto four and a half years of cardiac surgery (this is again omitting the extra time spent in research).

All big-name general surgery programs in the US require that 2 years of research anyway. So I am trying to compare apple to apple (i.e. Mass General's 7 year program to U of Toronto's 5 year program) and not orange to apple (i.e. US community hospital's 5 year general surgery program to U of Toronto).

If you want excellent fellowships (pediatric surgery and maybe cardiothoracic), you would need to undergo the academic 7 year general surgery programs anyway.

I have heard rumors that the cardiac surgeons completing the 6 year residency programs are not good. US programs are still insisting on completing general surgery first before being allowed to enter cardiothoracic fellowship. I have also heard rumors that this situation might change sometime soon (i.e. make the training shorter just like what plastic surgery has done).

 

[Ponyboy]

Regardless of whether research is required or not, the core clinical experience of a gen surg residency is five years in both Canada and the US. Extra years of research do not in any way make you a better clinician. Regardless, most surgical residents in Canada take time off to do a research fellowship. In fact, every Royal College Specialty has a program called teh Clinical Investigator Program, where residents can take several years off to obtain a PhD or Masters.

I highly doubt that the Royal College would allow a six year residency program for cardiac surgery if the mortality rates were higher. I also find it difficult to find the relevance of being able to do a hernia repair on a cardiac surgeon's ability to do a CABG.

One reason why many Canadian specialists are barred from their US specialty boards is due to the lack of reciprocity. Most American MD's who take the Royal College Exams fail and cannot gain licensure in Canada. As a result, many Specialty Boards in the US have refused to acknowledge Canadian training because of the apparent refusal of the Royal College to certify their American counterparts.

 

[MacGyver]

Originally posted by Ponyboy
Regardless of whether research is required or not, the core clinical experience of a gen surg residency is five years in both Canada and the US. Extra years of research do not in any way make you a better clinician.

Well, technically speaking you're correct. But research IS useful, its not totally irrelevant.

Regardless, most surgical residents in Canada take time off to do a research fellowship. In fact, every Royal College Specialty has a program called teh Clinical Investigator Program, where residents can take several years off to obtain a PhD or Masters.

A PhD in what field?

One reason why many Canadian specialists are barred from their US specialty boards is due to the lack of reciprocity. Most American MD's who take the Royal College Exams fail and cannot gain licensure in Canada. As a result, many Specialty Boards in the US have refused to acknowledge Canadian training because of the apparent refusal of the Royal College to certify their American counterparts.

I dont believe this at all, sounds like pure hearsay and innuendo to me. Where did you get your source on this?

 

[Ponyboy]

Spending time in the lab is not going to improve your clinical judgement.

You can get a PhD in just about any medical field, from experimental biology to epi.

My sources are Canadian docs who have been barred from writing their respective American Board exams and Royal College examiners who have stated that the pass rate for American MD's is close to zero.