Canadian Student: Realistically, what are my chances for matching in a US EM residency?

[Djcrzy]

Hi,

A little background: I'm an MS3 in a Canadian medical school (not big name). I have pertinent extracurriculars, an ongoing EM research project (and likely a 2nd before match), slightly above average grades and a 240 on Step 1.

I have already directly contacted 68 US residency programs to try to land an EM elective for the end of the summer. Based on feedback, I will likely apply to ~10 in the hopes of getting 1. I understand the importance of the SLOE. (keep in mind that I have a Canadian EM "back-up" elective already lined up at a solid program, which I would cancel if I get a good american one)

My dream is EM. Location is a non-issue. I wouldn't mind matching in Canada or US. My reasoning for applying to the US is to increase my program pool as much as possible and therefore increase my chances of matching somewhere.

I need solid no bull**** advice: am I shooting myself in the foot and thinning myself out too thin? Should I just forget about the states and channel all my energy into matching in Canada? Mind you, Canadian EM is ultra-competitive with only half of EM-applicants matching anywhere. Or should I continue along this path? Should I perhaps revise my strategy?

I really appreciate any advice I can get.

Thanks,
Djcrzy

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[Keladry]

I don't know enough about the Canadian process to really provide much advice, but I'd apply to waaaaaay more than 10 US rotations. I applied to about 10 as early as possible and got 1...with the help of an advisor. Generally you want at least 2 SLOEs, so you should be trying to do 2 rotations (unless you have a home rotation that will provide one that you're also doing?).

 

[Djcrzy]

Thanks for your reply. I would love to a apply to more than 10 but most programs are telling me they don't accept IMG's for rotations (even though technically I am not an IMG but that's a different story...). So so far, I've concluded that I am only eligible to apply to 10 of the 68 that I have personally researched.

Yes I have a home EM rotation coming up. We don't use SLOE's in Canada however. Although, you just gave me the idea to perhaps ask a future Canadian EM attending to fill out a SLOE for me... Don't know if that's even possible...

 

[Apollyon]

Which flavor of Canadian EM are you describing - CCFP-EM, or the TGH program?

Also, it is QUITE likely that the person with whom you spoke at approx 58 programs doesn't know that Canadian schools are LCME accredited; likewise, they didn't know you are indistinguishable from a US med student (until you reveal your accent!), for that reason.

I don't know when is the CARMS match.

I ask about the type of EM, because the SLOE is supposed to be written by an EM faculty member where there is an EM residency.

Maybe I just now didn't say anything at all!

Good luck!

 

[Lexdiamondz]

Which flavor of Canadian EM are you describing - CCFP-EM, or the TGH program?

Also, it is QUITE likely that the person with whom you spoke at approx 58 programs doesn't know that Canadian schools are LCME accredited; likewise, they didn't know you are indistinguishable from a US med student (until you reveal your accent!), for that reason.

I don't know when is the CARMS match.

I ask about the type of EM, because the SLOE is supposed to be written by an EM faculty member where there is an EM residency.

Maybe I just now didn't say anything at all!

Good luck!

True, but Canadian students still need visas to work here, and that's very much a limiting factor.

 

[Apollyon]

True, but Canadian students still need visas to work here, and that's very much a limiting factor.

Right on. I certainly did forget about that. Thanks!

 

[almirbhflfc]

I am a Canadian citizen at a DO school in the USA hoping for EM, waiting for match this year. No sugar coating it; it is rough sledding in EM this year, especially with the added layer of being a Canadian citizen. A lot of programs are getting 150-200 applications per spot. The best thing you can do is to identify the programs you would like a residency in, and try to audition there. That added face time with the audition is very valuable, because them seeing that you work well in a team and mesh well in that program's culture is more important than a lot of other things. Definitely contact as many programs as you can, and have your VSAS ready to go as well.

The other vital piece of information you may not know about; you can only do an EM residency as a Canadian in the USA at a program that sponsors H1-b visas OR a 4-year J-1 sponsoring program. This is because health Canada will not issue a Statement of Need for an EM residency that is 3 year, and a Statement of Need is required to get a J-1 visa. So, that cuts out a lot of potential programs right off the bat.

 

[Djcrzy]

I am a Canadian citizen at a DO school in the USA hoping for EM, waiting for match this year. No sugar coating it; it is rough sledding in EM this year, especially with the added layer of being a Canadian citizen. A lot of programs are getting 150-200 applications per spot. The best thing you can do is to identify the programs you would like a residency in, and try to audition there. That added face time with the audition is very valuable, because them seeing that you work well in a team and mesh well in that program's culture is more important than a lot of other things. Definitely contact as many programs as you can, and have your VSAS ready to go as well.

The other vital piece of information you may not know about; you can only do an EM residency as a Canadian in the USA at a program that sponsors H1-b visas OR a 4-year J-1 sponsoring program. This is because health Canada will not issue a Statement of Need for an EM residency that is 3 year, and a Statement of Need is required to get a J-1 visa. So, that cuts out a lot of potential programs right off the bat.

Thanks for your reply. 2 things: Canadian students cannot use VSAS. It's annoying but that's the way it is... A huge limiting factor for me trying to find an elective is that some schools are VSAS-only and are not willing to accommodate. 2) I am aware of the visa situation but had no idea that Health Canada only sponsors 4-year EM programs... That cuts out the majority of programs...

 

[Djcrzy]

Which flavor of Canadian EM are you describing - CCFP-EM, or the TGH program?

Also, it is QUITE likely that the person with whom you spoke at approx 58 programs doesn't know that Canadian schools are LCME accredited; likewise, they didn't know you are indistinguishable from a US med student (until you reveal your accent!), for that reason.

I don't know when is the CARMS match.

I ask about the type of EM, because the SLOE is supposed to be written by an EM faculty member where there is an EM residency.

Maybe I just now didn't say anything at all!

Good luck!

Thanks for the reply. In Canada, I am interested in the 5 year EM track. I would not do Med-Fam + 1.

 

[Apollyon]

Thanks for the reply. In Canada, I am interested in the 5 year EM track. I would not do Med-Fam + 1.

They should (at least one of the faculty) be familiar with the SLOE.

 

[almirbhflfc]

Thanks for your reply. 2 things: Canadian students cannot use VSAS. It's annoying but that's the way it is... A huge limiting factor for me trying to find an elective is that some schools are VSAS-only and are not willing to accommodate. 2) I am aware of the visa situation but had no idea that Health Canada only sponsors 4-year EM programs... That cuts out the majority of programs...

Wow no VSAS for Canadian students? That really sucks man sorry about that. Yeah the Health Canada thing is very unfortunate; their reasoning is that they will only recognize programs that are within 1 year of duration of the Canadian equivalent. Now, there are 4 year EM programs that sponsor j1 visas, just not that many.

Good luck with everything

 

[gro2001]

Hi,

A little background: I'm an MS3 in a Canadian medical school (not big name). I have pertinent extracurriculars, an ongoing EM research project (and likely a 2nd before match), slightly above average grades and a 240 on Step 1.

I have already directly contacted 68 US residency programs to try to land an EM elective for the end of the summer. Based on feedback, I will likely apply to ~10 in the hopes of getting 1. I understand the importance of the SLOE. (keep in mind that I have a Canadian EM "back-up" elective already lined up at a solid program, which I would cancel if I get a good american one)

My dream is EM. Location is a non-issue. I wouldn't mind matching in Canada or US. My reasoning for applying to the US is to increase my program pool as much as possible and therefore increase my chances of matching somewhere.

I need solid no bull**** advice: am I shooting myself in the foot and thinning myself out too thin? Should I just forget about the states and channel all my energy into matching in Canada? Mind you, Canadian EM is ultra-competitive with only half of EM-applicants matching anywhere. Or should I continue along this path? Should I perhaps revise my strategy?

I really appreciate any advice I can get.

Thanks,
Djcrzy

I know nothing about the Canadian EM match, so can not weigh in on how much you are risking by not focusing all your efforts on Canada. However, I do know quite a bit about FMGs matching in the US. Actually let's get that out of the way first: consider yourself an FMG going forward. Yes, your school is LCME accredited, so you are not actually an FMG. But because of the visa hurdle and programs' nonspecific fears of other unexpected obstacles, you might be handled/perceived closer to being an FMG than a US grad. It seems your experience so far (being limited in programs you can apply to, having difficulty scheduling electives) has been way closer to that of an FMG than of a US grad. That may not seem fair, but there it is. You will have an advantage over most FMGs because of language and cultural factors, so you can take some solace in being a super FMG. The best of FMGs. But an FMG nevertheless.

Now, do you think that one elective in the US is sufficient for an FMG to match in the US? I don't think so. Not in EM. I would urge you to do at least 2, if not 3. Have people matched having done just one? Sure they have. Just like people have matched having done just one interview. But you need to maximize your chances, and for that you need at least 2 US electives.

 

[Djcrzy]

I know nothing about the Canadian EM match, so can not weigh in on how much you are risking by not focusing all your efforts on Canada. However, I do know quite a bit about FMGs matching in the US. Actually let's get that out of the way first: consider yourself an FMG going forward. Yes, your school is LCME accredited, so you are not actually an FMG. But because of the visa hurdle and programs' nonspecific fears of other unexpected obstacles, you might be handled/perceived closer to being an FMG than a US grad. It seems your experience so far (being limited in programs you can apply to, having difficulty scheduling electives) has been way closer to that of an FMG than of a US grad. That may not seem fair, but there it is. You will have an advantage over most FMGs because of language and cultural factors, so you can take some solace in being a super FMG. The best of FMGs. But an FMG nevertheless.

Now, do you think that one elective in the US is sufficient for an FMG to match in the US? I don't think so. Not in EM. I would urge you to do at least 2, if not 3. Have people matched having done just one? Sure they have. Just like people have matched having done just one interview. But you need to maximize your chances, and for that you need at least 2 US electives.

Thanks for your reply man. Basically, I only have two elective windows to do an EM rotation. If I do both in the states, I think this will be detrimental to my Canadian applications. In light of the comments in this thread and some long and hard thinking, I have decided I will not pursue this any further. I will channel all my energy into developing a strong Canadian application.

Thanks all!
-djcrzy

 

[towelonthefloor]

Thanks for your reply man. Basically, I only have two elective windows to do an EM rotation. If I do both in the states, I think this will be detrimental to my Canadian applications. In light of the comments in this thread and some long and hard thinking, I have decided I will not pursue this any further. I will channel all my energy into developing a strong Canadian application.

Thanks all!
-djcrzy

I dont know if this would help, but I met a Canadian applicant during my last audition rotation. She said she could only apply to 4 year programs and that limits her to about ~40 programs. She actually had like a few weeks of traveling from program to program just to spend a day there. Apparently a lot of programs were receptive and told her to keep in touch, but she was also very meticulous with her driving around the coast lol. I have no idea how much this would have cost her but it seemed like she was determined to match in the US and was doing everything possible to get her foot in the door.
Also i expect the total number of 4 year programs to increase for the upcoming match since most programs that were AOA are now ACGME, and many of the AOA programs have remained 4 years.

 

[almirbhflfc]

I dont know if this would help, but I met a Canadian applicant during my last audition rotation. She said she could only apply to 4 year programs and that limits her to about ~40 programs. She actually had like a few weeks of traveling from program to program just to spend a day there. Apparently a lot of programs were receptive and told her to keep in touch, but she was also very meticulous with her driving around the coast lol. I have no idea how much this would have cost her but it seemed like she was determined to match in the US and was doing everything possible to get her foot in the door.
Also i expect the total number of 4 year programs to increase for the upcoming match since most programs that were AOA are now ACGME, and many of the AOA programs have remained 4 years.

Very few AOA programs that got accreditation were able to maintain a 4 year program, almost all had to convert to a 3 year program.