Canadian, US grad, US + Canadian residency

[xylem29]

This should be a sticky -

Questions about being a Canadian citizen who graduates from a US school:

US res:

What are the hoops that I need to jump through in order to land a US residency?

Will I be on a level playing field with US citizens in terms competitive specialities?

Canadian res:

What are the hoops that I need to jump through in order to land a Canadian residency?

Will I be considered the same as a Canadian graduate or as a FMG? Basically, will I be on a level playing field as other Canadians graduating from Canadian schools?

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[MadHopsMD]

Will I be considered the same as a Canadian graduate or as a FMG? Basically, will I be on a level playing field as other Canadians graduating from Canadian schools?

Cant answer all the questions. But this one I can. You are NOT considered FMG. And far as I am aware you are considered on the same level as Canadian students. The only problem is if you come from a lesser known US med school, residency directors would be more inclined to take Canadian med students, since they know the type of doctors they produce. As a result it almost a must to do 4th year electives in Canada. Remember, Canadian directors dont put as much stress on the boards as the American counterparts...

In fact, what I heard if you come from a famous university (like Wash U , harvard) you might be favoured more so then a Canadian med student, when all things are equal.

 

[MadHopsMD]

US res:

What are the hoops that I need to jump through in order to land a US residency?

Will I be on a level playing field with US citizens in terms competitive specialities?

the hoops that you need to jump through is convincing the hospital to give you a H1B visa eventually (After you complete your step 3). This is hard to do, and if you want a super competitive specialty it almost puts pressure on you to ace the boards and honor all throughout meds. if you search though these boards, it appears to be hard but not impossibile. even at top residency programs...

 

[xylem29]

Well - this certainly does not put at ease! You should know that WashU interviews 1100 peope for 120 seats - so I am far from being someone capable of honoring my entire med school record!

Sigh - this doesn't look promising.

 

[MadHopsMD]

Well - this certainly does not put at ease! You should know that WashU interviews 1100 peope for 120 seats - so I am far from being someone capable of honoring my entire med school record!

Sigh - this doesn't look promising.

It's not that bad. and its possible. Best way to judge is to take a look at matchlists.

UVM for example has three students who went back to Canada. One got accepted into a competitive residency (orthopaedic surgery)....so its possible to go back to Canada.

Just like practicing in the US is also possible. Search this website, and you can see ppl who have done it.

I think the hardest part of the process is getting INTO a medical school in the US...

 

[pitseleh2]

Thanks for this post. It's exactly the information I was looking for.

 

[t33sg1rl]

I'm a Canuck, too, going to school in the States and I don't have any firm plans to go back to Canada, but it's an option I would consider depending on what specialty I end up choosing (neurosurg -> USA, family -> Canada). Check out this website-

http://www.healthforceontario.ca/

This site suggests that an American graduate, who completed residency in the US, could be eligible to practice in Ontario without any Canadian residency training. Here's the excerpt:

If you trained in the United States

To receive a certificate of registration from the College of Physicians and Surgeons, you must:

Have a medical degree from an accredited US medical school.
Pass Parts 1 and 2 of the Medical Council of Canada Qualifying Examination.
Be certified by examination by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
Have completed one year of postgraduate training or active medical practice in Canada, or have completed a full clinical clerkship at an accredited Canadian medical school.
Be a Canadian citizen or permanent resident.

If you trained in the US, you may be exempt from some of these requirements based on when and where you did your training. For example, if you graduated from an accredited medical school in the US and have completed a residency program accredited by the US Accreditation Council for Graduate Medical Education (ACGME), you may be exempt from examination and postgraduate training requirements. There are also examinations that are considered equivalent to Parts 1 and 2 of the Medical Council of Canada Qualifying Examinations. These include:

The United States Medical Licensing Examination;
the Comprehensive Osteopathic Licensing Examination;

etc etc. I couldn't find any information on who might be able to skip taking Canadian exams-perhaps physicians willing to work in underserved areas or in a needed specialty???

Also check the section on "repatriation" for Canadian citizens who went to school elsewhere-seems like a residency fast-track and for FP/Peds/IM, you might be able to enter this program right after your American intern year.

 

[xylem29]

See - that's fine if one wants to practice in Canada but does not care about what specialty they are in. But I don't want my options to be limited to primary care/rural practice.

 

[xylem29]

I'm a Canuck, too, going to school in the States and I don't have any firm plans to go back to Canada, but it's an option I would consider depending on what specialty I end up choosing (neurosurg -> USA, family -> Canada). Check out this website-

If you choose neurosurg, will you be treated equally as Americans or will your canadian citizenship handicap your chances of matching into neurosurg? B/c no matter what, you will need to get either the J-1 or HB-1 visa

 

[MadHopsMD]

If you choose neurosurg, will you be treated equally as Americans or will your canadian citizenship handicap your chances of matching into neurosurg? B/c no matter what, you will need to get either the J-1 or HB-1 visa

Good question.

I think you will be at a disadvantage no doubt. But perhaps not neurosurg, because its a closely knit community and if you have the stats to get in, nothing should stop you.

However, I THINK being a Canadian US MD student probably has a big effect when applying to top intern medicine programs. Just because they have a LARGER pool of well qualified ppl.

Again, someone who is applying currently should comment on this....

Just adding my two cents here:

If you look at UWO 06 (last year) match list...you will notice number of ppl getting into top programs. eg. Mayo, Chicago hospitals...

Now if its possible for Canadian students from a largerly unknown school such as UWO (unknown in the US that is), it should not be a problem for Canadians applying who graduated from US. Should it?

 

[MadHopsMD]

I'm a Canuck, too, going to school in the States and I don't have any firm plans to go back to Canada, but it's an option I would consider depending on what specialty I end up choosing (neurosurg -> USA, family -> Canada). Check out this website-
.

Is it true that Canadian neurosurg are capped? As in the amount of money they can earn...while in the US it's not...I heard that from somewhere...

either way, I know there is a big salary difference...and most likely you DO not want to come back to Canada to practice and take a hefty paycut. Especially after investing close to 10-12 years getting specialised...

 

[Doc Ivy]

Don't lose hope. I'm a Canadian, on an F1 Visa at a US Medical school. I got general surgery interviews at Wash U, Columbia, NY Presbyterian, NYU, UCSF, UCLA, University of Washington, Mayo Clinic, Emory, Harvard's Brigham and Women's, University of Chicago and of course my home school Northwestern, etc, etc. I didn't even honor my 3rd year surgery rotation. I did well on the boards and had good letters but I didn't do anything superhuman. Only two programs OHSU and UC Irvine denied me an interview on the basis of my citizenship. As for the visa, I haven't pressed the issue yet, but I did casually ask some of the programs I'm interested in if they would consider the H1b (I only did this after I'd interviewed).

Keep hope alive. It can be done.

 

[MadHopsMD]

I did well on the boards and had good letters but I didn't do anything superhuman.

accept the schools you went too

But thanks...

 

[xylem29]

Is it true that Canadian neurosurg are capped? As in the amount of money they can earn...while in the US it's not...I heard that from somewhere...

either way, I know there is a big salary difference...and most likely you DO not want to come back to Canada to practice and take a hefty paycut. Especially after investing close to 10-12 years getting specialised...

i thought the salary capp was recently removed to help with the waitlist problem...it of course didn't help.

 

[Jspev]

I am a Canadian 4 months from graduating med school in the US. I am am going into psychiatry and have received interviews at nearly all of the top programs I applied to including Harvard, Cornell, Penn and Hopkins. All of these places and nearly all of the big academic centers have no problem offering the H1 visa. Since I am currently on a student visa, I can extend this for my first year of residency and then work on the H1 visa from the second year on. Just call programs and talk to the Graduate Med Education office. Most administrators at the residency office don't know the details and often will say J1 is the only thing that is sponsored. The situation of a Canadian at an American med school is relatively rare in that you are not a FMG but just need the paper work to be employed in the US. The fact that you can start residency on the student visa (on a 1 yr extension) usually makes the H1 not a problem at all. Good luck...!

 

[xylem29]

I am a Canadian 4 months from graduating med school in the US. I am am going into psychiatry and have received interviews at nearly all of the top programs I applied to including Harvard, Cornell, Penn and Hopkins. All of these places and nearly all of the big academic centers have no problem offering the H1 visa. Since I am currently on a student visa, I can extend this for my first year of residency and then work on the H1 visa from the second year on. Just call programs and talk to the Graduate Med Education office. Most administrators at the residency office don't know the details and often will say J1 is the only thing that is sponsored. The situation of a Canadian at an American med school is relatively rare in that you are not a FMG but just need the paper work to be employed in the US. The fact that you can start residency on the student visa (on a 1 yr extension) usually makes the H1 not a problem at all. Good luck...!

you da man! so there we have it folks - it's not a big problem. whew.

 

[Renovar]

Don't lose hope. I'm a Canadian, on an F1 Visa at a US Medical school. I got general surgery interviews at Wash U, Columbia, NY Presbyterian, NYU, UCSF, UCLA, University of Washington, Mayo Clinic, Emory, Harvard's Brigham and Women's, University of Chicago and of course my home school Northwestern, etc, etc. I didn't even honor my 3rd year surgery rotation. I did well on the boards and had good letters but I didn't do anything superhuman. Only two programs OHSU and UC Irvine denied me an interview on the basis of my citizenship. As for the visa, I haven't pressed the issue yet, but I did casually ask some of the programs I'm interested in if they would consider the H1b (I only did this after I'd interviewed).

Keep hope alive. It can be done.

Caution ahead.

I am a canadian citizen, US college and medschool grad who interviewed at many of the programs you listed as above (for internal medicine residency - right now I am a PGY3 on H1B), and I can tell you right off the bat that NYP and Wash U will not give you H1B's (maybe a couple more on your list as well). Getting the interview isn't the problem - the problem is finding a hospital that will do it for you. It is very program dependent, and extremely hard thing to swallow. If you match at a hospital that has a policy to not do H1B as a Canadian, you are pretty much screwed.

Speaking from my own experience, the biggest problem with an Canadian citizen/US medschool grad is hands down your visa. Health Canada will unlikely sign to sponsor you J1, so your only option for residency is H1B, which is very labor/time intensive and have certain element of uncertainty for the employee (the program). They dont like that. J1 is easy and efficient and most programs prefer it over H1Bs. I can't say for surgery or any other fields, but there are seriously some programs (including good ones like Hopkins and Michigan) that told me: "we appreciated your application which is very strong, BUT our current hospital's policy is that we dont support H1B for residency." It's seriously a tough pill to swallow.

In order to overcome this, at least for a big field like medicine, you have to prove that you are a superlative candidate and make programs think that you are worth all these extra efforts. I must agree that at some top hospitals, that is quite hard to do if their entire pool of applicants are self-selected and outstanding. I think graduating from a reputable med school helps, outstanding grades/externships helps too.

Best of luck.

 

[Jspev]

Just want to re-emphasize that you need to go to the "powers that be" at these programs to find answers. The last post said Hopkins did not offer H1b, but this is a copy of an email I received last week from a prgram director at Hopkins (granted things may have changed since the last poster applied to residency):

"I am sorry I did not reply earlier. We do sponosor H-1B visas for
foreign citizens who attended medical school in the US. I have
confirmed this with our Graduate Medical Education office."

The key is that you attend med school in the US. Most places quickly will say "no H1b" because they are used to the situation of a true FMG. I have also been had the H1 discussed and confirmed at Cornell (NYP). It is true some places are dead set against H1. Point is do the calling and investigating yourself as it seems things change year to year.

 

[Renovar]

Just want to re-emphasize that you need to go to the "powers that be" at these programs to find answers. The last post said Hopkins did not offer H1b, but this is a copy of an email I received last week from a prgram director at Hopkins (granted things may have changed since the last poster applied to residency):

"I am sorry I did not reply earlier. We do sponosor H-1B visas for
foreign citizens who attended medical school in the US. I have
confirmed this with our Graduate Medical Education office."

The key is that you attend med school in the US. Most places quickly will say "no H1b" because they are used to the situation of a true FMG. I have also been had the H1 discussed and confirmed at Cornell (NYP). It is true some places are dead set against H1. Point is do the calling and investigating yourself as it seems things change year to year.

That is true. That's the most important part - always call and make sure, and best of all, if you can bring it up personally with their program coordinator during interview. This will prevent any confusion about where they stand on this, and prevent disasters after match day. Different programs and departments are different. It may be highly specialty-dependant, and what I posted only reflect my personal experience in one major subspecialty (internal medicine). It may very well be different for psych, surgery, etc.

Here is the Hopkins medicine residency website: http://deptmed.med.som.jhmi.edu/housestaff/apply.html
J1 only. Talking to their residency program coordinator, he said that this is regardless of where you graduate, but rather a departmental policy. Offered a late interview, but I cancelled based on this.

Wash U's medicine residency info website: http://meded.im.wustl.edu/application/ResAppDocs.html
J1 only, H1B will not be sponsored under ANY circumstance. Offered interview, I have tried to explain, but no dice. Didn't even rank them based on this.

NYP-Cornell's response was actually what their assistant PD told my medical school dean of student, who made a call to them on my behalf. Even she couldn't believe that H1B looms so large (and sometimes buys you an auto-reject) even for an otherwise competitive candidate.

 

[xylem29]

Just want to re-emphasize that you need to go to the "powers that be" at these programs to find answers. The last post said Hopkins did not offer H1b, but this is a copy of an email I received last week from a prgram director at Hopkins (granted things may have changed since the last poster applied to residency):

"I am sorry I did not reply earlier. We do sponosor H-1B visas for
foreign citizens who attended medical school in the US. I have
confirmed this with our Graduate Medical Education office."

The key is that you attend med school in the US. Most places quickly will say "no H1b" because they are used to the situation of a true FMG. I have also been had the H1 discussed and confirmed at Cornell (NYP). It is true some places are dead set against H1. Point is do the calling and investigating yourself as it seems things change year to year.

I remember reading somewhere that this is the office to ask. Thnx for your help guys/gals!

 

[Jspev]

Here is the # for the Hopkins office for international residents:

410.955.3371

There web site says J1 with ECFMG but when you call them and explain

1) you are a US grad
2) you will be starting your PGY1 on your OPT of the student visa
3) you need an H1 starting in PGY2

They will say they have no problem sponsoring H1. They also will know exactly what you're talking about with OPT etc. They told me they ONLY will do H1 for a US grad who needs a visa. I have talked to them on 2 separate occasions and so has the PD I quoted above. But it does NOT state this on the web site because the info on the site refers to those who will have ECFMG (ie grads of foreign med schools). Call places and see for yourself and the confusion shall end!

 

[coffeebythelake]

I am also a Canadian citizen who will be studying in an American med school. I have been thinking about Canadian residency programs, and I am relieved that we will not be considered Foreign Medical Graduates. However, there seems to be a lot of confusion and I'm not sure how the process works.

You said that Canadian residency directors don't stress the boards as much as the Americans. Does this mean they use med school grades (e.g., AOA, etc...) and school reputation?

Also... according to the government website, the Ontario requirements for American trained physicians are:
- Pass Parts 1 and 2 of the Medical Council of Canada Qualifying Examination.
- Be certified by examination by either the Royal College of Physicians and Surgeons of Canada (RCPSC) or the College of Family Physicians of Canada (CFPC).
- Have completed one year of postgraduate training or active medical practice in Canada, or have completed a full clinical clerkship at an accredited Canadian medical school.
- Be a Canadian citizen or permanent resident.

How can one complete a year of postgraduate training or active medical practice in Canada if they do not already have a certificate of registration from the College of Physicians and Surgeons? How hard is it to secure clinical clerkship and electives (MS3? MS4?) in Canada?

 

[coffeebythelake]

See - that's fine if one wants to practice in Canada but does not care about what specialty they are in. But I don't want my options to be limited to primary care/rural practice.

I've been thinking the same thing. If Canadian residency requires so many hoops to jump and is so competitive that I end up in family practice or rural medicine, I would rather stick with American residency.

 

[omegaxx]

I've been thinking the same thing. If Canadian residency requires so many hoops to jump and is so competitive that I end up in family practice or rural medicine, I would rather stick with American residency.

Can we go back to Canada to practice as specialists after we are trained in the States? Or is primary care/rural health the only route still?

It's not about the pay-cut. Canadian doctors have a very good standard of living by all accounts. It's about staying in the career you want.

 

[xylem29]

Well, this may create even more confusion, but I remember reading somewhere that if you are already board certified in a subspecialty in the US, then you can come back to Canada and practice in your specialty - but I'm not sure of the hoops that you gotta to go through. Like taking the Canadian exams, etc.

 

[twoinone]

from reading the previous posts, it seems that the H1-B visa is an advantage to the J1 Visa. can someone please tell me the advantages of the H1b visa as compared to a J1. thanks

 

[xylem29]

from reading the previous posts, it seems that the H1-B visa is an advantage to the J1 Visa. can someone please tell me the advantages of the H1b visa as compared to a J1. thanks

yes - the H1B visa is a precursor to a green card. The J1 expires and when it does, you will have to return to Canada for 2 years before going back to the US...

 

[t33sg1rl]

So I wasn't really considering pediatrics, even though I love kids, because I don't want to do primary care and all the pediatric subspecialties in the USA are 6 years (except Neuro, which you can do in only 5-woo hoo) and the peds subspecialists all seem to make about 20% less than the corresponding adult specialists.

But I was just reading a Canadian peds residency description, and I found this interesting as a program goal:
To focus on clinical experiences of a secondary and tertiary nature in general and subspecialty pediatrics as seen in both a large academic health science centre for children and in community practice.
I also noted that there are three years of peds followed by ONE year of specialty training-so you can shave 2 years of every single subspecialty pathway.

This really has my attention. Can anybody comment on the difference between peds training in the US and Canada?

 

[tantrum]

So I wasn't really considering pediatrics, even though I love kids, because I don't want to do primary care and all the pediatric subspecialties in the USA are 6 years (except Neuro, which you can do in only 5-woo hoo) and the peds subspecialists all seem to make about 20% less than the corresponding adult specialists.

But I was just reading a Canadian peds residency description, and I found this interesting as a program goal:
To focus on clinical experiences of a secondary and tertiary nature in general and subspecialty pediatrics as seen in both a large academic health science centre for children and in community practice.
I also noted that there are three years of peds followed by ONE year of specialty training-so you can shave 2 years of every single subspecialty pathway.

This really has my attention. Can anybody comment on the difference between peds training in the US and Canada?

There's something wrong with this information. Canadian residencies are longer 4 years for Pediatrics and Internal Medicine. That's the reason why many US trained IM or Peds do an additional year to practice in Canada. But many of their subspecialty (fellowship) might be shorter (2 years).

 

[gesuchtish]

The rule says you can't take USMLE step 3 until you have your MD degree. And you can't get H-1B until you've taken step 3. How does that work out? So basically you would match into a residency without a visa (at least temporarilly)? I'm confused