Canadians accepted to a residency in Canada or the US

[UQmed]

Hello,
I could really use some help from Canadians who studied in Aus and have been accepted to a residency in Canada or the US.
Is the US match before the Canadian match, or are you pulled out of the Canadian match if you match in the US?
Do the requirements for and H-1b visa differ from state to state? Is step 3 of the USMLE required for and H-1b visa? Is post graduate experience required for an H-1b visa?
Please feel free to send me a private message if you have obtained a residency.
Thanks

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[Winged Scapula]

Hello,
I could really use some help from Canadians who studied in Aus and have been accepted to a residency in Canada or the US.
Is the US match before the Canadian match, or are you pulled out of the Canadian match if you match in the US?
Do the requirements for and H-1b visa differ from state to state? Is step 3 of the USMLE required for and H-1b visa? Is post graduate experience required for an H-1b visa?
Please feel free to send me a private message if you have obtained a residency.
Thanks

Not Canadian and didn't need a visa but can tackle a couple of the questions...

RE: Participating in both the NRMP and CARMS -

All Applicants registered with the Matching Program that are not matched in the first iteration of the matching process shall automatically be registered, without additional fees, into the second iteration of the matching process.

Applicants matched in the first iteration of the matching process, or matched in the U.S. or other programs not part of the Matching Program, are not eligible to register and participate in the second iteration of the matching process. If for any reason an Applicant is released from a contract in the first iteration of the matching process or released from a contract in the U.S., the Applicant is not eligible for registration in the second iteration of the matching process.

Any Applicant matched to a U.S. position through the NRMP shall be withdrawn from the second iteration of the CaRMS matching process.

http://www.carms.ca/eng/operations_contracts_e.shtml

RE: H-1b visas

This is a program of the US government not residency programs. Therefore, the program does not have different requirements state to state nor is there a requirement that you pass Step 3. The program is for any number of specialized professions and does not address any licensing except that you must be eligible for a license in the state in which you plan working and that you must have at least a bachelor's degree. Post graduate experience is only required such as needed for the specialized profession - ie, someone applying as a physician must have a medical degree.

However, residency programs may have different requirements and can require any of the above, although I would imagine it would be unlikely that they would require you to have previous GME. Check with some programs you are interested in to see what they require and IF they sponsor H-1b visas (many do not).

And perhaps some Canucks can weigh in here as well...

 

[UQmed]

Thanks Kimberli,
Some of the residency program websites are saying they require step 3 of the USMLE. I am wondering what step 3 is testing? Will a new Australian graduate struggle with this exam? I have completed step 1, and I am planning on writing step 2 in the middle of 4th year, and then I guess I could write step 3 in January after I graduate. Would the results be available in time for the match?

Do you know if the H-1B visa would require approval from your home country? One resident coordinator was telling me a Canadian is struggling to get her visa in time because the pediatric residency in the US is 3 years, where as in Canada it is 4 years, so she can't get the visa without writing an additional test, and I don't know what test this would be?

I am also wondering how many residency programs I can apply for in the match? Does it cost more to apply to a lot of programs?
Thanks!

 

[Winged Scapula]

Thanks Kimberli,
Some of the residency program websites are saying they require step 3 of the USMLE. I am wondering what step 3 is testing?

Step 3 is an integration of the basic clinical sciences with an unadvertised focus on peds and family medicine. You will find little surgery on it. Here is more information on it for you: http://www.usmle.org/step3/default.htm

Will a new Australian graduate struggle with this exam?

I doubt it. Its not a very difficult exam and most people pass it - especially if you take it early and you're not in a surgical field (ie, don't wait until you've forgotten all your peds and family medicine). Swanson's Family Practice Review is a good book to use to study; there's a thread right now about Step 3 in the Surgery forum which you might find useful: http://forums.studentdoctor.net/showthread.php?t=392100 Otherwise, you can check the USMLE forums here for more information.

I have completed step 1, and I am planning on writing step 2 in the middle of 4th year, and then I guess I could write step 3 in January after I graduate. Would the results be available in time for the match?

Not if you are planning on starting residency the July after your graduation. For programs to consider you, if they want Step 3 to apply, then you have to have Step 3 completed before the fall the year before.

If they only want you to have Step 3 completed before you start residency, then that's July 1, but I would imagine that programs that require Step 3 want you to have it when you apply. If they say you just need it before the match, remember that Rank Order Lists are due from programs and applicants in Mid-February, so taking the exam in January wouldn't give you enough time to get the results to the programs and have the use it to evaluate your application. So, my feeling is that if they say they require Step 3, they mean for it to be done by the time you apply to their program.

Do you know if the H-1B visa would require approval from your home country? One resident coordinator was telling me a Canadian is struggling to get her visa in time because the pediatric residency in the US is 3 years, where as in Canada it is 4 years, so she can't get the visa without writing an additional test, and I don't know what test this would be?

I don't know much more about the visas than what I've written above. I'm not sure what additional test the peds resident has to take either. Maybe someone else here?

I am also wondering how many residency programs I can apply for in the match? Does it cost more to apply to a lot of programs?
Thanks!

You can apply to as many programs as you want. There is no limit except your pocketbook and your time and patience. It does cost more to apply to a lot of programs. Here is the link for the cost to participate in ERAS: http://www.aamc.org/students/eras/feesbilling/start.htm

Bear in mind that there are charges for the match itself (ERAS is not the match but rather a centralized service which sends your applications out), costs for sending your transcripts, your USMLE scores, cost of travel, food and lodging for the interviews, etc. It can easily cost $5000 or more depending on the number of applications and interviews you go on.

 

[driedcaribou]

Any Applicant matched to a U.S. position through the NRMP shall be withdrawn from the second iteration of the CaRMS matching process.

http://www.carms.ca/eng/operations_contracts_e.shtml


And perhaps some Canucks can weigh in here as well...

That was awfullly nice of you to look all that up!

But yea, everything you said is correct.

I do not know how it works now with the spots for the 1st round Canadian residencies reserved for Canadian citizens who have went to medical schools abroad... but I assume it's the same. The US has their match before Canada does and Canada will honour the American match contracts.

Have you written your MCCEE and MCCQE already then?

 

[PeterJH]

Are the MCCEE and MCCQE similar to the USMLE steps?!? (ie. is it better to study for the USMLE step 1, and then write both step 1 and MCCEE at the same time?!?)

 

[UQmed]

Thanks for your help Kimberli!
How important do you think electives/rotations are in the US when applying for a US residency? Some schools are saying experience in Canada is fine so I am planning to do my electives in Canada, but do you know if any of the US schools will take students on for extra electives during the Christmas break (Nov-Dec)? I have noticed some schools saying they will only approve an elective if it is for credit at your uni?


I have not written the MCCEE and MCCQE yet because I'm only in third year. My understanding is it is only possible for Australian students to have the MCCEE done in time for the Canadian match? I believe this is what students in Ireland are doing as well and they are matching based on their MCCEE scores, is this correct driedcaribou? I am planning to write the MCCEE in Sept of my 4th year.

I think the MCCEE is very different from USMLE step 1. If anything, the MCCEE may be similar to USMLE step 2. I completed step 1 after my second year, and I do feel that was the best time to write it because it is testing pathology and basic science concepts. Hope that answers your questions Peter.

 

[driedcaribou]

How important do you think electives/rotations are in the US when applying for a US residency?

Essential. Think of it this way- you're making a job application which if accepted, will bind you to a contract for x number of years. If they do not know who you are, it will be very difficult for them to hire you.

You need reference letters for your application. These are letters from other doctors... it would be best if you can get them from US doctors.

Some schools are saying experience in Canada is fine so I am planning to do my electives in Canada, but do you know if any of the US schools will take students on for extra electives during the Christmas break (Nov-Dec)? I have noticed some schools saying they will only approve an elective if it is for credit at your uni?

US schools still have clerkships during that time.

You will be taking your electives for credit - if not, ask your Uni to draft you a letter saying it will be for credit.

I have not written the MCCEE and MCCQE yet because I'm only in third year. My understanding is it is only possible for Australian students to have the MCCEE done in time for the Canadian match? I believe this is what students in Ireland are doing as well and they are matching based on their MCCEE scores, is this correct driedcaribou? I am planning to write the MCCEE in Sept of my 4th year.

I haven't looked into the Canadian match much even though I am Canadian....
I thought you were matched based on MCCQE scores. I can't help you there.

I think the MCCEE is very different from USMLE step 1. If anything, the MCCEE may be similar to USMLE step 2. I completed step 1 after my second year, and I do feel that was the best time to write it because it is testing pathology and basic science concepts. Hope that answers your questions Peter.

The MCCEE and MCCQE are more similar to step 2 as they are more clinically based questions with a Canadian slant to it.

Sorry I can't give you definitive answers.

It's good that you've already written step 1.
What you need to do is pick a specialty you really want to do... and then gun for it.

Picking the country to practice in... that's the hard part.

 

[UQmed]

Thanks guys,
I have one big problem- as Kimerbli mentioned- it is true that the USMLE step 3 must be completed prior to the interview to obtain and H-1b visa- but this does not seem possible for Australian graduates.
This web site http://www.fsmb.org/usmle_elistep3.html states:

USMLE Step 3 Eligibility Requirements

The USMLE program requires the following to be completed prior to submitting a Step 3 application:​

• Obtain an M.D. degree (or its equivalent) or a D.O. degree (or its equivalent). ​
• Pass both USMLE Steps 1 and 2 (CK and CS). ​
• If a graduate of a foreign medical school, obtain certification by the ECFMG or successfully complete a "Fifth Pathway" program. ​
• Meet the requirements for taking Step 3 imposed by the individual licensing authority to which you are applying to sit Step 3. ​

You must be eligible to sit for Step 3 at the time you submit the application.​

I will not graduate until Dec so it is not possible for me to complete step 3 prior to residency interviews??? This would mean that Canadians studying in Australia are not eligible for H-1B visas?? The only option seems to be J1 visas which I have heard are not a good option?? It sounds very difficult to get a J1 waiver from Canada, and it is not something anyone wants to rely on. Driedcaribou-did you study in Australia and match into a US residency? What type of visa are you on?
Thanks

 

[PeterJH]

Do most Canadians who leave canada for med school end up practicing in the US?!? Since Canada recognising US residency training, why does it seem like no one goes back to Canada once they've finished residency?!? Is it purely because they can earn more money in the US??

 

[Winged Scapula]

Thanks guys,
I have one big problem- as Kimerbli mentioned- it is true that the USMLE step 3 must be completed prior to the interview to obtain and H-1b visa- but this does not seem possible for Australian graduates.
This web site http://www.fsmb.org/usmle_elistep3.html states:

USMLE Step 3 Eligibility Requirements

The USMLE program requires the following to be completed prior to submitting a Step 3 application:​

• Obtain an M.D. degree (or its equivalent) or a D.O. degree (or its equivalent). ​
• Pass both USMLE Steps 1 and 2 (CK and CS). ​
• If a graduate of a foreign medical school, obtain certification by the ECFMG or successfully complete a "Fifth Pathway" program. ​
• Meet the requirements for taking Step 3 imposed by the individual licensing authority to which you are applying to sit Step 3. ​

You must be eligible to sit for Step 3 at the time you submit the application.​

I will not graduate until Dec so it is not possible for me to complete step 3 prior to residency interviews???

IF the program is requiring you to have passed Step 3 to apply and before they will sponsor you for an H-1B visa, then yes, it does appear that you would have to sit out the year (ie, graduate in December, and apply for residency the following year, to start 1.5 years after you graduate). I had forgotten that to take Step 3 you must have graduated from medical school. Check with some of the programs that you are interested in that seem to require Step 3 and see what timeframe they are expecting.

 

[JPR22]

To my knowledge, unless you're going into Family med, very few programs sponsor H1B anymore. The H1B is a ton of paperwork, expense and liability for programs. Most programs however do sponsor J1. I think part of it is getting a letter from the Ministry of health. The law technically says that upon completion of residency one must return to Canada, however there's a number of ways out of that stipulation. I know of a number of Canadians who are doing an internship in Australia, perhaps thats an option. I think sitting out longer than a year might be a red flag for residency directors.
As an aside, I know how hard it is to get into a Canadian med school,and leaving Canada for med school is the only way to realize one's drea, but spending over $100,000 on med school without knowing where you'll train or practice is a little risky.
Good luck

 

[UQmed]

Thanks Kimberli,

JPR22-You are incorrect. There are many programs outside of family med that sponsor H-1b visas.
I am looking for information from people who have trained in Australia.
Thanks.

 

[JPR22]

JPR22-You are incorrect. There are many programs outside of family med that sponsor H-1b visas.
QUOTE]

Out of curiosity what specialty are you referring to? And how do you know that there's so many programs sponsoring H1-B? Im not being a smart ass,
just in my experience thats not the case.

 

[UQmed]

General surgery, pediatrics etc
You need to contact the individual residency programs and ask them-most do not advertise sponsoring H-1b visas. While it is true, the higher end schools prefer to sponsor J-1 visas (it is easier for them), and there are certain states that will not sponsor H-1b visas, there are still many schools that do sponsor H-1b visas- it takes a while to sort out who they are.
What is your experience?

 

[JPR22]

Its true that it's difficult to sort out which programs sponsor H1B, which is part of the problem. If you call/email, and ask about H1B odds are they'll say, "no", with some negotiation, that may change. Regardless there's so many good candidates who dont need H1B, there would really need to be a good reason for the program to sponsor it. The institution Im at used to sponsor it, and still has the capability, but hasnt entertained the idea in several years, particularily because of the increase in US seniors applying, and J1 applicants. That being said, there's likely differences among specialties, and programs.

 

[driedcaribou]

I will not graduate until Dec so it is not possible for me to complete step 3 prior to residency interviews??? This would mean that Canadians studying in Australia are not eligible for H-1B visas?? The only option seems to be J1 visas which I have heard are not a good option?? It sounds very difficult to get a J1 waiver from Canada, and it is not something anyone wants to rely on. Driedcaribou-did you study in Australia and match into a US residency? What type of visa are you on?
Thanks

Apologies for the late reply - I am doing a rotation overseas and haven't had access to the forum...

I think your question has already been answered... I haven't matched for a US residency yet- I am debating on whether or not I will apply for one to go to the US.

You have to graduate from MedSchool before you can write Step 3...

I think to get the J1, you need your MCCEE and MCCQE written as well.

Such a pain!