Canadians not allowed J1 visas for subspecialties anymore.

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There's a meeting between health canada and health ministers in september. We HAVE to educate the ministers of health in all provinces about this. It doesn't hurt to CC the federal minister. I don't even care if this goes to the prime minister himself. We have to stop this from being implemented.

how do you know there is a meeting between health canada and health ministers in september?
what education to the ministers of health do you want to provide? I ask this question because according to the website for statements of need says the provincial ministries of health are responsible for this scenario. What do you want to tell the ministers?

It's all well and good to voice your concerns over something that affects your career path. What do you want them to do about j1 visas? What are your suggestions for issuing visas? I don't have the answer, mind you, but I see how negatively affected students are, but I don't see (yet) what they want done.

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how do you know there is a meeting between health canada and health ministers in september?
what education to the ministers of health do you want to provide? I ask this question because according to the website for statements of need says the provincial ministries of health are responsible for this scenario. What do you want to tell the ministers?

It's all well and good to voice your concerns over something that affects your career path. What do you want them to do about j1 visas? What are your suggestions for issuing visas? I don't have the answer, mind you, but I see how negatively affected students are, but I don't see (yet) what they want done.

Have you been reading my posts? I already said what we want to be done. Revoke these new limitations. Keep opportunities open. At the very least grandfathering the current residents who cannot go back and change their life plans now, give a more advanced notice of this impending doom. Make better decisions based on rigorous research and not post some arbitrary numbers on the website for each specialty.

Why do you sound so defeated?

Also if you emailed Health Canada you would have received their generic email saying they will discuss it with their provincial partners.

SOCASMA mentioned there is a meeting in september. It's already mentioned in my previous post.
 
Have you been reading my posts? I already said what we want to be done. Revoke these new limitations. Keep opportunities open. At the very least grandfathering the current residents who cannot go back and change their life plans now, give a more advanced notice of this impending doom. Make better decisions based on rigorous research and not post some arbitrary numbers on the website for each specialty.

Why do you sound so defeated?

Also if you emailed Health Canada you would have received their generic email saying they will discuss it with their provincial partners.

SOCASMA mentioned there is a meeting in september. It's already mentioned in my previous post.

I am doubting there is a meeting with ministers.

You stated : "There's a meeting between health canada and health ministers in September."
that's not the same thing as "they will discuss it with their provincial partners"
provincial ministers are elected representatives who have been given the job of Minister.
provincial partners - I would guess these partners are the names listed on the health Canada website. those people are not Ministers.
I have not seen their generic email.

I asked what people want done about J1 visas. The visas. Not the letters from Canada.

the organization you may want to influence is this one.
http://www.hhr-rhs.ca/

Oh well.
 
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just saw this and told a friend of mine. she graduated from an american school and is now doing her residency in BC. She wants to subspecialize and goes to Boston for a one-year training. Does she fall under Cat A then if she's getting her residency training in Canada?
 
Looks like there may be some good news in the near future. From the Society of Canadians Studying Medicine Abroad:

"UPDATE on our concerns about the new Statements of Need policy announced in July: Health Canada had advised us in August that they would be meeting with the provinces to reconsider the Statements of Need policies they announced in July to attempt to address our concerns. We spoke to the policy analyst for Health Canada today who advised us that Health Canada will be modifying their policy to attempt to address some of the concerns that have been expressed. They are in the process of finalizing the changes and will have them posted on their website by the end of October".
 
Looks like there may be some good news in the near future. From the Society of Canadians Studying Medicine Abroad:

"UPDATE on our concerns about the new Statements of Need policy announced in July: Health Canada had advised us in August that they would be meeting with the provinces to reconsider the Statements of Need policies they announced in July to attempt to address our concerns. We spoke to the policy analyst for Health Canada today who advised us that Health Canada will be modifying their policy to attempt to address some of the concerns that have been expressed. They are in the process of finalizing the changes and will have them posted on their website by the end of October".


That's nice, but I don't see any changes on the Health Canada website except for the format/layout. The 2016 and 2017 changes are still there, there are no new disclaimers.

Am I missing it or is it not updated yet?
 
That's nice, but I don't see any changes on the Health Canada website except for the format/layout. The 2016 and 2017 changes are still there, there are no new disclaimers.

Am I missing it or is it not updated yet?

it is not updated. did you write to them and ask why not?
 
Thank you!! No, I did not yet. But I will soon... :)

Isn't this new
"Important Notice:
Applicants whose postgraduate training programs start in 2016 should use these instructions to apply for a Statement of Need. Please review these materials carefully, as significant changes have been made. "

Does this mean that the "old people" who started training before 2016 still follow the "old rules"??!:rolleyes::D:clap:
 
no. the rules/guidelines are updated annually, and apply to everyone who applies for a S of N in that year.
 
http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/postgrad-postdoc/cat_b-list-liste-eng.php

So I just read this. I'm slightly confused.

I started Psych Residency in the U.S on J1 in July 2014. I want to do 2 Fellowships:

1) Pain (ACGME 1 year Fellowship)
2) Neuropsychiatry (Non-ACGME 1 year fellowship)

Can I do this, or is it not allowed under the new rules? Can I get 2 Statement of Needs from Canada for 2 separate 1 year fellowships?


I'm a bit confused, since it states rules for "Before starting residency before 2015, and before 2016". It also states it is for "ACGME fellowships", which neuropsych is not....

Thanks,
 
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Someone please correct me if I'm wrong....

For IM, if we do 3 years + 1 year fellowship or chief year
Apply to take RSPSC certification exam in 4th year and pass..
Then can't we do CPSO pathway 4 (needing supervision for 1-1.5 years) and then have a full license.

This is assuming you have usmle 1-3 and ABIM certified in the US.. But why wouldn't you if you did training there.
But this way you don't have to take the MCC exams..

You would need to take ABIM qualifying exam in the US, the RSPSC certification exam in Canada and 1-1.5 years certification. Right?
If you do all this efficiently and get someone to supervise you, you should be done in 2 years - which would also suffice for the return home for 2 years criteria for J1.

Again, PLEASE CORRECT ME IF THIS IS WRONG.
Thank you!
 
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Someone please correct me if I'm wrong....

For IM, if we do 3 years + 1 year fellowship or chief year
Apply to take RCPSC certification exam in 4th year and pass..
Then can't we do CPSO pathway 4 (needing supervision for 1-1.5 years) and then have a full license.

This is assuming you have usmle 1-3 and ABIM certified in the US.. But why wouldn't you if you did training there.
But this way you don't have to take the MCC exams..

You would need to take ABIM qualifying exam in the US, the RSPSC certification exam in Canada and 1-1.5 years certification. Right?
If you do all this efficiently and get someone to supervise you, you should be done in 2 years - which would also suffice for the return home for 2 years criteria for J1.

Again, PLEASE CORRECT ME IF THIS IS WRONG.
Thank you!

This is correct more or less.

Except the intent for Pathway 3(if your a US grad who did ACGME) and 4(IMG grad who did ACGME) is that you would not have to be RCPSC certified(i.e. if you didn't do the fellowship to match the length of training and only got ABIM certified) - hence why you would have to do a 1 year supervision(debatable how easy this is to find).

If you do the +1 year fellowship, you would have 4 years and be able to get your RCPSC certification directly in GIM and not have to go through Pathway 3 or 4 for the restricted ontario license.

So your options are:

1. Become fully licensed in the US via ABIM (3 year IM only) and then apply back to Canada under either pathway 3 or 4; do a lot of paper work and supervision training - and get a restricted license to practice GIM in ONTARIO.

2. Do 3 year IM + 1 year fellowship/chief, get licensed in the US(i'm not sure its explicitly required, but would be a good idea anyways if you want to go for fellowship later), and then reach out to RCPSC to get your certification through them. Get a full-unrestricted license to practice in all of Canada for GIM.

In both cases you would do the RCPSC certification exam for IM. I don't think you would need to do the MCC exams, as you would have USMLE step 1-3.


Someone please chime in if my above understanding is incorrect.
 
http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/postgrad-postdoc/cat_b-list-liste-eng.php

So I just read this. I'm slightly confused.

I started Psych Residency in the U.S on J1 in July 2014. I want to do 2 Fellowships:

1) Pain (ACGME 1 year Fellowship)
2) Neuropsychiatry (Non-ACGME 1 year fellowship)

Can I do this, or is it not allowed under the new rules? Can I get 2 Statement of Needs from Canada for 2 separate 1 year fellowships?


I'm a bit confused, since it states rules for "Before starting residency before 2015, and before 2016". It also states it is for "ACGME fellowships", which neuropsych is not....

Thanks,

You will only be sponsored for the non-acgme fellowship, after you return to Canada and become fully licensed in Psychiatry. Then you can apply under Category C for the non-acgme fellowship.
 
http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/postgrad-postdoc/cat_b-list-liste-eng.php

So I just read this. I'm slightly confused.

I started Psych Residency in the U.S on J1 in July 2014. I want to do 2 Fellowships:

1) Pain (ACGME 1 year Fellowship)
2) Neuropsychiatry (Non-ACGME 1 year fellowship)

Can I do this, or is it not allowed under the new rules? Can I get 2 Statement of Needs from Canada for 2 separate 1 year fellowships?


I'm a bit confused, since it states rules for "Before starting residency before 2015, and before 2016". It also states it is for "ACGME fellowships", which neuropsych is not....

Thanks,

Q: are you planning to complete three or four years of adult psych?
The Pain fellowship would be fine for a S of N if you complete four years.

After that, the HC website seems to be saying that once you have met the Royal College requirements, you have to return to Canada. If you still want to do more training, you have to get a full licence first, and apply under Category C. that means writing the Royal College exams, the MCC exams, and get a job and work for a while.
 
This is correct more or less.

Except the intent for Pathway 3(if your a US grad who did ACGME) and 4(IMG grad who did ACGME) is that you would not have to be RCPSC certified(i.e. if you didn't do the fellowship to match the length of training and only got ABIM certified) - hence why you would have to do a 1 year supervision(debatable how easy this is to find).

If you do the +1 year fellowship, you would have 4 years and be able to get your RCPSC certification directly in GIM and not have to go through Pathway 3 or 4 for the restricted ontario license.

So your options are:

1. Become fully licensed in the US via ABIM (3 year IM only) and then apply back to Canada under either pathway 3 or 4; do a lot of paper work and supervision training - and get a restricted license to practice GIM in ONTARIO.

2. Do 3 year IM + 1 year fellowship/chief, get licensed in the US(i'm not sure its explicitly required, but would be a good idea anyways if you want to go for fellowship later), and then reach out to RCPSC to get your certification through them. Get a full-unrestricted license to practice in all of Canada for GIM.

In both cases you would do the RCPSC certification exam for IM. I don't think you would need to do the MCC exams, as you would have USMLE step 1-3.


Someone please chime in if my above understanding is incorrect.

just a note:
Category C applicants must have RCPSC, LMCC and a full unrestricted licence and be working in Canada. This is the current definition. Also, as far as I know, a licence that is issued without LMCC is not entirely transportable across Canada, at this time. The doctor would have to apply for a licence in another province and go through the process. If the doctor has RCPSC and LMCC, there is almost no 'paperwork' to do. See definition of Canadian Standard Medical Licence on the CPSO website.
 
Q: are you planning to complete three or four years of adult psych?
The Pain fellowship would be fine for a S of N if you complete four years.

After that, the HC website seems to be saying that once you have met the Royal College requirements, you have to return to Canada. If you still want to do more training, you have to get a full licence first, and apply under Category C. that means writing the Royal College exams, the MCC exams, and get a job and work for a while.

"that means writing the MCC exams"

So you know for a fact that to get a full license, I cant transfer over my USMLEs? I have to do MCCQE1 and 2?
 
"that means writing the MCC exams"

So you know for a fact that to get a full license, I cant transfer over my USMLEs? I have to do MCCQE1 and 2?

The definition of "Canadian Standard Medical Licence" is RCPSC plus LMCC. This is the definition currently used for category c applications for a Statement of Need.
Each province carries its own definition of 'full' licence; but they are not immediately transferable to another province. The definition of the canadian standard is published on the CPSO website (among other websites). Also google Agreement on Internal Trade (AIT) and see the part about medical licensure.
 
Ok thanks.

British Columbia (CPSBC) emailed me saying they accept USMLEs.

So am I good to go or do I need RCPSC approval as well?

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Hi guys,
I am currently in a surgery residency in the US on a J1 visa from Ontario. How do any of these changes effect me for residency? Fellowship?

Regards

they will not let you do fellowships unless you take a legal action against them. They did not even give us notice well-in advance only month ago before we applied in 2015. Thats not legal. Moreover, categorisations are unfair
 
So I'm currently doing a 3 year fellowship in U.S. (PGY5) on J-1 and was planning on doing an extra one year ACGME fellowship in July 2018. By the new rules that wont be a possibility anymore if I dont have royal college board certification? Given that this rule was implemented when I had already started subspecialty training I could not have possibly had sufficient time to complete all the Royal College exams to even become board eligible in my specialty. Do they seriously expect us to be unemployed for a few years after completion of training to take all their exams and pass them (assuming you pass everything on first try otherwise itll take even more than a couple of years) ? This seems pretty unreasonable to me. Is my understanding of this whole situation correct?
 
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hey guys i was wondering if i could grab your thoughts on this fellowship issue. I am a USDO going into internal medicine this match cycle. I am interested in Pulm/Crit or Crit
Regardless, So if i get an H1B from my program i wont be able to pursue fellowship b/c H1Bs expire in 6 years and most programs are worried about this.
Then i cannot do J1 route b/c of Canada..


any input?
 
hey guys i was wondering if i could grab your thoughts on this fellowship issue. I am a USDO going into internal medicine this match cycle. I am interested in Pulm/Crit or Crit
Regardless, So if i get an H1B from my program i wont be able to pursue fellowship b/c H1Bs expire in 6 years and most programs are worried about this.
Then i cannot do J1 route b/c of Canada..


any input?

Internal med + pulm/crit is 6 years total I thought. You should be fine if you manage to get an H1B


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Can I get help with my understanding of my options here?

So I graduated from a US medical school and I'm currently in my intern year on a J1. I DO NOT intend to return to Canada, however if I want to subspecialize here in the US, I still need to do 4 years IM equivalent here in the US, and be certified in Canada to be eligible for fellowship on a J1 in the US...This would be a total delay of ~2 years?.

It's either that or I do the J1 waiver and work in an undeserved area for 3 years, while on an H1-B and then apply for a greencard afterwards to finally be eligible to apply for fellowship.

This new rule really angers me. When I went to medschool I had no intention whatsoever of returning to Canada. And despite that I and many of us are screwed over in such a big way.
 
Hi Capostat

First of all, you cannot say that you do not intend to Canada as it defeats the purpose of the J1 visa, even though you apply for a waiver later ;). So, never mention this to anyone, it will backfire.
Instead of sitting and cursing yourself over this, you should curse them and ask them for the rationale behind unfair policy changes. I have been sending emails over this for long to federal J1 visa program, Deputy Health Minister (Simon Kennedy) who handles this branch, your local MP to raise your concern, and even PM Trudeau. I am also seeking help from legal aid program and can even go out to fight this in the court but I don't know much here. These changes were created in consultation of RCPSC (which is a "union" formed and funded by practicing doctors, known to control demand/supply, and lobby against IMGs) and provincial health ministry (who only care about lowering health care budget). Canada is the only country who is concerned about more doctors becoming a problem when it has a record length of waiting patients queues. While rest of the countries are indebted to US, Health Canada is creating roadblocks for its budding students from pursuing higher studies, which is unprecedented. The policy changes towards those who go to do IM will achieve nothing other than wrecking careers of many.
So here are some points you can fight on:

1. How does Categorization of candidates helps in limiting needs of sub-specialties as Category A and C have an unlimited endorsement?

2. Why the policy is biased and inconsistent that Category A can apply for fellowships directly as compared to Category B who need to apply from Category C. For fellowship in Canada, Category-A do 3 years IM in core IM then their fourth year is counted and done towards fellowship, hence it is same as 3 years IM done in the US.
Why Category B have to get full license in generic IM of 4 years. Its disrupting continuous education. Only when it comes to poractising and getting a license, RCPSC can dicate its requirements but here a US medical resident wanting to do US medical fellowship, why it needs to get a generic IM license?

3. From sub-specialty profile by CMA (you can find by googling it), you can see the employment and need for the sub-specialty you are interested in. For example, in Cardiology, the number 3.5 per 100K of the population which even decreased from 2015 to 2016. So, why the hell sub-specialists feel that they are employed when there are only handful of them. One cannot have everything one wants in a job. Just because one is not willing to move, or not getting hefty package, not getting research setup or academic designation, he/she cannot be considered unemployed. Just because some feel unemployed, . Like any other job sectors, there are no more cushy jobs, one needs to be flexible. And, govt. should try to make remote or rural areas attractive for doctors to have a uniform distribution of doctors instead of making us scapegoat

4. They don't have data on how many residents or fellows who got SON have returned. So, how can they determine their effect on the workforce. I have not seen anyone coming back to Canada. Most of them do J1 waiver. For cardiology, for example, only a handful of them (a single digit number) get SONs every year and we don't even know how many come back, so how its justified that they are saturating canadian job market.

5. And, finally why 2016 residents are not grandfathered under plan. We had already graduated and prepared our profiles to apply for a sub-specialty field when these changes were introduced in August or September. As we apply starting of september, why we were not given enough time to make an informed decision. IM is done mostly as it is a step to further sub-specialties. We would have picked some other area had we known that will be forced a gap of 2 years which will make us incompetent for fellowships, esp. competitive ones.

Btw, J1 waiver is 5 years not 3 years and route to green card will also depend on the country you were born in. J1 waiver is mostly done in remote, under privileged areas and in primary care. It will be hard to stay competent given the load of paper work etc. you will be given other than your core work. This long path will make you incompetent esp. for competitive fellowships.

It is a very poor strategy by Health Canada to discourage students from pursuing higher studies instead of solving the real issues.
No country in the world has done that. We are under democracy not dictatorship. If we take this matter to court, they won't stand a chance
 
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Isn't this new
"Important Notice:
Applicants whose postgraduate training programs start in 2016 should use these instructions to apply for a Statement of Need. Please review these materials carefully, as significant changes have been made. "

Does this mean that the "old people" who started training before 2016 still follow the "old rules"??!:rolleyes::D:clap:
Yeah..good for you and bad for so many...
Pls be supportive of your medical professional Colleagues.
 
Hi Capostat

First of all, you cannot say that you do not intend to Canada as it defeats the purpose of the J1 visa, even though you apply for a waiver later ;). So, never mention this to anyone, it will backfire.
Instead of sitting and cursing yourself over this, you should curse them and ask them for the rationale behind unfair policy changes. I have been sending emails over this for long to federal J1 visa program, Deputy Health Minister (Simon Kennedy) who handles this branch, your local MP to raise your concern, and even PM Trudeau. I am also seeking help from legal aid program and can even go out to fight this in the court but I don't know much here. These changes were created in consultation of RCPSC (which is a "union" formed and funded by practicing doctors, known to control demand/supply, and lobby against IMGs) and provincial health ministry (who only care about lowering health care budget). Canada is the only country who is concerned about more doctors becoming a problem when it has a record length of waiting patients queues. While rest of the countries are indebted to US, Health Canada is creating roadblocks for its budding students from pursuing higher studies, which is unprecedented. The policy changes towards those who go to do IM will achieve nothing other than wrecking careers of many.
So here are some points you can fight on:

1. How does Categorization of candidates helps in limiting needs of sub-specialties as Category A and C have an unlimited endorsement?

2. Why the policy is biased and inconsistent that Category A can apply for fellowships directly as compared to Category B who need to apply from Category C. For fellowship in Canada, Category-A do 3 years IM in core IM then their fourth year is counted and done towards fellowship, hence it is same as 3 years IM done in the US.
Why Category B have to get full license in generic IM of 4 years. Its disrupting continuous education. Only when it comes to poractising and getting a license, RCPSC can dicate its requirements but here a US medical resident wanting to do US medical fellowship, why it needs to get a generic IM license?

3. From sub-specialty profile by CMA (you can find by googling it), you can see the employment and need for the sub-specialty you are interested in. For example, in Cardiology, the number 3.5 per 100K of the population which even decreased from 2015 to 2016. So, why the hell sub-specialists feel that they are employed when there are only handful of them. One cannot have everything one wants in a job. Just because one is not willing to move, or not getting hefty package, not getting research setup or academic designation, he/she cannot be considered unemployed. Just because some feel unemployed, . Like any other job sectors, there are no more cushy jobs, one needs to be flexible. And, govt. should try to make remote or rural areas attractive for doctors to have a uniform distribution of doctors instead of making us scapegoat

4. They don't have data on how many residents or fellows who got SON have returned. So, how can they determine their effect on the workforce. I have not seen anyone coming back to Canada. Most of them do J1 waiver. For cardiology, for example, only a handful of them (a single digit number) get SONs every year and we don't even know how many come back, so how its justified that they are saturating canadian job market.

5. And, finally why 2016 residents are not grandfathered under plan. We had already graduated and prepared our profiles to apply for a sub-specialty field when these changes were introduced in August or September. As we apply starting of september, why we were not given enough time to make an informed decision. IM is done mostly as it is a step to further sub-specialties. We would have picked some other area had we known that will be forced a gap of 2 years which will make us incompetent for fellowships, esp. competitive ones.

Btw, J1 waiver is 5 years not 3 years and route to green card will also depend on the country you were born in. J1 waiver is mostly done in remote, under privileged areas and in primary care. It will be hard to stay competent given the load of paper work etc. you will be given other than your core work. This long path will make you incompetent esp. for competitive fellowships.

It is a very poor strategy by Health Canada to discourage students from pursuing higher studies instead of solving the real issues.
No country in the world has done that. We are under democracy not dictatorship. If we take this matter to court, they won't stand a chance


Thanks for the info, I will certainly be one to email and complain about the unfairness of it all. I'm not leaning towards any competitive fellowship at this time, but it could change next year. To have our lives dictated to significantly by the government after OUR sacrifices is insane.
 
Thanks for the info, I will certainly be one to email and complain about the unfairness of it all. I'm not leaning towards any competitive fellowship at this time, but it could change next year. To have our lives dictated to significantly by the government after OUR sacrifices is insane.
You can also join facebook group Society of Canadians Studying Medicine Abroad (SOCASMA).
 
Hi everyone

I'm a Canadian currently completing my general surgery residency in the States on a J1. I actually got accepted for a hand surgery fellowship in the States starting in August 2017 and now I'm having issues obtaining a Statement of Need to extend my J1 visa (only 1 year fellowships approved are colorectal and critical care). I have two questions:

1. Has any of you ever succeeded in having an exception granted and got a statement of need?
2. Is there any way to access to prior years' list of needed specialties. I'm hoping that maybe the list was different in 2012 when I started residency and that I can use this as leverage to try and convince my provincial representative to consider granting a statement of need under special circumstances.

Thanks!
 
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