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As a fellow Canadian Citizen who is born and raised in Canada. The system to comeback into a residency is extremely difficult. The next little bit will outline the grotesque nature of the system and how convoluted and unfair it is towards IMGs despite their BS guidelines. Get some popcorn because this will be a good read.
I have graduated from a Caribbean Medical School. Passed the Canadian boards (MCCEE, NAC-OSCE, MCCQE1), passed my USMLE Step 1, 2CK, 2CS with average scores I believe, and have done rotations and observerships in Canada. (Not going to say where and I am keeping it general as this could be career suicide for me). On top of that, I also have good Canadian and American reference letters. I have applied for the last three years in your typical FM, IM, Psych programs hoping for a shot. I have also interviewed each year thus far (this year is pending). So why is the system unfair?
Here are my reasons and not just from firsthand experience but also from my other colleagues from around the country who have matched and are also part of the evaluating process of CaRMS Applications.
1) ALL CANADIAN SCHOOLS PREFER IRELAND OR UK GRADS...anyone else you are even lower on the list
2) Canadian grads have it way too easy and don't require passing boards in order to match (I know grads that have failed their MCCQE1 in fourth year but are still able to continue)
a) Most CMGs only have a transcript with a Pass or Fail
b) Most CMGs will have a letter obviously from their preceptors
c) Most CMGs will also have research under their belts because the medical school programs are designed that way
3) IMGs will never be seen as equal to their CMGs despite half of the country and more are filled with IMGs who trained them
4) They will hand out interviews in CaRMS based on the medical school list first (Ireland/UK/Australia, St. George, Ross, (followed by the other bigger names in the Caribbean) etc.)
5) Some provinces (BC & AB) have their own evaluating programs that you must go through before you can apply and if you succeed there then you'll get an interview
6) Even after you have worked with the PD there is no guarantee that you'll get in
7) Despite having doctors in the community vouch for you, you probably won't get in
8) Despite talking to the Schools after an unsuccessful math you'll be told "You're doing everything you possibly can, hope it is better next year" they are all terrible for feedback
9) Your Grades somewhat matter but not in the grand scheme
10) Despite you being a tax paying citizen, because the government didn't actually pay for your medical schooling, your MLA or MP also cannot do anything (Yes I have tried explaining this process to help others not just myself)
The Canadian system once you are in, you are laughing no doubt. Arguably, the system in the United States is much more fair as it primarily just relies on your board scores, personal connections to the area and whether or not you rotated there/know someone there. I have gone to conferences at various places to make connections for the US and hope a PD is willing to listen to me and my story. Funny thing, it has certainly worked to help land interviews.
Several Universities may appear to be IMG friendly...but look at the skewed results of where the residents are from and in what programs. I bet you any amount of money, that you will find a dominant amount of them from Ireland/UK/Australian Medical Schools with Ross and St. George's coming behind them.
Ontario I am lumping together as they have this weird way of conducting interviews where you can get offers from multiple schools but you interview in one place. As Ontario has the bulk of the IMGs it is very obvious that you must have high scores on your boards otherwise no dice even if you are from there. They will be a little more fair when choosing who to interview but once again, unless you are from those schools mentioned before your chances of being selected for an interview and or being matched are low.
University of Manitoba is notorious for only interviewing candidates from those schools only and the only other way for you to land an interview there outside of being from one of those schools is if you are from Manitoba.
University of Saskatchewan once again follows that same pattern. However, if you are from there you may get an interview only as a courtesy because again they prefer those perceived "superior" schools.
Alberta and BC are being lumped together as you must go through their provincial method of evaluation and based on that lumped result you get an interview and then match. Once again though, they too have a preferred school list.
Newfoundland (Memorial University) No longer accepts IMGs.
Dalhousie University only has FM as a residency. They too have a preferred school list. You must do a MMI type of interview in the first iteration. In the event there are spaces available in the second iteration (usually not), you must have been invited in the first iteration and had completed the MMI in order to be ranked.
Quebec is a funny one that neither myself or my colleagues know too much about. Would be nice if they opened more spots and allowed those of us who are NOT fluent in French to have a shot as there are ALWAYS open residency training positions.
Several universities do require you as an IMG to have a Return of Service Contract if you match in the First Iteration. However, if you got the money or just work for the first year or so (depending on your contract length) you can BUY IT OUT and then you are free to go anywhere. They have done this in hopes that you stay and put roots down. But let us be honest here for a minute, you have lived in Brampton/Toronto/Ottawa/Vancouver for majority of your life and you find out you matched in Brandon, MB or in Prince Albert, SK or Regina, SK or Winnipeg, MB for your residency as an example. You do your residency and if you got the money after completing your training or you choose to do a year or so to earn some money, you may break the remaining contract and move. THIS IS WHAT HAPPENS ALL THE TIME. It is aggravating for those communities who could've had an IMG who is from that area stay in that area had they been chosen...but obviously that would've made too much sense. When a member of the community asks their politician they'll say "the universities operate in a fair manner without discrimination based on...carms site address here..."
Long story short, is it doable to get into a Canadian residency? Debatable unless you have an advantage that the schools will tell you over and over is not an advantage but it is. Friends of mine in IM, FM, PSYCH programs even told me they have filters based on school of graduation first.
Can something be done? Good question because I have personally tried and failed several times to bring light to this growing issue. You would think that the Government of Canada and their Provincial Governments would stop funding residency training programs that are just not needed at the moment and increase Primary Care positions. Fact: 20% or more CANADIAN TRAINED doctors will not have a job when they come out of residency...forget about the number of CMGs that won't match. But of course that would be too easy. Don't worry the US has that problem too but at least when you apply to a program there you'll know if you can based on the fact you need a VISA or if they say they just don't accept IMGs.
As a Citizen, I feel cheated that the system in place could cater to more talented foreign trained individuals but due to biases and complete BS it does not. Instead we get to just say how there is this vast shortage of physicians in Canada even though there are more than enough of us who are doing other jobs to make ends meet that could put a HUGE DENT in the shortage....
To you reading this, I thank you and wish you the best of luck. As for me, lets see what the year holds. But personally I would have better luck trying the Powerball lottery in the US or investing in Marijuana Stocks or opening up my own Marijuana Shop than waiting for the dream job. Also most likely have more luck in the US, and not just me, but probably you as well. Feel free to comment or respond, I will be happy to try and offer more insight.
I have graduated from a Caribbean Medical School. Passed the Canadian boards (MCCEE, NAC-OSCE, MCCQE1), passed my USMLE Step 1, 2CK, 2CS with average scores I believe, and have done rotations and observerships in Canada. (Not going to say where and I am keeping it general as this could be career suicide for me). On top of that, I also have good Canadian and American reference letters. I have applied for the last three years in your typical FM, IM, Psych programs hoping for a shot. I have also interviewed each year thus far (this year is pending). So why is the system unfair?
Here are my reasons and not just from firsthand experience but also from my other colleagues from around the country who have matched and are also part of the evaluating process of CaRMS Applications.
1) ALL CANADIAN SCHOOLS PREFER IRELAND OR UK GRADS...anyone else you are even lower on the list
2) Canadian grads have it way too easy and don't require passing boards in order to match (I know grads that have failed their MCCQE1 in fourth year but are still able to continue)
a) Most CMGs only have a transcript with a Pass or Fail
b) Most CMGs will have a letter obviously from their preceptors
c) Most CMGs will also have research under their belts because the medical school programs are designed that way
3) IMGs will never be seen as equal to their CMGs despite half of the country and more are filled with IMGs who trained them
4) They will hand out interviews in CaRMS based on the medical school list first (Ireland/UK/Australia, St. George, Ross, (followed by the other bigger names in the Caribbean) etc.)
5) Some provinces (BC & AB) have their own evaluating programs that you must go through before you can apply and if you succeed there then you'll get an interview
6) Even after you have worked with the PD there is no guarantee that you'll get in
7) Despite having doctors in the community vouch for you, you probably won't get in
8) Despite talking to the Schools after an unsuccessful math you'll be told "You're doing everything you possibly can, hope it is better next year" they are all terrible for feedback
9) Your Grades somewhat matter but not in the grand scheme
10) Despite you being a tax paying citizen, because the government didn't actually pay for your medical schooling, your MLA or MP also cannot do anything (Yes I have tried explaining this process to help others not just myself)
The Canadian system once you are in, you are laughing no doubt. Arguably, the system in the United States is much more fair as it primarily just relies on your board scores, personal connections to the area and whether or not you rotated there/know someone there. I have gone to conferences at various places to make connections for the US and hope a PD is willing to listen to me and my story. Funny thing, it has certainly worked to help land interviews.
Several Universities may appear to be IMG friendly...but look at the skewed results of where the residents are from and in what programs. I bet you any amount of money, that you will find a dominant amount of them from Ireland/UK/Australian Medical Schools with Ross and St. George's coming behind them.
Ontario I am lumping together as they have this weird way of conducting interviews where you can get offers from multiple schools but you interview in one place. As Ontario has the bulk of the IMGs it is very obvious that you must have high scores on your boards otherwise no dice even if you are from there. They will be a little more fair when choosing who to interview but once again, unless you are from those schools mentioned before your chances of being selected for an interview and or being matched are low.
University of Manitoba is notorious for only interviewing candidates from those schools only and the only other way for you to land an interview there outside of being from one of those schools is if you are from Manitoba.
University of Saskatchewan once again follows that same pattern. However, if you are from there you may get an interview only as a courtesy because again they prefer those perceived "superior" schools.
Alberta and BC are being lumped together as you must go through their provincial method of evaluation and based on that lumped result you get an interview and then match. Once again though, they too have a preferred school list.
Newfoundland (Memorial University) No longer accepts IMGs.
Dalhousie University only has FM as a residency. They too have a preferred school list. You must do a MMI type of interview in the first iteration. In the event there are spaces available in the second iteration (usually not), you must have been invited in the first iteration and had completed the MMI in order to be ranked.
Quebec is a funny one that neither myself or my colleagues know too much about. Would be nice if they opened more spots and allowed those of us who are NOT fluent in French to have a shot as there are ALWAYS open residency training positions.
Several universities do require you as an IMG to have a Return of Service Contract if you match in the First Iteration. However, if you got the money or just work for the first year or so (depending on your contract length) you can BUY IT OUT and then you are free to go anywhere. They have done this in hopes that you stay and put roots down. But let us be honest here for a minute, you have lived in Brampton/Toronto/Ottawa/Vancouver for majority of your life and you find out you matched in Brandon, MB or in Prince Albert, SK or Regina, SK or Winnipeg, MB for your residency as an example. You do your residency and if you got the money after completing your training or you choose to do a year or so to earn some money, you may break the remaining contract and move. THIS IS WHAT HAPPENS ALL THE TIME. It is aggravating for those communities who could've had an IMG who is from that area stay in that area had they been chosen...but obviously that would've made too much sense. When a member of the community asks their politician they'll say "the universities operate in a fair manner without discrimination based on...carms site address here..."
Long story short, is it doable to get into a Canadian residency? Debatable unless you have an advantage that the schools will tell you over and over is not an advantage but it is. Friends of mine in IM, FM, PSYCH programs even told me they have filters based on school of graduation first.
Can something be done? Good question because I have personally tried and failed several times to bring light to this growing issue. You would think that the Government of Canada and their Provincial Governments would stop funding residency training programs that are just not needed at the moment and increase Primary Care positions. Fact: 20% or more CANADIAN TRAINED doctors will not have a job when they come out of residency...forget about the number of CMGs that won't match. But of course that would be too easy. Don't worry the US has that problem too but at least when you apply to a program there you'll know if you can based on the fact you need a VISA or if they say they just don't accept IMGs.
As a Citizen, I feel cheated that the system in place could cater to more talented foreign trained individuals but due to biases and complete BS it does not. Instead we get to just say how there is this vast shortage of physicians in Canada even though there are more than enough of us who are doing other jobs to make ends meet that could put a HUGE DENT in the shortage....
To you reading this, I thank you and wish you the best of luck. As for me, lets see what the year holds. But personally I would have better luck trying the Powerball lottery in the US or investing in Marijuana Stocks or opening up my own Marijuana Shop than waiting for the dream job. Also most likely have more luck in the US, and not just me, but probably you as well. Feel free to comment or respond, I will be happy to try and offer more insight.
