DO/MD Residency as a Canadian

[Jinxapotato]

Hey guys,

I am a Canadian who recently got accepted to AZCOM (yay!). BUT, after looking into the whole residency/visa things AND the incoming merger, I am worried. Below are a few questions/concerns of mine, and I would really appreciate if you can address them. Thank you ahead of time.

1)After AZCOM, it is to my knowledge that current AOA residencies is not an option for us, as such we will have to go for the ACGME residencies? If what I want is a good internal medicine residency (good as in it is possible for me to go for a sub specialty like GI/Card), is that feasible as a Canadian DO matching into MD residencies? What USMLE score would I need for that?

2)As my class will graduate in 2019, the MD/DO merger will probably reach an end. As such, does it mean that "most" of AOA progrmas will now be ACGME accredited, and meaning I will have more options? Also, does this mean that all these newly ACGME accredited program will be good to work in Canada (which only accept ACGME residencies).

3)VISA issues, I heard that while most ACGME residencies offer J1 visa (reasonably easy to get), few offers H1B visa. If I take the J1, will I be sent back to Canada after my residency (3 years) for 2 years? In this case, if I went to an "post-merger-ACGME" residency, I will be able to practice in Canada for 2 years right? Of course I will gladly stay in US if they do offer me a H1B....

Thank you guys for your help!

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[NoLollipops4U]

1) By the time you graduate, the merger should be complete. By the time you finish residency in the US, the merger will DEFINITELY be complete. It won't matter if you go to ACGME or AOA residency by that point as they will all be ACGME accredited. You haven't spent a day in medical school so how do you know you want to do cardio or GI? Money is likely to significantly decrease in both those fields if that is your concern. Also, worry about the USMLE when you get halfway through M2. You are getting way too far ahead of yourself

2) Yes

3) Yes, you most likely have to return to Canada after the J1. Each year the Canadian government comes up with a quota of J1 visas to sponsor for each residency/fellowship. Internal medicine in the US is 3 years, but 4 in Canada, so the Canadian government will allow you to extend your J1 for one year only to make the training equivalent. Here is where it gets tricky. The only 1 year fellowship is pulmonary. So even though in 2015, Canada offered unlimited J1 visas for cardiology (GI only got 2. yes 2....for all Canadians....including IMGs from Caribbean etc) it wont meet the criteria because its a 3 year fellowship. GI is also 3 year. It seems like the only way to guarantee you do could do one of those fellowships on a J1 is to return to Canada for 2 years.....which is tough because the training isn't equivalent so I don't even think you can work (you will have 3 years of IM, not 4). I think theres some weird thing in Ontario where you can work under the supervision of an attending or something though? Anyways, it seems if someone wants to do a fellowship longer than one year (most them) you need to find a residency with H1B so that when you apply to fellowships, you aren't required to leave the country if accepted to a fellowship AND you aren't limited by length of training on that fellowship. I'm not 100% sure of all this, but this is what I gather from reading government pages online and talking to Canadian DOs (not pre-meds. Take what you hear from pre-meds with a grain of salt)

This list is irrelevant to you since it changes every year but it gives you an idea.....
http://www.hc-sc.gc.ca/hcs-sss/alt_formats/pdf/hhr-rhs/postgrad-postdoc/cat_b-list-liste-eng.pdf

 

[Jinxapotato]

1) By the time you graduate, the merger should be complete. By the time you finish residency in the US, the merger will DEFINITELY be complete. It won't matter if you go to ACGME or AOA residency by that point as they will all be ACGME accredited. You haven't spent a day in medical school so how do you know you want to do cardio or GI? Money is likely to significantly decrease in both those fields if that is your concern. Also, worry about the USMLE when you get halfway through M2. You are getting way too far ahead of yourself

2) Yes

3) Yes, you most likely have to return to Canada after the J1. Each year the Canadian government comes up with a quota of J1 visas to sponsor for each residency/fellowship. Internal medicine in the US is 3 years, but 4 in Canada, so the Canadian government will allow you to extend your J1 for one year only to make the training equivalent. Here is where it gets tricky. The only 1 year fellowship is pulmonary. So even though in 2015, Canada offered unlimited J1 visas for cardiology (GI only got 2. yes 2....for all Canadians....including IMGs from Caribbean etc) it wont meet the criteria because its a 3 year fellowship. GI is also 3 year. It seems like the only way to guarantee you do could do one of those fellowships on a J1 is to return to Canada for 2 years.....which is tough because the training isn't equivalent so I don't even think you can work (you will have 3 years of IM, not 4). I think theres some weird thing in Ontario where you can work under the supervision of an attending or something though? Anyways, it seems if someone wants to do a fellowship longer than one year (most them) you need to find a residency with H1B so that when you apply to fellowships, you aren't required to leave the country if accepted to a fellowship AND you aren't limited by length of training on that fellowship. I'm not 100% sure of all this, but this is what I gather from reading government pages online and talking to Canadian DOs (not pre-meds. Take what you hear from pre-meds with a grain of salt)

This list is irrelevant to you since it changes every year but it gives you an idea.....
http://www.hc-sc.gc.ca/hcs-sss/alt_formats/pdf/hhr-rhs/postgrad-postdoc/cat_b-list-liste-eng.pdf

Hello NoLollipops, thanks for the reply!

There is one point that I am really confused about and I can't seem to find any direct answers to it.

So if I do a residency on J-1 visa, I cannot extend this J-1 Visa to do other fellowships that is more than 1 year? I checked on some other threads and websites and most say that J-1 will end by the "end of your training", isn't fellowship also part of this training if I start it straight after my residency?

I have also heard about the J-1 waiver option. If I receive a waiver job after my residency (IM) and work for 3 years (I heard this is under H1B status?) will I be able to :
1) apply for green card?
2) apply for a fellowship? Would the 3 years out of residency hurt my chance of getting into a fellowship?

Thank you so much for your reply.

 

[BMSc2DO]

Hello,

Current 1st year DO student from Canada. The merger will not change much of our current situation by the time you graduate and find a residency. Current AOA programs, which will be ACGME accredited, are not going to start sponsoring visas just because they are now ACGME accredited. It is still hospital-dependent. I'd imagine that if you are able to match an AOA program in the process of ACGME accreditation, that you will be allowed to return to Canada when you complete the ACGME residency. However, that is something that is up in the air and only time will tell. Our best bet is to find an H1B sponsoring institution at an ACGME program. You will be able to do so if you are flexible and not gunning for surgery or GI. I have spoken with many Canadian DO graduates, and I have yet to come across a student who did not match into an ACGME program. That being said, if you come to the US do not mess around. Do what you can to boost that CV and focus board studying towards the USMLE (notice how I said USMLE).

There is a resource for Canadian DO students such as yourself. You can access the website here: www.studentdo.ca. You can also search "Osteopathic Medicine (DO) for Canadians" on Facebook. Both are valuable resources. Goodluck.

 

[Jinxapotato]

Hello,

Current 1st year DO student from Canada. The merger will not change much of our current situation by the time you graduate and find a residency. Current AOA programs, which will be ACGME accredited, are not going to start sponsoring visas just because they are now ACGME accredited. It is still hospital-dependent. I'd imagine that if you are able to match an AOA program in the process of ACGME accreditation, that you will be allowed to return to Canada when you complete the ACGME residency. However, that is something that is up in the air and only time will tell. Our best bet is to find an H1B sponsoring institution at an ACGME program. You will be able to do so if you are flexible and not gunning for surgery or GI. I have spoken with many Canadian DO graduates, and I have yet to come across a student who did not match into an ACGME program. That being said, if you come to the US do not mess around. Do what you can to boost that CV and focus board studying towards the USMLE (notice how I said USMLE).

There is a resource for Canadian DO students such as yourself. You can access the website here: www.studentdo.ca. You can also search "Osteopathic Medicine (DO) for Canadians" on Facebook. Both are valuable resources. Goodluck.

Hey there! Nice to find a Canadian buddy!
While I know our best bet is H1B, aren't those very hard to come by, and we're most likely to land on a J1?

PS: correct me if I am wrong but I thought GI is only after your internal med residency?

 

[BMSc2DO]

Yeah my apologies, GI is a fellowship. But back to the main concern: I do not know of anyone who has not entered an ACGME residency as a Canadian DO. I also have not heard of any Canadian DOs that entered their residency on a J1. They have gotten an H1B. Avoid J1 at all costs, unless you are doing primary care and the residency length requirements match up. The last thing you need to do is go back to Canada and can't get a medical license. Also, plans change... J1 forces you to return to Canada... What if you want to stay and work in the US? Meet someone? You can't stay... And you don't want to depend on a J1 visa waiver. But if it helps you at all, I know of a Canadian in a Rheumotolgy fellowship after completing an ACGME IM residency on an H1b, and another entering a Adolescent Psychiatry fellowship. If you are looking for concrete answers, I can't give them to you. No one can. But I can assure you that I wouldn't be at a US DO school if I thought that I wasn't going to get an ACGME residency and visa. Also, take advantage of the website and FB page I posted previously, there is an enormous amount of info and knowledgeable people there.

 

[NoLollipops4U]

Yeah my apologies, GI is a fellowship. But back to the main concern: I do not know of anyone who has not entered an ACGME residency as a Canadian DO. I also have not heard of any Canadian DOs that entered their residency on a J1. They have gotten an H1B. Avoid J1 at all costs, unless you are doing primary care and the residency length requirements match up. The last thing you need to do is go back to Canada and can't get a medical license. Also, plans change... J1 forces you to return to Canada... What if you want to stay and work in the US? Meet someone? You can't stay... And you don't want to depend on a J1 visa waiver. But if it helps you at all, I know of a Canadian in a Rheumotolgy fellowship after completing an ACGME IM residency on an H1b, and another entering a Adolescent Psychiatry fellowship. If you are looking for concrete answers, I can't give them to you. No one can. But I can assure you that I wouldn't be at a US DO school if I thought that I wasn't going to get an ACGME residency and visa. Also, take advantage of the website and FB page I posted previously, there is an enormous amount of info and knowledgeable people there.

There are 1-2 Canadian DOs each year who choose AOA to go into more competitive specialties. Of course, this has only been in the last 2 years. I definitely agree about the H1b thing.....which really sucks because it eliminates a TON of great hospitals that only sponsor J1. There (was) also a few Canadians the last two to three years who matched into Canada. I suspect this small number will decrease even more with the recent change in rules making DOs count as IMGs. However, the plan should have always been: Canadian --> US DO --> US ACGME residency on H1B --> US fellowship if needed --> Back to canada or stay in the US if you are lucky enough to get a green card. Of course there were a few exception of people who snuck back to Canada for residency in IM/FM/Psych before the rules change next year.

 

[Jinxapotato]

There are 1-2 Canadian DOs each year who choose AOA to go into more competitive specialties. Of course, this has only been in the last 2 years. I definitely agree about the H1b thing.....which really sucks because it eliminates a TON of great hospitals that only sponsor J1. There (was) also a few Canadians the last two to three years who matched into Canada. I suspect this small number will decrease even more with the recent change in rules making DOs count as IMGs. However, the plan should have always been: Canadian --> US DO --> US ACGME residency on H1B --> US fellowship if needed --> Back to canada or stay in the US if you are lucky enough to get a green card. Of course there were a few exception of people who snuck back to Canada for residency in IM/FM/Psych before the rules change next year.

US D.O.s are counted as IMG?! Wow that's news to me, I was told that we're in the first batch to match same as the Canadian MDs... Do you mind letting me know where did you find this information? thank you!

 

[s5260205]

US D.O.s are counted as IMG?! Wow that's news to me, I was told that we're in the first batch to match same as the Canadian MDs... Do you mind letting me know where did you find this information? thank you!

Check CARMS provincial criteria. USDO are only considered CMG in BC and Manitoba. Ontario recently changed the definition and USDO are now considered IMG starting next year. The prospect of matching in Canada for USDO is definitely worse than before since the change in Ontario.

 

[Jinxapotato]

Check CARMS provincial criteria. USDO are only considered CMG in BC and Manitoba. Ontario recently changed the definition and USDO are now considered IMG starting next year. The prospect of matching in Canada for USDO is definitely worse than before since the change in Ontario.

wow, much QQ, guess I'll have to stick to Uncle Sam then...I still have not figured out the J-1 dilemma though, some tell me that I need to get back to Canada after 3 years residency, others tell me that I can cover 3 years residency + max of 4 years of fellowship under the same J-1 Visa...very confused..

 

[NoLollipops4U]

Check CARMS provincial criteria. USDO are only considered CMG in BC and Manitoba. Ontario recently changed the definition and USDO are now considered IMG starting next year. The prospect of matching in Canada for USDO is definitely worse than before since the change in Ontario.

Oh what?! I thought it was nationwide. I didn't realize BC will continue to count USDOs are CMG?!

 

[s5260205]

Oh what?! I thought it was nationwide. I didn't realize BC will continue to count USDOs are CMG?!

Provinces set their own criteria. In fact, USDO can't even match in most provinces. Of the 5 provinces that allow USDO to match (BC, Alberta, Manitoba, Ontario, Quebec), only BC and Manitoba consider USDOs CMG. However, the only residency programs in BC and Manitoba are UBC and UManitoba, meaning that the spots available are greatly limited. UBC especially is notorious for their strong preference of Canadian medical students over others, even USMD. Chances of matching back in Canada are grim as a USDO, and the good match results that you see this year will likely be the last one for years to come.