Going to US for residency? Coming back for sub-specialty training?

[gggggg2]

I have become interested in doing a residency in the US. One because I think it would be a good experience and two the competition for residency spots is projected to skyrocket in Canada in the coming years due to cutbacks. I am a second year now, and want to pursue pediatrics. However, I know that there is the issue of needing a visa. The J1 is one option, but the Canadian government is reducing them. Also the training length of pediatrics is different in US, which is 3 years for general peds and 4 for general in Canada. I want to do subspecialty training too (potentially in Canada), but the J1 visa and doing residency in the US could cause issues for this I believe. At least I have been told that? I have also heard it is very hard to get the H-1B visa, and some American residency schools will look down on Canadian applicants as they have more paperwork. I guess I am just wondering if it is even worth it.

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[onelastpuff23]

Firstly, I applaud you for recognizing the current CaRMS crisis. It won't get any better, and your odds of matching to the preferred specialty is probably the lowest it's been (probability alone).

The US has tons of great peds programs, many of which are equivalent if not better than Canadian equivalents. Yes, it can be a bit shorter but you can always do fellowship etc.. to meet Royal College requirements. Look at the royal college site ..

At this stage, you should study for the USMLE step 1 and do well. You should also consider an elective in the USA. If you do well in both, you could consider the US as a possible alternative to keep your options open!

Is it worth it? It's up to you entirely!

 

[gggggg2]

Firstly, I applaud you for recognizing the current CaRMS crisis. It won't get any better, and your odds of matching to the preferred specialty is probably the lowest it's been (probability alone).

The US has tons of great peds programs, many of which are equivalent if not better than Canadian equivalents. Yes, it can be a bit shorter but you can always do fellowship etc.. to meet Royal College requirements. Look at the royal college site ..

At this stage, you should study for the USMLE step 1 and do well. You should also consider an elective in the USA. If you do well in both, you could consider the US as a possible alternative to keep your options open!

Is it worth it? It's up to you entirely!

This is what I was wondering, so if I take a 3 year peds program on the J1 visa. Doesn't that mean I have to come back to canada when it is expired, or can I just be given another J1 if I then say I want to do a sub-specialty training? As obviously if I did the 3 year peds program, then just jumped into a 2 year fellowship in say endo I would have the same 5 year training as Canada so I would be considered equivalent. My concern was being sent home after the 3 years and not being able to enter the canadian pediatric subspecialty match or being able to work.

 

[s5260205]

Don't quote me on this but I believe you will have to do 1 extra year as chief resident in US since Canada does not sponsor J1 visa for paediatric fellowships unless they are 1 year long which are few and far between.
Check out the statement of need page (2018-2019 List of Needed Specialties for Issuing Statements of Need under Category B - Canada.ca) for information about J1 visa.

 

[gggggg2]

Okay, so then i would be boarded as a general pediatrician. Then subspecialty training in Canada. Alternatively I guess during my 3 years on a J1 I could apply for a H-1B?

 

[onelastpuff23]

If you do your US boards, then you are eligible for the pathway 3 entry for an independent license after one year of supervision.

 

[UBC2014]

Listen, even with the CaRMS issues, you still have very strong odds of matching in Canada.

If you want to take the US boards and can manage, then do so - but know that you'll likely still match in Canada and it was just one expensive and time consuming endeavour. Depends on your risk-tolerance.

With J1, they SONs vary by year. One year it was 40, then 30, then 45 in 2019. Maybe it wont go over, maybe it will depending on a given years interests. Maybe with IM being more limited now, some interest will shift to peds, who knows. There is also no guarantee it will be 45 by the time you apply(2020 or 2021), it may drop down, or it may even go to zero. Who knows.

Also, you will have to get a 1 year fellowship after the 3 years of general peds, which as mentioned are not that proliferative, so do the research to see how many of those even exist. Alternatively a chief year, again you'll need to do some research there. Lots of variables. 2018-2019 List of Needed Specialties for Issuing Statements of Need under Category B - Canada.ca

Lastly, once you are boarded in general paediatrics, don't count it as a guarantee that you'll be able to do subspecialization training in Canada, doing it in the US may again be the route you would take.

If you already know you have a redflag or are a potentially weak applicant, then yes go for the USMLEs, but if not, it may be more work than its worth - but only you can make that decision for yourself.

 

[TinyMD94]

So I know this is an old thread but Im in pretty much the exact same position as you and have done all the research I can. I hope I can be of help.

If you match to a residency in the US for Pediatrics (higher match rate then family medicine somehow) this is what would happen:

1. You'd apply for a J-1 Visa Statement of Need. Pediatrics has consistently had no rejections in the past few years they have always needed more then they have given out. Of course thats no guarantee that it will be like that the year you match. Also they are on a first come first serve basis and they have the date and hour that they accept emails for the statement of need on their website so I think if you have all your documents ready and send it in right away you shouldn't have a problem.

2. Your residency is shorter then 4 years which arrises a problem with the RCPS:

Solutions include as I understand it:
A. Getting a PGY-4 Cheif Resident position (apparently very hard to get and not even garunteed that your program has them.
B. Doing a fellowship in the US after your specialty. Due to the complete lack of 1 year fellowships for pediatrics and OB/GYN The statement of need for these 2 specialties for subspecialty training will be allowed as long as its on their list of needed subspecialties online there are a lot of them dw, you wont be stuck with something weird (regardless of their length.)
C. Pathway 3 - You can secure a position with a Pediatrician at a hospital or private clinic for 1 year. (the health force ontario job search section has a place where you can check off supervision.) You'd be working as a general pediatrician with no problems other then securing one of these jobs.
D. Apply to a fellowship in Canada (apparently we are considered after the first and second match are done - puts us sort of at the bottom of the list.)
E. There is a Repatriation program for people specifically in this position where you would get a letter from the rcps saying that you completed 3 years of residency, adn that you require one more. You would then send an email to 1 or all of the university PGME offices and tell them your interested they will ask for paperwork etc. Then presumably theyd offer you a position and you would contact the RCPS for the endorsement (financial sponsorship) sort of to do that 1 year. The webpage there is no "application" for this process. I have emailed health force ontario asking if these programs are garunteed or is there some sort of chance I wont be accepted. Presumably (as I understand it) the positions for this program should only be applied to by people in our situation and if they are releasing 45 statements of need in this 2019 match then in 2022 they should have 45 spots ready for the people they sponsored to go to the US to do a pediatrics residency. If they have less its because of the other options maybe?



So in summary I spent all day stress searching instead of studying for step 1, There is many routes to come back so I hope its either garunteed by the repatriation program or you could work in the US until you get a job here that allows supervision.

 

[H1O1]

So I know this is an old thread but Im in pretty much the exact same position as you and have done all the research I can. I hope I can be of help.

If you match to a residency in the US for Pediatrics (higher match rate then family medicine somehow) this is what would happen:

1. You'd apply for a J-1 Visa Statement of Need. Pediatrics has consistently had no rejections in the past few years they have always needed more then they have given out. Of course thats no guarantee that it will be like that the year you match. Also they are on a first come first serve basis and they have the date and hour that they accept emails for the statement of need on their website so I think if you have all your documents ready and send it in right away you shouldn't have a problem.

2. Your residency is shorter then 4 years which arrises a problem with the RCPS:

Solutions include as I understand it:
A. Getting a PGY-4 Cheif Resident position (apparently very hard to get and not even garunteed that your program has them.
B. Doing a fellowship in the US after your specialty. Due to the complete lack of 1 year fellowships for pediatrics and OB/GYN The statement of need for these 2 specialties for subspecialty training will be allowed as long as its on their list of needed subspecialties online there are a lot of them dw, you wont be stuck with something weird (regardless of their length.)
C. Pathway 3 - You can secure a position with a Pediatrician at a hospital or private clinic for 1 year. (the health force ontario job search section has a place where you can check off supervision.) You'd be working as a general pediatrician with no problems other then securing one of these jobs.
D. Apply to a fellowship in Canada (apparently we are considered after the first and second match are done - puts us sort of at the bottom of the list.)
E. There is a Repatriation program for people specifically in this position where you would get a letter from the rcps saying that you completed 3 years of residency, adn that you require one more. You would then send an email to 1 or all of the university PGME offices and tell them your interested they will ask for paperwork etc. Then presumably theyd offer you a position and you would contact the RCPS for the endorsement (financial sponsorship) sort of to do that 1 year. The webpage there is no "application" for this process. I have emailed health force ontario asking if these programs are garunteed or is there some sort of chance I wont be accepted. Presumably (as I understand it) the positions for this program should only be applied to by people in our situation and if they are releasing 45 statements of need in this 2019 match then in 2022 they should have 45 spots ready for the people they sponsored to go to the US to do a pediatrics residency. If they have less its because of the other options maybe?



So in summary I spent all day stress searching instead of studying for step 1, There is many routes to come back so I hope its either garunteed by the repatriation program or you could work in the US until you get a job here that allows supervision.

Focus on studying for Step 1 and Step 2. Your score should be atleast 10 points above the average US grad...American Program directors don’t care what “Canadian” school you went to...an IMG is an IMG! Don’t be naive to think they respect Canadian schools like they respect an American school. Try get LOR from American docs. If you have time write Step 3 then you can come on an H1B Visa.

Good luck...study hard

 

[cmradu]

Can a Canadian IM licensed physician get ABIM board certified (in the US)? Can a Canadian board certified physician get an unlimited US license to practice (without doing residency again)?

I am a US FMG (ECFMG certified, all USMLEs) physician practicing IM in Germany, since many years, thinking of moving closer to family in Chicago. I was told it's easy to get a job in Canada as a European physician, but somehow I doubt it. Thanks beforehand for any suggestions and (polite ) feedback.