How "international" is path?

[EC3]

Is pathology an international specialty in the sense that the scope of practice is relatively unchanged from country to country

i.e. Can an american trained pathologist transition relatively easily to another country?

Also, is path a well-known specialty in other countries? I would assume yes, but not sure.

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[yaah]

You could transition but from what I know you'd probably have to go through your training again there...

 

[Pathoresident]

Yes Path is internationally recognized and also highly needed in many countries.

If you are US-trained, it is even easier to relocate. US-training is recognized by many countries. The countries that recognize your US-training are Canada, UK, Australia and NZ. However, you still need to sit for their licensing exams but you are exempted from doing a residency there. Their requirement is that you should be certified by American Board of Pathology.

 

[mlw03]

i would think diagnostic specialties like path and rad are more international than say, internal med. colon adenoCA is cancer whether you're in kentucky or thailand, but the management of NSTEMI can vary from hospital to hospital in the same city, let alone country to country. perhaps some staging guidelines are different, but a lot of staging is done using WHO guidelines, right? it's a great question though, as i've a few times myself pondered what life might be like in scotland or england. italy would probably be a great place to live too, but i don't speak italian.

like yaah said, moving around might require re-training, which would suck mightily. except canada to the US and vice versa - i believe the accrediting body for us and them is the same.

 

[deschutes]

like yaah said, moving around might require re-training, which would suck mightily. except canada to the US and vice versa - i believe the accrediting body for us and them is the same.

While the ACGME is responsible for residency and fellowship accreditation in North America, the Canadian body for certifying physicians as specialists is the Royal College of Physicians and Surgeons of Canada, certainly quite different from the American Board of Pathology. After having your credentials verified, the Royal College Pathology (General Pathology vs. Anatomical Pathology vs. Laboratory Medicine vs. Medical Microbiology vs. Neuropathology....) exam itself is a two-day exam taken in Toronto with slides (bring your own microscope) and an oral component on the second day.

You would also have to gain a general medical licence to practice in Canada, which involves the Licentiate of the Medical Council of Canada Examinations Parts I and II. Part I is computerized and similar to Step 2 CK/Step 3 (taken just prior to graduation), while Part II is a 14-station OSCE exam, a la Step 2 CS and Step 3, but more difficult in that it involves a management component. Stations in the past have included trauma management (10 minutes). Part II requires proof of 12 months of post-graduate medical education.

So the first years of residency would involve a lot of exams and distractions from actually learning pathology, should you want to explore this route.

Bottomline is: It is often not the pathology training that is the challenge in transitioning, it is immigration, licensure and certification requirements. Not to mention culture shock (oh yes, which exists, even in moving to Canada).

 

[mlw03]

call me uninformed. thanks for that clarification, deschutes.

 

[Pathoresident]

I totally agree with Deschutes.

I am familiar with the Canadian requirements and all what you said is totally right and perfectly explained.

The bottom line in moving to Canada is that the pathologist is not asked to repeat his residency. The Royal College recognizes the ACGME accredited training in the US. So the candidate needs to clear all the licensure exams which includes the royal college and medical council exams. Passing all these exams is a lengthy road and exhaustive. However, it can be a choice for pathology residents on J-1 visa and couldn't get a waiver in the US and prefer not to return to their own countries (misery escape!) !!.

In some Canadian provinces like Quebec, they recognize the American Board of Pathology but you still need to clear the royal college on the long run.

Below is an email message I received from a Canadian pathologist who answered my response about Canadian route for pathology:

It is always easier for someone with US training to be hired in Canada if they have the Canadian examinations. Makes getting the licsence easier.

Never the less we do hire people in Canada with only US training. How this happens probably varies form province to province but it usually means that you have to write the Canadian exam within a few years after.

LMCC exam is also a barrier usually.

You might consider looking into writing the Canadian pathology exam. The RoyalCollege of physician and surgeons can give you information.

LMCC is also an exam you could consider.

 

[torero]

While the ACGME is responsible for residency and fellowship accreditation in North America, the Canadian body for certifying physicians as specialists is the Royal College of Physicians and Surgeons of Canada, certainly quite different from the American Board of Pathology. After having your credentials verified, the Royal College Pathology (General Pathology vs. Anatomical Pathology vs. Laboratory Medicine vs. Medical Microbiology vs. Neuropathology....) exam itself is a two-day exam taken in Toronto with slides (bring your own microscope) and an oral component on the second day.

You would also have to gain a general medical licence to practice in Canada, which involves the Licentiate of the Medical Council of Canada Examinations Parts I and II. Part I is computerized and similar to Step 2 CK/Step 3 (taken just prior to graduation), while Part II is a 14-station OSCE exam, a la Step 2 CS and Step 3, but more difficult in that it involves a management component. Stations in the past have included trauma management (10 minutes). Part II requires proof of 12 months of post-graduate medical education.

I don't mean to be finicky, but the ACGME is responsible for residency and fellowship accreditation in the US and Canada – people tend to forget that Mexico is part of North America.

It is my understanding that currently, if you are certified by the ABPath, you are eligible, at least in some Canadian provinces, for a restricted/limited/temporary permit to practice pathology in a specific hospital/medical center. With the ABPath certification, you are also eligible to take the Royal College exam, and with that you are eligible to get a non restricted/ permanent license. All of this is possible without having to bother with the LMCC exams.

I think that Canada is a great opportunity for J-1 folks in general, if you can get the job.

 

[deschutes]

people tend to forget that Mexico is part of North America.

My bad. I didn't know that Mexico is part of North America (I thought it was Central Am), and plead non-nativity.

It is my understanding that currently, if you are certified by the ABPath, you are eligible, at least in some Canadian provinces, for a restricted/limited/temporary permit to practice pathology in a specific hospital/medical center. With the ABPath certification, you are also eligible to take the Royal College exam, and with that you are eligible to get a non restricted/ permanent license. All of this is possible without having to bother with the LMCC exams.

My understanding is that Ontario will recognize the USMLEs as equivalent of the LMCCs if you have taken Step 2 CS, which is the only good thing AFAIK to come out of taking the thing.

http://www.cpso.on.ca/Publications/Dialogue/0305/repcoun.htm

[Edit]Research yields the following:

Manitoba appears to require only Royal College certification!
http://www.cpsm.mb.ca/2_1_2_1_full.php

BC College requires LMCC for independent practice:
https://www.cpsbc.ca/cps/physician_resources/registration/physician_registration/fullregister

Alberta College requirements for "conditional defined practice" (i.e. not independent practice even!) requires LMCC and a sponsor:
http://www.cpsa.ab.ca/physicianregistration/registration_part2.asp

I mucked around trying to find the equivalent Collège des médecins du Québec page, but my French is too limited.

Sask College categories of licensure and requirements (full licensure requires LMCC):
http://www.quadrant.net/cpss/registration/register.html#p8

NS requires LMCC for full licensure:
http://www.cpsns.ns.ca/Registration/docfullreg.htm

Someone else can look up the Yukon, New Brunswick, PEI, NWT and Nunavut requirements! 🙂
[end edit]

Every Canadian attending pathologist I spoke to encouraged me to take the LMCCs, and depending on how heavily one is invested in getting to a specific location in Canada outside of Ontario, I would recommend taking them too.

~
(Incidentally, recognition of the LMCCs by US states is equally spotty. I know Canadian path residents who are unable to do a fellowship at MD Anderson because they don't have their USMLEs.)

 

[torero]

Thanks for the info.

 

[LADoc00]

You wanna hear something funny: I actually inquired some years ago into opening a path consultation business in Puerto Vallarta for rich folks and it is near impossible for an American MD to get a license there without tons of BS and government intervention, like vastly more than if someone from Mexico City popped into a residency program here...wth!! LOL Vincent Fox should be dropping to his knees and offering bjs to people willing to spend intellectual and monetary capital on the country.

Foreign countries will let you work FOREVER for free, but aside from maybe England, Canada and Aus/NZ, the second you try to earn a dime to live, they will beat you down. Sad really.

Gotta realize that in many if not most countries, doctors are still mostly charlatans and treated like huckster dogs. Why would you want to leave?? FFS, go on vacation there, dont live there.

 

[deschutes]

Gross oversimplification.
What are these foreign countries you speak of?

For sheer money-making potential, it is hard to beat the U.S.
That doesn't mean however, that you can't earn in the local currency and live more than comfortably.

 

[LADoc00]

Gross oversimplification.
What are these foreign countries you speak of?

For sheer money-making potential, it is hard to beat the U.S.
That doesn't mean however, that you can't earn in the local currency and live more than comfortably.

You mean what countries have old school snake oil selling charlatan docs? There are tons!!! hahahaha.

 

[deschutes]

You mean what countries have old school snake oil selling charlatan docs? There are tons!!! hahahaha.

You forget the U.S. has those too. Reality bites. hahahaha.