Licensing news for Canadians graduating from an Australian Medical School!

[OzTREKK]

For those of you who are Canadian and looking at completing a medical degree in Australia, exciting news from the HealthForceOntario Marketing and Recruitment Agency was released last week.

Earlier last week, I was in contact with the HealthForceOntario Marketing and Recruitment Agency and we received news that on Nov. 19, the College of Family Physicians of Canada announced that it has determined that accredited family medicine training and certification completed in both the U.S. and Australia meet its standard for certification in family medicine. The College of Physicians and Surgeons of Ontario has agreed that individuals who obtain certification without examination from the CFPC will be eligible to apply for a certificate of registration to practice medicine in Ontario.

For the full explanation and more information, visit oztrekk.com/blog.

Cheers,

Matt

Matt Miernik
Director
OzTREKK
P> 1 866 698 7355
E> [email protected]
W> www.oztrekk.com
A> 102 Sumac Lane
Perth, Ontario
K7H 3C7

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[FreakofMeds]

I hope this spreads to other specialties in Internal Medicine too.

 

[Giemsa]

The College of Physicians and Surgeons requires, in addition, the following for independent practice:

"Completion in Canada of one year of postgraduate training or active medical practice, or completion of a full clinical clerkship at an accredited Canadian medical school."

How do Oz certificants meet this requirement? The US guys can use the fourth pathway, but I don't see how this change does anyone any good unless you have US or Canadian residency training.

 

[MontereyMD]

This may seem good on the surface but the devil is in the details as they say.
This is only applied to Family Medicine and not to IM by the CPSO. First of all you need to get your CCFM through the CFPC by either getting Board Certified by the American Board of Family Medicine or achieve the RACGP which is a fellowship in Australia. This is where the problem is for Canadians attending Australian medical schools. You see the Australian Government has cut their residency positions way back so there are only enough residencies available to Australian citizen medical school graduates. Canadians are considered International students in Australia and there aren't any extra residency slots for the Internationals. So basically you're screwed if you're a Canadian at an Australian medical school as you can't get a residency slot and get your RACGP certification.
You're screwed a second time because if this said Canadian then goes to the US and does an American Residency it doesn't count. The fine print says in order to get the CCFM through a US Residency you must be a US Medical School graduate as well. Going to an Australian school for licensing purposes in typical condescending Canadian fashion is held against you. Unless you are a Canadian who goes to a LCME medical school in North America you are screwed and have wasted your parents money and years of your life.

 

[Transition]

This may seem good on the surface but the devil is in the details as they say.
This is only applied to Family Medicine and not to IM by the CPSO. First of all you need to get your CCFM through the CFPC by either getting Board Certified by the American Board of Family Medicine or achieve the RACGP which is a fellowship in Australia. This is where the problem is for Canadians attending Australian medical schools. You see the Australian Government has cut their residency positions way back so there are only enough residencies available to Australian citizen medical school graduates. Canadians are considered International students in Australia and there aren't any extra residency slots for the Internationals. So basically you're screwed if you're a Canadian at an Australian medical school as you can't get a residency slot and get your RACGP certification.
You're screwed a second time because if this said Canadian then goes to the US and does an American Residency it doesn't count. The fine print says in order to get the CCFM through a US Residency you must be a US Medical School graduate as well. Going to an Australian school for licensing purposes in typical condescending Canadian fashion is held against you. Unless you are a Canadian who goes to a LCME medical school in North America you are screwed and have wasted your parents money and years of your life.

They haven't cut residency spots. In fact, they've increased them. Instead, they've increased medical school spots tremendously; this is the reason for the scare over lack of post-grad internships. They appear to be working on the problem, but it's neither here nor there. No one can predict, accurately, what is going to happen.

As for your 2nd point, I'm not sure. I haven't read the US-route details too closely. All I know is that, if you are able to attain FM certification in Aus, you will be able to practice in Canada.

Redshifteffect posted this about 5 months back, so this is not novel news, necessarily. It's good news, regardless. It means that the Cdn medical system is opening up to IMGs - something that is beneficial to all, in my opinion.

 

[OzTREKK]

MontereyMD, you have raised some very good points. Regarding your first point, yes, you are correct that there are currently perceived shortages in internship places in Australia and at the moment, only Australian citizens/permanent residents who complete a medical degree in a particular state are guaranteed an internship place.

In the state of Queensland, for example, there's a priority ranking system for the intern positions that all doctors need if they're to become fully registered as medical practitioners. Queensland Health guarantees intern positions only for domestic graduates of the state's four medical schools. Australians from interstate schools are next in line, ahead of international graduates of Queensland schools.

Now, for your second point, effective December 1, 2008, physicians with US postgraduate training and certification will qualify for a certificate of registration with the College of Physicians and Surgeons of Ontario (CPSO) without further training or additional examinations. This was an initiative CPSO.

Pathway 4 was established where by the Registration Committee may direct the Registrar to issue a certificate of registration to an applicant who is an IMG, if the applicant has:
1. successfully completed a residency program accredited by the Accreditation Council for GraduateMedical Education;
2. been certified by a US Specialty Board;
3. successfully completed the US Medical Licensing Examination or successfully completed an acceptable qualifying examination; and
4. an independent or full license or certificate to practise without restrictions in the US or is eligible to apply for an independent or full license or certificate of registration to practise without restrictions in the US.

The following conditions will be placed on the certificate of registration:
1. The physician must practice with a mentor and/or supervisor until he or she has successfully completed an assessment.
2. The physician must undergo an assessment after completing a minimum of one year of practice in expires 18 months from the date of issuance, but may be renewed by the Registration Committee, with or without additional or other terms, conditions and limitations.

So what this means is that if you are a Canadian studying medicine in Australia and you are unsuccessful in attaining a residency in Canada upon your return, you can apply for a residency in the U.S. Once you have completed your residency in the U.S., and upon meeting the requirements for a full license in the U.S. to practice, you are eligible to apply for a license in Ontario. At that time, you must undertake 12 months of supervised practice upon which time you will undergo medical assessment.

According to the NRMP (CaRMS equivalent in the U.S.), 54% (2008) of Foreign-Trained Physician applicants were matched.

For more information for Canadians studying abroad and in Australia, please visit:

http://www.healthforceontario.ca/Wo...nsOutsideOntario/CanadiansStudyingAbroad.aspx

Just like in December 2008, where the CPSO approved Pathway 4 for Canadians who complete a residency in the U.S. after completing a medical degree overseas, this past November a new pathway branch was passed by the College of Family Physicians of Canada (CFPC) for Canadians who complete a residency in Australia are allowed to apply for licensing in Ontario through the CPSO. (Please read the OzTREKK blog for more details).

Regarding your reference to ‘CCFM', I think you were referring to the Certificant of the College of Family Physicians (CCFP). This is awarded by the College of Family Physicians of Canada (CFPC). The College of Family Physicians of Canada is a voluntary association of family physicians. The College does not conduct any training programs in Canada, as they are responsible for setting standards for training and for a national certification examination for graduates of these programs. They do not license family physicians either. If you would like to obtain a license to practice you receive that through the College of Physicians and Surgeons of Ontario (CPSO). The College of Family Physicians of Canada issues the CCFP designation.

In order to obtain the CCFP designation and be a member of the College, which again is voluntary, physicians must:
1. successfully graduated from accredited postgraduate training in family medicine in a jurisdiction where the standards for accreditation of postgraduate family medicine training and the criteria for certification are judged comparable and acceptable to the CFPC;
2. achieved certification in that jurisdiction;
3. met all other requirements for Certification in the CFPC;
4. met all other requirements for licensure and apply for or are granted registration to practice in a Canadian province or territory.
Approved jurisdictions include:
• United States of America: Graduates of family medicine residency training programs that have been accredited by the Accreditation Council for Graduate Medical Education (ACGME) and who also are Diplomats of the American Board of Family Medicine (ABFM)
• Australia: Graduates of Australian General Practice Vocational Training programs that have been accredited by the Australian Medical Council (AMC) and meet the standards of the Royal Australian College of General Practitioners (RACGP) and who also hold Fellowship in the Royal Australian College of General Practitioners (FRACGP)

At the end of the day what do all these developments mean?

As Transition mentioned, for Canadians studying medicine in Australia, it is a positive step as these developments try to alleviate the stress which is currently being felt throughout the Canadian medical community and the Canadian public due to the shortage of doctors in Canada. As the number of residencies in Canada for IMGs is not adequately large enough to have all the IMG applicants complete a residency program in Canada, many of the provinces and governing bodies have approved alternate pathways, which includes those Canadians who complete a residency in the U.S. or an internship in Australia. Yes, it is not the same as completing a residency in Canada, but these developments provide students options, options and pathways that were not present previous, and are a step in a positive direction.

Matt Miernik
Director
OzTREKK
P> 1 866 698 7355
E> [email protected]
W> www.oztrekk.com
A> 102 Sumac Lane
Perth, Ontario
K7H 3C7

 

[shan564]

you are screwed and have wasted your parents money and years of your life.

Ha, I wish I was wasting my parents' money... nope, in true American fashion, I'm wasting money that I borrowed at an excessive interest rate.

 

[Giemsa]

. . . this past November a new pathway branch was passed by the College of Family Physicians of Canada (CFPC) for Canadians who complete a residency in Australia are allowed to apply for licensing in Ontario through the CPSO.

The CPSO website still indicates that licensing requires:

"Completion in Canada of one year of postgraduate training or active medical practice, or completion of a full clinical clerkship at an accredited Canadian medical school."

How do Oz certificants meet this requirement?

 

[MontereyMD]

The Steps are positive but to achieve some of the hurdles are getting very difficult and almost impossible for born in Canada Canadians who have no where else to go and do not have dual citizenship. It's made to sound too easy getting a US Residency for a Canadian for example.
First of all the funding of US Residencies by US Department of HHS/GME will be cut drastically over the next several years.
Canadian citizens have to get a J-1 or H-1B visa.
H-1B visas are very difficult now as there is a yearly limit and in order to get one as a physician you have to have a US Medical License. It's the classical Catch 22 you can't get a US medical license unless you have a H-1B visa but you can't get the H-1B unless you have a US medical license.
Leaves only the J-1. J-1 needs approval from the Canadian Province and Health Canada. You have to demonstrate there is a shortage in your desired physician career shortage for that Province. So if there is a low demand for your specialty like Neurosurgery you're screwed. The Canadian Government won't issue the letter necessary to get the J-1 from the US. The condescending Canadian file clerk in Ottawa will tell you sorry sucker we can't issue that letter. See ya!
All this takes months and months or years for approval so make sure you have a Plan B.

 

[Transition]

The Steps are positive but to achieve some of the hurdles are getting very difficult and almost impossible for born in Canada Canadians who have no where else to go and do not have dual citizenship. It's made to sound too easy getting a US Residency for a Canadian for example.
First of all the funding of US Residencies by US Department of HHS/GME will be cut drastically over the next several years.

source?

Leaves only the J-1. J-1 needs approval from the Canadian Province and Health Canada. You have to demonstrate there is a shortage in your desired physician career shortage for that Province. So if there is a low demand for your specialty like Neurosurgery you're screwed. The Canadian Government won't issue the letter necessary to get the J-1 from the US. The condescending Canadian file clerk in Ottawa will tell you sorry sucker we can't issue that letter. See ya!

I doubt this is the case for FM, though. Aiming for neurosurg is not advised as an IMG. And if you've done your residency in neurosurg, why would you bother going to canada?

All this takes months and months or years for approval so make sure you have a Plan B.

wholeheartedly agreed

 

[shangul]

Oztrekk Says:
1- "there are currently perceived shortages in internship places in Australia..."
2- In Australia "there's a priority ranking system for the intern positions that all doctors need if they're to become fully registered as medical practitioners."
3-In getting the (the not so easy to get) internship positions, International graduates are moved to the back of the line (behind the domestic & Australians from interstate schools).
So, as an IMG, it's very difficult to secure internship position in Australia (something that you need to get first before getting licensed and be eligible to practice in Australia).
As an IMG you'd want to go to Australia either to get licensed, and start practicing there , or have an easy time coming back home to Canada or the U.S, after getting licensed in Aus (but you'll have a hard time just getting your internship done in Australia, even for Family Medicine/GP). With all the hurdles that you are going to face as an IMG in Australia, why bother going there in the first place? Why not go to Caribbean instead? As a Canadian you can go to Caribbean, spend the first 2 years in the islands completing basic science courses before taking USMLE Step I (Also, Basic science curriculums in the Caribbean are similar to US curriculums). Then you can do your 3rd & 4th year clinical training in the U.S. hospitals with which your Caribbean Med school has an active, written affiliation agreement. Also, you can take your USMLE Step 2 while you're in your 3rd year while doing your clinical in the US. (Caribbean medical schools, modeled after the U.S. system, with students who have USMLE pass rates and scores comparable to their U.S peers. So that's another reason why I see going to Caribbean to be the better choice than going to Australia ( since going to Aus Med school you are going to have a hard time just getting internship to get licensed and practicing there). So, forget about going to Australia Med School in hope of getting internship, residency, & license in Australia.
-As a Canadian, 99% of the time you wouldn’t go to Australia/Caribbean if you can get into a Canadian Med School. (Also, you know that IMGs in Australia have hard time getting internship there…)
- Canada is much tougher than U.S. for Canadian IMGs to get residency placements & a lot of Canadian IMGs go to the U.S. to do their residency…So knowing that, let’s say you as a Canadian, decide to take the IMG route & your goal (meaning your best option) now is to practice in the U.S . eventually...
In that case, if your goal is to ultimately get licensed & practice in the U.S, which seems to be the better route to take as an IMG: Going to Australia or Caribbean?

 

[pitman]

I don't think it makes much sense to make any sweeping judgment/comparison between entire regions of the world.

It'll come down to particular schools, their particular programs, and one's particular goals -- since people rarely have a single goal (e.g., to practice in the US).

Some Carib schools are crap, others are considered quite good. Some Australian schools don't have any track record of sending students to the US. Others have one, along with formal affiliations and/or programs which serve that function.

People have to weigh up how much they can direct their own studying, how much they want to pay, where they might have ties or might want to live/explore/travel, whether stigma might be an issue, whether they could see themselves deciding to live and practice elsewhere, and so on.

I think to answer the question 'which is better..?', you'd have to make so many assumptions to avoid using an impossibly huge (and subjective) flow-chart of permutations and weightings, that it would be quite meaningless to real people.

 

[shangul]

Pitman, you said what was in your mind. Thanks. Btw, the one who post the above message is a real person and wants to hear what others think, what their experiences & points of views are. Oztrekk has posted a big text hear, but to me just getting past the internship part as a Canadian/American citizen in Australia is hard, let alone the other steps... I really want to see what others think and that would help me in my decision making. Now, please Let others express their opinions.

 

[pitman]

Now, please Let others express their opinions.

Hmm. No one's preventing that, shangul. I'm merely pointing out that you may want to change the question, or explain what you value as "better", in order to get answers different than what's already available in these threads with much repetition, which is surely what you're asking for.

 

[MontereyMD]

Article from Bloomberg.com about the cutting in funding for US Residencies.
US Medical Schools have added 3000 new students since 2005 however the number of residencies has remained the same. Expansion of the number of residencies is unlikely due to costs.
This makes it even more difficult for IMG's and Canadians to acquire a US Residency.


"The number of residencies nowhere near meets the demand from the number of students who will be in the pipeline in the coming years, or the need the nation has for doctors,” Feinstein said.
Medicare, the federal insurance plan for those 65 and over and the disabled, pays about $100,000 a year for each residency, at a total cost to the program of about $9 billion, according to a report filed by the Medicare Payment Advisory Commission in June. Medicare reimbursements for service also take into account the number of residencies each institution maintains.
The funding mechanism was set up in 1965 when the U.S. was about to extend government health coverage to 19 million elderly Americans. As Medicare’s ranks grew -- to 45 million people as of the end of last year, according to the advisory commission -- the number of residencies was limited to contain spending.

Because Congress is looking to keep costs of the legislation down, that proposal may be cut or even eliminated during the debate, Grover said"

 

[OzTREKK]

The CPSO website still indicates that licensing requires:

"Completion in Canada of one year of postgraduate training or active medical practice, or completion of a full clinical clerkship at an accredited Canadian medical school."

How do Oz certificants meet this requirement?

Giemsa, to clarify, if you go to the College of Family Physicians of Canada (CFPC) section there you will find the most up to date information regarding the changes. It has not yet been posted on the College of Physicians and Surgeons of Ontario's (CPSO) website. Our contact at The HealthForceOntario Marketing and Recruitment Agency stated that this is currently all the documentation they have - but as soon as more information is available they will pass it on. Again, this is all very new and was only approved this past November.

Our contact at The HealthForceOntario Marketing and Recruitment Agency mentioned the following:
"What is important to note though is that these routes are now recognized by the CPSO. So someone in Australia pursuing family medicine can either now write the CFPC exams or if fully licensed can apply for certification without examination and the CPSO will recognize that and grant a 1 year restricted license with a peer assessment at the end."

If you visit the following CFPC website, it provides you with further information: http://www.cfpc.ca/English/cfpc/education/examinations/EQUIVALENT TRAINING/default.asp?s=1

Pathway 4, which was approved in 2008 by CPSO is different then these changes regarding the CFPC.

A family doctor in the US can go through Pathway 4 but then they will require supervision in Ontario for a period of one year. If a family doctor in the US or Australia does this new route with the CFPC then they won't need supervision. There are pluses and minuses to each route...but this new change with the CFPC only applies to family doctors. So if you are a family physician in the US or Australia you can now come back via this new route through CFPC. Pathway 4 applies to all specialties in the US.

I would also strongly recommend that anyone looking at completing their medical degree outside of Canada contact The HealthForceOntario Marketing and Recruitment Agency. Once you are on their database, they will provide you with information about the various licensing changes which have occurred and are occurring. For more please visit: http://www.healthforceontario.ca/Wo...nsOutsideOntario/CanadiansStudyingAbroad.aspx

All of the above information and recent changes, I have received first hand from The HealthForceOntario Marketing and Recruitment Agency.

For any questions, please don't hesitate to contact me at any time: [email protected]

Hope this helps and answers your question.

Cheers,

Matt

Matt Miernik
Director
OzTREKK educational services
P> 1 866 698 7355
M> 1 613 267 4004
E> [email protected]
W> www.oztrekk.com
A> 102 Sumac Lane
Perth, Ontario
K7H 3C7

 

[MontereyMD]

CFPC criteria states " who also hold Fellowship in the Royal Australian College of General Practitioners (FRACGP)" before applying for CCFM without examination.


This is the problem. In order to get the FRACGP a Canadian medical school student in Australia considered an International needs to compete with all the other Internationals for the very few residencies available in Australia. Then complete this Australian residency and achieve the Fellowship. Not that easy.

Oztrek has a vested interest as Oztrek is trying to sell something and may not be that impartial. The more Canadian students attracted to Australia the more money they make. This may not necessarily be in the best interest of these students.

 

[redshifteffect]

GP residency is currently very easy to get.

I've gotten it twice now, even after turning it down the first time. Compare that to the hassle of even getting it a single time in any Canadian province. The problem will be if you think you're going to get it in the city somewhere. If you have rural experience they don't care if you have PR or not (I didn't when I got it both times) I do have PR now though.

*Edit*

What may be difficult to get is the Internship required to get into GP training - you might have to go to NZ or somewhere else to do that. I think I posted a letter from last year where AGPT and the Federal govt increased the total number of training spots by over 25% over two years.

I wouldnt worry about training spots disappearing. Also GP jobs in Ontario and in Australia are very easy to get, Specialist jobs are much tougher. So there probably wont' be an undersupply (of jobs) in either country anytime soon.

 

[redshifteffect]

Matt,

This news happened 6 months ago and I already posted about it in the forum back then...but thanks for reiterating it.

Here's a link to that thread:

http://forums.studentdoctor.net/showthread.php?t=647701

 

[redshifteffect]

Then complete this Australian residency and achieve the Fellowship. Not that easy.

Sorry had to laugh at this comment. GP training is very easy to complete. Most RTPs have over a 90% first time pass rate on the FRACGP. If you've done any OSCEs in med school you shouldn't have too much trouble.

The MCCQE2 is also aimed at the Australian medical school level OSCEs so if you've done well in that, and studied for your FRACGP you should be able to clear EE -> QE2 while passing your FRACGP before you even step foot in Canada (the material is EXACTLY the same).

 

[redshifteffect]

Pay package for a GP Melbourne CBD which is a DWS so even someone without an 19AB exemption (10 year moratorium) can work there:

http://thebigchair.com.au/jobs/melb...ourne+gp+post+with+dws+approval.aspx?all=true

Metro Melbourne GP Post with DWS approval
earnings in excess of $270,000
within 20 mins of Melbourne CBD
supportive admin and nursing team


GP jobs for doctors with RACGP fellowship available in the city



These privately owned GP clinics in Melbourne are suitable for overseas trained GPs as they already have DWS approval. The practice principle is a dynamic and exciting guy to work with. Expect to gross in excess of $270,000/ 175,000 pounds per year. The practice will ensure you are busy from day 1 so there will be no earning delay and flexible terms can be put in place for the right candidate. The earning potential is just amazing. We have a number of doctors already on the ground in this team and they are loving it. Its fun, its friendly and its dynamic.



Melbourne is a fantastic place to live with world class sporting events from Grand Prix Motor racing to Grand Slam Tennis! Melbourne prides itself on being the cultural and food capital of Australia as well so you will not be sort of things to do!