Medical School in Canada, Residency in the USA

[StampLicker]

There has not been a current thread for this topic in a while, so I figured I would start one. I'm at medical student at the University of Ottawa in Ottawa, Ontario, Canada and I am seriously considering applying to the USA for residency. I have a couple of questions to get this thread started:

1) I have heard that American medical schools know how hard it is to get into a Canadian medical school compared to an American one (with Ivy league and other top-tiered American schools being the obvious exceptions to this "rule"). Would this help a Canadian medical student in terms of getting a more competitive residency in the States?

2) Contrary to my first question, I have also heard that because Canadians have Visa requirements when doing residency in the States, they actually have a harder time landing American residencies because program directors don't want to bother with all of that paper work. Is there validity to this statement? If so, how much would this Visa requirement actually weigh down one's application, in general, and also in comparison to the idea I spoke about in 1).

3) Does anyone have an actual statistic for the number of Canadians that apply to American residency every year, and how many land a spot out of this number? I want to know this in general, and also with regards to each specialty - if possible.

Just to give an idea as to why I am looking into the States for residency: 1) There are so many more spots in the USA for every specialty compared to in Canada, making even the most competitive specialties not as competitive as in Canada. 2) There are more opportunities to get into private-practice medicine in the States due to the nature of the system compared to the one in Canada. For example, you can open a private OBGYN clinic in the States, whereas that doesn't exist in Canada. 3) The pay is better for every specialty, except for family medicine (I put this as the last option because I did not get into medicine for the money, although a healthy amount of compensation is always a bonus for all my years of hard work).

Thanks in advance everyone!

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[Meh.meh]

http://www.nrmp.org/wp-content/uploads/2014/04/Main-Match-Results-and-Data-2014.pdf

The data certainly exist. I didn't really read too closely, but it looks as though 8 of 14 Canadian medical students who completed the process (24 entered, 6 withdrew, 4 did not make a rank list) made it into US residencies.

I'm curious about some of your other assertions. There are roughly 25,000 residency spots in the United States for a population of around 300 million. There are *2,800 residency spots in Canada for a population of 30 million.

There are also 40,000 applicants for the 25,000 spots in the united states. There are around 5,000 applicants for 2,800 spots in Canada. The numbers look very similar. Perhaps Canada has more spots allocated for primary care, and you mean it's harder to become a specialist?

I have never really seen the applications to US Medical schools compared to Canadian ones, but I'd always heard they are similarly competitive. Allopathic medical schools (MD producing schools) are extremely competitive. I go to a fairly mid-tier medical school, and even here there were 7,000 applicants for around 200 spots. Around 300-400 are offered admission.


Osteopathic schools and Carribean medical schools tend to be significantly less competitive, but they are also less likely to secure a residency. Perhaps those were the schools you're referencing?

 

[deleted500612]

There has not been a current thread for this topic in a while, so I figured I would start one. I'm at medical student at the University of Ottawa in Ottawa, Ontario, Canada and I am seriously considering applying to the USA for residency. I have a couple of questions to get this thread started:

1) I have heard that American medical schools know how hard it is to get into a Canadian medical school compared to an American one (with Ivy league and other top-tiered American schools being the obvious exceptions to this "rule"). Would this help a Canadian medical student in terms of getting a more competitive residency in the States?

2) Contrary to my first question, I have also heard that because Canadians have Visa requirements when doing residency in the States, they actually have a harder time landing American residencies because program directors don't want to bother with all of that paper work. Is there validity to this statement? If so, how much would this Visa requirement actually weigh down one's application, in general, and also in comparison to the idea I spoke about in 1).

3) Does anyone have an actual statistic for the number of Canadians that apply to American residency every year, and how many land a spot out of this number? I want to know this in general, and also with regards to each specialty - if possible.

Just to give an idea as to why I am looking into the States for residency: 1) There are so many more spots in the USA for every specialty compared to in Canada, making even the most competitive specialties not as competitive as in Canada. 2) There are more opportunities to get into private-practice medicine in the States due to the nature of the system compared to the one in Canada. For example, you can open a private OBGYN clinic in the States, whereas that doesn't exist in Canada. 3) The pay is better for every specialty, except for family medicine (I put this as the last option because I did not get into medicine for the money, although a healthy amount of compensation is always a bonus for all my years of hard work).

Thanks in advance everyone!

If you look at the statistics you will see that although there are far less residency training spots in Canada there are also far less medical students. Statistically most high-demand specialist residencies have higher match rates in Canada than in the US. Also, regarding visas... You will need to be sponsored by the Canadian government in order to get an H-1B visa to undergo a residency in the US. You basically have to agree to return to Canada to work for x amount of years following the completion of your training in order to qualify for this visa. They will only sponsor a very limited amount of US residency spots for most specialty positions based on the perceived demand for that specialty in Canada, whereas the sponsorships for primary care spots are unlimited (because they are in high demand). The US hospital will rarely/never sponsor you for a J-1 visa, you need to get an H-1B sponsorship from the Canadian government. The restriction of these visas for many specialties further increases the competitiveness of securing a US residency in a competitive specialty as a CMG.

If you go to the Canadian medical school forums on SDN there is a fairly recent thread about a Canadian who applied, and got accepted to an American radiology residency but the Canadian government would not sponsor him because the very limited number of allocated sponsorships for radiology was already filled for that year. Needless to say he got screwed over extremely hard. To be completely honest it is a much safer bet for you training in Canada.

 

[leggo_my_ecmo]

I have never really seen the applications to US Medical schools compared to Canadian ones, but I'd always heard they are similarly competitive. Allopathic medical schools (MD producing schools) are extremely competitive. I go to a fairly mid-tier medical school, and even here there were 7,000 applicants for around 200 spots. Around 300-400 are offered admission.

As an American who did my undergrad in Canada and then came back to the US for med school, I can tell you anecdotally that getting into med school in Canada is typically much harder than in the US (at least in Ontario, where OP is from). UWO for instance has a cutoff of 3.7/32. Add to that that Ontarians are really only competitive at in-province schools, of which there are only 6; whereas the 7,000 kids who applied to your school also all applied to 15-20 others, most of the thousands that apply to Ontario schools are competing for spots at just those six schools

 

[Meh.meh]

As an American who did my undergrad in Canada and then came back to the US for med school, I can tell you anecdotally that getting into med school in Canada is typically much harder than in the US (at least in Ontario, where OP is from). UWO for instance has a cutoff of 3.7/32. Add to that that Ontarians are really only competitive at in-province schools, of which there are only 6; whereas the 7,000 kids who applied to your school also all applied to 15-20 others, most of the thousands that apply to Ontario schools are competing for spots at just those six schools

I guess I'm up for a hypothetical pissing contest.

I don't think that comparing a subset of one country against an entire other nation is necessarily fair. I wouldn't compare Californian schools to those of another country.

Other points:
It's anecdotal, but I don't think most people apply to 15-20 schools. I applied to 10, and I applied to more than most people I know. 5-6 were realistic.
For a traditional, non-URM applicant, a 32/3.7 is essentially a requirement here as well (for allopathic).
A US applicant becomes significantly less competitive at other state public schools, and even some private ones.
My state school isn't that highly ranked, and still manages an average of 34/3.8. That includes non-trads with crazy ECs and diversity requirements.

In short, I'm still not exactly convinced that it's much more competitive. Definitely not convinced it's enough to justify choosing a Canadian graduate over a US graduate on that basis.

If we were to acknowledge all Canadian schools as being more competitive, it's not as though it would blast open all the doors. Even coming from a powerhouse like Harvard, I doubt you'd get anywhere competitive with a low step 1 and poor clinical evals.

It will still depend on the individual over the institution.

 

[leggo_my_ecmo]

I guess I'm up for a hypothetical pissing contest.

I don't think that comparing a subset of one country against an entire other nation is necessarily fair. I wouldn't compare Californian schools to those of another country.

Other points:
It's anecdotal, but I don't think most people apply to 15-20 schools. I applied to 10, and I applied to more than most people I know. 5-6 were realistic.
For a traditional, non-URM applicant, a 32/3.7 is essentially a requirement here as well (for allopathic).
A US applicant becomes significantly less competitive at other state public schools, and even some private ones.
My state school isn't that highly ranked, and still manages an average of 34/3.8. That includes non-trads with crazy ECs and diversity requirements.

In short, I'm still not exactly convinced that it's much more competitive. Definitely not convinced it's enough to justify choosing a Canadian graduate over a US graduate on that basis.

If we were to acknowledge all Canadian schools as being more competitive, it's not as though it would blast open all the doors. Even coming from a powerhouse like Harvard, I doubt you'd get anywhere competitive with a low step 1 and poor clinical evals.

It will still depend on the individual over the institution.

Not saying that just because acceptance into Canadian schools is harder that they should be chosen over an American (we already know from the NRMP PD survey that the school attended is not at the top of things they consider). 5-6 is honestly not that realistic, AMCAS says the average is 15. As for your point about California, 1) This phenomenon is most acute in Ontario and BC, which, granted, is a subset of the country, but together they account for over half the population. And since you brought up California, think about this: California residents can go elsewhere out of state, but for OP and the majority of Canadians, going out of province isn't really an option (imagine if you were from California, and that if you didn't get into one of the UCs then you couldn't go anywhere. That's what many Canadian students go through).

 

[Meh.meh]

Not saying that just because acceptance into Canadian schools is harder that they should be chosen over an American (we already know from the NRMP PD survey that the school attended is not at the top of things they consider). 5-6 is honestly not that realistic, AMCAS says the average is 15. As for your point about California, 1) This phenomenon is most acute in Ontario and BC, which, granted, is a subset of the country, but together they account for over half the population. And since you brought up California, think about this: California residents can go elsewhere out of state, but for OP and the majority of Canadians, going out of province isn't really an option (imagine if you were from California, and that if you didn't get into one of the UCs then you couldn't go anywhere. That's what many Canadian students go through).

This is somewhat of a reality for a lot of Californians, though it may not be to such an extreme. Hence the constant pre-med question of "is this school friendly to oos apps?"

Averages can be somewhat deceiving, because they include outliers. I'd be interested in both the median and the number of completed applications (If I'm remembering correctly, AMCAS tracks the number of primary apps opened, not secondaries or interviews. Many complete a primary application but not a secondary.)

My issue isn't with the idea that areas of Canada may be more competitive than the US as a whole, but rather that Canada as a whole is more competitive than the US allopathic schools as a whole. I probably wouldn't have said a word if OP said "Are program directors aware of how competitive med. schools in Ontario are?"

I'm not likely to be convinced without an objective source of data which I can examine myself at length. That's not likely to happen because I'm lazy, so expect a continued theme of " 'Merica" from this corner.

It's a silly conversation to even have, especially considering the existence of osteopathic schools and Caribbean options. While both of those are somewhat risky (especially the Caribbean), they are also both viable methods of obtaining a MD in the US. If you include those options, OP is probably correct (but that's not representative of who he/she would compete with in the match).

 

[100111]

In on pissing contest.

 

[StampLicker]

Hi Everyone,

Just wanted to say that I really appreciate the responses so far. Definitely good to get different perspectives.

I'm slowly starting to realize that a debate about whether Canada is harder to get into versus the States will go around in circles, so lets try to maybe concentrate on point 2) and 3) that I brought up. Ultimately, top-choice residency is the end goal for everyone haha.

 

[Meh.meh]

Hi Everyone,

Just wanted to say that I really appreciate the responses so far. Definitely good to get different perspectives.

I'm slowly starting to realize that a debate about whether Canada is harder to get into versus the States will go around in circles, so lets try to maybe concentrate on point 2) and 3) that I brought up. Ultimately, top-choice residency is the end goal for everyone haha.

Who cares what you want 😛 A pissing contest is much more interesting.

I gave you a link to the match data: is it working?

That will have the data if anything does, at least so far as I know. I certainly don't keep track of it personally, and I doubt anyone besides a program director would. Even for a program director, I'd guess it's a relatively rare situation.

If it helps, I don't think you actually need to complete a residency in the states in order to practice here. Canadians are unique among IMG in that respect. I may be wrong on this, I haven't done a ton of research on it. Practice your google-fu. It probably varies among specialties and states.

I doubt you'll find residency competition notably easier here than in Canada, so I would suggest completing a residency where you'll be most comfortable. I imagine that program directors would want to know you had a support system, had cleared any legal issues, a serious interest in practicing here, and a damn good reason for that interest. But I'm just a pre-clinical student, and I don't know jack.

Also, fwiw, a lot of the private practice models here are disappearing (although this trend appears to be slowing according to some).

As for the other issues: make sure you consider all the costs when you look at U.S. salaries. Some salaries here may include benefits like malpractice insurance and health insurance, which would be substantially more expensive here. Cost of living differences may be important as well, depending on what area you plan to live in.

You could try posting this to an international forum, or to a specialty forum of interest (which is technically a no no, but usually is allowed to slide). Attendings/residents frequent those forums more often, and you might get a more specific/informed response.

Good luck, and I'm happy to answer any question I'm capable of handling.

Edit: also, look at hours worked and vacation taken for pay. Our country is awful at both of those things, especially in medicine. Our newspaper take joy in pointing out how we get paid "50% more than physicians of other developed nations" without adding that we work 50% more hours. Slight exaggeration, but some truth.

 

[Dr Turkelton]

Dual citizen here who went to a Canadian undergraduate school and was recently accepted at an American MD school. Canadian med schools are definitely much more competitive to get into than American MD schools. I had a friend with a 3.9 33 who ended up going to an Irish med school after 3 failed cycles. The GPA cutoff at my undergrad's Medical school (U of T) are higher than the average GPA at any US MD School, including Harvard, Yale, Hopkins, etc...

 

[Psai]

Dual citizen here who went to a Canadian undergraduate school and was recently accepted at an American MD school. Canadian med schools are definitely much more competitive to get into than American MD schools. I had a friend with a 3.9 33 who ended up going to an Irish med school after 3 failed cycles. The GPA cutoff at my undergrad's Medical school (U of T) are higher than the average GPA at any US MD School, including Harvard, Yale, Hopkins, etc...

wtf average gpa in 2013 was 3.92?
then again with the way things are going here, it seems like we'll be there soon in america as well

 

[Meh.meh]

Dual citizen here who went to a Canadian undergraduate school and was recently accepted at an American MD school. Canadian med schools are definitely much more competitive to get into than American MD schools. I had a friend with a 3.9 33 who ended up going to an Irish med school after 3 failed cycles. The GPA cutoff at my undergrad's Medical school (U of T) are higher than the average GPA at any US MD School, including Harvard, Yale, Hopkins, etc...

Edit:
Sorry to hear about your friend. I'm out on this one. Removed personal details.
There is no purpose to this argument.

 

[MTL McDougall]

If it helps, I don't think you actually need to complete a residency in the states in order to practice here. Canadians are unique among IMG in that respect. I may be wrong on this, I haven't done a ton of research on it. Practice your google-fu. It probably varies among specialties and states.

I'm a dual citizen completing medical school at McGill (Canada). I'm assuming I would not have to worry about the whole H-1B visa right, since I have citizenship? Anyway my main question is about how you pointed out that one does not need to do a residency in the US in order to practice there later on. If I pass my USMLE and end up doing my residency in Canada, how hard would it be to get my MD AND specialty recognized in the US? It seems like there's a lot of hoops to jump through.

Would it be better to do a residency in a very good hospital in Canada and then move to the US, or just do my residency in the United States at a mid-tier school or hospital.

Thanks!

 

[Winged Scapula]

For most every specialty I'm aware of, Canadian training is considered equivalent to that of the US. There are some programs which are different in length but in general there should not be any licensing or credentialing issues.

While it will be specialty specific, and you can look up the requirements of each relevant specialty, here is the policy from the American Board of surgery:http://absurgery.org/default.jsp?publiccertprocess

Employment issues will be up to the particular hospital or institution or practice.

 

[W19]

This is somewhat of a reality for a lot of Californians, though it may not be to such an extreme. Hence the constant pre-med question of "is this school friendly to oos apps?"

Averages can be somewhat deceiving, because they include outliers.

It's a silly conversation to even have, especially considering the existence of osteopathic schools and Caribbean options. While both of those are somewhat risky (especially the Caribbean), they are also both viable methods of obtaining a MD in the US. If you include those options, OP is probably correct (but that's not representative of who he/she would compete with in the match).

I am not a DO student, but DO is not risky at all.