Perceptions of Canadian Programs

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levelsands

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Hi All,

I'm a Canadian medical student looking at Rad Onc residency programs and I was hoping to get some thoughts (if any) on the quality of Canadian residency programs. Are there programs in Canada that are well regarded in the US in terms of quality of training or research output? What are general perceptions of Canadian Rad Onc trainees? It seems like fellowships don't tend to be that competitive in the US, but would the residency program I attend in Canada make a big difference when applying for fellowships at premier centres likes MDA, MSK, etc?

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I know very little about Canadian programs other than Princess Margaret. They have some "big names" in the field that put out quality clinical research papers that are well known in our literature and training. I'm confident there are other big/good places to train but off the top of my head Princess Margaret sticks out.

Outside of that anecdote I can't help you much. I do know some Canadian trained rad oncs that went on to do fellowships in the U.S. - mostly to make them more competitive for a US job (either private practice or academics). In a prior era 5-10 years ago fellowships were not competitive and pretty much unheard of outside of niche areas where one wanted to be an academic guru in brachytherapy, peds, or protons...but now it's becoming more common largely due to a tightening job market.


My uninformed perception is that if you want a U.S. job you try to train at the premier Canadian residency at Princess Margaret. If you don't land there then you'll probably benefit (from a competitive standpoint, questionably so from a clinical standpoint) from a U.S. fellowship.
 
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I've also heard of McGill University.

Is the pathway of Canadian trained --> US fellowship --> US job still viable? I thought that pathway had been closed off to residency graduates from other countries. Nothing against our Canadian brethren, but I feel that pathway should be closed off if it's not already.
 
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I think you are still ABR boards eligible with US fellowship only. That's all that is needed for US credentialing, AFAIK.
 
Specifically from a Canadian residency or residency anywhere outside the US? I thought the outside of US grad doing 1-3 fellowships and then being board eligible was phased out long ago?
 
Hi All,

I'm a Canadian medical student looking at Rad Onc residency programs and I was hoping to get some thoughts (if any) on the quality of Canadian residency programs. Are there programs in Canada that are well regarded in the US in terms of quality of training or research output? What are general perceptions of Canadian Rad Onc trainees? It seems like fellowships don't tend to be that competitive in the US, but would the residency program I attend in Canada make a big difference when applying for fellowships at premier centres likes MDA, MSK, etc?

I don't remember the specifics but I am pretty sure there used to be some issues with the Match that you should be aware of if you are trying to apply to canadian and US programs in the same year. I think the problem a couple people ran into was that the Canadian equivalent of the Match didn't give results until after US Match day and in order to stay in the Canadian system you had to pull our of the US match before finding out if you matched in the US or not. I may have it backwards but I do know one of them basically pushed you to go all in. That was a while ago, and may have no relevance today, but you may want to find out.

As for programs, agree. PMH is a very solid program. They have a fair number of big name faculty and practice changing studies under their belts. McGill is as good as most mid-tier American programs.

You should get good training either way. The bigger question on your mind should be where do you want to practice after training and what are the logistic consequences of where you do residency. I can't speak to any of it. But we do have several Canadian physicists and for them the system is neither simple nor constant. If you know you want to ultimately live in Canada or the US when you are all growed up you should probably try to train in your target country. Requirements could change in the next 5 years. No reason to set yourself up for potential road blocks in my opinion.
 
I personally know an Australian MD who had done 2 US fellowships over the years, and then became US ABR RadOnc boards certified in 2016. He got all insurance and hospital privileges while still being board eligible.

Specifically from a Canadian residency or residency anywhere outside the US? I thought the outside of US grad doing 1-3 fellowships and then being board eligible was phased out long ago?
 
I would think most Canadian programs are better than many US programs from the standpoint that they typically have a larger number of patients under treatment. A program like Vancouver would probably have 3-4x patients on treatment than a TJU/Umaryland etc?
 
Is the pathway of Canadian trained --> US fellowship --> US job still viable?

Yes it is still viable and no that pathway has not been closed off. It's not just for Canadians either.

To the op's question: the bigger name places in Canada are recognized here. Training at Princess Margaret or McGill are well respected here.

There are some other good programs as well of course (Sunnybrook, Cross, etc...) and the name is only one part.

For fellows, many programs are looking for people who will be productive in research and having that experience is important to differentiate you. Bigger name places will generally have more of those research opportunities.
 
I know very little about Canadian programs other than Princess Margaret. They have some "big names" in the field that put out quality clinical research papers that are well known in our literature and training. I'm confident there are other big/good places to train but off the top of my head Princess Margaret sticks out.

Outside of that anecdote I can't help you much. I do know some Canadian trained rad oncs that went on to do fellowships in the U.S. - mostly to make them more competitive for a US job (either private practice or academics). In a prior era 5-10 years ago fellowships were not competitive and pretty much unheard of outside of niche areas where one wanted to be an academic guru in brachytherapy, peds, or protons...but now it's becoming more common largely due to a tightening job market.


My uninformed perception is that if you want a U.S. job you try to train at the premier Canadian residency at Princess Margaret. If you don't land there then you'll probably benefit (from a competitive standpoint, questionably so from a clinical standpoint) from a U.S. fellowship.

I don't remember the specifics but I am pretty sure there used to be some issues with the Match that you should be aware of if you are trying to apply to canadian and US programs in the same year. I think the problem a couple people ran into was that the Canadian equivalent of the Match didn't give results until after US Match day and in order to stay in the Canadian system you had to pull our of the US match before finding out if you matched in the US or not. I may have it backwards but I do know one of them basically pushed you to go all in. That was a while ago, and may have no relevance today, but you may want to find out.

As for programs, agree. PMH is a very solid program. They have a fair number of big name faculty and practice changing studies under their belts. McGill is as good as most mid-tier American programs.

You should get good training either way. The bigger question on your mind should be where do you want to practice after training and what are the logistic consequences of where you do residency. I can't speak to any of it. But we do have several Canadian physicists and for them the system is neither simple nor constant. If you know you want to ultimately live in Canada or the US when you are all growed up you should probably try to train in your target country. Requirements could change in the next 5 years. No reason to set yourself up for potential road blocks in my opinion.

Thanks for the responses! I'm not interested at working in the US (at least at this point in time), but it looks like a fellowship is becoming the norm to work in Canada now. It's good to hear that there are a few programs in Canada that have a decent reputation. Unfortunately, the field here is not a popular one, and there are perceptions of Rad Onc as a "back-up" specialty which takes students who don't match into more competitive residencies. Bobby, you mentioned that you know a few Canadian trained Rad Oncs, did you notice a difference in the quality of training compared to their american peers?
 
Yes it is still viable and no that pathway has not been closed off. It's not just for Canadians either.

To the op's question: the bigger name places in Canada are recognized here. Training at Princess Margaret or McGill are well respected here.

There are some other good programs as well of course (Sunnybrook, Cross, etc...) and the name is only one part.

For fellows, many programs are looking for people who will be productive in research and having that experience is important to differentiate you. Bigger name places will generally have more of those research opportunities.

Thanks for responding! I'm very geographically constrained so likely wont be able to go east to Toronto or Montreal. Do you have any insights into how the Cross Cancer (University of Alberta) or the Tom Baker Cancer Centre (Calgary) are viewed? I
 
Both Princess Margaret and McGill are EXCELLENT programs with very large volume, and will give you great training, with exposure to more treatment modalities than most US programs simply because of their facility size and volume. I honestly do not know anything about Alberta or Calgary.
 
Also, it seems like the consensus is that the Princess Margaret is the best program in Canada. What US institutions would it be comparable to, or in the same league with. Would doing residency there open up a lot of opportunities for US fellowships or jobs in relatively desirable areas like the west coast?
 
Yes it is still viable and no that pathway has not been closed off. It's not just for Canadians either.

WHY?

Do we not have enough Rad Oncs currently in the US? Every other specialty has closed this loophole, why are we still allowing this?
 
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WHY?

Do we not have enough Rad Oncs currently in the US? Every other specialty has closed this loophole, why are we still allowing this?

I'm curious as to what this loophole is. From what I understood every Canadian specialty other than neurosurg and otolaryngology were eligible to be board certified/ practice in the US without additional fellowships or training?
 
Another extremely well respected program that is closer to the west coast is BCCA. Especially if you are interested in prostate brachytherapy. At my institution we routinely take fellows from Canada and they have all been very good clinically and also very nice!
 
Thanks for the responses! I'm not interested at working in the US (at least at this point in time), but it looks like a fellowship is becoming the norm to work in Canada now. It's good to hear that there are a few programs in Canada that have a decent reputation. Unfortunately, the field here is not a popular one, and there are perceptions of Rad Onc as a "back-up" specialty which takes students who don't match into more competitive residencies. Bobby, you mentioned that you know a few Canadian trained Rad Oncs, did you notice a difference in the quality of training compared to their american peers?

I don't really know them well enough to comment on their quality or anything. I've never worked with them in a professional capacity. I studied some in a board prep group with one guy and I can't recall where in Canada he trained but he was in the US doing a fellowship and studying for boards. He seemed fine - no rock star or anything but no dunce either (he'd probably say the same thing about me I'd imagine). I don't recall him having any major different way of doing anything over what I was trained when we studied.
 
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