Pondering immigrating to Canada...

[bomgd3]

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I'm a 2nd year US MD student and just wanted to shoot the breeze about this possibility. Obviously the benefits to remaining in the US are high, like high specialty pay and all of the inherent barriers to changing medical systems. But Canada DOES accept US residency graduates with only a licensing exams to pass.

Some reasons why I'm thinking about this:
-Single payer insurance - I work at a free clinic for the uninsured, and it's heartbreaking to see people being disabled or dying from lack of medical care.
-Generally healthier and better educated population - less chronic disease, nicer people to deal with. My impression is there are fewer multi-generation noncompliant metabolic syndrome folks and other headaches.
-US national debt burden of the last generation will eventually fall on us, the high earners of the near-future. Lack of economic stability here.
-High GP pay. One of my interests is FM, although another is ENT.
-Better public education for my eventual kids. I attended one of the best public schools in my state and still feel there were significant shortcomings.
-Less income inequality (tying in with better educated/healthier population)
-Less income inequality between specialties. I think the huge gap between GP and specialist pay in the US poisons the professional atmosphere. GP's are really looked down upon here by many, both within the field and among the general population.

I think that overall, to live well and have kids who are globally competitive in the United States requires cushioning yourself with tons of money--the best private schools, expensive suburb with people of similar education and income, nice cars to deal with persistent traffic and crappy roads, etc. Even eating healthy is freaking difficult because produce is so expensive (conventionally grown apples cost $2-3/lb here, wtf?). This is obviously more or less true depending on location, but I think that in general it is the case.

One big issue is the cost of higher education. Even on $200k pretax, having two kids in college/med school in America will really nuke your income. My parents pay for most of my medical education and I strongly feel that I should do the same for my kids, should they choose this path. But what happens when an in-state medical education costs $70k/year in 20 years?? I was accepted to McGill for undergrad and I really agree with their way of running things--cheap tuition-->crappier facilities but still excellent education. I don't get why American schools need flat screen TV's in every classroom, iPads for every student, and multimillion dollar gyms. My own school is constantly buying fancy new equipment which is massively underutilized, then raises our tuition 4%/year.

Are my impressions correct? What else is there to consider? Is this just a case of the-grass-is-greener? Does anyone know Canadian physicians who can comment on the professional opportunities there? I've tried to dig up past info with the search function but haven't found much.

 

[Miss Alyssa]

I think about going back to Canada sometimes. My list of reasons would include giving back to the community that made me who I am today as well as maternity leave. One year >>> 5 weeks! Plus that 1 year is shared between both parents.

Are you a Canadian citizen? It's unfortunately difficult for non-Canadians to practice medicine in Canada. That's probably something you should research.

http://www.premed101.com/forums/ is a good place to start.

I personally know an ENT that did med school in Canada, residency in US and went right back to Canada after.

 

[drctother]

Some reasons why I'm thinking about this:
-Single payer insurance - I work at a free clinic for the uninsured, and it's heartbreaking to see people being disabled or dying from lack of medical care.
-Generally healthier and better educated population - less chronic disease, nicer people to deal with. My impression is there are fewer multi-generation noncompliant metabolic syndrome folks and other headaches.
-US national debt burden of the last generation will eventually fall on us, the high earners of the near-future. Lack of economic stability here.
-High GP pay. One of my interests is FM, although another is ENT.
-Better public education for my eventual kids. I attended one of the best public schools in my state and still feel there were significant shortcomings.
-Less income inequality (tying in with better educated/healthier population)
-Less income inequality between specialties. I think the huge gap between GP and specialist pay in the US poisons the professional atmosphere. GP's are really looked down upon here by many, both within the field and among the general population.

I think that overall, to live well and have kids who are globally competitive in the United States requires cushioning yourself with tons of money--the best private schools, expensive suburb with people of similar education and income, nice cars to deal with persistent traffic and crappy roads, etc. Even eating healthy is freaking difficult because produce is so expensive (conventionally grown apples cost $2-3/lb here, wtf?). This is obviously more or less true depending on location, but I think that in general it is the case.

One big issue is the cost of higher education. Even on $200k pretax, having two kids in college/med school in America will really nuke your income. My parents pay for most of my medical education and I strongly feel that I should do the same for my kids, should they choose this path. But what happens when an in-state medical education costs $70k/year in 20 years?? I was accepted to McGill for undergrad and I really agree with their way of running things--cheap tuition-->crappier facilities but still excellent education. I don't get why American schools need flat screen TV's in every classroom, iPads for every student, and multimillion dollar gyms. My own school is constantly buying fancy new equipment which is massively underutilized, then raises our tuition 4%/year.

Are my impressions correct? What else is there to consider? Is this just a case of the-grass-is-greener? Does anyone know Canadian physicians who can comment on the professional opportunities there? I've tried to dig up past info with the search function but haven't found much.

As a Canadian studying in the US, I 100% agree that overall the average person is much more educated and healthy in Canada. The basic things about the world/life that people in the US dont know absolutely baffles me sometimes. As a physician, our health care system is MUCH easier to work with. You dont have any of this insurance BS so you actually treat the patient and not worry about how many tests you have to order to make a certain income. Also the patients dont have to worry about whether or not something will be covered by their insurance. HUGE HUGE perks if you ask me. This stereotype that Canada has massive waiting times in hospitals is not true at all. I think American politicians just needed a reason to convince people to not go towards our health care system, found some rare exception at some random hospital, and claimed all our hospitals are like that.

You speak of the cost of higher education and im assuming you are referring to your future children? I did my undergrad in Canada. I paid $2000 a year in tuition to go to a school better than the large majority of american schools. That is something to keep in mind. We have about 3-4 schools that are highly ranked internationally.

One thing that you need clarification on.....you think American produce prices are expensive? EVERYTHING is more expensive in Canada. There is not much that is cheaper in my country. Food, cars, homes, electronics, clothes, alcohol...you name it, all cheaper in the US. For example I bought a car in the US when i started school that saved me $35000 compared to back home. With that being said, as a physician you will not notice the differences.

It comes down to personal choice, and what you want (and apparently what is best for your children). I love the US, there is so many good things about this country. But I am definitely returning home to practice. This country frightens me and I can see nothing but bad things coming for the US in the near future. This country is too broke, too afraid of change, and its priorities are WAY out of line (I just read an article about the US spending millions on a few military drones...why? millions of people are unemployed and cant afford basic health care).

At least in my country we have no enemies (its super safe), our health care is free, we have virtually no pollution, and our education is very very cheap. The cons would be that things are more expensive and we get ridiculously stereotyped by the US. THats about it though lol

I hope I didnt offend you or anyone, just some food for thought since you are considering raising a family

I Also forgot to mention, physicians arent payed as well as they are in the US....BUT its comparable and certainly enough to live comfortable on

 

[TAWS]

I spend about $15,000/year on ALL living expenses (rent, food, travel, etc) during college and medical school and don't feel poor. Do people really think $200,000+ income is not enough to live comfortably in the US? It boggles the mind.

 

[dr zaius]

I spend about $15,000/year on ALL living expenses (rent, food, travel, etc) during college and medical school and don't feel poor. Do people really think $200,000+ income is not enough to live comfortably in the US? It boggles the mind.

Do you have children? Do you pay for your own insurance (car, home owners, health)? Does your wife have an income, or is she a stay at home mom?

$200k can afford comfortable living in many circumstances. In others it might be stretched a little tighter depending on location, things mentioned above, etc.

 

[badasshairday]

The US medical system is going to implode if we don't take action. I think we can all take 30 seconds to help this cause which will directly affect us in terms of residency:

Congress is discussing a deficit reduction proposal that would cut up to 60% ($60 billion) in federal GME support and jeopardize residency training programs across the country. Congress is expected to finalize its multi-trillion-dollar package of program cuts in the next few days.

As soon as possible, please visit the AAMC Legislative Action Center (http://capwiz.com/aamc/home/) to send a pre-formatted electronic letter to your Senators and Representatives urging them to oppose GME cuts as part of deficit reduction.

If you reside in Arizona, California, Washington State, Massachusetts, Ohio, Pennsylvania, Montana, Michigan, Maryland, Texas, or South Carolina, it is particularly important to voice your concern, since you are represented by members of the "Super Committee" that will finalize the deficit reduction plan.

http://capwiz.com/aamc/home/

Click the link and the appropriate button "medical student" or "resident" and it is all preset. Also use your personal email rather than your institutions email address when you fill it in (instructions from my school, not sure why it would matter).

 

[Daedra22]

Do you have children? Do you pay for your own insurance (car, home owners, health)? Does your wife have an income, or is she a stay at home mom?

$200k can afford comfortable living in many circumstances. In others it might be stretched a little tighter depending on location, things mentioned above, etc.

15% of people in the US make over $100,000/year. You're saying that the top 15% income earners in the "richest country in the world" are struggling, or not living comfortably?

 

[MedMan25]

At least in my country we have no enemies (its super safe), our health care is free, we have virtually no pollution, and our education is very very cheap. The cons would be that things are more expensive and we get ridiculously stereotyped by the US. THats about it though lol

Your health care is not free. The real cost of health care in Canada is simply hidden in higher taxes and physicians who have less incentive to compete for patients which I believe translates into poorer quality of care. In my opinion, this makes Canada's health care (or any other government run health care program) in reality more expensive.

Canadians may be healthier, however, I would argue this has less to do with Canada's supposed superior health care system and more to do with America's bad eating habits, changing lifestyles, and lack of exercise.

 

[MajinVegeta]

:troll:

 

[stolis]

Your health care is not free. The real cost of health care in Canada is simply hidden in higher taxes and physicians who have less incentive to compete for patients which I believe translates into poorer quality of care. In my opinion, this makes Canada's health care (or any other government run health care program) in reality more expensive.

Canadians may be healthier, however, I would argue this has less to do with Canada's supposed superior health care system and more to do with America's bad eating habits, changing lifestyles, and lack of exercise.

"Bad eating habits, changing lifestyles, and a lack of exercise" ARE a consequence of the country's health care system - specifically the lack of emphasis on preventative care.

 

[link2swim06]

Two HUGE problems with Canada y'all are missing,

1. COLD! but seriously do you want to live somewhere it snow half the year?
2. TAXES! are much, especially when you compare the US tax deductions available to those with kids..etc..

 

[bomgd3]

"Bad eating habits, changing lifestyles, and a lack of exercise" ARE a consequence of the country's health care system - specifically the lack of emphasis on preventative care.

I think that even more so than lack of preventative care, our fatness is due to policies which make fattening foods extremely cheap and accessible while healthy foods are expensive and difficult for many people to buy. In addition, our development policies favor sprawl and car-dependence, making us even fatter. Combine that with horrible education in areas which are already nutritionally disadvantaged, and you wind up with an underclass of poor fat people who have no idea how to lose weight and no resources to do so. It's an extremely hard current for doctors to swim against.

I don't really want to discuss the "you need to live on HOW MUCH?" question here, although I know some people on SDN love to beat this to death. People have varying levels of spending. If you want to support several kids through college, it can get extremely expensive even for a $200k income. I also live on $15k a year, good for me?

My primary concern is that the US may not offer a good practice environment or socioeconomic environment in the future. If you think this is trolling then your eyes are not open.

I don't mind the cold that much, and I feel that increased taxes are partially weighed out by the increased benefits like not having to worry about kids' college tuition or private schools. I am aware that the cost of living is pretty high in Canada, though.

 

[Beta Cell]

Another socialist in-the-making dreaming of greener pastures. Not that you're one of these people, but for those who are truly unhappy in America, work to fix it, or leave. If you're thinking about leaving for the socialist reasons you said above, go ahead. Don't tell me you can't treat the underserved in a professional capacity in the US, there are thousands of opportunities.

 

[clifftacopter]

It's extremely easy for American trained physicians to practice in Canada, if that's your desire. Most provinces accept US licenses as equivalent to Canadian licenses without actually having to sit any exams or undergo licensing hurdles that most other foreign trained doctors have to go through. There are a few specialty exceptions where the residency training lengths are different (like anesthesiology, where it's four years in the US and five years in Canada), and they therefore require you to do an extra year of residency (or a one-year fellowship) to make up the difference. However, I'm pretty sure you won't have to take any special exams. Most hospitals in Canada will hire you with your USMLE/US boards being just fine.

EDIT: Also, check out the Canada subforum. There's a lot of information there that you might find helpful.

 

[Substance]

I don't really want to discuss the "you need to live on HOW MUCH?" question here, although I know some people on SDN love to beat this to death. People have varying levels of spending. If you want to support several kids through college, it can get extremely expensive even for a $200k income. I also live on $15k a year, good for me?
.

See, what I don't get is why people need to justify wanting a $200k or more income with putting their little spoiled kids through college with it.

I want 200k so I can drive a nice car, live in a nice house in the nice part of town, and take long vacations to exotic destinations. I want to be able to hire staff to clean my house, and take care of me when I'm old. Essentially I want a high quality of life and the freedom to live it how I choose. And I don't want kids.

Canada is ok. It has its pros and cons. FM does WAY better up here than it does in the USA.

Watch out though. I think American docs still need to sit for the royal college exams before they can practice in Canada. These exams are tough, British-style oral exams and its not uncommon for very high quality MGH types to fail them the first time around.

 

[clifftacopter]

Watch out though. I think American docs still need to sit for the royal college exams before they can practice in Canada. These exams are tough, British-style oral exams and its not uncommon for very high quality MGH types to fail them the first time around.

This is not true for American-trained physicians (at least in BC, Alberta, Ontario and Quebec).

Example: In Ontario, you can bypass exam requirements if you have US board certification in a specialty or are already licensed to practice without restrictions in the US.
http://www.healthforceontario.ca/Wo...ntario/PracticeRequirements/UnitedStates.aspx

 

[bomgd3]

Excellent information! So post residency, if I wanted to, I could directly apply for certain Canadian jobs?

 

[elmariachi]

I'm a 2nd year US MD student and just wanted to shoot the breeze about this possibility. Obviously the benefits to remaining in the US are high, like high specialty pay and all of the inherent barriers to changing medical systems. But Canada DOES accept US residency graduates with only a licensing exams to pass.

Some reasons why I'm thinking about this:
-Single payer insurance - I work at a free clinic for the uninsured, and it's heartbreaking to see people being disabled or dying from lack of medical care.
-Generally healthier and better educated population - less chronic disease, nicer people to deal with. My impression is there are fewer multi-generation noncompliant metabolic syndrome folks and other headaches.
-US national debt burden of the last generation will eventually fall on us, the high earners of the near-future. Lack of economic stability here.
-High GP pay. One of my interests is FM, although another is ENT.
-Better public education for my eventual kids. I attended one of the best public schools in my state and still feel there were significant shortcomings.
-Less income inequality (tying in with better educated/healthier population)
-Less income inequality between specialties. I think the huge gap between GP and specialist pay in the US poisons the professional atmosphere. GP's are really looked down upon here by many, both within the field and among the general population.

I think that overall, to live well and have kids who are globally competitive in the United States requires cushioning yourself with tons of money--the best private schools, expensive suburb with people of similar education and income, nice cars to deal with persistent traffic and crappy roads, etc. Even eating healthy is freaking difficult because produce is so expensive (conventionally grown apples cost $2-3/lb here, wtf?). This is obviously more or less true depending on location, but I think that in general it is the case.

One big issue is the cost of higher education. Even on $200k pretax, having two kids in college/med school in America will really nuke your income. My parents pay for most of my medical education and I strongly feel that I should do the same for my kids, should they choose this path. But what happens when an in-state medical education costs $70k/year in 20 years?? I was accepted to McGill for undergrad and I really agree with their way of running things--cheap tuition-->crappier facilities but still excellent education. I don't get why American schools need flat screen TV's in every classroom, iPads for every student, and multimillion dollar gyms. My own school is constantly buying fancy new equipment which is massively underutilized, then raises our tuition 4%/year.

Are my impressions correct? What else is there to consider? Is this just a case of the-grass-is-greener? Does anyone know Canadian physicians who can comment on the professional opportunities there? I've tried to dig up past info with the search function but haven't found much.

My wife is Canadian and she says don't believe everything you hear on NPR.

 

[bomgd3]

My wife is Canadian and she says don't believe everything you hear on NPR.

Interesting.... Care to be more specific? Is the quality of life just not there?

 

[clifftacopter]

Excellent information! So post residency, if I wanted to, I could directly apply for certain Canadian jobs?

Each of the provinces has slightly different rules and regulations regarding this, but generally speaking yes. My step-father got a job in Alberta within a matter of a month or two and it was a very straight forward and simple process. No tests or on-site evaluations or any other hurdles you commonly go through with IMGs.

 

[dr zaius]

15% of people in the US make over $100,000/year. You're saying that the top 15% income earners in the "richest country in the world" are struggling, or not living comfortably?

I'm saying it's circumstantial.

 

[elmariachi]

Interesting.... Care to be more specific? Is the quality of life just not there?

LOL, ok. Keep in mind this is free advice. Your original post suggests that you have fairly standard liberal views, and American liberals often look wistfully at Canada as the paragon of what America could be if only some of our attitudes were corrected and the right people were in charge. The favored media outlet for many of these types is NPR (National Progressive Radio, or as my wife calls it, Not Particularly Relevant--how many stories do we need to hear about the youth of Mongolia finding their collective voice in hip-hop, or the plight of the transgendered in Burkina Faso?)

But on to two specifics--first, waiting lists. You've heard urban legends about horrifically long waiting times for anything from MRIs to hip replacements. They're true. Several of my wife's friends and relations have taken their cue from the Premier (that's Canadian for Governor) of the Province (that's Canadian for State) of Newfoundland and flown to the States where they could pay for their care up front, rather than wait indefinitely for the care they already paid for in higher taxes. Seems like everyone I run into up there either just got back from some clinic down here, is planning on coming down, or has a brother or aunt in that situation.

Still, that doesn't affect you--you're going to be on the other side of the desk, with more patients than you can shake a stick at. Uh oh.

Now this is starting to change, but physician compensation has been traditionally worse up there than here--in order to keep costs down, the Crown (that's Canadian for Government) dictated how much physicians could take in. Doctors, understandably, didn't want to work for less than what they felt they were worth, so as soon as they maxed out their salary, they simply closed the office and went on vacation (see above, regarding wait times). As I said, this is changing now in limited jurisdictions. When I was in Vancouver a couple years ago, the CBC (that's Canadian for NPR) was wringing their hands over allowing radiologists to turn a profit.

As an aside, I was told by one of my professors that the Obama healthcare plan explicitly was NOT modeled on the Canadian system, specifically to circumvent this unintended consequence of government-incentivized scarcity.

I could spout forth about Canadian red tape, but there are some points raised by other posters that I would like to address.

I am not convinced Canadians are healthier. North Americans are North Americans, they eat the same food, and while they may watch different sports, they're sitting on the same furniture, in front of the same TVs. The Canadian First Nations (that's Canadian for Native Americans) have the same problems with obesity, diabetes, and alcoholism that the American Indians have down here--if you're interested in working with underserved populations, you'll have the same frustrating chronic conditions to contend with.

Nor do I see any signs of better education up there. My wife's school experiences sounded like they sucked just about as much as mine, from elementary school up through university. Again, North America is North America. One's education depends on who he is, not what school he attends.

Someone said Canada has "virtually no pollution." One word: Toronto. I think that same person said Canada has no enemies, unlike the US. Dude, have you been smoking David Suzuki's weed? Just 5 years ago a bunch of Muslim terrorists were arrested for conspiring to decapitate Prime Minister (that's Canadian for President) Stephen Harper. The Dominion of Canada has the same geo-political baggage as the United States.

So, after all that snark, what do I really think? I'd love to work up in Canada. I consider it my second home. Alberta is like boom-town now (because of their oil). Summers are heavenly, and in winter I could scurry back down to where it's warm. However, the problems that plague doctors and patients down here are concerns up there as well.

PS: I agree with you about ridiculously high education costs. I blame student loan subsidies, which give college administrators an easy set of shears to fleece taxpayers and students. That's a story for another day though.

 

[Miss Alyssa]

This is specific to Ontario:http://www.cpso.on.ca/policies/policies/default.aspx?id=2352#pathway3

It details the pathway in Ontario. I posted it it about a week ago in a different thread. If you complete residency in the US, you have to undergo a year of supervision and some type of an exam. What isn't clear to me is if this is just the policy for Canadian citizens that are US trained or if this includes non-Canadian citizens that are US trained.

Wait times by province and even individual hospitals are public record and this site would be a good gateway to get at that data if you're interested.
http://canadaonline.about.com/od/healthcarewaittimes/Wait_Times_for_Health_Care_in_Canada.htm

At Edmundston Hospital in New Brunswick 5/10 patients get bunion surgery in 20 days 🙂

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Someone said university cost them $2000 a year. To put it in perspective, I paid ~$5000/yr and if I'm not mistaken that was the most expensive school (UofT) and students were protesting the price. I don't know how much it costs now.

 

[ZtetNb]

Well I live in Canada, and I might as well say two things:
-On the issue of waiting lists, yes they are long, which is indeed why some people travel to and pay for operations in the states. In Canada, this is really only a setback for wealthy people, who can bypass the Canadian system by going to the States anyway.
-On physician compensation, specialists here definitely earn less than in the US, but primary case physicians are compensated much more than their US counterparts. Unless you want to live like a rock star, I don't think this should be a major problem, and it's really good if you like primary care.
Generally I feel like Canada is a more socialist country that has the benefit of piggybacking off the wealth generated by the US economy, and I can definitely say I'm glad I live here.

 

[Bigz]

Please let me rant a little

I as Canadian I someone who loves Canada I must say I am appalled at how some of you Canadians and US haters are insulting the United States. Canada is a great country to live and raise your children and i must say i was excited when I got 9 months off work to be with my first child. Lived in Canada for 17 years through high school, College and 5 yrs of professional life. With all that said The UNITED STATES OF AMERICA is still unequivocally the greatest nation in the world. Yeah the political system in the US is frustrating, and people are a bit too individualistic for my liking but fore those who are Hungry for success and willing to struggle for it, the opportunities in this country is second to none. Its amazing to hear people who are going to be physicians because of the opportunities here in the united states speak so ill about this Country. Don't bit the hands that feeds you.

If little Greece can have a such an impact on the world then guess what the US Going "broke" will do to the world economy. You think going to Canada is going to save you? Well guess what if the United states is going down as some of you proclaim then Canada is surely going down with the USA. Does Canada not export > 70% from the USA? We better hope the USA can continue to buy our products.

Now to medicine. I laugh when I hear the rosy descriptions of Canadian health care system. How would any of you guys/gals feel to go to the ED for 24 hours with severe pain due to a suspected kidney stone and be discharged without seeing a urologist because they could not get one to come in. In fact what about not being able to see a urologist for three days and having a cath bag strapped to you for those three days? How That sound like excellent care to you? Look the US does not have a health care quality issue we have a payment issue and lifestyle issue. I hope we can find ways to solve these and leave these.

 

[MedMan25]

"Bad eating habits, changing lifestyles, and a lack of exercise" ARE a consequence of the country's health care system - specifically the lack of emphasis on preventative care.

So why is it that obesity rates in the UK, Australia, and Eastern Europe have risen at almost the same rate as obesity in the United States? If it's all due to our broken health care system you'd expect obesity rates in countries with socialized medicine like the UK to be falling. Obesity rates in Switzerland for example are among the lowest in the entire world (7.7% vs 30% in the US) yet health insurance in Switzerland is run entirely by the private sector without any government-run insurance option available in that country.

 

[Miss Alyssa]

Please let me rant a little
With all that said The UNITED STATES OF AMERICA is still unequivocally the greatest nation in the world. Yeah the political system in the US is

Edit: The USA is the greatest nation in the world... for you. Individuals have their own thoughts about the place they want to live in. You want to live in the US, but not every one does

Now to medicine. I laugh when I hear the rosy descriptions of Canadian health care system. How would any of you guys/gals feel to go to the ED for 24 hours with severe pain due to a suspected kidney stone and be discharged without seeing a urologist because they could not get one to come in. In fact what about not being able to see a urologist for three days and having a cath bag strapped to you for those three days? How That sound like excellent care to you? Look the US does not have a health care quality issue we have a payment issue and lifestyle issue. I hope we can find ways to solve these and leave these.

Your anecdote could easily be from a patient in the US.

I already provided a link that give the wait times for ED visits, varies surgeries and specialty care. It is broken down nationally, by province and individual hospital. It is far more accurate and useful for someone looking for real information about the health care system.

Curious, what are the wait times like in the US?

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OP, You mentioned that education for your future children is a concern. While the future is hard to predict, I found an article about what's going on now.
http://www.guardian.co.uk/news/datablog/2010/dec/07/world-education-rankings-maths-science-reading
The article centers on the UK so it doesn't have specifics about what's going on in Canada. It does show that Canada is ranked 3rd in reading, 5th in math, and 5th in sciences among other OECD countries. Not sure if that helps you.

 

[drctother]

Two HUGE problems with Canada y'all are missing,

1. COLD! but seriously do you want to live somewhere it snow half the year?
2. TAXES! are much, especially when you compare the US tax deductions available to those with kids..etc..

typical wrong stereotypes. Very wrong

1) Depends where you live. Just like any country. For example, I am from British Columbia on the West coast. Specifically Vancouver. We get less than 5 snow days a year, if that.

2) Another misconception. Our taxes are more than US. But not by much, and for that little extra in tax we get free health care. Seems like a no brainer. We also have tons of tax deductions. Do you think the US is the only country that has tax deductions?

 

[drctother]

But on to two specifics--first, waiting lists. You've heard urban legends about horrifically long waiting times for anything from MRIs to hip replacements. They're true. Several of my wife's friends and relations have taken their cue from the Premier (that's Canadian for Governor) of the Province (that's Canadian for State) of Newfoundland and flown to the States where they could pay for their care up front, rather than wait indefinitely for the care they already paid for in higher taxes. Seems like everyone I run into up there either just got back from some clinic down here, is planning on coming down, or has a brother or aunt in that situation.




I am not convinced Canadians are healthier. North Americans are North Americans, they eat the same food, and while they may watch different sports, they're sitting on the same furniture, in front of the same TVs. The Canadian First Nations (that's Canadian for Native Americans) have the same problems with obesity, diabetes, and alcoholism that the American Indians have down here--if you're interested in working with underserved populations, you'll have the same frustrating chronic conditions to contend with.

Nor do I see any signs of better education up there. My wife's school experiences sounded like they sucked just about as much as mine, from elementary school up through university. Again, North America is North America. One's education depends on who he is, not what school he attends.

Someone said Canada has "virtually no pollution." One word: Toronto. I think that same person said Canada has no enemies, unlike the US. Dude, have you been smoking David Suzuki's weed? Just 5 years ago a bunch of Muslim terrorists were arrested for conspiring to decapitate Prime Minister (that's Canadian for President) Stephen Harper. The Dominion of Canada has the same geo-political baggage as the United States.

So, after all that snark, what do I really think? I'd love to work up in Canada. I consider it my second home. Alberta is like boom-town now (because of their oil). Summers are heavenly, and in winter I could scurry back down to where it's warm. However, the problems that plague doctors and patients down here are concerns up there as well.

PS: I agree with you about ridiculously high education costs. I blame student loan subsidies, which give college administrators an easy set of shears to fleece taxpayers and students. That's a story for another day though.

Your wifes "experiences" through her friends are the far exceptions and that is because they are NON EMERGENCY and far from important. There is almost no wait lists. I have been hospitalzied numerous times, many of my family members have been hospitalized too (emergency and non emergency). My grandparents for example have had non-emergency operations. They got in within 2 weeks. My experience goes way beyond my family as I worked in hospitals for years before starting medical school

So no your wifes experiences are not the norm.

You dont think Canadians are healthier? im not even going to comment on that.

Canada has virtually no pollution. TORONTO is the exception and its still no where near as bad as LA or NY. Vancouver, calgary, edmonton, montreal, etc are virtually pollution free

Bottom Line: The "lines" are small, if there is even a line in the hospital. Yes there is exceptions every now and than. Please dont listen to this person about these lines in our hospitals. I would also like to make it clear that I love the US, so im by no way saying the US is a bad country.

 

[bomgd3]

This is a really interesting conversation... since I'm currently in the depths of microbiology, I can't write a long response, but I want to also say that just because many of us find problems with the US doesn't mean we hate it. I'm hugely grateful for the opportunities it has given me and my parents. But my parents and I are first generation immigrants who came here for better job opportunities and better education. At this point I'm simply trying to decide what the best move would be for myself and my future family... everything else comes second.

 

[ambiti0n]

Do you have children? Do you pay for your own insurance (car, home owners, health)? Does your wife have an income, or is she a stay at home mom?

$200k can afford comfortable living in many circumstances. In others it might be stretched a little tighter depending on location, things mentioned above, etc.

To me its very funny that people tell me that you may be a stretch to live on 200k.

My mother has made less than 40k gross my whole life. Single mother, that is. 3 kids.
No we don't live in a big house. No we don't have movie channels. She doesn't drive a brand new car. Vacations ... what are those? Yet we managed the beach a few times and the state fair.

If you live outside your means, well... you live outside your means, and that's when your stretch comes into play.

Money is always important. Yet, the way you spend your money determines whether you will ever be satisfied.

Needs/Comfortable > Wants/Extravagant

 

[bomgd3]

I am better than the rest of you because my parents were poor. I like to bring this up often, even if it is not relevant to the topic at hand.

Paraphrased it for you. FWIW my folks made <60k combined for a long time--life was perfectly fine but we didn't have much of a pick of schools (couldn't afford a home in the best school district) and they didn't save any money for college.

 

[islandCrazy]

Thanks bomgd3 for paraphrasing that, cause that was the expression I got from the post.

Anyways as a Canadian I believe that before any American decides to immigrate to Canada that they spend a reasonable time understanding our health care system. Americans seem to have a distored view of our health care system due to the propaganda surrounding Obamacare.

 

[blizzah]

If anyone is interested in moving to Canada, I will marry you so you can get a fast track on Canadian immigration.

Then I start my path to becoming a US-Canada dual citizen too.


What a win-win

 

[badasshairday]

If anyone is interested in moving to Canada, I will marry you so you can get a fast track on Canadian immigration.

Then I start my path to becoming a US-Canada dual citizen too.


What a win-win

Shall we PM you for further details?

 

[elmariachi]

Your wifes "experiences" through her friends are the far exceptions and that is because they are NON EMERGENCY and far from important. There is almost no wait lists. I have been hospitalzied numerous times, many of my family members have been hospitalized too (emergency and non emergency). My grandparents for example have had non-emergency operations. They got in within 2 weeks. My experience goes way beyond my family as I worked in hospitals for years before starting medical school

So no your wifes experiences are not the norm.

You dont think Canadians are healthier? im not even going to comment on that.

Canada has virtually no pollution. TORONTO is the exception and its still no where near as bad as LA or NY. Vancouver, calgary, edmonton, montreal, etc are virtually pollution free

Bottom Line: The "lines" are small, if there is even a line in the hospital. Yes there is exceptions every now and than. Please dont listen to this person about these lines in our hospitals. I would also like to make it clear that I love the US, so im by no way saying the US is a bad country.

1. That's cute. You repudiate my argument as anecdotal, with appeal to anecdotes of your own. I stand by what I wrote. When the Premier of on of your own provinces skips town for medical care, that says something. Also, relying on your experiences in hospitals as evidence of no waiting for medical care in Canada gives you a greater-than-healthy case of observation bias--the people waiting were at home, not hanging out in the lobby where you could see them.

2. Regarding pollution--I haven't been to Montreal or Edmonton so I can't speak to those, but Calgary has air pollution advisories (like you couldn't tell from the brown smudge hanging over downtown during an inversion), and Vancouver, while situated in gorgeous landscape, is just as dirty and squalid as other North American cities. Victoria pumps its sewage into the Strait of Juan de Fuca--but hey, Canadians' Scheiss doesn't stink, right? I guess you don't have as much pollution from oil refineries as we do, but that's because you are dependent on the US for petroleum products. If you refined more of your own gasoline (and hey--that would make more sense than sending it all down to Texas, before importing it back up), you'd have more pollution than you do. As it is, the US is subsidizing Canada's "virtual pollution freedom."

3. Canadians being healthier or not--walk into a Tim Horton's up there and you'll meet people cut out of the same (sized) cloth as the ones eating at Denny's here.

4. What, you're not going to try and argue that Canada has no enemies?

Look, Canada is a lovely country. I'm not hating on it, just pooh-poohing anyone who preaches its superiority over the US, when in fact the things Liberals down here like about Canada are qualities that wouldn't be possible without neighbors like un-Canadianly Americans. Furthermore, Canada's health care system does have some very present problems that are ignored down here, as other posters have noted.

 

[Miss Alyssa]

So...

Did anyone figure out the path for a US-citizen (no current Canadian immigration status), who completed med school and residency in the US?

I haven't found anything on this specifically. The sites that I've found don't specify anything about immigration status...

 

[elmariachi]

So...

Did anyone figure out the path for a US-citizen (no current Canadian immigration status), who completed med school and residency in the US?

I haven't found anything on this specifically. The sites that I've found don't specify anything about immigration status...

Heh heh, I guess I can be a little excitable sometimes. I'm done now.

Have you called any hospital HR departments up there and asked what sort of hoops need to be jumped through for someone in your situation? I meant to do this last time I was up there on vacation, but I didn't get around to it.

 

[clifftacopter]

So...

Did anyone figure out the path for a US-citizen (no current Canadian immigration status), who completed med school and residency in the US?

I haven't found anything on this specifically. The sites that I've found don't specify anything about immigration status...

Look around for jobs up there. Depending on what you find, the practices/hospitals hiring will tell you what you need to do. In most provinces it should not be an issue at all. When my step-father was looking for a job up there, most of the listings said that Canadian -or- American board certification was required. He got a pretty nice job in Alberta within a matter of months without having to take any exams. He's a 100% American trained, US citizen with no Canadian ties.

You can look at some of the links previously provided in this thread for some information. You can also look at the Canadian sub-forum on SDN for even more information. But the best information you'll find (and the most specific to your situation) is by calling up hospitals that have dealt with hiring Americans before and asking them about it.

 

[Miss Alyssa]

Note: I was just asking to get the tread back on track and for the benefit of the OP and anyone else in that situation. (I'm Canadian) Thanks for the input?

"Physicians" might be on that list of preferred occupations for immigration...

 

[clifftacopter]

Sorry, was not aware. Was just trying to be helpful to what I thought was an earnest question.

 

[bomgd3]

Thanks for the info folks. Great to know that it's relatively easy for an American trained doctor to practice in Canada. I know that it's not scientific but check out this map:

http://eaves.ca/2008/07/08/fatness-index-canada-vs-united-states/

Seems to corroborate my own observations on numerous trips north of the border... Canadians are a lot less obese than Americans!

It's really unfortunate that there's no way to discuss the healthcare situation without it getting really heated. I'm not really sure why that is, since it would make sense that both nations borrow the best ideas from each other.

 

[FIREitUP]

To me its very funny that people tell me that you may be a stretch to live on 200k.

My mother has made less than 40k gross my whole life. Single mother, that is. 3 kids.
No we don't live in a big house. No we don't have movie channels. She doesn't drive a brand new car. Vacations ... what are those? Yet we managed the beach a few times and the state fair.

If you live outside your means, well... you live outside your means, and that's when your stretch comes into play.

Money is always important. Yet, the way you spend your money determines whether you will ever be satisfied.

Needs/Comfortable > Wants/Extravagant

if your mom wanted to go to medical school she would not only have to forgo her 40k salary for 4 years, but she would also have to take loans with interest. So the cost your mom going to medical school could be upwards of $300k or more depending on the cost of school. Now, did your mom work 80 hours a week to make 40k? That's what residents do. Now after all that crap what would your mom expect to make? 43k? If you're okay with that salary then you should tell your employer when you become an attending, I'm sure you won't have any issues finding a job, although you seem grossly incompetent due your previous comment so we'll just have to hope you get to that stage.

 

[TAWS]

if your mom wanted to go to medical school she would not only have to forgo her 40k salary for 4 years, but she would also have to take loans with interest. So the cost your mom going to medical school could be upwards of $300k or more depending on the cost of school. Now, did your mom work 80 hours a week to make 40k? That's what residents do. Now after all that crap what would your mom expect to make? 43k? If you're okay with that salary then you should tell your employer when you become an attending, I'm sure you won't have any issues finding a job, although you seem grossly incompetent due your previous comment so we'll just have to hope you get to that stage.

http://studentaid.ed.gov/PORTALSWebApp/students/english/IBRCalc.jsp

For kicks, I inputted this information on the IBR calculator. If his mother went to medical school while single with 3 kids, she would only have to pay $80 per month on her student loans on a resident's salary of $40,000 even if her student loans totaled $300,000. All of that interest she is paying is probably tax deductible, so she would actually come out ahead. Of course, if she made more money, her monthly payment would increase but then she also has more disposable income.

Medical school debt doesn't sound so bad now does it?

 

[drctother]

1. That's cute. You repudiate my argument as anecdotal, with appeal to anecdotes of your own. I stand by what I wrote. When the Premier of on of your own provinces skips town for medical care, that says something. Also, relying on your experiences in hospitals as evidence of no waiting for medical care in Canada gives you a greater-than-healthy case of observation bias--the people waiting were at home, not hanging out in the lobby where you could see them.

2. Regarding pollution--I haven't been to Montreal or Edmonton so I can't speak to those, but Calgary has air pollution advisories (like you couldn't tell from the brown smudge hanging over downtown during an inversion), and Vancouver, while situated in gorgeous landscape, is just as dirty and squalid as other North American cities. Victoria pumps its sewage into the Strait of Juan de Fuca--but hey, Canadians' Scheiss doesn't stink, right? I guess you don't have as much pollution from oil refineries as we do, but that's because you are dependent on the US for petroleum products. If you refined more of your own gasoline (and hey--that would make more sense than sending it all down to Texas, before importing it back up), you'd have more pollution than you do. As it is, the US is subsidizing Canada's "virtual pollution freedom."

3. Canadians being healthier or not--walk into a Tim Horton's up there and you'll meet people cut out of the same (sized) cloth as the ones eating at Denny's here.

4. What, you're not going to try and argue that Canada has no enemies?

Look, Canada is a lovely country. I'm not hating on it, just pooh-poohing anyone who preaches its superiority over the US, when in fact the things Liberals down here like about Canada are qualities that wouldn't be possible without neighbors like un-Canadianly Americans. Furthermore, Canada's health care system does have some very present problems that are ignored down here, as other posters have noted.

You have one of the most flawed view I think I have ever seen in my life. Please stay in the US.

OP: Please take what this poster says with a grain of salt (remember he is not Canadian, his wife is aka he has virtually no experience growing up in Canada). Or at the very least, travel to Vancouver, Calgary, Montreal, Toronto yourself to see how wrong he is. Spend some time in each city, and see for yourself that our obesity is no where near the US. People are often not as sick in Canada (I dont know if this is related to health care, prevention, or life style..or all of the above). Could also be due to the little pollution our cities have in general.

Obesity comparison (for example): http://eaves.ca/2008/07/08/fatness-index-canada-vs-united-states/

If you want your kids to attend college for cheap, come to Canada. If you want to live in a very peaceful country, come to Canada. If you want your children exposed to little violence, same thing. (Look at the number of school shootings for each country for example).

As a physician, Canada would be less stressful because you dont have to worry about the politics of insurance (as you do with the US), so you can treat patients without worrying about money or if the patient can afford it. With that being said, the US has much better technology to utilize in hospitals. Canada still has up to date, adequate technology though. Will you make as much in Canada? Probably not. You will make a significant amount though to live very comfortably.

Coming from the US, you should have no problems practicing as we have a large shortage just like America (especially if you are doing primary care).

Also, keep in mind Canada does not have In N out, football is not a big part of our culture, and same with sports in general (except for hockey) 😛

 

[Miss Alyssa]

Sorry, was not aware. Was just trying to be helpful to what I thought was an earnest question.

No apologies necessary! (I realized I didn't say I was Canadian in any previous posts) And I'm sure it was helpful. 🙂

 

[FIREitUP]

What's your point about loan repayment? When the hypothetical mother becomes an attending she would not qualify. Furthermore, to my knowledge, IBR doesn't stop the interest from accruing.

Where is the math saying she will come out ahead? Even if money wise she came out ahead the fact that it's such an arduous journey has it's own price.

http://studentaid.ed.gov/PORTALSWebApp/students/english/IBRCalc.jsp

For kicks, I inputted this information on the IBR calculator. If his mother went to medical school while single with 3 kids, she would only have to pay $80 per month on her student loans on a resident's salary of $40,000 even if her student loans totaled $300,000. All of that interest she is paying is probably tax deductible, so she would actually come out ahead. Of course, if she made more money, her monthly payment would increase but then she also has more disposable income.

Medical school debt doesn't sound so bad now does it?

 

[bomgd3]

http://studentaid.ed.gov/PORTALSWebApp/students/english/IBRCalc.jsp

For kicks, I inputted this information on the IBR calculator. If his mother went to medical school while single with 3 kids, she would only have to pay $80 per month on her student loans on a resident's salary of $40,000 even if her student loans totaled $300,000. All of that interest she is paying is probably tax deductible, so she would actually come out ahead. Of course, if she made more money, her monthly payment would increase but then she also has more disposable income.

Medical school debt doesn't sound so bad now does it?

How can you come out ahead with $300k in debt and a low income? Ahead of who? Why are we even arguing about this silly hypothetical situation?

 

[FIREitUP]

How can you come out ahead with $300k in debt and a low income? Ahead of who? Why are we even arguing about this silly hypothetical situation?

lol i dun trolled. srry

 

[TAWS]

How can you come out ahead with $300k in debt and a low income? Ahead of who? Why are we even arguing about this silly hypothetical situation?

10 year loan forgiveness program for working at a non-profit or public hospital....do a long residency (~6 years) and make no payments while in residency. After you finish residency, you only have to make minimum payments for 4 more years.

So basically, $300,000 debt is forgiven by just paying about about $5,000 of it over 4 years.

It's not as silly as you think....that's why I'm doing. I just came out ahead of the guy whose parents paid for their medical school tuition.