Return of Service (ROS)

[canmed1234]

Can anyone offer more information on ROS positions for residencies in Canada?

I have heard that they are a requirement for many IMGs who match in the second round, but it depends on the province, as per CaRMS. Some CMG also will be held to ROS if they are matched to these second round spots.

What happens if you cannot comply with your ROS after you are done residency? I have heard that you may have to pay up to 400K for a 5 year residency. Is this true? Does anyone have any actual recent values?



What happens if you are already a few years into your ROS residency spot, and realize that it is not the right path for you (you hate the specialty, location, etc.) Are you able to transfer out if another program will take you?

Thank you!!!

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[JediBookworm]

Bump. I think this is an important question that needs answering.

 

[JPR22]

The return of service is different for each province. I've known a few IMGs who dealt with this. The reality is that no one pays the full amount, you can hire a lawyer and negotiate down a bit. If you do walk away from the ROS, they will come after you! The other increasingly common scenario is that the community doesnt need your services, and then you can practice where you want until they do.

 

[Giemsa]

Can anyone offer more information on ROS positions for residencies in Canada?

I have heard that they are a requirement for many IMGs who match in the second round, but it depends on the province, as per CaRMS. Some CMG also will be held to ROS if they are matched to these second round spots.

In the first round, in most provinces that have separate CMG and IMG streams, the IMG positions come with a ROS contract. Typically, the ROS is of equal length to the residency e.g. you did a five year residency, then you return service to a underserviced / in-need community for five years.

In the second round, it depends. In some provinces, CMGs who match to the IMG spots are held to the ROS contract; in some provinces not. Check carms.ca for all the gory details. It is laid out very well.

What happens if you cannot comply with your ROS after you are done residency? I have heard that you may have to pay up to 400K for a 5 year residency. Is this true? Does anyone have any actual recent values?

Short answer: yes. Now, if you are subject to true hardship (you're a surgeon who loses your hands in a tragic sport-fishing accident) it has been my experience that the Departments of Health in most provinces are accommodating. (In my Canadian med school class, there were a number of people who took up ROS contracts in return for bursary support during medical school). Note that "I don't feel like practicing in the Pas" is not a true hardship.

What happens if you are already a few years into your ROS residency spot, and realize that it is not the right path for you (you hate the specialty, location, etc.) Are you able to transfer out if another program will take you?

First problem is transferring. There is not a huge amount of room for movement in the Canadian residency system, but it is easier if you are transferring from a 5-year specialty residency into family med, rather than the other way around. Assuming that it can be accomplished, you can apply to the province for an alteration of your ROS. In my experience, the provinces tend to be reasonably accommodating. But, of course, there is no obligation upon them to change your contract. It is a theoretical risk that they would decline to do so, and you would be required to pay it monies spent if you still wanted to proceed (budget about $100K / year of residency training).

I've not encountered anyone who managed to pay anything less than the full amount owing. And it's a lot of money; most people won't have that sort of cash available by the end of residency. (I have heard rumors - rumors mind - that some provinces will allow you to pay it back more slowly, but that's NOT confirmed). In the event that you sign a ROS contract, you should really be planning to serve it out. It's unlikely that you will squeak out of it.

 

[jnuts]

The details of each province's return if service contract can be found through CaRMS. Look in R-1 then contrat information for each province.

www.carms.ca

 

[iSurgeon]

Hey guys, after ROS can you practice in any province, I mean if you do ROS in Ontario are you obliged to only practice in Ontario or can you go to BC or Alberta and practice there?

 

[Giemsa]

Hey guys, after ROS can you practice in any province, I mean if you do ROS in Ontario are you obliged to only practice in Ontario or can you go to BC or Alberta and practice there?

AFTER you have fulfilled your ROS contract requirements (e.g. practiced where they tell you to for as long as they tell you to) then you are completely and entirely free to go wherever you want*

* assuming that you have a full and unrestricted medical license (which you will have if you go through a Canadian residency training program and pass all the exams that you need to pass).

(Your ROS contract will "match" you to a particular province, health region or community - talk to the provincial department of health for further details - it differs from province to province. In general you must fulfill your ROS in the community assigned to you - you can't sign a ROS in Saskatchewan and return the service in AB. But after you fulfill your obligations to Saskatchewan, you are free to go wherever you like).

 

[iSurgeon]

AFTER you have fulfilled your ROS contract requirements (e.g. practiced where they tell you to for as long as they tell you to) then you are completely and entirely free to go wherever you want*

* assuming that you have a full and unrestricted medical license (which you will have if you go through a Canadian residency training program and pass all the exams that you need to pass).

(Your ROS contract will "match" you to a particular province, health region or community - talk to the provincial department of health for further details - it differs from province to province. In general you must fulfill your ROS in the community assigned to you - you can't sign a ROS in Saskatchewan and return the service in AB. But after you fulfill your obligations to Saskatchewan, you are free to go wherever you like).

Thanks Giemsa! that was really helpful 🙂