Again, I'm just finishing 1st year but I'm not fresh out of undergrad and considered my situation carefully before accepting. I had friends in upper years tell be the good, bad and ugly before I came, and I still am fine taking this risk. Sure, there are days (and I'm sure there will be many more) where I freak out over debt. But if I had gone to the US, the debt would have been the same. Prospects may have been better, but debt = similar. I have a marketable undergrad though (professional degree) and combining it with any respected medical degree puts me in a place where I can get a job after school even if I don't match once I graduate. That helped make my decision.
Any school will have its ups and downs. And (this seems to be the trend with many people, across countries), the further you get into school, the more stressful it can get. A bit more so as a CSA as we do have to write, what, 6-8 more exams than an Irish student?
If you went to Australia, you would also have issues with timing lining up for electives and the exams too. That was one of the reasons I didn't go there (though I have friends that went and matched). So the new proposed schedule and the climate of Canadian schools towards IMGs is a bit disconcerting. But I also heard there are provinces that are opening up to CSAs within the next couple of years. I haven't had time to look into it, but that's what I've heard. BC is also pretty notorious for wanting to keep their own anyway, so I'm not really surprised at this move of closing their doors.
As for positives .... I really like PBL. I like the style of learning and it keeps you engaged. The tutors are great (at least all of mine have been, there are 1-2 that are alright, but you're going to have profs like that anyway wherever). I finally love what I'm doing which is important if you're going to be taking a risk and giving up the next decade of your life. I am also a self-starter and I do well with picking and choosing the information I need, so self-learning programs work for me (I am useless at sitting through hours upon hours of lectures). The clinical skills tutors are good. Again, some better than others. But I've been to the hospital a couple times since being here and the exams and questions we've learned seem to be what we're taught, so I take that as a good sign (back in Canada too). I'm also able to converse intelligently with friends back at med schools in Canada, so the learning isn't a hack. You're still being taught / you're learning medicine. It's just more primary care / clinically based vs basic sciences.
That said, they have made a big push this year with my year to focus more on pharmacology, microbiology and molecular medicine, because that is typically where UL students were the weakest on in rotations and on USMLE testing. So there is ongoing adaptation, and not all of it is negative.
I am still undecided on the USMLE course for my 2nd year. The appealing thing to me is that you get the Qbank free with it, and it's a fraction of the price back home (or that's what I've been told by 2nd years). I plan to do my own studying and review but I might use that as a structure. I still have time to decide. I know other upper years have said you don't need it, and I'm usually of the opinion to trust those who have gone before me ... but I still have to decide for myself. But I will be doing my own stuff on the side extensively. ... I wouldn't start studying now though. What I have been doing, as well as many classmates, is use the USMLE First Aid and Toronto Notes (for the Canadian boards) as guides and basis for our LOs week to week in first year. That way we know what we need to know later, and tailors our work better.
I am doing some observerships over the summer, and I've told the docs / surgeons that I will be looking for an elective later. I have pulled lots of family and friend connections to get them, and I'm grateful. The physicians all understand and even those at hospitals who don't accept IMGs / CSAs have found a way to bypass it for me. I'm shameless with networking when it comes to my future and success - you have to be when it's that competitive. I'm also working part time with a surgeon and biomechanical engineer on a research direction. I've never done research but this is my way of bridging the gap between my engineering background and medicine. I'm hoping it'll set me up for the SSM later because I wouldn't know where to start otherwise. I debated just enjoying my summer and traveling and spending time at my cottage, but I figured I would try to help myself out a bit on the uphill battle. And still enjoy summer and my cottage (travel I've done through the year and on breaks and I'll be doing a bit right after exams).
Ultimately, you have to decide for you whether it's worth it. It's overwhelming, definitely. You're going to hear lots of negative things, along with some positives. You just have to assess risk / benefit for yourself. I would rather have done 3 years in Ireland than 3 years applying to Canada as I'm already past mid-20s and I knew what I wanted. But I have my fallback of engineering / medicine career (with a work history).
I'm not naive enough to think it'll be "if I want it badly enough, I'll get it" but I'm also open to other routes than just Canada matching. And I decided I don't want a super competitive specialty (dream is ortho, but the climate sucks even for Canadian grads and I do want a life before I'm 50 at this point).
It's scary but I don't have regrets (yet lol) but I think I did a decent job of risk assessment when I chose to come here. You just have to do the same.
On a side note, before I came to Limerick / after quitting my job, I spent my whole summer at my cottage, or in wine country, or seeing friends and family, and took a dream trip where I camped through a couple countries in Africa. I definitely did nothing scholastically and I would encourage you to do the same!
