US general surgery resident (US MD) preparing to go back to Canada to practice

[meditmed]

Hi,

I am a Canadian citizen with a US MD and currently PGY2 at an ACGME accredited general surgery residency in the US. I would like to go back to Canada after my training and I need some help to figure out the steps for licensing (Exams, applications, timelines). I heard some conflicting information in terms of which exams I need to complete and it sounds like this may also differ between the provinces. I would like to go back to Ontario. I was hoping to find someone that has been through the process to share their experience or anyone with knowledge of the required steps. Thank you.

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[Psoralin]

I have just completed going through this process and will be starting a job in Canada this summer. You basically have two options

1. Do all the Canadian exams to make yourself the equivalent of a Canadian resident. That means the MCCQE1 and 2 (which gets you your LMCC), then the Canadian Royal College surgical board exam (assuming your training in the US is deemed equivalent to Canadian training and therefore makes you eligible for the exam). If you successfully complete all that, you're basically the same as any other Canadian resident and can apply for jobs without restrictions. This is time consuming and expensive, but doable since you're early in your residency. It also takes a lot of organization as exams like the MCCQE2 are only offered a few times a year. Also, you probably will have to have your US training verified to see if you would be eligible for the Canadian Royal College exam, and that is usually done at least a year before the exam.

2. Alternative pathway. You complete all your training in the US (including your surgical board exams) and only then apply for an Ontario medical license under the alternative pathway (Pathway 3). You will need to have supervision for one year, and you will only get a limited license after that year. Still a completely valid pathway that many doctors undergo, mostly those who are far removed from residency who cannot be bothered to repeat the MCC exams. You have to consider how soon after completing residency you would be able to write the US Boards, and then how long to get licensed in Ontario after. It might result in a significant delay before you're actually able to work in Canada.

That's really it. If I was in your shoes I would recommend option 1. It makes it significantly easier to apply for jobs in Canada vs option 2 which will limit you more to under-served areas where they are willing to go through the extra paperwork required of the alternative pathway etc. Feel free to message me if you have any specific questions.

 

[Iris42]

@Psoralin Thanks for the detailed response. Does your MCCQE score matter down the line if you're returning to Canada post-fellowship?

 

[meditmed]

Thank you

 

[Gos81238ia]

@Psoralin Thanks for the detailed response. Does your MCCQE score matter down the line if you're returning to Canada post-fellowship?

Scores definitely don't matter.

 

[Gos81238ia]

I have just completed going through this process and will be starting a job in Canada this summer. You basically have two options

1. Do all the Canadian exams to make yourself the equivalent of a Canadian resident. That means the MCCQE1 and 2 (which gets you your LMCC), then the Canadian Royal College surgical board exam (assuming your training in the US is deemed equivalent to Canadian training and therefore makes you eligible for the exam). If you successfully complete all that, you're basically the same as any other Canadian resident and can apply for jobs without restrictions. This is time consuming and expensive, but doable since you're early in your residency. It also takes a lot of organization as exams like the MCCQE2 are only offered a few times a year. Also, you probably will have to have your US training verified to see if you would be eligible for the Canadian Royal College exam, and that is usually done at least a year before the exam.

2. Alternative pathway. You complete all your training in the US (including your surgical board exams) and only then apply for an Ontario medical license under the alternative pathway (Pathway 3). You will need to have supervision for one year, and you will only get a limited license after that year. Still a completely valid pathway that many doctors undergo, mostly those who are far removed from residency who cannot be bothered to repeat the MCC exams. You have to consider how soon after completing residency you would be able to write the US Boards, and then how long to get licensed in Ontario after. It might result in a significant delay before you're actually able to work in Canada.

That's really it. If I was in your shoes I would recommend option 1. It makes it significantly easier to apply for jobs in Canada vs option 2 which will limit you more to under-served areas where they are willing to go through the extra paperwork required of the alternative pathway etc. Feel free to message me if you have any specific questions.

FM here, not surgery, but transitioned from US to Canada. Financially, #1 will let you make much more money off the bat as an attending, easily makes up for the costs of doing the exams. You will lose money doing #2 since you will need to be precepted. If you can at all stomach the extra exams, which you just need to pass, it will be worth your while. Also just anecdotally, when I was looking for jobs recruiters would be so relieved when I told them I had all my exams done and didn't need a preceptor. Makes the process much easier. Finally, if you do the alternative pathway there are usually in person assessments to be able to get an independent license and they can keep you on the restricted license really as long as they feel like based on your assessments.

 

[bearded frog]

@Psoralin Thanks for the detailed response. Does your MCCQE score matter down the line if you're returning to Canada post-fellowship?

Scores don't even matter for Canadians doing Canadian fellowships lol

 

[Neurogeneral]

Given that you are early in your residency I would strive for the first pathway (MCCQEs, Royal college boards, surgical foundations exam, etc.).

Especially in the case of your specialty (surgery), pursuing the first pathway will be prudent. This is not the same as getting an independent license somehow and then opening your clinic like in primary care. You will need to obtain operating privileges from hospitals and in most cases, the hospitals/institutions will require you to have not only have an independent license but also be royal college boarded.

Surgical jobs are also not readily available in Canada. So making connections and getting your foot in the door are going to be key, and the best way to do that is to do your fellowship in the Canada. Besides that, when you do fellowship, it will give you access to all the resources (i.e. study materials, released prior test questions, tutorials, know how) needed to prepare for the Royal College Board exams and surgical foundations exam, which are very different the US boards.

 

[MarryMeQueen]

Hello!

This sounds like a really knowledgeable page. I am rather early in the process (still need to get into MD schools), but will most likely have dual US-Canadian citizenship in a few years. Should I try to finish the USMLE and MCCQE's at the same time to apply for both Canadian and US residency? Or should I wait to get the US residency and then take the MCCQE's? How do I find out if my US residency is valid in Canada? I would like to eventually practice in Canada; I have family there.

Thank you so much for your time!

 

[jnuts]

Hello!

This sounds like a really knowledgeable page. I am rather early in the process (still need to get into MD schools), but will most likely have dual US-Canadian citizenship in a few years. Should I try to finish the USMLE and MCCQE's at the same time to apply for both Canadian and US residency? Or should I wait to get the US residency and then take the MCCQE's? How do I find out if my US residency is valid in Canada? I would like to eventually practice in Canada; I have family there.

Thank you so much for your time!

1) ideally train where you want to practice.

2) don't forget the principles of surgery exam (Royal college PGY-2 exam) if you're going for a full licence and not 3rd pathway.

 

[Frostmoon]

Agree with Gos81238ia. Do the exams and don't make the mistake I made by waiting till the end of the residency. I was set to write MCCQE2 earlier this year and it is getting deferred indefinitely...Start the process early.​

 

[Gos81238ia]

I have just completed going through this process and will be starting a job in Canada this summer. You basically have two options

1. Do all the Canadian exams to make yourself the equivalent of a Canadian resident. That means the MCCQE1 and 2 (which gets you your LMCC), then the Canadian Royal College surgical board exam (assuming your training in the US is deemed equivalent to Canadian training and therefore makes you eligible for the exam). If you successfully complete all that, you're basically the same as any other Canadian resident and can apply for jobs without restrictions. This is time consuming and expensive, but doable since you're early in your residency. It also takes a lot of organization as exams like the MCCQE2 are only offered a few times a year. Also, you probably will have to have your US training verified to see if you would be eligible for the Canadian Royal College exam, and that is usually done at least a year before the exam.

2. Alternative pathway. You complete all your training in the US (including your surgical board exams) and only then apply for an Ontario medical license under the alternative pathway (Pathway 3). You will need to have supervision for one year, and you will only get a limited license after that year. Still a completely valid pathway that many doctors undergo, mostly those who are far removed from residency who cannot be bothered to repeat the MCC exams. You have to consider how soon after completing residency you would be able to write the US Boards, and then how long to get licensed in Ontario after. It might result in a significant delay before you're actually able to work in Canada.

That's really it. If I was in your shoes I would recommend option 1. It makes it significantly easier to apply for jobs in Canada vs option 2 which will limit you more to under-served areas where they are willing to go through the extra paperwork required of the alternative pathway etc. Feel free to message me if you have any specific questions.

I agree - the Canadian exams can be taken in parallel to US ones. Study once, Do Step 3 and QE1 back to back. Then do QE2. Then study once and take the boards for both countries back to back. It’s all the same material, just different delivery formats. Then no headaches over supervision, you just apply and get a license.