USMD path back to Canada

[deleted1019257]

I recently gained admission to a USMD school.

Can anyone talk to me about the process of matching back to CARMS and or doing residency there and coming back after?

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[Gos81238ia]

I recently gained admission to a USMD school.

Can anyone talk to me about the process of matching back to CARMS and or doing residency there and coming back after?

You can return to Canada either way fairly comfortably. As a USMD, you are considered equivalent to a Canadian student when it comes time to do CARMS, so you will be in the regular stream, not the IMG stream. The regular stream has a match rate of 90+% (though the 10% who don't match make a lot of noise about it). The MCCQE1 will be required for CARMS as of 2021, so you will have to write that in addition to your Steps for the US. You could write it alongside Step 2, the content would be very similar. CARMS applications open fall of 4th year, similar requirements to ERAS - personal statement, exam scores and letters of reference followed by interviews. I used similar personal statements for ERAS and CARMS and the same letters of reference.

You will probably also be writing your USMLEs and preparing to apply to the US match through ERAS. If you do match in the states, you will definitely be able to return to Canada one way or the other. Canada has no limits on visas anymore for people staying for residency in the states. In terms of getting home, main thing to know is that most programs are a year SHORTER in the US than in Canada (ie. IM 4 yrs US, 5 yrs Canada), meaning you need to do a fellowship to match the training years in Canada. In some cases you can just apply directly to Canada for fellowship. Family med is the opposite, 3 yrs US vs. 2 in Canada so no fellowship needed there. To get home, it depends on your province. Generally, you can use just your US qualifications and start on a restricted license in Canada, or you can write all of the Canadian exams (ie. MCCQE2 and the Canadian boards for your specialty) and be equivalent to a Canadian and get an independent license right off the bat.

 

[nauru]

Whoa, American MDs have to redo all the exams and boards in Canada to practice in Canada? I thought US and Canadian medical training were considered equivalent?

 

[shadowblade]

Whoa, American MDs have to redo all the exams and boards in Canada to practice in Canada? I thought US and Canadian medical training were considered equivalent?

Yes, to get an unrestricted license with no hassles you need to write MCCQE1, MCCQE2 and your Canadian Boards.

An exception would be practicing in British Columbia where you can skip the QE1 and QE2 and get a full license. Additionally, family medicine boards in the USA allow you to waive the Canadian Family Medicine boards

US training is considered equivalent, as you do not have to repeat residency, only exams. Additionally, if you are willing to work under supervision, most provinces in Canada will allow you to practice with just your US boards and US exams.

 

[nauru]

That's really interesting, and does not sound equivalent at all if they don't trust your certification without a bunch of exams first. Family medicine sounds more like what I would expect: all exams waived, go ahead and get a full license. In BC would Canadian boards still be necessary? Practicing with supervision, is that for a period of time, or forever if you don't want to take the Canadian boards?

 

[Allosteopath]

If one takes the MCCQE exams during their US medical school, do the scores/grades ever expire, or would I be covered for life?

 

[shadowblade]

That's really interesting, and does not sound equivalent at all if they don't trust your certification without a bunch of exams first. Family medicine sounds more like what I would expect: all exams waived, go ahead and get a full license. In BC would Canadian boards still be necessary? Practicing with supervision, is that for a period of time, or forever if you don't want to take the Canadian boards?

In BC, you do not need to take MCCQE1 or MCCQE2, USMLE will suffice. So a US trained family doc can practice in BC with zero examination requirements, just paperwork and fees.

QE1, QE2 and Royal College Board Examination are not necessary if your willing to work under supervision until you receive a full license. Practicing under supervision is for variable periods of time, depending on province. E.g. in Ontario its generally for 18 months, before they do a formal assessment allowing you to remove that.

In my opinion working for 18 months for less pay is generally not worth it, unless you are far into practice. Exams are easy enough to just pass (if still in residency and not too far removed from medical school), so just take them for the $10-15k they cost. Thats far less than the 100k+ you will lose by having to pay for a supervisor.

If one takes the MCCQE exams during their US medical school, do the scores/grades ever expire, or would I be covered for life?

Covered for life. No expiration date as present.

 

[deleted853480]

How do residency transfer over. I plan on going to a usmd because there are a higher ratio of omd residency positions in the states. It’s 4 years in the states and 5 in Canada.

 

[Stroke7]

In BC, you do not need to take MCCQE1 or MCCQE2, USMLE will suffice. So a US trained family doc can practice in BC with zero examination requirements, just paperwork and fees.

QE1, QE2 and Royal College Board Examination are not necessary if your willing to work under supervision until you receive a full license. Practicing under supervision is for variable periods of time, depending on province. E.g. in Ontario its generally for 18 months, before they do a formal assessment allowing you to remove that.

In my opinion working for 18 months for less pay is generally not worth it, unless you are far into practice. Exams are easy enough to just pass (if still in residency and not too far removed from medical school), so just take them for the $10-15k they cost. Thats far less than the 100k+ you will lose by having to pay for a supervisor.



I was speaking to a physician who went back to practice in ontario through pathway 4 and he said the hospital you are in pays for your supervisor and there is no difference in the pay of a person practicing independently vs restricted licence (supervision). Things may have been different for others however.

 

[Stroke7]

I was speaking to a physician who went back to practice in ontario through pathway 4 and he said the hospital you are in pays for your supervisor and there is no difference in the pay of a person practicing independently vs restricted licence (supervision). Things may have been different for others however.

 

[shadowblade]

I was speaking to a physician who went back to practice in ontario through pathway 4 and he said the hospital you are in pays for your supervisor and there is no difference in the pay of a person practicing independently vs restricted licence (supervision). Things may have been different for others however.

This is also common.

However, the number of hospitals willing to take on this burden are low. And the ones that are, tend to be more rural.

Meaning, you will greatly limit where you can practice medicine for that 18~ or so month period.

 

[meditate19]

regular stream has a match rate of 90+%

Not for Canadian US MD grads, please view the stats on CARMS. You'll see that it's about 50%.

 

[AnesthAnon]

Not for Canadian US MD grads, please view the stats on CARMS. You'll see that it's about 50%.

You have to take this with a grain of salt. As many Canadian US MDs apply to CaRMS but end up not ranking Canadian programs as they may prefer US residency programs after the interview trail. CaRMS match happens before NRMP so if you want to end up in the US for residency you have to not 'rank' Canadian residency programs ending up with this statistic.

If you are a Canadian US MD student, you can be successful at landing Canadian residency spots into fields such as anesthesia, radiology, orthopaedics, internal medicine, etc. You just have to ensure that you do Canadian electives.

 

[Gos81238ia]

You have to take this with a grain of salt. As many Canadian US MDs apply to CaRMS but end up not ranking Canadian programs as they may prefer US residency programs after the interview trail. CaRMS match happens before NRMP so if you want to end up in the US for residency you have to not 'rank' Canadian residency programs ending up with this statistic.

If you are a Canadian US MD student, you can be successful at landing Canadian residency spots into fields such as anesthesia, radiology, orthopaedics, internal medicine, etc. You just have to ensure that you do Canadian electives.

This exactly.

 

[yokiguz]

Sorry if this is a bump or side-question. What is the path of Canadian who is at US-MD school to stay and practice in the US. That is my eventual goal and I was wondering what the VISA process is like and how difficult it would be?

 

[Iris42]

1-Get married during residency or before-->green card
2-Do residency on H1b, find a job to sponsor you for green card
3-Do residency on J1, work 5 years in an underserved area, then apply for green card
None of these are guaranteed btw but doable!

 

[yokiguz]

1-Get married during residency or before-->green card
2-Do residency on H1b, find a job to sponsor you for green card
3-Do residency on J1, work 5 years in an underserved area, then apply for green card
None of these are guaranteed btw but doable!

Thanks for the reply. How hard is #2/#3?


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[Iris42]

Thanks for the reply. How hard is #2/#3?


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Green card job is easy to find as an internist or other primary care specialties, granted you match into a residency that sponsors H1b in the first place, not that easy for specialists. J1 jobs are limited, also mostly for primary care specialties.

 

[meditate19]

If you are a Canadian US MD student, you can be successful at landing Canadian residency spots into fields such as anesthesia, radiology, orthopaedics, internal medicine, etc. You just have to ensure that you do Canadian electives.
[/QUOTE]


Not quite, the process is just more competitive in Canada than it is in the US, with fewer spots. Not every Canadian US medical grad is going to match back in Canada, even after completing rotations here, but networking can definitely help in both countries. CMGs will get preference here, just like USMDs will always get preferences in the States. This is how it is globally.

 

[yokiguz]

Green card job is easy to find as an internist or other primary care specialties, granted you match into a residency that sponsors H1b in the first place, not that easy for specialists. J1 jobs are limited, also mostly for primary care specialties.

I see, so aim for primary care?

 

[Iris42]

I mean it's a big decision, and things might change by the time you finish residency. But generally speaking, you would have a higher chance as a primary care doc.

 

[yokiguz]

I mean it's a big decision, and things might change by the time you finish residency. But generally speaking, you would have a higher chance as a primary care doc.

Yeah it is a huge decisions... maybe I’ll aim for #1

No but honestly just makes me feel better than there is a path I can follow. Thanks!


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[AnesthAnon]

If you are a Canadian US MD student, you can be successful at landing Canadian residency spots into fields such as anesthesia, radiology, orthopaedics, internal medicine, etc. You just have to ensure that you do Canadian electives.

Not quite, the process is just more competitive in Canada than it is in the US, with fewer spots. Not every Canadian US medical grad is going to match back in Canada, even after completing rotations here, but networking can definitely help in both countries. CMGs will get preference here, just like USMDs will always get preferences in the States. This is how it is globally.
[/QUOTE]

The Canadian and US matches are quite different. In the US, USMLE scores, AOA status (and to a degree, your medical school reputation) help you land interviews. In Canada, an elective is almost an unofficial requirement to get a CARMS interview. If you are serious about matching in Canada, you will need to do 2-4 wk electives in your specialty. I did not say the process was easy, but a Canadian citizen attending a US MD school, has a legitimate chance at matching, given one performs well on Canadian electives and is able to secure LoRs. At least this was the case 7-8 years ago when I went through the process.

 

[meditate19]

The Canadian and US matches are quite different. In the US, USMLE scores, AOA status (and to a degree, your medical school reputation) help you land interviews. In Canada, an elective is almost an unofficial requirement to get a CARMS interview. If you are serious about matching in Canada, you will need to do 2-4 wk electives in your specialty. I did not say the process was easy, but a Canadian citizen attending a US MD school, has a legitimate chance at matching, given one performs well on Canadian electives and is able to secure LoRs. At least this was the case 7-8 years ago when I went through the process.
[/QUOTE]


I've worked in both systems so think this is true in cities like Toronto, Montreal, Vancouver where people are more exposed to US-trained physicians and IMGs. I have noticed a fair bit of ignorance in other parts of the country towards anything US related (schools, healthcare system, etc). Which definitely plays a role in the hiring process even with electives. I've had to defend the quality of US medical exams (yes exams, the USMLEs aren't a joke) and clinical training from HCPs who think everything is better in Canada, and make disparaging comments when I mention anything about the US. Or who try to discount US clinical studies during meetings.
IMO OP is better off completing a competitive residency in the US then returning to Canada- especially with the cost of US med schools and the current exchange rate (definitely this). Times have changed from when you went through the process, the exchange rate is brutal.

 

[jackandjones1993]

is it required to take MCCQE Part 1 and 2 for USMD to match back to Canada?

 

[JadedJiroveci]

Would doing a fellowship in Canada count towards the 2 year j1 requirement?

 

[shadowblade]

Would doing a fellowship in Canada count towards the 2 year j1 requirement?

Yes of course.

Any time spent in Canada after your residency on J1 would count towards the 2 year requirement.

 

[Virk007]

Any recommendations on study material for MCCQE1? Looking to write the exam to get an unrestricted license, currently licensed in the US.