Will I be at a disadvantage? (Canadian at US Med School)

[The One Who Knocks]

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Hi all,

I have a question that I was hoping you guys could help answer. I am a Canadian citizen who attended a University in Michigan for undergrad, and also got accepted to that same university's med school.

Even though I am a Canadian citizen, I am leaning towards wanting to work/practice in Michigan when I am done, and I am also interested in pursuing residencies that are considered competitive.

How much of a disadvantage will I be at when it comes time to match for residency in the US? Would I be better off trying to go back to Canada? Again, I would prefer to stay in Michigan (and even match for residency in Michigan if I can).

Thanks for any insight.

 

[bannie22]

Yes. Disadvantage.

But it will prolly be harder going back than staying.

 

[Señor Científico]

UMich is a top ten school. Ask the admissions office to speak with someone from the school's student affairs/career area to get their opinion. They'll know more about 'international' students success. I've got a lot of canadian classmates at cornell, they seem unconcerned.

 

[xClashx]

Similar situation as you (Canadian studying in Michigan, wanting to practice in USA after). The biggest issue for you will be visa. You need an H1b or J1 visa. If you get the H1b visa, you will be set, but only a few schools offer it and with new policy changes, it may be difficult. Getting the J1 is a lot easier, but it would require you to return to Canada or practice in USA in an undeserved area after residency. With J1 visa, it is very difficult for you to get the visa in competitive specialties even if you manage to get a residency.

J1 = Canada sponsors, so there is a cap on which specialties get it (more info: Statements of Need for Postgraduate Medical Training in the US: 2017 and 2018 - Health Human Resources, Health Canada)
H1b = Hospital sponsors, and my understanding is that there is a fee hospitals need to pay (hence not a lot of schools willing to do it).

I ended up getting very lucky as my uncle had sponsored my mom when I was very young, and through her, just a few months ago, I ended up getting my green card, and therefore should be on equal footing.

 

[LyMed]

I personally think you're fine. There are many other FMGs that are at a more disadvantaged starting point than you, and they end up fine. Congratulations on getting into a very good school.

 

[bannie22]

H1b is cheaper than J1 for hospital but more paperwork, so hospitals dont like it

 

[gyngyn]

Some programs will support neither visa.
Others support both. Predictably, some support one and not the other.

In coming from a US school, you will have an advantage over IMG's requiring a visa. The number of residencies will be fewer and the time devoted to identifying the programs that will support your preferred visa in your specialty of choice could be significant.

 

[738177]

Similar situation as you (Canadian studying in Michigan, wanting to practice in USA after). The biggest issue for you will be visa. You need an H1b or J1 visa. If you get the H1b visa, you will be set, but only a few schools offer it and with new policy changes, it may be difficult. Getting the J1 is a lot easier, but it would require you to return to Canada or practice in USA in an undeserved area after residency. With J1 visa, it is very difficult for you to get the visa in competitive specialties even if you manage to get a residency.

J1 = Canada sponsors, so there is a cap on which specialties get it (more info: Statements of Need for Postgraduate Medical Training in the US: 2017 and 2018 - Health Human Resources, Health Canada)
H1b = Hospital sponsors, and my understanding is that there is a fee hospitals need to pay (hence not a lot of schools willing to do it).

I ended up getting very lucky as my uncle had sponsored my mom when I was very young, and through her, just a few months ago, I ended up getting my green card, and therefore should be on equal footing.

I've heard that if you hold other citizenships (other than USA and Canada), the J1 cap might not be an issue because most countries don't implement this cap.
Although i have no idea how that works, whether or not you have to go back to that country for 2 years as well.

 

[The One Who Knocks]

UMich is a top ten school. Ask the admissions office to speak with someone from the school's student affairs/career area to get their opinion. They'll know more about 'international' students success. I've got a lot of canadian classmates at cornell, they seem unconcerned.

It's actually Wayne State, not UMich. I see where I may have made that confusing though.

Similar situation as you (Canadian studying in Michigan, wanting to practice in USA after). The biggest issue for you will be visa. You need an H1b or J1 visa. If you get the H1b visa, you will be set, but only a few schools offer it and with new policy changes, it may be difficult. Getting the J1 is a lot easier, but it would require you to return to Canada or practice in USA in an undeserved area after residency. With J1 visa, it is very difficult for you to get the visa in competitive specialties even if you manage to get a residency.

J1 = Canada sponsors, so there is a cap on which specialties get it (more info: Statements of Need for Postgraduate Medical Training in the US: 2017 and 2018 - Health Human Resources, Health Canada)
H1b = Hospital sponsors, and my understanding is that there is a fee hospitals need to pay (hence not a lot of schools willing to do it).

I ended up getting very lucky as my uncle had sponsored my mom when I was very young, and through her, just a few months ago, I ended up getting my green card, and therefore should be on equal footing.

Do you know where I could find an official list of US hospitals that sponsor with the H1B visa? I can't seem to find anything. Also, just for clarification, if a hospital sponsors with the H1B, does that mean ALL residency programs at the hospital are viable under the H1B, or will there be some programs that the hospital sponsors, and others the hospital doesn't? (I'm wondering if the aforementioned list will even be of use).

 

[The One Who Knocks]

Yes. Disadvantage.

But it will prolly be harder going back than staying.

Why do you think it would be harder to go back to Canada? I was told that if I choose to try to match back in Canada, that I would still be matching in the first round of CaRMS. Can anyone verify?

 

[738177]

Why do you think it would be harder to go back to Canada? I was told that if I choose to try to match back in Canada, that I would still be matching in the first round of CaRMS. Can anyone verify?

The match rate for US-MD's are ~50% every year.
Yes you'll be considered "domestic", but it's not as discrimination free as it appears to be.

 

[bannie22]

Damn. Big difference between UofM and Wayne State haha.
Chances are even slimmer not being from a top 10/40

 

[xClashx]

It's actually Wayne State, not UMich. I see where I may have made that confusing though.



Do you know where I could find an official list of US hospitals that sponsor with the H1B visa? I can't seem to find anything. Also, just for clarification, if a hospital sponsors with the H1B, does that mean ALL residency programs at the hospital are viable under the H1B, or will there be some programs that the hospital sponsors, and others the hospital doesn't? (I'm wondering if the aforementioned list will even be of use).

No lists exists that I know of. You will have to go through the residency's website and see if they sponsor H1b. From what I researched myself, if a hospital sponsors h1b for one program, they usually do it for all their programs (just a trend I had noticed). However, not all hospitals will sponsors H1b. Only a select few will (these tend to be ivy leagues, but I do recall a few here and there that did as well. Getting an H1b is VERY difficult from what I hear. Aim for a less competitive specialty or start looking for an american girlfriend 😉.

 

[snarkie]

Yes, if you match to CaRMS you will be kicked out the US match system, which happen 3 weeks after the Canadian counterpart. So only apply/rank Canadian programs if you are prepared to go.

 

[futuremdforme]

You'll still be in the first CARMS match so staying in the US does not put you at a disadvantage for Canada. I hadn't heard that you'll be kicked out of ERAS though.

If you have gotten into a Canadian school, I personally would do that because it is so much cheaper. But if you haven't gotten accepted in Canada, go to the US school. You'll match somewhere.

 

[bearded frog]

While Canadian USMDs are eligible for first round applications, they are disadvantaged due to a lack of networking (<20 medical schools in the country means that the program director might know your LOR writer, etc) and more bureaucracy for electives, of which you'll want to do as much as possible in Canada. However, you do have the advantage of theoretically matching to the US, and you'll have a better chance of matching to the US than if you were at a Canadian school.

 

[ConfusedChemist]

Why do you think it would be harder to go back to Canada? I was told that if I choose to try to match back in Canada, that I would still be matching in the first round of CaRMS. Can anyone verify?

Because most specialities in Canada are VERY small, and in things like surg sub-specs they often only interview people who did electives with them. So that puts you at a big disadvantage, unless you're looking at FM or something of the lieks

 

[GadRads]

I applied for residency as a US MD on a student visa.

You have to call and email programs to see which ones offer an H1 visa; this will require some work on your part. I noticed some hospitals offered H1 visas to US grads in specific specialties and not in others. For example, I recall BIDMC offered the H1 visa to US grads in IM, but not radiology. At NYU, it was a GME office policy to offer H1 visas to US grads in all specialties. Frieda listed Stanford as offering the H1 visa, however the hospital only offers J1. Policies change from year to year, so verify policies when it's time to apply.
Some programs also require you pass Step 3 before you get the H1. As such, F1 visa students tend to use the OPT option as PGY1's, and complete Step 3 early enough to facilitate early H1 application for the PGY2 year (see Pitt).

You can't moonlight on a J1. Also consider that, if applying for fellowship, some programs may ask you give up your H1 since they only sponsor J1's.

While the J1 is not a death sentence, the H1 visa is superior. In my prelim program, a lot of the J1 IMG residents got nice hospitalist job offers and are using the J1 waiver program.