Yale med vs UofT med for a future career in neurosurgery

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scoobydoo1027

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Hi guys, I am a Canadian permanent resident, and I was fortunate this cycle to get into two of my top medical schools.

The problem I am facing now is trying to figure out which school to go to especially since I am considering a career as a neurosurgeon. My interest in neurosurgery are not final but it's something I am strongly considering.

As far as school is concerned both are fine and very comparable schools with abundant opportunities for research, some of the best clinical training and they are both highly ranked, although, Yale is more prestigious.

The most important factor that is influencing my decision is the fact that both these schools lie on different side of the border.

Cons of going to UofT:

- In Canada there are far fewer spots for neurosurgery residencies. This year there were a total of 15 spots across the country and it is unpredictable whether they will increase or decrease by the time I graduate.

- It is very hard to get a job in Canada after graduating from a neurosurgery residency program.

Cons of going to Yale:

- Very Very expensive. I estimate that by the time I graduate I will have accused a total of 420,000 CAD (includes both principle and interest) in debt which is double that of going to UofT.

- The immigration process and the process of getting an H1B in the US intimidates me, especially when Trump is on the loose, making it harder for foreign citizens to get H1B visas. Who knows by the time I graduate I might not be able to get one and will be screwed.

- It is also hard for foreign USMDs to get a residency spot for programs that sponsor H1Bs. This scares me too especially since there is no comprehensive directory that would provide such information.

Any feedback, suggestions and opinions will be welcome. Thank you.

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Hi guys, I am a Canadian permanent resident, and I was fortunate this cycle to get into two of my top medical schools.

The problem I am facing now is trying to figure out which school to go to especially since I am considering a career as a neurosurgeon. My interest in neurosurgery are not final but it's something I am strongly considering.

As far as school is concerned both are fine and very comparable schools with abundant opportunities for research, some of the best clinical training and they are both highly ranked, although, Yale is more prestigious.

The most important factor that is influencing my decision is the fact that both these schools lie on different side of the border.

Cons of going to UofT:

- In Canada there are far fewer spots for neurosurgery residencies. This year there were a total of 15 spots across the country and it is unpredictable whether they will increase or decrease by the time I graduate.

- It is very hard to get a job in Canada after graduating from a neurosurgery residency program.

Cons of going to Yale:

- Very Very expensive. I estimate that by the time I graduate I will have accused a total of 420,000 CAD (includes both principle and interest) in debt which is double that of going to UofT.

- The immigration process and the process of getting an H1B in the US intimidates me, especially when Trump is on the loose, making it harder for foreign citizens to get H1B visas. Who knows by the time I graduate I might not be able to get one and will be screwed.

- It is also hard for foreign USMDs to get a residency spot for programs that sponsor H1Bs. This scares me too especially since there is no comprehensive directory that would provide such information.

Any feedback, suggestions and opinions will be welcome. Thank you.

First of all, congrats on getting into two great programs... I think with either route, it is obviously difficult to land an NS residency... with the Canada option, you're already sure that spots are minimal and that getting a job is hard, that's something that has been proven year after year. With the US option, I think the immigration stuff is speculative and your odds are better going to the US. If you're going to practice NS in the US, don't worry much about the debt, I have friends in the field who got starting offers over 500k in private practice... I don't think you should make your decision out of fear for what Donald does... I'm not the biggest fan of him, but I think his immigration policies are more targeted more towards Hispanics and the Middle East/North Africa... also when you graduate, he may not even be the president, more likely than not, he won't be and if we have a liberal, you're going to be golden in terms of immigration... I have a mentor who was in your position several years ago when Bush was president, he was from Vancouver and was deciding between a canada school and an NYC school, now he is a few years out of interventional cards fellowship and immigration was a non-issue for him
 
Hi guys, I am a Canadian permanent resident, and I was fortunate this cycle to get into two of my top medical schools.

The problem I am facing now is trying to figure out which school to go to especially since I am considering a career as a neurosurgeon. My interest in neurosurgery are not final but it's something I am strongly considering.

As far as school is concerned both are fine and very comparable schools with abundant opportunities for research, some of the best clinical training and they are both highly ranked, although, Yale is more prestigious.

The most important factor that is influencing my decision is the fact that both these schools lie on different side of the border.

Cons of going to UofT:

- In Canada there are far fewer spots for neurosurgery residencies. This year there were a total of 15 spots across the country and it is unpredictable whether they will increase or decrease by the time I graduate.

- It is very hard to get a job in Canada after graduating from a neurosurgery residency program.

Cons of going to Yale:

- Very Very expensive. I estimate that by the time I graduate I will have accused a total of 420,000 CAD (includes both principle and interest) in debt which is double that of going to UofT.

- The immigration process and the process of getting an H1B in the US intimidates me, especially when Trump is on the loose, making it harder for foreign citizens to get H1B visas. Who knows by the time I graduate I might not be able to get one and will be screwed.

- It is also hard for foreign USMDs to get a residency spot for programs that sponsor H1Bs. This scares me too especially since there is no comprehensive directory that would provide such information.

Any feedback, suggestions and opinions will be welcome. Thank you.

Congratulations!

Like you mentioned, neurosurgery programs in Canada are limited, and completing residency doesn't guarantee a job. After a few years of completing a neurosurgery residency and not working in that speciality, your skills will likely be considered obsolete.

Alternatively, you could take the USMLE, do some electives in the US, and apply to US residency programs. However, you should note that you are automatically withdrawn from the US match if you match into a Canadian program. If you sign up for both CaRMS and ERAS, hypothetically, you could end up in a situation where an American neurosurgery program ranks you, but you match into a Canadian FM program, and thus have to go with the latter.

A more significant hurdle to doing residency in the US as a Canadian (whether you go to UofT or Yale) is obtaining a visa. In order to obtain a J-1 visa needed to do residency in the US, you must receive a statement of need from the Canadian government. Because there is no government-recognized shortage of neurosurgeons, you will most likely be denied this document unless you matched into a primary care speciality and intend to return to Canada.

Hypothetically, if you complete a US neurosurgery program, you would either have to return to Canada and compete with Canadian-trained physicians for the already limited neurosurgery positions, or apply for a waiver, then an H1-B visa to work in the US. The waiver involves working in an underserved area for 3 years (i.e. a primary care position).

It is also possible to skip the J-1 and apply directly for an H1-B after medical school, but this requires you to take Step 1, 2, and 3 (which is usually taken after PGY-1) before applying, so you would likely need to take a year off after medical school. Additionally, only a small percentage of residency programs are willing to sponsor H1-B applicants, so you'd be limiting yourself to much fewer programs.

In short, obtaining a neurosurgery position in Canada is difficult/unlikely, but obtaining one in the US as a Canadian is near impossible. Since UofT will likely give you a better chance at matching in Canada, I think staying in Canada (and perhaps being open to other specialities) is a much safer option.
 
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Congratulations!

Like you mentioned, neurosurgery programs in Canada are limited, and completing residency doesn't guarantee a job. After a few years of completing a neurosurgery residency and not working in that speciality, your skills will likely be considered obsolete.

Alternatively, you could take the USMLE, do some electives in the US, and apply to US residency programs. However, you should note that you are automatically withdrawn from the US match if you match into a Canadian program. If you sign up for both CaRMS and ERAS, hypothetically, you could end up in a situation where an American neurosurgery program ranks you, but you match into a Canadian FM program, and thus have to go with the latter.

A more significant hurdle to doing residency in the US as a Canadian (whether you go to UofT or Yale) is obtaining a visa. In order to obtain a J-1 visa needed to do residency in the US, you must receive a statement of need from the Canadian government. Because there is no government-recognized shortage of neurosurgeons, you will most likely be denied this document unless you matched into a primary care speciality and intend to return to Canada.

Hypothetically, if you complete a US neurosurgery program, you would either have to return to Canada and compete with Canadian-trained physicians for the already limited neurosurgery positions, or apply for a waiver, then an H1-B visa to work in the US. The waiver involves working in an underserved area for 3 years (i.e. a primary care position).

It is also possible to skip the J-1 and apply directly for an H1-B after medical school, but this requires you to take Step 1, 2, and 3 (which is usually taken after PGY-1) before applying, so you would likely need to take a year off after medical school. Additionally, only a small percentage of residency programs are willing to sponsor H1-B applicants, so you'd be limiting yourself to much fewer programs.

In short, obtaining a neurosurgery position in Canada is difficult/unlikely, but obtaining one in the US as a Canadian is near impossible. Since UofT will likely give you a better chance at matching in Canada, I think staying in Canada (and perhaps being open to other specialities) is a much safer option.

Hi @Noorh,

I wasn't clear on this point. Lets say I go to Yale and do well on my boards and clinical, would they still not rank me during the match? Why do you think that is the case? Is it because US neurosurgery residency programs do not sponsor H1B visas or they prefer not having international students? I would appreciate if you could clarify this for me.
 
Hi @Noorh,

I wasn't clear on this point. Lets say I go to Yale and do well on my boards and clinical, would they still not rank me during the match? Why do you think that is the case? Is it because US neurosurgery residency programs do not sponsor H1B visas or they prefer not having international students? I would appreciate if you could clarify this for me.

I apologize for my lack of clarity. Because of the way the Canadian match works, if you apply to both the Canadian and US match and match into a Canadian program, you are automatically withdrawn from the US match (Canadian match results are released shortly before US ones). This has nothing to do with your immigration/citizenship status.
 
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Hi guys, I am a Canadian permanent resident, and I was fortunate this cycle to get into two of my top medical schools.

The problem I am facing now is trying to figure out which school to go to especially since I am considering a career as a neurosurgeon. My interest in neurosurgery are not final but it's something I am strongly considering.

As far as school is concerned both are fine and very comparable schools with abundant opportunities for research, some of the best clinical training and they are both highly ranked, although, Yale is more prestigious.

The most important factor that is influencing my decision is the fact that both these schools lie on different side of the border.

Cons of going to UofT:

- In Canada there are far fewer spots for neurosurgery residencies. This year there were a total of 15 spots across the country and it is unpredictable whether they will increase or decrease by the time I graduate.

- It is very hard to get a job in Canada after graduating from a neurosurgery residency program.

Cons of going to Yale:

- Very Very expensive. I estimate that by the time I graduate I will have accused a total of 420,000 CAD (includes both principle and interest) in debt which is double that of going to UofT.

- The immigration process and the process of getting an H1B in the US intimidates me, especially when Trump is on the loose, making it harder for foreign citizens to get H1B visas. Who knows by the time I graduate I might not be able to get one and will be screwed.

- It is also hard for foreign USMDs to get a residency spot for programs that sponsor H1Bs. This scares me too especially since there is no comprehensive directory that would provide such information.

Any feedback, suggestions and opinions will be welcome. Thank you.

Hey, hopefully this is still helpful: If you do residency in Canada, you will NEVER be able to obtain AANS board certification. It is what the current rules are and there's no indication that this will change. This doesn't mean you can't practice in the US, but it may make it more difficult to get a job. Also realize that US programs are not very likely to sponsor you for an H1-B for neurosurgery, and the Canadian government WILL NOT issue J-1 visas for neurosurgery. You will have a very difficult time getting into the US system for residency if you do med school in Canada. I've been told recently that even going to a US school and applying to the match without a greencard is severely detrimental.
 
Hi @Noorh,

I wasn't clear on this point. Lets say I go to Yale and do well on my boards and clinical, would they still not rank me during the match? Why do you think that is the case? Is it because US neurosurgery residency programs do not sponsor H1B visas or they prefer not having international students? I would appreciate if you could clarify this for me.

Unless you are an EXCEPTIONAL applicant, programs are unlikely to sponsor an H1-B for you for neurosurgery. It's very competitive in the US, and there are more applicants than there are spots. I understand your pain because I'm in a similar situation. However, I have the ability to self-sponsor a GC because of my previous PhD.
 
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