Canadian citizens:Timeline for residency

[gesuchtish]

I think this thread probably should be a sticky

It's for Canadian citizens studying in US medical schools.

 

1.What's the timeline for getting a US residency?

a.the J1 visa route

b.the H1-b route

 

2.What's the timeline for getting a Canadian residency?

 

Does anyone want to share an optimal timing like when to take USMLE step 1,2,3 and MCCQE 1 2? Since you can't take USMLE step3 until you graduate from med school(which is in May) . I guess that's a problem.

[sonyvaio2700]

I think this thread probably should be a sticky

It's for Canadian citizens studying in US medical schools.

 

1.What's the timeline for getting a US residency?

a.the J1 visa route

b.the H1-b route

 

Well you want a H1-B visa. You dont have to worry about it for 4 years. but when you interview at residency placements, you ask the PD if the hospital will sponsor you a H1B visa. The answer can vary. but what I garner for reading threads on SDN is that apply everywhere. Lots of places on their websites "state" that they refuse to give you an H1B visa simply because they think you are a FMG. but technically you are not a FMG since you graduated from an American school. Thus they make you an exception.

 

I think because only 200 or so people will be in our situation. Since about 200 international students graduate from American MD universities each year. Compare that to 20K+ applying to residency programs. I know this has discuss significantly on the board, but, I think finding residency placement (with H1B visas) for even competitive programs should not be as difficult as it is made out to be. That said, you will need to get strong clinical grades and high board scores than your US competition...just so you are safe. Remember the paper work to get you an H1B visa is lots! The program really has to like you to do this for you.

 

BTW forget about J1, you need a H1B visa! This is because 1) Canada doesnt give J1visa's easily. 2) They are pretty much useless. Since you have to come back to Canada to practice for 2 years (mandatory). 3) lots of American residencies are not recognize by the Canadian hospitals. Thus you technically waste 2 years of your life.

 

 

2.What's the timeline for getting a Canadian residency?

 

Does anyone want to share an optimal timing like when to take USMLE step 1,2,3 and MCCQE 1 2? Since you can't take USMLE step3 until you graduate from med school(which is in May) . I guess that's a problem.

 

I am not sure if you have to take the MCCQE. Better ask someone else. But I was in the assumption that you are NOT...

 

As for the USMLEs...every school has set up time for you to take USMLE step 1. Most schools it during the summer of 2nd year after you finished all your preclinical work. But this can vary with school, for example at UVM you take USMLE step 1 in Feb (our preclinical stuff is accelerated).

 

USMLE step 2 is written really just before you graduate (feb-march). Lots of people write step 2 early only if their step 1 scores are below par (july, aug of graduating year). BUt all schools require you to finish step 2 by the time you graduate. Also some residencies taking the step 2 is mandatory.

 

As for USMLE step 3. Most people take that in PGY1 year. In fact, as a Canadian...you have to take USMLE step 3 to get a H1B visa.

 

If you are Canadian student applying from the Carribeans, its mandatory for you to write Step 1, 2, AND the more expensive step 3 before you even apply for American residencies. This is again because you need step 3 to get a H1B visa. But from the SDN forums, I have read situations where international students graduating from American MD schools are exceptions. I am not sure about how this works, but you can match into a program, but you getting a H1B visa will be contingent on the passing of Step 3 during your PGY1 year. So YOU dont have to take STEP 3 before you match!!

[Jochi1543]

BTW forget about J1, you need a H1B visa! This is because 1) Canada doesnt give J1visa's easily. 2) They are pretty much useless. Since you have to come back to Canada to practice for 2 years (mandatory).

The mandatory 2 years requirement is waived if you commit to practicing in an underserved area (3 years, I believe).

[gesuchtish]

Thanks a lot sony and jochi .By the way sony, I tried to PM you but the system says your mail box is full.

[Jochi1543]

Thanks a lot sony and jochi .By the way sony, I tried to PM you but the system says your mail box is full.

I apologize, he's in love with me, so he's been cataloguing my PMs.

[sonyvaio2700]

Thanks a lot sony and jochi .By the way sony, I tried to PM you but the system says your mail box is full.

 

ok fire away. didnt realise my box was full. and jochi stop pming me spam...

[The Law]

Umm could someone please explain this visa stuff to someone who doesn't know much about it? H1b, J1 what're all these visas

[The Law]

ok fire away. didnt realise my box was full. and jochi stop pming me spam...

 

She has to express her undying affection for you someway. loll

[Jochi1543]

Umm could someone please explain this visa stuff to someone who doesn't know much about it? H1b, J1 what're all these visas

H1B - work visa, generally requires you to graduate from a US medical school to be eligible. Not sure if it's always like that, but the few US med school sites I visited all stated that requirement. H1B also allows you to moonlight after your residency shifts, which can significantly impact your income. The hospital must sponsor you for the H1B visa.

 

J-1 - you need to be sponsored by the Canadian government. This visa puts a damper on your plans to stay in the US as it requires you to leave for 2 years after finishing your residency. The only way to get around it is to commit to practicing in an underserved area (very rural/inner city), then the requirement is waived. This visa also doesn't allow you to take on extra work outside your residency. However, it's easier to get since the main thing you have to prove to the US Embassy is that you plan on returning to Canada after your education; and with J-1 requiring it, it's a done deal.

[Ian Wong]

Here's the way the timeline generally breaks down:

 

USMLE Step 1: Written in the summer after the end of Med 2.

USMLE Step 2: Written at the end of Med 3, or sometime in Med 4 (usually in the Spring after interviews).

USMLE Step 3: Typically written at the end of PGY-1. Many states require you to have completed 6 months or a full year of internship/residency as a prerequisite, although if you register for this exam through certain states (ie. California, Connecticut), you may take it immediately after med school graduation before having started your PGY-1 year, even if your PGY-1 year is in a different state. http://www.fsmb.org/usmle_requirementschart.html?

 

MCCEE: Exam taken by graduates of non-LCME accredited med schools. If you are attending an LCME accredited school (ie. a US allopathic MD school), you don't need to take this exam. DO (osteopathic) graduates do need to take this exam before being eligible for the MCCQE Parts 1 and 2.

 

MCCQE Part 1: Written by Canadian med students at the end of Med 4. US med students are eligible to write this exam. This would be the best time to do it as a US med student. MCCQE Application and Eligibility for US med students

 

MCCQE Part 2: Written in the fall of your PGY-2 year. US med graduates now doing a Canadian or US residency are eligible to write this exam. This would be the best time to do it as well.

 

H1B visa: Best visa to be on as a Canadian for a US residency. Unfortunately, many US residency programs don't offer it, as it is significantly more paperwork than a J1 visa.

 

The requirements for an H1B visa include having graduated medical school, and successful passage of USMLE Steps 1, 2 and 3.

 

If you are a US medical school graduate, you can do your PGY-1 year on something called an OPT, which is an extension of the F-1 visa that you used to attend the US medical school. OPT stands for Optional Practical Training, which gives you an entire year to get the USMLE Step 3 completed, as well as apply for, and receive your H1B visa. The H1B visa would then go into effect at the start of your PGY-2 year.

 

This OPT year is key, because otherwise, you would need to graduate med school in May, send in USMLE Step 3 application (requires med school graduation as a prerequisite), take and pass USMLE Step 3 and receive said results, and apply for and receive your H1B visa, all before July 1 in order to start a US internship/residency on time (pretty much impossible).

 

If you can use the OPT year, then the H1B visa becomes a much more viable strategy. The strategy here is to contact each institution prior to applying there for residency, and see if they offer H1B visas. If not, don't apply there. Note that as the competitiveness of a specialty or its location increases, the likelihood of them offering the H1B visa decreases, since they'll fill their spots regardless of whether you interview there or not. Conversely, if you are applying for something like Internal Medicine, Family Medicine, Pediatrics, Psychiatry, etc, all of whom are relatively less competitive and often fill their vacant spots with international medical graduates, you are much more likely to ask for, and receive H1B sponsorship. Intermediate difficulty specialties will be somewhere in the middle in their stance on offering H1B visas.

 

The H1B visa allows you to be employed in the US, allows you to moonlight during residency, and also is on the pathway to obtaining a green card, which lets you live and work permanently in the US.

 

J-1 visa: The second option for a Canadian training in a US residency. This visa is a student visa, which means you can't moonlight on it. Additionally, once you finish your training, there is a home residency requirement, which means you need to return to Canada for 2 years before you can reenter the US on a different visa (such as an H1B visa).

 

Ways to get around that include working in a federally or state designated underserved area for 3 years, or working in a government institution (such as the VA hospital) for 3 years. Once you are signed up to a J-1 visa, you cannot convert over to an H1B visa without either fulfilling the home residency requirement, or obtaining a waiver through one of the above two mechanisms. Even marrying a US citizen at that point won't get you past the requirement.

 

Of course, if you married that US citizen and got your green card before starting internship/residency, then you'd be set and wouldn't need a visa at all...

 

Alternately, if you choose a US residency that is recognized as equivalent in Canada, you can take the Canadian Royal College exams, and if you pass them, come back to work in Canada or do a fellowship while simultaneously fulfilling the 2 year home residency requirement. After fulfilling that requirement, if you can find a hospital or private practice group willing to sponsor you for an H1B, then you can reenter the US to work. Otherwise, you can always stay in Canada to practice. It's not like you are sent to Siberia to serve out your 2 years!

 

The major advantage of the J-1 visa is that the paperwork requirements are much less, and many more residency programs offer the J-1 versus the H1B visa.

 

The J-1 visa requires Health Canada to issue a Statement of Need. You also need to make use of a US organization called the ECFMG, who will act as your J-1 visa sponsor. The ECFMG paperwork is relatively easy. The Statement of Need can be hit or miss, depending on the specialty you want, and the province from which you are applying.

 

The Health Canada administrator for issuing the Statement of Need is Judith Lewis, at: 613-952-1912. That information is also mirrored on the CaRMS website at: http://www.carms.ca/eng/ERAS_intro_e.shtml

 

It would be worth it to make a call to her relatively early on as you plan out your specialty choices to see if Health Canada will support you. If so, the J-1 visa may well be the difference between matching to a competitive specialty/location that doesn't offer H1B visas, or having to settle for a less competitive specialty/location that does offer H1B visas.

 

The J-1 visa is really not as bad as everyone makes it out to be, as long as Health Canada is willing to write that Statement of Need. Being willing to do a US residency on it could mean the difference between getting the spot or not.

 

Ian

[grapz]

what does the term moonlight mean

[KennethToronto]

what does the term moonlight mean

 

From what I gather, it's like filling in for someone else / working extra hours.

 

Would any current Canadian citizens (w/o US citizenship/PR) care to fill in on how they are dealing with residency issues? Problems matching to US spots?

[mdby2012]

does this simply mean that if i want a competitive specialty i'll have to go the J1 route, but the H1B is the better all around visa because I can get a green card faster and moonlight??

 

If i got this right, to both do a competitive specialty and after completing it, live and work in the states, the best way to accomplish this is to get the J1, get a J1 waiver for 3 years in an underserved/VA hospital, and then apply for an H1B. Is this the easiest way to accomplish this?

[Alastriss]

does this simply mean that if i want a competitive specialty i'll have to go the J1 route, but the H1B is the better all around visa because I can get a green card faster and moonlight??

 

If i got this right, to both do a competitive specialty and after completing it, live and work in the states, the best way to accomplish this is to get the J1, get a J1 waiver for 3 years in an underserved/VA hospital, and then apply for an H1B. Is this the easiest way to accomplish this?

 

In response to this..can you not do a chief resident year with the J-1 visa to get ur residency year numbers = to canada's standards and then go back for 2 years? Im sure this wouldve been thought of before, so I figure it comes down to either:

a) you can't do a cheif resident year on a J-1

doing cheif residency isn't a good enough compensation

[hippie]

In response to this..can you not do a chief resident year with the J-1 visa to get ur residency year numbers = to canada's standards and then go back for 2 years? Im sure this wouldve been thought of before, so I figure it comes down to either:

a) you can't do a cheif resident year on a J-1

doing cheif residency isn't a good enough compensation

 

You definitely can do Chief residency on a j-1 and this year can be added to the total number of year needed to have a training equivalent to the Canadian one.

As a US graduate you will find many competitive programs willing to sponsor you for a H1B.

And also even that you are not allowed to moonlight on a J-1 in principle, many people get away with it as hospitals tnd not to be so peculiar about it.

[Alastriss]

If you can do chief residency years to then get the right number of residencies..why is a J-1 soo bad? I'm definitely missing something here but Im not sure what

[hippie]

.........................

[Alastriss]

oooooooooh that isss bad. Ok so its not so much the "2 year return to canada" as much as it is what you just mentioned?

 

Just to get this straight - you do a few additional chief residency years/fellowships and u are on par with canada's residency years. After that you need to be Canadian board certified right? Anything else you need to do before you can start practicing in canada?

[hippie]

oooooooooh that isss bad. Ok so its not so much the "2 year return to canada" as much as it is what you just mentioned?

 

Just to get this straight - you do a few additional chief residency years/fellowships and u are on par with canada's residency years. After that you need to be Canadian board certified right? Anything else you need to do before you can start practicing in canada?

 

That's true.

It depends on the province, in ontario I know they needed clerkships in Canada, Don't know how many though and I don't know if there is a way around it (I think there is)

In quebec you will need to pass a french test. Another thing you can do is to become board certified in Maine which has reciprocity with new brunswick...

[clive]

...............

[Alastriss]

That's true.

It depends on the province, in ontario I know they needed clerkships in Canada, Don't know how many though and I don't know if there is a way around it (I think there is)

In quebec you will need to pass a french test. Another thing you can do is to become board certified in Maine which has reciprocity with new brunswick...

 

What do you mean by clerkships?

[chino]

Hey hippie,

 

Could you elaborate more on the part about ontario requiring a certain number of clerkships. I posted elsewhere about the ability to do electives in canada if you go to wayne state, would this be related to taht, and if so is there any way of knowing howmany clerkships are required.

 

thanks

[hippie]

Clerkships are your 3rd and 4th year clinicals.

 

According to CPSO, if you want to practice in Ontario after you have done your medical school and residency abroad you should have:

 

1-Passed MCCQ1 and 2 and all the equivalent exams

2-have had one year of clerkships (could be electives ) in Ontario

 

This rule will only apply to you if you did both your residency and medical school abroad. you are exempt of the 2nd requirement if you do medical school in the states but do your residency in canada.

 

http://www.cpso.on.ca/Info_physicians/applicants/pdfs/reg5.pdf page2

 

However, due to the current shortage of doctors ontario is experiencing, there are exemptions.

 

http://www.cpso.on.ca/Info_physicians/regpol/acgmecred.htm

[Alastriss]

Oh ok that's what I thought, I just didnt see how you could do anything in ontario other than electives for clerkship so assumed they were different Considering you have have to do them anyways to be competitive for the match that doesn't sound too bad.

 

We wouldnt have to do the MCCEE if we have USMLE step 3 right?

[hippie]

MCEE is only for IMGs you dont need to write it as a US graduate