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Hey guys, it's been a while since I have posted on these threads. The purpose of this post is to help any of you interested in staying in the US and clear up any confusion that may exist, especially for those considering the jump across the border. Mods can sticky if the interest for accurate information is as high as I believe it may be.

 

Briefly about me: Recently matched M4 in IM. Interviewed nationwide at almost every top program (and matched at one of them/my #1 this past March): Stanford, Johns Hopkins (Osler), Penn, Yale, Duke, Michigan, Cornell, UW, Mayo, Vanderbilt, Northwestern etc. Canadian citizen only (not dual/US), asked for and received the go-ahead on the H1B visa at almost all of these during the interview trail. Graduated from U of T (St. George Campus) with a 3.87, 33R MCAT, interviewed and WL at U of T and Dalhousie back in the day (missed out on a bunch of interviews due to 9 verbal) and chose to jump ship instead of waiting, for one of my (non-top tier) American offers.

 

My residency app in a nutshell: Multiple publications, leadership positions, Steps 250+ x2, AOA.

 

Facts to know and remember:

 

1) You are on equal footing with your US counterparts when applying for residency here. You are an American Medical Graduate, end of story.

 

2) You have 2 options: J1 visa will require you to go back home to Canada for 2 years or work in an underserved area in the US for 3 years. Not worth it. Work your butt off to be in the position to dictate what is offered to you. The H1b visa will allow for pathway towards citizenship. If you are a Canadian citizen at a US medical school you will be on an F-1 student visa. By February of M4 you apply for the OPT extension through your university which will give you one more year to work and do your internship while you write Step 3 and your residency programs applies for the H1b for you.

 

3) You can apply both CaRMs and NRMP. Traditionally the Canadian match runs first and if you match in Canada you are withdrawn from the US match. This is not the focus of this thread but deserves a mention.

 

4) The only addendum on #1 is that you need the H1b visa. As long as you are a superb applicant, you are in the driver seat. I was told I was certain to match at several of the above institutions who were ready to do the paperwork for me for the H1b.

 

Bottom line: Please shoot any questions you may have my way. I will try my best to answer them. Staying in Canada is not your only option if you want to have a successful career. You can make your dreams come true anywhere, it is on you. No US MD school will hold you back.

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Congrats, wishing you the best! If only medicine wasn't so stupidly expensive for us (e.g 70ish+ k with living) per year, US med schools would be an option. Even with LOC... :(

 

Hey IMislove. I did not personally have to do this fortunately, but I know several Canadians who took 2 LOCs to cover the costs. It is doable, it is a matter of negotiation with the banks. I am not privy to more detailed information on this but know it has been done.

 

Wishing you the best as well, hopefully third times the charm indeed, more than deserved!

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Thanks ubc2012! Best of luck to you as you begin your journey this year :).

Thanks..hopefully I don't have to begin the journey in the US and am able to stay in Canada - but still thrilled at having the option to go to the US (even if paying for it is proving a bit more difficult then I thought -thankfully I have saved income through working as a non-tradish, and parents willing to provide the difference of COA and loans.)

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Congrats, wishing you the best! If only medicine wasn't so stupidly expensive for us (e.g 70ish+ k with living) per year, US med schools would be an option. Even with LOC... :(

Definitely true, my US school of choice has tuition at 45k USD, and then adding a below average cost of living totals a generous 270-280K USD total COA. With the conversion at its current rate, thats about 340-350K CAD. A short fall of 30-40K CAD after 275K LOC and ~40K Provincial loans

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Thanks..hopefully I don't have to begin the journey in the US and am able to stay in Canada - but still thrilled at having the option to go to the US (even if paying for it is proving a bit more difficult then I thought -thankfully I have saved income through working as a non-tradish, and parents willing to provide the difference of COA and loans.)

 

Completely agree. Rooting for you to stay home as well. The journey I was referring to was medical school itself. Glad you have the financial situation mostly figured out just in case.

 

 

Congratz GGGSaint! Amazing stuff! 

 

Thanks medic101.

 

Didn't anticipate the nice outpour of support! Additionally, any Canadians who have matriculated and are early on in your med school trajectory, feel free to PM me if you have any questions.

 

I feel like this board has waned in those who have gone through the process of staying in the US and hopefully we can rejuvenate it some.

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For those in the future who may stumble across this, I will do my best to check this forum once every few months so feel free to PM me even a year or two down the road here. I hadn't posted since June 2011 until now and came back to be able to help any of the (admittedly few) who end up in the US and want to stay here.

 

Best of luck to all of you in your future endeavors and in your medical careers!

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  • 3 weeks later...

6 posters on these threads reaching out via private PM over these past 2 weeks, looks like I can fill a niche on these boards for accurate information regarding the US medical school route and pursuing residency in the US.

 

Bumping up this thread now to try and maximize exposure for anyone else who may have not stumbled on this thread yet. Hope to continue to be of help and look forward to further PMs.

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Hello GGGSaint,

 

Congrats on your success!!!

 

I have been accepted to an Australian medical school, and will most likely start in January. I know this thread is geared towards Canadians studying medicine in the US. However, could you comment on the difficulties for a Canadian citizen with an Australian medical degree in terms of obtaining a us residency in primary care i.e family or internal medicine, with competitive step scores. 

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Hello GGGSaint,

 

Congrats on your success!!!

 

I have been accepted to an Australian medical school, and will most likely start in January. I know this thread is geared towards Canadians studying medicine in the US. However, could you comment on the difficulties for a Canadian citizen with an Australian medical degree in terms of obtaining a us residency in primary care i.e family or internal medicine, with competitive step scores. 

As difficult as any other IMG. If there is any chance you can get into a US school, i would apply to them this upcoming cycle. 

 

With above average step scores, matching primary care somewhere is probably still do-able, but you aren't going to get a lot of flexibility in dictating where you want etc. But anyone can think they will have strong step scores, actually getting them is a different story haha.

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Well in terms of being accepted to US MD/DO schools, I would need to take an additional year to complete the inorganic chem pre-req, and will have to rewrite my MCAT. I would not have any support  to peruse this path, and the tuition fees would also be considerably higher as some schools charge up to 75k USD. Australia offers a great opportunity. I would apply to match in Australia, Canada and the US. I am indifferent where i work or the specialty( as of now at least).In terms of applying to Canada i know it's very difficult, I will need to write 3 exams as well as have electives in Canada, and recommendations from Canadian physicians(and still nothing would really be guaranteed). I would just like some information in term of the US match for  international students. Would it be as difficult as Canada? Is it essential to do electives in the US and have recommendations from US physicians? Do they have preference for recent graduates? Is the country or school you graduated from considered? Is the only examination you need the step 1? With the increase in MD/DO schools, will it be significantly more challenging to find a residency  or are the residency positions  keeping up with the grad increase? 

 

P.S I have done some research on this and read previous threads I wouldi just like a more updated perspective from someone who seems fairly familiar with the process.

 

Cheers, 

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Well in terms of being accepted to US MD/DO schools, I would need to take an additional year to complete the inorganic chem pre-req, and will have to rewrite my MCAT. I would not have any support  to peruse this path, and the tuition fees would also be considerably higher as some schools charge up to 75k USD. Australia offers a great opportunity. I would apply to match in Australia, Canada and the US. I am indifferent where i work or the specialty( as of now at least).In terms of applying to Canada i know it's very difficult, I will need to write 3 exams as well as have electives in Canada, and recommendations from Canadian physicians(and still nothing would really be guaranteed). I would just like some information in term of the US match for  international students. Would it be as difficult as Canada? Is it essential to do electives in the US and have recommendations from US physicians? Do they have preference for recent graduates? Is the country or school you graduated from considered? Is the only examination you need the step 1? With the increase in MD/DO schools, will it be significantly more challenging to find a residency  or are the residency positions  keeping up with the grad increase? 

 

P.S I have done some research on this and read previous threads I wouldi just like a more updated perspective from someone who seems fairly familiar with the process.

 

Cheers, 

I can say that there are at least 10-15 USMD and DO schools in the 45-55KUSD range.  What is the Australian tuition? I can't imagine it would be cheaper than those USMD/DO schools, but I do not know much about tuition costs in Aussie. Add to the factor international flights. 

 

EDIT: All of the 4 years schools listed here: http://www.oztrekk.com/programs/medicine/PG/overview.php are well above the range above. So i'm not sure what numbers you are working with or if there are other schools not listed?

 

US match is much easier than Canada, because there are a vast number more of spots. However, US grads match at significantly higher rates than IMG. They get first preference informally, and many places won't even consider IMGs. Look up the term "IMG mill". Of course there are many who get into good residencies at desirable locations, but that's not without a considerate amount more effort than their American graduate counter parts. And you will have much less choice in dictating where you want to go in the US. 

 

Also yes, you would definitely have to get US clinical experience to have any real shot, and US LORS, and definitely a preference for recent grads.  Applying to both Canada/US will split your limited time outside of Aussie to accomplish this. Also depends on what specialty you want, some will be off the table as an IMG. 

 

You would need all the same exams as US graduates (Step 1, Step 2 CK and Step 2 CS and Step 3 once in residency(or before if you dont match). 

 

Residency positions are not keeping up with the increase. IMGs still will be able to continue to match, but do you want a 40-50% chance or a 90%+ chance(speaking on average)? Again, everything is on you as an individual to get the step scores, LORs and experience as an IMG(and AMG). It will be that much pressure off as an AMG though, since you will not be as stressed to make sure to kill board exams and impress. You have more room for human error, which is normal when you're in a learning profession. You have to make mistakes to learn.

 

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Hi redhawk,

 

Gohan covered your questions well. I think it is entirely worth giving the US a legimitate chance before jumping ship to Australia. The benefits of being a US Med Grad:

 

1) Apply as a CMG back to Canada if interested.

2) Opportunity at any specialty if you are competitive enough, with a path to citizenship to boot (again, if competitive enough).

 

By going to Australia you are essentially resorting yourself to low (at best mid, if you are an exceptional rockstar/way above and beyond your US counterparts, rough) tier programs in FM and IM (the 2 you mentioned earlier). Thing is most people do not *need* to go to a top tier program; it is a minority of all people who actually need to in order to fulfill their goals. So perhaps you will be just fine pursuing this route.

 

Congratulations on your acceptance in Australia however! Depending on what your goals are my advice would change. If you are happy with the route I laid out above then you'll be fine. If you want more, you are truly short changing yourself not giving the US a legimitate chance.

 

And yes you will need US clinical experience and letters if you want to match at said low or hopefully mid tier programs, there are very very few exceptions to this general rule of thumb.

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I highly recommend not going to any school that is not affilated with a US site and US clinical experience. You are a non green card Candian, there is nothing that seperates you with the 10, 000 indian applicants who are applying for res in Canada.

 

Ireland is more prefered (and are ok with putting all your eggs in 1 basket) if your dead set on Canada only

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  • 2 weeks later...

Been a couple weeks since my original bump so bumping up again. Still have some semblance of free time with graduation and moving on the slate before June settles in. Again, several more posters have reached out since my original bump. Keep them coming guys and gals!

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Congrats on your offers. Those are definitely some big names! I have a few questions about Canadians matching NRMP. Maybe we can get this thread stickied

 

1. How much of a factor does school prestige play in matching? Does it play a role after matching? Like finding jobs for example.

 

2. I read on SDN that very few schools are true pass/fail and that residency programs like to see class rankings or grades to have something to work with. Is this true?

 

3. How much does residency program quality predict quality, quantity and diversity(both geographic and type) of future employment?

 

Appreciate it

 

Hi Makunouchi,

 

Some great and tough questions. I will do my best from what I have seen and learned both from faculty during medical school and from the interview trail and friends across the US who are becoming interns like me across a wide variety of specialties.

 

1. School prestige matters. More in some specialties than others. Internal Medicine (my field) is particularly well known for this kind of (unfortunate) elitism. Take a look at match lists from some of the top medical schools across the country and see how their "worst" IM matches are frequently top tier matches. This is not because IM is not competitive (it infact surpasses Anesthesia, EM and the like in terms of at least average Step 1 score to match); it is because brand does matter. We can PM about this further if you want but I have many anecdotes like a colleague from another school interviewing at Johns Hopkins (Osler) being told point blank that Osler "does not match students from schools of [his] caliber" (which by the way is not true...but a sentiment that overall rings true at the top level). Brand does not much matter in the private sector but does in the academic world. If you want a faculty attending position at MGH, Stanford, Yale, etc. it helps to have a brand name on your CV (in addition to all the other intangibles you must have).

 

2) True P/F are actually just Yale and Harvard for med school. They both recommend every one of their students "whole heartedly" (as per MSPE) and there is no mention of class rank. Every other school who tries to sell the P/F angle is lying by omission -> you will have P/F on your transcript but in your Dean's Letter (MSPE) your rank will be disclosed any number of ways. With this said, coming from a top 20 med school you can get away with things like being in the bottom half of your class and have a fantastic match as per point #1 assuming you are not a complete dud (decent Step scores, some research). And yes it is true that all other medical schools beyond the top 20 or so benefit from having class ranking/grading. I know for me that was the only way to the inner circle of the programs I interviewed in, by being at the top of my class/Junior AOA. If there were no rankings from mid tier (at best) medical school all of us would be homogenious to the top residency programs; this would hurt much more than it would help by "taking stress away" with P/F. Harvard and Yale do it because they are Harvard and Yale.

 

3) At the very elite level of residency all doors are open for future employment and fellowships in academia. Private sector doesn't care (as above). 90%+ of residents completing their residency in a particular location stay within an 80-mile radius to practice. More than anything, local connections help get local jobs.

 

Hope this helps. Feel free to PM for more.

 

+1 for getting this stickied for those who may benefit from this in the future

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Stanford is also true P/F, at least for preclinicals, and they also don't have an AOA chapter. I think there are at least a few more true P/F preclinical schools besides those three, like UChicago.

 

However, I don't know of any med school that doesn't have some form of grading during clerkships, whether it's A/B/C or Honors/High Pass/Pass etc. Yale grades clerkships using Honors/High Pass/Pass, while Harvard's clerkship grades are actually curved (30% get Honors with Distinction, 50-60% get Honors, 10-15% get a Pass). Apparently Stanford tried to implement P/F for their clerkships a few years ago and residency directors were very suspicious because they didn't have anything to differentiate applicants. So even though your MSPE might not formally or informally disclose your rank, residency directors will find a way to compare and rate you against your peers, whether they come from your school or other schools.

 

Also, prestige definitely matters. I'll be attending a top US MD program next year, and when I attended their second look weekend one of the Deans flat out told us that the single greatest predictor of how well you will do in the residency match is where you went to medical school. I also went to a top US undergrad and I strongly believe that it had a big impact in my medical school admissions process, even though many people on SDN will tell you that prestige is meaningless when it comes to these kinds of processes. 

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Congratulations on your acceptance, great future ahead uncharted1114! Yes your top US undergrad absolutely made a huge difference. When people on SDN talk about prestige they often refer to prestige being meaningless in terms of the ultimate goal of becoming a physician and also of not being wooed by prestige when you have a much cheaper state school alternative (this one is quite debatable in my mind but that's neither here nor there); not with respect to attaining admission or matching at the most selective institutions in the country.

 

It is an interesting process this, several of my colleagues opted for Ivy League undergrads and have had a direct path -> elite medical school -> elite residency etc. It is self perpetuating once you make that first jump (which is harder and harder to make as you move up the educational ladder) as long as you keep up the work ethic. I met a ton of people with the typical Harvard/Penn/Yale undergrad -> HMS/Penn/Yale Med -> Brigham/MGH/UCSF/Stanford for residency path. People like myself were definitely the exception on the trail, but these are the rules we play by and it does make sense to me that to some degree future success is awarded to those who had past success; it's just that there is heavy skew towards rewarding past success. A great decision to jump ship to the US for undergrad, I should have explored that option back in the day.

 

As far as Yale and Harvard are concerned, this is what I learned from their students on the trail. Having clerkship grades does not mean they are ranked at all for MSPE and the possibility they are not seems very strong based on what my colleagues from these two medical schools have told me. Pritzker students are ultimately ranked and Stanford I am not sure about. Regardless, whether you are ranked or not should not be making or breaking anyone's decisions to pursue one school over the other, in my opinion. Way too many other factors to consider.

 

By the way, what a ridiculous way to do clerkship grades re: Harvard from what you mention above. 80-90% effectively Honoring defeats the purpose of attempting to grade anything. You can look at that H w/Distinction = H / P as P/F ;)

 

Best of luck and enjoy the ride! I agree to a large extent with one of your Deans.

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  • 4 weeks later...

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