Valuable Information Regarding Uk, Ireland And Australia

[Edict]

http://www.carms.ca/wp-content/uploads/2016/04/2016-CaRMS-Forum-Data-Deck_FINAL_EN.pdf

 

Supposedly 

 

in 2016 90 IMGs who matched were from Ireland, 43 from UK and 35 from Australia. 

 

This is pretty surprising that there were 43 from the UK considering that there isn't that much talk about UK CSAs as compared to Australia for example. 

 

Also, 67% match rate from Australia and Oceania, which we can safely say is Australian CSAs mainly. 

41% from Europe but that includes a number of applicants from Eastern European countries. 

[JohnGrisham]

Interesting re: UK pool. I wonder if that is all CSAs or if there are older registrars in the mix there also?  I do know of one UK registrar who matched IM and essentially left his training behind in the UK...gained Canadian citizenship via marriage. But thats probably just a 1 off. It would be interesting if the situation in the UK is driving those with Canadian ties(either through familial right, marriage or just plain ole immigration) to just hop over to Canada for shorter training/redo training if their specialty is not easily recognized(or go for FM to keep things simple).

Could just also be a lot more direct from high school students hit graduation?

[Edict]

Interesting re: UK pool. I wonder if that is all CSAs or if there are older registrars in the mix there also?  I do know of one UK registrar who matched IM and essentially left his training behind in the UK...gained Canadian citizenship via marriage. But thats probably just a 1 off. It would be interesting if the situation in the UK is driving those with Canadian ties(either through familial right, marriage or just plain ole immigration) to just hop over to Canada for shorter training/redo training if their specialty is not easily recognized(or go for FM to keep things simple).

 

Could just also be a lot more direct from high school students hit graduation?

 

I think its definitely the high school students hitting graduation. I don't think there are that many registrars with Canadian citizenship in the UK who have never set foot in Canada. Most UK registrars end up doing fellowships in Canada but have never applied through CaRMS. Also, matching through CaRMS as a Brit would be very difficult. It just seems very unlikely someone with full training rights in the UK and was born and raised there would want to put in all that effort and take such a big risk to be a resident in Canada w/ ROS. 

 

I once estimated that about 80 or so Canadians from HS or undergrad go to the UK every year for medicine. It seems reasonable that some would stay in the UK and about 40 or so end up coming back to Canada. 

[JohnGrisham]

I think its definitely the high school students hitting graduation. I don't think there are that many registrars with Canadian citizenship in the UK who have never set foot in Canada. Most UK registrars end up doing fellowships in Canada but have never applied through CaRMS. Also, matching through CaRMS as a Brit would be very difficult. It just seems very unlikely someone with full training rights in the UK and was born and raised there would want to put in all that effort and take such a big risk to be a resident in Canada w/ ROS. 

 

I once estimated that about 80 or so Canadians from HS or undergrad go to the UK every year for medicine. It seems reasonable that some would stay in the UK and about 40 or so end up coming back to Canada. 

That sounds reasonable! 

 

(What i meant with UK registrars coming here, was those that somehow gained Canadian citizenship etc.)

[jnuts]

Wow.  Thanks for posting!  I've never seen CaRMS present their data that way before.  I'm glad that they've started giving country-specific data for IMGs.  That's a lot more useful than the regional data they used to give.

 

Someone needs to go through and work out participant numbers for those bubble sizes.  

 

My other question is where are the USDO grads?  In Alberta and Ontario they are IMGs but they're not on the bubble chart.  Everywhere else they can apply (QC, BC, MN) I think they'd be CMGs for all intents and purposes?   From all the talk on this forum, I thought there would be more of them.  I'll assume that they were lumped into USMG. For that group, going from 56 participants to 33 final participants--which to me means mostly no interviews--and then only 18 matches is pretty bad.  And I'm assuming with those numbers that all the USMGs were DO.  If there was any bias to US MD grads over US DO then I'm speculating the numbers would be worse. 

[JohnGrisham]

Wow.  Thanks for posting!  I've never seen CaRMS present their data that way before.  I'm glad that they've started giving country-specific data for IMGs.  That's a lot more useful than the regional data they used to give.

 

Someone needs to go through and work out participant numbers for those bubble sizes.  

 

My other question is where are the USDO grads?  In Alberta and Ontario they are IMGs but they're not on the bubble chart.  Everywhere else they can apply (QC, BC, MN) I think they'd be CMGs for all intents and purposes?   From all the talk on this forum, I thought there would be more of them.  I'll assume that they were lumped into USMG. For that group, going from 56 participants to 33 final participants--which to me means mostly no interviews--and then only 18 matches is pretty bad.  And I'm assuming with those numbers that all the USMGs were DO.  If there was any bias to US MD grads over US DO then I'm speculating the numbers would be worse. 

In 2016 most USDOs didn't apply to CaRMS. They had better options in the US. 

 

Also, USDOs are only CMG in BC and QC(where everyone competes in the same pool, regardless of CMG/AMG/IMG). And considering most people don't have french language skills, that limits the options in QC to McGill pretty much. Which some USDOs interviewed at. 

 

1 DO grad matched, and i think maybe 10  of the USDOs applied(just a general estimate, I have no data on this other than talking to individuals), but most pulled out of CaRMS because they wanted to go for sure matches in the AOA match (which happens before CaRMS) and go for dually-accredited programs. If they had forgone the AOA match, which includes dually accredited AOA/ACGME residencies, to take the risk for matching in Canada, at likely "undesirable programs"(for some people being forced to ROS is a turn-off, and being rural, which a good majority of IMG spots are) is a tough sell.   

 

Again, no those numbers for USMGs were not "all DO".  Before you go on doing makeshift "analyses" of match data, maybe make sure you actually understand the numbers and labels you are looking at. I admit though, that CaRMS does a confusing job of classifying USDOs. But since you claimed to have actually read the other thread(talking about match data), you would have seen that there were only 30ish DO grads, so how could they be suddenly 56 of them?

 

 

[jnuts]

In 2016 most USDOs didn't apply to CaRMS. They had better options in the US. 

 

Also, USDOs are only CMG in BC and QC(where everyone competes in the same pool, regardless of CMG/AMG/IMG). And considering most people don't have french language skills, that limits the options in QC to McGill pretty much. Which some USDOs interviewed at. 

 

1 DO grad matched, and i think maybe 10  of the USDOs applied(just a general estimate, I have no data on this other than talking to individuals), but most pulled out of CaRMS because they wanted to go for sure matches in the AOA match (which happens before CaRMS) and go for dually-accredited programs. If they had forgone the AOA match, which includes dually accredited AOA/ACGME residencies, to take the risk for matching in Canada, at likely "undesirable programs"(for some people being forced to ROS is a turn-off, and being rural, which a good majority of IMG spots are) is a tough sell.   

 

Again, no those numbers for USMGs were not "all DO".  Before you go on doing makeshift "analyses" of match data, maybe make sure you actually understand the numbers and labels you are looking at. I admit though, that CaRMS does a confusing job of classifying USDOs. But since you claimed to have actually read the other thread(talking about match data), you would have seen that there were only 30ish DO grads, so how could they be suddenly 56 of them?

 

 

I read and wrote this before I saw the other thread.  This conversation prompted me to look for it as I don't usually read the American threads.  I made the assumption you mentioned to be as charitable as possible to DOs not because I don't understand the data presented in the ppt attached to this thread (which is where the 56 came from). Who peed in your cornflakes tonight?  You're usually more civil.  Anyway, the comment applies to US grads regardless of the stream.  Given the difficulties getting back after residency, the requirement to leave if you're on a J-1, and the new issues with SON letters, I thought there would be more of them.  

[JohnGrisham]

I read and wrote this before I saw the other thread.  This conversation prompted me to look for it as I don't usually read the American threads.  I made the assumption you mentioned to be as charitable as possible to DOs not because I don't understand the data presented in the ppt attached to this thread (which is where the 56 came from). Who peed in your cornflakes tonight?  You're usually more civil.  Anyway, the comment applies to US grads regardless of the stream.  Given the difficulties getting back after residency, the requirement to leave if you're on a J-1, and the new issues with SON letters, I thought there would be more of them.  

Sorry perhaps it's the hot weather, or it's my anal nature perhaps constantly seeing non-factual statements on these forums being discussed as-if there's some "interpretation" to them or other. 

 

We all have our moments

 

Again though, with those going for non-primary care, many it seems choose to just go to the US for residency over Canada, because they realize they will probably have to end up in the US after residency for a job anyways. Its no different than the Canadian orthos and other specialists without jobs or more commonly underemployed, seeking US fellowships and opportunities to stay.  The Canadian USMGs are just making the choice earlier on to go to the US.  

 

I understand you are an IMG who then opted for a Canadian residency(correct?), so perhaps maybe you're views on US residencies are slightly different, because of that background. For USMGs, staying in the US for residency and then projecting forward isn't all that bad comparatively. Many, many of them are getting on H1B pathways to citizenship. Look at the 2016 USDO cohort for example, about half of them are on the H1B pathway. I would imagine the Canadian USMDs are even a higher percentage on the H1B pathway. 

 

[jnuts]

Sorry perhaps it's the hot weather, or it's my anal nature perhaps constantly seeing non-factual statements on these forums being discussed as-if there's some "interpretation" to them or other. 

 

We all have our moments

 

Again though, with those going for non-primary care, many it seems choose to just go to the US for residency over Canada, because they realize they will probably have to end up in the US after residency for a job anyways. Its no different than the Canadian orthos and other specialists without jobs or more commonly underemployed, seeking US fellowships and opportunities to stay.  The Canadian USMGs are just making the choice earlier on to go to the US.  

 

I understand you are an IMG who then opted for a Canadian residency(correct?), so perhaps maybe you're views on US residencies are slightly different, because of that background. For USMGs, staying in the US for residency and then projecting forward isn't all that bad comparatively. Many, many of them are getting on H1B pathways to citizenship. Look at the 2016 USDO cohort for example, about half of them are on the H1B pathway. I would imagine the Canadian USMDs are even a higher percentage on the H1B pathway. 

 

No worries!

 

I'm in Ortho so I hear what you're saying. Ortho is well known as the worst job market right now with about 200 grads waiting for jobs (underemployed, not unemployed).  With those numbers, the estimate is that only 10/year are immigrating to the States. Most are just waiting the job crunch out. Anecdotally, underemployment is still much  better than residency.  The migration is far from a flood because underemployment is livable and relocating to the US isn't easy technically or personally (but it's much easier technically than coming from the US to Canada).  Most Canadian graduates have very strong feelings about leaving.  The vast majority will be specialist physicians in Canada eventually. And it's not as though a Canadian specialist has lost his or her Canadian certification and those all important contacts if she or he goes to the US for a while after residency.

 

I have nothing against relocating to the US. I don't view it as a negative any more than I view staying in Europe or moving to Australia as a negative.  But reversing the ratio of ultimate Canadian:American physicians to say that the US and Canadian paths are equivalent because a minority of Canadian specialists are choosing the US while a majority of Canadian USMGs have no choice but to stay in the US is disingenuous.  

 

I'd agree with you that the US MD stream isn't doing much better than the DO(though more of them match back to Canadian residencies).  My question remains, is going to the US, especially in the DO stream, emigrating or is it reasonable to expect to be able to get back to Canada some day?  And what is going to happen to the DO residents on J-1s?

 

As long as the most likely outcome of staying in the US indefinitely is well known, I've no issue with advocating the DO route.  But I don't think that's the impression the aggressive DO marketing is putting out (and as an aside, that you're contributing to by not distinguishing between North American and American residencies when you talk about this).    I'd also speculate that if the majority of Canadian applicants to these programs knew that they were very unlikely to ever become physicians in Canada they might have different preferences.  

 

We can also compare the most likely eventual outcome of the USMG to the UK or Ireland graduate, the majority of whom will be physicians in Canada, but who run the risk of not having an easy alternative if they fail to match.  Then we can leave it up to the individual applicant to decide which path they'd prefer.

[JohnGrisham]

As soon as one leaves Canada for medical school, your best odds for a residency are in the U.S. Full stop.

As soon as you leave Canada, you should also be sticking with best odds for FM/IM residencies. Primary care.

So if that is the established case, then going to a USMD or USDO school makes the most sense - because you have vastly better US NRMP match rates than IMGs, essentially the same match rates as a CMG applying in CaRMs. 

Do we agree here? Qualitative and Quantitative data completely agrees with the above assertions.

Going back to the UK or Irish match rates to Canada, given that they are in the realm of 60% range, what are the other  40% doing? They are either going to the U.S. or staying in their training country, or simply going unmatched to retry again.

The only caveat here, is if you are doing the UK 6 year programs straight out of high school. This is a unique advantage, because even if you failed to match right away, and it took you another 2 tries, you would still be on par or  ahead than the majority of Canadian and US MD/DO medical students. But this only applies to the 6 year programs.  It also offers the possibility of simply applying to Canadian MD schools partway through training, much like one of our prominent posters here on the forum. HOWEVER, we are not talking about the 6 year programs right now - since its not an apples to apples comparision. Whenever we advocate for USMD or USDO, we are talking about the majority of the premedical applicant pool who has done at least 4 years of undergrad, and is for some reason not competitive in Canada, or has tried a few times and is looking for alternatives outside of Canada.  

Again, going back to the case I presented about WHY the USMD and partially the USDO match rates to Canada are low,  you don't think they could be pumped up if they REALLY wanted to ensure matches in Canada as the be-all-end-all instead of going to strong US residency programs and then returning later?

Also one partial reason the IMG match rates from some regions are even as high as they are in the first place, is because they encompass many of them that are matching to programs in rural Canada, or in -and I say this with a huge disclaimer of not trying to offend anyone- that are "less desirable" that frankly, most US trained students probably wouldn't rank at all. Why? Because they don't have the pressure of "matching in Canada or else" and  can just do their FM or IM residencies in the U.S. in big cities or cities they so choose at programs they so choose, rather than applying broadly in Canada. This is a double edged sword, because they have these extra US opportunities, they likely focus less on matching back to Canada as the "all or nothing".  I personally would enjoy rural trianing, and that is apart of my trajectory - but majority of medical students are from big cities, have certain preconceptions and all that.  You couldn't pay some medical students to go to Manitoba or Saskatchewan for residency for example, perhaps due to the climate/atmosphere and/or having other family considerations too. 

And again, as an IMG matching in Canada - one big thing you are neglecting to mention is Return of Service. Hypothetically, why would a USDO rank a program in a "undesirable"(to them) location of Canada, or simply any Canadian province that isn't their home province - and be tied to a ROS, when they could do their FM program in the states and hop back over and set up shop in their hometown? Or do their IM training and return if they wanted to. USMDs are more so about the location and program.  Many of the people are going for FM/IM anyways, where the barriers are significantly less when it comes to US training vs Canadian training. 

Anyways, I think we're at a standstill and we'll just have to agree to disagree. It seems that you are convinced that returning to Canada after a US-ACMGE residency is something ostensibly difficult, but really it has been getting somewhat easier with CPSO streamlining the pathway in Ontario for example and elsewhere. For 2015, about 70% of the Statement of Needs for J1 claimed, were for FM(183) and IM(196), if you include Psychiatry, Peds and EM, it was about 83%. All of which do not have onerous reciprocity requirements for becoming licensed in Canada. Subspecialization in IM can be hit or miss, mostly because of job opportunities anyways.

If you do the math, for CaRMS 2015 - 53% of the dedicated IMG spots are for FM(182), and 15% for IM(49). and then another 6% for peds and 7% for psych.  Percentage wise the numbers are looking pretty familiar, with the big exception being IM. There are 3.5 times as many Canadians(of various backgrounds) studying in the US for IM compared to IMGs in Canada. This is just an interesting fact, nothing really to do with the current discussion - other than that, if you really want IM as a non-Canadian med students, your odds are best for a US-ACGME residency. And who always has the best odds on average at a US-ACGME residency? A USMG.    IF health Canada were to just stop providing SONs for IM, the majority of IMGs going to the US for residency who need J1 would be screwed. USMDs and USDOs would  fall back on their F1-student visa OPTI extension for PGY1 and then go all out for an H1B.

But going back to FM, since 53% of IMG spots are for FM(182) in Canada, and 33%(183) for those doing US-ACGME residencies, you can pretty much say there's not much difference other than the fact that US training is 1 year longer. The US trained FM docs, have zero issues with mobility and practice. So for at least 1/3 of those training in the US, they are not effectively "emigrating".   So if we look at this subgroup, one could say - for FM, as an IMG applying to Canada, there is no guarantees of securing a spot- lets say a modest 65% chance at securing a FM spot for the best regions(e.g. ireland). But for USMDs/DOs, you are on average definitely above 90%, if not 95% going to match FM, you can probably pump that up even higher if you account for the IMG run US hospitals in rural america, and were willing to rank them.  So given that at least half of IMGs will match FM, if not more, wouldn't you rather want to be apart of the cohort with statistically much better odds and options for the US fall back? And remember there really is no reason that the USMDs couldn't pump up their Canadian match rate for FM, if they focused on Canada.  I would say though, that the extra year for FM training in the US perhaps would be a turn off for some applicants, so maybe if it meant doing 2 years in a less desirable locale/program versus 3 years in a US program of choice - some would undoubtedly choose to save a year and suck it up.

 

And again, I only promote USDO for those who are considering schools outside of Canada and USMD programs and are already at the end of their undergrad degree, even then one should try to improve their applications for Canada if possible.  


At this point, i'm really just putting thoughts down, just to provide as many different insights as possible for discussion.

One thing I have taken away from this though, is that if one can go to the UK right after high school - it's even better than Canadian MD/USMD from a purely mathematical point of view! At least on the surface. 6 Years for the MD, and then even if its only a 50% chance of securing residency in Canada right away, you automatically saved at least 2 years, if not 3 or 4. Sure there are some people who do 3 years UG and then 3 years of medical school...but those are a very small percentage of the total CMG pool. There are also that pool of students who do 3 years + 4 years of med, a large percentage than the 3+3 but definitely still small. Average is 4+4, with still many many people doing 5 or > + 4.   If you include the US match, a high schooler who went straight to the UK is looking pretty darn sweet assuming it all goes well along the way.      But the one thing to consider is cost - 6 years in the UK is probably going to be pretty pricey - but I wonder what the math is like if you compare it to 4 years of UG + 4 years of med school? 

[Font123]

Does anyone know how many Canadians are currently studying medicine in Ireland?

[thetsayer]

Does anyone know how many Canadians are currently studying medicine in Ireland?

 

All I could find was in 2010 there were 650+, i'd assume its increased since then.

[eruthia]

http://www.carms.ca/wp-content/uploads/2016/04/2016-CaRMS-Forum-Data-Deck_FINAL_EN.pdf

 

Supposedly 

 

in 2016 90 IMGs who matched were from Ireland, 43 from UK and 35 from Australia. 

 

This is pretty surprising that there were 43 from the UK considering that there isn't that much talk about UK CSAs as compared to Australia for example. 

 

Also, 67% match rate from Australia and Oceania, which we can safely say is Australian CSAs mainly. 

41% from Europe but that includes a number of applicants from Eastern European countries. 

 

 

Do you know if anyone actually saved this on their computer as the link doesn't work anymore?