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tere

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tere last won the day on December 15 2018

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  1. I think you’re getting into a different topic rather than education of the population at large. Both Canada and US have historically underrepresented minorities and there are initiatives to address that lack for indigenous and black students in medicine. Canada also has a higher proportion of immigrants, due to its smaller population,with second generation immigrants generally achieving high levels of success including education. But I think that’s a different issue than population education level.
  2. As Edict points out, those other types of careers are mostly available south of the border due to the critical mass that's present there with a more innovative economy. So those opportunities would much of the time mean leaving Canada (not that straightforward and not something many people want to do). It's a little complicated. There are more PhDs per capita in the US - in fact, historically a lot of US graduate students in STEM have been foreign. There are also more R&D opportunities available - in contrast, PhDs in Canada have a higher chances of under/unemployment. It does vary greatly by location - Silicon Valley, Boston & Seattle area have a much higher concentration of educated individuals (~15% of Google's jobs require PhDs).
  3. Expectations are high in medicine in terms of workload and responsibility - but the alternative careers you mention are no better and probably worse in terms of autonomy and life-style. A medical student has less responsibility than a staff physician, but a practicing physician may have more independence, depending on the specialty. If you're really unhappy, then by all means seek counselling, look into other options - realize that there are many who would do almost anything to be in your shoes and that working in a full-time career is a different experience than being a student (no matter what the career).
  4. The US has better odds for getting admitted and also way more residency spots than graduates - which allows IMGs to match a lot into primary care. That's why some Carrib med schools have 90s match rates. Nonetheless, IMG graduates have more trouble overall with matching. US medical students seem to go for more lucrative specialties - technically the overall match rate isn't as high as Canada, but I think more people choose to re-apply after a research year or similar to very competitive specialties than within Canada.
  5. A big challenge in Canada. It's not just just Canadian grads that make up the workforce - other provinces have a lot more IMGs than QC (~25% vs ~10%) because of the language barrier. So QC may have more med students than other provinces to compensate. QC med schools have also had more attrition too. Nonetheless, the per capita distributions in QC is basically identical to AB & BC. (link Appendix Figure 3)
  6. It seems we're looking at things different ways. From what I understand of your viewpoint, somehow today Canadian med students are intrinsically less motivated for the US and happy with the status quo (with the match rate, etc..). In the past, Canadian med students were possibly more motivated and thus would write and do well on the boards and match to the US. But to me, today, Canadian med students have even more reasons to be considering all options, including the US, and seem to even be applying to more programs in the past. The unmatched rate has reached unsustainable levels with a backlogs of med students. So I think med students are more motivated than ever. So why aren't more med students matching to the US? I think it's that all aspects of matching, including the boards have gotten more challenging. It's now a harder reach for the US for residency so less people are trying and succeeding. I know you see curriculum as being irrelevant, but when I look through a US med school block description and I see pretty much all the topics that are covered in Step 1 then I realize there is in fact a difference. Back in 2003, FA was 425 pages - today it's over 800. Despite the fact schools are now P/F, which should logically give more time to study for things like the boards, I think it's become a more challenging path to the US so less people are trying. McGill, which seems to have been the school which has had the most students match to the US, recently changed it's curriculum and dropped a lot of the basic sciences. At the same time, the number of matching US students has decreased greatly from its peak. This is consistent with my viewpoint. Canadian schools have no reason to teach to the boards and sometimes I wonder if some stakeholders would prefer to have unmatched students rather than an exodus of students to the US. I realize you'll disagree, but this my view of the whole picture.
  7. Except that it's difficult to stay in the US on a J-1 visa - so moving after Canadian training wouldn't have been any more difficult. I believe US residency was more of a low hanging-fruit at that point, so CMGs wrote the boards and matched. Now I think that route is more challenging even though there's more pressure than ever to match (record unmatched grads & tight matching ratios).
  8. A thread from 2003 seems to confirm that was the case back then too - it looks like CaRMS came out a week before the US match. https://www.valuemd.com/canadian-img/8476-going-carms-nrmp-match-simultaneously.html It is odd - perhaps someone who knew the older system would remember what the situation was like back then. I do feel there is a divergence though, and Western's apparent deemphasis of the MCAT confirms that at the premed level. What provincial government wants its subsidized grads going to the US?
  9. Thanks for going back another year and adding context. Nonetheless the 46 graduates matching in 2003 across many schools was surprising to me given the record number of unmatched CMGs and tighter matching ratios that occurred last year (with only 2 NRMP matched grads).
  10. Back in the day - sure. In 2003, McGill had 27 graduating students matching into NRMP. Last year, there was only a single current year graduate (visa) from McGill that matched there (i.e. non-Canadian). At the moment, McGill seems to admit only 2 internationals per year. McGill graduates leaving the province (and country) with subsidized education was a source of tension though, including from the current premier. Perhaps the divergence has helped keep graduates in the country.
  11. Back in 2003, a whopping 46 graduating students matched into the NRMP (with over half from McGill link). Last year there was one current year graduate (from UBC link) that matched [a second visa student matched from McGill], despite a record number of unmatched CMGs. I don't think it's because people are unwilling to consider the US route, I think it's more of a case of divergence of the Canadian from the US curriculum making it more challenging to ace the boards and increased residency competition on both sides of the border, including the IMG factor which has grown sharply over the past decades. Both US and some IMG schools prep their students to take their boards to get US residency positions. Canadian schools generally speaking don't. Even as a pathology resident, you've mentioned the long study you had before taking Step 1 - some Canadian schools don't cover almost any pathology which is a key component of that test. Of course most things can be overcome with time and effort, but then there's a tradeoff in terms of choices - after all Canadian programs generally don't use Step 1 as a criterion to be accepted to residency. People may disagree, but I think the broader trend in the numbers is more reflective of educational systemic & curriculum changes rather than individuals becoming more averse to the US route or being less capable.
  12. I can understand people being upset, but I personally don't see a legal case. Western's always had some disclaimer about making admissions cut-offs doesn't guarantee an interview - it's just in the past that rarely occurred. It was pretty much an open secret that meeting the high MCAT-cutoffs did in fact mean an interview. More signalling from Western would have been helpful - since people weren't sure to what extent the ABS would be taken into consideration. Western's change to me is less radical than when McMaster added CASPer or McGill removed the MCAT to increase accessibility to the French-speaking population in Quebec. Some felt McGill's changes, including an interest in diversity, was at the expense of the English-speaking population within Quebec. Some people wrote letters, etc.. but ultimately McGill stayed with its changes and does now have a more diverse body than before. There may now be more unity among both linguistic communities in medicine, at least at McGill. The only successful push-back against changes I've seen is when Ottawa temporarily added and then dropped the MCAT. But the argument to me seemed to be clearer regarding equity due to the bilingual character of Ottawa but the lack of a French version of the test. I don't see an equity argument as being applicable here, at least not for adding an ABS criterion for admissions.
  13. If you have time available, then I'd suggest writing & destroying the US MLEs and applying there. If you're in a busy clerkship before electives then I'd suggest having other electives of interest in less competitive programs that also give you chances at matching, besides your most desired specialty. If you don't pursue your most desired specialty at all you'll be left with "what if?", but I'd just make sure there are good alternatives since you have much less room to maneuver. Programs will do what's best for themselves (& to protect themselves), but if everything else in your application is competitive, I wouldn't give up completely at this point.
  14. Exactly - that barrier is not a trivial one esp at the professional level. Plus I think the degree approval process from the CMQ may take longer for the IMGs that do have an ability in French.
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