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BipolarBearr

Confused about USDO and International Options

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Heyo, I'm going into my fifth year at UWO to boost up my GPA and currently studying for an MCAT retake. That being said, I need some clarification because in my research, things have been very inconsistent or outdated and I would appreciate any help on sorting out options.

The purpose of the fifth year will be to make me competitive in places like Queens and Western (I did pretty well in my fourth year), although that depends on the MCAT as well.

That being said, I'm still looking to apply this cycle just for the sake of trying. Recently I have heard a lot of talk about USDO schools and Ireland's Atlantic Bridge MD program and would love to hear thoughts and ideas on this.

After my fifth year, would it be recommended to apply to both Ireland and various USDO schools? Should I apply to USDO schools NOW instead and possibly save some time and money?

I have heard USDOs have a much easier time matching into Canada after medical school but recently I have also heard of graduates from Ireland matching well here as long as they take some courses here during their time in medical school. My goal is definitely practicing in Canada but I just want to make sure either of these routes would let me become an MD practicing in Canada and what might be the benefits of picking one over the other. Additionally, any guidance or opinions as to when I should be looking into applying to these schools would be greatly appreciated. I'm tempted to apply to USDO schools now but I want to make sure it makes sense to do so if my goal is practicing in Canada.

I apologize if that was very scatter brained, I am very confused in this process and there is a shortage of clear, current information on this.

Obligatory stats
Ontario applicant, ~3.5 wGPA, not sure about cGPA. Pretty good LORS, Hospital volunteer experience, Quite a few extracurriculars with residence and clubs, ~2 yrs of research experience with a prof and anticipating a publication soon.
- If it changes anything, I had even been considering a research based masters AFTER that fifth year but I'm unsure about that now

Thanks!

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If your goal is to practice in Canada, you have two options. 

1. Doing residency in Canada (this is very very difficult for IMGs. Just look at the CaRMS data. Also keep in mind that CMGs in recent years have had worse and worse match rates due to increased enrollment numbers in Canadian medical schools. So I would expect it to become even harder for IMGs to match here. Not recommended. But if you want to go abroad and match in Canada, Ireland and US will both be equally reasonable.

2. Doing residency in the US then moving back. This is a lot easier. US DO schools have great match rates due to excess residency spots in the US. 

 

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Definitely consider USMD as well. It's still first round CARMs. It isn't less competitive, but GPA is less important and you get way more opportunity to explain your interests and qualifications than the Canadian application process. The biggest obstacle is that you only get one shot to apply to USMD. US schools don't typically like to see people who have applied more than once. You also really have to have your application submitted by early July. 

I would say apply to Canada a few times before considering international. Then apply to Canada and USMD. If that doesn't work, apply to Canada, USMD, USDO, and Ireland. In the meantime, get some good clinical experience, focus on the MCAT, and boost your GPA to be competitive for USMD if Canadian schools don't work out this year. The process sucks, but it's a numbers game and it often takes a few cycles. 

Applying to international schools now doesn't save you any money or time if you consider the international tuition vs Canadian tuition and how long you could have to wait to return home. 

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@runridge thank you for the reply, I wasn't aware applying multiple times was frowned upon in the US, I guess I'll wait till next cycle to apply so I can see where my GPA and MCAT are at, they should be better than they currently are. If my goal is practicing in Canada, is there a difference if I do USMD or USDO? 


 

11 hours ago, iFlayx said:

But if you want to go abroad and match in Canada, Ireland and US will both be equally reasonable.

So both Ireland and US are very difficult to match back into Canada but they are equal in difficulty? Am I understanding that right I've heard USDO has been easier for most. If Ireland and US are on the same level then are places like Australia and Caribbean more difficult than that? I'm not considering those two but I'd like to get a better understanding of how they are perceived

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26 minutes ago, BipolarBearr said:

@runridge thank you for the reply, I wasn't aware applying multiple times was frowned upon in the US, I guess I'll wait till next cycle to apply so I can see where my GPA and MCAT are at, they should be better than they currently are. If my goal is practicing in Canada, is there a difference if I do USMD or USDO? 


 

So both Ireland and US are very difficult to match back into Canada but they are equal in difficulty? Am I understanding that right I've heard USDO has been easier for most. If Ireland and US are on the same level then are places like Australia and Caribbean more difficult than that? I'm not considering those two but I'd like to get a better understanding of how they are perceived

USDO and USMD are great because you are basically guaranteed to match to the US and you have a decent shot at matching to Canada if you want (for US MD). Matching to Canada is not that easy since you have to split your electives between Canada and the US and things can get competitive when you are trying to outmuscle CMGs for their own spots especially with the current shortage of residency spots. 

I believe US DOs are considered IMGs in the big provinces which means that you might have a harder time matching to Canada. Going to the US as a DO is mainly to ensure you match to a residency in the US. You can complete your residency in the US and still practice as a doctor in Canada (will be hard to find a job as an academic in certain more competitive locations though). 

If your goal is to match to residency in Canada, CMG > USMD >> USDO/Ireland/Aus > Caribbean. Anecdotally, most of the IMGs who match back to Canada are from Ireland with a reasonable but lesser number from Australia and the Caribbean or other IMG schools (e.g. Poland). Ive yet to meet a US DO who matched to residency in Canada although that could be due to the fact that most US DOs end up preferring to do residency in the US and the numbers going to US DO schools are smaller. 

If your goal is to just be a doctor in North America, CMG = USMD > USDO >> Caribbean/Ireland/Aus. 

The cold truth of medicine is that pedigree does matter. If you want a competitive specialty or a competitive location, going to any of these schools will make it more difficult. I've yet to meet a DO staff in an academic position in Canada although I have seen a few in the states. If you don't mind about all this nonsense and would be happy in community and/or are interested in a less competitive specialty, then you don't need to be as picky on trying to get into Canadian or US MD schools. 

 

 

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24 minutes ago, BipolarBearr said:

@runridge thank you for the reply, I wasn't aware applying multiple times was frowned upon in the US, I guess I'll wait till next cycle to apply so I can see where my GPA and MCAT are at, they should be better than they currently are. If my goal is practicing in Canada, is there a difference if I do USMD or USDO? 

Yes! Big big difference. 

USMDs - if you're a Canadian citizen, you are put into the same stream as CMGs in the first iteration.

USDOs - if you're a Canadian citizen, you are put into the same stream as IMGs in the first iteration.

You would have a higher chance of matching back to Canada by virtue of you having access to CMG-designated spots!

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Thank you both for the reply! That helps clear things up a bit.

You mentioned it might just be easier to do residency in the US, so if I were to go to USMD or USDO and do residency there would I be able to come back to Canada as an MD after that? Is that a common route?

Interesting that according to CARMS data it's so difficult for Ireland IMGs yet I've heard from multiple people now that they seem to have the best shot at coming back to Canada.

Im sorry if this is a dumb question but what do you mean by first iteration? Is that pretty much saying they are the first group looked at for residency positions?

runridge already recommended a little plan of action for me but given my situation do either of you have any recommendations for where/when I should be applying to things? I'm still intending on doing a fifth year to get a competitive GPA and I'm in the process of preparing for the MCAT again. 

 

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Yes it is very common for doctors to move back to Canada after completing a residency in the states. However if you go to a DO school you won’t have the MD initials behind your name, if that’s something you care about. If you notice, there are many doctors here with different initials behind their name (MD, MBBS, DO) but in the end once you complete residency in North America, you will have no problem settling up practice in Canada or the US. 

The reason you don’t see many DOs here is because 1. Most end up in primary care and 2. Most choose to stay in the US. Imagine paying US tuition and cost of living, would you want to make CAD wages to pay back that USD debt?

All IMGs(Ireland or USDO) are considered in the second iteration. All Canadians in USMD and Canadian MD schools are considered in the first iteration. Yes you hear people come back as IMGs but you don’t hear about those that don’t come back. It is a very risky route to apply as IMG in Canada. 

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7 hours ago, la marzocco said:

Yes! Big big difference. 

USMDs - if you're a Canadian citizen, you are put into the same stream as CMGs in the first iteration.

USDOs - if you're a Canadian citizen, you are put into the same stream as IMGs in the first iteration.

You would have a higher chance of matching back to Canada by virtue of you having access to CMG-designated spots!

That is significant. Had not picked up on that before. Thanks for the info!

 

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23 hours ago, iFlayx said:

If your goal is to practice in Canada, you have two options. 

1. Doing residency in Canada (this is very very difficult for IMGs. Just look at the CaRMS data. Also keep in mind that CMGs in recent years have had worse and worse match rates due to increased enrollment numbers in Canadian medical schools. So I would expect it to become even harder for IMGs to match here. Not recommended. But if you want to go abroad and match in Canada, Ireland and US will both be equally reasonable.

2. Doing residency in the US then moving back. This is a lot easier. US DO schools have great match rates due to excess residency spots in the US. 

 

This is factually incorrect. You should be ashamed for even making the post. For Canadian matching purposes CANMD > USMD >> USDO >>>> other international options

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5 hours ago, premed_thr0waway said:

This is factually incorrect. You should be ashamed for even making the post. For Canadian matching purposes CANMD > USMD >> USDO >>>> other international options

Which part is incorrect?

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To clarify, the data I am looking at is here: https://www.carms.ca/data-reports/r1-data-reports/r-1-match-interactive-data/

In addition, news outlets have also reported more and more CMGs are unable to find a residency position in Canada.

http://www.cbc.ca/news/health/residency-ontario-1.4623120

https://www.thestar.com/vancouver/2018/04/17/official-data-confirms-more-canadian-medical-grads-are-without-residency-positions-than-ever-before.html

I apologize if I made any factually incorrect statements. I was suggesting that if you do decide to go abroad, both USDO and Ireland are reasonable options for matching back to Canada because both will be considered IMGs in CaRMS. Therefore it would be up to the individual to set up rotations/electives here. Both are equally required to pass the necessary boards/examinations as well. 

If you look at the match results of MSUCOM, the most Canadian friendly DO school probably. Their results are here.

http://com.msu.edu/Students/Career_Guidance/Match Data/Canadian Match Data 2015-2018.pdf

It is very obvious that most end up matching in the US. 

Now we can look the match list of say RCSI, one of the most popular international destinations.

http://rcsi.ie/files/admissions/docs/20170214033104_2017_North_American_Supplement.pdf

They also match many to both Canada and the US. In my opinion, IMGs from Ireland and USDO are on equally competing grounds because they are both considered only in the 2nd iteration. At that point, it really is up to the individual to jump through the necessary hurdles to ensure a successful match in the 2nd iteration.

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13 hours ago, premed_thr0waway said:

This is factually incorrect. You should be ashamed for even making the post. For Canadian matching purposes CANMD > USMD >> USDO >>>> other international options

Sorry, but iFlayx is right. There is nothing that states USDO is better than other international options when it comes to matching to Canadian residency. If you read below, this is how Canada considers DOs.

https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/summary-intake-criteria-osteopathic-school-graduates/

This is how Canada considers IMGs:

https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/summary-intake-criteria-international-medical-graduates-imgs-province/

In fact, IMGs are eligible in Nfld and Sask whereas DOs are not eligible to even apply. 

 

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Once you leave canada, your best chance at coming back to eventually practice is to do residency in the US then come back after residency completed. Thus going to a USMD or USDO is your best bet since youre near gauranteed a residency even if youre bottom of your class and have a step 1 fail.

Matching in canada for residency is hard for any international. The odds suck. So it shouldn't be your primary target. It should be considered as a bonus because of how.much of a crap.shoot it is.  

If your profile isnt strong enough for USMD(generally you need to be competitive in canada or just about, to even have a shot at USMD), then USDO is just as good. If you do well in med school, you'll have plenty of options for residency in the US. Prior to 2016 changes, USDOs matched decently in canada in the CMG stream into FM, IM, psych, and even anesthesia. Now in the IMG stream their odds are more or less the same as other IMGs with maybe a slight boost if you can show that you are more clinically capable having done North american standard rotations compared to other places that sometimes you only do more observation style clerkship. But thats too small of a sample size of people applying to carms IMG  stream, so just consider them equal in odds.

But when it comes to the US match they do well, and it depends on individual merits. Last two years people have matched into competitive specialties and strong programs such as rad onc, multiple plastic surgeries, and even optholmology. Those students were strong Canadian undergrads who maybe got boxed out in canada for MD but started right away in the US and did well in medical school. And then of course the usual FM, IM, PEDs, EM primary care matches in abundance.  

The point is, once you go abroad, if you want the safest path going to the US for med school is your best bet. Since chances are you'll be applying their for residency anyways if you dont want to put all your eggs in the crap shoot CaRMS basket. 

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On 6/22/2018 at 8:10 AM, Edict said:

USDO and USMD are great because you are basically guaranteed to match to the US and you have a decent shot at matching to Canada if you want (for US MD). Matching to Canada is not that easy since you have to split your electives between Canada and the US and things can get competitive when you are trying to outmuscle CMGs for their own spots especially with the current shortage of residency spots. 

I believe US DOs are considered IMGs in the big provinces which means that you might have a harder time matching to Canada. Going to the US as a DO is mainly to ensure you match to a residency in the US. You can complete your residency in the US and still practice as a doctor in Canada (will be hard to find a job as an academic in certain more competitive locations though). 

If your goal is to match to residency in Canada, CMG > USMD >> USDO/Ireland/Aus > Caribbean. Anecdotally, most of the IMGs who match back to Canada are from Ireland with a reasonable but lesser number from Australia and the Caribbean or other IMG schools (e.g. Poland). Ive yet to meet a US DO who matched to residency in Canada although that could be due to the fact that most US DOs end up preferring to do residency in the US and the numbers going to US DO schools are smaller. 

If your goal is to just be a doctor in North America, CMG = USMD > USDO >> Caribbean/Ireland/Aus. 

The cold truth of medicine is that pedigree does matter. If you want a competitive specialty or a competitive location, going to any of these schools will make it more difficult. I've yet to meet a DO staff in an academic position in Canada although I have seen a few in the states. If you don't mind about all this nonsense and would be happy in community and/or are interested in a less competitive specialty, then you don't need to be as picky on trying to get into Canadian or US MD schools. 

 

 

There have been a few DOs who matched in Canada as IMGs and previously as CMGs, pretty much most that tried. However... new exam restrictions coming in 2020 for all IMGs will make it much harder. Going the IMG route altogether is now very risky, especially with US visa difficulties arising. 

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22 hours ago, iFlayx said:

Yes it is very common for doctors to move back to Canada after completing a residency in the states. However if you go to a DO school you won’t have the MD initials behind your name, if that’s something you care about. If you notice, there are many doctors here with different initials behind their name (MD, MBBS, DO) but in the end once you complete residency in North America, you will have no problem settling up practice in Canada or the US. 

The reason you don’t see many DOs here is because 1. Most end up in primary care and 2. Most choose to stay in the US. Imagine paying US tuition and cost of living, would you want to make CAD wages to pay back that USD debt?

All IMGs(Ireland or USDO) are considered in the second iteration. All Canadians in USMD and Canadian MD schools are considered in the first iteration. Yes you hear people come back as IMGs but you don’t hear about those that don’t come back. It is a very risky route to apply as IMG in Canada. 

IMGs have their own spots in the 1st iteration. 

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So both USDO and Ireland IMGs are viewed equally in regards to matching in residency in Canada BUT USDOs are almost guaranteed matching into residency in the US?

It seems more appealing to me that Ireland IMGs can come back to Canada as an MD but USDOs don't count as MDs in Canada... I don't think I like the idea of that. If I'm going through this long, complicated, expensive route- I'm getting that damn MD lol.

After residency in the US, how easy is it to come back to Canada to actually practice?

Also- how does this plan sound:

2018: Apply to a couple Canadian schools with subpar GPA

2019: Apply broadly in Canada with competitive GPA

2020: Apply broadly in Canada, USMD/USDO and Ireland

 

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2 hours ago, medigeek said:

IMGs have their own spots in the 1st iteration. 

Sorry I did make a mistake here. IMGs and CMGs both participate but only about 10% of the seats are available to IMGs. Thanks for the correction :)

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1 hour ago, BipolarBearr said:

So both USDO and Ireland IMGs are viewed equally in regards to matching in residency in Canada BUT USDOs are almost guaranteed matching into residency in the US?

It seems more appealing to me that Ireland IMGs can come back to Canada as an MD but USDOs don't count as MDs in Canada... I don't think I like the idea of that. If I'm going through this long, complicated, expensive route- I'm getting that damn MD lol.

After residency in the US, how easy is it to come back to Canada to actually practice?

Also- how does this plan sound:

2018: Apply to a couple Canadian schools with subpar GPA

2019: Apply broadly in Canada with competitive GPA

2020: Apply broadly in Canada, USMD/USDO and Ireland

 

Realistically, the letters behind your name doesn’t matter as long as you can practice as a doctor :) there is no use to a MD if you can’t find a residency position. 

If you are competitive for Canada (at least one school), the prevailing advice here is attempt three cycles. So your plan is pretty spot on. Just ace that MCAT because it’s critical at the Ontario schools where you have a shot (Western, Queens, Mac).

 

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On 6/23/2018 at 1:30 PM, BipolarBearr said:

So both USDO and Ireland IMGs are viewed equally in regards to matching in residency in Canada BUT USDOs are almost guaranteed matching into residency in the US?

It seems more appealing to me that Ireland IMGs can come back to Canada as an MD but USDOs don't count as MDs in Canada... I don't think I like the idea of that. If I'm going through this long, complicated, expensive route- I'm getting that damn MD lol.

After residency in the US, how easy is it to come back to Canada to actually practice?

Also- how does this plan sound:

2018: Apply to a couple Canadian schools with subpar GPA

2019: Apply broadly in Canada with competitive GPA

2020: Apply broadly in Canada, USMD/USDO and Ireland

 

Realistically speaking it won't matter at all if you're an MD or DO or MBBS or whatever. Once you deviate from Canada/US MD you're an IMG. That's all that really counts. Whether DOs are seen as equal or not to Ireland or Australia or whatever is anyone's guess. From what I've heard, your school isn't usually even seen until interview time. 

With that said, the viability of a US residency is disappearing quickly with statement of need caps, residencies getting less friendlier to foreigners, and more US grads pushing out foreigners due to new DO and Md schools that opened.

Ultimately when a Canadian goes to Ireland or whatever, the realistic end goal is a US residency... not a Canadian one. Once that disappears, going IMG is a dead end. 

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On 6/24/2018 at 2:30 AM, BipolarBearr said:

So both USDO and Ireland IMGs are viewed equally in regards to matching in residency in Canada BUT USDOs are almost guaranteed matching into residency in the US?

It seems more appealing to me that Ireland IMGs can come back to Canada as an MD but USDOs don't count as MDs in Canada... I don't think I like the idea of that. If I'm going through this long, complicated, expensive route- I'm getting that damn MD lol.

After residency in the US, how easy is it to come back to Canada to actually practice?

Also- how does this plan sound:

2018: Apply to a couple Canadian schools with subpar GPA

2019: Apply broadly in Canada with competitive GPA

2020: Apply broadly in Canada, USMD/USDO and Ireland

 

Actually, in Ireland they don't award an MD, they award a MB BCh BAO, which is technically 3 bachelor's degrees. 

Your plan sounds about right. Give Canada at least 3 shots before you consider elsewhere. 

 

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8 hours ago, Edict said:

Actually, in Ireland they don't award an MD, they award a MB BCh BAO, which is technically 3 bachelor's degrees. 

Your plan sounds about right. Give Canada at least 3 shots before you consider elsewhere. 

 

Great, thank you!

Say I do have to end up applying to Ireland in 3 years, if I go to med school there and go to US for residency would I be able to practice in Canada afterwards? Obviously residency in Canada is ideal but from what everyone has been saying, that's a long shot

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17 minutes ago, BipolarBearr said:

Great, thank you!

Say I do have to end up applying to Ireland in 3 years, if I go to med school there and go to US for residency would I be able to practice in Canada afterwards? Obviously residency in Canada is ideal but from what everyone has been saying, that's a long shot

Yes, you can practice, may need some partial supervision for up to a year but you can practice in Canada provided you can find a job. 

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On 6/23/2018 at 12:40 AM, iFlayx said:

Which part is incorrect?

You said US is an equally reasonable option to Ireland and other IMG routes, USMD are essentially considered CMG for matching purposes.

You could have argued about USDO but with the upcoming merger I suspect USDO will have higher footing than IMG. As it currently stands, they are equivalent for CARMS, sure.

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