GrouchoMarx Posted August 20, 2015 Report Share Posted August 20, 2015 Canadian bureaucracy at its finest. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 Wait so if you lets say did residency in Canada and wanted to subspecialize in the US would that still be allowed? Can you just get an H1B instead? It seems ridiculous that our countries supposedly have free trade, we have the NEXUS cross border pass and yet getting a visa to work in the other country is more difficult than for 3rd world countries. Category C applies to all fully licensed physicians, regardless if your training was in Canada or US etc. So if you come back to Canada from the US as lets say a FM doc, and get fully licensed, then you would be allowed to do a +1 in the US on visa no problem under category c (this is another upcoming change in 2017 IIRC, whereas before you could just go ahead and do a +1 fellowship after FM). But in 2017, you have to come back to FM, get your full license, and then you can go to the US again for fellowship. For those in the US who want to subspecialize (i.e. IM), you'd have to come back to Canada first and get licensed in GIM first, and then you are free to subspecialize under category C after. The problem that is being put forward is, that many of those currently pursuing IM, with intent to subspec, all won't be able to get the +1's or chief residents to satisfy royal college year lengths. Just based on the fact that there are definitely not enough of those +1s for all Canadians currently in the various IM programs in the US, not to mention its even less because not all of them sponsor visas. This is the current issue, and why they want to grandfather in those who are currently in IM at US programs. Otherwise, a lot of them are really screwed and theres going to be a lot of potential law suits and media attention if you suddenly have 100+ people being scre*ed. That is how i understand it. There are no caps or restrictions under Category C for fully licenesed docs. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 There are options for IM and anesthesiology residents, namely to complete an additional year of training as a fellow or as a Chief Resident to get their training up to Royal College standards. They just couldn't do a multi-year fellowship to subspecialize. The complaint seems to be that those options are too difficult to reliably pursue, in which case the SON policy should be changed to provide some additional flexibility, but I have no idea whether that's a valid complaint or not. This. There are NOT enough +1s and chief resident roles in the US, for all of the Canadians currently in IM programs to satisfy Royal college standards. There just aren't. And then if you factor that a portion of those spots that there are, do not sponsor visas, and then it gets even smaller. If they don't grandfather in the current IM residents, then a lot of people are going to be left with useless training they can't use. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 More like you'd do 4 years in general IM, get certified, and then apply to the US for your subspecialty training. Category A applications also seem to imply that if you started your IM training here and wanted to do your subspecialty training in the US after three years of IM, that would not be subject to the restrictions, but the wording is not entirely clear to me. Edit - They're carving out a lot of exceptions for Canadians who want to get expert training in the US, to have that exchange of ideas you mention. Canadian physicians and residents can still do fellowships and subspecialty training in the US, without much difficulty. The goal seems to be to halt what looked to be a growing back-door to practicing medicine in Canada through US residencies. One poster on SDN reported that the number of Canadians doing IM on J1 visas in Canada shot up dramatically in the last 5 years or so. From the NRMP match stats, this isn't due to a rush of CMGs to the US and from CaRMs stats probably isn't due to an increase in Canadian USMDs either. It's CSAs (and maybe some Canadian USDOs) driving those numbers. If Canadian governments are worried about physician over-supply, as the Ontario government claims they are, cutting residency positions in Canada while leaving the J1 visa route as it was would have been like bandaging a paper cut on a gunshot victim. One thing i should note, reciprocity. Because they are ACGME trained in the US, there is no way of stopping them from coming to Canada to practice - they can limit them in the first place(i.e. limit Canadian non-dual citizens) from being able to pursue certain US specialties, but they can't stop them once they are already trained. If they started doing that, then there would be some issues. As its stands, someone who is a dual-citizen, if they planned ahead enough - could use their other citizenship to get the SON, and Canada would have zero say on what training they could do in the US. And then subsequently once their training was at the same requirements by the royal college - walk right back into Canada. Not 100% sure on this, but seems plausible and has been in some conversations with my IMG friends. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 Canadian bureaucracy at its finest. Too be fair, it is their choice on how they manage their healthcare workforce. I don't necessarily agree with their methods or rationales, but still it is their choice. Link to comment Share on other sites More sharing options...
NLengr Posted August 20, 2015 Report Share Posted August 20, 2015 Luckily, I don't think this will affect surgical fellowships, since we all have FRCSC before fellowships start. Correct me if I'm wrong. Can someone summarize how this effects CMG's and IMG's? It's pretty confusing for people who haven't looked into US residency/fellowships (myself included). I have a family member who has decided to go to the Carribean and this seems like it could have a huge impact on that person. Link to comment Share on other sites More sharing options...
ralk Posted August 20, 2015 Report Share Posted August 20, 2015 This. There are NOT enough +1s and chief resident roles in the US, for all of the Canadians currently in IM programs to satisfy Royal college standards. There just aren't. And then if you factor that a portion of those spots that there are, do not sponsor visas, and then it gets even smaller. If they don't grandfather in the current IM residents, then a lot of people are going to be left with useless training they can't use. If that's the case, it'll take more of a fix than simply grandfathering in current residents. They might be cutting the number of SONs for IM residencies, but they're still looking at 200 in the first year and likely over 100 for the foreseeable future. The 2017 incoming cohort looks to be bigger than the 2017 graduating cohort. Best solution I can see is expanding the specialty training requirements exemption to include two-year GIM fellowships, maybe include some in-demand subspecialties (like Rheumatology). As the number of SONs go down for IM, the problem gets easier for those who get one. Link to comment Share on other sites More sharing options...
ralk Posted August 20, 2015 Report Share Posted August 20, 2015 Luckily, I don't think this will affect surgical fellowships, since we all have FRCSC before fellowships start. Correct me if I'm wrong. Can someone summarize how this effects CMG's and IMG's? It's pretty confusing for people who haven't looked into US residency/fellowships (myself included). I have a family member who has decided to go to the Carribean and this seems like it could have a huge impact on that person. The difference is really between those in Canadians residencies and those in (or applying for) US residencies. Not really any different between how this effects CMGs and IMGs, though IMGs will be impacted more since they're far more likely to pursue their main residency in the US than a CMG. People in Canadian residencies: No impact for anyone except maybe those in IM or Peds looking to pursue their main subspecialtiy training in the US after 3 years of general IM/Peds. I think even those individuals should be covered under Category A, but the language there is vague. People in United States residencies: No impact for anyone currently in most programs except for IM, Peds and Anesthesiology currently studying on a J1 visa, since their training programs are shorter than Royal College standards. Under the proposed changes, they would be ineligible for further training in the US aside from 1-year programs. Without additional training, they cannot work in Canada. Because they're on a J1 visa, they also cannot return to work in the US for two years after completing their residency. They can apply for Canadian subspecialty fellowships, from what I understand, but there are far more Canadians on J1 visas training in IM in the US than that would allow for. People Applying for United States residencies: Hypothetically no impact on obtaining a US residency, but a large potential impact on keeping that residency. If the prospective resident cannot obtain a visa, they don't get their residency. CMGs (including fully-licenced physicians looking for a new specialty) and USMDs should have a reasonable shot at getting an H1B visa, which isn't subject to this change. CSAs and probably USDOs will have a tougher time getting those and are likely to be squeezed by the reduction in the number of Statements of Need Canada is willing to issue to endorse J1 visas. The exact effect depends on the specialty, how many Canadians match to programs in a given specialty relative to the number of SONs available. Haven't been able to find good numbers for any of the specialties though to determine which specialties will have it harder. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 The difference is really between those in Canadians residencies and those in (or applying for) US residencies. Not really any different between how this effects CMGs and IMGs, though IMGs will be impacted more since they're far more likely to pursue their main residency in the US than a CMG. People in Canadian residencies: No impact for anyone except maybe those in IM or Peds looking to pursue their main subspecialtiy training in the US after 3 years of general IM/Peds. I think even those individuals should be covered under Category A, but the language their is vague. People in United States residencies: No impact for anyone currently in most programs except for IM, Peds and Anesthesiology currently studying on a J1 visa, since their training programs are shorter than Royal College standards. Under the proposed changes, they would be ineligible for further training in the US aside from 1-year programs. Without additional training, they cannot work in Canada. Because they're on a J1 visa, they also cannot return to work in the US for two years after completing their residency. They can apply for Canadian subspecialty fellowships, from what I understand, but there are far more Canadians on J1 visas training in IM in the US than that would allow for. People Applying for United States residencies: Hypothetically no impact on obtaining a US residency, but a large potential impact on keeping that residency. If the prospective resident cannot obtain a visa, they don't get their residency. CMGs (including fully-licenced physicians looking for a new specialty) and USMDs should have a reasonable shot at getting an H1B visa, which isn't subject to this change. CSAs and probably USDOs will have a tougher time getting those and are likely to be squeezed by the reduction in the number of Statements of Need Canada is willing to issue to endorse J1 visas. The exact effect depends on the specialty, how many Canadians match to programs in a given specialty relative to the number of SONs available. Haven't been able to find good numbers for any of the specialties though to determine which specialties will have it harder. I just want to add, that the ability to get the H1B, is not going to be easier for CMGS/USMDs versus USDO/IMG for the main residency. It actually, would probably be easiest for USMDs and USDOs, because they are on F1 student visa's and can use OPTI for PGY1. That then gives the residency time to apply for H1B. (USMDs likely have an edge over USDOs, at the few programs that still have a bias towards MD etc. ) CMGs and IMGs do NOT have the option of going on the OPTI visa for PGY1, so would likely have a harder time getting the H1B via that method. Overall though, getting the H1B is still hard, when you're talking specifically about getting the main residency. If we are talking about practicing physicians moving to the US, that is a different story. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 If that's the case, it'll take more of a fix than simply grandfathering in current residents. They might be cutting the number of SONs for IM residencies, but they're still looking at 200 in the first year and likely over 100 for the foreseeable future. The 2017 incoming cohort looks to be bigger than the 2017 graduating cohort. Best solution I can see is expanding the specialty training requirements exemption to include two-year GIM fellowships, maybe include some in-demand subspecialties (like Rheumatology). As the number of SONs go down for IM, the problem gets easier for those who get one. Right, well, if they grandfather in the current residents - those current residents can go on and do their subspecialization training without limitation from Health Canada. Not all of them will want to come back to Canada anyways, many will stay in the US. For those going through the upcoming match, should be when the changes should affect them. It's just not fair to literally screw over those who already went into internal med and are currently PGY#'s, with hopes of subspecialization. Talking to a friend who is in this situation, they would simply have just gone into FM or a different field. It is perfectly reasonable to make the change, such that it would only affect those who have yet to match. That way they can plan accordingly and still decide if IM is right for them, without the option of subspec. Link to comment Share on other sites More sharing options...
ralk Posted August 20, 2015 Report Share Posted August 20, 2015 I just want to add, that the ability to get the H1B, is not going to be easier for CMGS/USMDs versus USDO/IMG for the main residency. It actually, would probably be easiest for USMDs and USDOs, because they are on F1 student visa's and can use OPTI for PGY1. That then gives the residency time to apply for H1B. (USMDs likely have an edge over USDOs, at the few programs that still have a bias towards MD etc. ) CMGs and IMGs do NOT have the option of going on the OPTI visa for PGY1, so would likely have a harder time getting the H1B via that method. Overall though, getting the H1B is still hard, when you're talking specifically about getting the main residency. If we are talking about practicing physicians moving to the US, that is a different story. Fair enough for the DOs, I forgot about the OPTI visa. I've heard the H1B visa route is a pain for programs, so stronger candidates are more likely to get into a program that offers one. Higher-end programs want the absolute best residents, they'll do the the extra legwork to get an H1B visa arranged. Middle- or low-tier programs aren't going to fight for a candidate when the replacement will be almost as good. Since many high-end programs don't even look at IMGs, it's tougher for them to get an H1B than it would be for CMGs who will at least be given a fair chance for those programs. Right, well, if they grandfather in the current residents - those current residents can go on and do their subspecialization training without limitation from Health Canada. Not all of them will want to come back to Canada anyways, many will stay in the US. For those going through the upcoming match, should be when the changes should affect them. It's just not fair to literally screw over those who already went into internal med and are currently PGY#'s, with hopes of subspecialization. Talking to a friend who is in this situation, they would simply have just gone into FM or a different field. It is perfectly reasonable to make the change, such that it would only affect those who have yet to match. That way they can plan accordingly and still decide if IM is right for them, without the option of subspec. J1s can't stay in the US. Even if they're grandfathered in, the visa stipulates that they have to leave the US for 2 years on completion of their training. Even if current IM residents are grandfathered in, they can't stay there. I agree it's unfair to current IM residents and should be changed to provide a pathway for them. However, grandfathering won't be enough. The number of IM J1s exploded because it's one of the few options for CSAs to match to, family being the other big one. This should push applicants to the US to non-IM fields, but many won't have much choice - it's hard enough for CSAs to get any residency in the US, they can't be picky. That means a lot of incoming Canadian IM residents in the US every year, the majority of which will be unable to complete their residencies - it doesn't end with the current crop. Sure, it'll be their own stupid faults for putting themselves in that situation, but the Canadian SON system will have abetted that stupidity... As much as I want to close back-doors into practicing medicine in Canada, there's no point trapping people half-way and without a long-term change, it sounds like that's exactly what the proposed framework will do. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 J1s can't stay in the US. Even if they're grandfathered in, the visa stipulates that they have to leave the US for 2 years on completion of their training. Even if current IM residents are grandfathered in, they can't stay there. I agree it's unfair to current IM residents and should be changed to provide a pathway for them. However, grandfathering won't be enough. The number of IM J1s exploded because it's one of the few options for CSAs to match to, family being the other big one. This should push applicants to the US to non-IM fields, but many won't have much choice - it's hard enough for CSAs to get any residency in the US, they can't be picky. That means a lot of incoming Canadian IM residents in the US every year, the majority of which will be unable to complete their residencies - it doesn't end with the current crop. Sure, it'll be their own stupid faults for putting themselves in that situation, but the Canadian SON system will have abetted that stupidity... As much as I want to close back-doors into practicing medicine in Canada, there's no point trapping people half-way and without a long-term change, it sounds like that's exactly what the proposed framework will do. The J1 goes up to 7 years, enough for those same IM residents to continue their training in subspecialization. That is the whole issue here, it is Canada's SON stipulations that are causing issue. Not the mechanics of the J1 visa. The majority of other countries do not have such stipulations on the SON. But again, most of them don't have the problem of not wanting their trainees to return, or care if they just stay in the US for the long term picture etc. Unless you meant the fully trained IM subspecialists being forced back to Canada for 2 years after being fully trained. That is correct there is a 2 year requirement. However, there are 2-3 ways of getting around this and staying indefinitely in the US, if that is what one wants. If those options do not work, and one still wants to long term stay in the US -they can fulfill the 2 year requirement and then be free to go back on a new visa. Definitely agree with you on the part of those who may currently be going through medical school and feeling the pinch - I agree, that is their own fault. I am more concerned for those who are current residents, and the changes only affecting those whom have yet to apply for residency. Link to comment Share on other sites More sharing options...
ralk Posted August 20, 2015 Report Share Posted August 20, 2015 The J1 goes up to 7 years, enough for those same IM residents to continue their training in subspecialization. That is the whole issue here, it is Canada's SON stipulations that are causing issue. Not the mechanics of the J1 visa. The majority of other countries do not have such stipulations on the SON. But again, most of them don't have the problem of not wanting their trainees to return, or care if they just stay in the US for the long term picture etc. Unless you meant the fully trained IM subspecialists being forced back to Canada for 2 years after being fully trained. That is correct there is a 2 year requirement. However, there are 2-3 ways of getting around this and staying indefinitely in the US, if that is what one wants. If those options do not work, and one still wants to long term stay in the US -they can fulfill the 2 year requirement and then be free to go back on a new visa. I agree though about not trapping people half-way and long-term change being necessary! What options are there for J1s to stay in the US besides marrying an American for a Green Card? Any reason an IM resident without a subspecilaty couldn't take advantage of those paths? As for what the issue is for all this, there's a lot of aspects and plenty of blame to go around. Canada's change to the SON might be the immediate cause, but really all they're saying is that Canada needs a limited number of US-trained physicians (not including fellowships for additional training of already-certified physicians). That's what they're supposed to do. US immigration are the ones insisting on the SON and tying it to a specific program (the 7 year limit only applies to programs that last 7 years). Heck, if the US had the same citizenship/PR requirements for residency positions Canada does, this wouldn't be a pathway at all. This problem also wouldn't exist if IM, Peds, and Anesthesiology training programs were standardized between the US and Canada. I realize Canada's SON changes are understandably the ones drawing the ire of those affected, but to me it seems like the policy change itself has some merit given their goals, they just failed to account for how broken the rest of the medical education system truly is. Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 What options are there for J1s to stay in the US besides marrying an American for a Green Card? Any reason an IM resident without a subspecilaty couldn't take advantage of those paths? As for what the issue is for all this, there's a lot of aspects and plenty of blame to go around. Canada's change to the SON might be the immediate cause, but really all they're saying is that Canada needs a limited number of US-trained physicians (not including fellowships for additional training of already-certified physicians). That's what they're supposed to do. US immigration are the ones insisting on the SON and tying it to a specific program (the 7 year limit only applies to programs that last 7 years). Heck, if the US had the same citizenship/PR requirements for residency positions Canada does, this wouldn't be a pathway at all. This problem also wouldn't exist if IM, Peds, and Anesthesiology training programs were standardized between the US and Canada. I realize Canada's SON changes are understandably the ones drawing the ire of those affected, but to me it seems like the policy change itself has some merit given their goals, they just failed to account for how broken the rest of the medical education system truly is. Through 2 specific programs, each state has 60 waivers available to offer physicians whom are on J1 visas, so that they don't have to return home for 2 years and can be transitioned onto the H1B visa. That is 300 total right there. Of course you have to agree then to work in underserved areas or for federal/municipal hospitals blah blah. And yes, then there is marrying an american for green card! And then, there is just going home for 2 years, and then simply getting another J1 visa or H1B to return to work again. An IM resident without subspec, could stay and work after transitioning. But that's not the point, the point is that they would not have sufficient options to be able to get required training and come back to Canada and would just have to keep trying to secure one of those fellowships to "top up" . Or that they only went into IM in the first place to subspecialize, and now just lost that option. The point is that its not really cool to change the rules once someone is already on a path, at least at the point of residency. I have no problem that those who aren't even in residency yet are having limited options - they can plan accordingly for the best path based on the new rules. ----- As for the rest, I agree - its a broken system. The one thing I don't agree with is the SON blame onto the US. Yes, the US requires the SON. But Canada is one of very few countries that then goes ahead and restricts it. I agree though 100% that it is their right to manage their potential workforce and that Canada has a very different health care system than other places in the world that send physicians to train in the US. Many of the other countries that send people to the US for training, don't have the same problem. Why? Because they know the docs are more likely to just stay in the US and not come back. Or if they do come back, that isn't an issue either - being a physician isn't as lucrative or tied to a special kind of health care system that would be upended if they did return. Or, they do have the capacity for them to return, simply because they need them to return (3rd world etc). Just so we're clear - we are both on the same page. I'm just sticking to the point that it's probably a good idea to make sure those whom are already in residency, don't get shafted. Shaft away to those whom aren't in training yet, and restrict it to FM for example and have them only be able to come back on a ROS if you need to. Or whatever else Canada wants to do that makes them feel better about the bloat in our healthcare system that is causing leakage on our effectiveness on health care $$. Link to comment Share on other sites More sharing options...
ralk Posted August 20, 2015 Report Share Posted August 20, 2015 Through 2 specific programs, each state has 60 waivers available to offer physicians whom are on J1 visas, so that they don't have to return home for 2 years and can be transitioned onto the H1B visa. That is 300 total right there. Of course you have to agree then to work in underserved areas or for federal/municipal hospitals blah blah. And yes, then there is marrying an american for green card! And then, there is just going home for 2 years, and then simply getting another J1 visa or H1B to return to work again. An IM resident without subspec, could stay and work after transitioning. But that's not the point, the point is that they would not have sufficient options to be able to get required training and come back to Canada and would just have to keep trying to secure one of those fellowships to "top up" . Or that they only went into IM in the first place to subspecialize, and now just lost that option. The point is that its not really cool to change the rules once someone is already on a path, at least at the point of residency. I have no problem that those who aren't even in residency yet are having limited options - they can plan accordingly for the best path based on the new rules. ----- As for the rest, I agree - its a broken system. The one thing I don't agree with is the SON blame onto the US. Yes, the US requires the SON. But Canada is one of very few countries that then goes ahead and restricts it. I agree though 100% that it is their right to manage their potential workforce and that Canada has a very different health care system than other places in the world that send physicians to train in the US. Many of the other countries that send people to the US for training, don't have the same problem. Why? Because they know the docs are more likely to just stay in the US and not come back. Or if they do come back, that isn't an issue either - being a physician isn't as lucrative or tied to a special kind of health care system that would be upended if they did return. Or, they do have the capacity for them to return, simply because they need them to return (3rd world etc). Just so we're clear - we are both on the same page. I'm just sticking to the point that it's probably a good idea to make sure those whom are already in residency, don't get shafted. Shaft away to those whom aren't in training yet, and restrict it to FM for example and have them only be able to come back on a ROS if you need to. Or whatever else Canada wants to do that makes them feel better about the bloat in our healthcare system that is causing leakage on our effectiveness on health care $$. Each state has 60 waivers? Isn't that 3000 waivers?! And yeah, I figured we were on the same page, and I totally agree that this change is being made with completely insufficient warning for those it affects. Still, it's good to hear contrasting viewpoints, even if there's agreement on many of the specifics. Thanks for the extra info on the visa system Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 US immigration are the ones insisting on the SON and tying it to a specific program (the 7 year limit only applies to programs that last 7 years). Just to be clear, if one wanted to do IM and then subspecialize - it would all be on the same J1 visa. Once they finish the first program, they would simply just get another SON for the fellowship option, and continue on up to a maximum of 7 years Link to comment Share on other sites More sharing options...
JohnGrisham Posted August 20, 2015 Report Share Posted August 20, 2015 Each state has 60 waivers? Isn't that 3000 waivers?! And yeah, I figured we were on the same page, and I totally agree that this change is being made with completely insufficient warning for those it affects. Still, it's good to hear contrasting viewpoints, even if there's agreement on many of the specifics. Thanks for the extra info on the visa system Oh I fail. Well, one program(IGA) has 30 waivers per state. And then the second program(Condrad 30), also has 30 waivers per state. So i guess you are right, that's 3000. Apparently I can't do math. This actually makes much more sense, given how many Indian and Chinese physicians are able to stay and immigrate to the US via the J1 waivers. Of course there are restrictions in their own right, but once you get a waiver job and "put in the work" for those few years while being on the H1B, then you get your green card. And with the green card, you can go do whatever the heck you want. http://www.nejmcareercenter.org/minisites/rpt/physicians-and-immigration-faq/ I'm actually slightly disappointed I made that brain fart EDIT: So I may have been incorrect about IGA being different from Conrad30... so it may be actually closer to >1000 waivers. Still alot! Further reading: http://www.cascadia.com/2013/12/j-1-waiver-recommendation-rates-posted-by-department-of-state/ Link to comment Share on other sites More sharing options...
Laika Posted August 21, 2015 Report Share Posted August 21, 2015 I've heard the H1B visa route is a pain for programs, so stronger candidates are more likely to get into a program that offers one. Higher-end programs want the absolute best residents, they'll do the the extra legwork to get an H1B visa arranged. Many programs just refuse to offer H1Bs to anyone, even some "higher-end programs." Another potential issue is that program directors will be made aware of this SON issue, and may be reluctant to rank Canadian applicants in case they match to their program and are unable to secure a SON to obtain a J1 visa. It's bad for the trainee - it's also problematic for the program who is missing a resident on their call schedule on July 1. Link to comment Share on other sites More sharing options...
ralk Posted August 21, 2015 Report Share Posted August 21, 2015 Many programs just refuse to offer H1Bs to anyone, even some "higher-end programs." Another potential issue is that program directors will be made aware of this SON issue, and may be reluctant to rank Canadian applicants in case they match to their program and are unable to secure a SON to obtain a J1 visa. It's bad for the trainee - it's also problematic for the program who is missing a resident on their call schedule on July 1. Oh, absolutely true on both counts. There are a subset of programs that will grant H1Bs though and since CMGs have much higher standing than CSAs at many programs, CMGs have a better shot at an H1B. I should mention that SON restrictions have applied to many specialties for years that still took on Canadians, so while I don't doubt there will be some hesitancy from programs to rank Canadians, from past experiences it doesn't sound like it'll be a deal-breaker either. Link to comment Share on other sites More sharing options...
ralk Posted October 15, 2015 Report Share Posted October 15, 2015 Just giving this a quick bump to say that the distribution of cuts for CMG positions this year, while not explicitly announced to my knowledge, can be determined by the quotas available on CaRMS for this coming cycle and last years' match results. It takes quite a bit of time to get the final answers (and Ottawa's numbers are clearly wrong on CaRMS right now) so I haven't compiled a full distribution of the changes, but on first glace it looks as though Family Medicine has been left largely untouched. Actually might have had a small bump in positions. OBGYN looks like it lost a few spots. A few surgical specialties may have lost one as well - Gen Surg, Cardiac, Plastics, Ophtho lost one each as far as I can tell. Internal lost a few as well, mostly from Toronto. Might try to compile a full distribution this weekend (no promises), but feel free to check it out yourself if so inclined! Link to comment Share on other sites More sharing options...
amichel Posted October 15, 2015 Report Share Posted October 15, 2015 Just giving this a quick bump to say that the distribution of cuts for CMG positions this year, while not explicitly announced to my knowledge, can be determined by the quotas available on CaRMS for this coming cycle and last years' match results. It takes quite a bit of time to get the final answers (and Ottawa's numbers are clearly wrong on CaRMS right now) so I haven't compiled a full distribution of the changes, but on first glace it looks as though Family Medicine has been left largely untouched. Actually might have had a small bump in positions. OBGYN looks like it lost a few spots. A few surgical specialties may have lost one as well - Gen Surg, Cardiac, Plastics, Ophtho lost one each as far as I can tell. Internal lost a few as well, mostly from Toronto. Might try to compile a full distribution this weekend (no promises), but feel free to check it out yourself if so inclined! This makes a good bit more sense than what people were originally saying Link to comment Share on other sites More sharing options...
GrouchoMarx Posted October 15, 2015 Report Share Posted October 15, 2015 great news (sarcasm x 100) Link to comment Share on other sites More sharing options...
3change Posted October 15, 2015 Report Share Posted October 15, 2015 . Link to comment Share on other sites More sharing options...
ellorie Posted October 15, 2015 Report Share Posted October 15, 2015 U of T psych lost one - but we're a massive program anyway. NOSM psych gained one. McGill psych lost two, but Laval psych gained two. Sask gained one and U of A lost one (though it seems like they've been leaving empty spots recently anyway). So psych broke even, I guess. Link to comment Share on other sites More sharing options...
ralk Posted October 16, 2015 Report Share Posted October 16, 2015 Ok, here's the full list, best as I can tell (definitely a possibility for some errors here, but I've tried to be careful): Western - 1 Emerg, 1 IM, 1 Neuropathology, 1 OBGYN, 1 FM (added 1 Psych) Toronto - 1 Derm, 1 Gen Surg, 4 IM, 1 Neurology, 1 OBGYN, 1 Psych (added 1 Rads, 1 Lab Medicine, 2 Ortho, 7 FM) Ottawa - 1 Medical Microbio, 2 Neurosurg, 1 OBGYN, 1 Ophtho, 1 ENT, 1 PM&R (added 1 Peds) NOSM - No reductions (added 4 FM, 1 Psych) McMaster's and Queen's numbers are still approximate now that I look at them, and so can't derive anything from those numbers yet. Both NOSM and Toronto actually gained spots... not a surprise with NOSM, that was announced, but a bit unexpected from Toronto. They did switch mostly from Royal College positions to FM positions, so that's positive at least. Overall the net change this year appears to be less than the 25 CMG spots advertised, and are weighted more towards programs with poor job markets than to specialties where there is a clear demand for additional physicians. Still not a good thing, but much less concerning than the original announcement, from what I can see. Edit: CaRMS report had a transcription error in the table I looked at, Toronto didn't gain 7 FM spots Link to comment Share on other sites More sharing options...
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