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bearpuppy

Med School In Canada Or The Us?

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Hi all,

 

I am in the fortunate position to have been accepted to two medical schools in the US: Dartmouth and Case Western Reserve University. I am currently leaning towards taking CWRU. My question however is regarding the ability to come back to Canada if I do end up doing med school in the US. I am currently waiting for some Canadian schools to give me my decision, but currently I think that the US might be a better option because I'm interested in neurosurgery. However, I also want to keep my options as open as possible. 

 

Would either Case (CWRU) or Dartmouth offer me a better chance to come back to Canada for residency, should I decide to do that instead of stay in the US? Thoughts?

 

Thanks!

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Hi all,

 

I am in the fortunate position to have been accepted to two medical schools in the US: Dartmouth and Case Western Reserve University. I am currently leaning towards taking CWRU. My question however is regarding the ability to come back to Canada if I do end up doing med school in the US. I am currently waiting for some Canadian schools to give me my decision, but currently I think that the US might be a better option because I'm interested in neurosurgery. However, I also want to keep my options as open as possible. 

 

Would either Case (CWRU) or Dartmouth offer me a better chance to come back to Canada for residency, should I decide to do that instead of stay in the US? Thoughts?

 

Thanks!

1. USMD -check ==> CMG status when you apply for CaRMS.

 

You will be fine. 

 

If you really want, you can simply re-apply to the Canadian Med schools you were interviewed at this year, while an M1 in the US. BUT i think because both Canadian MD and US MD schools are LCME accredited, they may not allow you to do this. I know for a fact if you go to a non-LCME accredited school(i.e. all the IMG schools, and USDO programs), you can do this. 

 

2.  Both are strong schools, pick whatever one you like better, or offers you a more affordable cost of attendance(if that is important to you), or one that has EASIER flight access back to Canada, for when you want to come back for leisure or rotations.

 

3. For Neurosurgery, its a small field anyways, but note that as a USMD if you do well, you would be able to get a H1B for a NeuroSurg residency. As far as a I know, you CAN NOT get a Statement of Need for the J1 for NeuroSurg.  

 

SO if you were to stay in Canada for medical school, you would have to gun for a  Canadian Neurosurg program, and if that didn't work out then sit out a year and re-apply to Canadian programs and then US programs too. You could not do a US neurosurg program right away, since you wouldn't be able to take USMLE step 3 in time to get an H1B as a Canadian med student.

 

However, if you went to a USMD program, you could definitely apply to H1B granting Neurosurg programs right away (because you have the F1-OPTI visa extension for PGY1 for doing Med school in the US) and as well apply to Canadian neurosurg programs - the downside to this, is that you would probably have less odds at the Canadian programs compared to a canadian. BUT the upside is that you would have the US as a direct option right after medical school without taking time off. 

 

That said, you may change your mind about neurosurg anyways, so if you get into a Canadian program, I would still go for the Canadian program. 

 

Good luck!

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If your interest is in surgery (any surgery, including nsx), go for a school in US. Whichever you choose, check out the school's own nsx program, because you'll need home field advantage for competitive specialties like nsx. Nsx residents have told me the job prospect for nsx is bleak in Canada. It's much better down south. You'll be well prepared for USMLE at a US school. 

 

Now if money is a concern for you then Canada is a much better option. You just have to be prepared to study USMLE on your own.

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1. USMD -check ==> CMG status when you apply for CaRMS.

 

You will be fine. 

 

If you really want, you can simply re-apply to the Canadian Med schools you were interviewed at this year, while an M1 in the US. BUT i think because both Canadian MD and US MD schools are LCME accredited, they may not allow you to do this. I know for a fact if you go to a non-LCME accredited school(i.e. all the IMG schools, and USDO programs), you can do this. 

 

2.  Both are strong schools, pick whatever one you like better, or offers you a more affordable cost of attendance(if that is important to you), or one that has EASIER flight access back to Canada, for when you want to come back for leisure or rotations.

 

3. For Neurosurgery, its a small field anyways, but note that as a USMD if you do well, you would be able to get a H1B for a NeuroSurg residency. As far as a I know, you CAN NOT get a Statement of Need for the J1 for NeuroSurg.  

 

SO if you were to stay in Canada for medical school, you would have to gun for a  Canadian Neurosurg program, and if that didn't work out then sit out a year and re-apply to Canadian programs and then US programs too. You could not do a US neurosurg program right away, since you wouldn't be able to take USMLE step 3 in time to get an H1B as a Canadian med student.

 

However, if you went to a USMD program, you could definitely apply to H1B granting Neurosurg programs right away (because you have the F1-OPTI visa extension for PGY1 for doing Med school in the US) and as well apply to Canadian neurosurg programs - the downside to this, is that you would probably have less odds at the Canadian programs compared to a canadian. BUT the upside is that you would have the US as a direct option right after medical school without taking time off. 

 

That said, you may change your mind about neurosurg anyways, so if you get into a Canadian program, I would still go for the Canadian program. 

 

Good luck!

 

Thank you for the detailed feedback. I think you've pretty much confirmed what I already knew - which is that for the most options down the road, assuming neurosurg is what I want to do, is to do the USMD. I'll add that the H1-B may not be an issue in the long run because I can (1) apply to the green card lottery [born outside of Canada] and (2) I can self-sponsor because of my PhD. So either way I should have it by the time I graduate from a US school. It's trickier coming from Canada for the reasons you mentioned, despite these other advantages, because timing is an issue.

 

Question for you about if one ends up deciding to try and match CaRMS neurosurg after USMD: Do you think in this case you would have to try and do an away rotation in Canada to try and make contacts?

 

 

If your interest is in surgery (any surgery, including nsx), go for a school in US. Whichever you choose, check out the school's own nsx program, because you'll need home field advantage for competitive specialties like nsx. Nsx residents have told me the job prospect for nsx is bleak in Canada. It's much better down south. You'll be well prepared for USMLE at a US school. 

 

Now if money is a concern for you then Canada is a much better option. You just have to be prepared to study USMLE on your own.

 

 

Interesting comment about surgery in general -- didn't know the outlook was poor overall. Dartmouth doesn't have a strong neurosurgery program - only 1 resident per year. But Case has lots - 3 residents there and 2 at cleveland clinic. Also the most recent NRMP match results are amazing - 10 students going into neurosurgery from Case. 

 

Money is a bit of a concern - but I'm not even sure yet if I will have the luxury to decide. I don't feel like my chances are that great at getting into either U of C or U of A, but one never knows. 

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"I can (1) apply to the green card lottery [born outside of Canada] "

What do you mean by this? As an FYI the green card lottery, I thought was defunct as of 2016? Even if it's not...its still an extremely slim chance even if you are born outside of Canada etc. 

But since you bring up being born outside of Canada, does that mean you have another citizenship other than Canada? Because if so, you may be able to get that country to sponsor your J1 SON..most countries other than Canada don't have the caps and all that. Just random thoughts to throw into the commentary.

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"Question for you about if one ends up deciding to try and match CaRMS neurosurg after USMD: Do you think in this case you would have to try and do an away rotation in Canada to try and make contacts?"

I think that would be a reasonable thing to do, that is what most Canadians have to do as well, i.e. attend med at UofC, do an away at UofT to get face time etc.

With careful planning, you should be able to make yourself a strong candidate on both sides of the border.

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"I can (1) apply to the green card lottery [born outside of Canada] "

 

What do you mean by this? As an FYI the green card lottery, I thought was defunct as of 2016? Even if it's not...its still an extremely slim chance even if you are born outside of Canada etc. 

 

But since you bring up being born outside of Canada, does that mean you have another citizenship other than Canada? Because if so, you may be able to get that country to sponsor your J1 SON..most countries other than Canada don't have the caps and all that. Just random thoughts to throw into the commentary.

 

It's called the "Diversity Lottery" and basically it is for citizens (or those born in) of countries that generally have low immigration rates to the US. Where I am born is one of these nations, and that makes me eligible to put my name in for the lottery. The chance of getting it is about 1/20 or so, which isn't great, but the chance is actually slightly better because they "over select" due to attrition either from people deciding they don't want to do it or from people who do not pass the screenings. Essentially it would give me permanent residency without having to qualify in specific categories.

 

"I can self-sponsor because of my PhD."

 

Again, can you elaborate? Do you mean you can self-sponsor your H1B? I'm not too sure what you mean by this, and if that is what you mean...i'm not sure that is how it works. May need more clarity on this.

 

 

I am eligible to self-sponsor a green card in either the E1 or E2 categories. It's not a sure thing, and it requires a ton of paper work, but people do it all the time, and there are no quotas. It does take a while for processing though. 

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It's called the "Diversity Lottery" and basically it is for citizens (or those born in) of countries that generally have low immigration rates to the US. Where I am born is one of these nations, and that makes me eligible to put my name in for the lottery. The chance of getting it is about 1/20 or so, which isn't great, but the chance is actually slightly better because they "over select" due to attrition either from people deciding they don't want to do it or from people who do not pass the screenings. Essentially it would give me permanent residency without having to qualify in specific categories.

 

 

 

I am eligible to self-sponsor a green card in either the E1 or E2 categories. It's not a sure thing, and it requires a ton of paper work, but people do it all the time, and there are no quotas. It does take a while for processing though. 

1. Right, I understand the diversity lottery, but I had thought for some reason it was going to be discountinued in the near future. I must have recalled incorrectly!

 

As for the odds, yes they are quite low...but not impossible as long as your country of birth is eligible.

 

2. As for E1 and E2, I won't pry into your personal life, but those are essentially for substantial business investments and the likes...I was just unclear what your PhD had to do with it - unless you are involved in multinational company that revolves around your PhD work /patents etc?      I have very little understanding of your personal position, so i'll leave that research for yourself.

 

 

But back to the part of having another nationality, I would definitely look into your countries J1-Statement of Need process. You may be able to use that as your ECFMG status. And then you would be able to bypass Health Canada's restrictions anyways...and open up a whole lot more options for residencies since you could then do any residency on a J1 etc. 

 

 

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Neurosurg isn't competitive in Canada. But you would definitely need to do one or more electives up here to get a spot.

 

The job market is bad for neurosurgeons but not as bad as some other surgical specialties. Funding problems may make the situation worse before it gets better. The big problem in neurosurgery residencies is attrition from burn out and transfer.

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Neurosurg isn't competitive in Canada. But you would definitely need to do one or more electives up here to get a spot.

 

The job market is bad for neurosurgeons but not as bad as some other surgical specialties. Funding problems may make the situation worse before it gets better. The big problem in neurosurgery residencies is attrition from burn out and transfer.

Which ones are worse than neuro? Out of curiosity. 

I thought neuro was one of/if not the worst for jobs

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Ortho and Cardiac 

Right.....scary situation. 

 

I'm worried about what things in even more disciplines will be like in a few years time as the amount of people looking for work seems to be increasing steadily 

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Right.....scary situation. 

 

I'm worried about what things in even more disciplines will be like in a few years time as the amount of people looking for work seems to be increasing steadily 

 

That's astute.  Most of us think it's getting worse and will be compounded by an excess of graduates for the next 5 years at least.  But it will rapidly reverse at some point. Or the healthcare system will collapse when no one can get elective surgeries.  It's not that the demand isn't there, but OR time is WAY down the list of funding priorities right now.

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That's astute.  Most of us think it's getting worse and will be compounded by an excess of graduates for the next 5 years at least.  But it will rapidly reverse at some point. Or the healthcare system will collapse when no one can get elective surgeries.  It's not that the demand isn't there, but OR time is WAY down the list of funding priorities right now.

Or maybe, the government will wake up and start providing enough funding to clear the massive waitlists for elective surgeries....

 

Wishful thinking, I know. But it is a bit scary knowing that we'll be facing a less-than-stellar job market with a debt that's not insignificant. Job market is definitely going to play a bigger role than it ideally would when it comes time to look at specialties  

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2. As for E1 and E2, I won't pry into your personal life, but those are essentially for substantial business investments and the likes...I was just unclear what your PhD had to do with it - unless you are involved in multinational company that revolves around your PhD work /patents etc?      I have very little understanding of your personal position, so i'll leave that research for yourself.

 

 

But back to the part of having another nationality, I would definitely look into your countries J1-Statement of Need process. You may be able to use that as your ECFMG status. And then you would be able to bypass Health Canada's restrictions anyways...and open up a whole lot more options for residencies since you could then do any residency on a J1 etc. 

 

 

 

 

Sorry, I had the numbers wrong. It is not the business investment ones. It is the following:

 

 

 
Green Card Through Self Petition

In two classifications of immigrant workers, the workers are not required to have a job offer and may self-petition (the worker does not need an employer to sponsor them).  These categories include:

  • Individuals of extraordinary ability in the sciences, arts, education, business or athletics, (E11)
  • Individuals who were granted a National Interest Waiver (NIW), (E21)

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If your interest is in surgery (any surgery, including nsx), go for a school in US. Whichever you choose, check out the school's own nsx program, because you'll need home field advantage for competitive specialties like nsx. Nsx residents have told me the job prospect for nsx is bleak in Canada. It's much better down south. You'll be well prepared for USMLE at a US school. 

 

Now if money is a concern for you then Canada is a much better option. You just have to be prepared to study USMLE on your own.

 

I wouldn't say this is try for ANY surgical specialty. It's an issue if your Canadian residency won't let you sit the American Boards, but if your program qualifies you for the US boards, you can pretty easily write your US boards the same year as your Royal College exam (they are easier than the RC exam for most specialities). 

 

A ton of Canadian trained surgeons go to work in the US after they are done residency.

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I wouldn't say this is try for ANY surgical specialty. It's an issue if your Canadian residency won't let you sit the American Boards, but if your program qualifies you for the US boards, you can pretty easily write your US boards the same year as your Royal College exam (they are easier than the RC exam for most specialities). 

 

A ton of Canadian trained surgeons go to work in the US after they are done residency.

 

 

How does one reasonably get a job if the american board won't certify you? That's my problem with neuro, is that it doesn't seem the US board will certify you. That doesn't prevent you from obtaining a licence or a job, but it seems that many jobs require certification. no?

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How does one reasonably get a job if the american board won't certify you? That's my problem with neuro, is that it doesn't seem the US board will certify you. That doesn't prevent you from obtaining a licence or a job, but it seems that many jobs require certification. no?

There is "board certified" and "board eligible", board certified being the best situation, but if for some reason or other you haven't taken the exams or let your certification lapse, being "board eligible" is considered next best. 

 

However, if you aren't even "board eligible" then that would be an issue.

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There is "board certified" and "board eligible", board certified being the best situation, but if for some reason or other you haven't taken the exams or let your certification lapse, being "board eligible" is considered next best. 

 

However, if you aren't even "board eligible" then that would be an issue.

 

 

Yea my understanding is that you wouldn't be board eligible based on the mere fact that they require 84mo and Canada is 72.

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Hey Bearpuppy. Nice to know you now have choices :) . Are you leaning one way or the other?

 

 

Struggling to decide but I think Calgary will probably win out. The financial difference is gigantic. I could do it, but it would be a rough 10-15 years before things equal out.

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