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Canadian Med Students Hoping To End Up In The Us

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Hi everyone,

I haven't posted too much on the forums, but I'm a pretty avid lurker and have checked most of the threads pertinent to my question haha. My girlfriend and I are both medical students in Quebec (year one and year two preclinical), and we are both very interested in pursuing a medical career south of the border.

Unfortunately, there is not much information offered by our school (University of Montreal) for people interested in this pathway. I've been looking around on the forums a lot, but I found certain things less clear than others and was hoping some people could help with some of my questions.

(P.S.  Francophones: J'ai écrit mes questions en anglais mais des réponses en français sont aussi appréciées!)

1) While writing the USMLE, I know the best time to write it is after second year, but what books would you recommend to buy? If anyone has a list of books they used that would be super helpful, because I am confused with all the different resources available. 

2) How feasible is it to get accepted for a residency position in a competitive residency program in the US for Canadians (i.e. ortho)? I've looked into the stats for IMG, which describe it as close to impossible, but I was wondering if the same applies for CMGs. I'm assuming the process for the H1b or J1 visa is still complicated, but if anyone has some light to shed on this, it would be super appreciated!

3) To pursue a medical career in the US, would it be easier to stay in Canada for my residency and apply for a position/H1B visa afterwards, or get into the US system right away for residency? I'm not sure which route would be the safer/easier one to pursue.

4) We are really looking for a Canadian medical graduate that ended up working in the states who could perhaps guide us on what he/she did. It would be really great if we could speak with you!


We really appreciate any answers to our questions and sorry if any of them are redundant,
Merry Christmas!/Joyeux Noël!

 

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3) To pursue a medical career in the US, would it be easier to stay in Canada for my residency and apply for a position/H1B visa afterwards, or get into the US system right away for residency? I'm not sure which route would be the safer/easier one to pursue.

 

It's almost universally considered easier to get into surgical residencies in Canada than the US. Afterwards, many Canadians do go to the US because of better employment opportunities. This is especially true in ortho. The MLE scores needed for residencies like ortho and plastics are very high - most Canadian med school do not have curriculums which are compatible with great MLE success (nor dedicated time for MLE studying). H1B is a visa that can lead to residency and immigration, whereas J1 is more of a student visa (which means in general one must return to Canada). H1B visas require completed MLEs. Many programs sponsor J1 visas.

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It's almost universally considered easier to get into surgical residencies in Canada than the US. Afterwards, many Canadians do go to the US because of better employment opportunities. This is especially true in ortho. The MLE scores needed for residencies like ortho and plastics are very high - most Canadian med school do not have curriculums which are compatible with great MLE success (nor dedicated time for MLE studying). H1B is a visa that can lead to residency and immigration, whereas J1 is more of a student visa (which means in general one must return to Canada). H1B visas require completed MLEs. Many programs sponsor J1 visas.

Thanks for the reply Calcan! Aside from MLE scores however, are CMGs looked at equally when compared to AMGs (once VISAs are factored in). I understand that we are not considered IMGs, but I don't really understand where that places us if we want to apply for a residency in the US. 

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Thanks for the reply Calcan! Aside from MLE scores however, are CMGs looked at equally when compared to AMGs (once VISAs are factored in). I understand that we are not considered IMGs, but I don't really understand where that places us if we want to apply for a residency in the US. 

 

 

I think it depends on the program to some degree.  School reputation and US electives would probably help (McGill and UofT grads likely get a reputation boost).  Here is a link that summarizes what program directors look for across specialties.  I would suppose that CMGs are in general somewhere in the middle of AMG and IMG - links here and here give outcomes by status 

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It is very, very difficult to obtain a H1B visa as a CMG.  Let me explain.

 

One of the prerequisites for applying for a H1B visa is to have passed the USMLE Step 3.  However, you cannot apply to write the USMLE Step 3 until after you graduate from medical school (so May to early June for most people in Canada).

 

It takes four weeks to receive your score for the USMLE Step 3.  Following that, the theoretical minimum time it takes for a H1B petition to get through and be approved is two weeks - however, recently (since last year or so) it has taken months for US Immigration to process H1B petitions.  Yet, to start residency on a H1B you'll need to have in your hands by July 1 at the very latest, if not mid-late June since many American residency programs start that early.

 

Which means it is basically impossible to obtain a H1B visa as a CMG.  Unless you take a year off after graduation or apply as a Canadian resident.  Graduates from US medical schools can get around this because they can do their internship year on their student visa, and use that year to get through the H1B application process.

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What if you get H1B premium processing time? Wouldn't that help. From what I understand, you can get it processed in 15 calendar days.

 

This is highly unlikely to happen. And most people can't just afford to sit a year out twiddling their thumbs.

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This is highly unlikely to happen. And most people can't just afford to sit a year out twiddling their thumbs.

It's one of the biggest benefits of going to a US med school in the first place if you want to do residency in the U.S. - being able to do PGY1 on a student visa(F1-OPTI), so that you can use that year to get affairs in order for H1B and not be stuck with Health Canada's Statement of Need system for J1 visa.

 

As a CMG, your involvement with NRMP is either using it as a back-up the first go around(as NRMP is usually after CaRMS and all that), or going guns blazing as a 2nd redemption after sitting out a year for either not matching via CaRMS or by choice of forgoing CaRMS. 

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Not trying to steal the thread, but I am a Canadian applicant currently applying to several US medical schools. I am planning to have a medical career in the US eventually. If I understand correctly, if accepted to a US school, I will spend my 4 years of MD + 1 year of internship on J1 Visa and spend that internship year to apply for the H1b visa. Is that correct?

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Not trying to steal the thread, but I am a Canadian applicant currently applying to several US medical schools. I am planning to have a medical career in the US eventually. If I understand correctly, if accepted to a US school, I will spend my 4 years of MD + 1 year of internship on J1 Visa and spend that internship year to apply for the H1b visa. Is that correct?

 

No, you would spend your 4 years of the MD program on an F-1 student visa, and if you can find a residency that will sponsor you for an H-1B, then you can extend your F-1 for up to 1 year to cover your internship year through Optional Practical Training (OPT) while you apply for the H-1B.

 

I do not know what the process is for the J-1, but if you want to be able to practice in the US after residency, then you need to get into a program that will sponsor an H-1B visa since the J-1 requires you to return to your home country at the conclusion of your residency training.

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No, you would spend your 4 years of the MD program on an F-1 student visa, and if you can find a residency that will sponsor you for an H-1B, then you can extend your F-1 for up to 1 year to cover your internship year through Optional Practical Training (OPT) while you apply for the H-1B.

 

I do not know what the process is for the J-1, but if you want to be able to practice in the US after residency, then you need to get into a program that will sponsor an H-1B visa since the J-1 requires you to return to your home country at the conclusion of your residency training.

You can also go onto residency on J1 visa, assuming Health canada offers a statement of need for that discipline, and then in order to stay in the US after training you can attempt to go for a j1-visa waiver program like conrad-30...such that you don't have to fulfill the 2 year home requirement. Generally things are easier if you're in a primary care field.

 

 

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Sorry for the delay in my response just start back at school and have been swamped!

Thank you everyone for your answers so far, I really appreciate it! From what I understand so far from all of you, the H1b route seems close to impossible due to the processing time constraints. I will definitely have to look more closely at the J1 waiver program to see what specialities it is offered to. Considering it's to work in underserved communities, I'm assuming it's mainly primary care as most of you have said.

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Sorry for the delay in my response just start back at school and have been swamped!

Thank you everyone for your answers so far, I really appreciate it! From what I understand so far from all of you, the H1b route seems close to impossible due to the processing time constraints. I will definitely have to look more closely at the J1 waiver program to see what specialities it is offered to. Considering it's to work in underserved communities, I'm assuming it's mainly primary care as most of you have said.

I checked out of curiosity knowing the difficult ortho job market in Canada - at this point Health Canada does not issue J-1 statements of need for the specialty.

 

Ortho is a premiere specialty in the US though, and even with visa, it would still be difficult to match at a good place. Long term, if you write the MLEs and do residency in Canada, you will open doors in the US too.

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I checked out of curiosity knowing the difficult ortho job market in Canada - at this point Health Canada does not issue J-1 statements of need for the specialty.

 

Ortho is a premiere specialty in the US though, and even with visa, it would still be difficult to match at a good place. Long term, if you write the MLEs and do residency in Canada, you will open doors in the US too.

 

Thanks for looking into this for me Calcan, I looked into the J-1 statements yesterday as well and came to the same conclusion. The most likely option definitely seems to be matching in Canada, then going down south after. 

 

Considering the job market (or lack thereof) for orthopods in Canada, I'm assuming many of them have already moved down south. I think my next step will be to get in contact with an orthopod who's already done this. The problem however, will be finding one haha.

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Thanks for looking into this for me Calcan, I looked into the J-1 statements yesterday as well and came to the same conclusion. The most likely option definitely seems to be matching in Canada, then going down south after. 

 

Considering the job market (or lack thereof) for orthopods in Canada, I'm assuming many of them have already moved down south. I think my next step will be to get in contact with an orthopod who's already done this. The problem however, will be finding one haha.

 

Good luck!

 

How hard is it to get an elite score on MLEs if you go to a Canadian med school?

 

It depends not only on the student, but the school as well.  Canadians value the notion of equality, but this isn't necessarily the case across med school teaching.  More traditional, 4 year programs like McGill or UofT seem to be more exposed to the MLE style curriculum.  That's probably partly why their graduate tend to participate more in the US Match (and the reputation of the school on top of more research opportunities helps).  

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Good luck!

 

 

It depends not only on the student, but the school as well.  Canadians value the notion of equality, but this isn't necessarily the case across med school teaching.  More traditional, 4 year programs like McGill or UofT seem to be more exposed to the MLE style curriculum.  That's probably partly why their graduate tend to participate more in the US Match (and the reputation of the school on top of more research opportunities helps).  

Not asking for analysis of all 15+ med schools, but with my chances being highest at UBC and Mac, could you comment on their ability to help prep for these exams?

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Not asking for analysis of all 15+ med schools, but with my chances being highest at UBC and Mac, could you comment on their ability to help prep for these exams?

 

It's great to think ahead - but having a strong app is key at this stage.  That being said - Mac has a 3 year curriculum without any real summer breaks which would make it harder to prep and write Step 1.  I don't know enough about UBC's curriculum to give much insight, unfortunately.    

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Would anyone know if having dual citizenship can help for a residency position?

At least one would not have to worry about visas. Just take appropriate USMLE tests.

 

For post canadian residency would someone need all USMLE tests to get a position in the US?

 

Not necessarily hoping to end up in US.

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Would anyone know if having dual citizenship can help for a residency position?

At least one would not have to worry about visas. Just take appropriate USMLE tests.

 

For post canadian residency would someone need all USMLE tests to get a position in the US?

 

Not necessarily hoping to end up in US.

Dual citizenship helps tremendously, as you don't have the visa issue which is the main issue. You then just have to do the same stuff as everyone else. And get some away electives at programs you want in the states.

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Would anyone know if having dual citizenship can help for a residency position?

At least one would not have to worry about visas. Just take appropriate USMLE tests.

 

For post canadian residency would someone need all USMLE tests to get a position in the US?

 

Not necessarily hoping to end up in US.

 

 

What I've been told is to write the USMLE exams regardless, if you do residency in Canada. I think the reason was that while most places will not require them once you have royal college status, that there are a few states that do? Something like that -- but please look into this on your own. Step2 should be very similar to MCCQE1 anyway, and Step3 similar to MCCQE2. It is Step 1 that is often the hardest for Canadian students because it is more of a basic science exam. BUT.. since you're not doing residency, you only need to pass.

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It's great to think ahead - but having a strong app is key at this stage.  That being said - Mac has a 3 year curriculum without any real summer breaks which would make it harder to prep and write Step 1.  I don't know enough about UBC's curriculum to give much insight, unfortunately.    

 

 

Yep, this was one reason why I decided not to go to UCalgary. Also, the way the visa system works in the states, you have to write USMLE Step3 before you can get an H1-B, and there's no way you can do it until after graduating. So that makes you rely on a J-1, which is horrible for multiple reasons.

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