neuralgal

Overview Of Uk, Ireland, Australia, And The Caribbean

16 posts in this topic

Hi all,

I think it's time someone put up a post with some updated and consolidated information. I know I had some difficulties in finding this information, so here's hoping it helps out some future applicants (and saves the regulars from having to answer the same questions continuously). 

 

Please comment if anything I've posted is incorrect, if you have anything to add, or if you have some questions! I'm most familiar with the UK and Ireland processes, so if someone has additional information about Australia or the Caribbean, that would be much appreciated.

I didn’t include USMD as that isn’t really going abroad in the same sense as the UK for example. USDO is included as starting in 2016, Canadian USDO graduates are considered IMGs by CaRMS. This means you are limited to the specialties that Health Canada will issue a Statement of Need for in the US, unless you want to apply as an IMG to Canada. 

 

My personal rankings for international schools:

 

1. UK **where I’m going, so bias alert**
You apply to UK schools through UCAS, picking a maximum of 4 medical schools. There are also two private medical schools (Buckingham and UCLan) that you can apply to separately, bringing your total up to 6. Each school has varying requirements, so you’ll need to contact each school you’re interested in to see if you meet their requirements. Graduates, some schools will look at your high school marks as well as your degree, so that’s an additional thing to watch out for. Your degree will also be classified differently depending on the school; all medical schools want a British 2.1 equivalent and different schools will assign different minimum GPAs corresponding to that (ex. school 1 will accept applications if you have at least a 3.4 whereas school 2 wants at least a 3.6). There are programs for both high school students and graduates, with most programs accepting graduates.

There are two admissions tests that you can take in order to apply to UK schools: UKCAT and BMAT. The UKCAT is an aptitude test whereas the BMAT is similar to the MCAT. Different schools require different tests. I only took the UKCAT because most schools accept it, but the BMAT is used by a select few like Oxford, Cambridge, etc. These test scores are only valid for the year you are applying.

A maximum of 7.5% of seats can be given to international students in UK schools, so it can be very competitive. The private schools are different; Buckingham doesn’t care about nationality and UCLan is only for international students. I advise playing to your strengths when applying. For example, my degree came out to a 2.1 but my UKCAT score was well into the 90th percentile. This definitely gave me a leg up compared to other internationals and I primarily applied to schools that gave a lot of emphasis to UKCAT scores.

There’s a separate Scottish-Canadian program, which I think is good. It’s 6 years long and allows rotations in Alberta but it doesn’t give you the backup of the UK and isn’t open to graduates I believe. There’s also the SGUL INTO program (open to high school students and graduates); its big pitch is that it gives you 2 years of clinical rotations in the US but it seems super sketchy and no backup option yet again.

In terms of matching back to Canada, the only downside of going to a UK school is that unlike the others, there is no specific coaching for applying to North American residencies. UCLan is the exception – it’s one of the private schools and they teach to USMLE. But if you are focused on matching back, know two things: it’s unlikely that you’ll get a competitive specialty (not impossible; similar outcomes for each country) and you’re going to have to do a lot of studying on your own. 

However, the biggest advantage is that you are able to pursue training in the UK. Despite being an international, as a UK graduate, you’re eligible to apply to whatever training without bias (you will need to switch visas eventually to work, but it doesn’t appear to be much of an issue).

There are also reciprocity agreements between Canada and the UK. Those who do family medicine have an easier time of going between countries. Those who do more specialized things (like surgery) will have to write some qualifying exams in order to get a Canadian medical license, but a job isn’t guaranteed. This means that you may have to stay in the UK indefinitely; I personally am fine with that as I’ve always liked the idea of practicing medicine in London but this is up to the individual.

If you do decide to stay in the UK and train/practice, there are three major differences between the UK and Canada: better pay in Canada, shorter training in Canada, better hours in the UK.

I found that the UK schools (or at least mine) are cheaper than the other options.

 

2. USDO
On my personal ranking list, this comes second. The application process is the same as to any Canadian or US MD school. And the residency application process is the same as any other international school. 

You will be limited to those residencies in the US that Health Canada will issue a statement of need for (ex. family medicine). So, if you want to do a surgical specialty or anything more competitive, your next best option will be to apply through CaRMS as an IMG (note: there are some statements of need issued for surgical specialties but not all). 

For me, this is second because while you're still in the US, you're limited to the residencies you can do afterwards. For those of you who are interested in surgical specialties (or more competitive specialties), this may not be a good option as you're essentially limiting yourself to a few things and have the greatest chance at matching to primarily family medicine. This is why I ranked the UK higher - I'm an IMG no matter where I go, but I still have the option of pursuing a more competitive specialty in the UK. If you do prefer primary care, then USDO is something to look into. 

 

You can then return to Canada after completing your US residency. There may be some additional exams/qualifications you have to provide. 

3. Ireland
The most popular option for Canadians going abroad! And for good reason – many Irish schools have a large Canadian population and there is a lot of support for applying back to the US/Canada.

Applications are made through the Atlantic Bridge program. There are 6 Irish medical schools, but based on whether or not you have an undergraduate degree, you’ll only be eligible at some or for certain programs. The school profiles are all on the Atlantic Bridge profile. You take a look through them, find the ones you like, and let Atlantic Bridge know through a form on their website (you enter your education history, age, MCAT scores, and schools). Atlantic Bridge will then send you an application package for all the schools you selected with further details as to what essay(s) to write, what kind of reference(s) to get, etc.

The Irish schools do accept the MCAT, so you don’t have to worry about writing another examination.

As mentioned, there is excellent support in matching back to Canada and a high percentage of Irish grads to match back each year. However, there’s no backup option. While it is theoretically possibly to do an internship year in Ireland, it is highly highly unlikely that you will get one. As an international, you are at the bottom of the barrel and all the posts will be filled before they have to scrape so low. There are also no reciprocity agreements.

4. Australia 
On par with Ireland for popularity I feel.

Applications can be made through OzTREKK, ISA, or directly to the schools themselves (more expensive option). There are about 8-12 Australian schools, and like the Irish ones, depending on whether or not you’re a graduate, you’ll only be eligible at some. The school profiles are all on the OzTREKK website as well. It’s a similar application process to the Irish schools.

Australian schools want either the GAMSAT or MCAT, so you don’t have to worry about other examinations. Each school has a GPA requirement listed out of 7, so contact them to make sure yours meets the requirement as it’s likely out of 4.

The number of available seats at schools can range from 10-100 for international students. These schools are less competitive than UK and Irish schools due to the increased number of spots and because international medical education brings in a profit to these schools.

I’m not too familiar with the level of support given to matching back to Canada or the US but the numbers are similar to Irish grads.

Like in Ireland, it is theoretically possible to do an internship year in Australia, but that has become much more difficult recently. However, it may still be possible to get an internship somewhere. Further specialty training is not guaranteed however.

Like the UK, Australian specialty training is accepted in Canada. If you complete training in Australia, you are eligible to get a Canadian medical license, providing you sit and pass the qualifying exams.

5. Caribbean **my least favorite option, so again, bias alert**
While these schools were a good option in the past, I feel that era has come to a close. You do get a chance to do US rotations with some schools even offering Canadian rotations. But these schools have a record for extremely large class sizes, poor teaching, and high attrition rates.

I personally would urge people to exhaust all other options before considering the Caribbean.

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I would strongly urge people to exhaust all other options before considering the Caribbean.

 

I'm a Canadian who graduated from the Caribbean and was good/fortunate enough to match into a Canadian residency program. The vast majority of IMGs all know, or at least eventually realize, that the specific country and school they studied at plays very little role in the ultimate outcome of who matches and who doesn't. Success and the effort put forth is highly individualistic.

 

It's true that Caribbean schools have high attrition rates, but that's because their threshold for acceptance is low. It's not a secret. They take average and below-average students, many who have absolutely no business being there, and it's no surprise to anyone that they get weeded out. It's not just the rigorous academic component which is challenging for some, you also need to adapt to the relative isolation, and a lifestyle without the comforts and amenities you previously had at home. One of the unstated benefits of going to the Caribbean is that it builds character. You appreciate everything more, and take less for granted once you're done.

 

Make no mistake; the students who survive and make it through the gauntlet are generally decent. The best students who get through the programs are frequently those who were waitlisted for Canadian and American MD programs, and who very likely would have been successful at a North American medical school anyways had they been admitted. Some Caribbean schools advertise that their USMLE Step 1 Pass Rates are 98%, and they're likely telling the truth, but the caveat is that it's from the remaining pool of non-attrited students whom the school gave eligibility and permission to sit the exam, because their chances of passing were respectably high.

 

The teaching done in the Caribbean is of variable quality. The instructors come from many different countries, and teaching for these private offshore schools still pays them more money than being a physician in their home country. Many of the American-trained doctors teaching in the Caribbean are there because they don't have an active US medical license due to professional or legal issues; however, they are still highly experienced individuals, and more than knowledgeable enough to teach basic science and clinical education to medical students. It gets better once you start your 3rd and 4th year clinical rotations in the United States though, assuming you don't get placed at institutions where all you do is endless scut work and receive limited academic value.

 

If you can get past the cost of tuition, logistics of travel, lack of amenities, and the possibility of being taught by rogue physicians, then the Caribbean is no worse than elsewhere. That being said, despite things working out for me, I don't recommend going to the Caribbean. These schools were intended for American ex-pats, and their citizenship generally gets them more US interviews come match time compared to similar Canadians students. If you're an IMG who went to the Caribbean, then you will likely be doing residency in the US, not Canada. It's fine though, because your ultimate goal as an IMG is to match. Location is secondary (some people will disagree with that, but those people are wrong). If you want Canada, then you need to go above and beyond. 

 

I don't recommend Ireland or Australia. I'm not sure about the UK. I don't have experience with these places, but it's also not necessary once you know the bigger picture. If you're going abroad, then do your homework and plan carefully, including having backups to your backup. Where you go is not as important as the overall decision to go at all.

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I'm a Canadian who graduated from the Caribbean and was good/fortunate enough to match into a Canadian residency program. The vast majority of IMGs all know, or at least eventually realize, that the specific country and school they studied at plays very little role in the ultimate outcome of who matches and who doesn't. Success and the effort put forth is highly individualistic.

 

It's true that Caribbean schools have high attrition rates, but that's because their threshold for acceptance is low. It's not a secret. They take average and below-average students, many who have absolutely no business being there, and it's no surprise to anyone that they get weeded out. It's not just the rigorous academic component which is challenging for some, you also need to adapt to the relative isolation, and a lifestyle without the comforts and amenities you previously had at home. One of the unstated benefits of going to the Caribbean is that it builds character. You appreciate everything more, and take less for granted once you're done.

 

Make no mistake; the students who survive and make it through the gauntlet are generally decent. The best students who get through the programs are frequently those who were waitlisted for Canadian and American MD programs, and who very likely would have been successful at a North American medical school anyways had they been admitted. Some Caribbean schools advertise that their USMLE Step 1 Pass Rates are 98%, and they're likely telling the truth, but the caveat is that it's from the remaining pool of non-attrited students whom the school gave eligibility and permission to sit the exam, because their chances of passing were respectably high.

 

The teaching done in the Caribbean is of variable quality. The instructors come from many different countries, and teaching for these private offshore schools still pays them more money than being a physician in their home country. Many of the American-trained doctors teaching in the Caribbean are there because they don't have an active US medical license due to professional or legal issues; however, they are still highly experienced individuals, and more than knowledgeable enough to teach basic science and clinical education to medical students. It gets better once you start your 3rd and 4th year clinical rotations in the United States though, assuming you don't get placed at institutions where all you do is endless scut work and receive limited academic value.

 

If you can get past the cost of tuition, logistics of travel, lack of amenities, and the possibility of being taught by rogue physicians, then the Caribbean is no worse than elsewhere. That being said, despite things working out for me, I don't recommend going to the Caribbean. These schools were intended for American ex-pats, and their citizenship generally gets them more US interviews come match time compared to similar Canadians students. If you're an IMG who went to the Caribbean, then you will likely be doing residency in the US, not Canada. It's fine though, because your ultimate goal as an IMG is to match. Location is secondary (some people will disagree with that, but those people are wrong). If you want Canada, then you need to go above and beyond. 

 

I don't recommend Ireland or Australia. I'm not sure about the UK. I don't have experience with these places, but it's also not necessary once you know the bigger picture. If you're going abroad, then do your homework and plan carefully, including having backups to your backup. Where you go is not as important as the overall decision to go at all.

 

Oh yeah, for sure there is the factor of the individual themselves putting in the hard work and effort needed to be successful. That applies to all countries. However, the reason I ranked the Caribbean so low is that out of all of them, it's the most challenging environment to do this in and, as you mentioned, the schools were intended for Americans.

 

This is just my personal preference list, taking into factors quality of education, backup options, support, etc. But hopefully the information in it will help others make informed decisions as to where they would like to go and make them aware of some of the challenges presented by being an IMG and of each country in particular. 

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My only comment to OP is that I would argue not all Irish schools are all that supportive in helping students apply back to USA and Canada.  I met numerous IMG's, studying in Ireland, on the Carms trail who were basically skipping out on clinical electives (after explaining the situation to their preceptors of course) to attend Carms interviews.  Their school did not provide time off for North American interviews.  The smart ones booked electives in North America during the Carms period, while some were planning on flying back to Ireland 1-2 days after interviews ended to restart clinical rotations.

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Any reason why you didn't consider DO?

I'm not completely clear on the classification of DO. The medical council classifies it a foreign degree but apparently provinces recognize it as equivalent to a US MD? If they're considered equivalent, then they don't belong in this category.

 

Personally, it was more so because I didn't know if I could agree with the teachings, wasn't sure how the merger would affect things at the time of application, and couldn't obtain a letter from a DO to fulfill the requirements.

 

Edit: Checked the status of DO - they are considered IMGs by CaRMS (https://www.studentdo.ca/residency). I'll update the post later to include that. 

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I'm not completely clear on the classification of DO. The medical council classifies it a foreign degree but apparently provinces recognize it as equivalent to a US MD? If they're considered equivalent, then they don't belong in this category.

 

Personally, it was more so because I didn't know if I could agree with the teachings, wasn't sure how the merger would affect things at the time of application, and couldn't obtain a letter from a DO to fulfill the requirements.

Knowing the hardships of the IMG routes now, are you still so gung-ho about going to the UK and somehow ending up in Neurosurgery in Canada?

 

You don't need a DO letter of recommendation for most schools. It's still not too late for you to reconsider the DO option :)

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Knowing the hardships of the IMG routes now, are you still so gung-ho about going to the UK and somehow ending up in Neurosurgery in Canada?

 

You don't need a DO letter of recommendation for most schools. It's still not too late for you to reconsider the DO option :)

 

This post was made so that others could make an informed decision regarding their options. 

 

Even if I don't end up in neurosurgery in Canada (and quite honestly, my preferences could change to something else), I still stand by my decision to go to the UK and I'm still so "gung-ho" as you put it. It's a tough route for IMGs no doubt, but I made this decision knowing full well what it entailed and picked a place that I wouldn't mind practicing in for the rest of my life (not that I need to defend my decision to you but you've irked me). 

 

You've been posting these kinds of messages on all of my posts here and elsewhere, and quite frankly, I'm getting quite tired of it. You clearly keep trying to push your agenda (and hey, you're entitled to your opinions) but it's not actually furthering discussion or helping anybody. People have so many different reasons for choosing what they do. DO was the right option for you? Congrats. Doesn't mean it's the right option for me (as I'll still be considered IMG by CaRMS) or others. So please, stop with your mocking and try to contribute something productive in a respectful manner. 

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I'm not completely clear on the classification of DO. The medical council classifies it a foreign degree but apparently provinces recognize it as equivalent to a US MD? If they're considered equivalent, then they don't belong in this category.

 

Personally, it was more so because I didn't know if I could agree with the teachings, wasn't sure how the merger would affect things at the time of application, and couldn't obtain a letter from a DO to fulfill the requirements.

 

Edit: Checked the status of DO - they are considered IMGs by CaRMS (https://www.studentdo.ca/residency). I'll update the post later to include that. 

USDO is equivalent for licensure in every province in Canada. 

 

CaRMS is irrelevant.

 

If you're going abroad, you should make sure your odds of getting a residency in the US is top priority. Going to a USMD and USDO school does that.

 

Health Canada is cutting statements of needs right left and centre, so don't be left holding the bag without considering all options.

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USDO is equivalent for licensure in every province in Canada. 

 

CaRMS is irrelevant.

 

If you're going abroad, you should make sure your odds of getting a residency in the US is top priority. Going to a USMD and USDO school does that.

 

Health Canada is cutting statements of needs right left and centre, so don't be left holding the bag without considering all options.

 

Taken directly from the website: "While in the recent past Canadian DOs were granted CMG (Canadian Medical Graduate) status in the Canadian residency match, recent increases in Canadian medical class sizes have caused the Medical Council of Canada (MCC) to change that accommodation, and instead label Canadian USDOs as IMGs (International Medical Graduates) for the purpose of CaRMS (Canadian Residency Matching System). As a result, most Canadians who enroll in DO school will have to remain in the US for longer than the 4 years of medical school.

 

Previously, with determination and persistence, Canadian DO graduates could enroll in a Canadian primary care residency program with relative ease. Now, as IMGs applying to residency in Canada, Canadian DOs must compete with ~2300 other IMG applicants for 323 designated spots. The odds have become so challenging that we at COMSA now recommend pursuing an ACGME residency training program in the US after graduating DO school, and returning to Canada as a licensed, fully trained and board-certified physician. "

 

Anybody wanting to do a surgical specialty or something that Health Canada deems not needed is pretty much out of luck. The specialties changes every year, but it's unlikely that there will be many surgical ones or some of the more popular ones. In my case, my previous experiences and interests have led me to want to pursue a surgical specialty. If I do DO or I go to the UK, I'm an IMG either way. Only difference is, I have a better shot at getting into a surgical specialty in the UK - so I am able to train there and, if I want to, get my Canadian license via the exams (difficult I know, but a possible route should I wish to pursue it). Even if I change my mind in medical school, I can still complete training somewhere recognized by Canada should I wish to return. 

 

DO is just not the best option for me based on this. 

 

However, I do not discourage others from applying DO. Every person's situation is different, and for some, this may be the best option. 

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Taken directly from the website: "While in the recent past Canadian DOs were granted CMG (Canadian Medical Graduate) status in the Canadian residency match, recent increases in Canadian medical class sizes have caused the Medical Council of Canada (MCC) to change that accommodation, and instead label Canadian USDOs as IMGs (International Medical Graduates) for the purpose of CaRMS (Canadian Residency Matching System). As a result, most Canadians who enroll in DO school will have to remain in the US for longer than the 4 years of medical school.

 

Previously, with determination and persistence, Canadian DO graduates could enroll in a Canadian primary care residency program with relative ease. Now, as IMGs applying to residency in Canada, Canadian DOs must compete with ~2300 other IMG applicants for 323 designated spots. The odds have become so challenging that we at COMSA now recommend pursuing an ACGME residency training program in the US after graduating DO school, and returning to Canada as a licensed, fully trained and board-certified physician. "

 

Anybody wanting to do a surgical specialty or something that Health Canada deems not needed is pretty much out of luck. The specialties changes every year, but it's unlikely that there will be many surgical ones or some of the more popular ones. In my case, my previous experiences and interests have led me to want to pursue a surgical specialty. If I do DO or I go to the UK, I'm an IMG either way. Only difference is, I have a better shot at getting into a surgical specialty in the UK - so I am able to train there and, if I want to, get my Canadian license via the exams (difficult I know, but a possible route should I wish to pursue it). Even if I change my mind in medical school, I can still complete training somewhere recognized by Canada should I wish to return. 

 

DO is just not the best option for me based on this. 

 

However, I do not discourage others from applying DO. Every person's situation is different, and for some, this may be the best option. 

I hope you look into the getting a license with foreign residency training more carefully. Everything I know on the topic(albeit limited), is that you are going to have one hell of a time doing that, and its going to be EXTREMELY unlikely.

 

Family medicine is really the only speciality in practicality that  has reciprocity.  While some sources online may "say" there is reciprocity with certain common wealth countries for royal college training, it is not really all that straight forward.

 

Just wanting to put that out there, that while you're early on in your career to really call people to see what the current state of affairs is for foreign specialty training and portability back to Canada. While it may have been easier in the 70's and 80s...you just don't see it these days.

 

Not to mention, that the back-up for many Canadian trained surgeons is to move south to the U.S and practice and/or augment their practice/training. 

 

This is simply NOT an option as a foreign residency trained(UK,ireland etc) specialist. The US only recognizes Canadian and American residency training for practice.  So if you did in fact do foreign training elsewhere, you'd be effectively closing the US as an option. That is okay for most people though, but just thought i'd bring that up also.

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This post was made so that others could make an informed decision regarding their options. 

 

Even if I don't end up in neurosurgery in Canada (and quite honestly, my preferences could change to something else), I still stand by my decision to go to the UK and I'm still so "gung-ho" as you put it. It's a tough route for IMGs no doubt, but I made this decision knowing full well what it entailed and picked a place that I wouldn't mind practicing in for the rest of my life (not that I need to defend my decision to you but you've irked me). 

 

You've been posting these kinds of messages on all of my posts here and elsewhere, and quite frankly, I'm getting quite tired of it. You clearly keep trying to push your agenda (and hey, you're entitled to your opinions) but it's not actually furthering discussion or helping anybody. People have so many different reasons for choosing what they do. DO was the right option for you? Congrats. Doesn't mean it's the right option for me (as I'll still be considered IMG by CaRMS) or others. So please, stop with your mocking and try to contribute something productive in a respectful manner. 

 

Good day to you and your family ;)

 

You really have to work on your patience and a better bedside manner than your behavior here.

Not everyone trying to help you is "mocking you", it certainly was not my intention. What do I care? I'm done with my training, and just trying out help out other premeds going through a similar thing I went through. Some might think the experience I offer is of value, in your case, if it feels like a dog's fart in the wind, forget everything I said then.

 

You shouldn't take every critique or comment that doesn't conform to your pre-held views so negatively.

At any rate, good luck, i hope you find whatever it is you are looking for across the pond.

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It's not an easy situation and there's probably no 'right' answer.  Decision theory gives some ways to evaluate choices, though.  

 

Under an optimistic strategy, the choice is based on the best possible outcome in each situation - in this case, the chance of matching to neurosurgery.  The optimistic reasoning could be applied to the DO situation though too - DOs have matched to neurosurgery, and it's sometimes possible to get away from J-1s after graduating from a US med school.

 

A pessimistic strategy, would essentially only consider the best outcome after the worse case scenario in each situation.  In this case for example, might consider the chances at matching to any program, and returning to Canada say, as an IMG.

 

The minimax strategy considers minimizing the regret or loss involved in making different choices.  Here it might be formulated in terms of differences in individual subjective payoffs between matching neurosurgery or not, in the different situations.  

 

Regardless of which decision is taken, it's clear as full as possible understanding of all outcomes is absolutely necessary.   

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Disclosures: IMG(Ireland), Canadian Residency(Orthopaedics), now working in US (Green card). 

I have a few points to add as food for thought.   

1)IMG Specialty matching

It is almost impossible to predict successfully matching to a small specialty as an IMG in either the US or Canada.  The number of programs and matriculants is so tiny every year that each match represents a unique set of circumstances.  I have seen practically perfect applicants from all streams denied a spot because someone did not like their interview outfit.  Most small Canadian programs would much rather a spot be unfilled than accept an applicant they doubted in even the most trivial way.  Unfortunately, that philosophy is often unfairly applied en-mass to D.O. applicants.   Failure to get a lottery assigned elective spot is another--totally capricious-- barrier to successfully matching that may be applied in some programs.   

That said, targeting a small non-competitive specialty in Canada is not a bad strategy.  Take the example of neurosurgery.  Unlike the in the US, Neurosurgery in Canada is not competitive and often accepts IMGs who demonstrate a significant interest in the field. (14 first choice CMG applicants for a quota of 15 spots; https://www.carms.ca/en/data-and-reports/r-1/r-1-match-reports-2017/).  The real challenge is finding a venue where you can demonstrate that interest to the right people at the right time.  Local knowledge and expertise will help an applicant match to a certain extent; but unfortunately, there is a lot of random chance involved.  I'm no expert, but I think that the small numbers and significant random chance impair the application of decision theory to this problem (which explains the hundreds of pages of posts on this topic). 

2)Reciprocity

Reciprocity gets very murky with specialization.  Licensing policies are province and state specific in North America. For example, physicians practicing in an academic setting in Canada may not need to qualify with the Royal College to receive a license from the CPSO. (http://www.cpso.on.ca/Policies-Publications/Policy/Academic-Registration).  Academic jobs are pervasive in the medical field and not limited to the principle university associated teaching hospitals.  Adjunct, junior, and tertiary professorships abound.  Another example, in most US states, board certification is not required to obtain a medical license.  In some specialties, Board Certification is granted many years after starting practice as a specialist.  But post-graduate residency training in an ACGME (or sometimes RCPSC/CFPC) program may be required.  A hospital may be able to make an independent decision on whether your specialist qualifications meet their needs.   

Each jurisdiction's policies have been designed to meet physician supply needs in both the acute physician shortage and oversupply situation.  If you can find an appointment many of the policy barriers have loopholes to ensure the health care system can meet it's staffing needs while at the same time preventing physician oversupply.  The systems are unfair, self-serving, and feudal.  

In my opinion, middle to late career specialist physician mobility is incredibly complex and should not be overly weighted at the medical school stage.  So much may change for an individual personally and professionally over the years that the whole exercise is akin to palmistry.  

I think the key to being happy with your choices is to have as many backup plans as possible that with which you'd be happy enough to live.  The IMG route favors the very rare easy-going obsessive planner with few or very accommodating family obligations!

 

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I was wondering where OP you got that hours in the UK are better? I'm only asking because I have several friends going through the system in the UK and they complain that the hours are brutal. On par or worse than anything in Canada. One has been actively trying to convince me not to bother applying to training in the UK after I'm done my med training in Poland (which may not be an option anyway because of brexit).

I do hear good things about Scotland though.

But it's a bit different for me as I'm an EU citizen so my options afterwards are different to those who are just Canadians.

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The hours in residency are definitely better in the UK than in North America.  There is a reason residency is much longer in the UK than in US/Canada.  They still suck, but not as much as a malignant IMG residency training mill in the US

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