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Posts posted by blueskyguy

  1. Hello all,

    I am a Canadian citizen currently in my 3rd year at a U.S. med school. I am interested in pursuing a career in FM, and I would ultimately like to live and work in Canada. I am at the point where I have to start to think about whether I should start aiming for a U.S. FM residency or a Canadian FM residency. I understand that the Canadian FM residency is 2 years and the U.S. FM residency is 3 years. 

    Does the 2 year FM residency in Canada adequately prepare you to practice right out of residency? I am mostly interested in working in an outpatient setting, including a clinic/walk-in clinic setting in Ontario.

    I recently spoke to a Canadian FM doc working in Ontario who completed his FM residency in the U.S., and he said something like "it takes 5 years for Canadian-trained FM docs to match U.S.-trained docs", but he also said he was biased.

    Is this true? How competent are Canadian-trained FM docs? Would they be adequately prepared to start working in a clinic/walk-in clinic setting right out of residency? Do they have to be "coached" or "groomed" after residency?

    Thanks for the advice and help!

  2. 7 minutes ago, JohnGrisham said:

    If you do LMCC 1 and LMCC 2, you do not need supervision. 

    It is very much to your advantage to just do the exams, and not very difficult to do as you would be doing USMLE 1-3 anyways.  

    So get those done, and you avoid all the wasted time, loss of income and needing supervision that Drake19 is talking about.

    Hey JohnGrisham,

    When you say LMCC1 and 2, that is the same as saying MCCQE1 and 2, correct?

    Also, do you know the timeline on when these exams are typically taken? If I am in the U.S. taking USMLE exams, do you know how they correlate, timeline wise?

  3. 18 hours ago, drake19 said:

    severe disadvantage

    -so you will be in a pathway 3 application if you graduated from U.S .residency without lmcc examinations - you need a supervisor for 1-2 years, you will pay a chunk to the supervsior, restricted license, etc - ontario license application was about 2,000. The end of year assessment from college i heard is 8,000-10,000? Don't quote me on that price.


    so to clarify the steps.

    1) pathway 3 application for Ontario license - only if you graduated from LCME (US/Canadian) medical school, have a U.S. state license, completed residency, ABFM-exam passed

    -will take 2-3 months assuming no hiccups - they have specific dates where they review application if you miss that deadline then you wait till next cycle - i almost missed deadline because my state-license confirmation letter took 2 months to mail to the college. 

    -ontario licesne application was very time consuming - alot of things out of your control - i.e. my USMLE scores cost ~$100 to submit and the college "lost them" the first time - had to resubmit this, i had to find a supervisor (college has strict requirements - cannot know the person, etc.) and meet/interview before submitting application (difficult to arrange if you live in the U.S.)

    -be prepared to have no income in 2-3 months+ if you can't find a job while awaiting ontario license - since I could only apply after graduating from residency

    -i moonlighted at our hospital's urgent care system and just continued this while awaiting ontario licnese - if you are not a U.S. citizen or on a visa i don't think you will be able to work

    -also lose 1 year of your life and 1 year of attending salary - since U.S. FM residency = 3 years

    2) restricted license for 1 year under supervision - you will need to find a supervsior - you will split costs with office and supervisor

    -i had to specifically fly back to meet with supervisor/job interview - loss 1 day of wages and flight so that was like 2000-3000 USD

    3) pass end of year assessment from college - expensive

    4) you wil always have a restricted Ontario license despite passing assessment - don't know how this affects your transferability from province to province


    i was lazy and didn't think ahead - i passed lmcc1 and will be taking lmcc2 then reapply for independent license after i pass the exam


    i highly recommend just completing a Canadian residency - makes things alot easier - especially if you have no U.S. citizenship

    guidelines, billing are different - i did spend 1-2 months reviewing all guidelines/studying (CHEP, canadian DM, billing, etc.) and met with other family physicians to become acquainted with the EHR they use in Ontario/billing as well before starting - so that took some time and lost income as well

    Hello drake19,

    Thanks for the response. I have a few more questions for you!

    When doing your 1 year with a supervisor in Ontario, are you making a normal FM physician salary (and have to split costs with the supervisor)? You are not making a resident salary, correct?

    Also, how many years do you have to spend with the supervisor before you can work on your own? Is it just 1 year? (Because you said 1-2 years)

    Also, after your 1 year with the supervisor, and you pass the assessment, does that give you a full Ontario license to go practice on your own? What do you mean that you "will always have a restricted Ontario license despite passing assessment"? How does this "restrict" you? Does it prevent your "earnings" in any way, etc.?

    Also, why are you taking LMCC 1 and 2 if you said that you did not need to?

    Thanks for the clarification.

  4. Hello all,

    I have a few questions that I am hoping someone will be able to answer.

    I am a Canadian currently in my 3rd year at a U.S. med school. I am hoping to return to Canada for a FM residency. I am from Ontario.

    Firstly, would I be able to complete a FM residency outside of Ontario? If so, would I be able to return to Ontario to live and work after my FM residency?

    What is this process like? Is it pretty straightforward?

    Thank you all for the insight. I look forward to hearing from you!

  5. 28 minutes ago, drake19 said:

    I have been practicing for last 2-3 mo in Ontario after us fm residency. 

    I cant answer if you can just practice anywhere but you can practice in Ontario.

    in Ontario you don’t need the lmcc 1,2 but you will be at a severe disadvantage. You will be on restricted license, end up needing a very expensive assessment over several days from the college. You will still need to have passed abfm, obtained a USA state license in order to qualify for that exception. - I was us and Canadian citizen so didn’t have issues with that. 

    be prepared for 2-3 mo possible gap to wait the Ontario license, I was a us citizen so was able to find work while waiting, for you are on visa may not be able to work

    oversll working in the u.s. as a primary care/ urgent care I made more money with less bureracy, less work, less overhead, less taxes compare to Ontario. Was making alot more per shift without needing to pay all these fees. In Ontario you have to split with the office, pay insurance, license is expensive. I also spend a lot more time doing lab Followup  etc in Ontario. 

    I came mainly for family reasons 


    it will fewer ever years and more straight forward if you plan to practice in Canada to just go to a Canadian residency. USMLE is expensive and fm residency is 3 years in USA. 

    Hi there! Thanks for the response. A few follow-up questions for you.

    What do you mean that I will be at a "severe disadvantage" if I do a U.S. FM residency and want to come back to Ontario? Do you mean that I will just have to go through a few more "hoops" to get Ontario license?

    So, to confirm, if I do a U.S. FM residency, would the path to an Ontario FM license be like this?

    Finish U.S. FM residency with U.S. license --> Finish "assessment" over several days by Canadian college --> Wait 2-3 months for Ontario license

    Thanks for the clarification.

  6. Hello all,

    I am a current 3rd year med student interested in pursuing a career in FM. I am interested in working in an outpatient clinic/walk-in clinic setting.

    I have read online about other fields (nurse practitioners, etc.) possibly encroaching on FM in Canada. Is there any truth to this? Are FM salaries affected by this in any way, etc.?

    Will FM ever be replaced by other fields, etc.? Will FM continue to be a solid and safe career choice in Canada for the future?

    (What about FM in the U.S.?)

    I love this field, I just want to be clear on its reliability and job security.

    Thanks for the input!

  7. 7 minutes ago, rmorelan said:

    while I am not really an expect on family medicine residency rules in terms of coming back here (other than you have to write our exam etc and that route should be open) the J1 visa situation is clearer to me - there would be no restrictions.


    The J1 visa only gives you restrictions on what you can do in the US - they grant the visa and they make their rules. Canada on the other hand has no restrictions at all - it isn't their visa. You don't give up your Canadian freedoms but having another country's visa. 


    Same with the H1B visa except you would have the option of potentially continuing in the US with coming back to Canada for 2 years first. 




    Hi there, thanks for the response!

    So, just to confirm, if I complete a 3 year FM residency in the U.S. (on a J1 or H1B) I would be able to return anywhere in Canada and work right away?

    Also- I thought that If I successfully complete a 3 year FM residency in the U.S., i wouldn't have to complete the Canadian exam. Is this true?

  8. Hi all,

    I am a Canadian citizen at a U.S. med school interested in pursuing FM. I have been hearing different things by students at my school regarding this stuff, so I wanted to get some clear answers.

    If I were to complete a FM residency in the U.S. on a J1 visa, would I be able to return to Canada to live and work wherever I want right after residency? Or would I have to work in an "underserved area" or something like that, etc.? (What about doing residency in the U.S. on an H1B visa?)

    i would like to live and work near my family, so I was hoping to be able to complete a U.S. FM residency (if I don't get into a Canadian residency) and then return to Ontario near my family to live and work.

    Any clarification on these points would be much appreciated.


  9. 2 minutes ago, drake19 said:

    to answer your question yes you can work in U.S. after residency


    I compelted U.S. residency but am a U.S./Canadian citizen...so not 100% sure how visa thing works.

    my brief understanding is there are two visas available J-1 and H1b - the J1 visa requires you to return back after you complete residency but can be renewed, H1b visa I believe allows you to stay in the U.S. and work after graduating from residency.

    you will need to get a green card/permanent residency, visa such as the H1b, or get married to an American

    i would talk to residency programs that offer the H1b visas and ask them




    Thanks for the response!

    Just to be clear- if you complete a 2 year Canadian FM residency, can you still work in the U.S. after? (Does the 2 year FM residency in Canada vs. the 3 year FM residency in the U.S. prevent you from working in the U.S., etc.?)

  10. Hi all,

    I have somewhat specific question that I was hoping to get answered.

    I am a Canadian citizen who is currently an M3 at a U.S. medical school. I have interests in pursuing FM. However, I would like to keep as many options open as possible in terms of working in Canada and/or the U.S. after all of my training.

    If I were to finish med school in the U.S., and then come back to Canada and complete a standard 2-year FM residency, would I be able to work in both Canada and the U.S. afterwards? How does this process work? Would I be restricted in any way?

    What if I were to complete a 3 year U.S. FM residency instead?

    Any clarifications on these points would be much appreciated. I look forward to hearing from you all!


  11. Hello all,

    I have a few questions regarding "+1" programs following a FM residency. When you apply for "+1" programs, can you only apply once? Or, can you apply multiple times? What happens if you fail to get into one of these programs? Are you allowed to keep applying every year if you choose to?

    Also, I understand there are a number of different "+1" programs (as outlined here: https://www.cfpc.ca/CAC/). How does it work if I want to apply to multiple different "+1" programs? Like say I want to apply to EM as well as Addiction Medicine, does the application program allow me to do this?

    Any clarification on these topics would be much appreciated.


  12. Hi all,

    Just a quick question. Does anyone know how FM docs are able to do pain clinics in Canada? Do they have to go through extra training? Do you they have to do a "+1" year in something? This link (https://www.cfpc.ca/CAC/) shows the possible certificates of added competence that family medicine physicians can get. I don't see anything regarding "pain" so I was wondering what it would fall under. (Would it fall under "Family Practice Anesthesia"?)

    Any clarification would be much appreciated!

  13. Hi all,

    I am a Canadian student currently at a U.S. MD school and I am interested in FM. If I were to complete a U.S. FM residency, would I be able to return to Canada to live and work without any problems? Could someone outline the pathway to doing this? My goal would be to return to Ontario to live and work.

    Are there some U.S. FM residencies that would not allow me to return to Canada? Or would the vast majority allow me to return? Also, someone on this forum mentioned that some provinces require "obstetrics" training for you to return. Do you know which provinces require this? Is Ontario one of them? How does this "obstetrics training" thing work when it comes to U.S. FM residencies and wanting to return to Canada? Would I be able to satisfy this requirement through my U.S. FM residency, etc.?

    Is there anything I need to be wary of with regards to doing a U.S. FM residency and returning to Canada, etc.? (Like certain requirements I need to be aware of, other things, etc.?)

    Any clarification would be much appreciated. Thanks for your time!

  14. On 5/22/2019 at 4:39 PM, icewine said:

    As long as your ABFM is through an ACGME residency you do not need to take the CCFP exam as you are applying under the CCFP designation without examination policy. After submitting your paperwork you are sent an eligibility letter from the CFPC which you then use to apply for provincial registration. Once registered you submit proof of registration to the CFPC, at which point you are granted the CCFP designation.

    The "Note" has no bearing on getting the eligibility letter from the CFPC as long as you meet the "Recognized Training" requirements. Issues arise when you apply for provincial registration. Some provinces may require residency training in obstetrics for registration while others may not have strict requirements (but encourage you to not include intrapartum care in your practice).

    Thanks for the reply. Is the obstetrics thing a problem I should be wary of? If I were to finish a standard U.S. FM residency, my goal would be to return to Ontario to live and work. Do you know of any problems with regards to returning to Ontario with regards to U.S. FM residencies?

  15. Hi all,

    I heard that Canadian FM physicians can do "colonoscopies" and other procedures. What is the route to be able to do something like this? Is this part of a "+1 year" program?

    Also, can someone list all of the "subspecialties" or "additional programs" that FM physicians can do to add to their practice? Are they all "+1 year" programs, or can they be longer, etc.?

    (I read online about "Certificates of Added Competence". Are these the same as "+1 year" programs? Here is where I read about this: https://www.cfpc.ca/CAC/) (Is it possible to do any of these kind of programs in the U.S., and then come back to Canada? Or no?)

    Also, can anyone outline the positives/negatives of doing these extra training programs? How commonly are they done? Are they more lucrative? How much so? Are they competitive? Ultimately, are they worth it?

    Thanks for the clarification!


  16. Hi all,

    I was hoping someone could explain and differentiate the different payment models for FM physicians in Ontario.

    From my understanding, there is the "fee-for-service" model, and "FHT/FHO" model. Which is the predominant model? Does "fee-for-service" still widely exist?

    Also, what is the payment model for a walk-in clinic? Is it possible to partake in both models? (For example, be apart of an FHT/FHO that also serves as a walk-in clinic that does fee-for-service, etc.?)

    If you are opening a FM practice, do you get to choose which model you want? Or are all initial practices essentially fee-for-service?

    ALSO: In terms of income, what is the average income for "fee-for-service" FM physicians in Ontario compared to "FHT/FHO" FM physicians in Ontario? Are they around the same?


    Any clarification on these points would be much appreciated! 

  17. 4 minutes ago, LittleDaisy said:

    Hey there is no cap for Ontario FM physicians, the government does not control the number of patients you can see per day. Physicians are self-employed professionals, you don't really have a boss unless you decide to work in an academic hospital as a new junior staff (you are on probation or temporary privilege at the beginning)  or you work for governmental agencies (CHC, ministry of health, etc). 

    Hey LittleDaisy! Thanks for the clarification.

    Quick question: I see a lot of FM talk on these forums, including salaries and payments structures, etc. However, a lot of them refer to B.C. family medicine, and I am in Ontario. Would it be okay to assume that the salaries and payment structures between B.C. and Ontario are essentially the same (averages, etc.)? Or are there any notable differences between B.C. FM and Ontario FM that I am not aware of? (What about other provinces?)

  18. Hi all,

    I am currently a second year Canadian student at a U.S. med school with interests in returning to Canada for FM. I was born and raised in Ontario, and that is where my family is located.

    Few quick questions regarding the current state of healthcare (especially FM) in Ontario:

    - How would you describe the current state of Ontario healthcare? I've heard people complaining about Ontario stuff on these forums, but I was always too young to understand what the actual problems were. Could you describe these problems to me, and have they changed at all?

    - Has anything changed recently (or will change) regarding Ontario healthcare?

    - Also, will any of this have any effect on me and my future in FM? Would you say that the future of FM in Ontario is bright? (I came across articles on the internet talking about "new contracts" being agreed upon in Ontario, including this one: https://www.theglobeandmail.com/canada/article-new-ontario-doctors-contract-will-increase-health-spending-by-1/) I was hoping you could help me understand how these "new agreements" affect us.

    -Also, are Ontario FM physicians "capped" in any way in terms of earning potential? Are they "capped" in the number of patients they can see, etc.? Are there any hindrances that I should be aware of, etc.? (What about other provinces?)

    Any clarifications you can give would be much appreciated. As always, your time is truly valued and appreciated!


  19. Hi all,

    I am a Canadian student currently at a U.S. med school with an interest in primary care. I have read about how General Internal Medicine in Canada is 4 years long, but I have also come across people saying that it is increasing to 5 years long. Can someone explain this to me? Is there a transition happening to 5 year programs now?

    Also, if I ended up doing a 3 year IM residency in the U.S. (say, on a J1 visa, which would force me back to Canada after residency), and I had to come back to Canada to live and work, how would this process work? Would I have to do extra year(s) of training somehow? Would I have to do 1 extra year or 2 extra years? (Considering the 4 year and 5 year GIM stuff)

    Any clarification on these topics would be much appreciated! Thanks for the help.

  20. So, I am a Canadian citizen who attended a U.S. university for undergrad, and then ended up getting into a U.S. med school. I am currently an M2 at this U.S. med school, with hopes of returning to Canada for a FM residency. My question is: will the fact that I did not go to a Canadian university for undergrad AND med school affect me negatively in any way? Will I still be able to apply to/get into Canadian residencies having not attended a Canadian university for undergrad and med school?

    Are there any rules, etc. against someone like me who did not attend a Canadian university or Canadian med school from returning to Canada for residency, or to live and work in Canada, etc.?

    (ALSO: What if I ended up doing a U.S. FM residency? Would I still be able to return to Canada to live and work having done undergrad, med school, AND residency in the U.S.?)

    Any clarification would be much appreciated. Thanks for your time and help.

  21. Hi all,

    I am currently a Canadian student at a U.S. med school with interests in FM. Quick question: if I were to do a FM residency in the U.S., how would it work if I wanted to come back to Canada to work? What is the process like? (Since the U.S. FM residency is 3 years and the Canadian FM residency is 2 years)

    I have been told that if I complete a U.S. FM residency, I will be able to come back to Canada and work. Is this true?

    Also, on the CCFP website, there is a page (this link: https://www.cfpc.ca/recognizedtraining/) that talks about coming back to Canada after a U.S. residency. After the section on "approved jurisdictions" it says: "Note: These programs vary from Canadian programs in that training in intrapartum care is not compulsory." 

    Does this "Note" have any affect on anything, etc.? (Are there certain U.S. FM residency programs that would not allow me to return to Canada after having completed them, or no? Will the vast majority of them allow me to return, etc.?)

    Thank-you for any help/clarification!

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