Canadian doctors trained overseas petition court to end 'system of exclusion'

[IMislove]

6 minutes ago, vino said:

I feel like if I told someone who took on $300,000 of debt, worked their asses off for 4-6 years and successfully completed an accredited, reputable medical program that they need to now accept one path for them is closed, I would be viewed as a condescending, elitist asshole. 

 

 

This is where the accountability factors in. Common sense would dictate do not blindly go to a foreign school and spend that much money without researching what your options are after school. It is a huge investment, I am not going to spend 200k downpayment on a house without checking the house out in person and getting records checked with the city to make sure all additions are legal, it's a lot of money to throw around on blind faith that my house is going to be just fine. Heck that's what we would have done as high school students to figure out what degree and school we should pursue for a job. Does it suck that they can't work in medicine? Yes, of course, it would be heartbreaking. But the common sense approach would be " well before I spend all this money, what happens if I want to come back to Canada?" Also I agree with what @GrouchoMarx said.

[MedMaybe3563]

Just now, GrouchoMarx said:

Reputable in what way?

 

I would not consider the Caribbean schools particularly reputable as they are first and foremost for profit institutions. Same with the European schools that profit exceptionally from accepting foreigners. 

 

I am not saying that students who matriculate from those schools couldn't make fine doctors, but the bar must be set exceptionally high for them.

 

Those students could also apply to the USA where there are loads more residency spots. This requires decent USMLE scores. If someone didn't get the scores for it, then that's on them.

 

I never said Caribbean schools are reputable. If you read my comments earlier I mention this. This lawsuit likely won't go anywhere and I don't have much sympathy for people who choose to go to schools which are basically diploma mills. But that does not change my opinion that Canadians who study medicine abroad at *reputable schools (e.g. RCSI, Limerick, Melbourne, etc) are pushed into a difficult corner and something should be done about it when they want to return home.

[MedMaybe3563]

Just now, IMislove said:

This is where the accountability factors in. Common sense would dictate do not blindly go to a foreign school and spend that much money without researching what your options are after school. It is a huge investment, I am not going to spend 200k downpayment on a house without checking the house out in person and getting records checked with the city to make sure all additions are legal, it's a lot of money to throw around on blind faith that my house is going to be just fine. Heck that's what we would have done as high school students to figure out what degree and school we should pursue for a job. Does it suck that they can't work in medicine? Yes, of course, it would be heartbreaking. But the common sense approach would be " well before I spend all this money, what happens if I want to come back to Canada?" Also I agree with what @GrouchoMarx said.

 

While I get what you're saying and I agree, (people who find this thread, don't ever ever go to medical school abroad without doing your research), my view is that if anything, I think the willingness to take such a risk and financial burden shows how dedicated they are to pursuing what they love and are passionate about. If they pass the necessary tests proving their competence to practice medicine, they should not be arbitrarily barred from having a better chance at a residency in their home nation. 

[IMislove]

1 minute ago, vino said:

 

While I get what you're saying and I agree, (people who find this thread, don't ever ever go to medical school abroad without doing your research), my view is that if anything, I think the willingness to take such a risk and financial burden shows how dedicated they are to pursuing what they love and are passionate about. If they pass the necessary tests proving their competence to practice medicine, they should not be arbitrarily barred from having a better chance at a residency in their home nation. 

 

I see, well this is where we will agree to disagree I fear. The government spends lots of money to fund the medical seats here, and with the ever-increasing unmatched students from Canadian schools, the government should be looking after their own students first. And seeing as residency positions have also been decreasing, the trouble increases. Nothing is stopping those Canadians from trying the US, they need to do well on the USLMEs to demonstrate competency there. Canada already accepts foreign-trained doctors that have already completed residencies after passing some exams and other barriers, as other countries in Europe do as well. Grade inflation has really messed things up here sadly. As I said, we can agree to disagree. I wish you luck in your cycle this year.

[MedMaybe3563]

Just now, IMislove said:

I see, well this is where we will agree to disagree I fear. The government spends lots of money to fund the medical seats here, and with the ever-increasing unmatched students from Canadian schools, the government should be looking after their own students first. And seeing as residency positions have also been decreasing, the trouble increases. Nothing is stopping those Canadians from trying the US, they need to do well on the USLMEs to demonstrate competency there. Canada already accepts foreign-trained doctors that have already completed residencies after passing some exams and other barriers, as other countries in Europe do as well. Grade inflation has really messed things up here sadly. As I said, we can agree to disagree. I wish you luck in your cycle this year.

 

Agree to disagree sounds good. Just because we have differing views doesn't mean we can't have a cordial discussion. It is a convoluted, grey topic anyway. I'm still in my undergrad, not going to be applying this cycle but appreciate the sentiment nonetheless. Best of luck at Queen's med.  

[Edict]

Its not easy being either, although I do have to say that whatever we do, we cannot just open the floodgates because it would destroy the profession. The issue with Australian and Irish schools, is that these are schools that have figured out that they can make a handsome profit by training people from overseas, and then ultimately leaving them with questionable job opportunities. They want to have their cake and eat it, and to do this they lower their entry standards significantly. 

It is not our responsibility to accept these people back. In a sense they have skipped the line. 

[medigeek]

On 10/3/2018 at 7:34 PM, Briannaxox said:

Failures always complain lmao IMG should be banned completely so people can't shortcut their way in with sucky marks and downgrade the profession as a whole 

There's already legal precedent for them having their own spots. It's not very reasonable to close the doors entirely anyway. 

 

On 10/3/2018 at 7:55 PM, tere said:

QC doesn't have separate streams and the number of matching IMGs, even at McGill (where language wouldn't be as much of an issue) is much lower than ON, suggesting that the parallel streams do increase the number of IMG matches.  

It's been previously speculated that familial influence could be more of an issue in resident selection for CSAs whose parents are prominent physicians.  I'm not sure that it would be any different than the current selection procedures for CMGs with such parents, though.  

A number of CaRMS programs do have language criteria, but I think they're within their rights to look for that kind of qualification in some cases (although there's not that much switching between the two official language groups from med school to residency).  

Don't most IMGs skip applying to Quebec anyway? Including Mcgill. Not sure on the #, but I'd guess data is limited due to a small sample size. Lot of english speakers also may skip over Mcgill if from Ontario etc. While francophones will go for french spots only. 

On 10/4/2018 at 11:21 PM, Edict said:

Its not easy being either, although I do have to say that whatever we do, we cannot just open the floodgates because it would destroy the profession. The issue with Australian and Irish schools, is that these are schools that have figured out that they can make a handsome profit by training people from overseas, and then ultimately leaving them with questionable job opportunities. They want to have their cake and eat it, and to do this they lower their entry standards significantly. 

It is not our responsibility to accept these people back. In a sense they have skipped the line. 

Very true. Medicine is literally the last standing profession that hasn't been overrun. 

[moonlitocean]

Who’s funding this ridiculous lawsuit? 

A) wealthy parents who send their incompetent kids to “medical schools” overseas 

b) Garbage Caribbean medical schools who have everything to gain if they win this lawsuit

 

or perhaps both??

[indefatigable]

17 hours ago, medigeek said:

Don't most IMGs skip applying to Quebec anyway? Including Mcgill. Not sure on the #, but I'd guess data is limited due to a small sample size. Lot of english speakers also may skip over Mcgill if from Ontario etc. While francophones will go for french spots only. 

It's hard to tell the exact numbers - but there are a number of QC IMGs, some of who have posted on this forum (QC is the 2nd largest province).  McGill doesn't have the same French-language proficiency requirements as the other QC schools (with some exceptions) and so basic French would be much less of a general issue.  From last year's CaRMS - there were 14 IMG matches at McGill vs 35 at Ottawa and 69 at UofT.  Many native French-speakers would have the ability to apply to English spots as well. 

https://www.carms.ca/wp-content/uploads/2018/06/r1_tbl43e_2018-1.pdf

[indefatigable]

On 10/3/2018 at 8:46 PM, A-Stark said:

We establish and fund residency positions for the same purpose that we train Canadians in Canadian undergraduate medical programs. They don't exist so that Canadian citizens and permanent residents having trained *anywhere* can obtain a Canadian residency. That IMG seats exist reflects provincial policies aimed at recruitment, generally for underserviced areas with ROS contracts attached. These are legitimate policy choices and I very much doubt the courts will take any of these "rights" claims seriously. 

Then again, I also thought that talk of using the Notwithstanding Clause for something as trivial as ensuring Toronto City Council has 25 not 47 members was unlikely...

I agree with a lot of your  earlier analysis on positive vs negative rights with respect to the case.  It seems to me that the lawyers are trying to blur the two - but they're also using "discrimination" which is a headline-grabbing accusation and helps the media report the case sympathetically and thus build public support.

But when it comes to ROS, I also don't think it  often serves its most basic function of addressing underserved areas -  e.g. ON has the most IMGs, but the ROS is almost meaningless since it only restricts people from the biggest centres.    

UBC has added a ROS CMG position into the first round which I think shows in theory that CMGs can also be used for ROS positions - it probably helps that it's in derm, a highly competitive specialty, where people would be willing to accept the conditions (which do seem to be more stringent than ON).  

[JohnGrisham]

2 hours ago, tere said:

I agree with a lot of your  earlier analysis on positive vs negative rights with respect to the case.  It seems to me that the lawyers are trying to blur the two - but they're also using "discrimination" which is a headline-grabbing accusation and helps the media report the case sympathetically and thus build public support.

But when it comes to ROS, I also don't think it  often serves its most basic function of addressing underserved areas -  e.g. ON has the most IMGs, but the ROS is almost meaningless since it only restricts people from the biggest centres.    

UBC has added a ROS CMG position into the first round which I think shows in theory that CMGs can also be used for ROS positions - it probably helps that it's in derm, a highly competitive specialty, where people would be willing to accept the conditions (which do seem to be more stringent than ON).  

Many derms leave BC I hear cause of lower pay.

[indefatigable]

1 hour ago, JohnGrisham said:

Many derms leave BC I hear cause of lower pay.

So it might also be about keeping derms in the province at large .. not just underserved areas.  

[dumbebell]

What about DO graduate from US? They are considered IMG by Carms standard too. Isn' t the concept that "IMG are lower" contradictory here?

[JohnGrisham]

4 hours ago, dumbebell said:

What about DO graduate from US? They are considered IMG by Carms standard too. Isn' t the concept that "IMG are lower" contradictory here?

Not all IMGs regardless are lower, its just a matter that they took a nontraditional route and shouldn't expect anything when they side step the system.

[Edict]

10 hours ago, tere said:

I agree with a lot of your  earlier analysis on positive vs negative rights with respect to the case.  It seems to me that the lawyers are trying to blur the two - but they're also using "discrimination" which is a headline-grabbing accusation and helps the media report the case sympathetically and thus build public support.

But when it comes to ROS, I also don't think it  often serves its most basic function of addressing underserved areas -  e.g. ON has the most IMGs, but the ROS is almost meaningless since it only restricts people from the biggest centres.    

UBC has added a ROS CMG position into the first round which I think shows in theory that CMGs can also be used for ROS positions - it probably helps that it's in derm, a highly competitive specialty, where people would be willing to accept the conditions (which do seem to be more stringent than ON).  

In fact, if you get an academic job, you can avoid the ROS. So the only thing the ROS is useful for is to prevent people from working in community hospitals in Toronto and Ottawa. That is basically the most meaningless ROS ever.

[Edict]

6 hours ago, dumbebell said:

What about DO graduate from US? They are considered IMG by Carms standard too. Isn' t the concept that "IMG are lower" contradictory here?

How so?

[medigeek]

45 minutes ago, Edict said:

In fact, if you get an academic job, you can avoid the ROS. So the only thing the ROS is useful for is to prevent people from working in community hospitals in Toronto and Ottawa. That is basically the most meaningless ROS ever.

What qualifies as an academic job? I always thought ROS was pretty strict with Toronto work. 

[rmorelan]

10 hours ago, Edict said:

In fact, if you get an academic job, you can avoid the ROS. So the only thing the ROS is useful for is to prevent people from working in community hospitals in Toronto and Ottawa. That is basically the most meaningless ROS ever.

I mean that is true - but it isn't like they are handing out those academic jobs like candy either. Those are in general some of the hardest jobs to get in medicine. 

[Edict]

8 hours ago, rmorelan said:

I mean that is true - but it isn't like they are handing out those academic jobs like candy either. Those are in general some of the hardest jobs to get in medicine. 

Yeah they aren't, but my point is that it isn't a real RoS. I'm not against the idea of allowing IMGs to work in academic centers in Toronto and Ottawa, i'm just against the wording of RoS, since in my opinion it is misleading people. People who want to argue in favour of continuing to have IMG only spots often use the argument that IMGs have return of service, implying that they work in rural communities, but like i've mentioned, it isn't really true, there are few limits to where IMGs can work in Ontario. 

[Edict]

17 hours ago, medigeek said:

What qualifies as an academic job? I always thought ROS was pretty strict with Toronto work. 

I'm going to guess anything that comes with the title of assistant professor would count as academic. With that being said, according to RoS rules, you must still spend at least 20 hours a week practicing in a community that is RoS eligible, but you are able to get the academic appointment. So, you wouldn't be able to for example work at Trillium full time and be an assistant professor, but you could work in R. Hill and be an assistant professor. 

[leviathan]

On 10/4/2018 at 11:30 PM, IMislove said:

The government spends lots of money to fund the medical seats here, and with the ever-increasing unmatched students from Canadian schools, the government should be looking after their own students first. 

The government ultimately doesn't care who ends up getting matched, as long as they end up getting *somebody* matched into all the available residency spots. It's a bonus to them if they end up with an even better qualified doctor (an IMG) than the medical student they initially 'invested' in. The only issue with a fully competitive match would be influential doctors sending their kids abroad and getting them access to a residency spot over a more qualified CMG.