Ireland Medical School Realities

[Coldery]

Hey guys,

Just curious about the nature of overseas medical schools (Ireland specifically) and the chances of returning to Canada for a residency as an IMG. According to CARMS match statistics, it seems like the total match percentage for European IMGs sits at around 41% (Final participation = 415, Matched = 172). I feel like there could be more subtleties which may include non-Canadian IMGs which may distort this statistic (with a higher level of importance given to Canadian IMGs) so I'd like to have that clarified if possible. 

This may also be a question which has been answered 20+ times before so I apologize in advance.

Thanks, Coldery

[JohnGrisham]

Try search function first and then report back if youre still unsure.

[Edict]

The TLDR is that its closer to 60% to match directly into US or Canada. The number is probably higher once you factor in people who match a year later to the US or Canada. There are documents floating around somewhere which breakdown the numbers by school and class year. 

The truth is that going to Ireland or Australia isn't a dead end like it's made out to be. If you can reasonably afford it, most people end up with something somewhere. The issue is going there with unrealistic expectations. You basically have to understand that you are getting yourself into very high debt, taking a risk, and you won't be able to choose where you live for the next 10 years or so. You also have to understand that you are going to need to work bloody hard, harder than a Canadian medical student would if you want to get anywhere. 

 

 

[JohnGrisham]

2 hours ago, Edict said:

The TLDR is that its closer to 60% to match directly into US or Canada. The number is probably higher once you factor in people who match a year later to the US or Canada. There are documents floating around somewhere which breakdown the numbers by school and class year. 

The truth is that going to Ireland or Australia isn't a dead end like it's made out to be. If you can reasonably afford it, most people end up with something somewhere. The issue is going there with unrealistic expectations. You basically have to understand that you are getting yourself into very high debt, taking a risk, and you won't be able to choose where you live for the next 10 years or so. You also have to understand that you are going to need to work bloody hard, harder than a Canadian medical student would if you want to get anywhere. 

 

 

That's assuming you write the USMLEs, alot of irish and aussie CSA's i've met havent wrote the exams, and then get stuck reapplying to Canada multiple times in hopes of a match.

[Edict]

Just now, JohnGrisham said:

That's assuming you write the USMLEs, alot of irish and aussie CSA's i've met havent wrote the exams, and then get stuck reapplying to Canada multiple times in hopes of a match.

If you ask me, that's a "them" problem. If you drop 300k on tuition and can't be bothered to write the USMLE's, i genuinely don't know what to say. 

[JohnGrisham]

1 hour ago, Edict said:

If you ask me, that's a "them" problem. If you drop 300k on tuition and can't be bothered to write the USMLE's, i genuinely don't know what to say. 

Yeah its unfortunate.

[indefatigable]

I've heard of unsuccessful attempts on Step 1.  Although there seems to be some support for the MLEs in some places there, they're not nearly as well prepped as a USMG.  I've also heard that CMGs are finding Step 1 tougher, as the Canadian curriculums move away from the basic science emphasis and the material for Step 1 keeps growing (even compared to ten years ago).  

[Edict]

11 minutes ago, tere said:

I've heard of unsuccessful attempts on Step 1.  Although there seems to be some support for the MLEs in some places there, they're not nearly as well prepped as a USMG.  I've also heard that CMGs are finding Step 1 tougher, as the Canadian curriculums move away from the basic science emphasis and the material for Step 1 keeps growing (even compared to ten years ago).  

You can easily self study the USMLEs. Most of the resources these days are USMLE focused. 

[indefatigable]

4 minutes ago, Edict said:

You can easily self study the USMLEs. Most of the resources these days are USMLE focused. 

I agree - but it helps if you've learned the stuff before, especially for people who are looking to US residencies and want competitive scores.  I've heard of CMGs also struggling to get through Step 1, despite being good students,etc..      

[Edict]

29 minutes ago, tere said:

I agree - but it helps if you've learned the stuff before, especially for people who are looking to US residencies and want competitive scores.  I've heard of CMGs also struggling to get through Step 1, despite being good students,etc..      

It definitely is harder if your school doesn't teach towards the USMLE. No question, but if you do go abroad, you should write the USMLE step 1 and aim for a high score. Wasn't there an Irish student who posted here a few weeks ago about getting a 260+ on the step 1? It is doable, whether you go to Ireland or Canada to do well on the USMLE and apply to the US. 

Ireland/Aus definitely isn't for everyone, you should have a good idea of what your plan is to get a job if you do go there and most likely that involves writing the USMLE, doing research/electives, and all in all having to work harder than a CMG to get the same residency. 

[indefatigable]

1 hour ago, Edict said:

It definitely is harder if your school doesn't teach towards the USMLE. No question, but if you do go abroad, you should write the USMLE step 1 and aim for a high score. Wasn't there an Irish student who posted here a few weeks ago about getting a 260+ on the step 1? It is doable, whether you go to Ireland or Canada to do well on the USMLE and apply to the US. 

Ireland/Aus definitely isn't for everyone, you should have a good idea of what your plan is to get a job if you do go there and most likely that involves writing the USMLE, doing research/electives, and all in all having to work harder than a CMG to get the same residency. 

Agree - that has to be the attitude.  Yeah - that was a great score, but really the exception from what I've heard.  And it means being adaptive, for example - less responsibility/time demands during clerkship/clinical training and so using all that time to study for MLEs, etc..  Going in knowing what it will take and sticking to a plan is key - and yeah knowing it might be more of a struggle to end up at the same spot.  

[JohnGrisham]

12 hours ago, tere said:

I've heard of unsuccessful attempts on Step 1.  Although there seems to be some support for the MLEs in some places there, they're not nearly as well prepped as a USMG.  I've also heard that CMGs are finding Step 1 tougher, as the Canadian curriculums move away from the basic science emphasis and the material for Step 1 keeps growing (even compared to ten years ago).  

There are so few CMGs taking USMLES that those statements are meaningless.

The ones i know that self studied and took Step 1 all did 240+.  You don't take it if you arent self motivated and going for a competitive specialty as a CMG. No one(or infinitely few people) are taking it to apply for FM or primary care specialties for example.

[indefatigable]

53 minutes ago, JohnGrisham said:

There are so few CMGs taking USMLES that those statements are meaningless.

The ones i know that self studied and took Step 1 all did 240+.  You don't take it if you arent self motivated and going for a competitive specialty as a CMG. No one(or infinitely few people) are taking it to apply for FM or primary care specialties for example.

Well I guess we’ve heard different things - it could be different where you are.  

Regardless, recently less CMGs are matching to the US - often it’s prior year grads (7/9 last year) or non-Canadians (1/9). 

More CMGs write the MLE for fellowship or other purposes - this is where  I’ve heard people are finding things tougher.  

[JohnGrisham]

14 hours ago, tere said:

Well I guess we’ve heard different things - it could be different where you are.  

Regardless, recently less CMGs are matching to the US - often it’s prior year grads (7/9 last year) or non-Canadians (1/9). 

More CMGs write the MLE for fellowship or other purposes - this is where  I’ve heard people are finding things tougher.  

Naturally its tougher, since those doing it for fellowships are likely doing it during residency when they are far removed from basic sciences. That said step 2 and 3 end up being easier with more clinical experience under your belt..but only up to a point.

[indefatigable]

36 minutes ago, JohnGrisham said:

Naturally its tougher, since those doing it for fellowships are likely doing it during residency when they are far removed from basic sciences. That said step 2 and 3 end up being easier with more clinical experience under your belt..but only up to a point.

Sure - but I've heard the same from med students, writing Step 1, who are not aiming for US residency.  UBC seems like it puts emphasis on the basic sciences still even though other schools have moved away (e.g. histology lab you've mentioned before).  Perhaps this explains part of the discrepancy.    

[JohnGrisham]

39 minutes ago, tere said:

Sure - but I've heard the same from med students, writing Step 1, who are not aiming for US residency.  UBC seems like it puts emphasis on the basic sciences still even though other schools have moved away (e.g. histology lab you've mentioned before).  Perhaps this explains part of the discrepancy.    

If youre going to write it for fellowships as a med student, seems silly to half-heartedly attempt it.

Again, with UFAP, it doesnt really matter what school you go to. I know people at 3 year programs who did well on it, and they arguably have the least amount of basic sciences. The main determining factor is finding time to go through and self prepare. Most canadian schools do very little pathology, microbiology and pharmacology, so you'll have to self teach anyways. 

[indefatigable]

19 minutes ago, JohnGrisham said:

If youre going to write it for fellowships as a med student, seems silly to half-heartedly attempt it.

Again, with UFAP, it doesnt really matter what school you go to. I know people at 3 year programs who did well on it, and they arguably have the least amount of basic sciences. The main determining factor is finding time to go through and self prepare. Most canadian schools do very little pathology, microbiology and pharmacology, so you'll have to self teach anyways. 

I don't believe these were half-hearted attempts - although they were definitely limited in time.  Perhaps MLE writing hadn't been planned throughout pre-clerkship and there was a lot of material to cover.  Strong scoring individuals have mentioned lengthy dedicated time for study.  

Kudos to your acquaintances, but the trend is both fewer CMGs applying and matching to the US than compared to the past. 

[JohnGrisham]

17 minutes ago, tere said:

I don't believe these were half-hearted attempts - although they were definitely limited in time.  Perhaps MLE writing hadn't been planned throughout pre-clerkship and there was a lot of material to cover.  Strong scoring individuals have mentioned lengthy dedicated time for study.  

Kudos to your acquaintances, but the trend is both fewer CMGs applying and matching to the US than compared to the past. 

Well, being limited on time and not pre-planning are  in my mind contributing towards half-hearted attempts.

[indefatigable]

3 hours ago, JohnGrisham said:

Well, being limited on time and not pre-planning are  in my mind contributing towards half-hearted attempts.

If you're seriously considering a US residency maybe - but even US schools sometimes only have a checkbox for Canadian students going for an elective (i.e. don't ask for the score).  Some people aim to write Step 1 for review and to prepare for clerkship and/or with the idea in mind that it would be easier to get it done closer to pre-clinical rather than later in their career.  

Perhaps if there's something we both somewhat agree on it's that Canadian students looking to write Step 1, even if only to pass, should plan ahead and dedicate significant time, especially given the lack of  coverage of a lot of the material (can vary by school).

[JohnGrisham]

2 hours ago, tere said:

If you're seriously considering a US residency maybe - but even US schools sometimes only have a checkbox for Canadian students going for an elective (i.e. don't ask for the score).  Some people aim to write Step 1 for review and to prepare for clerkship and/or with the idea in mind that it would be easier to get it done closer to pre-clinical rather than later in their career.  

Perhaps if there's something we both somewhat agree on it's that Canadian students looking to write Step 1, even if only to pass, should plan ahead and dedicate significant time, especially given the lack of  coverage of a lot of the material (can vary by school).

I see what you mean! I havent heard of many people taking Step 1 just for review and such, seems like a odd idea considering how expensive the exam is hah. Seems we've had different anecdotal experiences    I mean, you wouldnt be doing a US elective if you arent considering applying for residency, otherwise it would be a waste of precious elective time

I dont think the lack of coverage is really that big of a thing, american schools have similiar issues of lecturers focusing in on low yield info and not as much high yield info etc. 

 

[indefatigable]

15 hours ago, JohnGrisham said:

I see what you mean! I havent heard of many people taking Step 1 just for review and such, seems like a odd idea considering how expensive the exam is hah. Seems we've had different anecdotal experiences    I mean, you wouldnt be doing a US elective if you arent considering applying for residency, otherwise it would be a waste of precious elective time
I dont think the lack of coverage is really that big of a thing, american schools have similiar issues of lecturers focusing in on low yield info and not as much high yield info etc. 

Well "review" might not be the right word, given the self-learning involved  Honestly, I think people just figure if it's something they may need or could help, it's better to get it out of the way earlier, when some of the stuff is fresher in their memory.

I hear what you're saying regarding US schools, but I really do think that some Canadian schools are pretty far away from the MLE Step 1 type material (mine for example).  It's known to be a difficult test in the US and if you have additionally to pick up a lot of material, it doesn't make it easier.  

There's no reason for Canadian schools to cover that material either, since their student's futures don't depend on the MLEs, unlike the US.  I've also heard that the Canadian med schools are now more independent from US accreditation, which means their curriculum focus can definitely shift away from the US model.

[JohnGrisham]

Definitely! I will say that Canadian curriculum generally is more clinically related and definitely prepares you well for step 2 and step 3.  

All in all, we've diverted a bit from the thread focus, at the end of the day its mostly on an individual to sit down and dedicate the time to standardized tests regardless of where they are studying medicine, US, abroad or even Canada.

[indefatigable]

On November 5, 2018 at 10:13 AM, JohnGrisham said:

Definitely! I will say that Canadian curriculum generally is more clinically related and definitely prepares you well for step 2 and step 3.  

All in all, we've diverted a bit from the thread focus, at the end of the day its mostly on an individual to sit down and dedicate the time to standardized tests regardless of where they are studying medicine, US, abroad or even Canada.

I agree that we drifted off - my tangential comment did lack some context and I was responding to your skeptical viewpoints.

Ultimately, it's an individual effort, but individual conditions can vary greatly.  US schools typically offer review and dedicated study time for Step 1 - Canadian schools don't.  And nor do Canadian schools teach a lot of that material.

Even within Canada, some schools teach more basic sciences, others may have more free-time, etc, etc..  So individual up to a point - but, yeah let's agree to halt where we are.  

[HandyDandyNotebook]

On 11/3/2018 at 7:03 PM, JohnGrisham said:

There are so few CMGs taking USMLES that those statements are meaningless.

The ones i know that self studied and took Step 1 all did 240+.  You don't take it if you arent self motivated and going for a competitive specialty as a CMG. No one(or infinitely few people) are taking it to apply for FM or primary care specialties for example.

Hi. Let's say you're a CMG going for a competitive specialty in the states. Upon completion, what does the process look like (if at all possible) to return to Canada and practice? Thank you

[JohnGrisham]

22 hours ago, HandyDandyNotebook said:

Hi. Let's say you're a CMG going for a competitive specialty in the states. Upon completion, what does the process look like (if at all possible) to return to Canada and practice? Thank you

Its not easy, but its not impossible. Very specialty dependent. If you know you want to come back to Canada anyways, you may as well do your residency in Canada if you can.  Its so much easier already being in the system, buidling connections while in residency etc. Especially for small surgical fields.