..

[LittleDaisy]

I wonder if CFMS or unmatched CMGs should start the same initiative, and advocate for more residency spots for CMGs? 

Given that the unmatched CMGs are not guaranteed for spots in the second iteration, and there are unmatched CMGs who go unmatched despite a several years of trying. Robert Chu was a tragic case and it should not happen again!

[blah1234]

13 minutes ago, StarStrike said:

1) I think we are in agreement here. These are calculated risks for sure, but that doesn't mean it doesn't come with costs. I suppose the situation with our loan system here is no where near as bad as the US.

2) I never said anything about completely outsourcing education outside Canada. This is a straw man argument. I agree with you that we should have CMGs and Canadian medical schools.

3) It is true that the residency is an added barrier compared to most other professions. The addition of residency potentially adds yet another choke point. I see the rationale for wanting to stamp out competition, but I'm not convinced the argument is cohesive. I suppose what makes it more difficult is both of us are coming at this from different angles and understandably with different biases.

Do we have any information about the unmatched CMGs from CaRMS RE their choice of discipline? If most of these applicants were aiming for primary care, you could make a case about the allotment of residency spots to IMGs. Though before we do that we would need to determine whether this separation is unconsitutional and/or ethical.

4) Absolutely, I get that. If the purpose of these exams is to see that applicants are at the same standard of CMGs, why have that separation between the CMG/IMG group. If passing/doing well on these exams shows you are on the same playing field, why are we separating these groups still?

5) I'm in agreement with you on that. Nobody has a right to a certain career. Not everyone gets to go to medical school, or pursue a residency, or even have a job waiting for you at the end. What I am disagreeing with is why this is selectively being applied to different groups of Canadians. I could make the same argument about CMGs and say that getting into medical school doesn't entitle you to pursue a residency of your choice. Not everybody becomes a surgeon. As competition is getting more and more intense...not everyone gets to practice clinical medicine (though the upside is that this is not the only thing we can do with our credentials...). 

6) I'm glad to hear about that. I know many of our medical schools also have pathways to support our Indigenous population which I think, if it is working well, is fantastic. 

I'm not so sure I agree with you that we should base our admission just purely on academics. You just end up selecting for people that do well on exams and who focus their energies on the things that provide the highest yield. I know its a fluffy/subjective process the way we have it now, but I think it allows for some degree of diversity in the field and encourages people to build their soft skills and involve themselves in the community. Academics is only one of the many aspects that are important to be a good doc' nowadays (or so what most PDs tell me...).

2) Sorry, I just wanted to create a thought experiment to push the concept. The key message I wanted to convey is that we will always have domestic medical schools producing CMGs and that money being spent should see a return.

3) I think there is data on that but I'm not close to it.

4) I think my viewpoint is based on the fact that we should create some sort of economic certainty in the training process. If students are going through medical school -> residency -> fellowship -> staff and there is a significant chance to fail at any one of those steps you introduce significant uncertainty that will discourage certain applicants from applying to medicine in Canada. These applicants are the ones we need to diversify medicine.

5) I 100% agree that CMGs should not be entitled to a residency of their choice. I don't like how the rotating internship has been removed as FM refuses to be the "default" type of doctor. I disagree that everyone should not be able to practice clinical medicine. I believe that everyone in good standing should be able to qualify as some sort of default doctor which I suppose is FM at the very minimum and subsequently compete in the job market. The bad ones will simply get no patients. I don't believe we are close to this vision though.

6) I suppose I might have rambled here. I don't think academics should be the only basis for admission. I think extracurriculars and the interview provide colour into the profile of the candidate. However, I will say that many students are unable to pursue the traditional "prestige" extracurriculars because they come from backgrounds that require them to work a job during school or something like that. However, all students are able to put in the effort to do well academically theoretically. I think as students up the ante for their extracurriculars like overseas medical trips we should think about what kind of privilege allows some students to craft the profiles that they have. 

[blah1234]

9 minutes ago, LittleDaisy said:

I wonder if CFMS or unmatched CMGs should start the same initiative, and advocate for more residency spots for CMGs? 

Given that the unmatched CMGs are not guaranteed for spots in the second iteration, and there are unmatched CMGs who go unmatched despite a several years of trying. Robert Chu was a tragic case and it should not happen again!

I'm not sure there is political capital and will to find funding for more CMGs and I'm not sure if the CFMS will be able to enact large changes on this front. 

I think students who are in good standing but fall through the cracks repeatedly like Robert Chu are victims of a process that has changed little since he passed. I have heard through the grapevine of other unmatched students passing away that were not as publicized and I am saddened by the fact that the monolith of academic medicine continues to plod along unchanged. 

[Thunderbirds]

I simply do not understand the whining from CSAs. If you want to practice in Canada, then keep applying in Canada and get in on your own efforts. Do not rely on sub-standards of other countries to have a smaller chance, or skip undergrad to have a shorter route. Perhaps try a different career in health care if you can't get into Medicine. 

IMG spots should remain (limited, of course), but for people who are truly IMGs. A person who was born somewhere else, did their entire education there, and then immigrated to Canada should have a chance to match, if their skills and training are equivalent. In this instance, they didn't take an easier route... they did what they could, and as a result, they deserve a chance. 

[xiphoid]

36 minutes ago, Thunderbirds said:

I simply do not understand the whining from CSAs. If you want to practice in Canada, then keep applying in Canada and get in on your own efforts. Do not rely on sub-standards of other countries to have a smaller chance, or skip undergrad to have a shorter route. Perhaps try a different career in health care if you can't get into Medicine. 

IMG spots should remain (limited, of course), but for people who are truly IMGs. A person who was born somewhere else, did their entire education there, and then immigrated to Canada should have a chance to match, if their skills and training are equivalent. In this instance, they didn't take an easier route... they did what they could, and as a result, they deserve a chance. 

Completely in agreement with this. The sad reality is that there's been legal precedent already set saying that we cannot discriminate between IMGs on the basis of whether they are true IMGs or CSAs. Unfortunate, because this has likely cost IMGs a lot of residency spots since CSAs tend to be preferred by residency programs over them. In my opinion, residency spots should be CMGs > IMGs > CSAs.

[StarStrike]

1 hour ago, LittleDaisy said:

I wonder if CFMS or unmatched CMGs should start the same initiative, and advocate for more residency spots for CMGs? 

Given that the unmatched CMGs are not guaranteed for spots in the second iteration, and there are unmatched CMGs who go unmatched despite a several years of trying. Robert Chu was a tragic case and it should not happen again!

I think in BC there is the "No Docs Left Behind" initiative (https://www.nodocsleftbehind.com)!

[StarStrike]

1 hour ago, Thunderbirds said:

I simply do not understand the whining from CSAs. If you want to practice in Canada, then keep applying in Canada and get in on your own efforts. Do not rely on sub-standards of other countries to have a smaller chance, or skip undergrad to have a shorter route. Perhaps try a different career in health care if you can't get into Medicine. 

IMG spots should remain (limited, of course), but for people who are truly IMGs. A person who was born somewhere else, did their entire education there, and then immigrated to Canada should have a chance to match, if their skills and training are equivalent. In this instance, they didn't take an easier route... they did what they could, and as a result, they deserve a chance. 

1

Gotta love the emotionally driven hate that is being shared in this thread (including the quiet ones liking said posts...).

I appreciate the respectful chatter from the other members of this thread. Good to see that we can have some constructive discussion.

[indefatigable]

2 hours ago, StarStrike said:

Yeah, I see your point. Obviously not a straight forward situation, be interesting to see what if anything comes out of the petition.

Agreed with the point that some schools are predatory and yes they do use the revenue source to subsidize and improve the training of their own students. Personally, I think these overseas schools also have an ethical responsibility to provide a pathway for their international cohort if they are to continue taking them on.

As for stretching family finances, I agree 100%, but that doesn't stop people from taking these risks. I suppose the question is to see what if any obligation we have to our own fellow Canadians.

I think it's really important that would-be CSAs are fully informed of the risks and likely downsides to going abroad.  IMG schools are going to give a very positive spin, since many earn revenue from CSAs.  Similarly, the CSAs who match back to Canada represent a biased sample - so it's really important to see the whole picture, from the outset.  So ethically speaking, talking openly about the situation as it is today with potential CSAs before they decided to go anywhere is probably a good idea.  Unlike some others, I simply see CSAs as pursuing whatever advantages/opportunities they may have, but without full awareness of a certain ethical murkiness of their path nor of the impracticality wrt to matching to Canada, nor of the financial risk, nor of the resentment towards them.   

As others have mentioned, CMGs are going unmatched with only little concrete action - a few more spots, and some minor streaming adjustments, even though  CMGs are clearly the highest profile and priority group.  

Immigrant IMGs I think are probably now aware that generally speaking, that a medical training will favour entry to Canada, but not further practice as a physician.  I've noted before that I find it disturbing if the federal government is recruiting immigrants based on misleading promises of working as doctor in Canada when in the current system that's generally not probable (vs the past).  Immigrant IMGs may still choose to come to Canada for other reasons, often sacrificing career and migration for children's futures.  It's important to note that immigrant IMGs are also Canadians - with equal rights as CSAs.

And CSAs - well it's unfair to stereotype them, like it is with any group, but given the tightness of the match situation in Canada, they are going to be scapegoated to some extent.  Even if they won their petition (highly unlikely in my view), there's still way too many CSAs versus residency spots.  So in a sense we'd be back to square one.      

[StarStrike]

7 minutes ago, tere said:

I think it's really important that would-be CSAs are fully informed of the risks and likely downsides to going abroad.  IMG schools are going to give a very positive spin, since many earn revenue from CSAs.  Similarly, the CSAs who match back to Canada represent a biased sample - so it's really important to see the whole picture, from the outset.  So ethically speaking, talking openly about the situation as it is today with potential CSAs before they decided to go anywhere is probably a good idea.  Unlike some others, I simply see CSAs as pursuing whatever advantages/opportunities they may have, but without full awareness of a certain ethical murkiness of their path nor of the impracticality wrt to matching to Canada, nor of the financial risk, nor of the resentment towards them.   

As others have mentioned, CMGs are going unmatched with only little concrete action - a few more spots, and some minor streaming adjustments, even though  CMGs are clearly the highest profile and priority group.  

Immigrant IMGs I think are probably now aware that generally speaking, that a medical training will favour entry to Canada, but not further practice as a physician.  I've noted before that I find it disturbing if the federal government is recruiting immigrants based on misleading promises of working as doctor in Canada when in the current system that's generally not probable (vs the past).  Immigrant IMGs may still be choose to come to Canada for other reasons, often sacrificing career and migration for children's futures.  It's important to note that immigrant IMGs are also Canadians - with equal rights as CSAs.

And CSAs - well it's unfair to stereotype them, like it is any group, but given the tightness of the match situation in Canada, they are going to be scapegoated to some extent.  Even if they won their petition (highly unlikely in my view), there's still way too many CSAs versus residency spots.  So in a sense we'd be back to square one.      

Agree with ya :). If many of my classmates understood and internalized what they know now 4 years ago, I think many of them wouldn't have taken the risk going abroad (and rightly so). The funny thing though is the grass always seems to be greener on the other side - many of my friends (and some people on this forum too) over the years have asked me for my opinion on pursuing medicine abroad....and despite telling them of the risks, the competitiveness, stigma, etc. etc. many of them end up doing it anyway. I mean for me, I switched careers to medicine...and I went into this with the understanding that I might not make it, but perhaps naively so wanted to give myself a chance. I got lucky. 

[Thunderbirds]

45 minutes ago, StarStrike said:

Gotta love the emotionally driven hate that is being shared in this thread (including the quiet ones liking said posts...).

I appreciate the respectful chatter from the other members of this thread. Good to see that we can have some constructive discussion.

I'm sorry, but can you point out the "hate" in my post? As I already alluded to in my post, I am sympathetic to IMGs who had no chance of potentially training within our health care system.

[GrouchoMarx]

Stop using the term CSA. It's racist.

 

CSA sounds sexy, like studying art in Florence. It's an attempt to prop up this group above the mostly brown skinned IMG contingent. It's smoke and mirrors.

 

IMG sounds bureaucratic and coldly accurate, and most importantly doesn't differentiate by race.

 

They're the same thing. IMG is the proper term.

[Butterfly_]

1 hour ago, StarStrike said:

Agree with ya :). If many of my classmates understood and internalized what they know now 4 years ago, I think many of them wouldn't have taken the risk going abroad (and rightly so). The funny thing though is the grass always seems to be greener on the other side - many of my friends (and some people on this forum too) over the years have asked me for my opinion on pursuing medicine abroad....and despite telling them of the risks, the competitiveness, stigma, etc. etc. many of them end up doing it anyway. I mean for me, I switched careers to medicine...and I went into this with the understanding that I might not make it, but perhaps naively so wanted to give myself a chance. I got lucky. 

Just like with anything in life, people must understand the risks that they are taking. If they didn’t do enough research beforehand or didn’t understand what they are getting themselves into then they have no one to blame but themselves. 

There are plenty of resources out there regarding Caribbean schools. Lots of posts, blogs, and forums talk about the risks and financial burden of choosing this path. That’s why I never considered applying to these schools. 

Furthermore, even if I wanted to apply to these schools, it would have been financially impossible for me. The Caribbean school route can only work for middle to high income families. For students from low socioeconomic backgrounds, we can’t even secure the loans needed for the living expenses and tuition. Our credit is just not high enough for that.

 

 

 

[older]

On ‎4‎/‎7‎/‎2019 at 8:30 AM, COMMANDO said:

If you wanted to practice medicine in Canada so badly, reapply to Canadian medical schools. Move to Alberta or BC until you’ve in province advantage. Learn French and apply to Sherbrooke Laval UdeM. If you’re going to Ireland or England or Australia or the fucking Carribbean, don’t be butt hurt when your chances of matching are slim to none

Discussion style and language suitable for a medical professional.

[thesupreme]

On 4/6/2019 at 1:27 AM, thesupreme said:

Looks like the Society of Canadians Studying Medicine Abroad (SCSMA) has filed a suit against various parties involved in the MedEd and matching process arguing the CMG/IMG streaming is unconstitutional.

http://socasma.com/wp-content/uploads/2018/10/Petition-filed-copy.pdf

A judgment has been rendered by the Health Professions Review Board on this case: http://canlii.ca/t/j1hkd (Applicants v. College of Physicians and Surgeons of British Columbia). 

[62]        In making this decision, I have considered all of the information and submissions before me, whether or not specifically reiterated herein.

[63]        I find that none of the Applicants applied for registration in any class of registration of the College and that no registration decision was made by the Registration Committee.  I have therefore concluded that there is no basis on which the Review Board can conduct a review or make any order pursuant to s.50.54 of the Act.   Accordingly, I hereby dismiss the Applications.

[64]        Given my decision, it is not necessary to decide whether the Review Board can grant the remedial relief sought in the application for review, as amended in the alternative by the Applicants reply submissions, or whether Applicant No. 3 has standing to file an application or should be allowed to intervene in the application pursuant to s.33(1) of the ATA.

[65]        I have treated the Applicants’ Letter, including the material on the disc delivered with that letter and all submissions made by the Applicants to the Review Board with respect to this review as having been delivered and made on behalf of the Individual Applicants.  If I had decided that Applicant No. 3 had standing or should have been granted intervener status, the outcome for that applicant would have been same as for Applicants No. 1 and No. 2, given the basis for my decision.