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Working in the US <-> Canada


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1 hour ago, mdlifecrisis said:

What happens when the number of years of residency in a specialty is different between the 2 countries?

For example, if someone finishes FM (2 years) in Canada and wants to work in the US (3 years)?

Or if someone finishes IM (3 years) in the US and wants to work in Canada (4-5 years)?

 

Can't speak to going from Canada to US, but if you do residency in the US you will usually need to do a fellowship or otherwise extra time (chief year, etc) to meet the number of years that that specialty does in Canada to be able to sit the board exams.

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20 minutes ago, bearded frog said:

Can't speak to going from Canada to US, but if you do residency in the US you will usually need to do a fellowship or otherwise extra time (chief year, etc) to meet the number of years that that specialty does in Canada to be able to sit the board exams.

If you do a combined residency (ie IM+EM) in the US, would you be able to work in either specialty in Canada? (After sitting the boards of course)

Also, typically what are the strings attached? any ROS obligations?

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2 hours ago, mdlifecrisis said:

If you do a combined residency (ie IM+EM) in the US, would you be able to work in either specialty in Canada?

The main barrier to practising in Canada would be qualifying to to sit the boards. As @bearded frog said, you could theoretically qualify by doing a fellowship to make your length of training equivalent to what it is in Canada. However, I don't know if that would apply to combined training pathways. But that's how it works for things like EM, Psych, Ophtho, etc that are a year shorter in the US. I'd assume that combined residencies are so rare that it would be dealt with on a case by case basis by the Royal College.

I think that having a weaker network would also be a hindrance but I'd imagine with the EM job market in Canada, the Royal College would be the main barrier.

Additionally, I linked an article from two Canadian physicians who did a 4 year EM residency at Partners in Health(Mass-General/Brigham) yet couldn't make it back home to Canada straight away. One of them did a fifth year at USask and is now at Calgary while the other stayed in the US.

https://cmajblogs.com/we-want-to-come-home/

Also, EM has a terrible job market in the US right now. I wouldn't be surprised if some tried to come up here as I doubt that the job market gets any better down there in the next 20 years at least.

https://www.aaemrsa.org/about/position-statements/graduating-em-residents-and-the-current-job-market

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Funny I was reading about EM just a few weeks ago, apparently these HCA residencies, including EM, IM, Pathology, etc are basically scut mills with poor quality and lack of formal education, as far as the posters were concerned. I am sure the Harvard affiliated program in the article is better but the quality of some of these for profit residencies in the US sounds really questionable.

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3 hours ago, shikimate said:

Funny I was reading about EM just a few weeks ago, apparently these HCA residencies, including EM, IM, Pathology, etc are basically scut mills with poor quality and lack of formal education, as far as the posters were concerned. I am sure the Harvard affiliated program in the article is better but the quality of some of these for profit residencies in the US sounds really questionable.

The sheer number of new private EM programs, such as HCA, is the main reason that the job market is awful. EM used to have very few spots and the excellent job market, high pay, and flexibility made it competitive in the US, like it is Canada. Now that the supply of EM physicians is way up and the demand is static, their job market and pay is in the dump and it's the furthest thing from competitive.

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55 minutes ago, bearded frog said:

If you follow rеddit or SDN it seems like doom and gloom for EM in the states due to resident oversupply and shifting to a mid-level with physician supervision model. With the tendency at these places for hyperbole (and stakeholder biases), who knows how bad it actually is.

I mean, the numbers don't lie. I agree that SDN and r*ddit are prone to hyperbole but I think the doom and gloom is legit for EM. 

An external file that holds a picture, illustration, etc. Object name is AET2-4-S13-g001.jpg

 

An external file that holds a picture, illustration, etc. Object name is AET2-4-S13-g002.jpg

 

Source:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011403/

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4 hours ago, shikimate said:

Funny I was reading about EM just a few weeks ago, apparently these HCA residencies, including EM, IM, Pathology, etc are basically scut mills with poor quality and lack of formal education, as far as the posters were concerned. I am sure the Harvard affiliated program in the article is better but the quality of some of these for profit residencies in the US sounds really questionable.

Nice to find a fellow SDN reader here. I am guessing you are a pathologist :)

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