Which specialties is it worth it to study the USMLE for in an effort to apply to the US for residency?

[dermplan]

Which specialties is it worth it to study the USMLE for in an effort to apply to the US for residency?

[zoxy]

2 hours ago, dermplan said:

USMLE for in an effort to apply to the US for residency?

Specialties that are somewhat competitive in Canada and much less competitive in the US. Psychiatry, IM, EM, and Pediatrics are what immediately springs to my mind. I think Rads might have been one as well a few years ago, but it's getting less competitive in Canada due to AI fear mongering and fear of impending cuts to imaging payments.

By looking at your profile name, it's looks like you want to match Derm. If that's the case, it's similarly competitive down in the US and I don't think barring insane USMLE scores and research, you'd have a great chance of matching Derm down there. In fact many people interested in Derm in the US take a year off to do Derm research to make connections and boost their application. It's that competitive.

[dermplan]

3 minutes ago, zoxy said:

Specialties that are somewhat competitive in Canada and much less competitive in the US. Psychiatry, IM, EM, and Pediatrics are what immediately springs to my mind. I think Rads might have been one as well a few years ago, but it's getting less competitive in Canada due to AI fear mongering and fear of impending cuts to imaging payments.

By looking at your profile name, it's looks like you want to match Derm. If that's the case, it's similarly competitive down in the US and I don't think barring insane USMLE scores and research, you'd have a great chance of matching Derm down there. In fact many people interested in Derm in the US take a year off to do Derm research to make connections and boost their application.

I am interested in peds derm. Perhaps even doing peds residency followed by derm residency. 

I am worried about my chances in Canada because I go to a 3 year school and in the year above me - only one of six people who really wanted dermatology matched to it... I am trying to explore available options. 

 

I am 26 and in my last year of medical school - so I am okay with spending extra time to achieve my career goals

[offmychestplease]

59 minutes ago, zoxy said:

Specialties that are somewhat competitive in Canada and much less competitive in the US. Psychiatry, IM, EM, and Pediatrics are what immediately springs to my mind. I think Rads might have been one as well a few years ago, but it's getting less competitive in Canada due to AI fear mongering and fear of impending cuts to imaging payments.

By looking at your profile name, it's looks like you want to match Derm. If that's the case, it's similarly competitive down in the US and I don't think barring insane USMLE scores and research, you'd have a great chance of matching Derm down there. In fact many people interested in Derm in the US take a year off to do Derm research to make connections and boost their application. It's that competitive.

You can't work in EM in Canada by doing EM in the US. Also, Psych, IM and peds in the US are all 1 year shorter so you can't work in Canada if you do them in the US unless you do at least one fellowship.

[dermplan]

1 hour ago, offmychestplease said:

You can't work in EM in Canada by doing EM in the US. Also, Psych, IM and peds in the US are all 1 year shorter so you can't work in Canada if you do them in the US unless you do at least one fellowship.

I don't know if that's true. One of my preceptors who work at one of the ED in Calgary has finished her med school in Carribean and residency in US and currently work at one of the ED in Calgary. 

 

[zxcccxz]

2 hours ago, dermplan said:

I don't know if that's true. One of my preceptors who work at one of the ED in Calgary has finished her med school in Carribean and residency in US and currently work at one of the ED in Calgary. 

 

She would've had to do additional fellowship training in order to work in Canada, which she clearly did since she's working here.

[zoxy]

For all of the specialties that are one year shorter in the US in Canada, you need to do a year of residency in Canada or a year of fellowship to be able to sit the Royal College. If you look around you can find examples of people who did that and the Royal College documents also explains the process.

I know an EM physician in Calgary who did med-school in Australia, her 4 years EM residency at Harvard, and then had to do a year of residency in Saskatoon in order to qualify for the Royal College in EM. The irony is that there are plenty of physicians who work in EM with an FM+1  background while someone with 4 years of residency in EM from the US would need to do an extra year of training. The irrationality of Canadian bureaucracy reigns supreme.

[dermplan]

12 minutes ago, zoxy said:

For all of the specialties that are one year shorter in the US in Canada, you need to do a year of residency in Canada or a year of fellowship to be able to sit the Royal College. If you look around you can find examples of people who did that and the Royal College documents also explains the process.

I know an EM physician in Calgary who did med-school in Australia, her 4 years EM residency at Harvard, and then had to do a year of residency in Saskatoon in order to qualify for the Royal College in EM. The irony is that there are plenty of physicians who work in EM with an FM+1  background while someone with 4 years of residency in EM from the US would need to do an extra year of training. The irrationality of Canadian bureaucracy reigns supreme.

Indeed.

What if I finish 3 years of peds residency followed by derm residency is US? Will I be double board certified when i return to Canada? Or given discrepancy of years, I would not even be allowed to write Canadian boards.

Also what are the odds of matching to derm residency in US right after med school if you would go anywhere in the US and have high USMLE score and 3-4 derm pubs. 

I honestly would not be too upset if I can't practice in Canada, but just want to know. 

[zoxy]

4 minutes ago, dermplan said:

Indeed.

What if I finish 3 years of peds residency followed by derm residency is US? Will I be double board certified when i return to Canada? Or given discrepancy of years, I would not even be allowed to write Canadian boards.

Also what are the odds of matching to derm residency in US right after med school if you would go anywhere in the US and have high USMLE score and 3-4 derm pubs. 

I honestly would not be too upset if I can't practice in Canada, but just want to know. 

I'm not sure since that's such a unique case. Also I'm uncertain how easy a transition into derm from a peds residency in the US would be.

If you want more info, take a look at these Royal College requirements for specifics:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjuncmp8NTzAhVeQTABHbz9DS8QFnoECAMQAQ&url=https%3A%2F%2Fwww.royalcollege.ca%2Frcsite%2Fdocuments%2Fibd%2Fdermatology-str-e.pdf&usg=AOvVaw1EjzCq2nD08L33pgCnFhbY

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiF1oa08NTzAhWPdN8KHRsWAGIQFnoECAQQAQ&url=https%3A%2F%2Fwww.royalcollege.ca%2Frcsite%2Fdocuments%2Fibd%2Fpediatrics_str_e.pdf&usg=AOvVaw3GWtF4fXjkO4EHV1WzW2LG

 

[offmychestplease]

1) I don't think it would be possible as derm and peds are longer in Canada.

2) You said you're a final year medical student rn, if you wanted to do derm in the US you would have already applied by now so unsure about the timeline.

3) Derm is insanely compeptive for US MD's as is, I think chances are very slim for internationals.

4) Even if you got derm and peds spots are you really ok with doing 8+ years of residency. That's no joke.

[dermplan]

5 minutes ago, offmychestplease said:

1) I don't think it would be possible as derm and peds are longer in Canada.

2) You said you a final year medical student rn, if you wanted to do derm in the US you would have already applied by now so unsure about the timeline.

3) Derm is insanely compeptive for US MD's as is, I think chances are very slim for internationals.

4) Even if you got derm and peds spots are you really ok with doing 8+ years of residency. That's no joke.

1.   I would like to practice as a paediatric dermatologist eventually in Cda or US.

2. Yes, well if I don't make it in CaRMS this year for derm or peds, I will extend my clerkship as I go to a 3 year school and they allow us to extend clerkship. My application is more derm focused but peds is my back up. However, I know that sometimes people don't get into derm even if they show interest in it and have 2-3 publications in it. I also have no graduate degree, and I just got into medicine with my undergraduate degree making me a bit uncompetitive for derm. My CV is overall mediocre - however, I don't mind spending years to work on it to qualify for my goal.

3. I understand, but peds derm is my dream.

4. Yes, that's fine. Doing both residencies is an option that I am considering. It would be easier to just get into derm and do +1 in peds derm, but derm is very competitive residency to get.

[offmychestplease]

maybe your best option is do a research year next year in the US derm dept's. You seem really passionate about derms, best of luck 

[indefatigable]

6 hours ago, dermplan said:

I am interested in peds derm. Perhaps even doing peds residency followed by derm residency. 

I am worried about my chances in Canada because I go to a 3 year school and in the year above me - only one of six people who really wanted dermatology matched to it... I am trying to explore available options. 

There's a one year peds-derm fellowship available to both peds and derm grads in Canada.  You don't need to do both residencies - although this is stuff that you should know/learn well for any interviews in either discipline.  

Derm is more competitive than peds which is already competitive.  

Most derm matches don't have any grad work - although some places like U/T tend to look more for that profile.  If you have publications and some clinical experience then you have a good chance to get at least a home school interview.  

It's good to think about a plan C, D, etc..  but I tend to think that doing more clinical/research stuff in Canada is higher yield than the US.  

[bearded frog]

To clarify things, pediatric dermatology is a sub-specialty of dermatology. You do a derm residency then peds derm. There are some non-royal college fellowships for peds residents in Canada but it's more like pediatrics with a special interest in dermatology as opposed to being a pediatric dermatologist. Derm is one of the most compeditive, if not the most compeditive residencies every year. You really need to network. If you really want derm then I would see about doing a 4th year of research, electives etc. in derm. You can write the USMLEs to see where you stand but as a non-US applicant you would really need to be in the top tier of all applicants for the US.

I realize you are willing to apply multiple times but you really will only have one shot at derm - if you're not accepted the first time around you're almost certainly not going to be accepted as a re-applicant, and your peds application will also be more difficult (I would also back up with family etc. if you're re-applying) so better to not apply unless you're ready.

[indefatigable]

44 minutes ago, bearded frog said:

To clarify things, pediatric dermatology is a sub-specialty of dermatology. You do a derm residency then peds derm. There are some non-royal college fellowships for peds residents in Canada but it's more like pediatrics with a special interest in dermatology as opposed to being a pediatric dermatologist.

Unlike the US where most fellowships are ABD (american board of dermatoloy), it seems most in Canada are open to both peds and derms - the most high-profile fellowship is probably at Sick Kids where there is simply a box to check for peds vs derm.  There's also one mentioned at UdeM.  McGill derm seems to be the only derm department with a fellowship in Canada - maybe they restrict to derm graduates?  I think both backgrounds could be advantageous to pediatric derm - I suppose it depends on the type of practice.   

https://www.sickkids.ca/contentassets/7d4467147de749cab35779106c18b40f/dermatology-fellowship-application-form.pdf

https://pedsderm.net/training/fellowships/non-abd-pediatric-dermatology-fellowship-programs/

https://www.mcgill.ca/pgme/fellowships/fellowship-programs/dermatology

 

[dermplan]

32 minutes ago, bearded frog said:

To clarify things, pediatric dermatology is a sub-specialty of dermatology. You do a derm residency then peds derm. There are some non-royal college fellowships for peds residents in Canada but it's more like pediatrics with a special interest in dermatology as opposed to being a pediatric dermatologist. Derm is one of the most compeditive, if not the most compeditive residencies every year. You really need to network. If you really want derm then I would see about doing a 4th year of research, electives etc. in derm. You can write the USMLEs to see where you stand but as a non-US applicant you would really need to be in the top tier of all applicants for the US.

I realize you are willing to apply multiple times but you really will only have one shot at derm - if you're not accepted the first time around you're almost certainly not going to be accepted as a re-applicant, and your peds application will also be more difficult (I would also back up with family etc. if you're re-applying) so better to not apply unless you're ready.

Ok, I will try my best with the USMLE... If i am not accepted into peds or derm in Cda, I would much rather go to the US to pursue peds as a back up rather than do FM. 

[dermplan]

41 minutes ago, indefatigable said:

Unlike the US where most fellowships are ABD (american board of dermatoloy), it seems most in Canada are open to both peds and derms - the most high-profile fellowship is probably at Sick Kids where there is simply a box to check for peds vs derm.  There's also one mentioned at UdeM.  McGill derm seems to be the only derm department with a fellowship in Canada - maybe they restrict to derm graduates?  I think both backgrounds could be advantageous to pediatric derm - I suppose it depends on the type of practice.   

https://www.sickkids.ca/contentassets/7d4467147de749cab35779106c18b40f/dermatology-fellowship-application-form.pdf

https://pedsderm.net/training/fellowships/non-abd-pediatric-dermatology-fellowship-programs/

https://www.mcgill.ca/pgme/fellowships/fellowship-programs/dermatology

 

I looked into it - it seems that you need to self fund the sick kids fellowship or find funding somehow.

[indefatigable]

16 minutes ago, dermplan said:

I looked into it - it seems that you need to self fund the sick kids fellowship or find funding somehow.

Fundings can be tricky for fellowships - although there is a box in that form to indicate no funding.  Plus it's very hard to predict the future

It does sounds like there is a recent movement in the US to change pediatric dermatology into a derm subspecialty - which means Canada may follow.  

[dermplan]

1 minute ago, indefatigable said:

Fundings can be tricky for fellowships - although there is a box in that form to indicate no funding.  Plus it's very hard to predict the future

It does sounds like there is a recent movement in the US to change pediatric dermatology into a derm subspecialty - which means Canada may follow.  

It's hard to predict how things will be in 4ish years.  So if you have no funding, you will work 1-2 years for free. Is that true?

[indefatigable]

7 minutes ago, dermplan said:

It's hard to predict how things will be in 4ish years.  So if you have no funding, you will work 1-2 years for free. Is that true?

At this career career-stage it's really not an issue worth worrying about given how many hypotheticals there are.

However, I suspect that if one were to receive such a fellowship without an external funding source, then funding would be arranged or found.  I highly doubt working for free would be an option.

[Snowmen]

On 10/18/2021 at 9:24 PM, dermplan said:

It's hard to predict how things will be in 4ish years.  So if you have no funding, you will work 1-2 years for free. Is that true?

Something pretty typical is that you don't get paid for the fellowship but bill as an attending when you're on call.