Changes to US MD equivalencies - thoughts?

[ChemPetE]

I mean USMLEs require time and money, but unless you’re aiming to kill step 1 I wouldn’t qualify them as hard. More or just an inconvenience 

[Xbox Skully]

I got into a UDMD school last cycle but deferred it. Is there any carms could honour  the equivalence or am I screwed  I feel like an idiot for the deferral now.

[JohnGrisham]

1 hour ago, Xbox Skully said:

I got into a UDMD school last cycle but deferred it. Is there any carms could honour  the equivalence or am I screwed  I feel like an idiot for the deferral now.

They will not, as you would not be participating in the required year.

USMD is still an excellent option. You can still apply to carms under the IMG category, and who knows, you might still be favourably viewed versus carribs/other internationals.  

At the end of the day, youll be a physician, and depending on your chosen field, probably stood a better chance at getting into that program in the US anyways.

 

[ChemPetE]

1 hour ago, Xbox Skully said:

I got into a UDMD school last cycle but deferred it. Is there any carms could honour  the equivalence or am I screwed  I feel like an idiot for the deferral now.

No idea. I think unlikely

Depends on what your career goals are and where you want to work I suppose. There exists a process for med school to med school transfers and so failing all else could explore transferring to do your clerkship in Canada, and then your MD would come from a canadian med school. That is one thing that comes to mind at least, but that would be involved with a lot of paperwork and the transfer would not be guaranteed. I wouldn’t bank on it but could be an option to explore if all else fails I suppose

[Xbox Skully]

8 minutes ago, JohnGrisham said:

They will not, as you would not be participating in the required year.

USMD is still an excellent option. You can still apply to carms under the IMG category, and who knows, you might still be favourably viewed versus carribs/other internationals.  

At the end of the day, youll be a physician, and depending on your chosen field, probably stood a better chance at getting into that program in the US anyways.

 

I have a singular interview on Canada this year so hopefully that works out. And Manitoba is the only md school in Canada that takes transfers from the states. Possibly ubc as well.

[JohnGrisham]

45 minutes ago, ChemPetE said:

No idea. I think unlikely

Depends on what your career goals are and where you want to work I suppose. There exists a process for med school to med school transfers and so failing all else could explore transferring to do your clerkship in Canada, and then your MD would come from a canadian med school. That is one thing that comes to mind at least, but that would be involved with a lot of paperwork and the transfer would not be guaranteed. I wouldn’t bank on it but could be an option to explore if all else fails I suppose

As well re-applying again while an MS1 in the US, and restart in Canada...if being in Canada is important to the OP! 

[Xbox Skully]

Do you think usmd will look more favourable than other imgs, making it more difficult for other imgs to match in Canada.

[bearded frog]

14 hours ago, Xbox Skully said:

Do you think usmd will look more favourable than other imgs, making it more difficult for other imgs to match in Canada.

Perhaps, but if you have a compeditive application you will match in the US because the US match is first and you're not going to risk not applying to the US match which will give you significantly better chances at compeditive specialties and better than competing for the limited IMG spots, and if for whatever reason you are not compeditive and don't match in the US, you likely will not be compeditive for IMG spots in carms.

If you absolutely have to do residency in Canada, and only apply as an IMG to carms, then depending on your US school and application then you may have an advantage vs some other IMGs, but not enough to make up for the standard measures (IE, going to Harvard won't make up for a poor application vs an excellent application from ireland/aus, etc.). In theory going to a prestigious USMD may help your application with opportunities, research, etc. that wouldn't be possible overseas.

[Xbox Skully]

19 minutes ago, bearded frog said:

Perhaps, but if you have a compeditive application you will match in the US because the US match is first and you're not going to risk not applying to the US match which will give you significantly better chances at compeditive specialties and better than competing for the limited IMG spots, and if for whatever reason you are not compeditive and don't match in the US, you likely will not be compeditive for IMG spots in carms.

If you absolutely have to do residency in Canada, and only apply as an IMG to carms, then depending on your US school and application then you may have an advantage vs some other IMGs, but not enough to make up for the standard measures (IE, going to Harvard won't make up for a poor application vs an excellent application from ireland/aus, etc.). In theory going to a prestigious USMD may help your application with opportunities, research, etc. that wouldn't be possible overseas.

How hard is it to comeback to Canada aster doing residency in the states? Does it depend on specialty?

[Artier]

23 minutes ago, Xbox Skully said:

How hard is it to comeback to Canada aster doing residency in the states? Does it depend on specialty?

It depends on the specialty as some have different training times in Canada versus the US. If the training in the US for the specialty is equal to or greater than Canada, then I believe it is not hard to come back. I believe if the training time is shorter in the US (e.g. ER is 3 years in the US and 5 in Canada), you have to get some kind of additional training or supervised practice first, although I'm not entirely sure of the specifics.

[shikimate]

20 hours ago, Xbox Skully said:

How hard is it to comeback to Canada aster doing residency in the states? Does it depend on specialty?

It also depends on the province. Some provinces/locations/specialties that are desperate to recruit have more leniency. For example, NL/NB/PEI often have difficulty recruiting physicians and their provincial colleges are more lenient than, say ON.

[Xbox Skully]

I can also see international students not wanting to attend Canadian med schools because they can’t apply to carms and would be considered img for the us. So med school may be loosing some money from international students not wanting to attend.

[zoxy]

1 hour ago, Xbox Skully said:

I can also see international students not wanting to attend Canadian med schools because they can’t apply to carms and would be considered img for the us. So med school may be loosing some money from international students not wanting to attend.

As discussed somewhere else, Canadian schools don't actually make much money from international medical students. Tuition might be very high for them but that's what it costs to train them.

 

 

[jondoe]

How will this play out on practicing Canadian MDs? Will the US-Canada reciprocity removal block Canadian MDs from going to the US, and vice versa without redoing residency (or worse, medical school)? 

Seems like a slippery slope.

[shady]

This is a sad turn of events. It sets the stage for further decoupling between US and Canada in the future and I won't be surprised if the rate of decoupling of specialty boards increases.

Is there anything we can do to stop this?

[jondoe]

34 minutes ago, shady said:

This is a sad turn of events. It sets the stage for further decoupling between US and Canada in the future and I won't be surprised if the rate of decoupling of specialty boards increases.

Is there anything we can do to stop this?

Looking into it, it seems this was something that the Canadian association has been fighting for since 2014. CMAJ publication about it from back then..

[shady]

On 2/11/2022 at 7:03 PM, jondoe said:

Looking into it, it seems this was something that the Canadian association has been fighting for since 2014. CMAJ publication about it from back then..

Probably makes it easier for Canadian associations and/or saves them money. But it definitely is worse for Canadian doctors because it restricts their practice choice. Makes it easier for future governments to reduce physician salaries

[peace2014]

On 2/4/2022 at 6:07 PM, rmorelan said:

Perhaps not a perfect analogy as you picked two top US schools vs Canadian schools you are grading I suspect as of lower quality than other Canadian ones. 

Exceeding few people relatively speaking are getting training at MGH or Hopkins. How would the average American resident fair against the average Canadian one? I truly don't have any real objective evidence on that either way - if I had to guess probably fairly close

I will say having personally trained medical students a several Canadian schools, vs Harvard there is really no difference I could find in quality. I found that kind of surprising initially but when you look at the admissions data the required GPA and MCAT scores at least it makes sense. We just truly have very high admission requirements.  

The average Canadian and American physician is very similar in quality in terms of providing excellent healthcare, maybe Canadians are even better on average. Just because someone graduated from Harvard doesn't mean they are better at treating diabetes. However, top American schools train high-level physician-scientists that become Nobel Laureates, CEOs, chief medical officers, chief scientific officers, entrepreneurs, venture capitalists, leaders in the biotech/pharma/life sciences industry. These few exceptional individuals are really what make medicine great and innovative. Without those exceptional people, people would still be living until 40. Obviously, someone who is ambitious and wants to discover cures, training at MGH is vastly BETTER than NOSM or any Canadian school. The fact that US and Canadian med school no longer recognize each other's training suggests that their values vastly differ now. I hope moving forward, Canadians will keep the innovative aspects of medical training that Americans have (more focus on basic science and less on "innovative" educational strategies). This will hurt MD/pHDs from Canada who wants to do residency at MGH/Hopkins

[UWOFTW]

17 hours ago, peace2014 said:

This will hurt MD/pHDs from Canada who wants to do residency at MGH/Hopkins

Can't hurt what does not exist anymore: https://www.theglobeandmail.com/opinion/cutting-funds-for-mdphd-programs-a-blow-to-canadian-innovation/article26072106/

[Xbox Skully]

On 2/11/2022 at 6:28 PM, shady said:

This is a sad turn of events. It sets the stage for further decoupling between US and Canada in the future and I won't be surprised if the rate of decoupling of specialty boards increases.

Is there anything we can do to stop this?

Someone should start petition but I doubt anything will happen.

[bellejolie]

21 hours ago, peace2014 said:

The average Canadian and American physician is very similar in quality in terms of providing excellent healthcare, maybe Canadians are even better on average. Just because someone graduated from Harvard doesn't mean they are better at treating diabetes. However, top American schools train high-level physician-scientists that become Nobel Laureates, CEOs, chief medical officers, chief scientific officers, entrepreneurs, venture capitalists, leaders in the biotech/pharma/life sciences industry. These few exceptional individuals are really what make medicine great and innovative. Without those exceptional people, people would still be living until 40. Obviously, someone who is ambitious and wants to discover cures, training at MGH is vastly BETTER than NOSM or any Canadian school. The fact that US and Canadian med school no longer recognize each other's training suggests that their values vastly differ now. I hope moving forward, Canadians will keep the innovative aspects of medical training that Americans have (more focus on basic science and less on "innovative" educational strategies). This will hurt MD/pHDs from Canada who wants to do residency at MGH/Hopkins

i think the bigger issue is what the person below your response pointed out - we just don't have the funding. healthcare and these hospitals you are mentioning yes are excellent, but they're also private. healthcare in canada is public, for good reason with funds being controlled by the government and provinces and their priorities. its a vicious cycle, but the big schools in canada (like u of t) are rated higher and ranked more because they do more research, thereby attracting better candidates who also do those things etc etc. 

where i think we do excel in Canada, more than MGH and hopkins is patient centred care. MMIs are standard across majority of medical schools (which they are not in the states) and values such as empathy, kindness, collaboration etc are emphasized more amongst canadian schools in their selection process thereby producing less assholes than before. our medical school curricula also place high value on social determinants of health, health equity and social justice, and also tend to attract people who are interested in those things as well. in the US research/"innovation" is probably the most important thing when selecting candidates. think about our exams, vs the USMLE. there are hardly as many ethics questions as much as basic scientific details in the USMLE steps. Our OSCEs focus on the art of communication, and managing complex social situations which I would argue is far far more important to medicine than how much research a person has done. and medical schools in Canada value those things much more equally I find than in the states where research is seen as more valuable than the ability to communicate. We become much more holistic care providers which to me is "better education" than a top US school, though those values are increasingly becoming prominent there too.

to me, I think Canadian medical schools are superior. Our curricula ensure we have clinical experiences much earlier and have exposure to patient centred care. i have heard from many US staff that canadian grads are VERY well regarded tbh just because we only have 17 med schools (so to get in is already much harder), and we are hands on very fast. we also have integrated Indigenous curricula as well and overall have a different focus/priorities than the states schools. the standard is also much less variable across the 17 schools vs in the states. canadian medical license is probably one of the best to have globally, it translates to the most number of countries from what I've read and researched so I'd argue NOSM is a great medical school, please stop hating. Rural medicine is 100x harder than anything you practice in the city and the doctors that are produced there are probably smarter than i am or will ever have to be living in a city. 

[carmsregrets]

1 hour ago, bellejolie said:

i think the bigger issue is what the person below your response pointed out - we just don't have the funding. healthcare and these hospitals you are mentioning yes are excellent, but they're also private. healthcare in canada is public, for good reason with funds being controlled by the government and provinces and their priorities. its a vicious cycle, but the big schools in canada (like u of t) are rated higher and ranked more because they do more research, thereby attracting better candidates who also do those things etc etc. 

where i think we do excel in Canada, more than MGH and hopkins is patient centred care. MMIs are standard across majority of medical schools (which they are not in the states) and values such as empathy, kindness, collaboration etc are emphasized more amongst canadian schools in their selection process thereby producing less assholes than before. our medical school curricula also place high value on social determinants of health, health equity and social justice, and also tend to attract people who are interested in those things as well. in the US research/"innovation" is probably the most important thing when selecting candidates. think about our exams, vs the USMLE. there are hardly as many ethics questions as much as basic scientific details in the USMLE steps. Our OSCEs focus on the art of communication, and managing complex social situations which I would argue is far far more important to medicine than how much research a person has done. and medical schools in Canada value those things much more equally I find than in the states where research is seen as more valuable than the ability to communicate. We become much more holistic care providers which to me is "better education" than a top US school, though those values are increasingly becoming prominent there too.

to me, I think Canadian medical schools are superior. Our curricula ensure we have clinical experiences much earlier and have exposure to patient centred care. i have heard from many US staff that canadian grads are VERY well regarded tbh just because we only have 17 med schools (so to get in is already much harder), and we are hands on very fast. we also have integrated Indigenous curricula as well and overall have a different focus/priorities than the states schools. the standard is also much less variable across the 17 schools vs in the states. canadian medical license is probably one of the best to have globally, it translates to the most number of countries from what I've read and researched so I'd argue NOSM is a great medical school, please stop hating. Rural medicine is 100x harder than anything you practice in the city and the doctors that are produced there are probably smarter than i am or will ever have to be living in a city. 

A lot of curricula focus on these aspects because they really would like majority of their med students to become FM (not specialists), because the huge shortage of FM docs in Canada ( 45% of Canadian med students go into FM by choice and a big majority of Canadian medical students also go into it because they unfortunately did not match to their top choice speciality). I totally think that communication skills and SDOH are very important and I admire that the Canadian system focuses on that. However, research and innovation is also extremely crucial to the advancement of the field ( which is usually done by specialists/experts in the field).  

 

 

 

[Xbox Skully]

14 minutes ago, carmsregrets said:

A lot of curricula focus on these aspects because they really would like majority of their med students to become FM (not specialists), because the huge shortage of FM docs in Canada ( 45% of Canadian med students go into FM by choice and a big majority of Canadian medical students also go into it because they unfortunately did not match to their top choice speciality). I totally think that communication skills and SDOH are very important and I admire that the Canadian system focuses on that. However, research and innovation is also extremely crucial to the advancement of the field ( which is usually done by specialists/experts in the field).  

 

 

 

45% of all Canadian grads or 45% of people going into family med?

[bellejolie]

20 minutes ago, carmsregrets said:

A lot of curricula focus on these aspects because they really would like majority of their med students to become FM (not specialists), because the huge shortage of FM docs in Canada ( 45% of Canadian med students go into FM by choice and a big majority of Canadian medical students also go into it because they unfortunately did not match to their top choice speciality). I totally think that communication skills and SDOH are very important and I admire that the Canadian system focuses on that. However, research and innovation is also extremely crucial to the advancement of the field ( which is usually done by specialists/experts in the field).  

 

 

 

Sure I understand and agree with you we need both. I just don’t think SDOH and communication is specific only to family. I appreciate when specialists can recognize those things too and actually communicate and collaborate well. In general well rounded physicians are just extremely important. But I do think more funding towards research and innovation would be important and necessary. I just don’t think it necessarily makes MGHs medical education superior to ours. 

[peace2014]

3 hours ago, bellejolie said:

i think the bigger issue is what the person below your response pointed out - we just don't have the funding. healthcare and these hospitals you are mentioning yes are excellent, but they're also private. healthcare in canada is public, for good reason with funds being controlled by the government and provinces and their priorities. its a vicious cycle, but the big schools in canada (like u of t) are rated higher and ranked more because they do more research, thereby attracting better candidates who also do those things etc etc. 

where i think we do excel in Canada, more than MGH and hopkins is patient centred care. MMIs are standard across majority of medical schools (which they are not in the states) and values such as empathy, kindness, collaboration etc are emphasized more amongst canadian schools in their selection process thereby producing less assholes than before. our medical school curricula also place high value on social determinants of health, health equity and social justice, and also tend to attract people who are interested in those things as well. in the US research/"innovation" is probably the most important thing when selecting candidates. think about our exams, vs the USMLE. there are hardly as many ethics questions as much as basic scientific details in the USMLE steps. Our OSCEs focus on the art of communication, and managing complex social situations which I would argue is far far more important to medicine than how much research a person has done. and medical schools in Canada value those things much more equally I find than in the states where research is seen as more valuable than the ability to communicate. We become much more holistic care providers which to me is "better education" than a top US school, though those values are increasingly becoming prominent there too.

to me, I think Canadian medical schools are superior. Our curricula ensure we have clinical experiences much earlier and have exposure to patient centred care. i have heard from many US staff that canadian grads are VERY well regarded tbh just because we only have 17 med schools (so to get in is already much harder), and we are hands on very fast. we also have integrated Indigenous curricula as well and overall have a different focus/priorities than the states schools. the standard is also much less variable across the 17 schools vs in the states. canadian medical license is probably one of the best to have globally, it translates to the most number of countries from what I've read and researched so I'd argue NOSM is a great medical school, please stop hating. Rural medicine is 100x harder than anything you practice in the city and the doctors that are produced there are probably smarter than i am or will ever have to be living in a city. 

This is very well written, hence why LCME diverged. Canadians want to train physicians who practice medicine to serve their communities while a lot of US med schools provide physicians that serve the private sector in numerous ways. I would definitely recommend future students to consider their med schools in both countries carefully. If you just want to be a good physician, Canada should be top choice. However, Harvard or Hopkins will serve a small population of students better and will lead to rewarding careers in many other areas besides seeing patients. Which IMO are areas that are so deemphasized in Canadian schools that sometimes people don't see their values anymore cause we rely on other places to do them.... think about the vaccine development/trials, or new drugs for gene therapy, cancer