MD

[bluejay33]

Hello, I’m a Canadian who completed residency and fellowship in the States. I’ll be taking my Royal College exam in Feb 2023. 
 

1) what do people use for studying for the written part? I hear old exams get passed down in residency programs but if you aren’t in residency in Canada, how do you get access to these materials? What else do people use to prep? I’ve used uworld for all exams in America including my IM board exam; is that sufficient for the Canadian exam?

2) what is the oral portion of the exam like? Is it a SP encounter or do you just get asked questions by a group of physicians? How do you prep for this? Are there cases also available for study and how do I get them? 
 

3) anyone looking for a study partner for the oral aspect of the exam? 
 

[bearded frog]

6 hours ago, bluejay33 said:

Hello, I’m a Canadian who completed residency and fellowship in the States. I’ll be taking my Royal College exam in Feb 2023. 
 

1) what do people use for studying for the written part? I hear old exams get passed down in residency programs but if you aren’t in residency in Canada, how do you get access to these materials? What else do people use to prep? I’ve used uworld for all exams in America including my IM board exam; is that sufficient for the Canadian exam?

2) what is the oral portion of the exam like? Is it a SP encounter or do you just get asked questions by a group of physicians? How do you prep for this? Are there cases also available for study and how do I get them? 
 

3) anyone looking for a study partner for the oral aspect of the exam? 
 

1 - Generally, you don't. I highly suspect that the big discrepancy between pass rates between those who do residency in Canada and those who don't is access to these materials.

2 - The oral component varies between specialties, the info for IM is here. Again, Canadian grads usually have the stations from previous years.

[bluejay33]

Thanks for the reply. 
how have non Canadian grads studied then? 

[bearded frog]

13 hours ago, bluejay33 said:

Thanks for the reply. 
how have non Canadian grads studied then? 

Hopefully one can chime in, but in theory, for peds it was Canadian Pediatric Society position statements, AAP statements, and then Nelson Pediatrics (the Peds textbook of record). Probably similar for IM.

[zizoupanda]

I can't answer 2 and 3 because the oral was cancelled the year I did my IM RC.

To answer question 1 - I can't give you a clear answer but here's my 2cents as a Canadian IM resident who did both the RC and ABIM.

In Canada, we study the Toronto Review Course (usually study previous year's pdfs until they come out with the new ones) plus the old RC questions that get passed down in addition to guidelines.

The US board exam is easier than the Canadian one. I don't think UWorld (I used it personally as a refresher before my US board exam) alone is sufficient to be honest because the Canadian RC is ++ fixated with guidelines and there's a few esoteric questions that come back that I'm not sure how to answer without having seen it in previous years' exams. That being said, the RC also doesn't give out scores (unlike ABIM) so I don't how to gauge if I over studied it or studied just enough. Few Canadian IM residents fail but most study the blueprint I layed out. Those who fail usually have personal issues interfering with studying. Can you pass if you just do Toronto review + guidelines +/- uworld without the qbank? Possibly but I don't know for sure.

If you know anyone in Canada personally who could connect you with an IM resident, that's your best bet. The bank isn't passed down by programs; it's passed down between residents. I think people are a bit leery these days with sharing the qbank because there were rumours last year that the RC "found out" about the qbank whatever that means (as if they didn't all use it to pass their own RCs as well..)

[bearded frog]

On 8/5/2022 at 6:07 PM, zizoupanda said:

I think people are a bit leery these days with sharing the qbank because there were rumours last year that the RC "found out" about the qbank whatever that means (as if they didn't all use it to pass their own RCs as well..)

I think it's an open secret to be honest, but yeah I heard last year some got officially reported but AFAIK nothing came of it.

[bluejay33]

On 8/5/2022 at 9:07 PM, zizoupanda said:

I can't answer 2 and 3 because the oral was cancelled the year I did my IM RC.

To answer question 1 - I can't give you a clear answer but here's my 2cents as a Canadian IM resident who did both the RC and ABIM.

In Canada, we study the Toronto Review Course (usually study previous year's pdfs until they come out with the new ones) plus the old RC questions that get passed down in addition to guidelines.

The US board exam is easier than the Canadian one. I don't think UWorld (I used it personally as a refresher before my US board exam) alone is sufficient to be honest because the Canadian RC is ++ fixated with guidelines and there's a few esoteric questions that come back that I'm not sure how to answer without having seen it in previous years' exams. That being said, the RC also doesn't give out scores (unlike ABIM) so I don't how to gauge if I over studied it or studied just enough. Few Canadian IM residents fail but most study the blueprint I layed out. Those who fail usually have personal issues interfering with studying. Can you pass if you just do Toronto review + guidelines +/- uworld without the qbank? Possibly but I don't know for sure.

If you know anyone in Canada personally who could connect you with an IM resident, that's your best bet. The bank isn't passed down by programs; it's passed down between residents. I think people are a bit leery these days with sharing the qbank because there were rumours last year that the RC "found out" about the qbank whatever that means (as if they didn't all use it to pass their own RCs as well..)

Thanks for the info. By Toronto Review, do you mean this; https://internalmedicinereview.ca or do you mean Toronto Notes? 
 

Unfortunately I don’t have any IM resident connections (that would have made things super simple, including the job search, if I did). That’s why I’m trying to gauge the best plan of attack here. I was planning on the above course + uworld but I guess u world isn’t very helpful for Canadian boards. Would you recommend the above course and guideline refreshers then? Any particular source of Canadian guidelines you’d recommend? Anything else you’d recommend given that getting old exams seems unlikely for a non Canadian grad resident? 
 

Canada really is a tough market to crack into if you’re not a product of its system. 
 

[zizoupanda]

1. The Canadian health care system is rife with nepotism so unfortunately you're right. The Royal College is an opaque and frustrating organisation. I hear Americans complaining about the ABIM, they have no idea what we have to deal with up here. 

2. Yes it's the linked Toronto review course not the Toronto notes.

3. Note, the review course has a small question bank (and an oral examen practice section) that is pretty good.

4. As for guidelines, no there's no source. It's a mystery always which guidelines they prefer. I'd recommend reviewing Canadian guidelines for high yield topics: HTN, AF, HF, ... American guidelines are used when the Canadian ones are outdated or non-existant. The Review course gives a more or less complete overview of these guidelines as well tbh. 

5. I don't think uWorld is completely useless. On its own maybe not enough to pass but useful. Basic IM topics like heart murmurs, JVP, MEN, vasculitis, ... all come up and those aren't guideline based anyways. I think a refresher on high yield topics would be good. Don't waste your time though on primary care stuff such as OB/GYN and psych which are not tested on the Canadian exam.

6. The internist who runs the review course is really nice and approachable. I'm sure you're not the first person to go through it like this, I would suggest after you sign up to reach out to her and ask her advice. 

I don't want to discourage you at all. I think it might be a bit of a challenge but at the end of the day, you're a board certified internist in the US, this is an IM exam not a surgery exam. Do with that you have; immerse yourself with the Toronto Review course, review some guidelines, and review basic IM w/uWorld and it will likely work out just fine. Because of the opaqueness of it all, I'm sorry I wish I reassure you more but I can't. 

[bluejay33]

Thank you! I appreciate it