CaRMS 2023-Second Iteration

[Andrew]

On 4/12/2023 at 3:02 PM, Imghope said:

Wow you  wry immature and hence no point in arguing. 
Those you refer to are called CSA or Canadians studying abroad, these are Canadians who don’t get to med school here so they end up going to medical school in the Caribbeans or Ireland. IMGs are people who did medical school in their home country and immigrated to Canada. 
your comments essentially is saying immigrants not welcomed here which, if that is your point of view, then you are a racist person and conversation ends there. Or you are just uninformed and ignorant which I hope this thread educates you. 
CSA and IMGs are placed in the same cohort but preference are given to CSA. 
just to put it in perspective almost 80% CSA match while 20% of IMGs match. Are we worst doctors? I doubt it, the system is designed to favour legacies (those who end up going to Ireland are typically rich or doctors children as it costs nearly 100K a year for a 5-6 year program) and exclude immigrants. 
im sorry that I was too young to come here and do undergrad and med school here….. ignorant. 
Just to let you know most IMGs were the cream of the crop in their own countries hence the their acceptance in med school there. 
long story short, the fact that you go to med school here and someone else somewhere else doesn’t make you better. 
 

very insulting post, not sure if you are actually an MD but if you are I fear for your patient as you are clearly intolerant of other people. 

You seem really angry and for no reason at all. CaRMS and medical licensing in Canada is protectionist, but protectionism exists the world over, and in all likelihood exists in whatever country you came from as well. To be a US President, you have to be a NATURAL BORN CITIZEN of the US. You can never be US President, are you going to complain about that too?

My parents are immigrants, but I'm born in Canada, went to school in Canada and the Canadian medical system focuses the limited residency spots on CMGs (obviously because CMGs are taxpayer subsidized, so you have to ensure that every CMG finds a spot).

Providing CSAs preference over IMG's is a no-brainer to me also, because these are natural born citizens that in all likelihood went to highschool/university in Canada, have established community roots, and understand Canadian culture.

The reality is there are a limited amount of Residency spots (to the point that even CMGs have difficulty matching) and only a tiny fraction of IMGs are going to be accepted.

You're ranting about protectionism, but that's just dumb. Why do we support local businesses, why do we support national companies instead of importing from foreign companies?

[Edict]

On 4/12/2023 at 6:02 PM, Imghope said:

Wow you  wry immature and hence no point in arguing. 
Those you refer to are called CSA or Canadians studying abroad, these are Canadians who don’t get to med school here so they end up going to medical school in the Caribbeans or Ireland. IMGs are people who did medical school in their home country and immigrated to Canada. 
your comments essentially is saying immigrants not welcomed here which, if that is your point of view, then you are a racist person and conversation ends there. Or you are just uninformed and ignorant which I hope this thread educates you. 
CSA and IMGs are placed in the same cohort but preference are given to CSA. 
just to put it in perspective almost 80% CSA match while 20% of IMGs match. Are we worst doctors? I doubt it, the system is designed to favour legacies (those who end up going to Ireland are typically rich or doctors children as it costs nearly 100K a year for a 5-6 year program) and exclude immigrants. 
im sorry that I was too young to come here and do undergrad and med school here….. ignorant. 
Just to let you know most IMGs were the cream of the crop in their own countries hence the their acceptance in med school there. 
long story short, the fact that you go to med school here and someone else somewhere else doesn’t make you better. 
 

very insulting post, not sure if you are actually an MD but if you are I fear for your patient as you are clearly intolerant of other people. 

Great points overall, but although we welcome immigrants, we don't welcome them to any job without first proving their qualifications. 

To be frank with you, medical schools are not the same standards around the world. Some medical schools are easier to get into, some countries have pay to enter med schools, any IMG can tell you that. Others have free for all systems where people can graduate but may not have met any real standard. 

Also, being a physician isn't an entry level job in Canada. The problem for physicians in Canada is that a license to practice is a license to practice unsupervised. Its the proverbial key to the mayor's office. Doctors are kept always in demand in Canada due to our universal healthcare system, you can be a terrible doctor and you could be practicing poorly for years without punishment. I've run into licensed IMG doctors who've practiced for years in Canada who couldn't identify basic imaging findings of emergent issues that are learnt in the first year of medical school and voluntarily asked me to teach them. This difference extends to residency, there is a huge variation in quality of residency by country. Some countries offer a free for all pyramid scheme residency where anyone can be a resident but few actually receive training. 

I do agree that our method of evaluation of IMGs is questionable and unnecessarily complicated and does not truly identify the best candidates. We probably miss out on great candidates due to bias and blanket rules. 

Canada welcomes immigrants and we are a country built on immigration. However, being a physician is different from many other careers like CS or engineering where lives are not in the hands of one person, and supervision can be ensured and consequences don't immediately cost lives. An engineers work can be checked many times and standardized to minimize error, but a physician managing a medical emergency may not have that luxury. The other reality is that no one is going to pay you in the top 0.5% of Canadians and possibly the top 0.01% Worldwide without doing their due diligence on you. 

Although CSAs get preference, this is literally the case anywhere across the world. Many IMGs come from countries where there is even more corruption and nepotism, so they understand this preference. 

The real problem as I see it is immigrant doctors are sold a lot of hope, to convince them to emigrate by people with incentive to promote them to emigrate and then find out the reality is much more convoluted and challenging to navigate. 

[anon5678]

Anyone else end up not hearing back from several programs one way or the other? I even tried reaching out to the PDs and coordinators directly earlier this week and nothing still. 

[Samic1988]

On 3/22/2023 at 11:58 PM, bearded frog said:

 

 

On 3/23/2023 at 1:14 AM, bearded frog said:

 

 

On 3/25/2023 at 12:27 PM, cardio_enjoyer said:

 

 

On 3/25/2023 at 1:19 PM, cardio_enjoyer said:

 

 

On 3/29/2023 at 10:43 PM, ameltingbanana said:

 

 

On 4/4/2023 at 10:22 AM, usatocanada said:

 

 

On 4/11/2023 at 9:36 AM, abcdoc said:

 

You seem really angry and for no reason at all. CaRMS and medical licensing in Canada is protectionist, but protectionism exists the world over, and in all likelihood exists in whatever country you came from as well. To be a US President, you have to be a NATURAL BORN CITIZEN of the US. You can never be US President, are you going to complain about that too?

On 4/14/2023 at 4:56 PM, Andrew said:

My parents are immigrants, but I'm born in Canada, went to school in Canada and the Canadian medical system focuses the limited residency spots on CMGs (obviously because CMGs are taxpayer subsidized, so you have to ensure that every CMG finds a spot).

Providing CSAs preference over IMG's is a no-brainer to me also, because these are natural born citizens that in all likelihood went to highschool/university in Canada, have established community roots, and understand Canadian culture.

The reality is there are a limited amount of Residency spots (to the point that even CMGs have difficulty matching) and only a tiny fraction of IMGs are going to be accepted.

You're ranting about protectionism, but that's just dumb. Why do we support local businesses, why do we support national companies instead of importing from foreign companies?

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

[usatocanada]

1 hour ago, Samic1988 said:

 

 

 

 

 

 

 

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

Why was I tagged in this? I don't recall mentioning anything like that.

[Imghope]

5 hours ago, Samic1988 said:

 

 

 

 

 

 

 

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

I agree!

unfortunately I don’t think you all got the point, well how could you? You never lived through the experiences that Samic and I lived through, and I don’t blame you. 
just going to mention that creating two tier types of Canadians and segregating us based on where we were born is …… well, read your own post. 
truth is ethnocentrism lives even in the tolerant society like ours. 
Working for 5-6 years “to pay my dues” as an assistant in healthcare system I hear and see admission practices.
Who do you think will get a position: me who has no privilege of knowing anyone and relying on my own merits or the twenty something year old son/daughter of Dr. Abc who is the director of xyz? Everyone know him/her based on last names, and the fact that his parent/relative knew the people on committee? He/She didn’t even attempt undergrad degree and went straight to Ireland for med school because he knew with his parent’s privilege he can match no problem. 
you want to hear the kicker? This happened to me. 
you say it’s easy to get in med school in our home countries? At least in my case to get in all high school graduating class write a national entrance exam, and for one to be admitted to med school, they have to rank in the top 500 out of nearly 35,000 applicants. I ranked 82 my year and got in the most prestigious medical school. 
I scored 287 on MCCQE1 which is the 90th percentile, have published almost 20 papers (in Canada) with tons of volunteering and clinical experience. But when push came to shove that 23 year old with lower grade and 0 publication was taken over me. Why? Other than the obvious privilege probably because English is my second language , I’m not white and have an accent.  Prove me wrong… I dare you! 

just trying to educate you before you starting judging us for having it easy and feeling entitled.

Anyway…. I hope next time you see an IMG who is working hard or is in your program realize the hurdles they had to overcome to be there. 
 

Also I’m not saying take seats away from CMGs and give it to us, I’m advocating for the process to become more fair and to give us a fighting chance. 

[carms2tee2tee3]

46 minutes ago, Imghope said:

I agree!

unfortunately I don’t think you all got the point, well how could you? You never lived through the experiences that Samic and I lived through, and I don’t blame you. 
just going to mention that creating two tier types of Canadians and segregating us based on where we were born is …… well, read your own post. 
truth is ethnocentrism lives even in the tolerant society like ours. 
Working for 5-6 years “to pay my dues” as an assistant in healthcare system I hear and see admission practices.
Who do you think will get a position: me who has no privilege of knowing anyone and relying on my own merits or the twenty something year old son/daughter of Dr. Abc who is the director of xyz? Everyone know him/her based on last names, and the fact that his parent/relative knew the people on committee? He/She didn’t even attempt undergrad degree and went straight to Ireland for med school because he knew with his parent’s privilege he can match no problem. 
you want to hear the kicker? This happened to me. 
you say it’s easy to get in med school in our home countries? At least in my case to get in all high school graduating class write a national entrance exam, and for one to be admitted to med school, they have to rank in the top 500 out of nearly 35,000 applicants. I ranked 82 my year and got in the most prestigious medical school. 
I scored 287 on MCCQE1 which is the 90th percentile, have published almost 20 papers (in Canada) with tons of volunteering and clinical experience. But when push came to shove that 23 year old with lower grade and 0 publication was taken over me. Why? Other than the obvious privilege probably because English is my second language , I’m not white and have an accent.  Prove me wrong… I dare you! 

just trying to educate you before you starting judging us for having it easy and feeling entitled.

Anyway…. I hope next time you see an IMG who is working hard or is in your program realize the hurdles they had to overcome to be there. 
 

Also I’m not saying take seats away from CMGs and give it to us, I’m advocating for the process to become more fair and to give us a fighting chance. 

 

Was holding off on commenting but I don't think think that's what they meant. I don't think they mean to discriminate you based off of where you were born. To re-iterate a previous poster, Canada is literally a country made of immigrants. We are all immigrants here. Many of the CSAs are also people that immigrated to Canada. I don't think anyone meant for you to feel that we are discriminating here. I think they were just trying to explain the reasoning behind the admission system. 

I understand you are frustrated. As someone who have friends and family friends who immigrated to Canada with full on degrees in their home countries that aren't recognized in Canada and having to do entry level jobs when they are way competent to do more (I even know a  immigrant surgeon that once was a big shot in his home country who now works as a surgical assistant in Canada). This story is not unique to medicine but to immigrants of all specialties and careers. Yes there needs to be change but there's limitations to what Canada can do. There's only so much funding for so much spots. CMGs take priority because they are funded by taxpayers (aka need to make most out of our tax spending by ensuring they all become physicians). CSAs on the other hand may be preferred over other reasons including connections, knowing where to volunteer/ do electives cause they are more knowledgeable of the landscape here, and the moreso guarantee that they will train here and stay because they have roots here. From the school and college's POV, CSA are much more likely of staying in Canada compared to IMGs (just like how rural med schools here prefer to admit students from rural backgrounds because they are more likely to work in the rural community). The government is not thinking of the applicants when they are funding these spots, they are thinking of the people these trained physicians will serve one day. Yes, it does come to sacrifice of IMGs who were promised by the government that they can practice medicine here. I believe you that you were top of your class and was exemplary. Just like how there are many immigrant engineers and professors that come here to work behind the cashier, it's just unfortunately how Canada is right now. I honestly do wish we could change it but it's unlikely anytime soon . 

[Samic1988]

1 hour ago, carms2tee2tee3 said:

 

Was holding off on commenting but I don't think think that's what they meant. I don't think they mean to discriminate you based off of where you were born. To re-iterate a previous poster, Canada is literally a country made of immigrants. We are all immigrants here. Many of the CSAs are also people that immigrated to Canada. I don't think anyone meant for you to feel that we are discriminating here. I think they were just trying to explain the reasoning behind the admission system. 

I understand you are frustrated. As someone who have friends and family friends who immigrated to Canada with full on degrees in their home countries that aren't recognized in Canada and having to do entry level jobs when they are way competent to do more (I even know a  immigrant surgeon that once was a big shot in his home country who now works as a surgical assistant in Canada). This story is not unique to medicine but to immigrants of all specialties and careers. Yes there needs to be change but there's limitations to what Canada can do. There's only so much funding for so much spots. CMGs take priority because they are funded by taxpayers (aka need to make most out of our tax spending by ensuring they all become physicians). CSAs on the other hand may be preferred over other reasons including connections, knowing where to volunteer/ do electives cause they are more knowledgeable of the landscape here, and the moreso guarantee that they will train here and stay because they have roots here. From the school and college's POV, CSA are much more likely of staying in Canada compared to IMGs (just like how rural med schools here prefer to admit students from rural backgrounds because they are more likely to work in the rural community). The government is not thinking of the applicants when they are funding these spots, they are thinking of the people these trained physicians will serve one day. Yes, it does come to sacrifice of IMGs who were promised by the government that they can practice medicine here. I believe you that you were top of your class and was exemplary. Just like how there are many immigrant engineers and professors that come here to work behind the cashier, it's just unfortunately how Canada is right now. I honestly do wish we could change it but it's unlikely anytime soon . 

This is not your what your friend meant, he clearly stated “natural born citizen” have privilege over someone who has come to Canada 7 years ago and has now become a Canadian citizen, and I am not frustrated at all, I have matched to a top tier program that most CMGs have dream about it, all I am saying is we should not discriminate about others and competition should be based on skills not place of born or stupid terms like CMG, IMG or CSA, and med school in Canada is  not subsidized and not related to tax payers money. There is a rule that someone should be Canadian citizen or permanent resident to be able to apply and that’s it.

[bearded frog]

7 hours ago, Samic1988 said:

[hella quotes]

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

What is wrong with what I wrote... about how to transfer? It has nothing to do with Canadian citizens or IMGs?

19 minutes ago, Samic1988 said:

[...]med school in Canada is  not subsidized and not related to tax payers money.

It most definitely is? This is easily verifiable...

[Samic1988]

Looking forward to see your references about “med school subsidies in Canada”

[Salty_Ruin]

35 minutes ago, Samic1988 said:

Looking forward to see your references about “med school subsidies in Canada”

https://www.afmc.ca/resources-data/education/future-md-canada/

under How much is tuition at a Canadian Medical School: 

Tuition fees are mandatory fees paid by students to help cover the cost of their education. Although they may appear high, they represent a small portion of the total cost of training to become a physician. The actual costs of medical training in Canada are shared by the provincial governments, medical schools, and students. Medical education subsidies paid by the provincial governments vary both by program and province.

 

The subsidized tuition is why medical school is around 20K per year while dental school is closer to 50-60K. 

[BalkanRelations]

1 hour ago, Samic1988 said:

Looking forward to see your references about “med school subsidies in Canada”

Yeah this is pretty common knowledge. I think the faculty at our school actually gave us an estimate at one point that if Canadian Med School was not subsidized at all - then it would cost well over $100,000/year (I think they said 140K?). Obviously that number could be an overestimate, but it is quite clearly subsidized to a great degree - especially compared to other countries. 

[hero147]

7 hours ago, Samic1988 said:

This is not your what your friend meant, he clearly stated “natural born citizen” have privilege over someone who has come to Canada 7 years ago and has now become a Canadian citizen, and I am not frustrated at all, I have matched to a top tier program that most CMGs have dream about it, all I am saying is we should not discriminate about others and competition should be based on skills not place of born or stupid terms like CMG, IMG or CSA, and med school in Canada is  not subsidized and not related to tax payers money. There is a rule that someone should be Canadian citizen or permanent resident to be able to apply and that’s it.

Why go to a Canadian school then? Might as well go to one of those schools where you can complete medicine in 6 years after high school. Better yet, there's probably a couple schools out there that let you finish medical school in 3-4 years rather than the standard 6-8 in Canada (including undergrad). 

[carms2tee2tee3]

10 hours ago, Samic1988 said:

This is not your what your friend meant, he clearly stated “natural born citizen” have privilege over someone who has come to Canada 7 years ago and has now become a Canadian citizen, and I am not frustrated at all, I have matched to a top tier program that most CMGs have dream about it, all I am saying is we should not discriminate about others and competition should be based on skills not place of born or stupid terms like CMG, IMG or CSA, and med school in Canada is  not subsidized and not related to tax payers money. There is a rule that someone should be Canadian citizen or permanent resident to be able to apply and that’s it.

It most definitely is *HEAVILY* subsidized as many others have pointed out. Again, I wrote a whole paragraph explaining why "skills" will not be the determining factor. It's just the unfortunate reality of being an immigrant to Canada and not limited to Medicine. There's not going to be a system change anytime soon as much as you or anyone else can complain. No one's saying it's fair, it's just how it is. IMGs do have to jump through hurdles where as people born here/ came here earlier in their life may not have to experience that. The only stakeholder the government cares about is the people who are going to receive healthcare, not the applicants for the jobs. 

As to the "natural born citizen" bite. I don't think they mean they should have more rights. It's just part of the system that they end up having more rights. When you are born into a country when English is your first language, you naturally have more opportunities. You will also have parents who have connections in the country and can help you out. Those privileges comes from that. Imagine if any of us immigrated to your home country at this point and demanded to be chosen to be paid in the profession in the top 5% of high income earners there. Will we be treated equally compared to the "natural born citizens" there. Probably not. And probably won't have the connections/ opportunities that are available to them either. 

[ctucdn]

14 hours ago, Imghope said:

I agree!

unfortunately I don’t think you all got the point, well how could you? You never lived through the experiences that Samic and I lived through, and I don’t blame you. 
just going to mention that creating two tier types of Canadians and segregating us based on where we were born is …… well, read your own post. 
truth is ethnocentrism lives even in the tolerant society like ours. 
Working for 5-6 years “to pay my dues” as an assistant in healthcare system I hear and see admission practices.
Who do you think will get a position: me who has no privilege of knowing anyone and relying on my own merits or the twenty something year old son/daughter of Dr. Abc who is the director of xyz? Everyone know him/her based on last names, and the fact that his parent/relative knew the people on committee? He/She didn’t even attempt undergrad degree and went straight to Ireland for med school because he knew with his parent’s privilege he can match no problem. 
you want to hear the kicker? This happened to me. 
you say it’s easy to get in med school in our home countries? At least in my case to get in all high school graduating class write a national entrance exam, and for one to be admitted to med school, they have to rank in the top 500 out of nearly 35,000 applicants. I ranked 82 my year and got in the most prestigious medical school. 
I scored 287 on MCCQE1 which is the 90th percentile, have published almost 20 papers (in Canada) with tons of volunteering and clinical experience. But when push came to shove that 23 year old with lower grade and 0 publication was taken over me. Why? Other than the obvious privilege probably because English is my second language , I’m not white and have an accent.  Prove me wrong… I dare you! 

just trying to educate you before you starting judging us for having it easy and feeling entitled.

Anyway…. I hope next time you see an IMG who is working hard or is in your program realize the hurdles they had to overcome to be there. 
 

Also I’m not saying take seats away from CMGs and give it to us, I’m advocating for the process to become more fair and to give us a fighting chance. 

Why do you assume most CMG are from privileged backgrounds with connections. Many students have fostered connections through their own activities and resourcefulness through undegrad, research and extracurriculars. This is also available to you as an IMG. 

Speaking of sacrifices and merits, many CMGs are 1st or 2nd generation immigrants themselves with parents who have worked in low paying jobs (often below their qualification due to lack of recognition of foreign degrees or certifications) and have paid Canadian taxes for years, if not decades to afford their children the opportunity to pursue medicine.

Your feelings of entitlement to the rights and benefits of a system and society, to which you have only started to contribute to is wild.

[Bobthebuilder]

I'm not sure I completely understand the point Samic and Imghope are trying to make. Are you suggesting IMG and CSA be considered on the same ground as CMG on CaRMS match and on the same residency positions ?

To me, it would make absolutely no sense.

However, like I said, I'm just trying to understand. Could you enlighten me on this ?

[cardio_enjoyer]

21 hours ago, Samic1988 said:

 

 

 

 

 

 

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

Is this a glitch?  I have not even participated in this whole conversation or any IMG-related discussions.  Why am I tagged in this angry rant?

[Imghope]

I think we are confusing CMG with CSA here. 
I have one of my best friends who is a CMG came from humble backgrounds got into medical school after a couple of undergrads, master, PhD, a truly hard working guy, and I absolutely agree that CMGs should be protected and have their spots because they worked hard to get here and it is understandable. 
Our discussions were around a CSA (Canadians Studying Abroad), who are people that weren’t able to get into med school here or just didn’t do any undergrad and went straight to schools in Caribbean or Ireland.  Most of these (particularly those in Ireland) have strong medical connections here (family member or parents are doctors). When them and us are competing for the same spots, who do you think will get ahead? I think carms numbers speak for itself showing European and Caribbean graduates match rate of nearly 80% and the rest of IMGs around 20%. 
Is it racism? Nepotism? Ethnocentrism? Or mixture of all. 
I know I may sound salty but busting my butt to get into med school then, Immigrating here and busting my butt again to ace qualification exams while researching and volunteering to see some people who haven’t even done 1/10th of the stuff I have get in and I stay back stings. 
anyway life is not fair I know, it may just come to a point that people like me have to migrate again as we are not welcomed, as we did year back when we left our home countries. 

[bearded frog]

18 hours ago, Samic1988 said:

Looking forward to see your references about “med school subsidies in Canada”

lol, how embarrassing

[who_knows]

7 hours ago, Imghope said:

I think we are confusing CMG with CSA here. 
I have one of my best friends who is a CMG came from humble backgrounds got into medical school after a couple of undergrads, master, PhD, a truly hard working guy, and I absolutely agree that CMGs should be protected and have their spots because they worked hard to get here and it is understandable. 
Our discussions were around a CSA (Canadians Studying Abroad), who are people that weren’t able to get into med school here or just didn’t do any undergrad and went straight to schools in Caribbean or Ireland.  Most of these (particularly those in Ireland) have strong medical connections here (family member or parents are doctors). When them and us are competing for the same spots, who do you think will get ahead? I think carms numbers speak for itself showing European and Caribbean graduates match rate of nearly 80% and the rest of IMGs around 20%. 
Is it racism? Nepotism? Ethnocentrism? Or mixture of all. 
I know I may sound salty but busting my butt to get into med school then, Immigrating here and busting my butt again to ace qualification exams while researching and volunteering to see some people who haven’t even done 1/10th of the stuff I have get in and I stay back stings. 
anyway life is not fair I know, it may just come to a point that people like me have to migrate again as we are not welcomed, as we did year back when we left our home countries. 

I totally sympathies with you. But here's two points to consider.

A CSA is more likely to stay in the country and provide medical service to the citizens than an immigrant. There is always a possibility that you will take off to your country. Even if you are a refugee, if the regime in your country changes and the life starts to get better why stay when you can go back. Just a hypothetical.

I think it's not healthy to view this issue from the entitlement point of view. A rich and connected CSA still has parents who paid taxes here in Canada and contributed to the development of the healthcare system. This is not something to dismiss. As painful and ugly as it sounds, the reality is that a person who was born in a country and lived there their whole life is more of a citizen, than a person who acquired the citizenship by scoring points on an immigration questionnaire. I am sorry that this truth offends you, but it is reality. And it is so in any country on Earth including rich and developed democracies.

I do not think that PDs consider these two points outloud. However, they make decisions with this framework in mind. It may not be nice, but it's true that a person who was born in the same country, speaks the same language and has the same cultural background/traumas/pride will be more desirable and comfortable to work with/live/marry etc. These issues are engrained into our and your subconsciousness.

[indefatigable]

 I expect that PDs are making decisions on who they think will best succeed in the programs in part based on applicant's records.  However, CSAs benefit both from "natural" advantages from simply being raised in Canada, but also have "acquired" advantages in terms of understanding the "matching game".  This will only increase in the future as Canadian USMGs will be considered IMGs and CSAs as well.

 Unfortunately, sometimes baseline factors are much more favourable for CSAs rather than immigrant IMGs.  Language and communication jumps to mind - that simply might be much harder for an immigrant, and unfortunately could both affect performance in a clinical setting and patient care.  However, an evaluator may also simply react less positively to a non-native speaker.  Still, different cultural or training perspectives might also make adapting to the Canadian health care system harder.

 So to some extent CSAs are benefitting simply from "blending in" a lot easier - this of course extends even further when a CSA may have roots in a region, or benefit from more connections in the medical community etc..  And sometimes, unfortunately, this "blending in" may be the most important componen for which immigrant IMGs may have little control - although would hopefully not cross into the territory of discrimination.  Of course "connections" sometimes do go much deeper like the notorious case at UBC.    

However, it's also true that CSAs generally do come from more privileged backgrounds and understand the "rules" of the matching game much better almost from the outset.  An immigrant from a developing country may come unexpectedly to Canada later, after medical school for much different reasons. CSAs  though will generally be focused on laying the groundwork for a successful match from the beginning, i.e. during medical school - CSAs will do clinical rotations in Canada which can be extremely high yield in terms of matching  for demonstrating Canadian clinical performance, letters..  Immigrant IMGs may spend years trying to build resumes that have less related clinical experience to compete with CSAs while losing their clinical skills putting them at further disadvantage.  

First round IMG positions were created after/during a legal case in Manitoba which was bought by (likely immigrant) IMGs whose claim was discrimination based on country of training as they had trained outside of the some countries like Australia, Ireland, and UK (whose graduates were treated more favourably).  Ironically, it's probably trained IMGs from Australia, Ireland, UK, that have benefitted the most from those positions especially CSAs - amazingly, 20 years ago, at the time of those changes, CSA only made up less that 5% of IMGs (link)   

However, I think as Edict pointed out, one of the major problems is that immigrant IMGs are under the impression that they will be able to readily work in Canada as physicians.  As such, some may come to Canada in the hopes of a better future, and make many sacrifices in vain. I think the real disappointment comes in when realizing the image that Canada projects being open to immigration etc.. is really only part of the truth -  the reality is many immigrants struggle to re-establish themselves professionally working menial jobs and are overqualified and underemployed.  Some immigrants may have no choice but to leave their country; others, unfortunately may not be making a fully informed decision when deciding to come to Canada.  Highly-educated Immigrants may naturally assume that having qualifications which favour their immigration means that their qualifications will really mean something strong in Canada.

Of course CSAs often make the same mistake in assuming that matching to Canada will be much easier than it is - although the matching rate for Oceania (Australia) is the highest around 70%, these are probably CSA that have partly self-selected to come back to Canada (i.e. put in time, probably have strong standardized scores etc..)    

While Canada as a culture generally welcomes immigration more than the US, the reality is that the US is much more open to IMGs than Canada which actually many CSAs also recognize - this is because it has way more residency positions than graduate.  I think the smart play as an IMG is to match to the US with an eye on coming back to Canada later especially with the Ontario changes.  

Unfortunately, immigrant IMG may be victims of some misperceptions too - there's surprisingly little evidence that immigrant IMGs will have any fundamental different in mobility/work location patterns versus CSAs.

https://www.longwoods.com/content/25100//retention-patterns-of-canadians-who-studied-medicine-abroad-and-other-international-medical-graduate

 

[Edict]

15 hours ago, indefatigable said:

 I expect that PDs are making decisions on who they think will best succeed in the programs in part based on applicant's records.  However, CSAs benefit both from "natural" advantages from simply being raised in Canada, but also have "acquired" advantages in terms of understanding the "matching game".  This will only increase in the future as Canadian USMGs will be considered IMGs and CSAs as well.

 Unfortunately, sometimes baseline factors are much more favourable for CSAs rather than immigrant IMGs.  Language and communication jumps to mind - that simply might be much harder for an immigrant, and unfortunately could both affect performance in a clinical setting and patient care.  However, an evaluator may also simply react less positively to a non-native speaker.  Still, different cultural or training perspectives might also make adapting to the Canadian health care system harder.

 So to some extent CSAs are benefitting simply from "blending in" a lot easier - this of course extends even further when a CSA may have roots in a region, or benefit from more connections in the medical community etc..  And sometimes, unfortunately, this "blending in" may be the most important componen for which immigrant IMGs may have little control - although would hopefully not cross into the territory of discrimination.  Of course "connections" sometimes do go much deeper like the notorious case at UBC.    

However, it's also true that CSAs generally do come from more privileged backgrounds and understand the "rules" of the matching game much better almost from the outset.  An immigrant from a developing country may come unexpectedly to Canada later, after medical school for much different reasons. CSAs  though will generally be focused on laying the groundwork for a successful match from the beginning, i.e. during medical school - CSAs will do clinical rotations in Canada which can be extremely high yield in terms of matching  for demonstrating Canadian clinical performance, letters..  Immigrant IMGs may spend years trying to build resumes that have less related clinical experience to compete with CSAs while losing their clinical skills putting them at further disadvantage.  

First round IMG positions were created after/during a legal case in Manitoba which was bought by (likely immigrant) IMGs whose claim was discrimination based on country of training as they had trained outside of the commonwealth countries (whose graduates were treated more favourably).  Ironically, it's probably commonwealth trained IMGs (Australia, Ireland, UK) that have benefitted the most from those positions especially CSAs - amazingly, 20 years ago, at the time of those changes, CSA only made up less that 5% of IMGs (link)   

However, I think as Edict pointed out, one of the major problems is that immigrant IMGs are under the impression that they will be able to readily work in Canada as physicians.  As such, some may come to Canada in the hopes of a better future, and make many sacrifices in vain. I think the real disappointment comes in when realizing the image that Canada projects being open to immigration etc.. is really only part of the truth -  the reality is many immigrants struggle to re-establish themselves professionally working menial jobs and are overqualified and underemployed.  Some immigrants may have no choice but to leave their country; others, unfortunately may not be making a fully informed decision when deciding to come to Canada.  Highly-educated Immigrants may naturally assume that having qualifications which favour their immigration means that their qualifications will really mean something strong in Canada.

Of course CSAs often make the same mistake in assuming that matching to Canada will be much easier than it is - although the matching rate for Oceania (Australia) is the highest around 70%, these are probably CSA that have partly self-selected to come back to Canada (i.e. put in time, probably have strong standardized scores etc..)    

While Canada as a culture generally welcomes immigration more than the US, the reality is that the US is much more open to IMGs than Canada which actually many CSAs also recognize - this is because it has way more residency positions than graduate.  I think the smart play as an IMG is to match to the US with an eye on coming back to Canada later especially with the Ontario changes.  

Unfortunately, immigrant IMG may be victims of some misperceptions too - there's surprisingly little evidence that immigrant IMGs will have any fundamental different in mobility/work location patterns versus CSAs.

https://www.longwoods.com/content/25100//retention-patterns-of-canadians-who-studied-medicine-abroad-and-other-international-medical-graduate

 

Agree with the points here and interesting study but I have some concerns about the way they defined CSA and IMG. It sounds like they defined IMGs as non-citizen/PR and not born in Canada, but that captures visa trainees who are mostly funded by their home governments (Saudi/other ME trainees) not the immigrant IMGs most of us are speaking about who applied through CaRMS.

Immigrant IMGs would have obtained their citizenships or PR before applying for IMG spots in CaRMS and would be classified as CSA/non-Western in this dataset. Important to know. 

This is important when you look at retention rates, visa trainees may be mandated to go home after their training. Unfortunately, you need to read the fine print these days, can't even trust the literature. 

 

 

 

[Andrew]

On 4/15/2023 at 1:34 PM, Samic1988 said:

 

 

 

 

 

 

I just feel so sorry that I will be a colleague with ppl like you, the way you think doesn’t belong to Canada. I hope years of residency would grow you up. Where did you find the term “natural born Citizen ”??? Where in Canada ppl use this term? You should be ashamed of yourself and I am sure you will be down the road. 

Honestly, I think the moderators here need to have a look at Samic1988 and Imghope for a possible ban because the things they are posting are borderline ridiculous and offensive.  It's one thing to be frustrated and to express criticisms in a rational debate, but it's another thing to just irrationally rant.

On the one hand they criticize others for not "knowing about them", and then post in a way assuming everyone else on this forum is some young inexperienced 30 year-old CMG. "The exact quote from a few posts above is "unfortunately I don’t think you all got the point, well how could you? You never lived through the experiences that Samic and I lived through, and I don’t blame you."

First of all, the two of you don't even have all the facts straight, you didn't even know that the cost of Canadian medical school spots are taxpayer subsidized, around 10 other posters have already laughed at you and challenged you on this point.

Why don't you (Samic1998 and Imghope) come out and openly tell us what countries you are from, instead of making shadow criticisms about nepotism/racism/ethnocentrism/protectionism. I guarantee you I can pull up multiple examples of protectionism from your countries just with google search.

1. Canadian medical school spots are taxpayer subsidized, it is essential that every CMG get a spot in CaRMS. It makes sense to everyone on this forum and politicians/citizens in Canada that we prioritize CMGs for available residency spots and if you can't understand this, then go rant somewhere else.

2. Leftover spots can be divided among CSAs or IMGs. Here you seem to have a major axe to grind about nepotism, repeatedly citing that the "son of the program director went to Ireland and paid $200K for medical school" and then backdoored his way to an IMG spot.

Again, nobody cares about your anecdotal experiences with nepotism/racism and so on. 

CSAs are given priority because they went to a Commonwealth country with similar training standards to Canada, with similar culture and institutions to Canada (many Commonwealth countries have reciprocal agreements on matters like this, if you weren't aware of this go do some reading). They are natural born Canadian citizens, they were born and raised in Canada, with family and deep strong community ties to Canada, they are likely to remain in Canada and practice in a neighborhood with which they already share similar values and have deep connection. They understand Canadian culture and more readily converse appropriately in medical interviews without the need for additional cross-cultural training. IN ADDITION, I would guess that due to the above, they are likely to communicate better with greater rapport with the program director during an interview, and the program director will likely find they more personable. They are more likely to be higher ranked by the program director.

3. The concept of a natural born citizen exists worldwide. Again, tell us what country you from and I'm sure there are multiple rules favoring natural born citizens wherever you are from. And again, I will quote you the most famous job in the world, US President, requires that you be a natural born US citizen. Worldwide, many other specific jobs in the military, border services, intelligence agencies, judiciary, and politics and so on have requirements of being a natural born citizen. The CONCEPT/REALITY of favoring "Natural Born Citizens" exists worldwide and will exist for the forseable future. This is CaRMS 2023, not "ideal world neverneverland 3030".

It would be one thing for you to issue a more general statement, like "the entire CaRMS process sucks", the number of spots is tight for both CMGs/IMGs, and it sucks that despite my X years of training, and Y dollars spent, that I have difficulty matching to spot. And most people would support you,.

But that's not what you are doing here. You're criticizing the system as a whole on the basis of racism/ethnocentrism/protectionism/nepotism (your exact terms/words) without any solid evidence or rationale to back your claims.

You also spout off all your accomplishments as if they mean anything "20 papers published, 90th % on MCCQE". You obviously don't know this but EVERYONE who gets into Canadian medical school has these things or equivalents, you are honestly nothing special. I scored in the 99% on my SAT's and 99% on my MCAT, I don't even bother mentioning these things (in addition I have national level non-academic achievements, scholarships and so on, again this forum is not the place to brag about how much better you think you are than the son of the program director from Ireland).

The fact that you said there were 500 ranked people out of 35,000 candidates in your country for medical school means you are most likely from India or China. Both of these countries have poor standards for everything in general, and I say this as a non-white 2nd generation of immigrant parents.

[SnowmanTheSWOMEN]

I am also a "non-white second generation immigrant" who got into a Canadian medical school. I had a perfect GPA, near-perfect MCAT, with tremendous # of hours spent on activities to bolster my application, all the while working to fund my education and living expenses. None of my family members are in healthcare, and we most definitely don't come from money.

I have yet to encounter nepotism, racism, and ethnocentrism playing a role in gaining admission to a Canadian med school. I am sure there are racist people, with wealthy backgrounds, and medical connections, who get into med school. But to say that the majority of our applicants are such people is a gross overgeneralization. At least I don't buy in to that BS, because I made it through genuine hard work and of course, luck.

 

The IMGs do have a "fighting chance" in Canada because you are able to apply, gain interviews, and secure a residency position. If you want a surefire way to land a Canadian spot, then you should've gone to a Canadian medical school. That is the way it has been, and the way it should be as our medical schools are tailored towards the population we are meant to serve (as mentioend above, this is the case with every single developed country). Nothing about this suggests that IMGs are more or less competent than CMGs, but rather, that the requirements to practice are Canada-specific as are the standards imposed elsewhere. If you dislike the Canadian system so much, then what is stopping you from practicing in your home country?

[Andrew]

4 minutes ago, SnowmanTheSWOMEN said:

I am also a "non-white second generation immigrant" who got into a Canadian medical school. None of my family members are in healthcare, and we most definitely don't come from money.

I have yet to encounter nepotism, racism, and ethnocentrism playing a role in gaining admission to a Canadian med school. I am sure there are racist people, with wealthy backgrounds, and medical connections, who get into med school. But to say that the majority of our applicants are such people is a gross overgeneralization.

 

The IMGs do have a "fighting chance" in Canada because you are able to apply, gain interviews, and secure a residency position. If you want a surefire way to land a Canadian spot, then you should've gone to a Canadian medical school. That is the way it has been, and the way it should be as our medical schools are tailored towards the population we are meant to serve (as mentioend above, this is the case with every single developed country). Nothing about this suggests that IMGs are more or less competent than CMGs, but rather, that the requirements to practice in this country are different than the standards imposed elsewhere. If you dislike the Canadian system so much, then what is stopping you from practicing in your home country?

He assumes that any immigrant to Canada should have full privileges of a natural born Canadian and gets upset when that's not the case. (let's be honest, 99% of the time Canadian immigrants DO have the full privileges and no country on Earth gives their immigrants 100% privilege).