Doctors, get out of your cabs

[Guest ploughboy]

Globe & Mail article on the "Fair Access to Regulated Professions Act"

 

The comments are interesting too...

[Guest charmingbutterfly]

I am not trying to offend anyone or anything - but personally I am a bit weary about changing our regualtions and such about Internationally trained doctors. While I totally understand that some have fully completed their professional education , I still think that we can solve our doctor shortag e problem here in Canada, without the need of shaking things up to accomodate IMG's...I read about so many refugees comingthrough Canada now with false claims and just still passing through- what guarantee do I have that some Internationally tarined person doesnt have the capability of fudging things , even by just a little bit?...just my thoughts and concerns.

[Guest heho]

what guarantee do you have that a locally trained person can't fudge things, just a bit?

[Guest megustaeso]

Post-graduate positions are funded by the government, so why shouldn't Canadians- at least those that we train- benefit firstly from those tax dollars?

[Guest CanadianandIMG]

You people are so closeminded and full of your own importance. There is a huge difference between someone who hasn't worked in medicine for a decade and a recent Canadian graduate who went to Ireland/Australia/England to go to medical school...we are EQUALLY as good as you CMG'S!!...and lets leave it to the experts who KNOW what they're doing to decide if we're "suitable" to treat our fellow Canadians!! Your opinions are absolutely ridiculous and pig-headed!

 

Why does the most medically advanced country in the world (US!) welcome IMG's with open arms?!?! Nothing disastrous is happening there as a result!!

[Guest Madz25]

"Why does the most medically advanced country in the world (US!) welcome IMG's with open arms?!?!"

 

 

The US has 1000s of residency spots that go unfilled each year. Canada doesn't (there may be some but not 1000s!). I think CMG's are just worried about getting a residency position. With med schools increasing seats and now Canada being more open to IMG's - without an equivalent increase in residency positions - it's making CMG's nervous. It's not that IMG's are any less qualified. CMG's went to a hell of a lot of trouble to get accepted in Canada and they just want to be assured that it wasn't all for nothing. What good is an MD without residency?

[Guest moo]

Honestly, I trust some of these Indian/Chinese/etc. grads who've had years of experience more than some C/AMGs.

 

But yeah, there are some who are bad... just like there are C/AMGs who are bad. Canada is supposed to be a welcoming society. Don't prejudge based on someone's country of origin.

 

As for people saying we are poaching physicians. Well, maybe we should just shut our borders and not let anyone in. Let's go against what this country is built on and cut immigration down to zero. Nurses, engineers, teachers, professors, etc. are all in great demand throughout the world. I guess we're poaching from those professions as well.

[Guest CanadianandIMG]

Um yes, of course I realize that there aren't enough spots in Canada and yes, I know that's why the US is so welcoming (it was rhetorical)...and yes, I know CMG's are nervous....but I think that these nervous CMG's are hitting below the belt when it comes to IMG's "invading" on their spots and in response/nervousness/stupidity start being "weary" (as quoted above and on other posts) of IMG's, their training, and the feelings of our welcoming Canadian people when that's not the issue!!!!....irritating and laughable...honestly!!

 

I will say again, the decision to determine who is competent/not is made by people who KNOW and have been doing this for a long long time...not by a bunch of silly medical students who think they know so much...

[Guest CanadianandIMG]

that was in response to Madz25...by the way...

[Guest Lurkergonepublic]

As long as it is the competent residency directors and the like who are making the important decisions, and not politicians who know little to nothing of how the system works and are more focused on making it look to the public like something is being done. I have this nasty vision of CaRMS being thrown wide open to IMGs in the name of increasing the number of doctors in Canada, only to have the powers that be ignorant of the fact that without increasing the number of spots it doesn't matter who gets them - you have the same number of doctors. Now we have Canadain trained MDs driving the cabs because they can't get a residency spot...

:lol

 

And no I don't think that will actually happen, it's a tongue in cheek hypothetical result. I'm sure there are enough "in the know" making the decisions (or at least implementing the political decisions) to keep a realistic perspective in the changes. There are certainly enough fingers in the pot to keep things from changing too fast.

 

In looking at this and similar discussions it seems to me that CMGs and IMGs are often arguing about who gets how much of the pie, when really what is needed are a few more pies, and then it wouldn't be so much of an issue. That's the main reason why the US can bring in so many more IMGS, because they have so many more pies (must be all those private bakeries). Okay I'm losing my own train of thought on this metaphor, so I'll just stop right here.

[Guest avenirv]

in canada the residency spots are paid by the goverment (actually your tax money).

in usa the residency spots are not paid by tax dollars; there the health care system is PRIVATE.

for canada to have more doctors-i.e. more residency spots-more money are neede. goverments get more money by raising taxes or cutting the services it offers.

do you get the point ?

[Guest CanIMG]

I think lots of good points have been made so far on this thread. For starters it's definitley important to realize, as stated before, that without an increase in residency spots there will be no increase in the number of doctors, and more residency spots can't happen without more tax revenue. some of which is 'my tax money'. This is an entirely different issue and one I think CMG's and IMG's alike should be fighting for, rather than fighting one another over who should be allowed in the first round.

 

Another point that seems to get a lot of attention is the difference between true IMG's and Canadians studying abroad. Without a doubt in my mind there is a difference between a Canadian citizen who is training abroad in a reputable school and wants to return home and a non-Canadian who plans to immigrate with his entire family. The issues confronting the latter are numerous and personally I don't think valuable tax dollars should be wasted trying to accomodate those problems that arise. It is estimated that there are over 700 Canadians training outside of Canada currently. So that's nearly 200 grads/year, 200 educated citizens, that do not return home, and are lost for good to another country simply because of the limited opportunity the second round allows. I think this was major incentive for the proposed changes to Carms.

 

Finally I'd like to agree with 'CanadianandIMG' in saying that many Canadian medical students need to get over themselves. Getting into medical school in Canada is a great achievement, but so is leaving your family/friends/home behind and undertaking training in a new country solely to satisfy the desire to practice medicine. Some CMG's argue that acceptance to medical school is the barrier one must overcome to be deemed acceptable to a career in medicine. Bulls#@$! Gaining access to residency training is a far better place to assess one's suitability for a medical career. When you are first interviewed for med school you have not seen a patient or performed a procedure. You have gotten approx. 2650/3000 MC questions right in 4 years....way to go. Clearly you have what it takes to be a doctor. Sarcastic & arbitrary perhaps, but not too far from the truth.

 

By the way, the vast majority of the Canadians that go to Australia, England, Ireland are training at institutions that are more respected on a global basis, have a longer tradition of medical education, and teach the very same medicine in the same way as most Canadian schools.

 

If we were all smart we would be lobbying the government to create more residency spots so that all qualified applicants can be accomodated. And the unqualified applicants? Well I'm sure we can arrange a special cab-driver match through Carms so everyone is happy......

[Guest aneliz]

I think that CanIMG has hit on it... there is a very big difference between the different 'pools' of IMG's... not all IMG's are equal!

 

A Canadian citizen that left Canada to train in a well recognized, modern 'western' medical school, such as in the US, Australia, Ireland, etc. is not the same as someone that got into an unheard of, small medical school in Asia that accepts people solely on their ability to pay the tuition...

 

Training and the standards of medical care from the US or Western Europe are definitely NOT the same as they are in China, or Pakistan or Iran or Syria or Rwanda...etc, etc, etc. There are language issues, knowledge issues, technology issues, cultural/ethical issues and differences in medications and standards of care. All of which must be addressed by Canadian training before allowing these people to practice medicine unsupervised in Canada.

 

I agree that those that trained in the US and Ireland and Australia, have just as many qualifications as the CMG's... likely they ended up in other countries for med school because of our government's restrictions on the number of medical school seats. There is so much competition to get into medical school here... that many, many students that are just as qualified as those that get in are rejected from medical school every year... just because you get in to a Canadian medical school doesn't make you any 'better' than those that came close. So, why can't they come home??? Because the governments haven't funded enough residency positions so that someone isn't going to be left driving a cab. Period. That is the reason. If this could be fixed, I don't think anyone would have a problem allowing the IMG's into the first round.

 

In the US, everyone competes in the first round... however, if you look at the match statistics, the US grads are clearly favoured by the competitive programs... this doesn't prevent the 'strong' IMG's (ie US citizens that left the country for med school) from competiing for them (and I am sure that some of them succeed in getting competitive spots)... but if you look at the US example, you should be assured that the competitive residency positions are not going to be 'stolen' by people with questionable qualifications from questionable medical schools in other countries.

 

This is not to say that all IMG's from places other than the US and Ireland are inferior or not well trained. There are some exceptionally good IMG's that I have run into that have come from Russia and various places in Asia and South America. However, there are also some exceptionally bad ones too... if there were enough residency spots to allow more qualified people to match... I don't think that there would be such a problem...

[Guest CanadianandIMG]

Finally I'd like to agree with 'CanadianandIMG' in saying that many Canadian medical students need to get over themselves. Getting into medical school in Canada is a great achievement, but so is leaving your family/friends/home behind and undertaking training in a new country solely to satisfy the desire to practice medicine. Some CMG's argue that acceptance to medical school is the barrier one must overcome to be deemed acceptable to a career in medicine. Bulls#@$! Gaining access to residency training is a far better place to assess one's suitability for a medical career. When you are first interviewed for med school you have not seen a patient or performed a procedure. You have gotten approx. 2650/3000 MC questions right in 4 years....way to go. Clearly you have what it takes to be a doctor. Sarcastic & arbitrary perhaps, but not too far from the truth.

 

Thank you so so so much for this post...nail on the head!

[Guest Lurkergonepublic]

in canada the residency spots are paid by the goverment (actually your tax money). in usa the residency spots are not paid by tax dollars; there the health care system is PRIVATE.

for canada to have more doctors-i.e. more residency spots-more money are neede. goverments get more money by raising taxes or cutting the services it offers.

do you get the point ?

 

Yes, that was the subtle point I was making with my quip about "private bakeries" in the US. Not too clear I know.

 

Overall my point was (as can be seen from the last few posts) that this debate has already appeared numerous times in the short while I've been frequenting these forms and the conclusion almost always is that we need more residency positions in Canada to adequately solve the issue. And like all such solutions, it's not a simple as it sounds of course - where's the money coming from? Who's going to train all those extra residents? At what facilities, etc... it certainly can't happen overnight.

 

I definately agree that there's no reason an IMG (particularly a Canadian citizen, trained in a western country) isn't just as good or better at medicine as a CMG. Just like chosing a resident from grads from different schools within Canada, it's not the school that's important so much as how well the student has applied themselves and learned the skills. I think the current CaRMS system is set up simply as one solution to deal with the scarcity of residency spots vs abundance of potential candidates. It's not the best (which is why it's being re-examined), but until there are more spots it will continue to be an issue.As CanIMG said, that should the main focus.

 

As med students perhaps we could do a better job of making that more common public knowledge - the general public demands (and rightly so) that all the foreign trained doctors here should have the potential to practice (once their skills are verified and acredited of course), but as we can see from our position, simply throwing open the competition to those people is not the solution to the heart of that physician supply issue.

[Guest therealcrackers]

Good doctors are trained over roughly a decade of post-secondary education. The best training comes from experience and understanding the system and the market you will be operating in.

 

The final common pathway for every physician in Canada is COMPLETING A RESIDENCY AND GETTING A LICENCE. The biggest restrictions, I believe, to achieving those are the availability of residency spots and the standard of competence demanded by the licensing bodies and the Colleges. The former is a governmental problem, the latter is the job of every medical professional to meet that standard.

 

 

We as med students, residents, IMGs both in and out of medicine, need to do a better job of letting the public know about our situation, the job we do, the stresses and joys of becoming a competent physician over that lengthy period of time. If we let the government and the public know that our goal is to meet the licensing standard, then get out there and help people in the Canadian medical system (but that it takes time), maybe we can convince governments to make the necessary changes to let more people get the residency experience they need.

[Guest walton1]

Hello all,

 

I'm a Canadian med student who will participate in CARMS 2007.

 

Although objectively speaking, including IMGs in round 1 will put me at a disadvantage, in principle I'm all for it.

 

I think some competition won't hurt. The knowledge that there's a warm comfy residency spot waiting for all of us frankly makes some of us complacent. The sense of entitlement to big salaries and a job waiting for all comers permeates many of the postings on this board. There are no guarantees in life, no matter how hard you work or how much time you spend in school. Deal with it!

 

I'm just awestruck by people who feel that they have some sort of birthright to whatever residency they choose, in whatever location they wish. I certainly agree that it would be stressful to apply to derm or plastics, but.... life is tough.

 

One thing that bothers me about some of these postings is the relative lack of gratitude towards IMGs and what they have done for Canada. Many 'drive the cabs' *within* the medical profession -- IMGs work in the rural family medicine settings that can't recruit CMGs, and help provide manpower in some of our residency programs, neurosurgery for example. Many subspecialists approaching retirement in previously-obscure fields, such as radiation oncology, are foreign grads. Where would we be without their clinical contributions and teaching?

 

I enjoy having IMGs around. I find their knowledge and skill set has the same range as my Canadian colleagues. I have met both extraordinarily hard-working and lazy IMGs, friendly and rude, competent and questionable. As with the Canadians, those with the former characteristics outnumber the latter. We can trust residency programs to separate the wheat from the chaff.

 

 

Best wishes,

 

wally

[Guest peachy]

I'm just awestruck by people who feel that they have some sort of birthright to whatever residency they choose, in whatever location they wish. I certainly agree that it would be stressful to apply to derm or plastics, but.... life is tough.

I think that's terribly unfair. The percentage of students who are writing with this attitude is either non-existent or very tiny. I went back and read this thread and I still can't find anybody who posted an attitude like that. Nobody thinks that students should be entitled to a plastics residency no matter what.

 

Students are angry because the match system, already flawed, had the rules changed on them very suddenly. Students in the class of 2007 should have known this early enough, for example, to prepare to apply to the US match if they think this change is going to hurt their chances substantially in the Canadian match.

 

Students are also angry because there already simply aren't enough spaces in the match. People keep trotting out the examples of Canadian students thinking they are entitled to "derm" or "plastics". But (almost) nobody is complaining about these ultra-competitive and specialized residencies. This is about the other big fields that are not family. Students should have a reasonable chance at getting into internal medicine, pediatrics, ob/gyn, general surgery, etc (not at their top site, but a spot) if they are a competent medical student (not near the top of their class).

[Guest moo]

I think a lot of these problems could be relieved if a Canadian went to the US for residency training and can come back to Canada without jumping through all the bureacratic BS that people have to in order to practice in this country. I don't understand why in some specialties you can go back and forth, and others you can't. If we do this, I'm sure many more Canadians would train in the US, if they knew they could come back.

[Guest Littlest Zooropa]

People people people

 

Your number one absolute sure-fire secret weapon in getting the residency of your choice is:

 

(are you ready for this?)

 

Be there, bright eyed and bushy tailed when the staff arrives, be there when they go home. Be there when they stop by cause they forgot something at the office. See every patient. Write great notes. Do every procedure. Try NOT to screw up. Amaze everyone with your uncomplaining, graceful dedication.

 

This is the best way to get a residency spot (ask anybody who's gotten one). They'll pick you cause they know your face, and they love you. They'll pick you cause you never refused to do anything, no matter how scutty, and you never went home. They'll pick you cause they figure that you will never complain, never go home, never get sick and never refuse to do anything.

 

If you've missed the point, don't worry about the IMGs. The IMG's won't be at Foothills for eighteen months competing for procedures. They won't be at Vancouver General for eighteen months answering the attending's questions (Who can tell me what Muller's sign is? What is its significance? Who can name three other signs associated with the same condition?) They won't be delivering six to eight babies a night at the Royal for eighteen months. It's going to be you.

 

Your greatest competition in getting a residency will be yourself. How long can you stay awake? How much abuse can you take? How many factoids about the seratonin pathways in the brain can you memorize?

 

You know that freakin' keener who goes straight from class to hang out in neurosurg and watch them drill burr holes until well after dark? He's getting his residency because the neurosurgeons are going to remember him. The absolute LAST thing you want to do is be is just a name on a page with a bunch of journal articles listed.

 

You are going to have work very hard to get the residency you want (and then you're going to have to work a lot harder during your residency). If you don't (or can't) work hard enough, you won't get it. It's cruel and scary, but you haven't got any choice. This is the way it's done.

[Guest CanadianandIMG]

You are so misinformed that it's entertaining...

 

There IS no competition between IMG's and CMG's...this is the whole point...there is no "picking CMG over IMG/vice versa"...and shame on you for pitting people against each other.

[Guest Littlest Zooropa]

You're absolutely right that there isn't any competition between the IMG's and Canadian grads. Canadians will have each and every imaginable advantage because they are a known quantity (particularly those applying for residency at their home institution).

 

However, there is a lot of competition between Canadian grads. If you want to get the only PGY-1 spot in x-ology, you're going to have to be smarter, faster, stronger, better than everybody else who wants to get it. And you're going to have to prove it to everyone, everyday.

 

If that sounds like a lot of hard work, it is. But it's nothing compared to how hard you'll work as a resident, and, if you choose wisely, you'll enjoy your career for the rest of your working life (which may be a very long time).