Residency in the U.S.?

[Guest KJ]

I was just wondering if it is possible for Canadian medical school graduates to do residency in the U.S. If so, what are the benefits and disadvantages of this?

[Guest studentz]

Q1- Yes, you (we) can

 

Pro:

-Some US boards don't recognize Canadian residency training so if you want to practice there, you would have to do a US residency.

- Arguably better training in some fields; prestige and recognition of some institutions there may help if you want to practice there

- Potentially more opportunity for research

- Max. work hour agreements

 

Cons:

-Living expenses in major US cities (NY, Boston, San Fran, LA, even Baltimore) are much higher than those in Canada (try living in Manhattan on $42K US a year).

- Apparently the decision to do residency training there may affect the repayment terms of some lines of credit.

- They really don't get paid all that much

- Depending on what you're doing, you may finish faster in Canada (Cardiac surgery is ~6 years here, but you have to do gen surg then cardiac in the US)

 

others can add to or subtract from this list as necessary

[Guest Ian Wong]

Pro:

The US has many more residency positions than Canada for literally every specialty.

 

Con:

Just because they have more spots doesn't necessarily make you competitive for those spots. Particularly in competitive specialties, coming from Canada is likely to be a disadvantage as the US programs may not be familiar with your medical school, and you will require a visa of some sort if you aren't a US citizen or have a US green card/permanent residency status.

 

Pro:

Tons more money for research and technology, which you will see daily in the hospital. The access to high-end technology like PET scans, MRI's, new (and usually VERY expensive) drugs, potential to see WAY more trauma than an equivalent sized Canadian city.

 

Con:

If you aren't interested in research, the fact that your med school/residency gets tons more research money than the Canadian equivalent doesn't mean much. If you get too reliant on technology to make your diagnoses for you (ie. you get an echo to assess for every heart murmur, or a BNP blood test every time you think your patient is in congestive heart failure, or a head CT/MRI every time your patient does something even remotely abnormal), then your physical exam skills deteriorate.

 

Pro:

More likely to develop connections if working in the States is a future goal.

 

Con:

Depending on what visa you get to study in the US, you might be required to return to Canada for a period of 2 years before you are eligible to work down there. The J-1 visa, which is the only visa that many competitive specialties will sponsor, requires you to return to your home country for 2 years immediately post-training before you can re-enter the US for work purposes. If you can get the H-1B visa, you can avoid this protectionist clause, but many residency programs don't give out the H-1B visa because there's lots of paperwork involved, particularly after 9-11.

 

Pro:

You get to see the other side of health-care, that being what a for-profit, privately insured healthcare system can offer. You may actually decide that such a system would be better for you personally as a physician (simply because the potential is there to make more money than an equivalent job in Canada, and you will always have the money to take advantage of this privately-delivered health care).

 

Con:

You get to see the other side of health-care, that being what a for-profit, privately insured healthcare system can offer. You may decide that the bureaucratic nonsense and paperwork that dominates this system is something you want no part of as a physician. You might also decide that the ridiculous litigiousness that you see in the US (but interestingly enough, not in Canada), is something that makes you cynical, and makes you view your patients as potential enemies rather than people whom you can possibly help.

 

Pro:

If you do your residency in the US (and pass your boards), there's no way that your training can't be recognized in the US (assuming that it is your end goal to work in the US). There are certain Canadian residencies that aren't recognized by the corresponding US boards. An example of this is ENT. If you do your Canadian residency in ENT, you aren't allowed to sit for the US ENT board exam, and therefore can't get board certified to practice in the US.

 

Con:

This lack of reciprocity works in the other direction, as there are certain specialties where the US residency is shorter than the Canadian residency (ie. Ophthalmology, Pathology, Psychiatry, Dermatology, Anesthesiology, Neurology, General Pediatrics, General Internal Medicine). If you do a US residency in those (and become US board-certified), you may be required to do an additional year of residency training before you can become Canadian board-certified.

 

Ian

[Guest KJ]

Thanks for your responses! So doing a residency in the U.S. and coming back to Canada to practise shouldn't really be a problem?

[Guest Ian Wong]

If the US residency you do is shorter than the corresponding Canadian residency, then you could run into problems when trying to get back to Canada. This is something that's hard to predict ahead of time because the reciprocity is constantly evolving between Canadian and US boards for each specialty. The most important thing for you to do is when you finally start focussing in on one specialty, that you contact the corresponding US and Canadian boards to see what relationship exists.

 

Royal College of Canada

Requirements for each specialty by the Royal College

 

Links to all American Medical Boards Associations

 

Ian