IMGs first round

[Alastriss]

samsara, not everyone who goes elsewhere is rich. A lot of these people decided it was worth whatever massive debt that they would incur as a reult of their decision. I'd also like to say that if residency programs worked with international medical schools, or perhaps worked together to create a test to ensure that they did indeed come from a school that provided them with solid training, then the problems with training differences would not be so great. Canadians would benefit from the A) Boost in the number of doctors and I think also, The fact that Canada recognizes professionals from different countries, thus improving their immigration laws.

 

I understand your concern regarding having the money to pay, but this is a concern that always exists for anything. Some kids can't afford to even do undergraduate studies, is that fair? And as I mentioned earlier, a lot of these people did not have the money to pay - but took out big loans to accomplish their dreams. Is it fair that so many qualified people get rejected every yer from Canadian medical schools? In a country that is so developed, our students shouldn't be forced to going to other countries to get training!

 

Some people may feel that since the schools charge a lot then having money means you're guaranteed admission regardless of your academic capabilities. I don't think that this is really the case and if there was some standardized test (maybe like licencing exams), then the IMGs can take it to prove their capabilities. I don't know if something like this exists currently, but it's just something for people to think about rather than totally dismissing the idea of giving IMGs residency opportunities in the country.

 

 

Law you bring up a good point about residency programs working with international medical schools. I often thought of a solution where we can have delegate individuals (preferably people involved in residency admissions) to go to countries that already have a decent reputation in medicine (UK and south africa to start) and assess some of the major medical schools there in terms of their weaknesses and strengths as well their residency programs, to see whether or not graduates would be on par with canadian doctors.

[papazow]

Great post, Samsara.

 

From my experience, there are a lot of people going to the Caribbean. Nothing against them, they are good people. However, they are not qualified applicants for Canadian med schools. For one reason or another, they (or their parents), feel that they deserve to be a doctor. Why is this?

 

And, for many of these Caribbean schools, literally anyone can get in. I know that from experience. I personally know someone who was disinterested in high school, sort of attended college, and is now attending medical school in the Caribbean. How is this right?

 

In fact, while in second year, I took a look at an application. It did not ask for university marks. Yet, on the first page, it did ask how I intend to pay for my medical education.

 

Canadians hold physicians in high esteem and go to them for guidance. Would you want to go to someone who got in based on ability to pay? I definitely wouldn't.

[wildcard]

samsara, not everyone who goes elsewhere is rich. A lot of these people decided it was worth whatever massive debt that they would incur as a reult of their decision. I'd also like to say that if residency programs worked with international medical schools, or perhaps worked together to create a test to ensure that they did indeed come from a school that provided them with solid training, then the problems with training differences would not be so great. Canadians would benefit from the A) Boost in the number of doctors and I think also, The fact that Canada recognizes professionals from different countries, thus improving their immigration laws.

 

I understand your concern regarding having the money to pay, but this is a concern that always exists for anything. Some kids can't afford to even do undergraduate studies, is that fair? And as I mentioned earlier, a lot of these people did not have the money to pay - but took out big loans to accomplish their dreams. Is it fair that so many qualified people get rejected every yer from Canadian medical schools? In a country that is so developed, our students shouldn't be forced to going to other countries to get training!

 

Some people may feel that since the schools charge a lot then having money means you're guaranteed admission regardless of your academic capabilities. I don't think that this is really the case and if there was some standardized test (maybe like licencing exams), then the IMGs can take it to prove their capabilities. I don't know if something like this exists currently, but it's just something for people to think about rather than totally dismissing the idea of giving IMGs residency opportunities in the country.

 

Good point Law.

 

In order to apply for residency in Canada and the US, IMGs are currently required to write and excel in the LMCC and USMLE exams, respectively. So, they are definitely being evaluated (with more stringent rules...I think...in terms of the range of marks accepted for IMGs vs. 'local' students) before being even interviewed. Any residency postion in Canada is not simply 'handed' to an IMG applicant. They have to work for it just like any other Cdn student.

[samsara]

hey Samsara, nice post. your last phrase "reprehensible at worst" made me want to write this all out.

A few things, when you mentioned that it can't be completely ethical to go study in another country and then return to yours because you cost them money, then you have a point, however I can't say that you can also make the argument that people who can make the socioeconomic cutoff are reprehensible because high tuition fees = LESS government subsidization.

 

 

Hi Alastriss...Just want to clarify a few things. Let's start with dividing (roughly) the IMG's applying into two groups. One are the people who are Canadian citizens, born and raised here, who couldn't get into Canadian medical schools and decided to go abroad and are now in the process of attending Caribbean (or other medical schools where they have to pay big cash). And let's say the other group is composed of 1st generation immigrants who come here from other countries looking for work (I'm sure you could add or subtract from these, but these are the ones I focussed on in my post, so I'll stick to what I have an opinion about )

the individuals who are going to foreign medical schools and obtaining what often turns out to be an expensive education after failing to achieve their goals here - are the individuals who i somewhat ranted about. These people I have an issue with because in my opinion (and please note...this is just my opinion), they didn't make the cut here for a reason - whether that be intellect, personality, or just plain bad luck. Maybe...they didn't try hard enough in their undergrad years (which I too was once guilty of) or long enough (ie. trying time and again) and by choosing to go through a foreign medical school system, they bypassed the competition it takes to enter into a canadian medical school. This is a decision they made, and I simply have more respect for those individuals who stuck to their guns and made their dreams come true where the competition was hardest. Do I think it's unfair that some people have that option and others like myself don't? Definitely. Do I lose sleep over it late at night? Absolutely not. A few of you have mentioned that life is unfair...and I agree with you all completely. As an illustration...here's a quote from Nietzsche that works well.

"To those human beings who are of any concern to me I wish suffering, desolation, sickness, ill-treatment, indignities - I wish that they should not remain unfamiliar with profound self-contempt, the torture of self-mistrust, the wretchedness of the vanquished: I have no pity for them, because I wish them the only thing that can prove today whether one is worth anything or not - that one endures." - The Will to Power - 481.

 

"As I said, its not fair, but as much as I would love to believe in this, who says that the world is SUPPOSED to be fair? palestinian kids who have lost their parents can attest to this, let alone starving children in Africa.

I would like you to elaborate more on what your point is, as i don't want to make any ignorant assumptions. I take it that your view is to look down on those who have lower than average marks that can pay their way through meds. In an economicalyl driven world, if you can afford it, then there's no reason why it should be at all unethical."

Alastriss...coming from an economically poor but an educationally rich background, I have no qualms admitting that my preconditioning probably factors significantly into why I am a bit bothered by the idea of money buying an education. I understand at the same time too though, that I am living in a world run by capitalism, and so your statement that "in an economically driven world, if you can afford it, then there's no reason why it should be at all unethical" rings true, even though it doesn't sit well with my admittedly conservative outlook on life. I know life isn't fair...and potential is lost in droves every day as AIDS ravages through Sub Saharan Africa or cholera wipes out small pockets in India. This is the way the world's worked since before I was born, and I don't expect it to change with some juvenile idealism that's persisted past adolescence for some reason

 

"I won't go further until you respond, but i do want to close with this. I believe for people who are rich enough to get opportunities that other can't, they have an obligation to make something out of it. If i didn't get into a canadian med school. I would be able to go to a US school, and if i did, I would feel very uneasy knowing that some of my friends wouldn't have that option because they lack the doe. I would most certainly not deny myself the opportunity, but i would most certainly raise my personal standards and expect more out of myself because i was lucky enough to be in the position that I am. I would, as you would say...take on a personal 'debt'."

I actually love what you've said here. As a side note, I believe that a US medical education is fairly competitive as well...it's not just money that'll get you there- they have some semblance of standards. Sometimes these standards are lower than those of Canadian medical schools, but still, the average matriculant to a US school has an MCAT score of around 10 and a GPA around 3.5 or 3.6 if i'm correct? And that, imho, isn't bad at all. The individuals I know who got into the Caribbean schools on the other hand, were rocking 8's on the MCAT and valleygirl attitudes, and seeing them has disillusioned me. If you are the kind of person to understand your privilege and make good of what opportunities you have, then that's awesome, and I wish you the best in your future endeavors.

 

Okay...second part of this is addressed to "The Law". Firstly, you mentioned that not everyone who attends foreign medical schools is rich. But as far as I understand, very few banks will provide lines of credit to individuals who aren't attending Canadian schools (I'm not sure if matriculants at American schools are able to obtain LOC's). Therefore, these individuals probably need to take loans that require a cosigner with enough monetary clout to finance the expensive tuition and boarding of these schools. And again...it comes back to money. You mention, "Is it fair that so many qualified people get rejected every yer from Canadian medical schools? In a country that is so developed, our students shouldn't be forced to going to other countries to get training!" I agree it isn't fair in the least, but why aren't these individuals persisting and trying to get in year after year if this is their dream. Why are they taking the easy way out and going to places where standards are much lower? I mentioned people who tried year after year for years before they got in - and again, this is a personal opinion, I just have more respect for their dedication than I do for those taking the easier way out. And maybe, just maybe, we should have some faith in the ad coms and stay open to the possibility that the people we think to be great candidates for med school might genuinely not be physician material. The ad coms are made up of intelligent individuals who have been involved in the profession and know what it takes to become a physician (let's hope as much anyways). Pardon my cynicism here, and it might be unnecessary, but there is more to being a physician than a set of dreams gleaned from watching protracted doctor dramas. And yes, I've met people who have stated this as a major reason for their desire to be doctors. And I've met others who have no desire to be in medicine other than for status and glory and ethno-social pressures. Not for me to judge people and their hopes and dreams, but try as I might, I find myself severely lacking in terms of desire for these people to be trained as doctors anywhere, here or abroad. I know I'm taking the moral high ground here, and that's always shaky

The second point you bring up about high standards for the foreign trained doctors who AREN'T originally canadian still doesn't address the dilemma of the brain drain from their countries of origin. Someone mentioned earlier that the equivalent of two canadian medical schools migrates south every year. I think you'd agree that this is a problem. Coming from populations where hundreds of millions lack proper healthcare - see india and china here - is it ethical for us to allow these doctors to practice here when they are far more desperately needed in their countries of origin? And this is where the question of government subsidized funding for these doctors who are citizens of their respective countries becomes an issue for me.

To sum this mammoth of a post up...my experiences cloud my opinions on these issues as I'm sure the case is for you all too. It's all a bit here and ther e and everywhere, but I still hope this helps clear up anything I didn't clarify earlier.

Cheers,

[The Law]

I agree it isn't fair in the least, but why aren't these individuals persisting and trying to get in year after year if this is their dream. Why are they taking the easy way out and going to places where standards are much lower?

 

Well first, not all people have the time and money to just waste time trying to get into a career. I mean, it's obvious that the process does kind of favour people in better economic situations, but why should anyone be forced to wait 3 years to get in? In those 3 years, they could be 75% of the way to getting an MD. As for the "standards" being much lower, this does not mean the quality of the education is going to be any worse and the standards aren't really all that much lower (as can be seen through standardized testing, as wildcard pointed out).

 

Coming from populations where hundreds of millions lack proper healthcare - see india and china here - is it ethical for us to allow these doctors to practice here when they are far more desperately needed in their countries of origin?

 

I think it would be naive to think that these professionals aren't going to leave regardless. The trend is that many professionals, such as doctors, immigrate to Canada and end up working jobs like driving taxis. That's not to say anything is wrong with those jobs - it's just that they're doctors! They should be given a chance. I was the person who mentioned two medical schools worth of students leaving every year - this is just a sign that we need to make it more attractive for these professionals to come here.

 

Firstly, you mentioned that not everyone who attends foreign medical schools is rich. But as far as I understand, very few banks will provide lines of credit to individuals who aren't attending Canadian schools (I'm not sure if matriculants at American schools are able to obtain LOC's). Therefore, these individuals probably need to take loans that require a cosigner with enough monetary clout to finance the expensive tuition and boarding of these schools. And again...it comes back to money.

 

I'm not really sure of the intricacies of this issue. However, I've been led to believe that where there is a will - there is a way, and that it is possible. We live in a capitalist society, it's always going to come back to money. As a previous poster, how is it unethical to use money that you have (or obtained through loan) to give yourself an education?

[NLengr]

As a previous poster, how is it unethical to use money that you have (or obtained through loan) to give yourself an education?

 

I've bit my tongue on this for a few days because I really don't want to get too heavily involved in a debate, but I'll say something since it's now been mentioned a few times.

 

While the ethics of using money to get your education may be debatable, I don't think it helps the public perception of the profession (which is an important part of any profession). In the eyes of the public, if they rightly or wrongly gain the image that we have physicians who bought their way into foreign medical schools, the image of the physician will be tarnished. I feel that this is a huge issue for the profession overall.

 

Look at NL. With the recent incidences of removing 2 foreign trained radiologists because of possible quality of work issues, the public confidence in the health care system, NLMA and provincial physicians in general has been impacted. And if people lose faith in the system, they we will see more people disregarding or not seeking quality medical advice.

 

As for what to do. We know we will face a health care crisis as the population ages and demand for medical services increases. We should be focusing on long term plans to train more physicians in Canada, both at the undergrad and postgrad levels. This is a best solution. They would be under a training system that Canada developed, and meets our desired outcomes, while at the same time, more people who meet our entry standards will be let into our training programs. We get the best quality training for our physicians (at a small, but acceptable price) and we reduce the risk of getting people who bought their way in.

[JewelLeigh]

The second point you bring up about high standards for the foreign trained doctors who AREN'T originally canadian still doesn't address the dilemma of the brain drain from their countries of origin. Someone mentioned earlier that the equivalent of two canadian medical schools migrates south every year. I think you'd agree that this is a problem. Coming from populations where hundreds of millions lack proper healthcare - see india and china here - is it ethical for us to allow these doctors to practice here when they are far more desperately needed in their countries of origin?

You have neglected to mention the individual perspective here - that is, the individual perspective of the foreign trained doctor. Is it ethical to deny these individuals the chance for a better life for themselves and their families simply because they come from a particular country?

 

While I don't disagree that there is a monstrous health care shortage in many developing countries, I am definitely skeptical at the idea of discriminating against someone who wants to immigrate to Canada (whatever their reasons) simply because they are a doctor from country X.

[samsara]

Law,

You mention that not everyone has the time and money to waste. But since we've established that most of the people pursuing a medical education abroad would be coming atleast from money (and given the adage that "time is money", they probably aren't too scrapped for time either), that argument doesn't hold much water. As far as the standardized testing and residencies are concerned, If I'm not mistaken, there are interviews for residency positions as well. Those who have gone through a foreign medical school and successfully compete for these positions must be at a distinct advantage over the other dozens of applicants they supercede. Any idea what that could be? It's possible that USMLE scores explain everything, but I somehow doubt that.

Secondly, you mention that these professionals would be leaving anyways. Two things - firstly...why would someone who is a doctor - having put in years of education, want to leave their country if they didn't have some semblance of hope that they would be able to pursue their profession in the immigrating country. Secondly, there are several universities in India and China. Some of these are much more difficult to get into than others (and some, you can buy your way into with a generous donation). I have never met a taxi driver who boasted a degree from an elite institution - IIT or AIIMS for example (I'm sticking with Indian examples here, because like it or not, that's the background ethnicity of many immigrant taxi drivers). I do however, meet people who have finished their medical education in places like Russia (and again, these are more often than not the people who couldn't get into medicine in India but have the money and means to travel abroad to get an education). What I'm trying to say is...their education is probably substandard even by the standards of their countries of origin, much less Canadian standards, and in that event, I don't believe that they should be allowed to practice in their home countries. Furthermore, there are language difficulties that must be transcended, and some people simply don't have the ability or drive to do so.

As far as the last point you brought up is concerned...if anyone else would like to jump in and clarify whether banks provide loc's to foreign medical school bound chicos and chicas, that'd be great. Keep in mind that this IS a profession where people's lives are at stake, and I don't think that it's good enough that you have a will to become a doctor. There are standards that need to be upheld so that anyone and everyone can't just become a doctor. Otherwise..what is the value of the difficulties undertaken by those who did well in university and got good mcat scores if they're just going to end up next to someone who (atleast at some point of time) lacked the skills or intellectual background to be studying next to them in a Canadian educational milieu? And even though what the previous poster wrote was quite compelling...if money is enough to buy an education - regardless of capability, then why don't we throw out all semblance of standards altogether and just allow the socio-economically elite to take over the educational system. Perhaps Paris Hilton and her pet chihuahua ought to be conferred honorary degrees of medicine. I am speaking tongue in cheek here, but I assure you that it wouldn't be difficult for her to obtain a degree of medicine if she put some money in the right places (perhaps some of those Indian universities where standards are low and money grubbing high? ). And perhaps, with choice phrases like "that's hot", she should be allowed to practice as well and make a visually appealing difference in the lives of her male patients? I am taking an extreme here, but I hope it illustrates my point. Money is a privilege, and I agreed with the poster because he treated it as such. With that, I hope the ethics are clearer, and if you'd like, I could provide a moderate example as well.

Cheers

PS. You brought up some good points btw...I think you'll do great on the ws of the MCAT.

[JewelLeigh]

...if money is enough to buy an education - regardless of capability, then why don't we throw out all semblance of standards altogether and just allow the socio-economically elite to take over the educational system.

This is getting a little out of hand samsara. Money does not buy the education...at best it buys the opportunity for education. People who leave Canada to pursue medical education elsewhere still go through years of medical school! It's not like they just hand over their $200k and then are allowed to sign an MD behind their name. Yes, money (via parents or a loan that must be repaid) may be needed to open the door of opportunity, but it is a load of hard work over many years that earns an medical degree.

 

Your rather sweeping generalizations wrt training internationally, particularly in the Caribbean, are to me, a tad insulting. How many people who chose to pursue medical education in the Caribbean have you actually met? Of those who YOU deemed to be "valley girls," how many were accepted to residency in Canada? I personally know 2 current family medicine residents who completed their training in the Caribbean. When compared to residents at the same level who trained in Canada, I found both to be incredibly kind, hardworking, intelligent and knowledgeable.

 

With respect to the quality of international training, much of Caribbean medical school clinical training takes place in the States. For the portion that takes place in the classroom during med 1 and 2, it's laughable to believe the Caribbean is so far behind the rest of North America that it's medical schools can't properly teach the basics of anatomy, physiology and pathophysiology, most of which has been unchanged for decades.

 

I am confident that those who successfully complete training in the Caribbean and who eventually are accepted to residency in Canada (not an easy feat) will be doctors of equal competency as those who train in Canada. Perhaps the "valley girls" known to samsara will never obtain a residency in Canada because samsara was right and they just weren't up to snuff in Canada. This is a risk that they chose to take when they left. Perhaps they will obtain residency in Canada because they simply stink at writing MCQ tests like the MCAT but are incredibly intelligent otherwise. Perhaps it just shouldn't be up to anyone on this board to pass judgement and make generalizations regarding the applications, motives, decisions and suitability to medicine of others who we barely or don't even know.

[Alastriss]

Nice post from the medical post, glad to see canadian grads doing well in the first round. Out of curiosity, anyone know what the stats for IMGs are and/or how they did in the match?

[shoopshoop]

I agree with JewelLeigh that the preclinical years outside the Unites States/Canada that med schools teach is not so "far behind" as many may think so. I am a med student in Jordan and to be honest I am learning all the material on my own...the school only guides us on what to concentrate or if there is anything in particular that you might need an extra hand in understanding e.g. cardio physiology. The preclinical years facilities are terrible here and the vast number of students CANNOT learn anatomy with the help of cadavers(we study from the gross anat books or simply the internet)...but in the end, most of instead of requiring 6 weeks to study for the usmle1/mcq's, its more like 12-16 weeks as the system of exams is different than in Canada/US. Almost all that try for the "lower end" specialties have no trouble getting in...so shouldn't that mean IMG's are not all incapable/incompetent(yes we are weaker at start but in the end it all settles out the same)??

 

okay...i will stop this rant - I hope it makes some sense.

[wildcard]

This is getting a little out of hand samsara. Money does not buy the education...at best it buys the opportunity for education. People who leave Canada to pursue medical education elsewhere still go through years of medical school! It's not like they just hand over their $200k and then are allowed to sign an MD behind their name. Yes, money (via parents or a loan that must be repaid) may be needed to open the door of opportunity, but it is a load of hard work over many years that earns an medical degree.

 

Your rather sweeping generalizations wrt training internationally, particularly in the Caribbean, are to me, a tad insulting. How many people who chose to pursue medical education in the Caribbean have you actually met? Of those who YOU deemed to be "valley girls," how many were accepted to residency in Canada? I personally know 2 current family medicine residents who completed their training in the Caribbean. When compared to residents at the same level who trained in Canada, I found both to be incredibly kind, hardworking, intelligent and knowledgeable.

 

With respect to the quality of international training, much of Caribbean medical school clinical training takes place in the States. For the portion that takes place in the classroom during med 1 and 2, it's laughable to believe the Caribbean is so far behind the rest of North America that it's medical schools can't properly teach the basics of anatomy, physiology and pathophysiology, most of which has been unchanged for decades.

 

I am confident that those who successfully complete training in the Caribbean and who eventually are accepted to residency in Canada (not an easy feat) will be doctors of equal competency as those who train in Canada. Perhaps the "valley girls" known to samsara will never obtain a residency in Canada because samsara was right and they just weren't up to snuff in Canada. This is a risk that they chose to take when they left. Perhaps they will obtain residency in Canada because they simply stink at writing MCQ tests like the MCAT but are incredibly intelligent otherwise. Perhaps it just shouldn't be up to anyone on this board to pass judgement and make generalizations regarding the applications, motives, decisions and suitability to medicine of others who we barely or don't even know.

 

I couldn't have said it any better JL. Right on!!

[samsara]

Jewel, I think you're misconstruing much that I have said. I understand that everyplace has standards for success that are met. I am speaking more to the fact that at some point of time, these individuals did not meet the standards for Canadian schools. This could be for a whole gamut of reasons that can range from poor grades to a bad interview. And of all the people who have chosen the Caribbean that I have met (around 5), all are people who didn't choose to go there as a first option, but rather as a backup. My initial premise was that folks like me...who would have had no backup due to financial issues in the event of a rejection, would get the short end of the stick in this situation. As someone who would have been at the receiving end of having absolutely no backup, I suggested that it is unfair to me and others like me that these individuals- who had lesser marks and MCAT scores than myself (and perhaps others) - would be able to pursue their dreams and goals while I wouldn't. I don't think this is too hard to understand . And as far as the "valley girls" are concerned - they're in their second year, and quite far away from residency. As a side note, I also mentioned that these individuals were intelligent and kind and genial in an earlier post - perhaps you glazed over this portion. You might say though, that I have no right to pass judgment on positive attributes either, and this I would fully respect. I hope I didn't offend you in any case. Secondly, I don't lay claim to judging what makes a good doctor - GPA, MCAT and ad coms do, and if individuals weren't accepted in Canada, then as I mentioned earlier, they were either found lacking in some regard, or maybe even victims of bad luck?

Also, I am aware that Caribbean schools have standards to uphold as well. One individual has informed me that there are exams to be written and done well in otherwise individuals flunk out of these medical schools and the deposit money is retained by the institution. But my argument ihas never been that these people will make bad doctors. It's the way that they're obtaining their education, by money rather than worth. Granted that those who will become residents will only become so by going through stringent selection processes, but again, what is the point of having high standards in this country if they can be bypassed by going someplace else? What is the point of having undergrad kids work their asses off during their bachelor degree years if they can just get bad grades with the knowledge that they can eventually move to a Caribbean medical school, pick up their slack big time and come back and walk shoulder to shoulder with someone who has spent their time being diligent and hardworking? Why have standards if they're not going to be the same across the board for everyone, rich or poor?

[JewelLeigh]

My initial premise was that folks like me...who would have had no backup due to financial issues in the event of a rejection, would get the short end of the stick in this situation. As someone who would have been at the receiving end of having absolutely no backup, I suggested that it is unfair to me and others like me that these individuals- who had lesser marks and MCAT scores than myself (and perhaps others) - would be able to pursue their dreams and goals while I wouldn't. I don't think this is too hard to understand .

Since you do not seem to clearly know what the financial options are for yourself if you were to go abroad, I DO find it hard to understand. I too do not know the policies of Canadian banks on lending money to Canadian medical students studying outside the country...but if they do in fact lend to foreign training Canadians, then your argument stating that only those who are rich can access foreign training is invalid.

 

Why have standards if they're not going to be the same across the board for everyone, rich or poor?

I believe you are miscontruing Canadian medical school admissions to suit your argument. Cut-offs and other parts of the admissions process exist not as "standards" but as a means to narrow down the ridiculously huge field of candidates that schools must consider. It is a matter of resources for medical admissions and not "standards." A perfect example of this is Dalhousie University's Faculty of Medicine.

 

Dalhousie is the only medical school serving the Maritime provinces and thus is mandated to train physicians for these provinces. While still receiving quite a number of applications, Dalhousie has a significantly smaller applicant pool for it's Maritime positions than do most other Canadian medical schools. As a result, Dalhousie has the ability to continue with their very personal process in which every interviewed applicant is discussed by the admissions committee individually before a decision is made. In this context, Dal's cut-offs are significantly lower than most other medical schools (GPA 3.3 and MCAT 24 total) for Maritime applicants.

 

Do Dalhousie's graduates, (who, by your argument, may not meet the "standards" of most Canadian medical schools) perform at a lower level compared to graduates of other Canadian schools when it comes to CaRMS or beyond? No, they do not (http://www.carms.ca). Dal simply recognizes that these "standards" as you call them, are not the only factors that make good doctors for Canada...and unlike most other schools, it has the resources & smaller applicant pool to be able handle their admissions process accordingly. I am sure if given unlimited resources, many other Canadian med schools would adopt similar policies. In fact, I believe that Western has a similar policy for applicants for the underserviced south western Ontario region that it is partially mandated to serve.

 

Even in these situations when all applicant factors and not just academic results are considered, there are STILL more qualified people then there are positions. Medical schools in Canada simply have too many well-qualified applicants for too few positions. As ABbound already said:

 

Are you expecting me to really accept that only 100 out of 3000 applicants are qualified? BS.

I echo this completely!

 

Canadian medical schools do have standards for admission, yes...but they are not as you are trying to imply samsara. Someone who does not gain admission to a Canadian med school has not failed to meet the standard, but has simply failed to be in the top X number of well-qualified applicants for whom there are positions. As someone who has previously been a member of the AdCom for a Canadian medical school, let me assure you that if there were an unlimited number of positions, significantly more applicants would be successful at gaining admission in Canada.

[wildcard]

Since you do not seem to clearly know what the financial options are for yourself if you were to go abroad, I DO find it hard to understand. I too do not know the policies of Canadian banks on lending money to Canadian medical students studying outside the country...but if they do in fact lend to foreign training Canadians, then your argument stating that only those who are rich can access foreign training is invalid.

 

I know for a FACT that RBC (Royal Bank of Canada) has a medical line of credit and as long as you're a Cdn citizen you are eligible for this loan even though you're studying outside the country. I know that numerous students from the US and some from Canada have obtained this loan without any problems. Hence, samsara's recurring argument that only rich people can access foreign training is in fact, invalid.

[The Law]

Jewels, your post sums up my thoughts perfectly.

[leviathan]

I am speaking more to the fact that at some point of time, these individuals did not meet the standards for Canadian schools.

Oh samsara.

 

Canadian medical schools have thousands of applicants and only hundreds of spots available, thus they can raise the standards for admission to levels not reflective of what it takes to be a good physician. If you think you need a 4.0 GPA to be a good doctor, you've been brainwashed by our own system.

 

You have hundreds of students being accepted to Caribbean schools, all with grades which were too low for Canadian acceptance. Some of them were rightfully declined acceptance to Canadian schools because of their GPA. Others were not. What you're not taking into account is the ones who were not accepted to Canadian schools for good reason, end up getting kicked out of their Caribbean medical school by the end of the first year when they fail out of a very challenigng program. There is a VERY high attrition rate at Caribbean schools, because you're right, a lot of those people were rejected from domestic schools for a reason. The rest of them all get that second chance they deserve, they graduate from school, and that is why there is a 99% pass rate on the USMLE licensing exams, and MCCQE exams in Canada for these IMGs.

 

And about the whole concept of leaving these caribbean countries with a medical education and not coming back: those schools are designed for international students, they are FOR profit schools, and they help the economy of those countries.

[samsara]

Jewel, you obviously seem to know this subject in far greater depth than I do...but just to clarify something. Dalhousie's "cutoffs" are by no means unique. The university of Manitoba has in province cutoffs of 3.6 on a 4.5 scale (3.2 on 4.0) and drops as many as 30 of a student's lowest credit hours if the student has completed 120 credit hours or more. MCAT cutoffs are 24N I believe. I'm not sure about the University of Saskatchewan or British Columbia, but if I remember correctly, their cutoffs for in province folks aren't too high either. Also, the average matriculant GPA and MCAT scores at Dalhousie for 2006 ( I just checked) were 3.7 and 30, which are by no means paltry. BC's average GPA was about 83% and MCAT average about 10.21, so Dalhousie is again, by no means unique, and it's matriculants ARE meeting standards or "cutoffs" established across Canada. Call them cutoffs or call them standards, people are still getting in or not getting in on the basis of them. And just to compare, Caribbean school matriculant averages range from 3.2 to 3.4 GPA and 19-26 MCAT ( the upper ends of those averages are St. George's).

Furthermore, I'm still not entirely convinced that there are "too many well qualified applicants". Medical schools choose those who in the eyes of their ad coms are the best of these many "well qualified applicants". In every single facet of life, there are always several "well qualified applicants" and a few who are given the opportunity to showcase said qualifications. Applying for a job for example, there may be tons of "well qualified applicants" and yet only a select few who get it. These select few might have had a good day, other "well qualified applicants" might have had bad days, we can postulate this to the ends of the earth. But ultimately, what I'm getting at is that the ad coms and these "cut offs" serve to select those who their respective universities consider to be the BEST candidates. Is it always fair...definitely not. Do people like myself get lucky? Probably But we've already established that life isn't fair in previous posts so I won't dwell on this much longer.

I myself had asked RBC about LOC's for medical schools outside Canada and was told that it wouldn't be a viable option for me. Guess I just ended up speaking to the wrong people at the wrong time?

Leviathan, I DON'T believe that a 4.0 GPA makes a good doctor - but my beliefs on the university grading schema are enough to fill up another forum, so I won't bring them in here. What I do know however...is that not making these "cut offs" DOES close doors for individuals - regardless of their aptitude/lack thereof for medicine. I'm not sure if your second paragraph was meant to agree with me or not...but the concept of a second chance is present. "The rest of them all get that second chance they deserve" is what I have selective issues with. Perhaps some of them do deserve a second chance...and perhaps, some of them don't. I don't know, and neither does anybody on this forum. But given the nature of these schools, money is what ultimately determines whether they'll get the second chance or not. I would much rather see these second chances given to students so they can stay in Canada - and hopefully the ad coms can serve to weed out those who "deserve" from those who don't (which becomes subject to debate again, because many question whether the ad coms are doing a good job - as I did too when I saw individuals I considered to be excellent future doctors not getting in).

I don't think I've ever spent this much time online before. So, I'll let y'all have the last word, and from there on, I'd personally like to drop this topic. I have my opinions on this subject and they're founded partly on the basis of my experiences, and mostly on the basis of my preconditioning. I've never claimed to be entirely objective here. Many people seem to have very strong opinions on the subject and I respect these opinions as well. Ultimately though, I would like capable, hard working physicians to be serving the masses, and I intend to be one myself. Maybe I don't see eye to eye with several of you on this particular topic, but as long as the condition of good service for humanity is in place, other topics such as the one I'm arguing are relatively unimportant to me.

Thanks everyone, and cheers.

[leviathan]

Furthermore, I'm still not entirely convinced that there are "too many well qualified applicants". Medical schools choose those who in the eyes of their ad coms are the best of these many "well qualified applicants".

So you're saying, out of the ~1500 applicants to UBC, only the 256 who got accepted were worthy, with the exception of a few who were unlucky? You are very misled if that's the case.

 

Leviathan, I DON'T believe that a 4.0 GPA makes a good doctor

Since GPA is one of the primary determinants of whether one will make it into a Canadian school, why do you believe people don't deserve to come back if they go to a Caribbean school because of a low GPA?

 

What I do know however...is that not making these "cut offs" DOES close doors for individuals - regardless of their aptitude/lack thereof for medicine.

Not when they can get their medical education outside of Canada. Whether that's the US, the UK, Caribbean, Australia, or wherever...

 

I'm not sure if your second paragraph was meant to agree with me or not...but the concept of a second chance is present. "The rest of them all get that second chance they deserve" is what I have selective issues with. Perhaps some of them do deserve a second chance...and perhaps, some of them don't.

Who are these people that don't deserve it? Think about the essentials here: Why do medical schools want to see your GPA? Does GPA make you a caring, compassionate doctor? No, it provides evidence that you can handle the demanding educational workload of medical school. So if they deny a student solely because of a low GPA not meeting the cutoffs, they're saying, "sorry, we can't trust that you will succeed in our program as much as we can for the top X students that were accepted." Now if they go to a Caribbean school, graduate with flying colours, pass their Canadian or US board exams with flying colours, are you saying they didn't deserve that? I don't quite follow your reasoning, if you are saying that. When someone is rejected because of their GPA, and they really can't handle the workload, it's not like they can just shell out money and get an MD. No, if their GPA exclusion really meant they couldn't handle medicine, then they are one of the thousands of people who fail out of medical school in international schools. Problem solved!

 

I don't know, and neither does anybody on this forum. But given the nature of these schools, money is what ultimately determines whether they'll get the second chance or not. I would much rather see these second chances given to students so they can stay in Canada - and hopefully the ad coms can serve to weed out those who "deserve" from those who don't

With GPA cutoffs, it's an automatic NO, no matter what. Yeah, I'm one of those who will never even get a chance, because of my GPA. Part of that had to do with a lack of motivation to study a subject I wasn't particularly interested in. Although every course in physiology, anatomy, pathology, or other health sciences I ever took, I got an A+. Every single one. There are lots of people like me in that boat, too. Most of those people end up going to foreign schools. Why do I not deserve that second chance? I'm pretty sure I will excel studying a subject I love. So do I not deserve that second chance which Canadian schools will never offer?

 

Ultimately though, I would like capable, hard working physicians to be serving the masses, and I intend to be one myself.

And capable, hard working physicians are the ones who graduate from any medical school foreign or domestic and pass board exams, so you need not worry.

[wildcard]

I myself had asked RBC about LOC's for medical schools outside Canada and was told that it wouldn't be a viable option for me. Guess I just ended up speaking to the wrong people at the wrong time?

 

You most definitely did. I simply filled out an online application and went into the bank to sign the papers. Guess the stars just weren't aligned in the optimal conformation for you.

 

Funny thing though, after all your arguments....at some point in your education, when you were rejected you did consider 'buying' a non-Canadian substandard (in your eyes) education that would eventually allow you to 'unethically' 'sneak' past the the ad coms and become a physician in Canada....since its so easy to return to Canada as an 'incompetent' physician from a non-Canadian school.

 

"I'll let you have the last say"

 

How noble of you.

 

Cheers

[Alastriss]

Samsara, I mentioned this way before you posted, I was directing it towards someone else who was saying that IMGs can walk back shoulder to shoulder..i said..they don't walk back..they run a military obstacle course...check carms statistics for that.

 

And no, not everyone who doesn't make it isn't qualified. A lot of people with 4.0s and 35+ mcats and great ECs get rejected one way or another, and I dare not say that these people might not be qualified. Maybe they are not good at interviews or can't be eloquent and poetic in their PS, but I wouldnt say not qualified!

 

But what i mean to say, there is a lot of luck involved..go to UBC forums and read how the NAQ score of people changes from year to year when they don't improve their ECs. Med schools pick the best of the best, but just cuz ur not the best of the best doesn't mean your not qualified. Its just downright awful to say that if you don't make med school your not qualified period.

Example: a prof was looking for a lab assistant, NOT a student that will do a project and maybe get an abstract/publication. This assistant job is pretty much emptying bleach buckets, making solutions, buying solvents, etc. ~ 50 would apply, but 1 would get. Are you telling me that the 49 others aren't qualified to do simple tasks? Absolutely NOT! its just a matter of seat numbers

 

Med school is similar in these respects. here is a simple demonstration, many people try again, and they get in for a second attempt. If they didn't get in from the first are they just not qualified? No definetely not; this could mean that they weren't qualified before, and they are now..but then qualification can be acquired..so who's to say that those that go to carrib may not become "qualified" by the time they actually practice?

What abot people who get in somehewre and get flat out rejected from other schools? wouldn't that mean that getting an offer goes beyond having a black and white view of qualification?

 

I forget where my friend got this quote, it was what a med school ad com said...500 students would interviewed. 250 would have been great doctors, but only 125 chosen or something along those lines..i forget the exact numbers

 

Is it fair to those people who are qualified to get in but didn't due to luck or chance to not use their own resources to go to another medical school? No its not?

But is it fair to people who are not financially capable to formulate a plan B to suffer while others who have backups can get to their hopes and dreams? absolutely not, and i sympathize with you genuinely.

 

Whats the objective here? I can only see it going to suggesting that if one person can't go to the carrib for med school, then no one can.

but if we're going to take that route, then why don't we let no one go to undergrad if everyone cant, or let no one drive a nice car if not everyone can.

This leads to civilization advancement coming down to a grinding halt.

 

other than that, If you want financially incapable people to be recognized and acknowledged, then I wholeheartedly am doing so right now. It is unfortunate that the world is like this... makes me want to slap Adam smith's invisible hand. Some sort of policy or action would be very appropriate to address this issue.

 

 

I am very much enjoying this!

 

 

ps..I thought carrib schools were similar in terms of tuition to canadian schools, no? how much more are they?

[Zuckman]

I'll have to agree with what Leviathan has said.

 

Zuck

[Zuckman]

Also, I'd like to add...There are many physicians in Canada who have been trained abroad (UK, South Africa are really common) who work as specialists. I have been treated by a few of them and they are tremendous in their skills. How can anyone say these people are underqualified!!! Give me a break.

 

Also, is it really that practical to try 6-7 times in Canada if one could much more easily go abroad? I guess this depends on the person...but for me the answer is 'no'. For some, it is 'yes' and that's fine too. For me, I'm willing to try a couple of more times in Canada.

 

I've said it before and I'll say it again...I've seen very unqualified people get into Canadian med schools and very qualified ones get rejected. Unqualified to me means either horrible bed side manner or just above average grades or both. I know one person who got into uOttawa Med and the person's average was 3.61 (lived in Ottawa so it passed), MCAT of 23 (yes, I know Ottawa doesn't look at MCAT but still...this person can't be too bright), and lied on the sketch...all my friends were stone-faced when we found out she got in. All I can say is that I've lost a lot of respect for the admissions process in Canada.

 

Samsara, I respect your opinion...but the premises you base your argument on are sooo misaligned. I can elaborate a lot on this but Leviathan did a good job. Samsara you say "I would like capable, hard working physicians to be serving the masses, and I intend to be one myself"

Trust me, people being trained abroad will be just as capable as you...if not more capable.

 

Zuck

[Bittersweet]

As a Canadian resident, who has applied to medical school in Canada, and was waitlisted, I can completely understand why some Canadians choose to go abroad to complete their medical education. It is not because they are looking for an easy way out, or to 'buy their education'.

Although I intend on re-applying, I am 36, and do not have years to wait. I am a health care professional, who is considered a competetive applicant (GPA, etc), however for whatever reason, I was not accepted this year. I was accepted to 2 schools in the Carribean, and intend on attending one. I do not come from a wealthy family, and am willing to be in a ridiculous amount of debt to attain my dream.

 

As for the assumption that 'anyone can get into the Carribean', that is a ignorant comment. As future physicians, I strongly suggest you be careful not to generalize like that.

Yes there are many international schools to be wary about, but lumping all foreign schools together like that is a dangerous assumption.

 

Any school that does not require undergraduate marks, GPA, and a thorough screening process / interviews, is in all probability, not accredited. Why would anyone want to attend one of these universities?

 

It is the applicants responsiblity to research the schools' accreditation and reputation before applying. Recognition by the ECFMG and WHO, is increadibly important, but does not guarantee Canadian recognition / school accredition. Applicants should do alot of research regarding eligibility for MCCEE, their schools accreditation within Canada, and Canadian elective / core rotatiions.

Most Carribean (Irish, etc) schools require MCAT marks, and a minimum 3.50 for their applications to even be processed. Yes they require information on how finances will be arranged, but that is for their protection; why would they risk accepting international students who are not able to afford tuition?

 

I am not happy about leaving Canada to further my education, however I am willing to do whatever it takes (including financial hardship, and being seperated from family). Yes I will re-apply to Canadian schools while overseas, because I believe Canadian medical ecucation is among the best in the world.

 

However, after working in health care for over a decade, I am also not naive enough to think it is the 'end all be all'.

I currently work with many different physicians from all over the world, and all agree that the North American health care system has a certain ignorance about it. Many of the Canadian physicians I work with, chose to go abroad to do extra training, as they feel that the rest of the world has much to offer in terms of medical research / training.

 

Certainly working in such a multicultural environment has opened my eyes, as all the Canadian graduates and foreign graduates respect each other and work cohesively without any superiority complex. It has not only given me a more informed opinion, but a new perspective. The Canadian system does have a high standard (which I believe in), but there is an accreditation process with foreign schools that must be trusted, so all physicians can work together and learn from each other.

[wildcard]

As a Canadian resident, who has applied to medical school in Canada, and was waitlisted, I can completely understand why some Canadians choose to go abroad to complete their medical education. It is not because they are looking for an easy way out, or to 'buy their education'.

Although I intend on re-applying, I am 36, and do not have years to wait. I am a health care professional, who is considered a competetive applicant (GPA, etc), however for whatever reason, I was not accepted this year. I was accepted to 2 schools in the Carribean, and intend on attending one. I do not come from a wealthy family, and am willing to be in a ridiculous amount of debt to attain my dream.

 

As for the assumption that 'anyone can get into the Carribean', that is a ignorant comment. As future physicians, I strongly suggest you be careful not to generalize like that.

Yes there are many international schools to be wary about, but lumping all foreign schools together like that is a dangerous assumption.

 

Any school that does not require undergraduate marks, GPA, and a thorough screening process / interviews, is in all probability, not accredited. Why would anyone want to attend one of these universities?

 

It is the applicants responsiblity to research the schools' accreditation and reputation before applying. Recognition by the ECFMG and WHO, is increadibly important, but does not guarantee Canadian recognition / school accredition. Applicants should do alot of research regarding eligibility for MCCEE, their schools accreditation within Canada, and Canadian elective / core rotatiions.

Most Carribean (Irish, etc) schools require MCAT marks, and a minimum 3.50 for their applications to even be processed. Yes they require information on how finances will be arranged, but that is for their protection; why would they risk accepting international students who are not able to afford tuition?

 

I am not happy about leaving Canada to further my education, however I am willing to do whatever it takes (including financial hardship, and being seperated from family). Yes I will re-apply to Canadian schools while overseas, because I believe Canadian medical ecucation is among the best in the world.

 

However, after working in health care for over a decade, I am also not naive enough to think it is the 'end all be all'.

I currently work with many different physicians from all over the world, and all agree that the North American health care system has a certain ignorance about it. Many of the Canadian physicians I work with, chose to go abroad to do extra training, as they feel that the rest of the world has much to offer in terms of medical research / training.

 

Certainly working in such a multicultural environment has opened my eyes, as all the Canadian graduates and foreign graduates respect each other and work cohesively without any superiority complex. It has not only given me a more informed opinion, but a new perspective. The Canadian system does have a high standard (which I believe in), but there is an accreditation process with foreign schools that must be trusted, so all physicians can work together and learn from each other.

 

Very well put. I especially agree with the last paragraph.

 

Good luck in the Carribean!! Apart from the education, I've heard that its a great learning environment!!