IMGs first round

[leviathan]

Canadian schools take the cream of the crop, and thus they have a very low attrition rate because they work hard to keep their students in the program, and the students in general are all very hard working to have been accepted. Caribbean schools have a high attrition because a lot of those people who didn't get into Canadian schools were rejected for a good reason. The ones that don't get kicked out were rejected for a wrong reason, and deserve a second chance. With that second chance they prove everyone wrong by successfully completing the program and scoring well above their Canadian graduate counterparts on the board exams. Yes, they have to outperform everyone else to prove they are worthy.

 

So $$$ will not buy you an MD, but hard work will. This is ESPCIALLY the case if you're wading through a minefield to get back to Canada by going to an international school.

[Prime]

There's no doubt that many would-be doctors are turned away each year because their applications did not meet the standard set by the Canadian faculties of medicine to which they applied. However, with few exceptions, most matriculants will make excellent physicians. This is in response to a poster posting a story about an applicant who lied on her application and was accepted nonetheless. Such errors persist in any system designed to stratify and weed out people and the existence of said errors does not invalidate the admission process.

 

As I see it, Canadian applicants work hard to get into Canadian medical schools. Success in the form of an acceptance letter comes more easily for some (i.e. the first try) than others who may have submitted applications for years before they are finally accepted. When one applies to Canadian medical schools one does so without any guarantee of acceptance. Applying to Caribbean schools is not so unreliable, so there is less uncertainty about getting in. But that bypasses what I believe is an instructive lesson in 1. patience and 2. learning to tolerate ambiguity; both desirable qualities in a physician. And so, in regards to IMGs who are Canadians choosing to study at an international institution, I ask: 'why the hurry?' If your desire is strong and pure enough, why not get into a school in Canada and demonstrate that you have a strong commitment to staying in this country because you persevered and succeeded?

 

I'll keep it short and address the issue of physician shortages. Somewhat echoing another poster's sentiments, I believe that we need a more permanent solution and less band-aids for the problem of physician shortages. Certifying IMGs en masse is not a long-term solution; increasing the number of seats in medical school, as well as residency positions, is the key, coupled with a focus on retention of graduates.

 

On a final note, dare I point out to all the capitalists that a professional shortage is a desirable state of being for any profession. A physician shortage only ensures that you needn't worry about a steady stream of patients. Just thought I'd point out that you needn't complain and whine so much; there are plenty of folks out there to bi*ch about a physician shortage for you.

[The Law]

I ask: 'why the hurry?' If your desire is strong and pure enough, why not get into a school in Canada and demonstrate that you have a strong commitment to staying in this country because you persevered and succeeded?

 

While I agree with most of what you said, I can't help but ask -why wait, if you know that this is what you want? You know it's going to take a very long time, so you might as well get a head start on it. In the end, saving a few years may make a big deal if one plans on starting a family and what not. If a school is accredited, there is no reason not to go to it. While it may seem so idealistic to wait it out and "persevere" through the great uncertainties of the Canadian med school admissions process, this raises a question on this notion's practicality.

[Alastriss]

There's no doubt that many would-be doctors are turned away each year because their applications did not meet the standard set by the Canadian faculties of medicine to which they applied. However, with few exceptions, most matriculants will make excellent physicians. This is in response to a poster posting a story about an applicant who lied on her application and was accepted nonetheless. Such errors persist in any system designed to stratify and weed out people and the existence of said errors does not invalidate the admission process.

 

As I see it, Canadian applicants work hard to get into Canadian medical schools. Success in the form of an acceptance letter comes more easily for some (i.e. the first try) than others who may have submitted applications for years before they are finally accepted. When one applies to Canadian medical schools one does so without any guarantee of acceptance. Applying to Caribbean schools is not so unreliable, so there is less uncertainty about getting in. But that bypasses what I believe is an instructive lesson in 1. patience and 2. learning to tolerate ambiguity; both desirable qualities in a physician. And so, in regards to IMGs who are Canadians choosing to study at an international institution, I ask: 'why the hurry?' If your desire is strong and pure enough, why not get into a school in Canada and demonstrate that you have a strong commitment to staying in this country because you persevered and succeeded?

 

I'll keep it short and address the issue of physician shortages. Somewhat echoing another poster's sentiments, I believe that we need a more permanent solution and less band-aids for the problem of physician shortages. Certifying IMGs en masse is not a long-term solution; increasing the number of seats in medical school, as well as residency positions, is the key, coupled with a focus on retention of graduates.

 

On a final note, dare I point out to all the capitalists that a professional shortage is a desirable state of being for any profession. A physician shortage only ensures that you needn't worry about a steady stream of patients. Just thought I'd point out that you needn't complain and whine so much; there are plenty of folks out there to bi*ch about a physician shortage for you.

 

Nice Post!

 

A few things..what need is there to demonstate that you can do it? that is not the goal, the goal is ultimately to become a physician period and for those who want to have families early, why wait? Sure it will carry weight and it has novelty value, but many people will say that the novelty of it wears off too fast for it to be worth the effort...so to some your goal might seem completely trivial, not to me, but to some.

 

Secondly, certifying IMGs is one way we can solve the problem.

I think what they are trying to do is increase residency seats. It is easier to increase residency seats than medical school seats. Increasing med school seats means the government bears the costs of funding for the 4 years before getting an MD since most of the tuition is government subsidized. If you let students who go to the US (where they themselves carry the burden of the cost for the most part) or to an international country where their government/the student bears the cost and then allow them to come back for residency, its cheaper for canada cuz theyre getting people with MDs ready to go without have had to invest money to get them to that stage and thus more seats can be made available.

 

Your right, shortage is desirable, but that's depending on the magnitude of shortage. As you have put it, there are enough people that will whine and bicker about it and rightfully so, because the shortage that does exist has gone beyond desirable.

[leviathan]

And so, in regards to IMGs who are Canadians choosing to study at an international institution, I ask: 'why the hurry?' If your desire is strong and pure enough, why not get into a school in Canada and demonstrate that you have a strong commitment to staying in this country because you persevered and succeeded?

But that doesn't make much sense. Some people will not gain an acceptance no matter how much they "perservere", so it's not a question of patience. For others, there is a hurry because every extra year they wait is one less year of salary before they have to retire. That adds up very quickly. And if option B gets them to the same endpoint but quicker (which international schools in reality will do for very few people), then there is no logical reason to wait.

[Prime]

But that doesn't make much sense. Some people will not gain an acceptance no matter how much they "perservere", so it's not a question of patience. For others, there is a hurry because every extra year they wait is one less year of salary before they have to retire. That adds up very quickly. And if option B gets them to the same endpoint but quicker (which international schools in reality will do for very few people), then there is no logical reason to wait.

 

I don't buy the notion that there are people who won't gain an acceptance no matter how hard they try. It's entirely up to each applicant how long they wish to spend improving their application. But if you choose to abandon the endeavor and go abroad then don't expect any sympathies, especially if you wish to get into Medicine earlier because you wish to start earning a physician's salary that much sooner.

 

On another note, I believe there's a high correlation, which I can't, of course, support with hard numbers, between those attending medical school abroad (be it Ireland, the Caribbean or elsewhere) and higher than average family income. It just seems counter-intuitive that there exist very many people barely making ends meet who walk into a bank for a LOC so they can go abroad.

[NLengr]

Secondly, certifying IMGs is one way we can solve the problem. I think what they are trying to do is increase residency seats. It is easier to increase residency seats than medical school seats. Increasing med school seats means the government bears the costs of funding for the 4 years before getting an MD since most of the tuition is government subsidized. If you let students who go to the US (where they themselves carry the burden of the cost for the most part) or to an international country where their government/the student bears the cost and then allow them to come back for residency, its cheaper for canada cuz theyre getting people with MDs ready to go without have had to invest money to get them to that stage and thus more seats can be made available.

 

The downside of course is that Canadian grads are trained in Canada in schools that are set up to follow Canadian guidelines and policies, and are overseen by Canadian associations. We know exactly what we are getting out of the Canadian medical school system. Foreign schools, not so much.

 

The cost savings for the government, IMO, does not outweigh the advantages to training physicians at home. Most Canadians would rather spend the extra cash to train our physicians in Canada.

 

As I have said before, the best solution to the physician shortage is not to rely on foreign trained personnel. It is to assess out future needs, and increase medical school enrollment, as well as residency slots, to meet those needs.

[Alastriss]

The downside of course is that Canadian grads are trained in Canada in schools that are set up to follow Canadian guidelines and policies, and are overseen by Canadian associations. We know exactly what we are getting out of the Canadian medical school system. Foreign schools, not so much.

 

The cost savings for the government, IMO, does not outweigh the advantages to training physicians at home. Most Canadians would rather spend the extra cash to train our physicians in Canada.

 

As I have said before, the best solution to the physician shortage is not to rely on foreign trained personnel. It is to assess out future needs, and increase medical school enrollment, as well as residency slots, to meet those needs.

 

 

Point made and well said and I agree with you. Remember that one strength of relying on foreign trained personel is that with a relatively large pool of applicants, we can be picky in who we admit, and surely there are doctors out there who are as strong as canadian doctors. I personally, know of some great doctors that are from Iraq. Other posts have been made about how many people have seen foreign doctors (one example off the top of my head - south africa) have actually been more knowledgeable than canadian doctors.

 

What I would like to see happening is assigning a team of doctors with the responsibility of assessing strengths and weaknesses of medical educations in popular international schools in the UK, south africa, Ireland, Carribean, etc.

 

You raised an excellent point when you mentioned that we know what we are getting out of a canadian medical school and not so much about foreign medical schools, but I think that making an effort to actually get out there and find out may prove to have benefits on many levels.

[Dwayner]

Howdy...

I am sure this can be a touchy issue for some. I just had a few comments.

I agree with a patience and perseverence comment.

I think that patience will be needed regardless. Either deal with it before your degree or after, but it will have to be dealt with. Doing the degree abraod and returning will require not only patience, but likely comprimise too. It is not easy to come back and do what you want, where you want - with respect to residency. You know what I mean - do you want the headache now or later. For me the residency is more important so I was willing to apply several times to a Canadian school...

Also... Training IMG's is very expensive for the government! Here in Vancouver St. Paul's hospital has 18 residency spots each each year, 12 of those family. There is a long and competative process for these individuals and it is expensive! I think that to train one IMG in family (2 years) here at St Paul's costs the government around 200,000 dollars. I was reading on this yesterday. I would think that it may cost less to put one person though medical school...

food for thought.

cheers

d-wayner

[Alastriss]

Howdy...

I am sure this can be a touchy issue for some. I just had a few comments.

I agree with a patience and perseverence comment.

I think that patience will be needed regardless. Either deal with it before your degree or after, but it will have to be dealt with. Doing the degree abraod and returning will require not only patience, but likely comprimise too. It is not easy to come back and do what you want, where you want - with respect to residency. You know what I mean - do you want the headache now or later. For me the residency is more important so I was willing to apply several times to a Canadian school...

Also... Training IMG's is very expensive for the government! Here in Vancouver St. Paul's hospital has 18 residency spots each each year, 12 of those family. There is a long and competative process for these individuals and it is expensive! I think that to train one IMG in family (2 years) here at St Paul's costs the government around 200,000 dollars. I was reading on this yesterday. I would think that it may cost less to put one person though medical school...

food for thought.

cheers

d-wayner

 

 

just a few things to say...200,000 dollars may be more than what it cost to put one person through medical school..but what you need to look at is cost of medical school + cost of residency which should be <200,000 dollars to make a valid comparison.

Can you explain further why it would cost to train the IMG more than it would cost to train a canadian medical graduate? all things considered equal?

[Dwayner]

sure

good point... I guess not everyone else read what I had yesterday.

1 - do not forget students still pay 60,000. so there education would need to 260,000 for what we are talking about. though they can not really be compared.

2 - So the hospital gets near 100 IMG applicants that pass all the preliminary screening processes (Not sure how many apply). These applicants then write a paper exam (like an ee) and 35 are chosen. Now those 35 then take part in a 3 month! clinical evaluation. They work for 3 months and get paid and are continuously being evaluated by nurses, physicians, ect. As you can see this requires a lot of fiscal resources... The figure is around 200,000 dollars per successful applicant. There are a max of 18 seats for those 35 applicants - often they can not find 18 people that are suited for the positions.

 

However....

This is training IMG and screening preresidency.

Practising physicians from the UK, Aus, and the US are different. They just come here and practice... Often the must start rural, but whatever. The financial burden on the governemt is not nearly as high. But.... this is an pretty big ethical issue.

Physicians per 1000 people (apprx)

canada 2.1

us 2.5

sweden 4

south africa .7

There are about 3000 doctors needed in south africa and there are like 2000 south african doctors in canada... is that ethcal.

 

Hope that was a little helpful. I am little busy at work and am just typing quickly - not sure if this makes sense.

I did have a long converstation with my cooworkers yesterday about this (IMG's applying for this hospital residency program)...

anyway - sticky situation

dw

[leviathan]

I don't buy the notion that there are people who won't gain an acceptance no matter how hard they try.

Well, I can easily give you one example. GPA cutoffs. If you don't make it, it's over for you instantly. You could go back and do more school, but if there's nothing you can study which you will do well in other than medicine, then it's a dead end for you and you would never improve your GPA.

 

It's entirely up to each applicant how long they wish to spend improving their application. But if you choose to abandon the endeavor and go abroad then don't expect any sympathies, especially if you wish to get into Medicine earlier because you wish to start earning a physician's salary that much sooner.

I don't think anyone here asked for sympathy; I think the only request was to abandon this haughty sense of entitlement that some people are displaying in regards to qualified foreign physicians trying to enter Canada.

 

On another note, I believe there's a high correlation, which I can't, of course, support with hard numbers, between those attending medical school abroad (be it Ireland, the Caribbean or elsewhere) and higher than average family income. It just seems counter-intuitive that there exist very many people barely making ends meet who walk into a bank for a LOC so they can go abroad.

For medical school, the banks are usually treating you as a first class customer and giving you what you need to get your education. I'm not experienced in that regard though, so I could be wrong.

[Prime]

Well, I can easily give you one example. GPA cutoffs. If you don't make it, it's over for you instantly. You could go back and do more school, but if there's nothing you can study which you will do well in other than medicine, then it's a dead end for you and you would never improve your GPA.

 

 

I don't think anyone here asked for sympathy; I think the only request was to abandon this haughty sense of entitlement that some people are displaying in regards to qualified foreign physicians trying to enter Canada.

 

 

For medical school, the banks are usually treating you as a first class customer and giving you what you need to get your education. I'm not experienced in that regard though, so I could be wrong.

 

With the wide variety of schools in Canada, all with slightly different cutoffs, surely there's one school an applicant can apply to by boosting a deficient portion of his or her application. If you want to go abroad to do your medical degree, then why not do residency there instead of complaining about how the system here works against IMGs? If anything the sense of entitlement seems to be in reverse. You can see this reflected in sensational media stories like those of the man, a doctor in his home country, forced to drive a taxi in Canada. I'm sorry, but enough of the sob story already.

 

If you're a Canadian citizen, then you're entitled to certain benefits and perks by holding the status of citizen. So you bet I support Canadian medical graduates receiving priority in residency match.

[Alastriss]

With the wide variety of schools in Canada, all with slightly different cutoffs, surely there's one school an applicant can apply to by boosting a deficient portion of his or her application. If you want to go abroad to do your medical degree, then why not do residency there instead of complaining about how the system here works against IMGs? If anything the sense of entitlement seems to be in reverse. You can see this reflected in sensational media stories like those of the man, a doctor in his home country, forced to drive a taxi in Canada. I'm sorry, but enough of the sob story already.

 

If you're a Canadian citizen, then you're entitled to certain benefits and perks by holding the status of citizen. So you bet I support Canadian medical graduates receiving priority in residency match.

 

Lol of course prime..no one can, and no one has here at least made an argument that canadian medical graduates shud not receive priority because we have an obligation towards them

 

One school is not enough, is there even a school that has a 50% chance to get in once you reach the interview stage? if its not even 50% then its not expected that you would get in.

Also people who study abroad and want to come back have every right to, they just don't have a right to complain about why theyre not shoulder to shoulder with Cdn med graduates, which it may seem on paper (now that they are allowed in the first rounds) but in reality it is not. They also lose the right to complain about how hard it is.

 

ahh yes, teh doctor who's now a cab driver. Me knowing of many who are in that situation, i do think that they should be given a chance to prove their worth at least, not deny them the opportunity to practice right off the bat.

but what i have just said has many complications (ie takes away resources from cdn graduates, etc)

[NLengr]

Well, I can easily give you one example. GPA cutoffs. If you don't make it, it's over for you instantly. You could go back and do more school, but if there's nothing you can study which you will do well in other than medicine, then it's a dead end for you and you would never improve your GPA.

 

It's EXTREMELY unlikely that you can't do well in anything but medicine. There is at least a broad category of areas that you should be able to do well in if you can do well in medicine.

 

If you can't pull off a high enough GPA in an area of study, you wash out of the application process. Sounds tough on some people, but that's the way the world is. We expect our physicians to have demonstrated a certain level of academic accomplishment prior to starting medical training.

 

The only other way to do it is use the engineering approach. Let in huge numbers and intentionally fail out 50%-70% of the class. But that method is expensive and has it's own downsides. Either way the person who can't pull the marks ends up washed out (this way is even harsher to them then the current med school selection process).

[leviathan]

If you can't pull off a high enough GPA in an area of study, you wash out of the application process. Sounds tough on some people, but that's the way the world is. We expect our physicians to have demonstrated a certain level of academic accomplishment prior to starting medical training.

This is exactly the arrogant thinking that I'm talking about. You expect a certain level of accomplishment prior to medical training for WHAT reason? I'll fill that blank in for you. It's because you want to make sure the students in that class do not drop out of the program. If they can succeed in a foreign school and pass board exams, then they have proven that there was no good reason they were rejected from a domestic school. Many others who go down the IMG route fail out and were rightfully declined from a domestic school, so it's not even an issue for those folks.

 

 

The only other way to do it is use the engineering approach. Let in huge numbers and intentionally fail out 50%-70% of the class. But that method is expensive and has it's own downsides. Either way the person who can't pull the marks ends up washed out (this way is even harsher to them then the current med school selection process).

Precisely what happens when they go to a foreign school. Annnnnd I think we beat this dead horse for long enough.

[NLengr]

This is exactly the arrogant thinking that I'm talking about. You expect a certain level of accomplishment prior to medical training for WHAT reason? I'll fill that blank in for you. It's because you want to make sure the students in that class do not drop out of the program. If they can succeed in a foreign school and pass board exams, then they have proven that there was no good reason they were rejected from a domestic school. Many others who go down the IMG route fail out and were rightfully declined from a domestic school, so it's not even an issue for those folks.

 

There was a perfectly good reason they were rejected. They were not ranked high enough in the applicant pool to be offered a seat. They may be capable of handling the program, but the fact is they were rejected because the committee felt there were other applicants who were more desirable for the limited seats available. Applicants are told when they apply that it is a competitive process, and they will take the people they consider the best for the seats.

 

You're right though, this has gone on long enough. I still think I have the best idea for increasing doctors in the country. Open more medical school and residence seats (less quality applicants will have to go IMG then). Train our own people from the ground up. The investment is worth it.

[Prime]

I think it's right to expect a certain level of accomplishment from a student prior to start of medical school. In Canada that accomplishment is academic, yes, but also one based on personal development. I support the fact that Medicine is not a direct entry program here like it is in some other countries where students go into med right out of high school. I believe that such students, generally, aren't at the right maturity level.

[leviathan]

There was a perfectly good reason they were rejected. They were not ranked high enough in the applicant pool to be offered a seat. They may be capable of handling the program, but the fact is they were rejected because the committee felt there were other applicants who were more desirable for the limited seats available. Applicants are told when they apply that it is a competitive process, and they will take the people they consider the best for the seats.

 

You're right though, this has gone on long enough. I still think I have the best idea for increasing doctors in the country. Open more medical school and residence seats (less quality applicants will have to go IMG then). Train our own people from the ground up. The investment is worth it.

I'm not even sure what you're trying to debate, because the controversial topic was whether or not IMGs deserve to come back and work here if they couldn't get into a Canadian school. Maybe I misunderstood you.