Guest UTMed07 Posted December 21, 2004 Report Share Posted December 21, 2004 Preamble ----------------------- In Canada, getting in medical school is tough, especially if you are in Ontario, and many good candidates (that would make fine physicians) do not manage to gain an offer of admission. Many unsuccessful candidates look elsewhere in the pursuit of their dream. This guide explores some of the options out there and pulls together some collected wisdom and a few links. I hope that this guide will do two things (1) show people that there are a few feasible options for excellent candidates Canadian med schools didn't have a place for, and (2) make people aware that there are a number of dubious for-profit medical schools that will take your money and are unlikely to lead to certificate of registration in Canada. Older versions of this document are further down in the thread. This post is the most up-to-date. See the "Edited by: UTMed07 at:" date at the bottom to ascertain when it was last up-dated. Summary of Options ----------------------- United States of America - not considered as 'foreign' by Canadian medical colleges (licensing bodies) Pros - most like Canada - same accreditation body (LCME), re-entry into Canada easiest Cons - high tuition ($30,000 US/year), US health care culture (?) Caribbean Schools Pros - low tuition ($5-27K US/year), low cost of living, schools designed for re-entry into the US Cons - many considered dubious (cater to US medical school rejectees) Irish Medical Schools Pros - good schools Cons - high tuition (22,325 Euro/year) Australia & New Zealand Pros - good schools Cons - high tuition ($25,000-35,000 AU/year), far away Eastern European Schools Pros - many well established schools, low tuition, some schools offer programs in English Cons - need to learn a new language, adjustment to a different culture Others? Understanding Licensure (in Canada) ----------------------- To practice medicine (independently) in Canada one needs a certificate of registration (also known commonly as a "license"). Certificates of Registration are granted by the provincial medical colleges. In Ontario the licensing body is the CPSO (College of Physicians & Surgeons of Ontario). Licensure (for Ontario) is described here. A list of other provincial licensing bodies is found here. Ontario is generally considered to be the most difficult place to obtain a Certificate of Registration (if one has done medical school outside of the USA and Canada). My advice - read the rules from the source. Dubious Medical Schools ----------------------- There are a significant number of dubious medical schools. They feed off of people that dream of medicine, but could not gain admission in Canada and the US. If you are considering a foreign medical school I urge you to do some research. The American Association of International Medical Graduates (AAIMG) is worth a look. However, I do NOT think the AAIMG is credible. That said, it is probably illustrative of what some of the Caribbean schools are like and that sometimes things in Caribbean aren't above the board. Another site worth checking is the World Health Organization. They maintain a list of medical schools based on submissions of the national governments. If a medical school in a country does not appear in the World Directory of Medical Schools it is not recognized as a medical school by the government in that country. The Canadian Federation of Medical Students (CFMS) has the following warning: Applicants should be aware that enrolling in dubious, proprietary, for-profit medical schools opened specifically to cater to rejected applicants to medical schools in Canada or the USA is highly unlikely to be a path to practicing medicine in Canada. [boldface is CFMS'] Cost ----------------------- Foreign medicals schools can be expensive. Tuition in the US is around $30,000 US/year. Data from the American Association of Medical Colleges (AAMC) for public schools is here (2003 data), private schools is here (2004 data). If you assume the cost of living is $10K/year (not a conservative estimate) after four years your wallet is missing $160,000 US. Irish schools are 22,365 Euros/year. With the current exchange rate (1 Euro = 1.34 US dollars) -- the cost is not much different than US schools on a per year basis. Overall they are more expensive, as medical school (for someone with advanced standing) in Ireland is five years. Is Australia a tuition heaven? No. The Australian Medical Students Association seems to be fighting the same battle Canadian medical students (outside of Quebec) are fighting. An Australian Medical Students Association page explains - ...international medical students which start at $25,000 [AU]/year and are up to $35,000 [AU], the cost of a full-fee paying degree in medicine is likely to cost a minimum of $100,000 [AU] and probably closer to $175,000 [AU] or more. Monash University is one school I took a closer look at. They charge $34,000 AU. Current exchange rates show the Australian dollar is about 6% lower than the Canadian one. Medical school in Australia is not a cheap option. New Zealand doesn't appear to be cheaper. In Auckland the domestic fees are $9856 [NZ]... the international fees aren't listed. How can one pay for medical school? ----------------------- (1) Loans - CanHELP, BMO Financial + others. (2) The MD/PhD option. If you like research this may be the way to go. A general description is here. Admissions is competitive. One school that lays it out on their web page is Upstate University - Students admitted to the program with full funding support receive tuition remission and a stipend for the period of their training. During all years of training, the stipend totals $19,282/year.(3) Wealthy parents and/or relatives. Closing Comments ----------------------- If you do medical school outside of Canada there is no guarantee you'll be able practice medicine here. The Canadian Federation of Medical Students has the follow statement: Although Canadian citizens will always have the right to return to and work in Canada, Canadians contemplating enrolment in a foreign medical school should know that any limitations on recognition of foreign earned MDs apply to qualification earned abroad by citizens AS WELL AS BY NON-CITIZENS of Canada. Strong motivation, determination and adequate academic preparation are in themselves NO GUARANTEE that a Canadian citizen who attends a foreign medical school will be able to train or practice medicine in Canada in the future. The reality is not pretty. Medical education abroad is associated with risk and can be very expensive. Selected Links ----------------------- - Irish Medical Schools - a page describing the Irish Medical Schools. - Australian Medical Council - the accreditation body for medical schools in Australia & NZ. A list of medical schools. - IMG Ontario - describes the process International Medical Graduates must go through to get a Certificate of Registration. - ValueMD.com - a discussion board that specializes in Caribbean and other foriegn medical schools for people hoping to practise in the USA. It claims to be "the best site for answering your questions about medical school education." - CaribbeanMedicine.com - a page written by a Canadian medical school post-interview rejectee that went to the Caribbean for med school. I think the Open Letter he wrote is worth skimming through. - Large numbers of would-be Canadian MDs migrating Down Under - CMAJ, Oct 29, 2002; 167(9). - Shut out at home, Canadians flocking to Ireland's medical schools - and to an uncertain future - CMAJ, Mar 21, 2000; 162(6). Afterword ----------------------- Why did I write this? I had some difficult getting in to med school and explored other options. I think it is important to understand what options are out there and what the limitations and difficulties associated with them are. I feel that some people who dream of practicing medicine in Canada are conned out of a lot of money and given false hope. Who am I? I'm the author of the (unofficial) UT Meds Admissions FAQ. As my login suggests, I'm a medical student at the University of Toronto. God and faculty willing, I'll be graduating in 2007. Link to comment Share on other sites More sharing options...
Guest AusMeds Posted December 22, 2004 Report Share Posted December 22, 2004 UTMed07, This is an excellent guide and I am certain that many will appreciate your efforts in pulling it together!! I would like to add to the body of knowledge with some information that documents "How Can I Return To Canada?" This was written from the perspective of returning from an Australian School; however, it likely applies equally to Irish schools. Grads of US Schools will have the additional benefit of being able to apply to the first round of CARMS making their re-entry somewhat easier. Grads of other foreign schools will generally have a tougher time with the probability of success highly dependent on the reputation of the school, scores on relevant board exams, the country of study and citizenship of the student. At any rate, here is my understanding of the available options for a Canadian graduate of an Australian medical school to return to Canada. I invite anyone to clarify, correct or add to the information below. Path 1: Match to a Canadian Residency Program through CARMS IMG's can apply to Canadian residency programs in the second round of CARMS (http://www.carms.ca). To qualify, you must successfully pass either the Medical Council of Canada Evaluating Exam (http://www.mcc.ca) or Part 1 of the Medical Council of Canada Qualifying Exam. This is a tough route to take as there is high demand for a very limited number of residency positions that are still open after the first round. Being acepted to a Family Practice residency program (especially in a rural area) is a little easier than the competitive specialties which are nearly impossible. Path 2: Match to a U.S. Residency Program This is likely the most popular route back to Canada. The U.S. has thousands of residency positions which are made available to international graduates so the competition for positions is not nearly as competitive as in Canada. The majority of positions are made available through the National Residency Matching Service (http://www.nrmp.org); however, it is also possible to arrange for a residency directly with a program outside the match. To qualify for a U.S. residency program, one must pass the U.S. Medical Licensing Exam (USMLE - see http://www.usmle.org). For Canadians, a visa is required to work in the U.S. as a resident. There are two options ... the J1 or H-1B. The J1 is easier to get; however, one of the conditions of this visa is that you must leave the U.S. immediately after your residency is completed for at least 2 years. It is possible (but not guaranteed) to obtain a waiver on this condition by working in a rural, underserviced area. The H-1B visa is the preferred visa as it does not require one to leave the U.S. after your residency; however, this visa is tougher to get. Once you complete a U.S. residency, if you are on a H-1B visa, then you can practice in the U.S. while you pass your Canadian exams relevant to your area of specialty and secure licensure in a Canadian province. Then you can move back to Canada and practice. If you are on a J1 visa, then the best option would be to return to a province that provides conditional licensure (e.g. Manitoba, Newfoundland) and practice in this province while you concurrently work on your Canadian examinations and full licensure. The Canadian exams that must be passed are the MCCQE Part I and Part II (http://www.mcc.ca) and relevant specialty exams administered by either the Royal College of Physicians and Surgeons of Canada (rcpsc.medical.org) or the College of Family Physicians of Canada (www.cfpc.ca). Provincial Licensure is administered by the various provincial authorities (see www.cfpc.ca/chapters/cps.asp). Path 3: Complete post-Graduate Training in Australia This used to be tough, and remains tough in the major urban centres (Sydney, Melbourne, etc.). However, it is becoming easier to be accepted to an Australian Residency Program and to obtain an appropriate Australian visa. As one would expect, the ability to take this path becomes easier if one is willing to consider locating to an underserviced area. Australian credentials are recognized by the Royal College of Physicians and Surgeons of Canada and deemed acceptable to allow one to write the relevant Canadian exams for their specialty (see rcpsc.medical.org/residen...mg_e.php). For Family Practice, one would have to apply for "individual consideration" with the College of Family Physicians of Canada in order to secure permission to write the Canadian exams for Family Practice. Provincial Licensure would then be through the various provincial authorities. Of course, one could also likely stay in Australia by obtaining PR status (given that you've probably been in Australia so long by this point that you've fallen in love with the country and grown roots). Medical Practitioners have recently been added to the list of professions in need which has eased the ability for doctors to obtain PR status. Path 4: New Provincial IMG Assessment and Integration Programs Some provinces have setup specialized programs for the integration of IMG's into Canadian practice. As an example, Ontario has recently established IMG Ontario www.health.gov.on.ca/engl...g_mn.html) and Alberta also has a similar program (www.aimg.ca). These programs are new, have limited enrollment and are often considered "trials". However, it is likely that over the next several years that these types of programs will become more popular as the need for doctors continues to grow, and provincial governments increasingly turn to IMG's to help increase the number of doctors practicing in their provinces - most especially in underserviced areas. In conclusion, going the Australian or Irish route certainly carries added risk (especially when you consider the dollars involved). In my mind, the risk is manageable if you desire to work in Family Practice and even more manageable if you would like to work in a rural area. If you have your heart set on a competitive specialty and an urban centre, then the risk of being disappointed as an IMG is significant. For those interested in "shortage" specialties and/or rural areas, if one works hard and dedicates themselves to their dream and ensures that they perform well on their relevant board exams - then the worst case is that it will take you a year or two or three longer to achieve your goal. Considering the "lottery" nature of Canadian medical school admissions, it is not uncommon for applicants to spend several years filling out lottery tickets (i.e. application forms , so perhaps these potential extra years are not actually lost in the end. At any rate, for those considering the IMG route - there is a lot of great information on this board. Consider your options carefully and the very real risks involved. However, in the end, if a Canadian ticket remains elusive and you have a passion to achieve your goal no matter what obstacles are thrown in your way, and you desire a "shortage" specialty such as rural Family Practice - then going the Australian and/or Irish route is a very viable option with alternative paths back to Canada that will allow you to satisfy your dream. The extra blood, sweat and tears involved in going the IMG route can be much easier to take than a lifetime living with regret for sacrificing a dream. Link to comment Share on other sites More sharing options...
Guest moo Posted December 22, 2004 Report Share Posted December 22, 2004 I would just like to add that US DO schools are quickly gaining recognition in Canada and might be a viable option if you are sure you want to do primary care back in Canada. DOs are not limited to primary care in the US and can specialize in anything they want. For more information, there is a FAQ in the American forums written by thatvicguy who is currently applying to US DO schools. Link to comment Share on other sites More sharing options...
Guest physiology Posted December 23, 2004 Report Share Posted December 23, 2004 AusMeds, Once you complete a U.S. residency, if you are on a H-1B visa, then you can practice in the U.S. while you pass your Canadian exams relevant to your area of specialty and secure licensure in a Canadian province.<!--EZCODE QUOTE START--><blockquote><strong><em>Quote:</em></strong><hr> I don't think this is always true. As you alluded to earlier, certain provinces such as Manitoba and Newfoundland may allow you to practice conditionally, but some residencies like optho, ortho, or emerg won't, because of differences in length in the American and Canadian residency training programs. (perhaps NF and Man provide loopholes? I know that BC doesn't). For instance, EM is 3 years in the US, 5 in Canada. I believe derm, optho, ENT, are also 4 years in the states and 5 years in Canada (this INCLUDES the one year rotating internship for Americans). Because the programs are shorter, they're not considered equivalent. One requirement for equivalency by the Royal College is program length. I believe the only US residency that is longer than a Canadian residency is family medicine (US = 3 years, Can <hr></blockquote><!--EZCODE QUOTE END--> Link to comment Share on other sites More sharing options...
Guest moo Posted December 23, 2004 Report Share Posted December 23, 2004 There are repatriation programs across Canada that allow you to do a year of residency so that you meet the requirements. I wonder if you can work in Canada as an ER doc if you do a three (or four year) residency in the US, since many ER docs in Canada do the three year CCFP-EM program anyway. Link to comment Share on other sites More sharing options...
Guest UTMed07 Posted December 23, 2004 Report Share Posted December 23, 2004 ... I know that BC doesn't). For instance, EM is 3 years in the US, 5 in Canada.The majority of ER docs have three years of residency, even the in the urban core. The five year specialist program is still pretty small--26 spots for all of Canada in 2004 (CaRMS web page). Mount Sinai Hospital, one the big U of T teaching hospitals, runs its ER exclusively with 3-year EM/family medicine docs [--heard this the Family Med residency director @ UT]. Also, if you go outside of the larger centres isn't unusual to see (regular) family docs in the ER. I think getting back into Canada is do-able--you just don't have a choice of location. AusMeds: What is your sense of where the Canadians in Australia go? Do most of 'em go to the US and stay there? Link to comment Share on other sites More sharing options...
Guest cradlecrotch Posted January 22, 2005 Report Share Posted January 22, 2005 Just so everyone knows, the American Association of International Medical Graduates is widely known to be a sham organization and is not recognized by any official body. It is actually the work of one individual who accepts payment from the lesser-known Caribbean schools for favourable reviews. Most school reviews are grossly inaccurate thus the AAIMG should not be used as a source of reliable information. Attempts to contact their "offices" reveal that they are not staffed, and calls are not returned. Beware of this organization. Link to comment Share on other sites More sharing options...
Guest UTMed07 Posted January 23, 2005 Report Share Posted January 23, 2005 I've picked apart AAIMG (Amer. Assoc. of IMGs) here in this thread (St Christopher's College of Medicine). My conclusion is the organization/who ever runs the web site has an agenda different that stated on the (AAIMG) web site. Looks like the Guide will need some re-writing. The only consolation is the AMSA (American Medical Student Association) and CaribbeanMedicine.com also seem to have got taken... Link to comment Share on other sites More sharing options...
Guest Mike84 Posted February 5, 2005 Report Share Posted February 5, 2005 What if I went to an Irish or Australian school, then U.S. residency for family medicine. Then wrote all four of those Canadian exams. What next? I've tried looking at the provincial and national sites and there really isn't much info on this. Link to comment Share on other sites More sharing options...
Guest DDOCS Posted February 16, 2005 Report Share Posted February 16, 2005 Excellent article and quite helpful. However, if I'm not mistaken, British med schools havent been mentioned. They're quite credible and internationally recognized, but a bit on the expensive side just like the Irish schools. Link to comment Share on other sites More sharing options...
Guest UTMed07 Posted March 20, 2005 Report Share Posted March 20, 2005 This is an older (archival) version of the guide. See the first post in the thread for the newest version. ----------------------- Preamble ----------------------- In Canada, getting in medical school is tough, especially if you are in Ontario, and many good candidates (that would make fine physicians) do not manage to gain an offer of admission. Many unsuccessful candidates look elsewhere in the pursuit of their dream. This guide explores some of the options out there and pulls together some collected wisdom and a few links. I hope that this guide will do two things (1) show people that there are a few feasible options for excellent candidates Canadian med schools didn't have a place for, and (2) make people aware that there are a number of dubious for-profit medical schools that will take your money and are unlikely to lead to certificate of registration in Canada. Summary of Options ----------------------- United States of America - not considered as 'foreign' by Canadian medical colleges (licensing bodies) Pros - most like Canada - same accreditation body (LCME), re-entry into Canada easiest Cons - high tuition ($30,000 US/year), US health care culture (?) Caribbean Schools Pros - low tuition ($5-27K US/year), low cost of living, schools designed for re-entry into the US Cons - many considered dubious (cater to US medical school rejectees) Irish Medical Schools Pros - good schools Cons - high tuition (22,325 Euro/year) Australia & New Zealand Pros - good schools Cons - high tuition ($25,000-35,000 AU/year), far away Eastern European Schools Pros - many well established schools, low tuition, some schools offer programs in English Cons - need to learn a new language, adjustment to a different culture Others? Understanding Licensure (in Canada) ----------------------- To practice medicine (independently) in Canada one needs a certificate of registration (also known commonly as a "license"). Certificates of Registration are granted by the provincial medical colleges. In Ontario the licensing body is the CPSO (College of Physicians & Surgeons of Ontario). Licensure (for Ontario) is described here. A list of other provincial licensing bodies is found here. Ontario is generally considered to be the most difficult place to obtain a Certificate of Registration (if one has done medical school outside of the USA and Canada). My advice - read the rules from the source. Dubious Medical Schools ----------------------- There are a significant number of dubious medical schools. They feed off of people that dream of medicine, but could not gain admission in Canada and the US. If you are considering a foreign medical school I urge you to do some research. *** The following part has to be re-worked -- see comments here and other comments in this thread. After some more reading, I've come to the conclusion that the AAIMG isn't credible. *** -- Jan 22, 2005. The American Association of International Medical Graduates is good place to start. They evaluate foreign medical schools. The process they use is described here -- in general terms. This page lists the specific evulation criteria. Here is an example from one report: This school has experienced serious internal management problems with both high faculty and administrative turnover. The labs and library remain inadequate; plastinated parts are used in anatomy instead of cadavers. School takes significant amount of transfer students and failures from other medical schools. Web site is misleading as to facility and actual onsite fulltime faculty. Clerkship program is loosely organized. Another site worth checking is the World Health Organization. They maintain a list of medical schools based on submissions of the national governments. If a medical school in a country does not appear in the World Directory of Medical Schools it is not recognized as a medical school by the government in that country. The Canadian Federation of Medical Students (CFMS) has the following warning: Applicants should be aware that enrolling in dubious, proprietary, for-profit medical schools opened specifically to cater to rejected applicants to medical schools in Canada or the USA is highly unlikely to be a path to practicing medicine in Canada. [boldface is CFMS'] Cost ----------------------- Foreign medicals schools can be expensive. Tuition in the US is around $30,000 US/year. Data from the American Association of Medical Colleges (AAMC) for public schools is here (2003 data), private schools is here (2004 data). If you assume the cost of living is $10K/year (not a conservative estimate) after four years your wallet is missing $160,000 US. Irish schools are 22,365 Euros/year. With the current exchange rate (1 Euro = 1.34 US dollars) -- the cost is not much different than US schools on a per year basis. Overall they are more expensive, as medical school (for someone with advanced standing) in Ireland is five years. Is Australia a tuition heaven? No. The Australian Medical Students Association seems to be fighting the same battle Canadian medical students (outside of Quebec) are fighting. An Australian Medical Students Association page explains - ...international medical students which start at $25,000 [AU]/year and are up to $35,000 [AU], the cost of a full-fee paying degree in medicine is likely to cost a minimum of $100,000 [AU] and probably closer to $175,000 [AU] or more. Monash University is one school I took a closer look at. They charge $34,000 AU. Current exchange rates show the Australian dollar is about 6% lower than the Canadian one. Medical school in Australia is not a cheap option. New Zealand doesn't appear to be cheaper. In Auckland the domestic fees are $9856 [NZ]... the international fees aren't listed. How can one pay for medical school? ----------------------- (1) Loans - CanHELP, BMO Financial + others. (2) The MD/PhD option. If you like research this may be the way to go. A general description is here. Admissions is competitive. One school that lays it out on their web page is Upstate University - Students admitted to the program with full funding support receive tuition remission and a stipend for the period of their training. During all years of training, the stipend totals $19,282/year.(3) Rich parents/relatives. Closing Comments ----------------------- If you do medical school outside of Canada there is no guarantee you'll be able practice medicine here. The Canadian Federation of Medical Students has the follow statement: Although Canadian citizens will always have the right to return to and work in Canada, Canadians contemplating enrolment in a foreign medical school should know that any limitations on recognition of foreign earned MDs apply to qualification earned abroad by citizens AS WELL AS BY NON-CITIZENS of Canada. Strong motivation, determination and adequate academic preparation are in themselves NO GUARANTEE that a Canadian citizen who attends a foreign medical school will be able to train or practice medicine in Canada in the future. The reality is not pretty. Medical education abroad is associated with risk and can be very expensive. Selected Links ----------------------- - Irish Medical Schools - a page describing the Irish Medical Schools. - Australian Medical Council - the accreditation body for medical schools in Australia & NZ. A list of medical schools. - IMG Ontario - describes the process International Medical Graduates must go through to get a Certificate of Registration. - ValueMD.com - a discussion board that specializes in Caribbean and other foriegn medical schools for people hoping to practise in the USA. It claims to be "the best site for answering your questions about medical school education." - CaribbeanMedicine.com - a page written by a Canadian medical school post-interview rejectee that went to the Caribbean for med school. I think the Open Letter he wrote is worth skimming through. - Large numbers of would-be Canadian MDs migrating Down Under - CMAJ, Oct 29, 2002; 167(9). - Shut out at home, Canadians flocking to Ireland's medical schools - and to an uncertain future - CMAJ, Mar 21, 2000; 162(6). Afterword ----------------------- Why did I write this? I had some difficult getting in to med school and explored other options. I think it is important to understand what options are out there and what the limitations and difficulties associated with them are. I feel that some people who dream of practicing medicine in Canada are conned out of a lot of money and given false hope. Who am I? I'm the author of the (unofficial) UT Meds Admissions FAQ. As my login suggests, I'm a medical student at the University of Toronto. God and faculty willing, I'll be graduating in 2007. Link to comment Share on other sites More sharing options...
Guest immernoch Posted October 23, 2005 Report Share Posted October 23, 2005 For Ireland medical schools, do Canadian Banks give out loans? Link to comment Share on other sites More sharing options...
Guest AusMeds Posted October 24, 2005 Report Share Posted October 24, 2005 Yes, at Royal Bank and BMO, they will approve (based on a good credit rating) their Professional Medical School Student Loan program for international students (with the caveat that your school is on their list of approved programs) which usually includes a credit line of about $140-150K. Canada Student Loans will also provide some funding but it's limited; however, everything helps so even their $6,000 / year will help pay for something! Link to comment Share on other sites More sharing options...
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