Guest redshifteffect Posted January 25, 2003 Report Share Posted January 25, 2003 Sorry for annoying all of you, but one more thing came to my mind: Ian seems to mention in nearly every post that as IMG's we have less of a chance of getting into so called "prefered" specialities...while may well be the case let me mention a brief story to you: In Tasmania (where I study) there are two Canadians and numerous American doctors employed at the hospital where I have done some (although very brief) clinical observations during first year. Now I happen to ask them why the heck they were working in Tasmania when they were trained licensed etc..in North America. By the way these were so called "prefered specialists" working in the field of Neurosurgery, Orthapaedic surgery (sorry using the Aussie spelling) "ironically not so "prefereed amoung aussie grads..but that's an aside", Cardiac Thoracic Surgery etc...and they said that the work load in America and Canada was too much. They made the same amount of money in Australia as in America and more than in Canada and they didn't have to work as much. In North America they were on call nearly 24 hours, and to maintain their own practice meant that they sacrified a lot of family. Now most of them (though not all) told me that in North America their family life was in jeopardy and most were on the verge of divorces, and many were simply fed up. So again please be very weary with what you hear from others. I mean I know I'm presenting a "rosy" picture here, but just because you can only practice family med, or IM or whatever...doesn't mean you will be getting the short end of the stick here. I mean what is more important to you, a family or your career? I know that if my parents would have picked the later, there is no way that I would be studying in Australia right now...I owe a lot to my parents, and I'm sure that many of you feel this way too. So again there is always a good side and a bad side to everything, and I'm just trying to give you all an equal view on this so that you can make your own decisions. Sorry for taking up your time! Link to comment Share on other sites More sharing options...
Guest kellyl20 Posted January 26, 2003 Report Share Posted January 26, 2003 so what specialties are preferred by aussie med students? Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted January 26, 2003 Report Share Posted January 26, 2003 aussie grads prefer cardiac surgery and generally any specialty related to the heart. They do not however prefer Orthapaedic Surgery, as it is a fairly easy elective to get into. Here is some hope for all of you: www.nrmp.org/res_match/ta...6_2002.pdf As you can see a lot of "prefered" specialties went unfilled in the US last year. Link to comment Share on other sites More sharing options...
Guest strider2004 Posted January 27, 2003 Report Share Posted January 27, 2003 I wouldn't say that neurosurgery is a 'preferred' specialty in Canada. It takes a very select breed of person (ie. hardcore) to want to be a neurosurgeon. The preferred specialties are ones like plastics, urology, ENT, radiology, dermatology. They are preferred because they have better hours and are higher paying. Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted January 27, 2003 Report Share Posted January 27, 2003 Well you can from that link that there were International students admitted in the USA for the specialities that you listed. Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted January 27, 2003 Report Share Posted January 27, 2003 Heya, This table is not quite as informative as you might expect. There's an excellent discussion on the studentdoctor.net website which illustrates how this exact table is not very reliable when it comes to figuring out how competitive each specialty really is. Unfortunately, SDN is down for the moment, but I'll post a link to the discussion when it returns. Suffice to say that yes, I do believe that you are going to be at a significant disadvantage as a foreign med grad when applying into the more competitive specialties, particularly the super-competitive specialties like Derm, Ortho, ENT, and Plastics. For each of the above specialties, there are many more applicants than US residencies, and many people will NOT match these specialties. The fact that US Seniors don't take all the spots means that either US grads who went unmatched the previous year and are reapplying again (they aren't counted as US Seniors anymore) got some of the spots, and others went to Canadian/Australian/UK/Other countries graduates. Many of these spots can also fill outside the match (and would still be listed as "unfilled" by the NRMP), or else programs may elect not to take any applicants that year (and this could still be listed as "unfilled"). All I'm trying to say is that the table you've quoted may be deceptive. Certainly, as a medical graduate (regardless of whether it's Canada/US/Australia/wherever), you have a chance of getting into any residency in any location. It's just that the hill you must climb gets steeper the further your medical school deviates from a "US"-recognised education (with all its emphasis on USMLE Step 1 scores, US electives and reference letters, presenting at US conferences, etc). I think this is something you definitely need to know about before going international, and if this doesn't pose a problem to you personally, then that's great. But it's definitely something to think about ahead of time in order to make the most informed decision for yourself. Ian UBC, Med 4 Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted January 28, 2003 Report Share Posted January 28, 2003 Well didn't know that about this chart, but I will keep that in mind. However I know two ppl that graduate from UNIBE in the DR which has a much worse reputation than any Aussie school, and both are in Derm, and Radiology respectively...so it's not impossible. Also what about Canadian med students? Aren't these fields competitive for them as well? And what are their chance of getting into these specialities? And finally as far as the US is concerned Canadian med grads are IMG's as well....they still have to write the USMLEs if they want to get into these specialities. Last but not least, these specialities have some of the highest insurance rates in the US especially plastics..so any monetary advantage you may earn because of practicing them would be greatly offset by the insurance premiums you would have to fork out! Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted January 28, 2003 Report Share Posted January 28, 2003 Oh and one more thing as I have mentioned before if you are an Aussie student you are eligible to apply for their specialty training programs....so if you are really really stuck up on getting back to Canada here is a route you can take: 1) finish med school 2) do one year internship 3) compete for spots for specialty training program 4) return to Canada as a specialist and sit your exams so you will not require retraining or the Carms Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted January 29, 2003 Report Share Posted January 29, 2003 Also what about Canadian med students? Aren't these fields competitive for them as well? And what are their chance of getting into these specialities? And finally as far as the US is concerned Canadian med grads are IMG's as well....they still have to write the USMLEs if they want to get into these specialities.Good points. It's competitive to get into those specialties in Canada through CaRMS, and also competitive to get into those specialties in the US through the NRMP/SFMatch/etc. However, unlike IMG's, a Canadian med student has a go at all these specialties through the first round of CaRMS, which IMG's aren't allowed to enter. By the second round of CaRMS, when IMG's can finally apply, those spots are all gone, except in freakishly-rare circumstances. I can virtually guarantee you that there will be no IMG's matching into either Radiology or Dermatology in Canada this year. There is currently noise rumbling to give IMG's access to applying during the first round of CaRMS, but this is not universal nor carved in stone currently. When applying to the US match system, Canadians (so I've heard), are NOT considered IMG's in the same fashion that graduating from the Caribbean, or to a lesser degree Ireland or Australia would be. Ireland and Australia produce great doctors and have a very strong educational system; likewise in Canada. Because all Canadian schools are accredited by the LCME, US schools recognise our training as equivalent. During my interviews in ENT this month, I've heard of at least two fourth year Canadian med students who have matched into ENT in the US, at least one of which was in a super top-flight ENT residency. I don't know if these individuals are American citizens, or whether there is some other reason why they may have an advantage in the US match versus other Canadian med students, but ENT is a seriously hard match in the US, and these two folks succeeded. The bottom line is that residencies and licensure are a constantly evolving process, and the rules that you hear about when applying to med school may not still apply by the time you become a resident or a staff doctor. However, if there is a country in which you wish to train and practise, the simplest solution would be to do your training there, instead of going abroad and then having to navigate the required series of licensing exams and other hoops. Ian UBC, Med 4 Link to comment Share on other sites More sharing options...
Guest strider2004 Posted January 29, 2003 Report Share Posted January 29, 2003 Unfortunately, you cannot return to Canada and work as a specialist unless you go through residency here. There are many IMGs with high qualifications that are doing menial jobs in Ontario because they can't get a license to practice. Yes, they can pass the LMCC exam but they can't get into residency - even family medicine sometimes. It's a bit different in other provinces though. For instance, Manitoba is really pushing to let IMGs into the first round of its CaRMS match. I don't know what the official word on this is. Also, I believe Newfoundland is offering a training program where you work with a family doc there for a year and can qualify to work as a family doc in Newfoundland. I don't know if this license is then transferrable to other provinces. Many Canadians write the USMLEs while they are still in med school in Canada. This allows them to do electives in the US and can make them quite competitive in the NRMP. The USMLE Step 1 marks are taken into account by the US residency programs so if you do well on that exam, then you have a better chance of matching to a good spot. Ian is right - if you want to eventually practice in Canada, then it's probably easier simply to train in Canada. Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted January 29, 2003 Report Share Posted January 29, 2003 Unfortunately, you cannot return to Canada and work as a specialist unless you go through residency here.Just to interject, there are some countries which Canada recognises as being equivalent if you possess that country's certifications in a given specialty. I don't know which countries those would be; the only one that I'm definitely sure about is South Africa because I've worked with and talked with a few of them. My hunch is that countries like Australia would likely be one of those countries where Canada has a mutual understanding, but I'm not sure where you'd investigate to find that out. As a result, if you are from one of those countries, you would not need to redo residency, but you might have to practise in an underserved community for a few years before you are given a full license and can practise anywhere in Canada. Ian UBC, Med 4 Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted January 29, 2003 Report Share Posted January 29, 2003 After that last post, I decided to do some searching, and came up with the following article from the Medicalpost.com. This article has a quotation which seems to say that Commonwealth countries may indeed have some portability between them: Australia, New Zealand, South Africa, and the UK. Worth reading in any event; it's pretty interesting. Link to Article 1: As well, here's another article from the Medical Post regarding Canadian citizens applying to Australian medical schools, essentially echoing the need to practise in an underserved community in order to receive payment. Link to Article 2: Ian UBC, Med 4 Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted February 2, 2003 Report Share Posted February 2, 2003 Ian, Are you then saying that if I were to get my speciality training in say ENT in Australia and then were I to come back here I would be required to work in an underserved area, but I wouldn't have to undergo any further training? Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted February 2, 2003 Report Share Posted February 2, 2003 Ian, there was an error in one of the articles that you posted a link for. It was saying that of those students that stay in Australia they have difficult in getting medicare benefits unless they practice in underserviced areas. I know from first hand experience that this is not the case. Maybe the students that they are talking about did not get a PR but once you get a PR and you have graduated from an Aussie school you are NOT AN IMG...so they can not prevent you from any discriminatory actions. Also medicare is not the bulk of anything. Plenty of doctors (even family ones) make a very lucrative living on fees without receiving a single penny of Medicare. Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted February 2, 2003 Report Share Posted February 2, 2003 Also, It doesn't really matter whether your school is LCME certified or not (though I believe that all aussie schools are) but what makes a difference is your USMLE scores. and for your information even if you do graduate from Canada and apply to the US it's the final decisions of the residency director as to whether you gain entry or not...and a lot of residency directors are IMGs in the US... I have also spoken to a lot of US doctors as my aunt/uncle reside there and I got admission into Brown and Case Western Reserve for their accelerated medical programs (but they were too expensive for my parents and I) and from what I have heard they think that Canadian universities are sub-par...NOW I not for one second believe they are, trust me I know how good they are, and this angers me alot. So just because you graduate from a Canadian school, don't assume that this will get you brownie points with the residency directors, in many way this may be a disadvantage! IMGs take care of their own, before they help others..that's a simple fact. And if you look at the names of most of the residency directors in the US you can easily tell they are IMGs... I can probably find just as many cases of IMGs practicing ENT in the US, so your case of the two Canadians isn't limited to Canadian schools. Link to comment Share on other sites More sharing options...
Guest Ian Wong Posted February 3, 2003 Report Share Posted February 3, 2003 rse, Are you then saying that if I were to get my speciality training in say ENT in Australia and then were I to come back here I would be required to work in an underserved area, but I wouldn't have to undergo any further training?I really don't have any idea, and I'm certain that the rules now will be different from say 10 years in the future.It doesn't really matter whether your school is LCME certified or not (though I believe that all aussie schools are) but what makes a difference is your USMLE scores.No offense, but that's just wrong. For North American schools, it's vitally crucial to be LCME-certified, as this is the organization that sets the standards for all North American schools to meet. If your school didn't meet this accreditation, it'd be to its extreme detriment. The LCME also only accredits North American med schools, so Australian schools are not included. Here's a link to some Frequently Asked Questions on the LCME website: www.lcme.org/faqlcme.htm As you've mentioned, USMLE scores ARE extremely important, because they allow comparison of students from non-LCME med schools (ie. in India, the UK, etc) with LCME med students, in addition to their main tasks of stratifying LCME med students who are applying to residency and serving as board certification material. If you come from a non-LCME school (which might have a completely different curriculum and timeline than an LCME school) yet do extremely well on the USMLE's, that helps program directors feel confident that you can perform on the same tests as US med students. So just because you graduate from a Canadian school, don't assume that this will get you brownie points with the residency directors, in many way this may be a disadvantage! IMGs take care of their own, before they help others..that's a simple fact. And if you look at the names of most of the residency directors in the US you can easily tell they are IMGs... I've heard the exact opposite, which is that Canadian med grads are very clinically strong, and usually do quite well in the US. Rightly or wrongly, there is a stereotype in the US that the weaker residency programs need to use IMG's to fill their ranks; the stronger programs often openly use the fact that they have few to no IMG's as residents as evidence that they are able to recruit US seniors into their residency programs. I can't see many program directors actively soliciting IMG's if they could instead sign up US seniors as residents. As for the rest of this, I'm not trying to sell Canadian med schools or anything. It matters not one iota to me as a patient where my physician graduated from, as long as he/she knows his stuff, and is willing to spend time working with me to make sure that my concerns are properly addressed. What I do think is important is that if you are considering doing your medical education away from the country in which you'd like to practise, that you be fully aware that the playing field will NOT be even when you try to re-enter. There will always be more obstacles and hoops to overcome if you go international for your med education than if you'd stayed in Canada. That may manifest itself when you try to do electives in Canada, try to get a residency in Canada, or try to get licensed to practise in a given area in Canada. If you go to the US instead, then you're into territory that I know nothing about, but I suspect there's paperwork and headaches there too. With that said, there's also lots of advantages to going away (getting to live in a different country, experience a different culture, perhaps learn a new language, etc), but we weren't discussing those. Ian UBC, Med 4 Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted February 4, 2003 Report Share Posted February 4, 2003 Actually Ian, You are correct on the fact that LCME only certifies North American Schools, but I still doubt that as a Canadian you will be at a significantly greater advantage than other schools. First of all correct me if I'm wrong but dont' Canadian students have to write all three steps of the USMLE? Also why would IMG directors recruit IMGs over American graduates? Well simple because they are IMGs..believe me I have two classmates who both graduated from highschool who went to Dominican Republic to do med, and they are both in California doing Radiology ..my point is that IMGs take care of their own, (though they did have really good USMLE scores as well) but they were told in confidence by the director of the program that because she too was an IMG that this played a role in her decision.... I know you can't "research" favouritism on the net, but I'm sure that any advantages that you claim a Canadian degree may have are averaged out by the fact that there are very few Canadian residency doctors out there, and the majority are either American or IMG, and as I said they take care of their own. Link to comment Share on other sites More sharing options...
Guest redshifteffect Posted February 4, 2003 Report Share Posted February 4, 2003 From what I gather the reason that Aussie schools aren't registered with the LCME is that this is a local body that only judges North american schools, however to solve this the US has another body known as the ECFMG that does recognize foreign schools here is the link to search for your school: imed.ecfmg.org/search.asp and if your school is listed with them (all aussie schools) are, and your USMLE scores are high, your chances of getting into a "good" residency program are just as good as a Canadian, who by the way are in reality, "though not on paper" considered IMGs... I think that the reason your friends got into that program was probably because they were smart, and I doubt that the fact that they were from Canada helped them significantly... Link to comment Share on other sites More sharing options...
Guest UWOMED2005 Posted February 4, 2003 Report Share Posted February 4, 2003 Would I be correct in assuming that director also did her MD at that same Dominican school? I couldn't see doing school in Ireland being an advantage when dealing with a Residency Program director from Australia - they might be in favour of Australian students as they are familiar with that product, but being completely unfamiliar with Irish medical schools, I doubt that would be an advantage. Furthermore, that kind of thinking severely limits your options when applying to residencies. Even if you're right and IMG program directors are biased to ALL and not just IMGs from their country of medical training, you'd be limiting yourself to programs with IMG program directors who have a bias towards IMGs. There may be "a lot," but there's no guaranteeing the program YOU WANT has an IMG program director that is biased towards IMGs. As Ian point out, the LCME is the Continental standard for accrediting North American Medical Schools. As Canadians, we're not really considered IMGs in the US as we have a separate, non-IMG stream through with to apply to NRMP, the US residency matching surface (though admittedly it's a bit fuzzy as we're not technically US grads either!) That's the reason Canadian Grads don't even have to bother with the ECFMG standard. And program directors know and trust the LCME standard, which they might not as much if they are not themselves an IMG. Bottom line is that International medical schools are an option for Canadians who want to study medicine, but they really need to think through that decision, and realize practicing in North America (especially Canada) after such a decision might be difficult. For further info - check this link to the AAMC with info about applying to American residency programs. I also noticed the American College Board of Ophthalmology considers Canadian and US school graduates equally for certification as an Ophthalmologist. Wouldn't be surprised if this was the case for other specialties as well. This Link has some more info about the ECFMG certification you were talking about, redshifteffect. Yes, it's possible as an IMG to be recognized by the ECFMG, but Canadian grads (being LCME accredited school grads) don't even have to bother with this. This is an interesting site with a commentary on options for Canadians in both the US and Canada who are thinking of going the foreign route. Link to comment Share on other sites More sharing options...
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