US radiology residency -- > practice in Canada?

[gaveawayallmymoney]

Hello,

 

I am a 4th year Canadian med student interested in doing rads in the US. Initially, I thought of it as a backup, but I am starting to get interested in the places that are interviewing me. I have several questions:

 

1) Will a standard ACGME approved residency make me eligible for CANADIAN Boards?

2) Does it matter if I do a prelim in medicine, surgery, or transitional year? Will any of those be acceptable?

3) Are there any possible pitfalls with respect to coming back to Canada?

[Ian Wong]

Hello,

 

I am a 4th year Canadian med student interested in doing rads in the US. Initially, I thought of it as a backup, but I am starting to get interested in the places that are interviewing me. I have several questions:

 

1) Will a standard ACGME approved residency make me eligible for CANADIAN Boards?

2) Does it matter if I do a prelim in medicine, surgery, or transitional year? Will any of those be acceptable?

3) Are there any possible pitfalls with respect to coming back to Canada?

At this time, an ACGME approved residency in the US will make you eligible to take the Royal College exams in Diagnostic Radiology. However, this doesn't necessarily mean that this will hold true 5 years from now.

 

The only stipulation from the Royal College is that you complete 1 basic clinical year, prior to the 4 years of radiology training. As such, a TY year, or a prelim medicine or surgery year are acceptable. Again, though, what is true today may not necessarily hold true in the future.

 

Here are the training requirements from the Royal College:

 

http://rcpsc.medical.org/residency/certification/training/diarad_e.html

 

The biggest thing is that there is an element of risk going to the US. While at the current time, US radiology residency training is accepted as making you eligible to take the Royal College exams, it's never a guarantee that the Royal College will continue to hold this stance.

 

Now, having said that, I don't think there's anything out there to suggest that this will change, but not all specialties have Canadian/US reciprocity, and if a policy change happened, you could be left out in the cold.

 

Another theoretical problem is the type of training you will receive. It's a little speculative on my part (I'm a radiology resident training in the US), but I believe that most US residencies have a much higher volume in the "high-end" modalities, that being CT, MRI, and PET.

 

Plain films, ultrasound, and fluoroscopy are less emphasized, as the skills needed to get good at these basic modalities is more difficult to acquire if you always have the option of getting a CT or MRI the same day. There are a lot of patients who come through the ER, or from the primary care offices, where a CT is the first study of choice, rather than a CXR or an AXR.

 

I think if you train in the US, you will probably develop a stronger skillset in advanced modalities, while probably under-training in basic radiology studies like plain films, U/S, and fluoro. This is all speculative on my part, as I'm obviously not on site in Canada to see how Canadian residents train.

 

Ian

[gaveawayallmymoney]

Thank you for your reply.

 

You mention that the "risk" is that the Royal College may not recognize ACGME approved training 5 years from now.

 

What I don't understand is that wouldn't that require a change in the training in Canada (a change in the training requirements extending radiology training here)?

 

Isn't the recognition by the royal college for training in the US based on the time spent during training?

 

Thanks

[Ian Wong]

Thank you for your reply.

 

You mention that the "risk" is that the Royal College may not recognize ACGME approved training 5 years from now.

 

What I don't understand is that wouldn't that require a change in the training in Canada (a change in the training requirements extending radiology training here)?

 

Isn't the recognition by the royal college for training in the US based on the time spent during training?

 

Thanks

Radiology is in a decent position, in that the length of training is a total of 5 years, for both Canadian and US residencies. So, from your above reasoning, most likely the reciprocity between US and Canadian residencies will continue (ie. as long as you complete a 5 year radiology residency, you should be eligible to take both the US and Canadian boards).

 

All I was saying is that nothing is set in stone. The Royal College could decide tomorrow for any reason that US training does not fulfill its mandate. If your eventual plan is to practice in Canada, the safest way to guarantee that is to do all your training in Canada.

 

Ian

[Bancroft]

Hey Ian,

 

Would you happen to know if Pathology residency training in the US would make me eligible to take my Royal College Exams here in Canada?

 

I notice that Anatomical Path in the US is only 3 years of training, while here in Canada it is 5. Feels like the US may be a better option for this very reason...

 

B

[Ian Wong]

In general, the Royal College will require you to complete the same number of years of training before considering you to be eligible for the Canadian exam.

 

For Pathology in the US, you'd therefore have to add an additional fellowship year in order to achieve the 5 year equivalence in Canada. In other words, 1 year internship + 3 years Pathology residency + 1 year Pathology fellowship.

 

Ian

[gaveawayallmymoney]

Thank you for your help Ian...

 

 

I have a question concerning J1 visas...

 

Assuming I match to radiology in the US, will I be eligible to complete a fellowship after residency? Or do I require a new statement of need?

 

Thanks

[Ian Wong]

You need a new J-1 visa and new Statement of Need from Canada.

 

As an aside, in the US, you match for a PGY-1 year in one of the three following 1 year programs:

 

a) Transitional Year Internship

Prelim Medicine Year

c) Prelim Surgery Year

 

The three 1 year programs vary in the number and type of required rotations, with the TY year being the easiest, and the Prelim Surg year being the hardest.

 

These are often done at an institution different than where you do the PGY-2 through PGY-5 years of your radiology residency.

 

So, when you apply to US programs, you actually apply for, rank, and subsequently match into both an internship year as well as the radiology years. You get Statements of Need for both the internship year, as well as the radiology years from Health Canada, and get J-1 visas for each program from the US government through ECFMG.

 

If you stay in the US to do a fellowship, you have to get another Statement of Need and J-1 visa. In general, this isn't an obstacle at all. Just a little more paperwork, but it's stuff that you've already filled out before.

 

Ian