rad86 Posted February 11, 2009 Report Share Posted February 11, 2009 Does anyone know if it's true that canadian radiologists are directly eligible to sit for the American board without USMLE 1-3? And does passing the board mean being able to practice anywhere in the states? Also, is radiology any different from the other specialties when it comes to getting licensed down south? Link to comment Share on other sites More sharing options...
Ian Wong Posted February 11, 2009 Report Share Posted February 11, 2009 The USMLE Steps 1-3 and the ABR board exams are not directly linked. At this time, being in a Canadian radiology residency makes you eligible to take the 3 components of the ABR exam, which includes a physics exam done during PGY-2, a written exam done in either PGY-3 or 4, and an oral exam done at the end of PGY-5. You don't need to have your USMLE's to take the ABR exams. If you take and pass these three exams, you are board certified in radiology in the US. However, in order to practice medicine independently in the US, you also need a full state license. To get that, you need to get a license to practice from whichever state you'll be residing in. One of the pre-requisites for getting this state license is having completed the USMLE Steps 1-3. Many states (I think the majority now), will accept the LMCC's (MCCQE Parts 1 and 2) in lieu of the USMLE Steps 1-3. However, in order not to close any doors off at all, it would be advantageous to have passed USMLE Steps 1-3 as well. At this point, there is reciprocity between Canada and the US as far as radiology goes. In other words, doing a residency in 1 country makes you eligible to take the board exam in the other country. Of note, the ABR is changing the exam format and residency curriculum for US radiology programs starting in the next year or so. Very little information has been publically released. It will be switching to a new comprehensive exam done in your PGY-4 year, followed by a second exam done approximately 15 months after graduating from residency. Given these imminent changes, I don't believe any information has been released as to whether the reciprocity between Canada and the US is going to continue. Ian Link to comment Share on other sites More sharing options...
rad86 Posted February 11, 2009 Author Report Share Posted February 11, 2009 Thanks Ian! In your opinion, if I want to stay in Canada for residency, but hoping to leave open the option of going to the states if I don't get matched here and/or potentially being able to practice in U.S. in the future, do you recommend writing USMLE I the summer after second year or wait until the CaRMs results come out first? Link to comment Share on other sites More sharing options...
Lactic Folly Posted February 12, 2009 Report Share Posted February 12, 2009 Writing Step 1 the summer after second year is probably easiest since you will have just finished the preclinical curriculum. If you apply to CaRMS and ERAS at the same time, your Step 1 score will be required for your US residency applications. At the end of 4th year, you will be writing MCCQE Part 1, which is more akin to USMLE Step 2. If you decide to go to the US in the future, it will be a bigger hurdle to write USMLE 1, 2 CK, 2 CS, and 3 all at once, although it has been done. Link to comment Share on other sites More sharing options...
Ian Wong Posted February 12, 2009 Report Share Posted February 12, 2009 Writing it in the summer after Med 2 would be the easiest, as you have just completed the type of pre-clinical material tested on Step 1. However, you have to have the motivation to study hard for it, and do well on it. If you score average or below average, you have essentially eliminated any chances of coming to the US for a radiology residency. The trouble is that Med 2 generally is a HARD year. Most students are pretty burned out by the end of Med 2, and particularly if you are a Canadian and are not pressured to study for Step 1, it becomes easy to blow it off. If you decide to take it after Med 2, then you need to buckle down and really take it seriously, which is much more difficult to do than it sounds. Ian Link to comment Share on other sites More sharing options...
rad86 Posted February 12, 2009 Author Report Share Posted February 12, 2009 Thank you both for your insights! That's exactly my concern Ian, since it'll be hard to be very motivated to study for something that I might not even need eventually. Since ERAS results come out before CaRMs, I probably can't apply to both at the same time if I want to stay in Canada as my first choice. I also don't know if it's mandatory to report USMLE 1 score for CaRMs, and how that would affect my applications. Someone suggested to leave USMLE 1 until after CaRMs, so that if I don't get matched in Canada, I'll be much more driven to do well on it, and if I end up taking the USMLEs for licensing purposes I'd just need to pass, which is a lot less pressure. It's really helpful to clarify these I guess I'll just have to find out more about the test itself and see how much studying it takes to really do well. By the way, what's a good score that's considered competitive for US radiology residencies? Anything else that's particularly important for matching over there besides a good USMLE score? Link to comment Share on other sites More sharing options...
rad86 Posted February 12, 2009 Author Report Share Posted February 12, 2009 Hi Ian I just noticed something from the 2nd post that I hope to clarify, what does getting board certified but without a full state licence allow you to do? Is it a partial license that allows one to work as an associate or to do long distance work from Canada? You said that a full state license is required for indepent practice, but don't most (if not all) radiologists practice in groups? Or is that structure different in the states? I'm not sure if I'm understanding this correctly... Also, does passing both the board exam and the USMLEs make you eligible to apply for licence in any state? Sorry for asking so many questions, is there a site where I could read up on some of these issues? Link to comment Share on other sites More sharing options...
Kirsteen Posted February 12, 2009 Report Share Posted February 12, 2009 Hi there, On a related note, over the past few months I've been in touch with a few US Program Directors who are running fellowships that are of interest to me. I haven't taken the USMLE (nor do I plan to) and this is a key factor with respect to US fellowships since some fellowship programs require completion of the USMLEs while others will accept the MCCQEs in lieu. As for US rads jobs, I've heard that it can be much easier to secure a job (and the associated state licence) when you complete a fellowship at a given centre. Seems logical since, by completing the fellowship you've worked with the group for 1-2 years and they know you and your work and will be either motivated or unmotivated to hire you before the fellowship's end. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
Lactic Folly Posted February 13, 2009 Report Share Posted February 13, 2009 Thank you both for your insights! That's exactly my concern Ian, since it'll be hard to be very motivated to study for something that I might not even need eventually. Since ERAS results come out before CaRMs, I probably can't apply to both at the same time if I want to stay in Canada as my first choice. I also don't know if it's mandatory to report USMLE 1 score for CaRMs, and how that would affect my applications. Someone suggested to leave USMLE 1 until after CaRMs, so that if I don't get matched in Canada, I'll be much more driven to do well on it, and if I end up taking the USMLEs for licensing purposes I'd just need to pass, which is a lot less pressure. It's really helpful to clarify these I guess I'll just have to find out more about the test itself and see how much studying it takes to really do well. By the way, what's a good score that's considered competitive for US radiology residencies? Anything else that's particularly important for matching over there besides a good USMLE score? Except for that year when SARS messed things up, I believe CaRMS comes out first before NRMP, so you can apply to both at the same time. See: http://www.carms.ca/eng/ERAS_intro_e.shtml CaRMS does ask for USMLE scores, but it's not strictly *mandatory* to fill them out on the application. I would think the effect on your application depends on how familiar the reader is with the USMLE scoring system and how much emphasis they place on standardized testing that you probably took just to keep your doors open. I was told that it showed motivation and achievement and that I should put it down. I guess it depends on what your plans are in case you apply to CaRMS alone and do not match, but going unmatched is pretty stressful and amidst scrambling to arrange plans for next year, I wonder how well you'd be able to prepare for Step 1. I wrote it for licensing purposes, but since it is a challenging exam, the fear of failing and wasting my time and money was most of the motivation I needed Link to comment Share on other sites More sharing options...
Ian Wong Posted February 15, 2009 Report Share Posted February 15, 2009 Hi Ian I just noticed something from the 2nd post that I hope to clarify, what does getting board certified but without a full state licence allow you to do? Is it a partial license that allows one to work as an associate or to do long distance work from Canada? You said that a full state license is required for indepent practice, but don't most (if not all) radiologists practice in groups? Or is that structure different in the states? I'm not sure if I'm understanding this correctly... Also, does passing both the board exam and the USMLEs make you eligible to apply for licence in any state? Sorry for asking so many questions, is there a site where I could read up on some of these issues? Getting board certified and getting state licensure are two different pre-requisites to practising medicine in the US. Most states require you to be board certified (which means completing a radiology residency, and then passing the ABR exams) to practise. There are a few exceptions where you can be only board eligible (which means you've completed a radiology residency, but haven't passed the ABR exams), but generally these are confined to areas of high need, and aren't generally considered to be a community standard. You also need state licensure. Without this, you cannot practise medicine within that state, whether within a group or solo. Even if you were doing teleradiology, if you are interpreting studies generated from within that state, you need to have state licensure (despite the fact that you might be living in a different state or country at the time). Getting state licensure requires proving to the state that you have graduated from a recognized medical school, have passed USMLE Steps 1-3 (or the equivalent, like the LMCC's for states which recognize the Canadian exam as equivalent to the USMLE), as well as completing a defined amount of post-graduate training, which is often just your PGY-1 year. When I say practising independently, I mean that you are interpreting studies under your own name, without signing that study off under your attending's name or license. It does not refer to working in a group practice versus a solo practice. A partial state license also exists, but only within the context of internship or residency training. They are temporary licenses, which can no longer be used once you graduate from residency. Many residents use them because they are cheaper to obtain than a full license. However, you cannot practise as an attending on one. As well, if you were to do moonlighting during your residency, you would need a full state license, as that clinical work generally falls outside of your defined duties in residency (which is all that the temporary license enables you to do). Generally, once you have passed your USMLE Steps 1-3 and completed residency and gotten ABR board certified, you are free to apply for full state licensure in any state you want. As far as more in depth reading on the above, there is no real one site that covers all of this stuff, as far as I know. Ian Link to comment Share on other sites More sharing options...
Guest copacetic Posted March 3, 2009 Report Share Posted March 3, 2009 what about canadians who do a radiology residency in the united states and are looking to return to canada. is that possible? what sorts of hurdles will be faced. from my understanding the royal college on paper allows reciprocitiy, but in practice its a whole other story. Link to comment Share on other sites More sharing options...
Guest copacetic Posted March 3, 2009 Report Share Posted March 3, 2009 never mind the above post, i found a thread that addresses the issue Link to comment Share on other sites More sharing options...
rad86 Posted July 30, 2010 Author Report Share Posted July 30, 2010 The USMLE Steps 1-3 and the ABR board exams are not directly linked. At this time, being in a Canadian radiology residency makes you eligible to take the 3 components of the ABR exam, which includes a physics exam done during PGY-2, a written exam done in either PGY-3 or 4, and an oral exam done at the end of PGY-5. You don't need to have your USMLE's to take the ABR exams. If you take and pass these three exams, you are board certified in radiology in the US. However, in order to practice medicine independently in the US, you also need a full state license. To get that, you need to get a license to practice from whichever state you'll be residing in. One of the pre-requisites for getting this state license is having completed the USMLE Steps 1-3. Many states (I think the majority now), will accept the LMCC's (MCCQE Parts 1 and 2) in lieu of the USMLE Steps 1-3. However, in order not to close any doors off at all, it would be advantageous to have passed USMLE Steps 1-3 as well. At this point, there is reciprocity between Canada and the US as far as radiology goes. In other words, doing a residency in 1 country makes you eligible to take the board exam in the other country. Of note, the ABR is changing the exam format and residency curriculum for US radiology programs starting in the next year or so. Very little information has been publically released. It will be switching to a new comprehensive exam done in your PGY-4 year, followed by a second exam done approximately 15 months after graduating from residency. Given these imminent changes, I don't believe any information has been released as to whether the reciprocity between Canada and the US is going to continue. Ian Has there been any news on the effect of the ABR changes on the reciprocity between Canada and the US? If the reciprocity continues, there seems to be really no point in doing the USMLEs, if we were potentially interested in only fellowships/teleradiology (with some states restricted, but I guess I can always go for those that don't require USMLEs, which seem to be majority anyway) but not residency in the US, correct? Link to comment Share on other sites More sharing options...
monkey799 Posted July 31, 2010 Report Share Posted July 31, 2010 I am not certain, the ABR & royal college has reciprocity every where in US I think the majority of the states will require USMLE for state license, which is not reciprocal with LMCC so you'll still need to take USMLE to get state license to do any clinical work or read scans Link to comment Share on other sites More sharing options...
Kirsteen Posted August 6, 2010 Report Share Posted August 6, 2010 I am not certain, the ABR & royal college has reciprocity every where in US I think the majority of the states will require USMLE for state license, which is not reciprocal with LMCC so you'll still need to take USMLE to get state license to do any clinical work or read scans Hi there, I just heard from a colleague who's completing a rads fellowship in the US and he noted that the completed, 3-step USMLE is required to achieve state licensure, which is also related to obtaining a certain visa that permits a Canadian to work in the US. Additionally, there remain some states in which you cannot apply for a rads fellowship without USMLE scores, i.e., they do not recognize the MCCQEs. Incidentally, this past year, the majority of rads PGY-5s (from English universities) wrote both, the ABR and the RCPSC diagnostic radiology exams. Cheers, Kirsteen Link to comment Share on other sites More sharing options...
tooty Posted August 6, 2010 Report Share Posted August 6, 2010 Hi there, I just heard from a colleague who's completing a rads fellowship in the US and he noted that the completed, 3-step USMLE is required to achieve state licensure, which is also related to obtaining a certain visa that permits a Canadian to work in the US. Additionally, there remain some states in which you cannot apply for a rads fellowship without USMLE scores, i.e., they do not recognize the MCCQEs. Incidentally, this past year, the majority of rads PGY-5s (from English universities) wrote both, the ABR and the RCPSC diagnostic radiology exams. Cheers, Kirsteen Thanks Kirsteen. Is it wise for a radiologist's career to earn licensure in the states combined with a license in Canada? Link to comment Share on other sites More sharing options...
Kirsteen Posted August 7, 2010 Report Share Posted August 7, 2010 Thanks Kirsteen. Is it wise for a radiologist's career to earn licensure in the states combined with a license in Canada? Hi there, I suppose it depends on what you'd like to do and the current requirements re: licensure and visas. For example, originally I hadn't considered venturing to the US for a fellowship nor full-time job, post-fellowship. However, now that this is a consideration I'm planning to complete the three steps of the USMLE to keep all options open. Cheers! Kirsteen Link to comment Share on other sites More sharing options...
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