For those waiting on Canadian schools to make the final decision...

[flamesfan]

I imagine there are some people out there waiting to hear from Canada before making the final decision about where to attend. I do not want to count my chickens before they have hatched but I am aware of the possibility of having a choice between Canadian school(s) and Vanderbilt.

 

Beyond the obvious financial disparity there are many aspects that of an American school that set it apart, most noticeably the resources available. I am open to practicing in both Canada and the US, I just want to go to the school that opens the most doors...

 

Anyone else in the same dilemma?

 

 

BTW - anyone know what happens if you choose not to attend a US school after may 15?

[silvermen85]

I imagine there are some people out there waiting to hear from Canada before making the final decision about where to attend. I do not want to count my chickens before they have hatched but I am aware of the possibility of having a choice between Canadian school(s) and Vanderbilt.

 

Beyond the obvious financial disparity there are many aspects that of an American school that set it apart, most noticeably the resources available. I am open to practicing in both Canada and the US, I just want to go to the school that opens the most doors...

 

Anyone else in the same dilemma?

 

 

BTW - anyone know what happens if you choose not to attend a US school after may 15?

 

You forfeit your 100 bucks deposit? But anyway Vanderbilt is a great school to pass by. I know finance is a major reason, but you should really consider that the chance to attend a Top20 medical school don't come by very often and there are many people who would dream to be in the same situation as this. However, in the end, you just need to access which is the best option for you. Frankly as many people have told me in the past couple month, a couple hundred thousand dollars may seem a lot now, but it won't be that significant many years down the road.

[Typical Premed]

I'm also in a similar situation. Accepted at Northwestern and waiting for a bunch of Canadian schools tomorrow. Will be a tough decision if I get an acceptance tomorrow.

[Monster]

I'm waiting for a couple Canadian schools. I am holding a spot at Rosalind Franklin. I really liked the school and I would be happy to go there but it's not a top tier school, it will be way more expensive and I will have to worry about whether or not I will be able to come back to Canada to practice. Also, my fiance will have to worry about getting a work visa if I go to the U.S. which may end up being very difficult.

 

Considering you guys have all gotten into like top 10 schools, if you can afford to go to school there, I would do it. You know it'll be a breeze coming back to Canada with that or getting good residencies in the U.S. (I know it's not just the school you come from that determines that but come on..who are we kidding). I think it also depends on your family situation, if you're ok going a bit further from your family.

 

Anyway, good luck with the Canadian schools today and also with making all these difficult decisions (which would actually be the awesomest difficult decision you will ever have to make:p )

[xylem29]

If you feel that you'd be able to get some meaningful research done in Vandy that you wouldn't be able to get in Canada, and this is the opportunity that you are referring to, then go to Vandy.

 

But I still hold my opinion, and it is just my humble one , that unless you have a PhD going into medical school, or extensive experience, any medical student would probably have the same experiences or opportunities for research in Canada as in the US. Remember that even if you are a medical student in UWO you can still find research positions at the research powerhouses.

 

If you are referring to residency opportunities, many Canadians head south - Ian Wong is one example - just write the USMLEs as you go along. A good friend of mine will be completing his NS residency in Canada, he has just taken Step 3 and is planning on doing his fellowship in the US b/c there's more opportunities for the field he is interested in - lots of Canadians take this route. I don't think you'd be limiting yourself at all from this perspective.

 

Finally, I think the importance of the school is way overblown in our minds - when you're 45 and practicing, it's really going to matter little. Where you are practicing, your patient base, your family life, etc are probably going to play bigger roles in affecting your satisfaction. Related to that is - keep in mind that the system in the US can be really frustrating.

 

Finally regarding this as being a once in a life-time opportunity aspect, I'd agree if this was a Top 5. That's just my opinion. Don't pick Vandy for the prestige factor, because to me there isn't any - but I acknowledge that it is very difficult to get accepted to Vandy and any other Top 20 so I am NOT taking this achievement away from you. Silverman's decision on the other hand - it's friggin Stanford. But in anycase, I wouldn't take prestige or the idea that it's a "Top 20" school into account because getting accepted into a Canadian school - for those who are from ON or BC - is one of the most difficult things to accomplish and there's a lot of prestige in that. Point is, don't pick a school to stroke your ego BUT if you ARE, I'd pick a Canadian school anyday - the way Canadian med students are pampered compared to their US counterparts, you'll receive a bigger ego stroke in Canada.

[Typical Premed]

Well after my results from today its looking more and more like I will be attending Northwestern next year, lol.

[silvermen85]

Well after my results from today its looking more and more like I will be attending Northwestern next year, lol.

 

Its only like 10 hours drive from Toronto!

[Ian Wong]

My opinion is that it depends where you think you'll want to practice eventually.

 

If you think that you will most likely be working in Canada, I would choose the Canadian school. It will be much easier to get a Canadian residency position, and you will have no issues relating to licensing. Also, the clinical training in Canadian medical schools is uniformly strong; you will get a good education at any of them, at least commensurate (in my opinion) to what you would get from a strong US medical school.

 

If you go to a US school, you will have an easier time matching to a US residency, but will almost certainly have a more difficult time getting a Canadian residency, since most of your CaRMS success comes from networking and electives.

 

If you do a US residency and then decide to return to Canada to practice, you will face licensing issues from the Royal College for many specialties, as many US residencies are shorter than their Canadian equivalents.

 

As well, if you are not a US green-card holder or citizen, you will end up with visa issues, which are a definite hassle, and potentially will limit your residency choices. Many of the competitive US specialty programs do not want to deal with applicants who require visas, particularly since they have a huge number of US citizen applicants who are equivalently strong on paper.

 

Finally, I'm not sure what Canadian med school tuition is like, but almost certainly, Canada will be less expensive than if you are either an out-of-state applicant attending a state medical school, or an international applicant attending a private medical school.

 

While an extra $100,000 here or there might not seem like a lot of money, it very much is, especially considering that the interest on it will be compounding through the life of the loan. This is also exacerbated by the fact that US physician salaries have been declining every year for at least the last decade, and will only continue to do so as the US tries to reign in costs after all the out of control spending that has been going on recently.

 

I, and probably the majority of the physicians in the US, are predicting significant further cuts to physician reimbursement over the next several years. The US medicare system, which is one of the most stingy/frugal payers in the US, is running out of money, and all of the private insurance companies titrate their payments to medicare.

 

Bottom line, I would go to a Canadian school if you are planning on working in Canada. Vandy is a good school, no doubt about it, but staying in Canada for med school will get you further if you are planning on practicing in Canada eventually.

 

Ian

[flamesfan]

wow so much help!! so i received canadian acceptances so the scenario played out. i definitely agree stanford is in a class of its own.

 

i am waiting for the aid package from vandy and that will play a large part in my decision as well. i am leaning canada for the reasons you posted above ^^ but i never thought about taking the USMLEs concurrently

 

appreciate the help...

 

any news from others?

[token]

Very good insights from Ian Wong as usual!

 

flamesfan I think I mentioned this before, but you may want to nudge Vandy about the money situation. Once people withdraw today they'll likely have some more scholarship money to go around. However unlike most of their matriculants, you have other options.

[Halcyon]

My opinion is that it depends where you think you'll want to practice eventually.

 

If you think that you will most likely be working in Canada, I would choose the Canadian school. It will be much easier to get a Canadian residency position, and you will have no issues relating to licensing. Also, the clinical training in Canadian medical schools is uniformly strong; you will get a good education at any of them, at least commensurate (in my opinion) to what you would get from a strong US medical school.

 

If you go to a US school, you will have an easier time matching to a US residency, but will almost certainly have a more difficult time getting a Canadian residency, since most of your CaRMS success comes from networking and electives.

 

If you do a US residency and then decide to return to Canada to practice, you will face licensing issues from the Royal College for many specialties, as many US residencies are shorter than their Canadian equivalents.

 

As well, if you are not a US green-card holder or citizen, you will end up with visa issues, which are a definite hassle, and potentially will limit your residency choices. Many of the competitive US specialty programs do not want to deal with applicants who require visas, particularly since they have a huge number of US citizen applicants who are equivalently strong on paper.

 

Finally, I'm not sure what Canadian med school tuition is like, but almost certainly, Canada will be less expensive than if you are either an out-of-state applicant attending a state medical school, or an international applicant attending a private medical school.

 

While an extra $100,000 here or there might not seem like a lot of money, it very much is, especially considering that the interest on it will be compounding through the life of the loan. This is also exacerbated by the fact that US physician salaries have been declining every year for at least the last decade, and will only continue to do so as the US tries to reign in costs after all the out of control spending that has been going on recently.

 

I, and probably the majority of the physicians in the US, are predicting significant further cuts to physician reimbursement over the next several years. The US medicare system, which is one of the most stingy/frugal payers in the US, is running out of money, and all of the private insurance companies titrate their payments to medicare.

 

Bottom line, I would go to a Canadian school if you are planning on working in Canada. Vandy is a good school, no doubt about it, but staying in Canada for med school will get you further if you are planning on practicing in Canada eventually.

 

Ian

 

What if you are planning on a less competitive residency? How would that impact all this? I'm interested rural family med. Of course, I'd love to get into a Canadian school, but the US schools are quite amazing back-ups. I'd be honoured to get into any North American school, seeing how competitive it is.

 

p.s. Congrats to everyone today!

[Monster]

well...those dreams are crushed. rejected outright at the Canadian schools I interviewed at...my heart hurts.

[Halcyon]

well...those dreams are crushed. rejected outright at the Canadian schools I interviewed at...my heart hurts.

 

Monster - Are you taking your US offer then?

 

Sorry to hear your news.

[token]

Aw I'm sorry Monster

 

At least you still have somewhere to go next year right?

[silvermen85]

Aw I'm sorry Monster

 

At least you still have somewhere to go next year right?

 

Roseland Franklin I think he said earlier.

[token]

Roseland Franklin I think he said earlier.

ah ("she" btw )

 

silver did you hear anything today or you had already decided?

[silvermen85]

ah ("she" btw )

 

silver did you hear anything today or you had already decided?

 

I'm already decided for Stanford, I did get an UT acceptance today. So I guess I will have to give up the spot soon or later, but UT will always hold a special place in my heart!

[Ian Wong]

What if you are planning on a less competitive residency? How would that impact all this? I'm interested rural family med. Of course, I'd love to get into a Canadian school, but the US schools are quite amazing back-ups. I'd be honoured to get into any North American school, seeing how competitive it is.

 

p.s. Congrats to everyone today!

Even with what you mentioned, I would still go Canadian if I was planning on practising in Canada.

 

The trouble is that you never know what you will fall in love with as a specialty. One of my friends swears to this day that when I met him after med school orientation (which would have been 10 years ago this fall), I was pretty convinced that I would be going into Family Medicine. I'm now 6 weeks away from finishing my radiology residency, which is about as 180 degrees away as you can get from FM.

 

Don't misunderstand what I wrote above; I'm not stating that US schools are a poor choice, nor that you shouldn't be honoured to get accepted to one. However, if you are planning to work in Canada, the easiest (and cheapest) path will be to do as much of, or all of, your training in Canada.

 

As someone else has already noted above, I'm actually doing my residency in the US, so I have seen and traversed some of the additional paperwork which is required.

 

Ian

[Halcyon]

Even with what you mentioned, I would still go Canadian if I was planning on practising in Canada.

 

The trouble is that you never know what you will fall in love with as a specialty. One of my friends swears to this day that when I met him after med school orientation (which would have been 10 years ago this fall), I was pretty convinced that I would be going into Family Medicine. I'm now 6 weeks away from finishing my radiology residency, which is about as 180 degrees away as you can get from FM.

 

Don't misunderstand what I wrote above; I'm not stating that US schools are a poor choice, nor that you shouldn't be honoured to get accepted to one. However, if you are planning to work in Canada, the easiest (and cheapest) path will be to do as much of, or all of, your training in Canada.

 

As someone else has already noted above, I'm actually doing my residency in the US, so I have seen and traversed some of the additional paperwork which is required.

 

Ian

 

Thanks for the reply, Ian.

 

Indeed. I suppose you never know what area of medicine you'll fall in love with from the start to the end of that long journey.

 

Do you expect to stay in the US after you've completed your residency? Congrats on being (almost) done!

[flamesfan]

Ian - where did you go to med school if you dont mind me asking....

[Tan008]

well...those dreams are crushed. rejected outright at the Canadian schools I interviewed at...my heart hurts.

 

Sorry to hear that Monster. But you do have an acceptance and it is awesome!

[Rach]

My opinion is that it depends where you think you'll want to practice eventually.

 

If you think that you will most likely be working in Canada, I would choose the Canadian school. It will be much easier to get a Canadian residency position, and you will have no issues relating to licensing. Also, the clinical training in Canadian medical schools is uniformly strong; you will get a good education at any of them, at least commensurate (in my opinion) to what you would get from a strong US medical school.

 

If you go to a US school, you will have an easier time matching to a US residency, but will almost certainly have a more difficult time getting a Canadian residency, since most of your CaRMS success comes from networking and electives.

 

If you do a US residency and then decide to return to Canada to practice, you will face licensing issues from the Royal College for many specialties, as many US residencies are shorter than their Canadian equivalents.

As well, if you are not a US green-card holder or citizen, you will end up with visa issues, which are a definite hassle, and potentially will limit your residency choices. Many of the competitive US specialty programs do not want to deal with applicants who require visas, particularly since they have a huge number of US citizen applicants who are equivalently strong on paper.

 

Finally, I'm not sure what Canadian med school tuition is like, but almost certainly, Canada will be less expensive than if you are either an out-of-state applicant attending a state medical school, or an international applicant attending a private medical school.

 

While an extra $100,000 here or there might not seem like a lot of money, it very much is, especially considering that the interest on it will be compounding through the life of the loan. This is also exacerbated by the fact that US physician salaries have been declining every year for at least the last decade, and will only continue to do so as the US tries to reign in costs after all the out of control spending that has been going on recently.

 

I, and probably the majority of the physicians in the US, are predicting significant further cuts to physician reimbursement over the next several years. The US medicare system, which is one of the most stingy/frugal payers in the US, is running out of money, and all of the private insurance companies titrate their payments to medicare.

 

Bottom line, I would go to a Canadian school if you are planning on working in Canada. Vandy is a good school, no doubt about it, but staying in Canada for med school will get you further if you are planning on practicing in Canada eventually.

 

Ian

 

I have heard that because the US has a huge number of residency spots compared to Canada, it is easier to get into the more competitive residencies over there. Is this true? And if it is, does the abundance of spots make up for the fact that some will outright reject us due to visa issues?

[silvermen85]

I have heard that because the US has a huge number of residency spots compared to Canada, it is easier to get into the more competitive residencies over there. Is this true? And if it is, does the abundance of spots make up for the fact that some will outright reject us due to visa issues?

 

Visa could be an issue, but I think the best way to counter that is to make yourself more competitive by getting better USMLE scores, better dean's letter, better clinical rotation score, better references, better research experience and publications etc. Those will go much further in landing you a competitive residency spot than say that you got a green card. Keep in mind that for Canadian citizen to get a J1 is rather simple, H1B is a little more tricky. So if you are willing to do your residency with J1, I don't think how that could results in automatic rejection.

[Ian Wong]

I have heard that because the US has a huge number of residency spots compared to Canada, it is easier to get into the more competitive residencies over there. Is this true? And if it is, does the abundance of spots make up for the fact that some will outright reject us due to visa issues?

It is easier in some respects, and harder in others. For example, in 2003, when I was applying for Canadian ENT spots, there were roughly 13 in Canada. The US had around 200-250. However, you need to realize that the majority of those 200-250 spots would NEVER be available to you as a Canadian citizen applicant.

 

The reason for this is that from the program director's side of the computer, they are able to place all sorts of filters to screen out residency applications before they are actually downloaded and viewed. Most of these program directors will set a filter to block out applications if they require visas (ie. the applicant doesn't have US citizenship or a US green card). It's a mandatory part of the US residency application process that you disclose whether you are a US citizen or greencard holder, or whether you would require a visa for your residency training.

 

This is no different than if you have a MCAT score which doesn't make the cut-off. You can apply to all the medical schools that you want, but that doesn't mean that you actually have a chance of attending those schools.

 

Now, if you were comparing a US citizen at a US school getting into a competitive US residency, I think that's significantly easier than if you were a Canadian citizen at a Canadian school getting into a competitive Canadian residency. All of those extra spots would be available to you, and the reality is that most US applicants don't need to, and don't apply to all the residency spots in their specialty the way we often do in Canada. But, that doesn't really help you, since you probably aren't a dual US/Canadian citizen.

 

Visa could be an issue, but I think the best way to counter that is to make yourself more competitive by getting better USMLE scores, better dean's letter, better clinical rotation score, better references, better research experience and publications etc. Those will go much further in landing you a competitive residency spot than say that you got a green card. Keep in mind that for Canadian citizen to get a J1 is rather simple, H1B is a little more tricky. So if you are willing to do your residency with J1, I don't think how that could results in automatic rejection.

I can tell you that I applied to radiology in the US during what has so far been the most competitive cycle in the US radiology application in the last decade (that being 2004), with USMLE Step 1 and 2 scores that would be considered obscene by SDN standards, and still only found 2-3 programs that would be willing to do an H1B visa. While there were many programs that were willing to consider a J-1 visa, many others WERE NOT.

 

You cannot go by what SDN states for visas when it comes to competitive specialties. The majority of US programs which regularly offer visas to residents are those which cannot fill their rosters with 100% US medical graduates. In other words, the non-competitive specialities like PM&R, Internal Medicine, Family Medicine, Psychiatry, Pediatrics, Pathology, etc.

 

On the other end of the spectrum, you have the hyper-competitive specialities like Dermatology, Plastics, and Radiation Oncology, who simply have so many overly qualified candidates that they never need to consider taking a visa-requiring applicant. Usually, if you match to a program like this as an international grad, or a visa-requiring grad, it's because you've spent years there doing research for the department, and they eventually take you in as a resident.

 

You have to remember that taking in a visa-requiring applicant is a huge risk to a program. If the paperwork gets muddled or lost, that resident can't enter or stay in the US. I've heard of numerous horror stories of residents who are trapped outside of the US because of paperwork issues. The program is directly affected by that; it screws up the rotation schedule and the call schedule, and puts the resident at risk of not completing the required rotations in time to graduate on time. Also, if the specialty program has never taken a visa-requiring applicant before, they are unlikely to start doing so now, because it requires familiarizing themselves with a whole new list of requirements. There is a great deal of inertia involved in the residency selection process.

 

As well, there's a stigma against US residency programs if they have lots of international medical graduates (IMG's), and to a lesser degree, DO graduates. In the US, everyone gets super-excited about rankings and prestige. If a residency program takes lots of the above applicants, it raises all sorts of questions from US medical student applicants, who are all wondering "why couldn't this program fill with 100% US allopathic graduates? There must be something wrong with the program." A US residency program that takes in visa-requiring applicants runs the risk of attracting less US med student applicants the following year.

 

For an experiment, if you want, go look up FRIEDA, which is the search engine for nearly all of the US residency programs. You can use this to look up each program in a given specialty. See how many programs will list on their website whether they will take J-1 visa applicants, particularly if they are a competitive specialty. You can even call the programs directly, which is what I had to do when I was applying to Radiology.

 

Even if they are willing to do a J-1 visa, that still doesn't put you on equivalent ground as a US citizen applicant. You still have a big minus sign next to your application when compared to the rest of your applicant cohort.

 

My opinion on the bottom line is still the following. If you want to practise in Canada, I would train in Canada.

 

If you want to practise in Canada, but got accepted to and will be attending a US med school, then you go and study hard, and do as well as is humanly possible. If you excell in your med school, you'll probably still end up where you want to be, but it potentially may take some additional hoop-jumping.

 

Ian

[UserName]

Thanks Ian that was very insightful