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

[Tan008]

So...just to ask this again. How hard is it to match in the US having finished US medschool versus having finished a Canadian one? Is there much difference or not really since either way (providing you have your USMLEs) you will need to get a visa to do residency is the States?

[token]

Theoretically it should be the same, though obviously American program directors would rather have someone from an American school (just as Canadian PDs would prefer Canadian graduates).

[Tan008]

Theoretically it should be the same, though obviously American program directors would rather have someone from an American school (just as Canadian PDs would prefer Canadian graduates).

 

Well, from various conversations with some upper year meds and residents, it seems that it is not that simple to come back to Canada. It can be done and people do it all the time, but it's tough because there are fewer spots to begin with already and it is more difficult to match. I was wondering if it would be similar the other way around or if it might be easier (depending on the residency program you are choosing) to go to the states simply because there are more residency spots (even though most of those won't be open to people with visas, as pointed out by Ian).

[token]

Well, from various conversations with some upper year meds and residents, it seems that it is not that simple to come back to Canada. It can be done and people do it all the time, but it's tough because there are fewer spots to begin with already and it is more difficult to match. I was wondering if it would be similar the other way around or if it might be easier (depending on the residency program you are choosing) to go to the states simply because there are more residency spots (even though most of those won't be open to people with visas, as pointed out by Ian).

From what I've seen on SDN, it's easier to get an American residency from an American school...even though schools like UofT and McGill are well known in the US, it seems program directors would feel more comfortable with a visa-needing graduate of an American school vs. a visa-needing graduate of a Canadian school. Just the same way there's a bias against US grads trying to match into Canada.

 

Also if you go to a US school you can do your internship year without a visa, which removes a lot of the hassle for the program. So hospitals are a lot more willing to sponsor visas for US grads vs. Canadian grads. I think that's why it may have been tough for Ian.

[Ian Wong]

From what I've seen on SDN, it's easier to get an American residency from an American school...even though schools like UofT and McGill are well known in the US, it seems program directors would feel more comfortable with a visa-needing graduate of an American school vs. a visa-needing graduate of a Canadian school. Just the same way there's a bias against US grads trying to match into Canada.

 

Also if you go to a US school you can do your internship year without a visa, which removes a lot of the hassle for the program. So hospitals are a lot more willing to sponsor visas for US grads vs. Canadian grads. I think that's why it may have been tough for Ian.

It would be easier to match into a US residency coming out of a US med school compared to a Canadian med school. I think that holds true even coming out of U of T or McGill, which are generally the 2 schools that US folks are at all familiar with.

 

If you do your med school in the US, you would be on an F-1 student visa. You can use something called OPT (Optional Practical Training), which functions as a 1 year extension to that F-1 visa. This means that you can do your PGY-1 intern year on this OPT. However, after that, you still need either a J-1 visa or an H1B visa in order to complete the remainder of your residency. So, you still need to find residency programs that are willing to sponsor you for a visa.

 

An advantage of OPT is that it gives you the entire PGY-1 year to get your visa applications together (more critical for the H1B) rather than trying to cram it all in after graduating med school, but before starting internship. A second advantage is that it means you have an extra year off leeway before you start either an H1B or J-1 visa, which can be important if you end up in a long residency + fellowship that could run 7 years (an H1B visa can only be used for up to 6 years).

 

However, as mentioned above, the OPT only gives you 1 year. You will still need either an H1B or J-1 visa for the remainder of your residency training, and that is one of the big limiting factors if you are going after a competitive specialty.

 

Ian

[Tan008]

Thanks Ian. You are the medschool guru

[token]

The gist I get from SDN is, if you're going for primary care/ob gyn/psych/surgery, you can probably get an H1B as an American graduate. If you want something more competitive, you have to do a J1. But I don't believe any hospital would refuse to take a US grad on a J1, since the application process is so easy, and with the OPT they'll have a year to do it. It should put you on the same page as a US citizen US graduate. Our situation is so rare, probably <300 of us each year so it's really hard to find out what the typical success rate is (and why Ian's posts are so valuable).

 

http://forums.studentdoctor.net/showthread.php?t=450230&page=2

http://forums.studentdoctor.net/showthread.php?t=363725

 

Some posters had no trouble getting interviews at top programs since they didn't insist on an H1B. Renovar was more direct and may have missed out on some. For e.g. Hopkins DOES sponsor H1Bs but for US graduates only. However they apparently didn't mention that on their website so he didn't apply. On the other hand I got this scary letter from NYPH Columbia/Cornell saying that they changed their policy, and will no longer sponsor H1Bs for US graduates, but will take us on J1s (apparently P&S and Weill have been really attractive to international students as an easy in to the NYPH system, so they were just warning all prospective internationals). So there definitely are some places that are dead set against H1Bs, but there still shouldn't be a problem with a J1. I guess a J1 would be tough to swallow if you're trying to settle in the US, however. Also the availability of the J1 varies by province...I have Ontario and Quebec's lists of specialties "in need" if anyone wants to see them.

 

I was going to ask people I know at US med schools, but I realized they both got married and are likely on their way to green cards anyway But if anyone knows anyone IRL who will be doing residency on a visa rather than a permit we'd love to hear how it went.

[Tan008]

Thanks for the info token. I have some serious thinking ahead of me.

[silvermen85]

As far as I have checked so far, most if not all competitive specialties at the well known hospitals sponsor J1 at the minimum.

[Tan008]

As far as I have checked so far, most if not all competitive specialties at the well known hospitals sponsor J1 at the minimum.

 

I know four people who went to the States to do residency (three of them got J1), so people do move back and forth

[The Journey Man]

Thanks for all the wonderful info.

 

Quick question though: Does anyone know why a Canadian would want an H1B?

 

From looking it up, Aside from having to go back for 2 years after your training (which can be waived in some circumstances), the J1 has more advantages than a H1B in terms of taxes (less taxes paid), your spouse can work (your spouse cannot on a H1B) and its a less of a hassle in terms of paper work.

 

Why would a Canadian want a H1B?

[token]

From what I understand the J1 is a non-immigrant visa.

 

If you do your residency on an H1B you can probably get your green card within a couple years afterwards. So if you're planning on staying in the US it's a better option. I've heard varying opinions about how annoying the 2 year requirement/waiver is.

 

Also you can moonlight on an H1B.

[silvermen85]

From what I understand the J1 is a non-immigrant visa.

 

If you do your residency on an H1B you can probably get your green card within a couple years afterwards. So if you're planning on staying in the US it's a better option. I've heard varying opinions about how annoying the 2 year requirement/waiver is.

 

Also you can moonlight on an H1B.

 

J1 is very annoying mostly due to the 2 year requirement. However, to get a H1B it does cost a lot more money to sponsor. One of the reason why many institutions don't wish to do that.

[silvermen85]

Thanks for all the wonderful info.

 

Quick question though: Does anyone know why a Canadian would want an H1B?

 

From looking it up, Aside from having to go back for 2 years after your training (which can be waived in some circumstances), the J1 has more advantages than a H1B in terms of taxes (less taxes paid), your spouse can work (your spouse cannot on a H1B) and its a less of a hassle in terms of paper work.

 

Why would a Canadian want a H1B?

 

Try to get that waiver is very difficult and unpredictable.

[Dr. Jack Shephard]

Great posts, just what I have been agonizing over lately.

 

Here's my situation: I will be attending Dartmouth Medical School in the fall unless I get in off one of two waitlists in Canada: Queen's and University of Manitoba. I may or may not have this difficult choice to make in the imminent/near future, which is why I am thinking about it now.

 

I came across this website today, about the ease of returning to work in Ontario after completing residency in the States:

 

http://www.cpso.on.ca/policies/policies/default.aspx?id=2352

 

It seems like there is another path to come back to Ontario, which just requires some sort of assessment in the first 18 months of practising in order to receive a full license to practice in Canada. There is no mention of comparing residency training or taking further exams. What are your thoughts on this? Is it reasonable to expect that this path will still be around 7-10 years from now?

 

Cheers,

 

--Jack

[a41]

I saw a billboard advertising that in Michigan. It seems like they're pretty serious about it.

[foregoneconclusion]

Yeah, I'd love to hear any thoughts on:

 

http://ontario.ca/USdoctors

 

Saw billboards in the airport. Is there a catch?

[token]

The new pathway only came into place this past December, so no one really knows how onerous the "monitoring" process is, or how long the policy will last.

 

Alastriss yeah you will be limited with the J-1, but if you're from Ontario I don't think there would be a problem getting your preferred specialty. Either you send in your application early, or you get limited to the "list." FWIW last year it was:

 

Anesthesia

CCM

Radiology

EM

FM

Gen surg

Geriatrics

IM

Lab medicine

Heme/Onc

OB/GYN

Ortho

Peds

Path

Psych

Rad Onc

Rheum

Vascular surgery

 

+ assorted sub specialty fellowships

 

The only specialty that jumps out to me as missing is derm. 110 people (+ 15 for fellowships) get them each year on a first come first serve basis. Initially they will be issued for any specialty, then as they approach 125 (and I think this is deliberately vague) they give preference to the above list.

 

Basically the overall gist is that Ontario is currently desperate for doctors, which is good news if you're from there/want to live there. Who knows what the demographics will be like in 8 years, but I doubt they're going to open up enough med schools in that time to satisfy the increasing demand.

 

If you're from any other province though you might be kind of screwed. Quebec for example has quotas for each specialty (maximum of 6 in internal medicine, 2 in pediatrics, etc.)

[tryhard]

what about a person in a situation like this. Canadian citizen, US med school, wants to stay in the US.

If this person got a J-1, and they wanted to stay in the US, wouldn't that cause some big problems?

[token]

what about a person in a situation like this. Canadian citizen, US med school, wants to stay in the US.

If this person got a J-1, and they wanted to stay in the US, wouldn't that cause some big problems?

If you want to stay in the US you should be aiming for an h1b anyway (precursor to green card). But if you can't you could do an j-1 waiver (instead of returning to Canada, work in an underserved area of the US for a few years).

[new_intern]

what about a person in a situation like this. Canadian citizen, US med school, wants to stay in the US.

If this person got a J-1, and they wanted to stay in the US, wouldn't that cause some big problems?

 

I did exactly what the OP wrote. Canadian citizen, US MD school grad, now doing residency on a J-1 visa. Waivers are not that hard to obtain, but with the new policies by the Ontario government at least there is that option. On the interview trail, I learned that H1B are becoming increasingly diffcult regardless of whether you are a US grad or not...esp in these economic times, programs do not want to spend the money. Factor in the increasing number of US citizen DO grads every year, and H1B is becoming less and less of a possibility.

[The Journey Man]

Does anyone know whether doing a fellowship in Canada would be sufficient for "mentored" period of stay in Canada.

 

Suppose I do residency in the US on a J-1 and have to leave for 2 years because of the J-1. So I do a fellowship for a couple years in Ontario --> wouldn't this set me up to return to the US at the same time have the option to practice independently Ontario?

[tryhard]

I did exactly what the OP wrote. Canadian citizen, US MD school grad, now doing residency on a J-1 visa. Waivers are not that hard to obtain, but with the new policies by the Ontario government at least there is that option. On the interview trail, I learned that H1B are becoming increasingly diffcult regardless of whether you are a US grad or not...esp in these economic times, programs do not want to spend the money. Factor in the increasing number of US citizen DO grads every year, and H1B is becoming less and less of a possibility.

 

I see. So than what is the process of becoming a US citizen (green card holder) on a J-1, would it be very difficult? Are you planning on practicing in the US?

 

Does all this mean a competitive residency in the US for someone like you is out of the picture?

[new_intern]

I see. So than what is the process of becoming a US citizen (green card holder) on a J-1, would it be very difficult? Are you planning on practicing in the US?

 

Does all this mean a competitive residency in the US for someone like you is out of the picture?

 

If I decide to stay in the US, I will most likely take a waiver (which is not hard to get for my specialty). That would put me on a H1B for the 3 years that I fulfill my waiver job requirement, and then I would apply for the green card for my next job.

 

As I said before, I wanted to get a H1B visa for residency, but programs who said they sponsored told me at the interview they were changing their policy because of the cost and hassle etcetc. I've been reading some posts here, and trust me, being a US MD grad or not makes no difference. There will always be a US citizen MD grad just as qualified as you so why would they bother?