Canadian IMG getting residency in US

[cnhoslcher]

Hey guys,

 

After few rejections from Canadian school I have decided to go overseas and get my education in Ireland. I know it is difficult to get residencies back in north America but I will write both MCCEE and the USMLE. I was wondering if anyone can shed some insights on if it would be possible for a Canadian citizen with Irish MD degree to land a residency position in the states. Thanks!

[killahkam]

Same question here....If I go to carib or Oz, it is hard to get residency in canada. But will i get residency in the US?

[KTWD]

Hey guys,

 

So the information sessions I have gone to say it is MUCH easier purely based on the fact there are more spots. You may still have to sacrifice where you live, in terms of not your first choice. But to get a residency position is possible. It is my plan. By going to the states if you want to return to canada you can also by pass the return of service Canada makes you do if you do your residency in Canada. From my understanding, because the states is more privatized when it comes to residency, they really care about your score on the USMLEs.

 

Now keep in mind I am probably more optimistic than most ppl. However, just study your a** off for those exams.

[Mashmetoo]

Hey guys,

 

After few rejections from Canadian school I have decided to go overseas and get my education in Ireland. I know it is difficult to get residencies back in north America but I will write both MCCEE and the USMLE. I was wondering if anyone can shed some insights on if it would be possible for a Canadian citizen with Irish MD degree to land a residency position in the states. Thanks!

 

First of all, you'll have an Irish MBBS degree, NOT MD.. If you get this wrong then... As for landing into a US residency, will you have any US core rotations? Is the curriculum in Ireland designed to make you pass the USMLE board exams? It certainly is "possible", but the difficulty will be increased without US core rotations.

[Mashmetoo]

Hey guys,

 

So the information sessions I have gone to say it is MUCH easier purely based on the fact there are more spots. You may still have to sacrifice where you live, in terms of not your first choice. But to get a residency position is possible. It is my plan. By going to the states if you want to return to canada you can also by pass the return of service Canada makes you do if you do your residency in Canada. From my understanding, because the states is more privatized when it comes to residency, they really care about your score on the USMLEs.

 

Now keep in mind I am probably more optimistic than most ppl. However, just study your a** off for those exams.

 

Getting a residency in Canada, easier said than done. Check out these abysmal IMG stats from this year: http://www.carms.ca/eng/operations_R1reports_10_e.shtml

 

check out these equally abysmal IMG stats for the ACGME residency match in the US: http://www.nrmp.org/data/advancedatatables2010.pdf

 

Your best bet is to get into a US residency.

[killahkam]

im guessing Oz is the same thing as Ireland?

You can get US residency but you will need to study for the boards on your own?

[Mashmetoo]

im guessing Oz is the same thing as Ireland?

You can get US residency but you will need to study for the boards on your own?

 

http://www.carms.ca/pdfs/2010R1_MatchResults/IMGs%20by%20Region_1stand2nd%20Iteration_en.pdf

 

that's the stats for Australian grads who got into a Canadian residency this year. Only 39 applicants, and 25 acceptances. Realize this: there are over 1400 Canadians studying med in Australia, and 39 CANNOT possibly be representative of ALL the Canadians in Australia that's in need of a residency this year. What happened to the rest of them? Most likely US residencies, and God knows what else

 

And yes, you'll be on your own studying the boards for the USMLEs.

[leviathan]

Yes, it's possible, but without doing your rotations in the US you are at a huge disadvantage, especially now that those 'extra spots' are starting to dwindle down significantly and even Family Med spots are becoming more competitive. Without experience in the US system, and good LORs from American physicians, it will be tough. Also as mentioned, you will have a harder time performing well on the USMLE Step 1 if you are in Ireland/Oz.

[cnhoslcher]

Thanks for the reply guys. I can see that this will be difficult path compared to going to school in North America. I know I will be getting MBBS degree when I graduate from Ireland. But I was under the impression that MBBS degree will be considered equivalent to North American MD degree. Now I am not sure what to do. I think it would be as difficult to secure 'core' rotations in US hospitals..

[nosuperman]

Thanks for the reply guys. I can see that this will be difficult path compared to going to school in North America. I know I will be getting MBBS degree when I graduate from Ireland. But I was under the impression that MBBS degree will be considered equivalent to North American MD degree. Now I am not sure what to do. I think it would be as difficult to secure 'core' rotations in US hospitals..

 

The degree is equal. Core rotations I don't think you'll be able to do but most schools will give you a dozen or so weeks worth of elective rotation during clerkship.

[nosuperman]

 

40% with downward trend? Damn thats basically the same as the match rate for coming back to Canada. I thought it'd be higher. I wonder if Canadians do disproportionately well as compared to other non-US IMG's?

[Mashmetoo]

40%. Damn thats basically the same as the match rate for coming back to Canada. I thought it'd be higher. I wonder if Canadians do disproportionately well as compared to other non-US IMG's.

 

It probably is slightly better, probably by a single digit percent. But I doubt that it'll be better than the match rate for IMGs who are US citizens.

[nosuperman]

It probably is slightly better, probably by a single digit percent. But I doubt that it'll be better than the match rate for IMGs who are US citizens.

 

US Citizen IMGs were @ 47% (only 7% higher than non-US) so you're right, it probably isn't much.

[Mashmetoo]

US Citizen IMGs were @ 47% (only 7% higher than non-US) so you're right, it probably isn't much.

 

This is why I tell people to research research research their options BEFORE heading overseas. Too many people are simply too naive, and assume they'll be fine with their Irish/Australian education when the numbers are less than encouraging at best. What they don't realize is that Ireland/Australia do not offer core US core rotations. They then somehow assume that they'll land into a US residency.. gee, I wonder how that would work if they don't get any US rotation in the first place. I mean, it is possible, but it's just that much harder without US rotations. Then it becomes a question of why they chose Ireland/Australia in the first place, when there are other US options possible.

[RyGuy123]

Getting a residency in Canada, easier said than done. Check out these abysmal IMG stats from this year: http://www.carms.ca/eng/operations_R1reports_10_e.shtml

 

check out these equally abysmal IMG stats for the ACGME residency match in the US: http://www.nrmp.org/data/advancedatatables2010.pdf

 

Your best bet is to get into a US residency.

 

But take into account this is just not canadians coming back, it is people from Pakistan ect that are put into the same pool that a canadian that went to OZ and came back

[Mashmetoo]

But take into account this is just not canadians coming back, it is people from Pakistan ect that are put into the same pool that a canadian that went to OZ and came back

 

Read nosuperman's post

 

"US Citizen IMGs were @ 47% (only 7% higher than non-US) so you're right, it probably isn't much."

 

US citizen IMGs were at 47%, as a Canadian, do you really think you'll do better than US citizens in the match in their own country? As a Canadian, you'll be just another foreigner to the Americans. Because to the Americans, THAT is what you are, no one cares if you are a Canadian. You'll be in the same footing as an Pakistani, or Indian med graduate trying to get into a residency in the US. Do you think they'll show you leniency simply because you are Canadian? You are just another foreigner to them! If you think you'd get it easier as a Canadian, you are dreaming.

[Zuckman]

A Canadian IMG trying to match into the US definitely has an advantage compared to a Pakistani. This is because Canadians speak perfect English. I've talked to several program directors and if all things are equal, the Canadian would be preferred. If an IMG resident does not speak very good English, it makes the program and hospital look 3rd rate.

[leviathan]

I'd rather people be afraid than confident when deciding if they should pursue medical training overseas, but I'd look at those numbers with a for US IMGs with a grain of salt. You have to take into account all of the dubious medical training institutes where people go for their training and subsequently don't match because a) they weren't properly educated they aren't capable or some combination of A and B. Yes the numbers themselves are accurate but there is a wide variation in success rates across individual schools.

 

If you look at the 4 Caribbean medical schools which have received site visits and accreditation in all 50 states, the match rate is more about 80% for those schools. Still not perfect, but 2x better than what you're seeing in that table. I don't want to know how awful it is for other schools to balance out the overall match rate down to 40%. I am curious to see how this trend will continue and how the match rates will be affected at the reputable Caribbean schools, where the majority of US IMGs are studying. Certainly the overall match rate is going to continue to fall due to both an increase in applicants and a decrease in spots.

[leviathan]

A Canadian IMG trying to match into the US definitely has an advantage compared to a Pakistani. This is because Canadians speak perfect English. I've talked to several program directors and if all things are equal, the Canadian would be preferred. If an IMG resident does not speak very good English, it makes the program and hospital look 3rd rate.

That might be one explanation, but another more likely reason (or at least more politically correct) is that programs do not want to train physicians who cannot effectively communicate with their patients.

[medmal]

If you look at the 4 Caribbean medical schools which have received site visits and accreditation in all 50 states, the match rate is more about 80% for those schools. Still not perfect, but 2x better than what you're seeing in that table. I don't want to know how awful it is for other schools to balance out the overall match rate down to 40%.

 

For what it is worth the dean of University of Sydney said in his webcast that more than 90% of Canadian trained there were able to get residencies back in Canada if they applied for it.

[nosuperman]

I'd rather people be afraid than confident when deciding if they should pursue medical training overseas, but I'd look at those numbers with a for US IMGs with a grain of salt. You have to take into account all of the dubious medical training institutes where people go for their training and subsequently don't match because a) they weren't properly educated they aren't capable or some combination of A and B. Yes the numbers themselves are accurate but there is a wide variation in success rates across individual schools.

 

If you look at the 4 Caribbean medical schools which have received site visits and accreditation in all 50 states, the match rate is more about 80% for those schools. Still not perfect, but 2x better than what you're seeing in that table. I don't want to know how awful it is for other schools to balance out the overall match rate down to 40%. I am curious to see how this trend will continue and how the match rates will be affected at the reputable Caribbean schools, where the majority of US IMGs are studying. Certainly the overall match rate is going to continue to fall due to both an increase in applicants and a decrease in spots.

 

Are Carrib top 4 schools considered IMG to the US? I don't doubt your 80% figure, I'm just trying to mesh it with the article's 47% figure for US IMG's matching in their own country. How does this work out?!

 

Presumably Canadians match better than Pakistanis but there'd be uproar if they out-competed American IMGs applying to hospitals in their hometowns.

 

If the stats are accurate then it means there are tons of Americans graduating from international med schools that have single-digit% match rates (To pull the high numbers from top 4 down from 90-100 to 47) for coming back home to the US, which is crazy.

[bloh]

For what it is worth the dean of University of Sydney said in his webcast that more than 90% of Canadian trained there were able to get residencies back in Canada if they applied for it.

 

Why would you believe him when the statistics show the exact opposite?

[Mashmetoo]

Why would you believe him when the statistics show the exact opposite?

 

because if you want to believe in something strong enough, you'll take any dubious info/lie and ingest it wholly as we have seen here. It's not the first time he's taken in information, and reacted without any critical analysis, and it most certainly will not be the last.

[Mashmetoo]

Finally, I've found a statistically backed study looking into the different selection patterns between IMGs and AmericanMGs. Now I have a scientific study backed by statistics that warn people about the risks of going IMG.

 

 

http://ap.psychiatryonline.org/cgi/reprint/25/3/184

 

***Differences in Selecting U.S. and International Medical Graduates for U.S. Residency Programs

 

 

 

Academic Psychiatry 25:184-185, September 2001

© 2001 Academic Psychiatry

Letter

Differences in Selecting U.S. and International Medical Graduates for U.S. Residency Programs

Richard Balon, M.D., Ahsan Naseem, M.D., Wayne State UniversityDetroit, MI, Ravi S. Kribat, M.D., Todd Moore, M.D., Phillip Bowman, M.D. and Michelle Riba, M.D., University of MichiganAnn Arbor, MI

 

Key Words: Letters • International Medical School Graduates • Admissions Criteria

 

TO THE EDITOR: The prospect of an oversupply of physicians has led some experts to propose a reduction of the total number of graduating residents to 110% or 120% of the number of graduates of U.S. medical schools. However, not everybody agrees with the prediction of an oversupply of physicians. There is also some evidence that medicine has attempted to address this issue through various measures, including limiting the number of international medical school graduates (IMGs) entering residency programs. Nasir (1) demonstrated a pattern of dissimilarity in the way family practice programs responded to requests for residency applications. In this study, 50% of responding programs replied to an IMG applicant, whereas 90% replied to a U.S. medical school graduate asking for an application for residency. We conducted a similar study (2), in which residency programs in psychiatry responded significantly more frequently to a U.S. medical school graduate asking for an application than they did to an IMG.

 

We then investigated whether the results of our study among psychiatry programs are applicable to other disciplines; that is, whether other disciplines respond more frequently to an application request from a U.S. medical school graduate than to one from an IMG. During November 1998, we mailed two letters requesting an application for a residency position to 105 randomly selected family medicine (approximately 22% of the programs), 103 internal medicine (24%), 105 neurology (86%), 95 obstetrics/gynecology (36%), 101 pediatrics (46%), and 101 general surgery training programs (38%). The letters differed in only two respects: the names of the writers (American or Indian) and the medical school from which the writers graduated (United States or Indian). Example of the letter:

 

Dear Dr. ...

 

I am a graduate of the University of .... I am very much interested in a residency training position in [specialty]. Kindly send me an application for your residency training program.

 

Thank you.

 

Sincerely,

 

..., M.D.

 

Return addresses were both from southeastern Michigan.

 

The study was approved by both institutions' Internal Review Boards.

 

We received 167 responses for the IMG and 256 responses for the U.S. medical graduates (27% vs. 42%; chi-square=28.66; P<0.0001). All disciplines except obstetrics/gynecology had higher point response rates for the U.S. graduates. However, the difference was significant only for family medicine (57% vs. 32%; chi-square=13.26; P<0.0001); pediatrics (43% vs. 17%; chi-square=16.03; P<0.0001); and internal medicine (41% vs. 24%; chi-square=6.39; P=0.01). The response rates for the U.S. graduates were marginally higher in neurology (42% vs. 30%; chi-square=3.51; P=0.06) and surgery (40% vs. 29%; chi-square=2.66; P=0.1). In obstetrics/gynecology, the rates were 28% for the U.S. graduates and 34% for the IMGs (chi-square=0.62; NS).

 

The detailed analysis of positive vs. negative, as well as further quality of responses, are both beyond the scope of this letter. The quality of responses was mostly similar. Some programs specified the visa status they required from IMG applicants. In both family medicine and obstetrics/gynecology, most of the responses to both requests suggested using the electronic application system (ERAS). In two disciplines, neurology and pediatrics, we noted, occasionally, a qualitatively different response (for example, a letter to the IMG stated that the interview process was finished, whereas the U.S. graduate received the application; or the IMG was informed that he had missed the deadline, whereas the U.S. medical graduate received the application).

 

Our study had several limitations:

 

1. For various reasons, we mailed the application requests fairly late during the application season (November). That might influenced the point response rate in this study. In our previous study of psychiatric residency training programs (2), we mailed the letter in August–September, and our point response rate was 159 for the U.S. medical graduate request and 105 for the IMG request, both out of 188 programs. Nasir (1) did not specify the time of the year when their letter was sent out. However, the response rate in our study would correspond to a remission rate in clinical trials, and our primary outcome measure was whether the program responded or not. Thus, the percentage of responding programs does not have to meet some predetermined point. The response rate pattern—higher response rates for U.S. medical graduates—is similar in all three studies (1,2, and our current investigation).

2. Two entire disciplines (family medicine and obstetrics/gynecology) and some programs in other disciplines included in our study used the electronic application system (ERAS) in 1998. However, the use of ERAS does not seem to be a factor in the differential response by some disciplines. Some programs responded to mailed application requests. The two disciplines that had switched completely to ERAS, obstetrics/gynecology and family medicine, had a different response pattern. Family medicine had a significantly higher point response rate for U.S. medical graduates, but in obstetrics/gynecology, the rates were higher for the IMGs, although not significantly so. In both these disciplines, most responding programs sent a letter suggesting using the ERAS and some material about the program; yet the response pattern was different.

3. We did not mention the visa and citizenship status in the request letter, which some suggest may be an important issue for training programs who wish to guarantee that the residents they accept will be able to start on time. However, the visa or citizenship status would be indicated on the application form that was requested. We felt that having the letter requesting an application differing only in one fact—the school of graduation—is the simplest way to address our hypothesis, and that providing other information would further complicate and bias the responses (e.g., as in the case of U.S.-born IMGs). Also, the return address for the IMG was in the United States.

 

Nevertheless, the results of this study, in combination with the results of the studies among family medicine and psychiatry programs, demonstrate different response rates for the application for residency training positions, mostly in favor of U.S. medical school graduates. Results of these studies suggest that medicine is trying to limit the influx of IMGs at the first level—the request for an application for a residency position. As we pointed out before (2), we can only guess about the reason for the higher rejection rate for IMGs, but discrimination seems to be a plausible explanation. ***

 

ACKNOWLEDGMENTS

 

The authors thank Cynthia L. Arfken, Ph.D., for statistical analysis and expertise.

 

REFERENCES

 

1. Nasir LS: Evidence of discrimination against International Medical Graduates applying to family practice residency programs. Fam Med 1994; 26:625-629[Medline]

2. Balon R, Mufti R, Williams M, et al: Possible discrimination in recruitment of psychiatry residents? Am J Psychiatry 1997; 154:1608-1609

[leviathan]

Are Carrib top 4 schools considered IMG to the US? I don't doubt your 80% figure, I'm just trying to mesh it with the article's 47% figure for US IMG's matching in their own country. How does this work out?!

That's what I'd like to know, too. Our dean of clinical medicine visited the school today to talk about matching strategies and some stuff with respect to clerkships. He said in 2010 ~60% of our grads got residencies in the match, 20% are getting residency offers outside the match ("pre-matching"), and 10% are matching after in the scramble. I don't know if that 37-40% number quoted earlier only includes those in the primary matching round, because if that is true, then it might make more sense as only 60% of our grads are matching in the first round (but 90% overall are getting residencies).

 

Also he said 6 Canadians from my school applied solely to CaRMS, and 5/6 of those matched. He didn't give any stats about overall #s of CaRMS applications, and I forgot to ask. Nevertheless I thought that match rate was interesting, but obviously it's a small sample size so you can't really draw any conclusions from it.