Looking for some guidance

[whattodonow]

Looking for a Canadian perspective. Basically, I am torn right now between MCAT and accepting an offer from an Osteopathic Medical School. Similar to all of us premeds out there, I have worked extremely hard during undergraduate working, doing ECs, sports, research while maintaining a solid 3.85 Grade Point Average. Despite being a native speaker of English, I have struggled on three MCATs in verbal reasoning with my highest being an 8, not good enough as an Ontario resident. Now on the one hand I can attend SGU this August, go to an Osteopathic Medical School in the USA or try the MCAT one last time and continue with my research. With this my concern is the Canadian luck factor as, even with a solid MCAT, schools like Mac, Ottawa, Toronto seem to be a crapshoot. I like the notion of Osteopathic Medicine, I am just confused why we can only apply through CARMS in Ontario/BC (Alberta maybe) It just seems like the DOs in Canada are rising and it will be an amazing alternative to US/CAN MD in like 5-6 years but right now, I am not so sure. What do you think, SGU, MCAT redo or DO?

[Mashmetoo]

Hey whattodonow, glad to hear from you again. I was basically in the exact same situation as you are in right now back in 2008. I am also a native speaker of English, and I also tried the MCAT 3 times. My highest VR was a 7, so right off the bat, my choice of schools in Ontario was limited. At the time, I also had 3 options: I was accepted into an Osteopathic medical school, I could redo my MCAT for the 4th time, or I could go to SGU/Ireland/Australia. After some HARD soul searching and self reflection, I chose Osteopathic medicine. My reasons were as follows: 1) Life is short, enjoy it while you still can. Yes, I could have redone my MCAT, but there was absolutely no guarantee that I could get that 10+ in VR to meet all the Ontario cutoffs. What if I got another 7? What if I got a 9, but is still below the cutoffs? What if I did get that 10 in VR, but my BS and PS all dropped below the cutoffs? What I wrote about myself also applies to you. What if you fail to achieve that 10 in VR, and you gave up that guaranteed seat at a US med school? Imagine how sad you will be when you realize that another year of med school application just went down the sh!tter without anything to show for it. What I’m saying is this: WHY would you give up a SURE chance of attending an AMERICAN MEDICAL SCHOOL ONLY TO HAVE A CRAP SHOT AT AN ONTARIO SCHOOL? Where is the logic in that?

 

I had a friend who did SIX years of undergrad. He also took the MCAT 3 times, and the highest VR he got was a 7. He knew that he couldn’t get into any of the Ontario med schools with MCAT requirements, so he put all his eggs into one basket, and applied only to Ottawa. In his 6th year of undergrad, the heavens and the stars aligned for him, and he actually DID get into Ottawa off a waitlist. What he did was quite foolish in my opinion. He promised me that he would apply for US DO schools if he failed to get into Ottawa this one last time. But with LOTS luck and lots of fate tempting, he did manage to pull it off, although the amount of sadness and stress of having to do SIX years of undergrad, and the uncertainty of getting into med school must have been slowly killing him during his last 2 years of undergrad. Imagine how SAD and angry he would have felt if he failed to get into Ottawa this last time? He did not have ANY backup plans, he didn’t apply to ANY schools except Ottawa. What I’m saying is this: yes, it is possible that you might pull through, and get that 10 in VR on your 4th try of the MCAT. But are you ready to pay the price if you fail to get that 10+ in VR? Are you ready to give up your SURE chance of attending a US medical school only to have a MAYBE chance of going to a Canadian one? Imagine the worst case scenario: you failed to get a 10+ VR, and you gave up your Osteopathic seat, are you going to be happy with your decision at that time?

 

I also wanted to say that a seat at an American Osteopathic schools should not be squandered, especially at the institute that you have been accepted into. Do you have ANY idea how many people I have come across that would literally sell crack to babies to have a seat at the school you are accepted to? The answer is: MANY.

 

2) I have been accepted into an AMERICAN medical school. I could have gotten into SGU, ANY of the Caribbean/Ireland/Australian medical schools, but the stigma of being an IMG was simply too great for me. If you are given the choice being labelled an AMERICAN MEDICAL GRADUATE, or an INTERNATIONAL MEDICAL GRADUATE, which title would YOU take? Isn’t the answer obvious? I have written extensively on the advantages of having an “advanced US medical degree, and of being an AMG compared to an IMG”, you can find more on this post here: http://www.premed101.com/forums/showthread.php?t=42401. Read up especially on the part about residency matching in the US as an AMG, and getting the H1B visa. The question is this: WHY would you choose to become an IMG when you already have your foot in the door to be a native AMG? What do you think will bring you more benefit? Being an IMG, or an AMG?

 

I have been reading your progress here and on SDN for quite some time. What I have to say is this: you can debate the merits of going DO, IMG MD/MBBS, or redoing the MCAT ad infinitum, there will be advantages and drawbacks for each option. There WILL be factors and circumstances that you CANNOT FORESEE. All you can do is take the data that is currently available to you, and make the best possible educated guess at what will bring you the MAXIMUM benefit. Hell, you could die from a plane crash on route to SGU for all you know , some things we just don’t know. The other thing I wanted to say is this: human life is short. As doctors, we’ll already be spending our 20s, even 30s studying for stuff. So you should get on the road to becoming a doctor AS SOON AS POSSIBLE. You have already been accepted into an American medical school, this in itself is a great achievement, WHY would you cause yourself MORE pain by redoing the MCAT for the FOURTH time, giving up a SURE SPOT, and even consider castrating yourself as an IMG when you’ve already got into the medical profession in an AMERICAN medical school of all places.. Why? Why? Why??? The point is this: the time for debate is over, it is time to choose, and all the data clearly point to Osteopathic medicine in AMERICA as the best possible choice out of the three options that you have offered us today.

[icewine]

these quotes are from the linked thread. just thought they'd be more appropriate here.

 

For the record, the Irish/Australian medical schools DO NOT offer the MD degree. They offer the MBBS medical degree, which (some say), is interchangeable with the MD degree.

 

no need to imply ambiguity here. the degrees are equal. MBBS grads can use the MD title in Canada/U.S. if they are fully licensed.

 

I've also researched the Caribbean/Irish/Australian schools, but the stigma of being labeled an IMG was just too great for me.

 

fair enough, though there is stigma associated with any route outside LCME schools, especially in Canada. if you go international, it's "you couldn't get in at home". if you go DO, it's that plus "what's a DO" or "why didn't you become an MD". i'm not trying to be facetious - this is the kind of sentiment that we may face as non-LCME grads in Canada. though the more likely situation is if you're a good doctor, then no one will care where you went to school.

 

OP: i don't want to read too much into your post but it sounds like you're pretty set on the DO route, in the absence of a Canadian acceptance. my advice would be to take the offer, but to rewrite the MCAT and apply once more after you've matriculated (i'm assuming you've applied once already). good luck with your decision.

[Mashmetoo]

no need to imply ambiguity here. the degrees are equal. MBBS grads can use the MD title in Canada/U.S. if they are fully licensed.

 

I keep hearing that MBBS can use the MD title in Canada/US, do you have any proof of this? Have you ever seen a doctor MBBS doc legally referring himself as a MD? Can a DDS dentist legally call himself a DMD?

 

fair enough, though there is stigma associated with any route outside LCME schools, especially in Canada. if you go international, it's "you couldn't get in at home". if you go DO, it's that plus "what's a DO" or "why didn't you become an MD". i'm not trying to be facetious - this is the kind of sentiment that we may face as non-LCME grads in Canada. though the more likely situation is if you're a good doctor, then no one will care where you went to school.

 

What you say about the LMCE schools and the stigma is mostly true. I'd like to point out however that what I'm talking about here, and all the strategy I've been writing about is getting into a medical school so one can get the coveted ACGME (MD) residency AFTER the initial 4 years of medical school are over. Only with a ACGME residency can anyone hope to make back their 300k+ of med school tuition, and to eventually become a practising doctor. The nightmare situation are those unfortunate souls who go to the Caribbean/Ireland/Australia, but FAIL to land into ANY residency, especially US residencies, when they could have gone to a DO school, and got into a ACGME residency almost assuredly. All that stuff about stigma of not going to a LCME school in Canada is a bit off topic. After all, if one could get a US DO degree, get into their 1st/2nd/3rd choice residency spot in the US, then waltz back to Canada to do the MCCEEs/MCCQEs and be licensed, who gives a DAMN if they initially went to a LCME accredited school or not? If they did pull off the above, a DO would be legally protected as a doctor just like all their MD colleagues who went to LCME accredited schools. Another thing, DOs are firstly not IMGs, so they are not even in the same class as IMGs. Secondly, a lot of people actually like the DO philosophy, as I mentioned, I've seen US applicants reject their MD offers to go to DO schools. In the USA, DOs are just as legitimate as MDs, and command the same respect as doctors under the law. So really, the world is bigger than Canada, and if you really ran into "wth is a DO" moment, taking 30 seconds to explain the DO difference/similarity to your patient is probably a good idea.

 

OP: i don't want to read too much into your post but it sounds like you're pretty set on the DO route, in the absence of a Canadian acceptance. my advice would be to take the offer, but to rewrite the MCAT and apply once more after you've matriculated (i'm assuming you've applied once already). good luck with your decision.

 

From what the OP posted, I don't think he's that set on the DO route, if he was, he'd have made that decision months ago. He's been basically asking this same question since last year, and from this post, he doens't seem anywhere close to getting an answer.

 

The time might not be feasible for him to fully prepare for the MCAT again, accept his DO acceptance, and reapply to MD schools one last time.. I though of doing the same thing during my time, but the amount of effort and expectation was just too much, it really isn't worth it in my opinion.

[icewine]

I keep hearing that MBBS can use the MD title in Canada/US, do you have any proof of this? Have you ever seen a doctor MBBS doc legally referring himself as a MD? Can a DDS dentist legally call himself a DMD?

 

In the U.S. (NY): http://www.op.nysed.gov/prof/med/med-mdconferral.htm. there are similar pathways in place in other states, AFAIK. also, anecdotal account from SDN: http://forums.studentdoctor.net/showpost.php?p=9061419&postcount=30. the SDN post makes clear though that when asked by licensing authorities in the U.S. they must specify the exact degree, ie. MBBS. however, she can "legally" identify herself to patients as an MD. FWIW, i personally know an MBBS grad in Canada that is identified as an MD in hospital, though i assume the same stipulation (re: licensing authorities) exists here as in the U.S.

 

All that stuff about stigma of not going to a LCME school in Canada is a bit off topic. After all, if one could get a US DO degree, get into their 1st/2nd/3rd choice residency spot in the US, then waltz back to Canada to do the MCCEEs/MCCQEs and be licensed, who gives a DAMN if they initially went to a LCME accredited school or not? If they did pull off the above, a DO would be legally protected as a doctor just like all their MD colleagues who went to LCME accredited schools. Another thing, DOs are firstly not IMGs, so they are not even in the same class as IMGs. Secondly, a lot of people actually like the DO philosophy, as I mentioned, I've seen US applicants reject their MD offers to go to DO schools. In the USA, DOs are just as legitimate as MDs, and command the same respect as doctors under the law. So really, the world is bigger than Canada, and if you really ran into "wth is a DO" moment, taking 30 seconds to explain the DO difference/similarity to your patient is probably a good idea.

 

this is the point i was trying to make, and it applies equally to those who go international or DO - if you're a good (and licensed) doctor then no one cares where you went to school. no one route is better than the other. there are advantages and disadvantages to each.

[Mashmetoo]

In the U.S. (NY): http://www.op.nysed.gov/prof/med/med-mdconferral.htm. there are similar pathways in place in other states, AFAIK. also, anecdotal account from SDN: http://forums.studentdoctor.net/showpost.php?p=9061419&postcount=30. the SDN post makes clear though that when asked by licensing authorities in the U.S. they must specify the exact degree, ie. MBBS. however, she can "legally" identify herself to patients as an MD. FWIW, i personally know an MBBS grad in Canada that is identified as an MD in hospital, though i assume the same stipulation (re: licensing authorities) exists here as in the U.S.

 

 

 

this is the point i was trying to make, and it applies equally to those who go international or DO - if you're a good (and licensed) doctor then no one cares where you went to school. no one route is better than the other. there are advantages and disadvantages to each.

 

 

Thank you for that first link, it's the first time I've actually seen an authentic document stipulating that "foreign med schools" that "do not grant the degree of doctor of medicine MD", but with same philosophy/curriculum, can legally be conferred the MD title in NY.. The second post from SDN was equally as interesting. So you CAN'T legally address yourself to the licensing authorities as a MD if you graduated with the MBBS degree.. BUT.. you can "legally" add address yourself as a MD to your unknowing/unread patients?.. The practice seems at best pretty shady to me. This issue mirrors a similar situation with DOs in the US who refuse to add the "DO" part after their name. It's almost like they are ashamed of their medical degree, and try VERY hard to blend in with the majority MDs.. Only with MBBS, you are "legally" protected to do so lol... Also, do you have any documents that show the same practice in Canada where MBBS can legally refer themselves to patients (maybe licensing authority?) as MD?

 

In your second part, I completely agree with your first assessment, that whether one is international or DO - if you're a good (and licensed) doctor then no one cares where you went to school. However, the second part you said about how "no one route is better than the other", I disagree with that. If no one route is better than the other, what you are saying then is that in the USA, an IMG will get it just as easily as an AMG.. This just isn't right. I've said this many times before, and I'll say it here again for the record.

 

As Canadians, the moment you set foot in the Caribbean/Australia/Ireland/Poland/Russia/China/Romania/England for medical school, you WILL be an international medical graduate. No matter what anyone tells you, or anecdotes you hear on forums such as these, currently, GETTING A RESIDENCY IN CANADA AFTER MED SCHOOL IN A FOREIGN COUNTRY OUTSIDE CANADA/US IS EXTREMELY DIFFICULT. Your only sure bet of ever recovering your 300,000+ DOLLARS of medical school tuition is land into a US residency. Now, have a look at this link here: the NRMP matchlist for 2010: http://www.nrmp.org/data/advancedatatables2010.pdf. Scroll down to the part where they mention the match rate for Osteopathic medical students to ACGME residencies compared to Canadian MDs, IMG MDs with US citizenship, and IMG MDs without US citizenship: if you don't believe what I say, at least believe in these numbers:

 

Students/Graduates of Osteopathic Medical Schools

- Active Applicants 2,045 applicants

- Matched PGY-1 1,444 (applicants) 70.6% successful match

- Unmatched PGY-1 601 (applicants) 29.4% unmatched

 

Students/Graduates of Canadian Medical Schools

- Active Applicants 24 applicants

- Matched PGY-1 18 applicants 75.0% successful match

- Unmatched PGY-1 6 applicants 25.0% unmatched

 

Notice how Osteopathic students have almost as good a chance of matching into ACGME (MD) residencies in the USA as Canadian MD students.

 

Now look at this:

 

U.S. Citizen Students/Graduates of International Medical Schools

- Active Applicants 3,695 applicants

- Matched PGY-1 1,749 applicants 47.3% successful match

- Unmatched PGY-1 1,946 applicants 52.7% unmatched

 

Non-U.S. Citizen Students/Graduates of International Medical Schools

- Active Applicants 7,246 applicants

- Matched PGY-1 2,881 applicants 39.8% successful match

- Unmatched PGY-1 4,365 applicants 60.2% unmatched

 

Soo, foreign IMGs, (read Canadians who went to the Caribbean/Ireland/Australia) had only a 40% chance of getting into an ACGME residency, where as 70% of DOs got into ACGME residencies, not to mention the AOA accredited DO residencies which will no doubt took up all the DOs who were not accepted into MD residencies.

 

So no, I absolutely disagree that "no route is better than the other", look at those numbers, and if you are realistic, you'd come to a similar conclusion as myself.

[icewine]

Thank you for that first link, it's the first time I've actually seen an authentic document stipulating that "foreign med schools" that "do not grant the degree of doctor of medicine MD", but with same philosophy/curriculum, can legally be conferred the MD title in NY.. The second post from SDN was equally as interesting. So you CAN'T legally address yourself to the licensing authorities as a MD if you graduated with the MBBS degree.. BUT.. you can "legally" add address yourself as a MD to your unknowing/unread patients?.. The practice seems at best pretty shady to me. This issue mirrors a similar situation with DOs in the US who refuse to add the "DO" part after their name. It's almost like they are ashamed of their medical degree, and try VERY hard to blend in with the majority MDs.. Only with MBBS, you are "legally" protected to do so lol... Also, do you have any documents that show the same practice in Canada where MBBS can legally refer themselves to patients (maybe licensing authority?) as MD?

 

i think you're reading far too much into this. the MBBS degree is considered equal to the MD degree. there is nothing shady or unethical in regards to MBBS grads presenting themselves as an MD to a patient. IMO it is not similar at all to the situation you presented - DO's not using the DO designation in the US, perhaps because they want to blend in. the SDN post said it best - it's important to be clear when presenting one's self to a patient and using the MD title does this. i don't have a link "proving" that MBBS grads can use the MD title in Canada but anecdotally i know it's done.

 

However, the second part you said about how "no one route is better than the other", I disagree with that. If no one route is better than the other, what you are saying then is that in the USA, an IMG will get it just as easily as an AMG.. This just isn't right. I've said this many times before, and I'll say it here again for the record.

 

i didn't say that at all. in fact, i agree with you in that a DO grad is likely better off getting a residency in the US compared with an IMG. however, if you're looking beyond training in the US (ie. Canada or Australia) then things aren't so clear cut. in Canada, DO's are restricted to 3 provinces for matching whereas IMG's have to deal with the parallel match (http://carms.ca/eng/r1_eligibility_prov_e.shtml) so it's a toss up. in Australia DO's can't apply for internship or training, AFAIK, whereas Australian grads can apply for internship in Oz, NZ, or Singapore which opens the door for further training. and the data you presented in regards to foreign IMG's matching in the US is of limited use since it doesn't specify country/school of graduation or citizenship of the applicant. it's a bit misleading to unequivocally state that "Canadians studying in Aus/Ireland/Caribbean only matched 40% into US residencies" because there are many variables unaccounted for. i suspect that Canadians who studied in the Carib, Ireland, or Aussie probably matched higher than 40% into US residencies but that is only my speculation. that is definitely the case in Canada, however. in the 2009 and 2010 match roughly 50% of Canadians studying abroad who applied through CaRMS matched (http://www.som.uq.edu.au/Podcast/Files/CaRMS_Sandra%20Banner.mp4, approx. 40 mins. in) whereas IMG's as a whole matched at a roughly 20% rate in the 2010 match (http://www.cmaj.ca/cgi/rapidpdf/cmaj.109-3260v1.pdf).

 

to summarize: if you don't care about the designation and want to train in the US, then the DO route is likely your best bet. however, training in Canada or the US are certainly plausible options as an IMG, with an added option of training in Oz if you are an Aussie grad. all 3 routes lead to full licensure as doctors in those particular jurisdictions (ie. MBBS/MD with full practice rights), with the possibily of reciprocity in other jurisdictions (ie. Aussie FRACGP, Canadian CCFP, and American ABFM). definitely not saying it's going to be easy but if one puts in the work it certainly is possible.

[future_doc]

What do you think, SGU, MCAT redo or DO?

 

I totally agree with Mahmetoo. You have been offerred a gift - take it.

[Mashmetoo]

i think you're reading far too much into this. the MBBS degree is considered equal to the MD degree. there is nothing shady or unethical in regards to MBBS grads presenting themselves as an MD to a patient. the SDN post said it best - it's important to be clear when presenting one's self to a patient and using the MD title does this. it is not similar at all to the situation you presented - DO's not using the DO designation in the US, perhaps because they want to blend in. the DO degree is not the same as an MD degree. i don't have a link "proving" that MBBS grads can use the MD title in Canada but anecdotally i know it's done.

 

I'm still having trouble wrapping my ahead around how MBBS can legally refer themselves as MD in front of their patients. In my personal opinion, it seems like a lie. They graduated with a MBBS degree, but they "falsely" claim or imply to their patients that they have the MD degree, which they don't... The truth is that they have the MBBS degree, which is considered workably equivalent to the MD degree. Why can't they just say that they have the MBBS degree, and that it is equivalent to the MD? I really don't think it's that difficult to explain what a MBBS is to a patient. My hunch is that they still have the unsubconscious need to conform with the MD title... But that's just a personal opinion.

 

i didn't say that at all. in fact, i agree with you in that a DO grad is likely better off getting a residency in the US compared with an IMG..

 

Ok, I totally agree with you there.

 

 

however, if you're looking beyond training in the US (ie. Canada or Australia) then things aren't so clear cut. in Canada, DO's are restricted to 3 provinces for matching whereas IMG's have to deal with the parallel match (http://carms.ca/eng/r1_eligibility_prov_e.shtml) so it's a toss up. in Australia DO's can't apply for internship or training, AFAIK, whereas Australian grads can apply for internship in Oz, NZ, or Singapore which opens the door for further training.

 

What I wrote about is Canadians who wish to practise in the US and Canada. The sure way of obtaining this goal is to get a US residency. Now, if the Canadian med student didn't want to work in the US/Canada, and would prefer to stay in Australia/Europe, then yes, what you say is true, all bets are off then. Australia/Ireland/wherever could be a better choice if they wanted to practise outside of Canada/US. I actually know a friend who did this. He refused to apply DO and went to Australia, and he plans to stay there.

 

and the data you presented in regards to foreign IMG's matching in the US is of limited use since it doesn't specify country/school of graduation or citizenship of the applicant. it's a bit misleading to unequivocally state that "Canadians studying in Aus/Ireland/Caribbean only matched 40% into US residencies" because there are many variables unaccounted for. i suspect that Canadians who studied in the Carib, Ireland, or Aussie probably matched higher than 40% into US residencies but that is only my speculation. that is definitely the case in Canada, however. in the 2009 and 2010 match roughly 50% of Canadians studying abroad who applied through CaRMS matched (http://www.som.uq.edu.au/Podcast/Files/CaRMS_Sandra%20Banner.mp4, approx. 40 mins. in) whereas IMG's as a whole matched at a roughly 20% rate in the 2010 match (http://www.cmaj.ca/cgi/rapidpdf/cmaj.109-3260v1.pdf)..

 

Well, what you say is true, there are some variables in there that do not match the Canadian reality. However, do you know of any other data chart pertaining strickly to Canadian IMG MDs like the one I posted? The Canadian match rate of 50% you posted really isn't that far off from the posted 40% NRMP rate. It's within the ball park range, and can still be pretty useful. Those posted numbers are most likely pretty close an approximation of what's really going on. In the absense of any other data pointing to the contrary, I'd prefer to make my arguments based on that chart, published by the NRMP. Anything else will be anecdotes and here say, and my spidie senses are tingling.

[Mashmetoo]

well whattodonow, it'd be nice to get a response from you. I only got two more days left of stalking this forum lol, then school starts, and I'll be a med student! Whatever you want to say, do it fast! Starting monday, I'll be lucky to hit these forums once per week :|

[icewine]

I'm still having trouble wrapping my ahead around how MBBS can legally refer themselves as MD in front of their patients. In my personal opinion, it seems like a lie. They graduated with a MBBS degree, but they "falsely" claim or imply to their patients that they have the MD degree, which they don't... The truth is that they have the MBBS degree, which is considered workably equivalent to the MD degree. Why can't they just say that they have the MBBS degree, and that it is equivalent to the MD? I really don't think it's that difficult to explain what a MBBS is to a patient. My hunch is that they still have the unsubconscious need to conform with the MD title... But that's just a personal opinion.

 

honestly i doubt MBBS grads even think about this particular issue much as it's pretty trivial; IMO the need for clarity/ease is the most likely explanation and not some desire to misrepresent themselves.

 

Well, what you say is true, there are some variables in there that do not match the Canadian reality. However, do you know of any other data chart pertaining strickly to Canadian IMG MDs like the one I posted? The Canadian match rate of 50% you posted really isn't that far off from the posted 40% NRMP rate. It's within the ball park range, and can still be pretty useful. Those posted numbers are most likely pretty close an approximation of what's really going on. In the absense of any other data pointing to the contrary, I'd prefer to make my arguments based on that chart, published by the NRMP. Anything else will be anecdotes and here say, and my spidie senses are tingling.

 

well, we can agree to disagree on what the NRMP numbers mean. i believe the numbers are probably better for Canadians who studied in Aus/Ireland/Carib while you do not - fair enough. as for data that pertains strictly to Canadian IMG's - data from the 2010 IMG CaRMS match: http://carms.ca/pdfs/2010R1_MatchRes...eration_en.pdf. Canadians who studied in Oceania/Pacific Islands matched at a 64.1% rate through CaRMS this past year. using your argument, Canadians who studied in Oz have by far the best chance of matching through CaRMS - almost as good as DO's matching into ACGME residencies (70.6%). so for Canadians who want to complete residency in Canada and can't get into LCME schools at home or the US, then going to Aussie is by far your best bet and a sure way of paying back loans/practicing in Canada or the US.

[CAS]

haven't posted on here for a while, but figured I'd chime in on how Australia is.

I'm a GEMP 1 at Flinders. Have a browse of the following for info:

http://www.medinoz.com

 

 

It's a blog I run with a colleague about what studying in Australia/being a doctor here is like.

 

Anyways, as for the MD discussion, note that Flinders is switching to an MD program soon. I will be posting a blog post about that soon, but have exams in a week so don't have the time to explain it right now.

 

Feel free to email me via the blog (I'm Dr. Polar Platypus) if you have questions.

 

[whattodonow]

Hey everyone,

Thanks again for the insight offered, especially Mashmetoo once again you are sharing your DO knowledge which all of us appreciate. Overall, I feel that the DO route is definitely one worth considering seriously. There are many advantages and of course a few disadvantages, the main being the novelty of the profession up here. Again I am not to familiar with the number of DOs in Canada but asides from Emerg and family med, are there currently any specialists practicing? Here is another question that I have been trying to answer. If you go on Carms for instance on the U of Ottawa or NOSM sections (http://www.carms.ca/eng/r1r3_univ_ottawa_e.shtml), you can see that they say DOs (Only Fam Med), whereas I was under the impression you could try and match back here in any specialty? Also, I was a little confused on your response in regards to AOA residencies. I have always felt that one of the advantages DO offer students is the options for a back up in terms of residency. I guess my question is are the AOA residencies also open to Canadians (aka do they provide visas) or are Canadian DOs pretty much only going for the ACGME ones?

 

Again DO seems to be a feasible route for Canadians right now. It seems like every year things change in Canada (for instance all American docs (MD or DO)) now I think need to spend like a year under a mentor so all we can do is be on the lookout for things that.

[Mashmetoo]

well, we can agree to disagree on what the NRMP numbers mean. i believe the numbers are probably better for Canadians who studied in Aus/Ireland/Carib while you do not - fair enough.

 

Well, I DO agree with you that the numbers for Canadians who studied in Aus/Ire/Carib are probably better. The devil is in the details, and how much better. My hunch is that the Canadian numbers closely mirror the NRMP numbers. As I said, a a 40% vs a 50%, it's "basically" the same, all in the same ball park.

 

 

as for data that pertains strictly to Canadian IMG's - data from the 2010 IMG CaRMS match: http://www.carms.ca/pdfs/2010R1_MatchResults/IMGs%20by%20Region_1stand2nd%20Iteration_en.pdf. Canadians who studied in Oceania/Pacific Islands matched at a 64.1% rate through CaRMS this past year. using your argument, Canadians who studied in Oz have by far the best chance of matching through CaRMS - almost as good as DO's matching into ACGME residencies (70.6%). so for Canadians who want to complete residency in Canada and can't get into LCME schools at home or the US, then going to Aussie is by far your best bet and a sure way of paying back loans/practicing in Canada or the US.

 

The link you gave didn't work, so I googled and found it again. It says:

 

International Medical Graduates by Region of Graduation

2010 R-1 Match - 1st and 2nd Iteration

 

Region of Graduation

Oceania/Pacific Islands

 

Participants

39

 

Matched

25

 

1) These number seem too small. Only 39 Australian Med students applied through CaRMs, and it didn't even mention if they were all Canadians. Can we assume at least 1 or 2 are actual Australians who want to come to Canada?

 

My question is, can the 39 be representative of the TOTAL number of Canadians who finished med school and are applying for residencies this year? I seriously doubt that 39 is reflective of the true number. Why? Check these following links: http://www.canada.com/edmontonjournal/news/story.html?id=32f7eb85-625f-4ced-8539-c69c04029712

 

"...are enrolled at the University of Queensland medical school, where at least 50 students from Canada will begin studies early next year." -> This was back in 2007.

 

http://www.cmaj.ca/cgi/content/full/176/8/1069

 

"The survey revealed that 222 Canadians are studying at 3 Australian universities" --> this was also in 2007.

 

Currently, Oztrekk has SEVEN Australian medical schools that accept Canadians. I actually attended one of their sessions in 2008. At that time, the lower end of their schools accepted around 20 - 30 foreign students, while their larger schools around 50 foreign students, the majority of which is filled by Canadians. I assume that with the situation in Canada in 2008-2010, the number of Canadians going abroad, like Australia, probably increased, or at best, increased only slightly. There are most likely more than 222 Canadians in Australia now. Also, in 2007, "at least 50" Canadians went to University of Queensland. Do you know why they said "AT LEAST 50'? Because they actually don't know the total number of Canadians who went to Australia. My question is, how can 39 be representative of the entire graduating number of Canadians ready for residency this year, when in ONE SCHOOL ALONE, you have "AT LEAST 50" Canadians going into that academic year? Do you know what I think? I think the remaining 11+ missing Canadians applied for Australian residencies, US residencies, and God knows what else.

 

So out of (say) 50+ or more Canadians, or however many there are that were ready for residency this year, only 39 had the guts to apply for CaRMs, and only 25 matched, so at best, around 50%, the numbers are much more sobering if you look at it like that.

 

Yet again, it is what it is. There's no need to sugar coat something when the reality is that it's more like a piece of sh!t. Honestly, if you were a premed, and you had to spent 300,000 dollars on medical tuition. Even assuming that it REALLY was a 64.1% chance of matching, would you choose Australia (which is more like a ~50% chance if you even bothered to apply to CaRMs), or a DO school, with an assured 70.6% chance (and ALL THE AOA RESIDENCIES AS YOUR FALL BACK PLAN)? Take in mind, that the tuition will be the same, you'll reap the benefits of being an AMG in the US, vs an IMG in Australia, AND on top, you still (conservatively estimating) have a 6.5% better chance of matching into a residency? If you wanted to maximize your benefit, which route do you think the premed would objectively take?

 

And again, I have yet to see any numbers that have made me objectively question the vastly better prospects of an Osteopathic school in the USA for Canadians compared to the IMG options.

 

In summary:

 

Australia

tuition: Comparable to Osteopathic medical schools

status: International med Graduate + all the stigma of being an IMG

matching rate: ~64.1% (if you bothered to apply to Carms) - out of only 39 applicants, while at UofQueensland, 50+ Canadians matriculated in 2007... 64.1% is highly unreliable, the true % is probably less than 50%

~40% to ACGME residencies

Clinicals: Limited US rotation (if at all), rotations mostly done in Australia, and the Philippines/other 3rd world countries (but how would doing your rotations in these places help you get into a US residency?)

visa status: most likely J1, H1B if you are lucky

 

Osteopathic medical schools

tuition: ~ comparable to Australian schools

status: AMERICAN med graduate

Matching rate: 70.6% for ACGME US MD residencies + ALL the AOA residencies to fall back on

Clinicals: US CORE ROTATIONS - vital if you want to secure a US ACGME residency

visa status: F1 student visa, a DO degree is an "advanced US medical degree", you are then entitled to the H1B visa (from US government H1B website)

 

Is it really that difficult to come to my conclusion?

[Mourning Cloak]

1) These number seem too small. Only 39 Australian Med students applied through CaRMs, and it didn't even mention if they were all Canadians. Can we assume at least 1 or 2 are actual Australians who want to come to Canada?

 

By definition, to match in CaRMS you must be a Canadian (or permanent resident). So those 39 Australian Med students MUST have been Canadians studying in Australia.

[Mourning Cloak]

Useful link:

 

Some residencies are dually accredited AOA and ACGME (the latter being necessary to being eligible to sit the Royal College exams to gain licensure in Canada). You can search for them http://opportunities.osteopathic.org/search/. It's not clear from this data whether they offer visas or not.

[Mashmetoo]

Just curious.

 

Assuming you did match to an AOA residency (assuming they give J1 visas, which I suppose they must or this whole discussion is moot) what happens when you want to practice? I though AOA residencies weren't accepted in Canada.

 

Do you mean getting a green card and staying in the US? And since the J1 visa requires you to return to Canada for two years after finishing residency (where, presumably, you can't practice), what do you do during that time?

 

Well, currently, most AOA do not sponsor either the H1B or J1 visas, but a few rare ones do. The AOA is currently aware of the problem and is talking to ECGMG about it. http://blogs.do-online.org/dailyreport.php?itemid=26041

 

***Advocacy Victory for Osteopathic Students

Several Canadian students attending AOA colleges of osteopathic medicine recently contacted the AOA regarding their inability to secure J-1 visas, which foreign students need in order to enter residency training programs in the US before returning to Canada to practice. To advocate for these students, the AOA set up a meeting with the Educational Commission for Foreign Medical Graduates (ECFMG), which administers the J-1 visa program. AOA staff and I spoke with the ECFMG’s Executive Director on the call, during which the ECFMG committed to treating international students who graduate from AOA-accredited colleges of osteopathic medicine the same as international graduates of LCME-accredited allopathic medical schools for purposes of sponsoring J-1 visas. The AOA will now work with the ECFMG to prepare information for medical students concerning how to apply for a J-1 visa and related aspects of this situation. ***

 

What I meant was that a Canadian with a US green card, or married a US citizen and then became a green card holder, could apply to all the AOA residency spots without any problems. The AOA is only recently becoming aware of the visa issue for international (read Canadian) students due to the increasing numbers of international students enrolling in DO schools, then needing visa to finish their residency. In the next 4-6 years, this will be huge. A lot of the strategy I wrote about basically involves staying in the US and not having to come back to Canada and jump through all those hoops again. Getting a green card first, then an AOA residency is one possible scenerio that can happen.

[Mashmetoo]

Hey everyone,

Thanks again for the insight offered, especially Mashmetoo once again you are sharing your DO knowledge which all of us appreciate. Overall, I feel that the DO route is definitely one worth considering seriously. There are many advantages and of course a few disadvantages, the main being the novelty of the profession up here. Again I am not to familiar with the number of DOs in Canada but asides from Emerg and family med, are there currently any specialists practicing? Here is another question that I have been trying to answer. If you go on Carms for instance on the U of Ottawa or NOSM sections (http://www.carms.ca/eng/r1r3_univ_ottawa_e.shtml), you can see that they say DOs (Only Fam Med), whereas I was under the impression you could try and match back here in any specialty? Also, I was a little confused on your response in regards to AOA residencies. I have always felt that one of the advantages DO offer students is the options for a back up in terms of residency. I guess my question is are the AOA residencies also open to Canadians (aka do they provide visas) or are Canadian DOs pretty much only going for the ACGME ones?

 

Again DO seems to be a feasible route for Canadians right now. It seems like every year things change in Canada (for instance all American docs (MD or DO)) now I think need to spend like a year under a mentor so all we can do is be on the lookout for things that.

 

This will be my last post for a while, I've got too many things to take care before school starts. Please read my above post on the AOA visa situation. And the current Canadian policy is - if you ever plan on practising in Canada, you need a ACGME residency.

 

Your question on DOs matching into specialties in Canada is exactly what I was talking about earlier. Somethings we just DON"T KNOW. All you can do is make the best possible educated guess with the amount of data we have presently. I've been at it since 2008, and I haven't found any advanced specialty matching rates for DOs in Canada. And I've given you multiple posts on basically EVERYTHING I know about DOs. Isn't that enough? Everything I have posted is basically all the data that I needed to make an informed decision and choosing the DO path.

 

I understand that you want to specialize. This sentiment is shared by the vast majority of med students. But understand this: 50% of Canadian MD students match into FAMILY MEDICINE IN CANADA. I once heard that at UofT, 80% of students match into family medicine. So having the DO degree isn't even relevant to your wanting to match into specialties, ESPECIALLY when the current situation in Canada is that the VAST MAJORITY OF (even) MD graduates match into primary care, especially family medicine!

 

How would knowing how many DOs matched to specialties benefit you? Suppose you knew the answer, and that 5 DOs matched into specialized residencies this year. This doesn't mean that YOU will have the necessary grades, capability to pull it off. Especially for the competitive residencies, radio, derma, surgery, cardio, etc etc, it mostly depends on your board scores, not your title. Even in the USA, do you have any idea how many MD students DREAM of matching into cardio/neuro/thoracic surgery, but can't do so because their USMLEs simply ISN'T HIGH ENOUGH?

 

It is NOT a question of matching into derma/radio/surgery simply because you have that overabundant MD degree. It's how good your STATS/Scores are!! If you were in the top 99%th percentile in your USMLE step 1,2,3, and aced your MCCQEs, do you really think that you'd have difficulty getting into a heart surgery residency?

[icewine]

we can debate this until the leafs win the cup and still not get anywhere. i don’t feel like posting a dissertation arguing the numbers so i’ll restate my opinion: if you’re looking to match into the US and don’t care about the designation, the DO route is probably better. if you’re Canadian (no US green card, etc.) and are looking beyond just matching into the US (ie. Canada, Australia) with the eventual goal of returning back home then the international route is a viable one. based on previous posts it seems the AOA residencies aren’t much help if you want to go home; even if you plan on staying in the US with AOA training, returning home for 2 years (J-1 visa req) and not being able to practice medicine while +300K in loans need to be paid off doesn’t seem very logical. banking on getting a green card while in school seems a tad optimistic, IMO.

[Mashmetoo]

we can debate this until the leafs win the cup and still not get anywhere. i don’t feel like posting a dissertation arguing the numbers so i’ll restate my opinion: if you’re looking to match into the US and don’t care about the designation, the DO route is probably better. if you’re Canadian (no US green card, etc.) and are looking beyond just matching into the US (ie. Canada, Australia) with the eventual goal of returning back home then the international route is a viable one. based on previous posts it seems the AOA residencies aren’t much help if you want to go home; even if you plan on staying in the US with AOA training, returning home for 2 years (J-1 visa req) and not being able to practice medicine while +300K in loans need to be paid off doesn’t seem very logical. banking on getting a green card while in school seems a tad optimistic, IMO.

 

Alright, I couldn't help but give a reply. I agree, if you plan on staying in the US, and don't care about title, DO is the better choice. I agree with what you are saying now, since before, you were saying that going to Australia was a "better" choice. I just couldn't let that go because potentially hundreds of Canadians will be reading up on these DO forums and deciding what route to take. I don't want them to get the iffy impression for their sake that by going to Australia, they'll be cruising and home free. When you take a look at all the numbers, all the data I've shown, and the kind of medical graduate category you'll be in (i.e., AMG vs IMG), I'll never agree that Australia is a "better" choice even if the Canadian applicant wishes to return home to Canada. But I do agree that it is a viable choice and could probably work out for the Canadian with guts and determination.

 

As for the AOA residencies, I never said that the Canadian with the J1 will be set in an AOA residency. I said that if the Canadian had a US greencard, such as some of my friends who are Canadian and went to DO schools because they have a green card - they'll get it that much easier than then Canadian without the green card. Also, getting married while in Medical school isn't too far fetched. The mighty Ian Wong knew some Canadian medical students who did get married to Americans and are now green card holders. It is done, and it's not far fetched. Also, I never said that Canadians who went to AOA residencies would want to go home. The specific scenerio I mentioned is for the small set of Canadians who 1) does not want to go home 2) has a greencard/became a greencard holder 3) can then do AOA residencies just like their American counterparts without putting too many restrictions on themselves.

 

Lastly, regardless of our personal beliefs, I really like and appreciate the discussion that resulted. MANY Canadians will no doubt find useful data out of this discussion regardless if they chose DO or Australia, and it will no doubt help in their medical career decision making process

[leviathan]

we can debate this until the leafs win the cup and still not get anywhere.

Good line, I'm saving that one for later use.

[Quester]

This indeed was a very useful thread. Thanks a lot.

 

Best of luck in med school, Mashmetoo, and please update us on your experience

[rahnjacey]

Hi everybody..,

 

I am rahnjacey from US.., new to this forum want some guidance regarding my licensing examinations at Canada... Here is my question..

I am currently doing a MPharm degree in the UK as well, and I'm thinking about returning to Canada after finishing my course. Do you know if I can pay the licensing examinations of Canada with the MPharm degree alone? Do I have to complete one year of pre-registration training and be licensed in the UK to be eligible to take the licensing exam in Canada? Thank you very much!

 

Foreign Pharmacy

[IamSuperDoctor]

I think the international option is a viable one. At RCSI we had ~24 matched (into Can/US) and ~3 unmatched in 2011. In 2010 everyone matched. The match rate has been pretty good over the last few years. I think the rest of the Irish medical schools are in a similar situation.