Matching back to Canada after US graduation

[VTeight7]

Hey all,

 

I'm a CDN citizen, 1st yr at EVMS, & planning to apply to CARMS in a few yrs.

 

Would anybody know if I would be treated like a Canadian med student during the CARMS applications, considering I'll still be a CDN citizen and I'm studying at a LCME-accredited school (even though it's US)? Or will I be at a great disadvantage simply because I didn't attend a Canadian med school? If I'm at a disadvantage, does anyone know what might give me a leg up for the Canadian match (i.e. should I plan electives in Canada over the next few years)? Thanks!

[moo]

From personal experience, it's not that difficult. I got interviews at all FM places I applied to. For anesthesia, I got interviews at most of the places I applied to. The PD at McGill specifically stated he wanted me in the program and the fact that I went to a good US school was an asset (even though I graduated in the bottom quartile of the class). In the end, I chose FM over anesthesia but I have no doubts I would've been able to match into anesthesia had I wanted to (which is of course more competitive than FM).

[Guest copacetic]

you will experiences no problems or bias. this is for several reasons:

1) you are a canadian citizen/permanant resident

2) you are attending an LCME accredited school (only in north america...carribean excluded)

 

I confirmed this 2 years ago with CARMS and the heads of some residency programs in canada before i applied to the states. You are essentially treated just like any other canadian who graduates from a canadian medical school. The only disadvantage you have is that you cannot do your core roatations at canadian schools, like canadian graduates do. So you will need to do most if not all of your electives in canada just so the programs get to know you. but the same goes for canadian grads applying to programs not run by their native institution anyways, so it doesnt really affect you all that much.

 

honestly the states is a wonderful option for canadians if you can afford it. most people will need wealthy parents, or wealthy benevolent relatives, or a line/2 lines of credit to do it. I personally was unable to get a line of credit (one of those 150K variety ones) because my parents do not have a house. I was lucky however in the sense that I got a scholarship.

[Moderate]

you will experiences no problems or bias. this is for several reasons:

1) you are a canadian citizen/permanant resident

2) you are attending an LCME accredited school (only in north america...carribean excluded)

 

I confirmed this 2 years ago with CARMS and the heads of some residency programs in canada before i applied to the states.

 

This is really good to hear. Are you sure about it though?

 

I've read elsewhere (I think it was on studentdoctor, but I don't remember the specific thread now) that Canadians at American schools are treated almost on par with the rest of IMG's.

 

I've heard that students really need to make themselves "known" in Canada and to do many rotations at Canadian schools (the same as you are saying). But even after this, the chances of getting a residency are apparently worse than those for Canadians at Canadian schools.

 

On a slight tangent: How have the first year and a half been at Case? Is the learning environment cooperative, or is it very cutthroat? Are your classmates friendly?

I've heard that it's a really great school, and I'll be applying there next year. Are there aspects of Case that you feel make it unique? I.e., special programs or specific clinical experiences that you wouldn't get at other schools?

 

(I am curious, but I also need to figure out how to answer the "Why Case?" question )

[AnxiousBoy]

Info regarding US trained students matching in canada can be found on Carms website. Quick summary,

 

1) If you attend MD schools, you will compete for the same slots as canadian students.

2) If you attend DO schools, you will for the most part NOT compete for the same slots.

 

Now, I'm gonna warn you that the next part is purely speculative of my own opinion.

 

I gotta think that the US trained students are at a disadvantage. Conventional wisdom says that if you have two equally qualified students with one from canada and one from the states, you would think the student from canada would be picked. The program directors would be more familiar with the background and education they came from making it the safer choice. Now, from my observation, there has been over 5 students matching in canada from my school in the last few years and all went into family. I gotta think this is not a coincidence. Bottom line, if you do well in an away rotation in canada and the preceptor can vouch for you to their program director, you'll stand a good chance. However, I gotta think the playing field is not even if you are applying to a program that doesn't know you. And if you are in a school like mine that limit the number of away rotation you can do, then you'll have to make good use of the little time you get.

[moo]

Probably a minor disadvantage. But I generally didn't experience a lot of discrimination when I applied and went on interviews, even in a semi-competitive specialty (anesthesia). I just never ranked anesthesia but I'm pretty sure I would've been able to get to where I wanted to go in Canada.

 

Generally, my experience is the big name schools in Canada (UA, UT, McGill, UBC) and the lesser knowns (Sask, Dal, Memorial) are more likely to view US schools favorably--however this is a big generalization and likely varies from program to program. I know many US grads at UT in peds, IM, and other specialties other than FM. I wouldn't read too much into carms stats either, as many US grads may only apply to one or two Cdn programs and end up not matching and matching in the US (for example, I'd much rather go to UCSF or live in NYC or train at one of the Harvard hospitals, or live in many other US cities than match into a five year program in Kingston, London, NFLD, Sask, or some other small town in Canada--this was one of the many reasons I canceled most of my anesthesia interviews because I knew I could not stomach living in Sask or NFLD for five years. I ended up only interviewing at UT and McGill and even then decided not to rank anesthesia).

 

Other thing is even if you match into FM in Canada, it's typically not that difficult to transfer out to another non ultra competitive specialty (like IM or peds). Many Cdn grads do this. For me, I applied for re-entry into a non-competitive specialty, bypassing Carms round 2.

[VTeight7]

Thanks for the input, guys! I was definitely planning on doing Canadian electives every chance I can get, so I guess I'll stay on that path. Shame though, that as an elective student in Canada, I'll be treated as an international.

 

And does anyone know if USMLE scores really matter for matching to Canada? I know you need to pass Step 1 & Step 2 CK to graduate . . but do the Canadian residency programs mind too much if you only marginally pass them?

[The Law]

Great thread.

 

I'm also wondering, do we have to do additional licencing exams besides the USMLE's to apply in Canada? Anyone know?

 

Also - how does this work in 4th year? If you match to something, isn't it a contractual obligation to go there? What if the american match is before CARMS? Should a student only apply through one?

[moo]

Thanks for the input, guys! I was definitely planning on doing Canadian electives every chance I can get, so I guess I'll stay on that path. Shame though, that as an elective student in Canada, I'll be treated as an international.

 

And does anyone know if USMLE scores really matter for matching to Canada? I know you need to pass Step 1 & Step 2 CK to graduate . . but do the Canadian residency programs mind too much if you only marginally pass them?

 

You will not be treated as an international. Everything that applies to Cdn grads apply to US grads nothing more, nothing less. USMLE scores don't matter, but I would take them (of course). I actually took and passed all three steps. I did step 3 my first year in practice--helpful for me in getting a California license as I did a rotation there this summer. Passing or not passing probably doesn't matter either.

 

My experience is that studying at a US school is like studying at a Canadian school with respect to Carms with the exception that you do not have the admin support from your school because they are not familiar with the procedures, so you will have to do some research yourself (a la this forum). My school was very supportive of me, however, and applying to Carms wasn't that much of a hassle. Just be sure you get documents sent back to Canada in time, because of the delay in international mail.

[moo]

Great thread.

 

I'm also wondering, do we have to do additional licencing exams besides the USMLE's to apply in Canada? Anyone know?

 

Also - how does this work in 4th year? If you match to something, isn't it a contractual obligation to go there? What if the american match is before CARMS? Should a student only apply through one?

 

The only additional licensing exams you have to do are the LMCCs which all Canadian grads take. You do not need to take the Evaluating exam that other IMGs take.

 

You can apply to both Carms and NRMP. The two matches are linked but separate. Most years, the Canadian match is run before the US match (with the exception of the SARS year), so if you match in Canada you are automatically withdrawn from NRMP. Essentially you are ranking all Canadian programs above US programs and that's why I say Carms stats are misleading (as to the number of "unmatched" US grads)--for example, many US grads may only rank 1 or 2 Canadian programs in the major cities and would rather stay in the US. If they don't get their first or second choice, they are withdrawn as "unmatched" and end up running the NRMP match. I knew several Canadians from interview trails and also who did electives at Northwestern with me or applied to Carms but ended up ranking only 1 or 2 or not ranking any at all because they didn't want to go back to Canada, but they would end up in the statistics as unmatched. Thats why I caution against reading too much into the Carms stats.

[biogirlsbro]

Thanks Moo for the very informative posts! Keep them up

[The Law]

The only additional licensing exams you have to do are the LMCCs which all Canadian grads take. You do not need to take the Evaluating exam that other IMGs take.

 

You can apply to both Carms and NRMP. The two matches are linked but separate. Most years, the Canadian match is run before the US match (with the exception of the SARS year), so if you match in Canada you are automatically withdrawn from NRMP. Essentially you are ranking all Canadian programs above US programs and that's why I say Carms stats are misleading (as to the number of "unmatched" US grads)--for example, many US grads may only rank 1 or 2 Canadian programs in the major cities and would rather stay in the US. If they don't get their first or second choice, they are withdrawn as "unmatched" and end up running the NRMP match. I knew several Canadians from interview trails and also who did electives at Northwestern with me or applied to Carms but ended up ranking only 1 or 2 or not ranking any at all because they didn't want to go back to Canada, but they would end up in the statistics as unmatched. Thats why I caution against reading too much into the Carms stats.

 

I wish that the two systems were linked where you could rank some Canadian programs above some US ones, and not arbitrarily rank all of them above.

[Malagasy]

Hey moo,

 

Thanks for your answers. What would you recommend in terms of doing electives? I go to wayne state which gives us up to 3 months of electives that we can do in canada. Is it better to maybe do a month for each location as seems to be common in the united states, or doing smaller 2-3 week rotations as I understand they can be done in canada? Also, When do you think it is good to do them (ie. July/Aug/Sept) in fourth year?

 

Thanks

[moo]

Hey moo,

 

Thanks for your answers. What would you recommend in terms of doing electives? I go to wayne state which gives us up to 3 months of electives that we can do in canada. Is it better to maybe do a month for each location as seems to be common in the united states, or doing smaller 2-3 week rotations as I understand they can be done in canada? Also, When do you think it is good to do them (ie. July/Aug/Sept) in fourth year?

 

Thanks

 

Would probably do a month each at a place in which you're interested. I would definitely do them before Carms, so July/aug/sept is good.

[AnxiousBoy]

I have a question regarding away rotations in Canada.

 

Does anyone have any personal experience regarding the relative ease of getting the elective of your choice? It seems as though most schools are implying that they will place their own students first, then the rest of canada, then to US and internationals. Some schools specifically says that you can only be considered for certain electives. The only school that seems to be elective friendly was UToronto.

 

I'm worried that with the influx of new students from recent expansions across canada, there will be lesser and lesser spots for the rest of us. I'm also hoping that I can sneaking in some rotations of choice during July and August before the rest of Canada start their 4th year (although I looked at UofT schedule that has the 3rd year ending on Sept 2 and 4th year starting at Aug 16th, so I don't know how that works out). Would you think it would be difficult to schedule something in during sept or october? My school's being a douche as usual and making it really difficult to schedule my rotations, unfortunately.

[Guest copacetic]

This is really good to hear. Are you sure about it though?

 

I've read elsewhere (I think it was on studentdoctor, but I don't remember the specific thread now) that Canadians at American schools are treated almost on par with the rest of IMG's.

 

I've heard that students really need to make themselves "known" in Canada and to do many rotations at Canadian schools (the same as you are saying). But even after this, the chances of getting a residency are apparently worse than those for Canadians at Canadian schools.

 

On a slight tangent: How have the first year and a half been at Case? Is the learning environment cooperative, or is it very cutthroat? Are your classmates friendly?

I've heard that it's a really great school, and I'll be applying there next year. Are there aspects of Case that you feel make it unique? I.e., special programs or specific clinical experiences that you wouldn't get at other schools?

 

(I am curious, but I also need to figure out how to answer the "Why Case?" question )

its important to make yourself known to the program yes. but this applies to canadian graduates applying to canadian programs. thats the whole point of away rotations. As for case, case is an awesome school...thats why i decided to go there. we've got 4 teaching hospitals here and their all top notch. cleveland clinic is number 1 in the world for heart and heart surgery, and rainbow babies i think is top 10. case is 20th in the nation (top tier). the environment is one of the main reasons i decided to come. its pass/fail so its not that competitive. the student body participate in the interviews (im an interviewer myself) and have a big say in who gets in so you get a very nice culture where there are lots of smart easy going ambitous people.

 

Info regarding US trained students matching in canada can be found on Carms website. Quick summary,

 

1) If you attend MD schools, you will compete for the same slots as canadian students.

2) If you attend DO schools, you will for the most part NOT compete for the same slots.

 

Now, I'm gonna warn you that the next part is purely speculative of my own opinion.

 

I gotta think that the US trained students are at a disadvantage. Conventional wisdom says that if you have two equally qualified students with one from canada and one from the states, you would think the student from canada would be picked. The program directors would be more familiar with the background and education they came from making it the safer choice. Now, from my observation, there has been over 5 students matching in canada from my school in the last few years and all went into family. I gotta think this is not a coincidence. Bottom line, if you do well in an away rotation in canada and the preceptor can vouch for you to their program director, you'll stand a good chance. However, I gotta think the playing field is not even if you are applying to a program that doesn't know you. And if you are in a school like mine that limit the number of away rotation you can do, then you'll have to make good use of the little time you get.

 

as for the part on not being equal, like i said, i confirmed the information with CARMS AND with the heads of some residency programs. canadian citizens or permanent residents, from LCME accredited schools are not treated all that differently. the only reasons canadian students would have an advantage at their home institution is because that is simply where they spent most of their away cor rotations, and so they are known there.

 

Probably a minor disadvantage. But I generally didn't experience a lot of discrimination when I applied and went on interviews, even in a semi-competitive specialty (anesthesia). I just never ranked anesthesia but I'm pretty sure I would've been able to get to where I wanted to go in Canada.

 

Generally, my experience is the big name schools in Canada (UA, UT, McGill, UBC) and the lesser knowns (Sask, Dal, Memorial) are more likely to view US schools favorably--however this is a big generalization and likely varies from program to program. I know many US grads at UT in peds, IM, and other specialties other than FM. I wouldn't read too much into carms stats either, as many US grads may only apply to one or two Cdn programs and end up not matching and matching in the US (for example, I'd much rather go to UCSF or live in NYC or train at one of the Harvard hospitals, or live in many other US cities than match into a five year program in Kingston, London, NFLD, Sask, or some other small town in Canada--this was one of the many reasons I canceled most of my anesthesia interviews because I knew I could not stomach living in Sask or NFLD for five years. I ended up only interviewing at UT and McGill and even then decided not to rank anesthesia).

 

Other thing is even if you match into FM in Canada, it's typically not that difficult to transfer out to another non ultra competitive specialty (like IM or peds). Many Cdn grads do this. For me, I applied for re-entry into a non-competitive specialty, bypassing Carms round 2.

 

agreed you should have no problems. assuming your not applying to a super competitive specialty like derm or something.

Thanks for the input, guys! I was definitely planning on doing Canadian electives every chance I can get, so I guess I'll stay on that path. Shame though, that as an elective student in Canada, I'll be treated as an international.

 

And does anyone know if USMLE scores really matter for matching to Canada? I know you need to pass Step 1 & Step 2 CK to graduate . . but do the Canadian residency programs mind too much if you only marginally pass them?

canadian citizens/or permanent residents only have to indicate wether or not they passed the exam. they do NOT have to indicate their scores. confirmed by CARMS.

[keith_015]

If you plan on shadowing, there are some variables at stake. Does your school insure you for the summer, or offer that opportunity (ours doesn't unless we register and pay for an "early experience" course - we are actually not considered "students" of the school if there are no classes/rotations)? Doctors will be more than likely very uneasy to take you on without insurance. At U of M, any shadowing experience must be submitted to the school in advance and approved - partly a tracking thing, partly insurance. If you are a med student and looking to get "hands on" shadowing, I'm sure traceability from your school & insurance factors, especially if you cross borders, will be a factor.

 

If you are looking for school specific shadowing (ie @ U of T affiliated facilities), I'm not sure how receptive people will be. If you try to shadow in summer, consider some doc's will be off, some will be left to supervise the Med 3's and likely some PGY's. You likely would be some stranger from a non affiliated school that would get in the way.

 

Also, will you be eligible to register for the corresponding provinces' College of Physicians and Surgeons? Some places require students to register (as MB does) and some don't (ie Ont). If you don't/can't register, you shouldn't be allowed to shadow.

 

As for research, don't bank highly on it. A typical US school year is longer (some up to 11 months), and start in August. You won't have any time during 1st summer to get meaningful research done (and researchers won't take you on bc of that), and 2nd summer, you would be writing the USMLE likely meaning no time.

 

Bottom line, I think you'd have a hard time getting into experiences to get "known" in Canada if you go to the US.

[moo]

Hey Guys, I am thinking about applying to US schools next year so this thread is very, very helpful. So far it seems that applying to the US is a good option if you have the ability to pay for your tuition. Thanks Moo for giving me hope that you don't just have to match in FM if you go to the States. I am wondering, would doing research/shadowing in Canada during your summer breaks also help get you "known" in Canada?

 

I definitely would NOT shadow in Canada during your only summer, the one bt 1st and 2nd years. A big difference between Cdn and US schools is that US students only have one summer. You can do research during that summer (I'd do it at your school and not in Canada as your school likely has more opportunities and is easier for you to make connections). Cdn students have the luxury of having two summers. US schools typically start 3rd year in July whereas Cdn schools start in Sept. That and plus 2nd year ends around end of May, plus the USMLE means you don't have any time off between 1st and 2nd year... in fact, I would say that from 2nd year April - end of 3rd year is the most gruelling part of your US medical training. Cdn students have the luxury of not having to take Step 1 and have a relaxing summer before beginning 3rd year. The upside is, I think in general, in US schools, you have more time to do rotations (Cdn schools also have a back to basics whereas most US schools do rotations until end of April fourth year... I started clinicals July and went straight till April the end of fourth year) and hence, my clinical skills were far superior to Cdn grads, as evidenced by my evals during a Cdn residency, even though I graduated bottom quarter of my class (a top 20 school).

[The Law]

Do you guys know if it's possible to set-up electives in Canada at most US schools?

[Prion]

Do you guys think that such difference(55% vs 65%) could also be due to difference in the rankings of US med schools? For Canada, it's pretty much accepted that all Canadian med schools are top-notch but in the US, there's a greater variability in terms of school qualities.

 

Is there maybe a way to look at the data comparison between Canadian and the Top 20 US med schools for example?

[CdnatWayne]

@TheLaw - I think it depends on the school. At Wayne, you can do up to 3 away electives, all of which can be done in Canada. You might want to check the how your school considers Canadian electives either as international or away. The distinction is important because schools usually limit international electives you can do, i.e. 1.

[CdnatWayne]

Do you guys think that such difference(55% vs 65%) could also be due to difference in the rankings of US med schools? For Canada, it's pretty much accepted that all Canadian med schools are top-notch but in the US, there's a greater variability in terms of school qualities.

 

Is there maybe a way to look at the data comparison between Canadian and the Top 20 US med schools for example?

 

I think there are a multitude of factors accounting for that difference (competitiveness of specialty, programs having strong home applicants, etc).

 

It's important to note that whatever 'variability' there is between schools is minimal. All US and Canadian schools are accredited by the LCME to ensure a medical education standard.

[DubZteR]

Do you guys think that such difference(55% vs 65%) could also be due to difference in the rankings of US med schools? For Canada, it's pretty much accepted that all Canadian med schools are top-notch but in the US, there's a greater variability in terms of school qualities.

 

Is there maybe a way to look at the data comparison between Canadian and the Top 20 US med schools for example?

 

I think it may have more to do with the way the data is collected by carms. As far as I'm aware, if a US applicant decides last minute that they don't want rank programs and they don't withdraw then they would be lumped into the unmatched category. In my year, there were 4 Canadians and I was the only one who applied to carms and actually ranked Canadian programs. The others wanted to stay in the US.

[Prion]

I think it may have more to do with the way the data is collected by carms. As far as I'm aware, if a US applicant decides last minute that they don't want rank programs and they don't withdraw then they would be lumped into the unmatched category. In my year, there were 4 Canadians and I was the only one who applied to carms and actually ranked Canadian programs. The others wanted to stay in the US.

 

Ah cool. So I suppose the difference is definitely inflated:)

 

Good to know that the data support that US med grads are just as competitive as Canadian med grads when it comes to carms!

[The Law]

Great information everyone! Great posts.

 

Does anyone know how beneficial it is to do electives in the city you are interested in getting a residency in during carms?