Handsome88 Posted February 13, 2011 Report Share Posted February 13, 2011 I wonder why this question wasn't answered before. It is a very important factor for IMGs to think about! Suppose you signed the ROS agreement when you received a Gen Surg or IM spot. Can you still do a fellowship anywhere or will you be tied down by your ROS agreement (which says you have to start your service within 3 months of graduation). Does that mean that those IMGs are not entitled for the various subspecialties!? Please post if you know the answer. Thank you. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 13, 2011 Author Report Share Posted February 13, 2011 Here's some information from the contract on queens website (I don't think its the same for all universities). "The term of return-of-service must commence no later than three (3) months from the date on which the College of Physicians and Surgeons of Ontario (CPSO) issues you the certificate of registration to practice medicine in Ontario. " You will not be issued the certificate of registration to practice medicine in ON if you choose to continue through a fellowship, is that correct? Link to comment Share on other sites More sharing options...
Mourning Cloak Posted February 13, 2011 Report Share Posted February 13, 2011 You will not be issued the certificate of registration to practice medicine in ON if you choose to continue through a fellowship, is that correct? You will be issued a certificate after you apply for it. Using GIM as an example, you become eligible after finishing GIM & passing your boards. The Ontario ROS Guidelines require you "to apply for College of Physicians and Surgeons of Ontario (CPSO) registration within one month of completing your program and [you] are expected to start your service within three months of receiving your CPSO registration." http://www.carms.ca/pdfs/OntarioROS.pdf You can apply for an adjustment to your contract so that you can do more training e.g. cardiology fellowship, and then practice in that specialty instead of your primary one BUT: 1) they don't have to give it to you 2) they might not want to give it to you - if you signed up to work in Little Town in Northern Ontario, they probably need a general internist, but they probably have no use for a cardiologist. 3) interest continues accumulating Golden rule: Read your contract before you sign it. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 13, 2011 Author Report Share Posted February 13, 2011 You will be issued a certificate after you apply for it. Using GIM as an example, you become eligible after finishing GIM & passing your boards. The Ontario ROS Guidelines require you "to apply for College of Physicians and Surgeons of Ontario (CPSO) registration within one month of completing your program and [you] are expected to start your service within three months of receiving your CPSO registration."http://www.carms.ca/pdfs/OntarioROS.pdf You can apply for an adjustment to your contract so that you can do more training e.g. cardiology fellowship, and then practice in that specialty instead of your primary one BUT: 1) they don't have to give it to you 2) they might not want to give it to you - if you signed up to work in Little Town in Northern Ontario, they probably need a general internist, but they probably have no use for a cardiologist. 3) interest continues accumulating Golden rule: Read your contract before you sign it. When do we have to apply for the adjustment, is it before we go into R1 or just before we apply to R4? Is it common for them not to give you the adjustment? Should we be worried about that? In UBC and Dal you cannot specialize, you can only do GIM. Is there any talk about anything changing in regards to the ROS in the near future as doctor shortages decrease? I'm sure that a lot of IMG students are going to graduate from IM and Gen Surg and many will choose to sub-specialize which would put pressure on the program. Link to comment Share on other sites More sharing options...
Mourning Cloak Posted February 13, 2011 Report Share Posted February 13, 2011 When do we have to apply for the adjustment, is it before we go into R1 or just before we apply to R4? I'd ask if it's even possible to do this BEFORE YOU SIGN THE CONTRACT. If you would be miserable doing GIM or GS, ask BEFORE YOU SIGN. Is it common for them not to give you the adjustment? Should we be worried about that? I have no idea if they've ever let an IMG do this, ever. (One of my husband's classmates was a CMG and had a ROS in med school which gave him funding - med school tuition - in exchange for practicing in a underserved area - and they let him do an R3 after finishing family med). He sought (in his second year) and got permission to do the extra R3 year (Emerg). There was a discussion between him, the government and the community he was returning to; the community supported it, since they felt that Emerg would be of use in the community. As an IMG, ASK BEFORE YOU SIGN. Is there any talk about anything changing in regards to the ROS in the near future as doctor shortages decrease? As the number of MDs improves, the number of CMG spots in med school will level off (? decrease), and the IMG residency spots will, of course, decease. In the shorter term, those individuals with ROS will gradually find themselves going further and further afield to practice GIM and GS as the more ideal ROS locations are gradually filled up. I'm sure that a lot of IMG students are going to graduate from IM and Gen Surg and many will choose to sub-specialize which would put pressure on the program. This is why I'd imagine it would be quite difficult to get them to make an exception and let you sub-specialize. They need general surgeons and general internists in the small, chronically underserved rural locations, not specialists, in most cases. GOLDEN RULE: IF IT'S IMPORTANT, ASK BEFORE YOU SIGN. Link to comment Share on other sites More sharing options...
NLengr Posted February 14, 2011 Report Share Posted February 14, 2011 No the real golden rule is to make sure it's in writing, in the contract. If it's not in writing, then they can promise you the moon and then turn around and give you nothing later on. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 14, 2011 Author Report Share Posted February 14, 2011 I'd ask if it's even possible to do this BEFORE YOU SIGN THE CONTRACT. If you would be miserable doing GIM or GS, ask BEFORE YOU SIGN. I have no idea if they've ever let an IMG do this, ever. (One of my husband's classmates was a CMG and had a ROS in med school which gave him funding - med school tuition - in exchange for practicing in a underserved area - and they let him do an R3 after finishing family med). He sought (in his second year) and got permission to do the extra R3 year (Emerg). There was a discussion between him, the government and the community he was returning to; the community supported it, since they felt that Emerg would be of use in the community. As an IMG, ASK BEFORE YOU SIGN. As the number of MDs improves, the number of CMG spots in med school will level off (? decrease), and the IMG residency spots will, of course, decease. In the shorter term, those individuals with ROS will gradually find themselves going further and further afield to practice GIM and GS as the more ideal ROS locations are gradually filled up. This is why I'd imagine it would be quite difficult to get them to make an exception and let you sub-specialize. They need general surgeons and general internists in the small, chronically underserved rural locations, not specialists, in most cases. GOLDEN RULE: IF IT'S IMPORTANT, ASK BEFORE YOU SIGN. I'm confused now. Why would they have to "make an exception" when the contract says that I can start after I graduate, or after applying for CPSO (which is after one month of completing my program). I will not have applied to CPSO yet if I choose to go through R4 and so I really wont be required to start my ROS yet. True that interest will be accumulating, but do they really have the right to stop me from applying to a longer fellowship than the 1 year GIM (after the 3 years)? When do we even have to choose our community? If it's in our last year (which would be the last year of Cards if that's what I'm doing) then I will just look for a community that wants a cardiologist. There are ROS contracts attached to R4 fellowships in ON for IMGs anyways! Is my understanding of this totally wrong? Also, I heard that there have been changes to the ROS agreement and now we can do our ROS anywhere in ON excluding GTA and Ottawa. Does that mean we can choose communities like Niagara, Hamilton...etc? I wouldn't mind these areas. This is very important matter to me as it will change my career choice completely. Link to comment Share on other sites More sharing options...
Mourning Cloak Posted February 14, 2011 Report Share Posted February 14, 2011 This is very important matter to me as it will change my career choice completely. In that case, it would be best to get it straight from the horse's mouth (there's a lot of contradictory data floating around out there). And I like NL's suggestion: get it in writing. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 14, 2011 Author Report Share Posted February 14, 2011 In that case, it would be best to get it straight from the horse's mouth (there's a lot of contradictory data floating around out there). And I like NL's suggestion: get it in writing. Thanks, Mourning Cloak, I will do that. Just was wondering if anyone had a first hand experience with this. If anyone does please let us know! Link to comment Share on other sites More sharing options...
dogbiscuit Posted February 19, 2011 Report Share Posted February 19, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way. From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Link to comment Share on other sites More sharing options...
dogbiscuit Posted February 19, 2011 Report Share Posted February 19, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way. From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Link to comment Share on other sites More sharing options...
dogbiscuit Posted February 19, 2011 Report Share Posted February 19, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way. From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Link to comment Share on other sites More sharing options...
dogbiscuit Posted February 19, 2011 Report Share Posted February 19, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way. From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 20, 2011 Author Report Share Posted February 20, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way.From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Great to know Hope it stays that way, or else some people will not be happy...law suites will fall on their heads from angry IMGs lol. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 20, 2011 Author Report Share Posted February 20, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way.From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Great to know Hope it stays that way, or else some people will not be happy...law suites will fall on their heads from angry IMGs lol. Link to comment Share on other sites More sharing options...
Handsome88 Posted February 20, 2011 Author Report Share Posted February 20, 2011 I tried contacting HFO by email and by phone. I got nowhere. They wouldn't say either way.From talking to PDs along the interview trail, no IMG in Ontario has ever had trouble doing a fellowship if they wanted to. I know the new contract is different but it does not specifically say no fellowship. Legally they wouldn't have much ground to stand on by denying you training, just as the legal framework for return of service is barely legal and infringes on any Canadian's right to work and live anywhere in the country. Great to know Hope it stays that way, or else some people will not be happy...law suites will fall on their heads from angry IMGs lol. Link to comment Share on other sites More sharing options...
dogbiscuit Posted March 15, 2011 Report Share Posted March 15, 2011 The Ministry of Health normally allows IMGs to complete subspecialty training before commencing the return of service commitment. All requests to defer your start date for the ROS commitment would have to be approved by the Ministry. If you have questions about the ROS contracts, you can also contact the Ministry of Health and Long Term Care's Physician Planning Unit at: General Inquiry: 416-314-0400 Fax: 416-327-0167 Link to comment Share on other sites More sharing options...
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