IMG positions this year

[ddocs]

Agreed 100%! I think it's completely untrue and unfair to say IMGs took the easy route (which I do hear from people and not implying you were saying that), BUT I think it's fair to say that CMGs should always have first pick at their residency choices before IMGs.

 

I concur. If you look at countries similar to Canada e.g. Britain or Ireland, there is inherent preference for local graduates over those coming into the country to train from abroad. It is understandable.

[Der Kaiser]

What a lot of people probably don't realize is a good portion of Canadian doctors are IMGs, in fact, roughly 21.7% according to this 2009 Canadian Journal of Rural Medicine journal (http://docs.google.com/viewer?a=v&q=cache:J05r2VU4IzAJ:prismadmin.cma.ca/multimedia/staticContent/HTML/N0/l2/cjrm/vol-14/issue-3/pdf/pg120.pdf+25%25+of+canadian+doctors+are+international&hl=en&gl=ca&pid=bl&srcid=ADGEESirzYv-UhpFXXMM_uAb3rfJomtn-uhyce1JQbrSyLgCpKPLkw-9Tw5SLvsdCh0342V6neezTTjAgnzLwyv988P-2q_WRBC_HqJfteL4WkXKKkKFQ6p7GrC8TehsP5pK-_4pRg3U&sig=AHIEtbQoOXgS6i6pyGOy_qCyU_BcQSJifw )

Traditionally, IMGs have trained in countries like Britain and Ireland.

 

I think an under-appreciated thing for Canadians looking to go abroad is studying in a British medical school. Those graduating from schools in Ireland, Australia, New Zealand, Eastern Europe and the Carribean have a harder chance of obtaining postgraduate training positions in the country where they completed their medical education either because of a shortage of spots for that country's own citizens or because no mature system actually exists e.g. the Carribean. In Britain, at the current moment, students graduating from a British medical school, irrespective of their citizenship, are guaranteed 2 years of postgraduate training in what is known as the Foundation Programme. As a British graduate, I did not apply to CaRMs in my final year of medical school but did a few months in the Foundation Programme before applying to the CaRMS 2011 round and I'll be coming back home this July to start my IM residency. I think those looking to go abroad should seriously consider Britain as the 2 years of postgrad training does offer a bit of peace of mind.

 

Hey ddocs,

 

are there any Graduate Entry Programs in Britain that North American applicants could actually get into? Do any accept the MCAT in place of the UKCAT?

[entkeener]

Truth is that even if the match wasn't segregated, IMG's would still be at a major disadvantage. Even programs with IMG spots dedicated to them often decide not to take an IMG and instead opt to open that spot up to Canadian graduates by letting it go unmatched and leaving it open for the second round. Some examples of this include Ottawa's ENT program last year and Ottawa's plastic surgery program this year.

 

The truth is that Canadian programs have a sense of comfort from the familiarity that comes from knowing the quality of the Canadian medical schools. While I'll give you that there are programs abroad that probably provide better training that what we get here, it is hard to know exactly what you're getting. Also, people wonder why you chose to go abroad. Is it because you didn't have the grades? Is it because you tanked the MCAT? Is it for another totally legitimate reason (want to study in a different culture, have family abroad, just got unlucky applying domestically)? The problem is they will never know and that can be concerning.

 

 

As a Canadian citizen who chose to do complete my medical degree in Britain, I do not think Canada should necessarily provide me with a residency position. I think the onus is on the person to fully appreciate the potential challenges and pitfalls of studying medicine outside of North America before making the decision to go. Obtaining a residency position in CaRMs is no easy task and probably includes a bit of luck and both Canadians studying abroad and CMGs need to prepare for the match though the vast majority of CMGs do obtain some kind of position in CaRMs versus IMGs. Funding and system capacity is probably the main issue for having a select number of IMG spots in CaRMs. It is unfortunate, in my opinion, that valuable spots are being bought by countries like Saudi Arabia for their trainees as these spots could potentially be funded by the provinces for either CMGs or IMGs.

 

But I don't think IMGs should be frowned or looked down upon. In my opinion, the term International Medical Graduate (IMG) is relative. If a Canadian medical graduate went to Britain to train/practice medicine, they would be viewed as an IMG and as I'm coming back to Ontario for residency this July and as I've studied in Britain, I'm viewed as an IMG. Because of information technology and globalization, medicine in my opinion, is very global and interconnected. Doctors and scientists around the world share ideas and research on a regular basis and simply because the research or medical talent isn't from an LCME accredited North American institution does not mean it is rubbish. As an IMG educated in Britain, I do not feel inferior to a Canadian medical graduate. In fact, I appreciated my time spent in the British health care system as there are many good things both countries can learn from each other and I think I've received good education from the UK.

 

What a lot of people probably don't realize is a good portion of Canadian doctors are IMGs, in fact, roughly 21.7% according to this 2009 Canadian Journal of Rural Medicine journal (http://docs.google.com/viewer?a=v&q=cache:J05r2VU4IzAJ:prismadmin.cma.ca/multimedia/staticContent/HTML/N0/l2/cjrm/vol-14/issue-3/pdf/pg120.pdf+25%25+of+canadian+doctors+are+international&hl=en&gl=ca&pid=bl&srcid=ADGEESirzYv-UhpFXXMM_uAb3rfJomtn-uhyce1JQbrSyLgCpKPLkw-9Tw5SLvsdCh0342V6neezTTjAgnzLwyv988P-2q_WRBC_HqJfteL4WkXKKkKFQ6p7GrC8TehsP5pK-_4pRg3U&sig=AHIEtbQoOXgS6i6pyGOy_qCyU_BcQSJifw )

Traditionally, IMGs have trained in countries like Britain and Ireland.

 

I think an under-appreciated thing for Canadians looking to go abroad is studying in a British medical school. Those graduating from schools in Ireland, Australia, New Zealand, Eastern Europe and the Carribean have a harder chance of obtaining postgraduate training positions in the country where they completed their medical education either because of a shortage of spots for that country's own citizens or because no mature system actually exists e.g. the Carribean. In Britain, at the current moment, students graduating from a British medical school, irrespective of their citizenship, are guaranteed 2 years of postgraduate training in what is known as the Foundation Programme. As a British graduate, I did not apply to CaRMs in my final year of medical school but did a few months in the Foundation Programme before applying to the CaRMS 2011 round and I'll be coming back home this July to start my IM residency. I think those looking to go abroad should seriously consider Britain as the 2 years of postgrad training does offer a bit of peace of mind.

[ddocs]

Hey ddocs,

 

are there any Graduate Entry Programs in Britain that North American applicants could actually get into? Do any accept the MCAT in place of the UKCAT?

 

There are indeed but limited. Not every school accepts internationals for graduate entry. Some require UKCAT or GAMSAT. Though I believe most North Americans go for the traditional undergraduate medical courses lasting 5 years b/c of the limited availability of the graduate program spots.

 

Totally agree with ENTkeener. It is near impossible for Canadian residency programs to assess all the medical schools that IMGs matriculate from and this is equally so for UK programs assessing schools outside of the UK.

[Lezesh]

I think some people are missing half of the IMG argument here. Some are forgetting that a lot of the IMG's are born in another country, have a family, and come here to give their family a better life. They work hard and, in some sense, do deserve a fair shot at entering this system.

 

A case in point is my dad, who was an ENT specialist in our home country. We immigrated here close to 23 years ago. It took him 12 years of working random jobs to support the family, going back to school to complete certain English requirement courses, writing exams, applying for residency spots every year, and creating an IMG advocacy group. Finally he landed a FM residency spot and is now happily practicing. While he didn't get to practice as an ENT spec., he's happy that he gets to practice his career at all. I think he worked his ass off to get to that point, and that (I may obviously be biased here) he deserves to work more than any regular Canadian med school grad. But then again, I believe any IMG that can do that much work and never give up even though everyone along the way says that they'll never practice deserves it more than most grads.

 

On the other side of the token though, my brother Canadian graduated and is a senior resident, and he says that a lot of the reasoning is because that the program directors are very unhappy with the way IMG's are working out. A lot of them are being lazy in their junior res years, refusing to do some scut work like admitting patients, and even taking 3x longer to admit a patient than some of the Canadian grads.

 

Moral of the story. The IMGs who are getting spots are (and im saying for the most part, some are really hard working) f**king over the ones who still don't have a spot.

If they work hard enough and are willing to bend over backwards to work in Canada, then yes they should be able to work in Canada. But by bending over backwards, I mean that they have to make concessions. For instance, take the work they are willing to give you (ie FM). You want to practice medicine, but holding out for Cardiac Surg is slightly unrealistic.

 

You can't have your cake and eat it too.

[leviathan]

On the other side of the token though, my brother Canadian graduated and is a senior resident, and he says that a lot of the reasoning is because that the program directors are very unhappy with the way IMG's are working out. A lot of them are being lazy in their junior res years, refusing to do some scut work like admitting patients, and even taking 3x longer to admit a patient than some of the Canadian grads.

That might be an individual experience of your brother, because in general international med students do work very hard if they ever want a decent shot at residency. The people who work hard get those residencies and I'd imagine usually carry on that way once they are in residency too. Also, you probably have the story a bit off there...admitting patients isn't "scut work", that's one of the day-to-day requirements of being in medicine.

[Handsome88]

That might be an individual experience of your brother, because in general international med students do work very hard if they ever want a decent shot at residency. The people who work hard get those residencies and I'd imagine usually carry on that way once they are in residency too. Also, you probably have the story a bit off there...admitting patients isn't "scut work", that's one of the day-to-day requirements of being in medicine.

 

You're right. Though he has a point too, some people (like his father) move their family to Canada but cannot work there because they are foreign trained doctors (even though they may have become permanent residents or even citizens). So now they either have to work as cab drivers or work their ***** off for decades to try and get ANY type of medical job. And believe me, I've seen this happen many times, I personally know FMG doctors now working as building security guards or even unemployed.

 

Sorry if this has gotten off topic.

[Robot Unicorn]

I never said those words! Again, they should only offer the training to CANADIAN IMGs, not "the rest of the world's doctors".

 

You're right. Though he has a point too, some people (like his father) move their family to Canada but cannot work there because they are foreign trained doctors (even though they may have become permanent residents or even citizens). So now they either have to work as cab drivers or work their ***** off for decades to try and get ANY type of medical job. And believe me, I've seen this happen many times, I personally know FMG doctors now working as building security guards or even unemployed.

 

Interesting - so which is it?

[obi]

Interesting - so which is it?

 

I think in this case he means foreign doctors that have already done their residency / been practising for many years so you would think they wouldn't need to do a residency all over...

 

Thats a whole other debate though so i guess that shouldn't be brought up lest we get into another 7 pages.. This argument is basically going in circles, and the original question was answered a long time ago. I think we should just let this thread die folks.

[ophtho_gunner]

 

And let me tell you this, IMGs are more resourceful, hardworking, ambitious, independent, and determined than most CMGs who may still be living in their parents house and studying for their upcoming test without worry of whether they will be accepted into a scpecialty or not, without having to go the extra mile or work for back-up plans (writing USMLEs, doing electives through out ALL your summers...etc). After going through all that, being technically 'exiled' by the silly admissions system, you don't want them to have the same rights as CMGs?

 

What is this joke? This is exactly why we dont want arrogant IMG colleagues working with us.

[cardiomegaly]

http://www.cfms.org/papers.asp?ID=32

 

A well formulated perception of this type of debate.

[rmorelan]

http://www.cfms.org/papers.asp?ID=32

 

A well formulated perception of this type of debate.

 

Good article - I suppose since it is written by the CMFS one would expect it to focus primarily on supporting canadian students trained within canada.

 

Strangely it doesn't mention any of the issues of increased training in the face of the projections by the OMA/CMA of the shortage in terms of raw numbers ending within the near future. You would think that would have a fairly major impact on the allocation of residency placements etc. It is quite possible that in the not too far future the number of medical students admitted may have to actually fall (not immediately but looking out 5-10 years here). Since setting up DME is time consuming and expensive, I can see some government forecasters wondering what the point would be if long term demand for local residency positions would fall. That position might even strengthen the CMFS position that residency positions would have to be priortized further for local graduates.

 

In any case in the next little while things are going to start getting messy!

[staradmiral]

I think Canadian citizen graduates regardless of where they graduated from should be treated fairly and residency positions given based on merit, and not what school their degree is from. Its no different from choosing applicants based on gender or race. Someone who scored better on the standardized tests and has a stronger application should recieve the residency, end of story.

 

If this is not done, then the canadian public suffers the most. Their doctor was not the best applicant and may not do as good of a job as the other applicant could of done. Regardless of whether one graduated from Mcmaster, oxford, the carribean, or harvard, the residency selection should be based on merit and not whether or not they were educated in canada.

[bloh]

I think Canadian citizen graduates regardless of where they graduated from should be treated fairly and residency positions given based on merit, and not what school their degree is from. Its no different from choosing applicants based on gender or race. Someone who scored better on the standardized tests and has a stronger application should recieve the residency, end of story.

 

If this is not done, then the canadian public suffers the most. Their doctor was not the best applicant and may not do as good of a job as the other applicant could of done. Regardless of whether one graduated from Mcmaster, oxford, the carribean, or harvard, the residency selection should be based on merit and not whether or not they were educated in canada.

 

Your post is absurd.

 

How do you decide if X school abroad has merit or not? If my daddy paid for me to get through Tanzanian school of medicine, should I have just as much merit as someone graduating from UBC?

[ophtho_gunner]

Your post is absurd.

 

How do you decide if X school abroad has merit or not? If my daddy paid for me to get through Tanzanian school of medicine, should I have just as much merit as someone graduating from UBC?

 

He is talking about standardized exams administered by Canada such as MCCEE and MCCQE. I however think, if not mistaken, that CMGs do better than IMGs on these tests. So even merit is in favor of IMGs.

 

IMGs go to med school in their country ONLY to come to North American for residency, I mean that is their thinking before starting med school. :S

[HBP]

I think Canadian citizen graduates regardless of where they graduated from should be treated fairly and residency positions given based on merit, and not what school their degree is from. Its no different from choosing applicants based on gender or race. Someone who scored better on the standardized tests and has a stronger application should recieve the residency, end of story.

 

If this is not done, then the canadian public suffers the most. Their doctor was not the best applicant and may not do as good of a job as the other applicant could of done. Regardless of whether one graduated from Mcmaster, oxford, the carribean, or harvard, the residency selection should be based on merit and not whether or not they were educated in canada.

 

Sure... just like the best MCAT makes the best doctor?

 

C'mon.

 

If they were such a strong applicant, they should have tried harder to get into Canada.

[Mourning Cloak]

Basically, this is all a game of musical chairs.

 

Going from med school to residency is when you get up off your chair, move around, and try to find a better chair before the music stops.

 

Each Canadian medical school pays to maintain residency positions in proportion to it's medical student class load. Some even contribute slightly above that. This is important because if they didn't, there would be fewer residency positions than graduating medical students (right now the ratio is pretty close to 1:1).

 

The foreign schools don't contribute any funds to maintain residency positions in Canada, and therefore their graduates end up with the odds and ends in this country. Virtually no countries (other than the US) provide residency positions for unfunded students of foreign schools in substantial numbers; they've got enough of their own students to contend with. Canada is no exception.

[ddocs]

I would like to add that the UK has many postgraduate/residency positions for non - UK trained doctors that are not funded. Remember, the term IMG is a relative term. For example, all Canadian medical graduates are IMGs if they went across the pond to England.

 

In my opinion, residency spots boil down to $$$. Not enough of it going around or it is used in an inefficient manner e.g. eHealth scandal in Ontario.

 

Basically, this is all a game of musical chairs.

 

Going from med school to residency is when you get up off your chair, move around, and try to find a better chair before the music stops.

 

Each Canadian medical school pays to maintain residency positions in proportion to it's medical student class load. Some even contribute slightly above that. This is important because if they didn't, there would be fewer residency positions than graduating medical students (right now the ratio is pretty close to 1:1).

 

The foreign schools don't contribute any funds to maintain residency positions in Canada, and therefore their graduates end up with the odds and ends in this country. Virtually no countries (other than the US) provide residency positions for unfunded students of foreign schools in substantial numbers; they've got enough of their own students to contend with. Canada is no exception.

[leviathan]

Your post is absurd.

 

How do you decide if X school abroad has merit or not? If my daddy paid for me to get through Tanzanian school of medicine, should I have just as much merit as someone graduating from UBC?

You should probably read more carefully in the future as nobody referenced 'merit' of schools, rather merit of the applicants. I personally feel like the majority of Canadian students should be guaranteed a residency position after graduating, but not necessarily guaranteed the best specialty or best location if there is a better candidate out there who is suited to that spot. After all, if this Tanzanian school of medicine is so poor at training physicians, then what do you have to worry about?

[Handsome88]

Your post is absurd.

 

How do you decide if X school abroad has merit or not? If my daddy paid for me to get through Tanzanian school of medicine, should I have just as much merit as someone graduating from UBC?

 

Through CaRMS... This is nothing new, the US uses board scores, LORs, research...etc to decide on merit of applicant from ANYWHERE in the world (I know people from IRAQ who got into good residencies there). But Canada sadly just doesn't really want to bother protecting their own citizens. I study in Europe and European citizens seem to all (or lets say over 95%) have a position ready for them after they graduate, where Canadians studying there (who happen to be in the top 10% of their class all the time) only get the left over scraps like hyenas. Same with Australia, US, Singapore, India, Hong Kong...etc. Why Canada doesn't? And they do have doctor shortages!

[Mourning Cloak]

But Canada sadly just doesn't really want to bother protecting their own citizens.

 

It's all about protecting their own citizen graduates.

 

residency spots boil down to $$$

 

Absolutely. If there's only enough money to fund 1000 residency spots, you can't have more than 1000 residents (and, by extension, can't have more than 1000 students in medical school in Canada, etc. etc.)

[Handsome88]

He is talking about standardized exams administered by Canada such as MCCEE and MCCQE. I however think, if not mistaken, that CMGs do better than IMGs on these tests. So even merit is in favor of IMGs.

 

IMGs go to med school in their country ONLY to come to North American for residency, I mean that is their thinking before starting med school. :S

 

What? IMG's don't go to med school in their country, they choose to pursue their dream outside Canada because of failing to get into med school there due to how ridiculously competitive it is (only 16? schools, and if you are from ON then forget getting accepted out-of-province if you don't have 3.9+).

 

Who said CMGs do better than IMGs? The IMGs accepted back into Canada have several standard deviations higher board scores (MCE's) on average than CMGs in their respective specialties. They really need to have a much higher score because the competition between IMGs is 10x more fierce than it is between CMGs...and it really shouldn't be like that, like winning a lottery.

 

As mentioned above, they are only protecting their own *graduates* and not their citizens. Why?

 

Consider this scenario:

Student X: European studying in Canada/US

Student Y: Canadian studying in Europe

 

Student X applies to Europe while Student Y applies to both Canada and Europe for residency. Student X gets ranked before Student Y in Europe (solely because X is has European citizenship from his Grandparent) and thus Student Y goes unmatched in Europe. Student Y also goes unmatched in Canada because of having <10-5% chance of matching in his/her desired 1st choice specialty. Student Y (Canadian) becomes a taxi-driver in Canada, or applies to Family Med (or IM if lucky) in the US, only to spend more years in "exile" away from family and home and spend the next 10-20 years of his life paying back his 350k Debt.

 

I think it is saddening that Canada is not taking any action towards this.

[A-Stark]

You know, there are much more pressing policy concerns in health care and other areas than developing ways of helping the career aspirations of Canadian citizens who choose to attend non-LCME-accreditated medical schools.

[lazyboy]

Everyone has to follow the rule of the game. The rule of the game is if you want to do resident in Canada, you have 99% chance of getting one if you graduate from medicine in Canadian Universities. Nobody says that it is easy, but that is the rule.

 

It is not easy to get into USA medicine either, but if you do, prepare to spend over $300K, and your chance of doing resident in Canada is not bad, but why would you? you know you will choose to do resident in USA.

 

If you do medicine elsewhere, you know your chance of doing resident in Canada is slim. This rule is in place long before you apply.

 

What would happen if the rule suddenly changes, and every Canadian, according to the post here, no matter where they graduate in the world, can apply to resident in Canada. It is unfair to someone like LostLamb (she probably becomes famous after this), who apply to medicine for 5 years and finally get in this year, suddenly find herself compete with all the Canadian medical students all over the world for the same resident spot? She spent five year to fulfil her dream, because she knows if she gets into a medical school in Canada, she will become a doctor. It is unfair because someone, I am not saying less smarter, thinks the rule should be changed now they are IMG, and wants to go back to Canada for a resident spot. According to the them, the rule should be changed because they spend a fortune getting educated in foregin country.

 

What happen to Canadian and provinical government who spend million on each and every medical student in Canada think if their investment is lost because the medical student in Canada cannot become a doctor in Canada.

 

We have a limited number of resident spots in Canada, and that is not going to changed. We know it is your dream to become a doctor, but not everyone can become one in Canada. You know the road you're taking when you decide to go oversea to study medicine.

[Lactic Folly]

Nice post Alastriss.