Medical Licensing Bridging Program

[frenziedmalady]

Hi guys, I was reading a newspaper awhile ago and read that there's a bridging program for medical doctors that are licensed in other countries. I've never heard of this before. I know how competitive medical schools are here in Canada and the training is excellent.

 

http://testunix.mediaforce1.com/itp/Ottawa/MLBP.htm

http://www.ontarioimmigration.ca/en/working/OI_HOW_WORK_PHYSICIAN.html

 

Does this mean doctors from other countries like india, china, russia whatever can just practice here that easily??? I mean I know they still get training there but I think the training here in Canada is just top notch.

 

Input please.

[Robin Hood]

Hi guys, I was reading a newspaper awhile ago and read that there's a bridging program for medical doctors that are licensed in other countries. I've never heard of this before. I know how competitive medical schools are here in Canada and the training is excellent.

 

http://testunix.mediaforce1.com/itp/Ottawa/MLBP.htm

http://www.ontarioimmigration.ca/en/working/OI_HOW_WORK_PHYSICIAN.html

 

Does this mean doctors from other countries like india, china, russia whatever can just practice here that easily??? I mean I know they still get training there but I think the training here in Canada is just top notch.

 

Input please.

 

It's hard for Canadians to go into med school and have their dreams realized, so I'm against bringing non-Canadians to practice medicine here.

As for IMGs who are Canadian citizens and permanent residents, if they score well in the certification exams, then they should be treated as CMG, those who score close to good should follow special training, those who score poorly should redo med school.

[nikki dale]

Does this mean doctors from other countries like india, china, russia whatever can just practice here that easily??? I mean I know they still get training there but I think the training here in Canada is just top notch.

No they can't practice just that easily. That's the point of the bridging program. They just don't need to re-learn EVERYTHING because they already had their MD education.

 

 

And while it may not make sense to "bring" foreign doctors here, if somebody immigrates here for whatever reason, and they happen to be a doctor, there's no reason why they shouldn't be allowed practice after taking the bridging program. What should someone who already spent time getting educated do? Do their MD all over again?

[apache]

If by easy you mean waiting 4-20 years (usually about 10, if you're one of the fortunate few to get a license (i.e. have top scores in everything and 4 reference letters for neurology if you're applying to neurology and happen to be of a certain ethnicity (i'm not kidding, but on the bright side, it varies by program, so you can hopefully the program you're interested in racially biased towards your ethnicity ) while you work as a cab driver and/or security driver, you should also probably have a phd or something as well, if you want family, psychiatry or internal and are willing to work in a remote location)... then there's the other 95 percent of imgs who never get a license and open a gas station or liquor store... if you're really lucky you can get a clinical assistant position, where you do the work of a doctor, but for half the pay... which is still better than being a security guard right?

 

you know what's really easy to bridge into... pharmacy, those guys are fully fledged pharmacists in at least a couple years, guaranteed, nursing is pretty good too... medicine, lol, well if you want to be 50 when you start practicing and live in poverty your whole life, is doable

 

Hi guys, I was reading a newspaper awhile ago and read that there's a bridging program for medical doctors that are licensed in other countries. I've never heard of this before. I know how competitive medical schools are here in Canada and the training is excellent.

 

http://testunix.mediaforce1.com/itp/Ottawa/MLBP.htm

http://www.ontarioimmigration.ca/en/working/OI_HOW_WORK_PHYSICIAN.html

 

Does this mean doctors from other countries like india, china, russia whatever can just practice here that easily??? I mean I know they still get training there but I think the training here in Canada is just top notch.

 

Input please.

[future_doc]

... which is still better than being a security guard right?

 

I know a medical doctor from abroad who has been a massage therapist for the last 10 years.

[Robin Hood]

I know a medical doctor from abroad who has been a massage therapist for the last 10 years.

 

I don't get it why Canada brings people in based on their professional qualification while not recognizing them.

[ArchEnemy]

I don't get it why Canada brings people in based on their professional qualification while not recognizing them.

 

It's actually decided by two different organizations. The country recognizes their qualifications, ie MD, but in order to practice medicine the union (RCPSC i think) has to approve of it.

[apache]

yes and no, the first part is right it's the provincial body primary... which, is self-regulating and autonomous (although they obviously work together and with the RCSPC)... the government needs to tighten the leash on these guys, the mistreatment of IMGs is a downright criminal act, I'm tired of hearing *****y medical students complain that med school here is so hard to get into (it's a lot easier to get through medical school here than a lot of foreign med schools, they'll push you through unless you're a completely huge dumb ass), if an IMG is better than you, then study more, or become a more attractive applicant than the img, what the canadian government and provincial (and national) associations is purely akin to economic cronyism or nepotism... in the us there's a much more level playing field, the only thing that saves a lot of the american grads is that the img's can't get permanent green cards or a permanent resident status... here they're damn citizens and we still discriminate against them... it's time to move towards a meritocracy, everyone knows that getting into med school is hard, guess what, so is being born in uganda and immigrating to canada and still being better than a cmg, and still being discriminated against after you're a canadian citizen because you're an img... we need to move towards a more meritocratic system, if a you received a "superior" education but are still inferior to someone who graduated in another country, immigrated here, took all the exams you did (and unlike you, before they matched) and scored in the 99th percentile, then they deserve to get a spot over you...

 

It's actually decided by two different organizations. The country recognizes their qualifications, ie MD, but in order to practice medicine the union (RCPSC i think) has to approve of it.

[Robin Hood]

yes and no, the first part is right it's the provincial body primary... which, is self-regulating and autonomous (although they obviously work together and with the RCSPC)... the government needs to tighten the leash on these guys, the mistreatment of IMGs is a downright criminal act, I'm tired of hearing *****y medical students complain that med school here is so hard to get into (it's a lot easier to get through medical school here than a lot of foreign med schools, they'll push you through unless you're a completely huge dumb ass), if an IMG is better than you, then study more, or become a more attractive applicant than the img, what the canadian government and provincial (and national) associations is purely akin to economic cronyism or nepotism... in the us there's a much more level playing field, the only thing that saves a lot of the american grads is that the img's can't get permanent green cards or a permanent resident status... here they're damn citizens and we still discriminate against them... it's time to move towards a meritocracy, everyone knows that getting into med school is hard, guess what, so is being born in uganda and immigrating to canada and still being better than a cmg, and still being discriminated against after you're a canadian citizen because you're an img... we need to move towards a more meritocratic system, if a you received a "superior" education but are still inferior to someone who graduated in another country, immigrated here, took all the exams you did (and unlike you, before they matched) and scored in the 99th percentile, then they deserve to get a spot over you...

 

It's silly how in some provinces (like Quebec), IMGs are placed at disavantage for residency even if they did well on the qualification exams. If someone from Colombia studied medicine there and did well on the qualification exams, there's no reason to judge his education as being inferior.

[nikki dale]

If by easy you mean waiting 4-20 years (usually about 10, if you're one of the fortunate few to get a license (i.e. have top scores in everything and 4 reference letters for neurology if you're applying to neurology and happen to be of a certain ethnicity (i'm not kidding, but on the bright side, it varies by program, so you can hopefully the program you're interested in racially biased towards your ethnicity ) while you work as a cab driver and/or security driver, you should also probably have a phd or something as well, if you want family, psychiatry or internal and are willing to work in a remote location)... then there's the other 95 percent of imgs who never get a license and open a gas station or liquor store... if you're really lucky you can get a clinical assistant position, where you do the work of a doctor, but for half the pay... which is still better than being a security guard right?

 

you know what's really easy to bridge into... pharmacy, those guys are fully fledged pharmacists in at least a couple years, guaranteed, nursing is pretty good too... medicine, lol, well if you want to be 50 when you start practicing and live in poverty your whole life, is doable

 

+1, this is what I was trying to say.

[frenziedmalady]

Thanks for all the replies. I want to keep an open mind and not be biased. So I am considering everyone's input. But don't you feel that we should have the priority first over international medical doctors? Are the assessments they do to see if you're as competent as the doctors here in Canada good enough?

[The Law]

For any Canadian studying outside of the country who has an interest in going to Ontario afterwards:

 

The following links may be useful to you:

http://www.healthforceontario.ca/Work/OutsideOntario/PhysiciansOutsideOntario/CanadiansStudyingAbroad.aspx

(You can sign up and have a counselor help explain stuff to you and help you with applications, etc)

 

http://www.healthforceontario.ca/Work/OutsideOntario/PhysiciansOutsideOntario/PracticeRequirements.aspx

[notjk]

It's hard for Canadians to go into med school and have their dreams realized, so I'm against bringing non-Canadians to practice medicine here.

As for IMGs who are Canadian citizens and permanent residents, if they score well in the certification exams, then they should be treated as CMG, those who score close to good should follow special training, those who score poorly should redo med school.

 

+1000000000000000,

[leviathan]

I think it's unfair to compete with IMGs for training positions in your own country, but I don't think a marginal amount of competition from IMGs is unreasonable. At the end of the day Canada deserves to have the best trained and brightest people in charge of their health care. Even in an equal opportunity match system like in the US, the majority of IMGs, by definition, are average/unimpressive and will always get ranked below all the CMGs, even the ones who are less than stellar. This means CMGs don't have to worry about competing with IMGs and failing to match. But for those few IMGs who are truly brilliant and stand out from everyone else, I think they deserve a spot over a very weak Canadian student.

 

Obviously I'm biased, but I don't think it's unreasonable.

[The Law]

I think it's unfair to compete with IMGs for training positions in your own country, but I don't think a marginal amount of competition from IMGs is unreasonable. At the end of the day Canada deserves to have the best trained and brightest people in charge of their health care. Even in an equal opportunity match system like in the US, the majority of IMGs, by definition, are average/unimpressive and will always get ranked below all the CMGs, even the ones who are less than stellar. This means CMGs don't have to worry about competing with IMGs and failing to match. But for those few IMGs who are truly brilliant and stand out from everyone else, I think they deserve a spot over a very weak Canadian student.

 

Obviously I'm biased, but I don't think it's unreasonable.

 

 

Well, this is even more the case for Canadian citizens who are having to leave the country to study elsewhere because of the lack of medical school spots here. It's kind of embarassing for Canada, I think, the brain drain that occurs because of this. Obviously, I have a bias as well, but I do think it is important that Canadians feel they have a pathway to return back home to practice medicine, given they have undergone proper the proper evaluations. As a US medical graduate, I will be able to apply to residency and be treated like a CMG - but I think it is important that all IMGs be given a chance to match, particularly Canadian citizens.

 

I think what this speaks to is an even more pressing issue. We urgently need doctors, but we aren't producing enough of them (both, with respect to residency & medical education spots). Students are leaving the country in large amounts to study medicine because of this lack of opportunity. You don't see this happening in the US, Australia, England, or in most of Europe. Either the government needs to fund more spots, and do it soon, or they need to consider allowing the entry of privately funded medical schools. As much as some people are opposed to this, it would certainly allow for a dramatic influx in the number of Canadian trained physicians.

 

Let's not even get started on the other issues at hand here. There is excess demand for medical resources that we don't seem to be able to keep up with. The best thing governments think they can do is throw money at the problem and hope it goes away --- it won't. We need a more flexible health care system and there needs to be a serious evaluation of our health care model by the Feds & the provinces. Paul Martin's previous health accord, the so-called "fix for a generation" is not a fix at all... it was just a "let's keep ignoring this issue" waste of time.

[leviathan]

You actually bring up a good point, Law. Canadians are already competing with IMGs for spots, it's just that the IMGs are from the US. I'm aware US grads are not IMGs by CaRMS definition, but they are IMGs from a political definition. Why not open up that system to all IMGs of all countries like Manitoba has.

 

I don't hear many stories or concerns about them stealing spots from CMGs because the same condition exists: CMGs will almost always be ranked before grads from the US, except when you have exceptional applicants.

[cardiomegaly]

If anyone reads the Medical Post, there is a really great article written by an IMG lady doc who immigrated from Oman. She describes her experience with the AIMG program (specific to Alberta, pairs IMGs with preceptors so they can do an externship before applying and starting residency). For her, the experience was quite necessary for the culture change and learning to discuss certain topics with her patients that were absolutely taboo in her own country - abortion, homosexuality, even basic sexual histories for men and her first DRE.

 

I do believe there is a place for programs like this. If I were to move to Afghanistan, China or South America I certainly would not feel comfortable beginning practice without learning about the culture, language and ways of communication first.

 

It's unfortunate that there are more students than available medical schools spots as well as the shortage of physicians in certain areas of medicine. Medical schools are expanding at a rate that some can barely handle (U of A as a perfect example). At the end of the day I think we are most limited by infrastructure, rather than manpower. We are lacking hospital space and OR time to train more residents and students. It's obvious when you see a simple appendectomy that has a staff, senior resident, junior resident and 2 students scrubbed in. Who is learning anything with that type of experience? Students take 1 in 7 call for rotations like obstetrics because there are simply too many learners in the system. We are delivering half the amount of babies as students a few years ahead of us.

 

I think more provinces need to adopt a program like AIMG where IMGs can apply through a separate stream and be given an externship experience to better help their chances of matching in the second round if they do not end up matching first through AIMG.

[Mourning Cloak]

Thanks for all the replies. I want to keep an open mind and not be biased. So I am considering everyone's input. But don't you feel that we should have the priority first over international medical doctors? Are the assessments they do to see if you're as competent as the doctors here in Canada good enough?

 

CMGs are given preference over IMGs in Canada (and every other country in the world with the exception of the US) simply because:

 

1) a huge amount of government funding has gone into training them - if they don't match, it's an enormous waste of tax payer money

2) there is an implicit understanding that - within reason - if you get into medical school there is an expectation of residency following (this is why the provinces are ethically compelled to provide at least as many residency spots as they have people graduating from their medical schools)

 

Amongst IMGs, it is a human rights violation to discriminate between IMGs who were born Canadian citizens and went abroad to train, and those who were born citizens of other countries but are now Canadian.

 

The problem is that there's no extra money to train more residents. Residents are very expensive to train, and the provinces are stretched to the limits just funding the positions they have. And, as cardiomegaly points out, certain places / programs have indeed reached functional resident saturation with resultant dilution of the learning experience. God knows I don't see very much scrubbed in from behind the attending, her first assist, the fellow, two surgical residents, the family med resident, the anesthesiologist and his resident!

[A-Stark]

Well, this is even more the case for Canadian citizens who are choosing to leave the country to study elsewhere because of the lack of medical school spots here. It's kind of embarassing for Canada, I think, the brain drain that occurs because of this. Obviously, I have a bias as well, but I do think it is important that Canadians feel they have a pathway to return back home to practice medicine, given they have undergone proper the proper evaluations. As a US medical graduate from an LCME-accreditated school, I will be able to apply to residency and be treated like a CMG - but I think it is important that all IMGs be given a chance to match, particularly Canadian citizens.

 

Edits mine. It seems to me that a fair number of Canadians who go abroad for medical training do so without adequate foreknowledge of the difficulties of coming back, and at least some of them do so in order to skip doing an undergraduate degree. IMGs already have a chance to match, and to my knowledge eligibility for both CMG and IMG streams already require that applicants be Canadian citizens or permanent residents. I do not feel that it is appropriate to discriminate based on immigration status and neither, I'd expect, would the courts.

 

I think what this speaks to is an even more pressing issue. We urgently need doctors, but we aren't producing enough of them (both, with respect to residency & medical education spots). Students are leaving the country in large amounts to study medicine because of this lack of opportunity. You don't see this happening in the US, Australia, England, or in most of Europe. Either the government needs to fund more spots, and do it soon, or they need to consider allowing the entry of privately funded medical schools. As much as some people are opposed to this, it would certainly allow for a dramatic influx in the number of Canadian trained physicians.

 

You don't? My understanding from my time in Austria is that many students from Germany choose to study there because it is much easier to get in there. And there is little relevant to be drawn in comparison between countries which offer direct entry from secondary school and the Canadian/US system. We certainly do need more physicians in many areas, but the notion that we are going to solve, say, human resources issues in rural or remote communities by allowing more "Canadian" IMGs into residency is completely unrealistic. It's also debatable just how much of a shortage there is - in primary care in some areas there is absolutely true. But we're already training more residents in some specialties than the job market will bear.

 

Private medical schools are not going to happen. The training system is 100% university-based and requires extensive input of both capital and labour/teaching costs. It's already difficult enough to find cadavers for anatomy labs. And any such school would necessarily have to meet LCME/CACMS accreditation standards.

 

In the end, we are not really in need of a "dramatic" influx of physicians, and none of this will aid the actual causes of "orphan" patients or even wait lists to a great extent.

 

Let's not even get started on the other issues at hand here. There is excess demand for medical resources that we don't seem to be able to keep up with. The best thing governments think they can do is throw money at the problem and hope it goes away --- it won't. We need a more flexible health care system and there needs to be a serious evaluation of our health care model by the Feds & the provinces. Paul Martin's previous health accord, the so-called "fix for a generation" is not a fix at all... it was just a "let's keep ignoring this issue" waste of time.

 

A great deal of the problem relates to actual management and - yes - money. Acute medical care is capital and labour-intensive and governments have been neglecting the capital side of things for 20 years. That's evident to anyone riding the TTC lately or since 1995. Around here we need to replace the older site of the tertiary hospital and upgrade and standardize IT systems throughout the province. In Ontario they need to eliminate the deadweight of individual hospital boards and formally merge - to take one example - all of Toronto's downtown hospitals both to reduce duplication and rationalize resource use. A fine example of a system which is not so much mismanaged as it is not managed at all. So far, though, I was fairly impressed with how things work at Vancouver Coastal Health...

[apache]

I have two IMG's staying at my house today (literally in the other room) with my room mate because they just did TOEFL here in the city (which they have to score nearly perfect in), they do everything CMG's do and more.

 

I don't think CMG's should have any priority, you keep forgetting that although these people come from a foreign country they have gotten their canadian citizenship or permanent residency, how are they distinguishable from the multiple permanent residents who get into Canadian medical schools every year and get their citizenship sometime during medical school or residency?

 

The assessments are exactly the same as those for Canadian applicants plus more, I really don't see where the problem of "adequacy" exists, if the assessments are inadequate to test whether and IMG is acceptable then what is their validity in assessing CMG's learning after their medical education, why should we assume that a student is adequate just because they graduate from a Canadian schools, a few people (current CMG's) in particular come to mind who I won't believe will have licenses one day, there are also some extremely incompetent doctors in practice. I never liked this bs continuing medical education credit stuff, you should have to re-write your licensing exam every 5 years and there should be committees external to the medical community overlooking the regulation of licensure of physicians.

 

Thanks for all the replies. I want to keep an open mind and not be biased. So I am considering everyone's input. But don't you feel that we should have the priority first over international medical doctors? Are the assessments they do to see if you're as competent as the doctors here in Canada good enough?

[ArchEnemy]

Muse, you gave some constructive points, but I think you may be overlooking the fact that many IMG have gone abroad to pursue medicine right out of high school, in order to skip out on undergrad. I do not doubt their level of training and assessment. But the criteria of having an undergrad is the rule that was set by this country, hence it should be adhered to and not taking any short-cuts.

 

In my opinion, those who have had an undergrad before going overseas for their medical career should be prioritized over those who went straight out of high school.

[Robin Hood]

Muse, you gave some constructive points, but I think you may be overlooking the fact that many IMG have gone abroad to pursue medicine right out of high school, in order to skip out on undergrad. I do not doubt their level of training and assessment. But the criteria of having an undergrad is the rule that was set by this country, hence it should be adhered to and not taking any short-cuts.

 

In my opinion, those who have had an undergrad before going overseas for their medical career should be prioritized over those who went straight out of high school.

 

Here in Quebec, you can get into med school after cegep, which is equivalent to freshman. Are they less competant?

[ArchEnemy]

Here in Quebec, you can get into med school after cegep, which is equivalent to freshman. Are they less competant?

 

Yes I am well aware of that. Please read my above statement carefully. I am NOT doubtful of their competency to practise medicine.

 

I merely stated that some of these IMG students are taking short-cuts, since they skipped out on undergrad. Hence why should they be treated as equals to someone else who has gone through the traditional route, but unable to gain admission into local medical schools due to the lack of spots?

 

This system of having 2-3years of undergrad before applying is in place, for whatever reason, so it should be adhered to. He who chooses to do otherwise, should not demand to be treated as equals.

[The Law]

Edits mine. It seems to me that a fair number of Canadians who go abroad for medical training do so without adequate foreknowledge of the difficulties of coming back, and at least some of them do so in order to skip doing an undergraduate degree. IMGs already have a chance to match, and to my knowledge eligibility for both CMG and IMG streams already require that applicants be Canadian citizens or permanent residents. I do not feel that it is appropriate to discriminate based on immigration status and neither, I'd expect, would the courts.

 

The CMG and IMG streams both require applicants to be either permanent residents or citizens, to the best of my knowledge

 

 

You don't? My understanding from my time in Austria is that many students from Germany choose to study there because it is much easier to get in there. And there is little relevant to be drawn in comparison between countries which offer direct entry from secondary school and the Canadian/US system. We certainly do need more physicians in many areas, but the notion that we are going to solve, say, human resources issues in rural or remote communities by allowing more "Canadian" IMGs into residency is completely unrealistic. It's also debatable just how much of a shortage there is - in primary care in some areas there is absolutely true. But we're already training more residents in some specialties than the job market will bear.

 

Private medical schools are not going to happen. The training system is 100% university-based and requires extensive input of both capital and labour/teaching costs. It's already difficult enough to find cadavers for anatomy labs. And any such school would necessarily have to meet LCME/CACMS accreditation standards.

 

It is my understanding... (and correct me if I am wrong) the only reason the job market won't bear these new physicians is mainly the government won't pay them. With respect to medical education, the countries I listed all seem to have it figured out. How many English do you see coming to Canada to try to earn their medical degree?

 

In the end, we are not really in need of a "dramatic" influx of physicians, and none of this will aid the actual causes of "orphan" patients or even wait lists to a great extent.

 

I'm on the fence about this, I don't think a dramatic influx of physicians could hurt. I don't know how fiscally sustainable it is though.

 

A great deal of the problem relates to actual management and - yes - money. Acute medical care is capital and labour-intensive and governments have been neglecting the capital side of things for 20 years. That's evident to anyone riding the TTC lately or since 1995. Around here we need to replace the older site of the tertiary hospital and upgrade and standardize IT systems throughout the province. In Ontario they need to eliminate the deadweight of individual hospital boards and formally merge - to take one example - all of Toronto's downtown hospitals both to reduce duplication and rationalize resource use. A fine example of a system which is not so much mismanaged as it is not managed at all. So far, though, I was fairly impressed with how things work at Vancouver Coastal Health...

 

These are good points. I also would like to see a more patient-centred approach to patient treatment. Vaguely speaking -- I think we need to somehow introduce a way for their to be a little competition in the system and somehow turn the system into one where physicians strive to deliver the best "customer service" to their patients.

[apache]

When I refer to IMG, I mean foreign born IMG, so someone born say in south America who does medical school there, reads about practicing medicine in Canada, and comes to Canada as a skilled worker to try and get a license. I'm not personally referring to Canadian citizens who leave Canada to go to med school, that's a totally different group of people I'm unfamiliar with, so, I would interpret my comments with regard to the first group.

 

Muse, you gave some constructive points, but I think you may be overlooking the fact that many IMG have gone abroad to pursue medicine right out of high school, in order to skip out on undergrad. I do not doubt their level of training and assessment. But the criteria of having an undergrad is the rule that was set by this country, hence it should be adhered to and not taking any short-cuts.

 

In my opinion, those who have had an undergrad before going overseas for their medical career should be prioritized over those who went straight out of high school.