ENT from American medical school

[vomer]

Hello all,

 

I'm currently a Canadian about to graduate from an American medical school. I applied for ENT this past year and did not end up matching, likely due to the fact that I am not an American citizen and required visa sponsorship (I applied to 65 programs across the US and only received 6 interviews).

 

I go to a middle-tier medical school in the US. My preclinical grades are alright (mix of pass and honors). I have honored all my clinical rotations in 3rd year and my dean's letter had excellent comments in it. My board scores are strong (both over 240) and I was elected to AOA (top 15% of medical school class). With respect to research, I have two first-author publications and four oral/poster presentations, all in ENT. I also have strong letters of recommendation, all from ENT attendings.

 

At this time I plan on doing a clinical research fellowship for the coming year, and then reapplying to ENT this fall, both in the US and Canada. I was just wondering how difficult would it be to come back to Canada for residency? As a Canadian at a US medical school, I would be considered the same as a Canadian medical graduate, but would programs even consider me given all of the qualified candidates from Canadian schools? I will also likely not have a chance to do an away rotation at any programs in Canada. Is there any other way I can improve my chances?

 

Any advice would be more than appreciated. Thanks!

[NLengr]

Hello all,

 

I'm currently a Canadian about to graduate from an American medical school. I applied for ENT this past year and did not end up matching, likely due to the fact that I am not an American citizen and required visa sponsorship (I applied to 65 programs across the US and only received 6 interviews).

 

I go to a middle-tier medical school in the US. My preclinical grades are alright (mix of pass and honors). I have honored all my clinical rotations in 3rd year and my dean's letter had excellent comments in it. My board scores are strong (both over 240) and I was elected to AOA (top 15% of medical school class). With respect to research, I have two first-author publications and four oral/poster presentations, all in ENT. I also have strong letters of recommendation, all from ENT attendings.

 

At this time I plan on doing a clinical research fellowship for the coming year, and then reapplying to ENT this fall, both in the US and Canada. I was just wondering how difficult would it be to come back to Canada for residency? As a Canadian at a US medical school, I would be considered the same as a Canadian medical graduate, but would programs even consider me given all of the qualified candidates from Canadian schools? I will also likely not have a chance to do an away rotation at any programs in Canada. Is there any other way I can improve my chances?

 

Any advice would be more than appreciated. Thanks!

 

Did you apply to CaRMS this past year?

[vomer]

No, I only applied to American programs.

 

My medical school has a very small ENT department and no one in Canada would have known the attendings writing my letters. At the institution where I will be doing clinical research this year, there are a number of attendings who are familiar with a couple of the Canadian programs... so I figure it would be better to try CaRMS this coming cycle.

[D-Rock]

There is only one ENT program that takes IMGs, and it only takes one per year. You'll be considered an IMG since you did not go to a Canadian medical school. Unfortunately this is going to be a major uphill battle for you, in part because you went to a US medical school and also because the AAO doesn't license Canadian ENT trainees and so there is little interest in supporting American trainees in Canada.

[battleford]

There is only one ENT program that takes IMGs, and it only takes one per year. You'll be considered an IMG since you did not go to a Canadian medical school. Unfortunately this is going to be a major uphill battle for you, in part because you went to a US medical school and also because the AAO doesn't license Canadian ENT trainees and so there is little interest in supporting American trainees in Canada.

 

That is completely false. As a graduate of an American med school, the OP will be able to apply to the CMG stream of carms.

 

Might want to look into Canadian elective time if possible.

[moo]

There is only one ENT program that takes IMGs, and it only takes one per year. You'll be considered an IMG since you did not go to a Canadian medical school. Unfortunately this is going to be a major uphill battle for you, in part because you went to a US medical school and also because the AAO doesn't license Canadian ENT trainees and so there is little interest in supporting American trainees in Canada.

 

Completely false. Don't know where you're getting this information from. USMGs are not considered IMGs.

 

Whether each individual PD has a preference for CMGs over USMGs is another story. In my experience, most (not all) PDs don't.

[A-Stark]

That is completely false. As a graduate of an American med school, the OP will be able to apply to the CMG stream of carms.

 

Might want to look into Canadian elective time if possible.

 

But... if this "clinical research fellowship" is considered "postgraduate training" then the OP will not be eligible to enter the first iteration. I expect it's not, but it would be key.

[D-Rock]

I stand corrected--when I asked our program director why we didn't interview American students before, he said American trainees were IMGs. Perhaps there is a mistaken understanding in some programs, or perhaps that it was an easy way to make me stop asking questions.

[thebouque]

I stand corrected--when I asked our program director why we didn't interview American students before, he said American trainees were IMGs. Perhaps there is a mistaken understanding in some programs, or perhaps that it was an easy way to make me stop asking questions.

 

American trainees are definitely not IMGs. In French the translation is DHCEU (diplomés hors Canada et ÉTATS UNIS).

[vomer]

I stand corrected--when I asked our program director why we didn't interview American students before, he said American trainees were IMGs. Perhaps there is a mistaken understanding in some programs, or perhaps that it was an easy way to make me stop asking questions.

 

From my understanding, if I am a Canadian citizen at an LCME accredited medical school (essentially all M.D. granting schools in Canada and US), then I am eligible for the first iteration match in CaRMS.

Perhaps the American students your PD was referring to were not Canadian citizens, and thus would not be considered in the first iteration.

 

But... if this "clinical research fellowship" is considered "postgraduate training" then the OP will not be eligible to enter the first iteration. I expect it's not, but it would be key.

 

The fellowship is not considered postgraduate training by any means. I did not enter a match system to obtain the position and most of my time will be spent conducting research, not direct patient contact.

 

In any case, is anyone able to shed some light onto my chances?

I will be graduating medical school in May, so I won't be able to do any Canadian electives for malpractice coverage reasons. Is there anything else I can do to improve my chances of matching in Canada?

[bloh]

I think the problem is that no one can give you reliable 'chances'. Aside from doing electives in Canada, which you say you can't, are you able to do the clinical research fellowship in Canada?

 

You probably have a chance in matching provided you had good evaluations on your electives and good letters but one thing from your post really stuck out for me. You had 6 interviews (from departments that were presumably willing to sponsor your visa) and you didn't match? Did you do electives in these places? Did your interviews not go well?

[vomer]

I think the problem is that no one can give you reliable 'chances'. Aside from doing electives in Canada, which you say you can't, are you able to do the clinical research fellowship in Canada?

 

I figured not many people would be able to offer much in terms of my chances, but thanks anyways! I will try to contact the PD at a program in my home town and try to set up a meeting when I return for a break.

I have not actively looked for any research positions in Canada. While there are many available here in the US, I would ideally like the year to be funded, and this severely limits my options. Are you aware of any funded positions at any of the Canadian programs?

 

You probably have a chance in matching provided you had good evaluations on your electives and good letters but one thing from your post really stuck out for me. You had 6 interviews (from departments that were presumably willing to sponsor your visa) and you didn't match? Did you do electives in these places? Did your interviews not go well?

 

I can understand how this may appear to you. I have sought feedback from a few programs where I interviewed, and they all said that I was well-liked but the applicant pool was tremendously strong this year. As well, 5 of the 6 places I interviewed at were either in California or New York City... these programs are inherently more competitive and typically do not go far down on their rank lists, so I am not surprised I slid down in the end.

 

I have one final question regarding applying to Canadian programs. Looking at application requirements for various programs, they seem to require anywhere from 3 to 5 letters of recommendation, with at least 1 or 2 from an ENT physician. Would it be appropriate to submit all my letters from ENT physicians? I have worked with many who know me well - some are larger names in the field while others are younger but have worked with me for over 2 years.

 

Thanks again!

[PPE]

hey, having all your letters from ENT physicians is fine as long as they know you well and give readers a good sense of who you are. If you want to match into Canada I would really recommend doing as many ENT electives here as possible and get reference letters while you're on elective (as long as they are positive ones). you're really shooting yourself in the foot by not doing ENT electives in Canada (if your goal is to match in Canada). You sound like you've accomplished a lot as a medical student, but your CV doesn't really count for squat if they have no idea who you are and you don't have residents or people in the programs vouching for you.

[n00b]

Your application sounds fantastic and it's a bummer you didn't match. How are things going?

[vomer]

Your application sounds fantastic and it's a bummer you didn't match. How are things going?

 

Seems as if the OP has a really tight application and was sought out by the strong coastal programs but ignored by the fly-over programs because they were reluctant to fund his visa. It's bullshit, but it really all does come down to money in the end.

 

This is a bit late to comment but I would not get discouraged. The fact that coastal big city programs sought you out speaks volumes of the strength of your application. A Canadian school, none of which surpass UCSF or Stanford (which I assume you interviewed for?), would be foolish to not rank you. Keep going.

 

Thank you for your kind words and encouragement folks. Things are going alright so far. I have been working closely with attendings here both clinically and academically, and have added to my publications and presentations. They have also written me strong letters of recommendation.

 

I have submitted my ERAS application to American programs and now working on filling out the CaRMS application. Although I have applied to more programs this year (>90), I am not expecting much from the American programs as my citizenship status has not changed. I will likely only apply to 2-3 programs in Canada where I feel I have a shot without rotating -- U of T, a program in my hometown (met with PD when I was back over summer), and possibly another where two of my mentors have trained.

 

I will let you know how things go. Thanks again!

[NLengr]

Now's not the time to apply to only three Canadian programs! Apply to them all! ENT is one of the top specialties in terms of difficulty in matching. Leave no stone unturned. Take advantage of every opportunity. You only have one shot at this.

 

Seconded. Apply everywhere. Try to cram electives in before you graduate. If its only malpractice holding you back try to buy some for the time you could be on elective.

 

Failing that, do observerships and site visits. Ask every program if you can help them with research.

 

ENT in Canada is small. Face time and personal connections matter a whole lot.

 

Apply everywhere. As was said, this is your only shot, and you are already handicapped.

[D-Rock]

Have to agree with above. If you want to get in to a Canadian program, you need to spend some time there. If we haven't met you, you are not getting in to our program. You probably won't even be interviewed. My suggestion is to try to get as many electives as possible in Canada between this coming Monday and January.