International Medical Graudates Trying to Return

[Robin Hood]

@leviathan: you say you went into Saba because your parents couldn't affort a huge loan for US med schools, will you and them be able to afford the 150k unpayable debt that you will most likely end up with?

[moo]

I'd have no problem going down there for a good chunk of years, if I could get in somewhere in California or Florida.

 

I imagine that would be pretty sweet.

 

I'd come back of course.

 

Good luck with California. Impossible as a Canadian, unless you are a US citizen or have US PR. Well, also if you're SDA and will go to LLU or a DO school.

[tupacandbiggie]

Nope, they have both and most of the schools have a 4 year program, geared towards those who have an undergrad degree already. But even though I'd pick Canada over Australia its not because of the quality of education but more personal reasons because my family (sisters who I am close to), friends live in Canada and I'd be able to see them more. I have a car that I'd hate to sell, have a house that I just renovated that I'd hate to leave etc.

 

And yes, Australia is VERY expensive if you are an international but I can get domestic rates after my permanent residency is established, so it wouldn't be that much more expensive than Canada (for tuition). Cost of living there is more for sure though.

 

I wonder though, if some people on here arguing so valiantly for Canadian universities will sing a different tune if they don't get accepted anywhere in Canada...

 

The key info here to dig out is that u will be getting a PR status in Australia and going to their med school and working there or even coming back to Canada and practice FM is all possible. So for U, this choice seems rational. However this does NOT change the fact that the international route has extremely low standards when it comes to accepting students. Education wise, I cannot comment on Australian schools.

[raptors]

@leviathan: you say you went into Saba because your parents couldn't affort a huge loan for US med schools, will you and them be able to afford the 150k unpayable debt that you will most likely end up with?

 

It's fairly easy to obtain a 150K line of credit at a Canadian bank and fund 150K. Many US med schools would cost double that. I think in most cases if one were to pay for med school on their own in the US it wouldn't be feasible.

 

That's a huge difference.

 

I think you're missing a key point. It's not about paying the debt. It's about obtaining the funds intially to go to medical school. The debt is easily payable once you obtain a residency and thereafter

[Robin Hood]

It's fairly easy to obtain a 150K line of credit at a Canadian bank and fund 150K. Many US med schools would cost double that. I think in most cases if one were to pay for med school on their own in the US it wouldn't be feasible.

 

That's a huge difference.

 

I think you're missing a key point. It's not about paying the debt. It's about obtaining the funds intially to go to medical school. The debt is easily payable once you obtain a residency and thereafter

 

leviathan is at Saba, a Caribbean school. Chances of getting a residency for people in this situation are low.

[tupacandbiggie]

300k to a good US med school vs 150k debt to Saba I choose US any day. Who wouldn't? Also some banks give 200k LOC. and + other stuff and burseries scholarships government loans etc you should be able to get through and it's a guarenteed return for investment. Moo is a good example. US is costly but worth it no doubt about that.

[raptors]

leviathan is at Saba, a Caribbean school. Chances of getting a residency for people in this situation are low.

 

I don't know Leviathan, but I full well know that Saba is a Caribbean School. I'm finishing up myself and starting a Canadian Residency in a Specialty. I've only glanced at the last page or two of this thread, but thought i'd answer your question earlier.

 

While obtaining residency in Canada is low it's not impossible. Our Canadian match list this year is actually pretty good. Disciplines including Internal, Anesthesia, PMR, Ortho, Familiy, Psych, Surgery, etc. our match list should be coming up soon.

 

Anyways, my point was not to talk about Saba, but just to answer your question about debt and being able to repay it back. Yes, easily even if not obtaining a residency in the Canada. You are correct that matching in Canada is low, but I have many classmates that end up matching into the US and will pay their debts off.

 

Going to an international school is obviously not most people's first choice, I don't hide that. I'm pretty adamant it should be a last resort. There are so many obstacles you probably can't fathom unless you've been through it. However, I just wanted to shed light that if one goes the international route it's still possible.

[raptors]

300k to a good US med school vs 150k debt to Saba I choose US any day. Who wouldn't? Also some banks give 200k LOC. and + other stuff and burseries scholarships government loans etc you should be able to get through and it's a guarenteed return for investment. Moo is a good example. US is costly but worth it no doubt about that.

 

I'm not disagreeing with you that for a new student appying to med they should choose a US school over Saba anyday. That wasn't my point. I was merely answering the question in the last page - Some individuals might not be able to get more than a 150K Canadian Loan if they have no help. You can say some banks give 200K, bursaries etc etc..every single case is different, but unless you have ever been in that situation I don' think you have a full grasp on specific person's choice.

[Robin Hood]

I don't know Leviathan, but I full well know that Saba is a Caribbean School. I'm finishing up myself and starting a Canadian Residency in a Specialty. I've only glanced at the last page or two of this thread, but thought i'd answer your question earlier.

 

While obtaining residency in Canada is low it's not impossible. Our Canadian match list this year is actually pretty good. Disciplines including Internal, Anesthesia, PMR, Ortho, Familiy, Psych, Surgery, etc. our match list should be coming up soon.

 

Anyways, my point was not to talk about Saba, but just to answer your question about debt and being able to repay it back. Yes, easily even if not obtaining a residency in the Canada. You are correct that matching in Canada is low, but I have many classmates that end up matching into the US and will pay their debts off.

 

Going to an international school is obviously not most people's first choice, I don't hide that. I'm pretty adamant it should be a last resort. There are so many obstacles you probably can't fathom unless you've been through it. However, I just wanted to shed light that if one goes the international route it's still possible.

 

At how much do you evaluate Saba's match rate? If it's like 50%, then it should be a no-no for any Canadian.

[tupacandbiggie]

At how much do you evaluate Saba's match rate? If it's like 50%, then it should be a no-no for any Canadian.

 

There numbers are inflated (although I don't know the specific rate) because a lot of their med students don't even make it to 4th year. Hence already lots of them out of the race before the race even starts. Hence the final match rate is based on the students who made it all the way through 4 years of school. This is not the case in North American schools. If you consider the drop out rates i think the number for Carribean schools would be extremely low.

[Robin Hood]

There numbers are inflated (although I don't know the specific rate) because a lot of their med students don't even make it to 4th year. Hence already lots of them out of the race before the race even starts. Hence the final match rate is based on the students who made it all the way through 4 years of school. This is not the case in North American schools. If you consider the drop out rates i think the number for Carribean schools would be extremely low.

 

Well, that's not a bad thing that these students fail, a lot of people at Saba are bad students who can't put the world for med school, if they fail, they are weeded out, and it's better than granting them an MD, they just don't deserve it. A good thing with Saba is that it can give a second chance, especially to those who did bad due to uncontrollable reasons.

[raptors]

At how much do you evaluate Saba's match rate? If it's like 50%, then it should be a no-no for any Canadian.

 

I really have no concrete facts or numbers nor have the time to find that out for you. Not even sure why i'm on this thread just clicked on it when directed from the CaRMS forum. Really should be studying for the LMCC after this.

 

Anyways, my scientific facebook methodology..haha rough estimates only from my semester a few friends, from what I remeber, could account for five or so people who didn't match out of over 50 something students (majority to the US). Mind you three of those people made the mistake of not applying more broadly and only to one specialty (US). Mind you there's two other semesters in the same year which I don't keep in touch with from everyone in those classes.

 

But even if it was "50%", which clearly from my scientific facebook method haha j/k is not I wouldn't say it's a no-no for any Canadian. It's not your choice, not your circumstances, not your life so really who are you to say it should be a no-no. Can't you keep an open mind? that's all I'm trying to get across to you.

 

But I'll say it again for any potential pre meds it should be a last resort after US/Canadian schools! Trust me.

[raptors]

Well, that's not a bad thing that these students fail, a lot of people at Saba are bad students who can't put the world for med school, if they fail, they are weeded out, and it's better than granting them an MD, they just don't deserve it. A good thing with Saba is that it can give a second chance, especially to those who did bad due to uncontrollable reasons.

 

Just read this now..and agree with some of your points. That last sentence..that's all I was trying to convey.

[leviathan]

Match rate at Saba is reported by the school to be around 90%. Based on the match lists every year I tend to believe they're telling the truth when they say that.

 

This is not accounting for all the people who fail out in the pre-clerkship phase. Those people shouldn't be counted though since they never should have been in medical school in the first place (most of them anyway).

[leviathan]

300k to a good US med school vs 150k debt to Saba I choose US any day. Who wouldn't? Also some banks give 200k LOC. and + other stuff and burseries scholarships government loans etc you should be able to get through and it's a guarenteed return for investment. Moo is a good example. US is costly but worth it no doubt about that.

I think raptors cleared up the confusion here and I agree with both of you. If you actually have enough equity in your family to get a 300k loan, then it's a no-brainer to attend a US school. That said, I'm sure many other people are like me who do not come from wealthy families that have the kind of collateral to secure a loan that large. You need to have a house with a mortgage that is paid off, or enough of the mortgage paid off to cover however much the bank is lending you. I hope that makes sense.

[futureGP]

Oh the malfunctioning system of medical education in Canada.

 

There are two types of Canadians that go abroad to study:

 

1. Those who screwed off in undergrad and want to just get straight to the MD without having to improve their crap paper application.

 

and

 

2. People with bad luck and a big dream. You know the type - 4.0/36 and didn't get in because Zach Zock, the grandson of the great med school donor Brack Zock, was applying too (and yes, it happens. Welcome to reality)

 

The second type will probably shine as an IMG and will have more opportunities to return to the system. The first type, however, probably won't. In fact, they should be held to even higher scrutiny than the second, to prove that they've shown intelligence and diligence (since they didn't in UG).

 

----

 

What about the FMG? You know, the applicant from another, usually 2nd world, 3rd world, or presently nonexistent country with medical educational systems that may run the gamut from passable to Hollywood Upstairs quality. Now it is these applicants I take issue with. Though I realize that many of them would make excellent physicians here, there is absolutely no way we can safely assess their competence and training. You think nepotism is bad in Canada? You should see India! This is why I think any FMG should have to go straight back to the regular system Canada uses for its domestic applicants: an undergrad degree, and then a Canadian medical school degree, and then residency. None of this fast-track garbage. Sure it is a hard and long road, but its not impossible - in fact I've seen many people better than I do it - and we should demand it.

 

Not to mention that if we fast-track FMGs into our system we are implicitly stating their undergraduate medical educations are on par with Canada's, and this is certainly not true.

 

 

 

 

 

 

+1 well said

[tupacandbiggie]

Oh the malfunctioning system of medical education in Canada.

 

There are two types of Canadians that go abroad to study:

 

1. Those who screwed off in undergrad and want to just get straight to the MD without having to improve their crap paper application.

 

and

 

2. People with bad luck and a big dream. You know the type - 4.0/36 and didn't get in because Zach Zock, the grandson of the great med school donor Brack Zock, was applying too (and yes, it happens. Welcome to reality)

 

The second type will probably shine as an IMG and will have more opportunities to return to the system. The first type, however, probably won't. In fact, they should be held to even higher scrutiny than the second, to prove that they've shown intelligence and diligence (since they didn't in UG).

 

----

 

What about the FMG? You know, the applicant from another, usually 2nd world, 3rd world, or presently nonexistent country with medical educational systems that may run the gamut from passable to Hollywood Upstairs quality. Now it is these applicants I take issue with. Though I realize that many of them would make excellent physicians here, there is absolutely no way we can safely assess their competence and training. You think nepotism is bad in Canada? You should see India! This is why I think any FMG should have to go straight back to the regular system Canada uses for its domestic applicants: an undergrad degree, and then a Canadian medical school degree, and then residency. None of this fast-track garbage. Sure it is a hard and long road, but its not impossible - in fact I've seen many people better than I do it - and we should demand it.

 

Not to mention that if we fast-track FMGs into our system we are implicitly stating their undergraduate medical educations are on par with Canada's, and this is certainly not true.

 

 

 

 

 

 

Not to mention people who cant get in here in Canada and abuse that route. Once the back door is open there's no way we can ensure fairness.

[rswim]

Oh the malfunctioning system of medical education in Canada.

 

There are two types of Canadians that go abroad to study:

 

1. Those who screwed off in undergrad and want to just get straight to the MD without having to improve their crap paper application.

 

and

 

2. People with bad luck and a big dream. You know the type - 4.0/36 and didn't get in because Zach Zock, the grandson of the great med school donor Brack Zock, was applying too (and yes, it happens. Welcome to reality)

 

The second type will probably shine as an IMG and will have more opportunities to return to the system. The first type, however, probably won't. In fact, they should be held to even higher scrutiny than the second, to prove that they've shown intelligence and diligence (since they didn't in UG).

 

----

 

What about the FMG? You know, the applicant from another, usually 2nd world, 3rd world, or presently nonexistent country with medical educational systems that may run the gamut from passable to Hollywood Upstairs quality. Now it is these applicants I take issue with. Though I realize that many of them would make excellent physicians here, there is absolutely no way we can safely assess their competence and training. You think nepotism is bad in Canada? You should see India! This is why I think any FMG should have to go straight back to the regular system Canada uses for its domestic applicants: an undergrad degree, and then a Canadian medical school degree, and then residency. None of this fast-track garbage. Sure it is a hard and long road, but its not impossible - in fact I've seen many people better than I do it - and we should demand it.

 

Not to mention that if we fast-track FMGs into our system we are implicitly stating their undergraduate medical educations are on par with Canada's, and this is certainly not true.

 

 

 

 

 

 

 

 

 

For better or for worse we don't have that kind of nepotism in Canadian medical schools, it is for this reason precisely that 23% of Canadians studying abroad are the sons and daughters of Canadian Physicians. It is also for this reason that the faculty won't take a strong stance against this CSA/IMG movement, because too many faculty members have a vested interest in seeing their children come back to Canada. Perhaps a little nepotism would take the wind out of the sails of this movement. Without the well connected medical and political parents this campaign would be a non-issue and we would do whats best for the patients and quality of healthcare which is to keep the backdoor shut, or at least VERY tightly regulated.

[RickRick]

For better or for worse we don't have that kind of nepotism in Canadian medical schools, it is for this reason precisely that 23% of Canadians studying abroad are the sons and daughters of Canadian Physicians. It is also for this reason that the faculty won't take a strong stance against this CSA/IMG movement, because too many faculty members have a vested interest in seeing their children come back to Canada. Perhaps a little nepotism would take the wind out of the sails of this movement. Without the well connected medical and political parents this campaign would be a non-issue and we would do whats best for the patients and quality of healthcare which is to keep the backdoor shut, or at least VERY tightly regulated.

 

Yet another one of these articles surfaced today, at least this one has some information from both sides:

 

http://thetyee.ca/News/2012/04/10/Canadian-Doctors-Trained-Abroad/index.html#comment-252881

[leviathan]

For better or for worse we don't have that kind of nepotism in Canadian medical schools, it is for this reason precisely that 23% of Canadians studying abroad are the sons and daughters of Canadian Physicians.

Oh come on, rswim. What about the other 77%? How many Canadians have doctors as parents? I doubt it's appreciably lower. What is the average SES status of those who apply vs matriculate to Canadian med schools? Those are the kind of interesting things you might want to read up on, I bet they would be pretty telling.

[Dr.Henderson]

Yet another one of these articles surfaced today, at least this one has some information from both sides:

 

http://thetyee.ca/News/2012/04/10/Canadian-Doctors-Trained-Abroad/index.html#comment-252881

 

This is particularly interesting to me (regarding CSAs surveyed):

 

"The survey also found that only 21 per cent of the respondents planned to pursue a career in family medicine, the area where Canada has the biggest shortage of doctors. "Since many of them intend to be specialists most likely in urban settings, it does little to solve the doctor shortage in Canada," it said. "

 

We already need to adjust the system so that we get more family docs out of our schools at home before we even begin to consider bringing IMGs into the mix imho.

 

I'm all for giving everyone a fair shake, but let's be honest- the perceived doctor shortage is actually a shortage of family physicians and it is mainly in rural areas. "Doctor shortage" shouldn't be used as a crutch for the argument unless its confined to people who are studying abroad and wishing to pursue family medicine (preferably in a rural area, where we need them most).

[leviathan]

I'm all for giving everyone a fair shake, but let's be honest- the perceived doctor shortage is actually a shortage of family physicians and it is mainly in rural areas.

 

There is an important distinction to be made though - one that I'm sure we're all aware of but it never seems to be mentioned. We DO have a shortage of specialists, it's just that we have an even greater shortage of OR time and other resources that these specialists need to access to have a job for themselves. Even in areas where there are no special resources needed, like dermatology, there are still long wait times to get a referral.

[Dr.Henderson]

There is an important distinction to be made though - one that I'm sure we're all aware of but it never seems to be mentioned. We DO have a shortage of specialists, it's just that we have an even greater shortage of OR time and other resources that these specialists need to access to have a job for themselves. Even in areas where there are no special resources needed, like dermatology, there are still long wait times to get a referral.

 

Also true; however, the fact remains that there are larger systemic issues that need to be addressed before we proceed to the issue at hand in this thread. Those jobs are hypothetical, they're needed but they're not there so bringing in CSAs to fill the void as many articles purport would help alleviate a doctor shortage, doesn't actually help solve anything as it stands. We have specialists already here, trained in Canada, waiting to fill those spots who are doing fellowship on top of fellowship as Moo has pointed out in other discussions. When those people have jobs and we're still short then we need to move ahead and assess how the remaining void is best filled. WRT specialties that require less resources, I'm sure dermatology spots (or any other specialist spots) would be filled up pretty quickly if more residency spots were opened up to Canadian grads. Just more evidence that residency spots don't match the job market.

 

The most pressing issue is a shortage of family physicians, in rural areas. That's my biased opinion as someone from a rural area that isn't on a wait list to see a specialist, of course. There are jobs there, right now, tons of them waiting to be filled and we can't fill them. We're recruiting docs internationally for those jobs, they fulfill their contract and move on to larger centres (I've lost a few family docs this way). If CSAs were primarily wanting to fill a void that's urgently needed, like family med in rural areas, I'd be banging on doors, writing letters, and handing out flyers for them:) . 21% is just discouraging, and how many of those are actually interested in somewhere outside a major centre?

 

Cliff notes: Restructure our system at home first. Residency spots need to be re-jigged to match the needs of our healthcare system, more money needed for OR time and specialist jobs. Something has to be done to ensure that rural residents have access to care- contractual obligations, whatever (far more complex than that and I don't pretend to think its not). After that's taken care of, increase seats at Canadian med schools if needed, fill the rest of the void with highly competent, proven CSAs/IMGs.

 

 

I write these statements more as someone who has experienced the struggle to find a family doctor and experienced a high turnover rate of family doctors as a result of living in a rural area, than I do as someone interested in a career in medicine.

[Mourning Cloak]

http://med.ubc.ca/files/2012/03/img_bc_and_canadians_studying_abroad-briefing-March-2012.pdf

[aaronjw]

 

The most pressing issue is a shortage of family physicians, in rural areas. That's my biased opinion as someone from a rural area that isn't on a wait list to see a specialist, of course. There are jobs there, right now, tons of them waiting to be filled and we can't fill them. We're recruiting docs internationally for those jobs, they fulfill their contract and move on to larger centres (I've lost a few family docs this way). If CSAs were primarily wanting to fill a void that's urgently needed, like family med in rural areas, I'd be banging on doors, writing letters, and handing out flyers for them:) . 21% is just discouraging, and how many of those are actually interested in somewhere outside a major centre?

 

Cliff notes: Restructure our system at home first. Residency spots need to be re-jigged to match the needs of our healthcare system, more money needed for OR time and specialist jobs. Something has to be done to ensure that rural residents have access to care- contractual obligations, whatever (far more complex than that and I don't pretend to think its not). After that's taken care of, increase seats at Canadian med schools if needed, fill the rest of the void with highly competent, proven CSAs/IMGs.

 

 

I write these statements more as someone who has experienced the struggle to find a family doctor and experienced a high turnover rate of family doctors as a result of living in a rural area, than I do as someone interested in a career in medicine.

 

Agree. It's pretty grim.

 

In 2004, physician supply in rural and small town areas accounted for 9.4%, compared to 90.6% for urban areas (Canadian Institute for Health Information, 2005). This represents a stark decline of 14.9% from the 1991 statistics (Pitblado & Pong, 1999). Taking into account physician type, rural areas have just 16% the family physician supply and only 2.4% of physicians who are specialists. To further complicate the issue of limited physician supply in rural areas, 21% of all Canadians live in areas classified as rural and/or small town (Canadian Institute for Health Information, 2005).

 

Trying to find updated from these figures is pretty damn tough so if ANYONE does know of where I can find them or who I might be able to contact to try and find them I would be forever grateful....