International Medical Graudates Trying to Return

[seeking1]

- and... just to continue my statements about abolishing the differences - the language issue is NOT an issue at all, any language is learned if it is practiced, give to an IMG a chance to be all around the english environment for few months and he/she will learn not only the language , but also the accents of the region

 

I expected more realistic reasons to be said here, not some romantic views about an utopic world

 

I know little about the tests you mentioned and how they apply to medical education, which is why I did not quote them. All I can say is that all natives of Ontario who are forced to take the TOEFL in undergraduate (i.e. the University of Waterloo) consider TOEFL to be a forced joke of a test.

 

With regards to the quoted statement: I hardly consider what I detailed as a view to be a utopic world/utopia. I consider it to be gritty realism about how people judge and discriminate against one another.

 

I agree with you that I believe that IMGs can, in fact, pick up a language and the accents of a region, and perform competently. I was not implying by my statements that I feel IMGs cannot learn language. That is patently false, many underserviced areas of Canada take in lots of IMGs for primary medicine.

 

Rather, what I am suggesting is that at more specialized levels of medicine (i.e. tertiary, quaternary) you will be constantly judged on your language English skills and comprehension. I imagine this could be justified for a variety of reasons (i.e. short amount of time in the day, many cases, do not have time to sit around correcting people's English, etc.).

 

Remember, please, I am speculating. I do not factually know if this is the case.

[moo]

Yes, because residency supervisors do not trust IMGs as much as they trust CMGs.

 

I am sure people will have issue with this statement, so I will clarify. I do not mean "trust" as in "I trust this person's diagnostic skills and knowledge". Rather, I mean "I trust this person's skill in the English language and comprehension".

 

Basically, I am saying that CMGs are seen as better English-speakers than are IMGs by residency supervisors, regardless of if that stereotype is true or not.

 

What proof do I have of my claim? Well, admissions for MD programs reward high verbal reasoning score moreso than any other section on the MCAT. Further, most medical school programs in Canada operate their programs in the English language only. Those that do not usually have the program in French, and applicants to that program must be fluent in French.

 

It follows, then, that this bias is prevalent through to residency training as well.

 

I will never argue with anyone that IMGs are worse than CMGs at the science of medicine; some are far better, in fact. I truly believe, though, that the perception of greater in trust in CMGs, particularly in language faculties, is the reason why CMGs are preferred to IMGs for competitive residency positions.

 

You are right to a certain extent. Most complaints are brought on against IMGs (the Sask Coll of Physicians published a report about this a few years ago), not Canadian IMGs.

[cclawfjj]

I would take a Harvard/Johns Hopkins/U Penn/Washington U in St. Louis med school acceptance any day of the week over any Canadian med school

 

so enough with this pompous, arrogant nonsense. Canadian med schools are quality, which we all appreciate. But there are even better med schools out there. Let's not act as if we have the absolute best med schools in the world

[jag@19]

I like sports analogies because well, most of us medical students are the over-achieving types and are thus well rounded in both the academia and sports.

 

And here's my dilemma as a soccer coach and club coordinator. I have a soccer tournament to organize and there are going to be qualifying games, quarters, semis and finals. Now I realize there are A LOT of good teams coming into this charity tournament from BC but at the end of the day, all teams have a fair chance at the qualifiers to fight for and proceed to the next round. So should a team lose in the qualifiers or quarters or semis, doesn't matter how qualified they may be, should I give them another chance to-enter for the finals?!

 

Now I've been to both University of Queensland in Brisbane, AUS and now UBC and I know how tough it has been. But the profession of medicine is tough and competitive ... everyone knows that. I consider getting in to be like winning the finals and I had a fair chance to apply and I failed the first time around, knew I wanted medicine, which is why I left the province, but returned upon applying for a 2nd time. Let there be no prejudice against those who sit 'around' in BC waiting for the next cycle. At the end of the day, we've all had a fair shot on getting in and ultimately, there is no formula or algorithm that can fairly determine who deserves to be in or not which is why I'm extremely proud of the current system at UBC. Having spent ~2years with my current class of 2014, I'm proud of each and everyone of us and sure there may be 1 or 2 people who raise the eyebrow but no system is perfect.

[jojojaxon]

I've worked with IMG"s on a few 4th year rotations and what you guys are saying is very true. Some are ok, some are not. I worked with a student from an Aussie med school who hadn't even seen a delivery before- an R-1 is expected to be able to DO these themselves, and Caribbean students who hadn't done an intubation before- an R-1 in any specialty needs to have this skill down. These guys are vying to become R-1's with in many cases pretty suspect clinical training and I think the rights of the public to have competent residents far exceeds the rights of IMG's to come back here and practice just because they put in their time at whatever school would take them and feel they deserve it.

[dokrbb]

I know little about the tests you mentioned and how they apply to medical education, which is why I did not quote them. All I can say is that all natives of Ontario who are forced to take the TOEFL in undergraduate (i.e. the University of Waterloo) consider TOEFL to be a forced joke of a test.

 

With regards to the quoted statement: I hardly consider what I detailed as a view to be a utopic world/utopia. I consider it to be gritty realism about how people judge and discriminate against one another.

 

I agree with you that I believe that IMGs can, in fact, pick up a language and the accents of a region, and perform competently. I was not implying by my statements that I feel IMGs cannot learn language. That is patently false, many underserviced areas of Canada take in lots of IMGs for primary medicine.

 

Rather, what I am suggesting is that at more specialized levels of medicine (i.e. tertiary, quaternary) you will be constantly judged on your language English skills and comprehension. I imagine this could be justified for a variety of reasons (i.e. short amount of time in the day, many cases, do not have time to sit around correcting people's English, etc.).

 

Remember, please, I am speculating. I do not factually know if this is the case.

 

If you are speculating, you should say

"...residency supervisors said that do not trust IMGs as much as they trust CMGs

, and not "...residency supervisors do not trust IMGs as much as they trust CMGs" - this I think is a part of language skills Chapter,

 

So, your point - would you trust my writing as an IMG (just from what you have seen in my messages, so far)?

[dokrbb]

You are right to a certain extent. Most complaints are brought on against IMGs (the Sask Coll of Physicians published a report about this a few years ago), not Canadian IMGs.

 

here, I think would be appropriate to discuss how this fierce licencing canadian system allowed these IMGs to practice, since they didn't practice until being licenced in Canada,

 

what have been said a little bit earlier on this thread about canadian standards ?

[seeking1]

If you are speculating, you should say , and not "...residency supervisors do not trust IMGs as much as they trust CMGs" - this I think is a part of language skills Chapter,

 

So, your point - would you trust my writing as an IMG (just from what you have seen in my messages, so far)?

 

You are correct about how I should reword things regarding residency supervisors.

 

Regarding me trusting your writing skills....well...based off of what I've seen, I'm not sure, truthfully.

 

I should say, though, that English comprehension is far more than just English writing skills alone; that is evident enough from the verbal reasoning sections of the MCAT.

[dokrbb]

You are correct about how I should reword things regarding residency supervisors.

 

Regarding me trusting your writing skills....well...based off of what I've seen, I'm not sure, truthfully.

 

I should say, though, that English comprehension is far more than just English writing skills alone; that is evident enough from the verbal reasoning sections of the MCAT.

 

I knew you would say that, sincerely

 

but don't take as an offence, it wasn't my intention,

 

It was just interesting to see wat do you (you - in general, not you-personally) think about about IMGs, because in the real life canadians rarely would tell you something straight speaking;) , especially if there is a chance to have some of you as colleagues one day hmm...

[medigeek]

what OP says holds true for those with <3.5 gpa type applicants.

[sprinkles]

Mashmetoo, good job on the english lesson, but you kind of failed to make a point.....you say there are more than two sides but you haven't really expressed any alternatives

 

I'm personally on the fence on this issue.....on one side....if you didn't get into Canada why do you get to get a free pass later? But on the other side....'doctor shortages' is all we ever hear(but that has changed has it not?) I think if foreign trained doctors want to go into Family Med here then they should be able to (due to the shortage) but all the other specialties not only have no shortage but some even have too many!

 

But yes. Still would like to know the other side better

 

Oh. and btw, the disease argument .... was that you trolling or what? haha because in this day and age saying a disease 'belongs' to a region is kind of retarded. But then I guess I forgot....AIDS only happens in Africa, and SARS only in Asia, and TB ONLY in certain places I mean come one

[leviathan]

Waiting out and reapplying is not a bad thing, I hope I didn't give that impression. I just said those who decide to bite the bullet and attend international schools shouldn't be looked at like they took an 'easy' way out, which is what I hear said all the time. The reality of going abroad is the exact opposite.

 

Everyone goes through hardships in Canada, and while I always tell people to keep reapplying yearly until you get in, it's not always the best scenario for every student. I'd love to tell 'my story' as an example of that, once I've graduated.

 

As for your experience with IMGs, I think that also extends to CMGs as I've met many R1s who have not intubated, done central lines, had trouble getting ABGs etc It depends more on how proactive you are. I've personally done every procedure you'd expect of an R1 with the exception of intubation, but my anesthesiology rotation is still coming up.

 

As for your story about the M4 who hadn't seen a delivery, I have to call you out on that one...do they not have OBGYN as a mandatory rotation in Australia?

[dokrbb]

Oh. and btw, the disease argument .... was that you trolling or what? haha because in this day and age saying a disease 'belongs' to a region is kind of retarded. But then I guess I forgot....AIDS only happens in Africa, and SARS only in Asia, and TB ONLY in certain places I mean come one

 

So what, the fact that Canada is far from Africa, AIDS is not studied in medshools here, or TB is not a topic of Internal medicine curricula ?

- from what I know, you could be asked about all of these Dx during your EE or QE1 exams,

 

a stupid statment is a stupid one, that's it

[seeking1]

I knew you would say that, sincerely

 

but don't take as an offence, it wasn't my intention,

 

It was just interesting to see wat do you (you - in general, not you-personally) think about about IMGs, because in the real life canadians rarely would tell you something straight speaking;) , especially if there is a chance to have some of you as colleagues one day hmm...

 

I hope I did not offend you with my statement about English writing. I wanted to be sincere and answer your question directly, but not insulting.

 

I value IMGs and feel that they make up an important element in the fabric of Canadian health care. The North American countries of Canada and the USA are dependent on outsiders bringing in their experience and knowledge. I just think that they will get discriminated against for non-primary medicine positions.

[axialpac]

I value IMGs and feel that they make up an important element in the fabric of Canadian health care. The North American countries of Canada and the USA are dependent on outsiders bringing in their experience and knowledge. I just think that they will get discriminated against for non-primary medicine positions.

I agree with this.

[concernedmedstudent]

Not only is that extremely offensive to people who had to endure multiple application cycles, but who are you to make claims about their confidence and abilities? Do you know how it feels being rejected 2-3 times in a row every application cycle? Since when did you figure out and study the condition of every single IMG?

 

Hundreds of well qualified Canadian applicants are routinely rejected every year and most people had to endure Multiple application cycles before considering to attend an International school (whether it's the US or Caribbean) I know a friend at John Hopkins right now and he's an MS-1. John Hopkins is a TOP medical school, even higher ranked than Toronto. He was rejected from all Ontario schools and didn't want to endure another application cycle because of personal and family reasons.

 

You have no right to make claims about the abilities of applicants who are rejected. They probably had better stats and EC's then you, and their a variety of reasons why they must have been rejected. To comment on their perseverance is just absurd. It takes a lot of courage to endure multiple application cycles and also to make the decision of attending an International school; whether or not it's an American School or Caribbean school.

 

Of course those kids who went to the Caribbean straight out of high school or undergrad without trying here first and working hard, and just wanted the easy way out, are the ones your comments could be referred to but certainly not to those applicants who were well qualified, had to endure multiple application cycles, worked hard here in Canada but just couldn't make it through.

 

Check your stats on the average number of times that students studying in Canada applied compared to the average number of times that Canadians Studying abroad have applied. "While some students have entered into their international medical school directly from high school, most CSAs have not applied to Canadian medical schools as many times (1.76 times) as the successful Canadian students (CMGs) studying in Canada who apply 2.95 times prior to being admitted. (CaRMS Survey, 2010)"

[dokrbb]

I hope I did not offend you with my statement about English writing. I wanted to be sincere and answer your question directly, but not insulting.

 

Why? It was nothing offensive in your answers

 

...as for this one...

I value IMGs and feel that they make up an important element in the fabric of Canadian health care. The North American countries of Canada and the USA are dependent on outsiders bringing in their experience and knowledge. I just think that they will get discriminated against for non-primary medicine positions.

 

maybe we should just take off our politeness and say frankly - exactly the medical issues should be those discriminatory criteria,

 

I don't mean the difference in diseases , but the difference in approach , critical thinking, medical decision making - these are the factors that make different canadian med education from others, and this would be fair, wouldn't it ?

 

.. but just looking for some discriminatory positions, and applying them variably on each candidate, I mean - depending on their english skills, or if it's OK with that, let's see from wich country is he coming, in hope that this would "serve" as excluding criterion, and so on...

 

This is just... not what the selection criteria pretend to be

[concernedmedstudent]

You missed the boat with that publication. The roadblock BC students studying abroad are facing is that they can't even apply for IMG positions in BC. The OSCE they hold for IMGs is administered in April, after CaRMS is finished. So all the qualified IMGs who could have addressed the shortage in BC end up matching elsewhere.

 

Congrats on your med school acceptance. Your sense of entitlement, however, is nauseating. There are far more qualified applicants than seats, and so if a student decides to seek education abroad, it's probably best not to hold such a condescending attitude like they are less worthy or capable than you. While some IMGs are weaker students, the rigorous training of medical school weeds the vast majority of these people out. There are many more IMGs who are likely much more capable than you because of how many strong applicants get rejected yearly and go abroad, and then are forced to work much harder than their Canadian counterparts. For various reasons, not everyone has the capacity to keep applying for years without a guarantee that they'll eventually get an acceptance.

 

I would argue it takes far more courage and hard work to attend an international medical school than to sit around idly in Canada until you get an acceptance. Especially if you are the type who comes from a wealthy family that pays all your student loans, and allows you to lie around their house for free and reapply yearly until you get in. I think we can all agree that once you're in med school in Canada, it's smooth sailing from there. The same is clearly not the case for international students.

 

"While some students have entered into their international medical school directly from high school, most CSAs have not applied to Canadian medical schools as many times (1.76 times) as the successful Canadian students (CMGs) studying in Canada who apply 2.95 times prior to being admitted. (CaRMS Survey, 2010)" If the average Canadian medical student has had to wait 1.2 years longer than CSAs it seems fair that they should have to wait an extra 6 mo or year so that they can do the Canadian OSCE. It isn't BCs responsibility to have exams that conveniently fits into every IMGs schedule.

 

Ps. I was an IMG who was accepted back to Canada. When I was down there I was prepared for a long hard battle to come back. I have no problem with IMGs coming back, in fact I am very supportive of this idea, but there needs to be a process and standards to assure that we are only getting very high quality candidates.

[jag@19]

Call me biased but it is fair to say that the CaRMS and residency program directors put faith into the 'Canadian' training system and will obviously defer to a canadian trained student over anyone else. ANd the problem I see with opening to 'IMGs' regardless of whether you're a Canadian studying abroad or not, is that you'll need to be very cognescent of EVERY training program out there and that is simply not possible. For instance, the Year 1 and 2 anatomy program at Univ of Queensland was really sketchy but their clinical skills program is hands-down superior to that of UBC in terms of specialty clinic patient contact for physical exams. I don't expect the CaRMS program directors to have to treat any international medical graduate individually which is why we may see the wide brush stroke approach.

 

And more importantly, I should hope that you are not expecting Canadian medical students to have to compete with IMGs for those already-uber competitive residency spots?! I certainly hope you are referring to IMGs being allowed to increase their chances in applying to the 2nd iteration and more.

[concernedmedstudent]

I like sports analogies because well, most of us medical students are the over-achieving types and are thus well rounded in both the academia and sports.

 

And here's my dilemma as a soccer coach and club coordinator. I have a soccer tournament to organize and there are going to be qualifying games, quarters, semis and finals. Now I realize there are A LOT of good teams coming into this charity tournament from BC but at the end of the day, all teams have a fair chance at the qualifiers to fight for and proceed to the next round. So should a team lose in the qualifiers or quarters or semis, doesn't matter how qualified they may be, should I give them another chance to-enter for the finals?!

 

Now I've been to both University of Queensland in Brisbane, AUS and now UBC and I know how tough it has been. But the profession of medicine is tough and competitive ... everyone knows that. I consider getting in to be like winning the finals and I had a fair chance to apply and I failed the first time around, knew I wanted medicine, which is why I left the province, but returned upon applying for a 2nd time. Let there be no prejudice against those who sit 'around' in BC waiting for the next cycle. At the end of the day, we've all had a fair shot on getting in and ultimately, there is no formula or algorithm that can fairly determine who deserves to be in or not which is why I'm extremely proud of the current system at UBC. Having spent ~2years with my current class of 2014, I'm proud of each and everyone of us and sure there may be 1 or 2 people who raise the eyebrow but no system is perfect.

 

EXCELLENT POINT! I couldn't agree with you more. I think it is generous that we have avenues for them to get back in, kind of like a wild-card race. Like a wild-card race, it is very challenging and there are very few spots available. If we just open up the gates to them we are devaluing the hard work and perseverance of Canadian Medical students. Can you imagine of the NHL said, just to be nice all of the teams now make the playoffs, not only would that make for a boring regular season with no meaning, but it would take away from the intensity and quite frankly the quality of the playoffs. This isn't kindergarten anymore, not everyone gets a blue ribbon!

[Mashmetoo]

Mashmetoo, good job on the english lesson, but you kind of failed to make a point.....you say there are more than two sides but you haven't really expressed any alternatives

 

lol, I thought my point was pretty clear.

 

- I'm skeptical at the conclusions and "call to action" reached by someone who has a flawed logic. And I will not take what they have to say seriously in light of their flawed arguments.

 

the false dilemma

Either they are not qualified at this time to compete with successful candidates, or, they are not cut out for a competitive and demanding career in medicine.

IMGs were either unable to get into Canadian Schools or they couldn't be bothered to apply

 

option 3: Maybe candidate C is qualified, has the stats, but the competition for very limited spots without IP preference worked against him. - I see 3.9+ omsas cgpa, 35+ mcat, ECs who get no interview invites all the time. It doesn't mean they are "unqualified", or "not cut out for medicine" - it means the person is very qualified, but the competition is absolutely brutal. Luck is also a huge factor.

 

Option 4: Maybe a candidate has family ties to (say) Australia, and preferred to do their med there, and now would like to come back to Canada.

 

Non sequitur logical fallacy:

If they truly are exceptional students with high quality training, then they will no doubt find a spot back in Canada

 

There are tons of over qualified IMGs who are exceptional aiming for VERY limited spots. This is not how the game is played for IMGs - it doesn't matter how much training or how exceptional you are for the most part. It's a numbers game, with the available spots being a small fraction of the demand.

 

You know of many Canadians but I'm sure there are also many who didn't match who you never hear of.

 

I see the struggles IMGs face (both Canadian-born who went abroad and newer Canadians who immigrated here) and it's not pretty. For Round 2 of Carms, my program (which isn't even that competitive to get into in Round 1) got 122 applications for 1 spot. The vast majority were IMGs who went to Ireland, Australia, and the Caribbean who didn't match first round.

 

Yes, you will here of the one or two grads who went to SGU and got derm somewhere. But what you won't hear about are the countless others who make it through four-five years of med school, only to get rejected again in trying to secure a residency. Going overseas (non-LCME) is a HUGE risk and don't fool yourself into thinking that it's not.

[concernedmedstudent]

perhaps you would be better suited for a career as an English prof, politician, or perhaps a lawyer. Playing the semantics game is such a waste of time.

[cardiomegaly]

Check your stats on the average number of times that students studying in Canada applied compared to the average number of times that Canadians Studying abroad have applied. "While some students have entered into their international medical school directly from high school, most CSAs have not applied to Canadian medical schools as many times (1.76 times) as the successful Canadian students (CMGs) studying in Canada who apply 2.95 times prior to being admitted. (CaRMS Survey, 2010)"

 

A better quote from that paper is how many CSA's did not even apply to Canadian schools before going abroad - it's something ~20%

 

There is a very well written position paper by the CFMS that essentially addresses the human rights issue of IMG's. What often happens is people argue that Canadian born citizens who train in Australia, Ireland, Carib etc should be given priority. But you can't discriminate between the IMG Irish trained doctor who immigrated here and became a Canadian citizen from the IMG Canadian born guy/girl who went to the same Irish medical school either directly after high school or after trying the Canadian admissions system. http://www.cfms.org/attachments/article/163/cfms_-_2011_img_position_paper_final.pdf

 

I fully respect there are individuals with an incredible back story who struggled through a lot of adversity who may very well become great physicians but can't hack through the rigours of the Canadian requirements. Those are often the ones that make it back successfully.

 

What I don't respect as much is the ones who never give the Canadian system a decent shot or zip straight through to expensive overseas programs.

 

What pisses me off the most is programs like this:

 

http://medicine.st-andrews.ac.uk/documents/2011_pro_alberta.pdf

 

International medical programs catered to Canadians, unbelievably expensive, but with that kind of money you can buy yourself 16 weeks of clinical rotation at the University of Alberta. I don't think anyone can make an argument that high school grads are able to find student loans to cover this exorbitant tuition...40,000 pounds in clinical years... it's straight up Mommy and Daddy (who are more often than not physicians) funding their kids around the system. I have read one too many article written by a physician lamenting the fact that their kid went to England straight after high school and is having a hard time coming back because Canada is unfair to IMGs.

[Mashmetoo]

perhaps you would be better suited for a career as an English prof, politician, or perhaps a lawyer. Playing the semantics game is such a waste of time.

 

I'm not trying to pick on you on purpose. When I read what you wrote, those logical fallacies blew up in my face. Those logical fallacies are very hard to miss, especially whenyou are advocating for something that will have such dramatic outcomes for the lives of IMGs.

 

This isn't simple semantics, the conclusions you draw from your premises is entirely wrong. You put forth an invalid argument. No authority would take what you say seriously because you work on false conclusions.

 

I just wish that you'd think through these things a bit deeper.

 

 

Also, you just made the non sequitur logical fallacy again:

perhaps you would be better suited for a career as an English prof, politician, or perhaps a lawyer.

 

Or, perhaps I should continue being a med student, and point out these logical fallacies whenever I see them...

[dokrbb]

A better quote from that paper is how many CSA's did not even apply to Canadian schools before going abroad - it's something ~20%

 

There is a very well written position paper by the CFMS that essentially addresses the human rights issue of IMG's. What often happens is people argue that Canadian born citizens who train in Australia, Ireland, Carib etc should be given priority. But you can't discriminate between the IMG Irish trained doctor who immigrated here and became a Canadian citizen from the IMG Canadian born guy/girl who went to the same Irish medical school either directly after high school or after trying the Canadian admissions system. http://www.cfms.org/attachments/article/163/cfms_-_2011_img_position_paper_final.pdf

 

I fully respect there are individuals with an incredible back story who struggled through a lot of adversity who may very well become great physicians but can't hack through the rigours of the Canadian requirements. Those are often the ones that make it back successfully.

 

What I don't respect as much is the ones who never give the Canadian system a decent shot or zip straight through to expensive overseas programs.

 

What pisses me off the most is programs like this:

 

http://medicine.st-andrews.ac.uk/documents/2011_pro_alberta.pdf

 

International medical programs catered to Canadians, unbelievably expensive, but with that kind of money you can buy yourself 16 weeks of clinical rotation at the University of Alberta. I don't think anyone can make an argument that high school grads are able to find student loans to cover this exorbitant tuition...40,000 pounds in clinical years... it's straight up Mommy and Daddy (who are more often than not physicians) funding their kids around the system. I have read one too many article written by a physician lamenting the fact that their kid went to England straight after high school and is having a hard time coming back because Canada is unfair to IMGs.

 

Good point, If I had been canadian in my premed period, I would have never thought of doing med school abroad.

 

There are people that don't appreciate properly the opportunities they have as living in this country per se,