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Hi,

 

I've tried to read up as much as I could on this site regarding Emerg Programs and still have many questions. Instead of asking 100 questions, I was hoping someone could point me in the right directon/direct me to resources so I can figure stuff out on my own (and who knows, hopefully post my findings here for others).

 

I'm entering third year in the next couple of months so I am trying to plan out electives and learn more about different programs. Let's assume I don't know anything about the differences between residency programs at Canadian schools (best? worst? - what makes a program good/bad), which schools require on-site electives for interviews, or anything of the like.

 

So, where could I get solid info on individual programs, or even comparisons? (things like the RBC profiles don't say much). I know talking to individuals in programs would be best, but being a non-trad student, I don't have many med contacts other than my home school although I'm working on it. So for now I'm looking for secondary sources.

 

Any help is appreciated. ER is my Plan A, B, and C, as I have ruled out other areas I was interested in through summer electives and other experiences, so I'm pretty motivated to read up and get a game plan set.

 

thanks

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Talk to your emerg club leaders - I faintly remember a document being sent out with details about the individual programs. They should have a copy.

 

That's great that you feel so passionately about ER but I would caution you to still keep your options open as clerkship itself is very different than summer electives. A lot can change in 8 weeks of a rotation. Emerg is also very competitive (rivaling anaesthesia and other surgical subspecislties) so having a plan B isn't such a bad thing. definitely get a game plan set up but have some flexibility in case you do change your mind. One thing most senior medical students and residents will tell you is that a huge chunk of students change their minds in third year.

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Talk to your emerg club leaders - I faintly remember a document being sent out with details about the individual programs. They should have a copy.

 

That's great that you feel so passionately about ER but I would caution you to still keep your options open as clerkship itself is very different than summer electives. A lot can change in 8 weeks of a rotation. Emerg is also very competitive (rivaling anaesthesia and other surgical subspecislties) so having a plan B isn't such a bad thing. definitely get a game plan set up but have some flexibility in case you do change your mind. One thing most senior medical students and residents will tell you is that a huge chunk of students change their minds in third year.

 

Cardiomegaly - thanks for the insight. I would definitely be open to a Plan B, and if I find something I really like then it would be great. I'm pretty sure I won't change my mind on the things I ruled out this summer as there is no exposure to these specialties in clerkship, so that's why I'm focusing on ER since it's all I have...for now. In our third year, we only have 4 weeks of electives, so I've booked two wks in ER. I'll probably book another two wks in ER at another school as well, just so I have it locked. But I surely will take your advice to heart. I do find it daunting to rack up enough electives in one competitive area while still being competitive for whatever Plan B is. I've got to think Plan B needs to be an area that is not competitive at all. For now I just want to ensure I've got a plan to tackle at least one area I'm interested in.

 

 

 

Check out the CAEP student section, http://caep.ca/medical-students

 

Hopefully there is a little in there for you.

 

They also offer a mentorship program that I can't seem to find right now, where they pair you up with a current resident that's volunteered to mentor... so hopefully could answer your questions.

 

best of luck

 

Thanks - I found that site yesterday and it had some useful links, along with the carms site and the descriptions it contained. I'll look for the mentorship program - sounds great.

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Talk to recently matched R1s in ER, if you still have their emails.

 

A common Plan B is the CCFP-EM route.

 

 

Thanks, and the CCFP-EM is definitely something I'll consider heavily during 8 weeks of FM in Year 3. The reason why I haven't yet taken it seriously is because frankly I'm a weirdo, and I enjoy shift work and the work environment of the ER compared to a Family practice. While considering career options, I've tried to also think of the environment I'd be in and if its a fit for me. There's something about routine and the 9-5 everyday that just gets to me. Been like that all my life. I've also been told countless times "one day you'll be old and you'll want to sit down so having the FM option is great" - but I'm not sure that's a good reason for going this route. If I like FM, then yes, I'd consider it. If not, then I won't. I figure this is logical yet very simple. Maybe too simple? who knows....

 

I don't know whether I prefer high risk/high reward, but sometimes I wonder: Why not dedicate the time you put towards a Plan B, towards making you a better Plan A candidate? I know I'm in the minority with this thinking, but thought I'd finally pose the question. Is it because it's still a numbers game and great candidates can actually strike out of multiple programs across Canada? Or just that so many people change their mind late in the game? I've got about 4 cities across three provinces I'd have no problem living in, so I guess that would make me somewhat flexible location wise. I figure that would help my chances but then again, what do i know.....things are just getting started.

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Our CCFP-EM ER docs practice ER fulltime, same as their FRCPC colleagues. Unless you're talking about the first two years of FM training.

 

4 cities out of ~13 English speaking programs is flexible? The problem with not having a plan B is that it's hard to know how strong your candidacy is until everything pans out post-match. You could do all your electives and research in a single field, but should you not be well-liked.. you'll need a plan B.

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Our CCFP-EM ER docs practice ER fulltime, same as their FRCPC colleagues. Unless you're talking about the first two years of FM training.

 

4 cities out of ~13 English speaking programs is flexible? The problem with not having a plan B is that it's hard to know how strong your candidacy is until everything pans out post-match. You could do all your electives and research in a single field, but should you not be well-liked.. you'll need a plan B.

 

If I am right about my fit for ER, I figured the FRCPC route would be best in terms of future opportunities (jobs, locations). And if its ER i truly care about (and not FM), I figure I'd go the extra mile

 

You are right about the 4 cities. I guess I have talked to too many peers who plan on staying in the same province and thus made an incorrect comparison. There's actually 6 cities (two in Ontario that are just okay but not great like the other 4 cities on my list) but I get the message - it's hard to guage on my own how well I'm doing and a false sense of security could be fatal. I'll try to be more active and look for a plan B instead of hoping it finds me.

 

thanks for the help and questioning - I need it.

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I've also been told countless times "one day you'll be old and you'll want to sit down so having the FM option is great" - but I'm not sure that's a good reason for going this route.

 

Very little makes me burst out laughing at the computer ... maybe once every 4-6 months .... but you sir made me laugh my a$$ off when I read that ...

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I don't know whether I prefer high risk/high reward, but sometimes I wonder: Why not dedicate the time you put towards a Plan B, towards making you a better Plan A candidate? I know I'm in the minority with this thinking, but thought I'd finally pose the question. Is it because it's still a numbers game and great candidates can actually strike out of multiple programs across Canada? Or just that so many people change their mind late in the game? I've got about 4 cities across three provinces I'd have no problem living in, so I guess that would make me somewhat flexible location wise. I figure that would help my chances but then again, what do i know.....things are just getting started.

 

Agreed... for FRCP emerg 4 cities is not very flexible. You want to apply to every program in the country.

 

Great candidates go unmatched to all sorts of specialties.

I don't think you have to compromise on Plan A by keeping open a plan B. Doing 20 weeks of elective in any specialty is a stupid idea IMO. It's narrow minded and you miss out on learning about other parts of medicine. It's all about smart diversification - if you want to do ophtho for example, do an elective in neurology, in plastics and internal medicine, or even emerg. If you want to do anaesthesia, spend time in cardiology, respirology, gen surg or ICU. Emerg is even more flexible...you'd be hard pressed to find an elective that wasn't applicable (maybe pathology).

You'll be a much better, more well rounded clinician.

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Agreed... for FRCP emerg 4 cities is not very flexible. You want to apply to every program in the country.

 

Great candidates go unmatched to all sorts of specialties.

I don't think you have to compromise on Plan A by keeping open a plan B. Doing 20 weeks of elective in any specialty is a stupid idea IMO. It's narrow minded and you miss out on learning about other parts of medicine. It's all about smart diversification - if you want to do ophtho for example, do an elective in neurology, in plastics and internal medicine, or even emerg. If you want to do anaesthesia, spend time in cardiology, respirology, gen surg or ICU. Emerg is even more flexible...you'd be hard pressed to find an elective that wasn't applicable (maybe pathology).

You'll be a much better, more well rounded clinician.

 

Hey, thanks for the advice.

 

I totally agree about smart diversification (already had planned on electives in at least ortho surg, radiology (perhaps a second surg instead), anaesthesia). But to be competitive for a Plan B, I thought I'd have to have 4+ electives in that field. For example, if I'm gung-ho on ER but do an elective in each of the above fields plus another one (ICU/CCU), I don't see how that makes me any more competitive for anything else. Well rounded for sure.....better ER applicant I beleive so......but could I apply to anything else and stand a chance? What am I missing here?

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  • 3 weeks later...

If you want FRCP EM do lots of EM electives. Not all EM electives are equal. For FRCP EM I would take a close look at doing electives at academic EDs, places which are level one centers. You want to work with FRCP EM docs and if you can and get reference letters from them if possible.

 

Some other good options to supplement your main EM electives is a CCFP EM elective, maybe at a rural ED. This helps you say with more authority that you want FRCP as you explored both. During CaRMS you will need to justify your FRCP preference versus CCFP. So this experience can be high yield.

 

Also anesthesia, peads EM, trauma, CCU and ICU overlap well.

 

But mainly you want academic EM electives. These are gold.

 

 

Good luck!

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The best and worst program for you, is going to depend on you, where your interests are both academically and non-academically.

 

Knowing you will finish a competent emerg doc from whatever Canadian program you complete, you also need to consider other factors. Such, as significant other, family, hobbies etc.

 

You'll be in that residency program for 5 years, which is a fairly long time. So you have to be happy with your life during that time. For example, I horseback ride and so I would have been miserable in say Montreal or Toronto where I would have had to have given this up. So there are certainly considerations outside of academics.

 

Other considerations are how well people get along in the program etc. This won't be found on a piece of paper handed to you by someone listing pros and cons of a program. It's something you have to just get a feel for and you do this on your electives. So do electives in the places you think you want to go to, and see how you feel when you do them. Do the residents seem happy? etc.

 

Along the lines of academics, see where you interests are - is it research? simulation? teaching? etc. And see which programs are stronger in these areas.

 

 

Hi,

 

I've tried to read up as much as I could on this site regarding Emerg Programs and still have many questions. Instead of asking 100 questions, I was hoping someone could point me in the right directon/direct me to resources so I can figure stuff out on my own (and who knows, hopefully post my findings here for others).

 

I'm entering third year in the next couple of months so I am trying to plan out electives and learn more about different programs. Let's assume I don't know anything about the differences between residency programs at Canadian schools (best? worst? - what makes a program good/bad), which schools require on-site electives for interviews, or anything of the like.

 

So, where could I get solid info on individual programs, or even comparisons? (things like the RBC profiles don't say much). I know talking to individuals in programs would be best, but being a non-trad student, I don't have many med contacts other than my home school although I'm working on it. So for now I'm looking for secondary sources.

 

Any help is appreciated. ER is my Plan A, B, and C, as I have ruled out other areas I was interested in through summer electives and other experiences, so I'm pretty motivated to read up and get a game plan set.

 

thanks

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thanks very much for the reply.

 

Most certainly, I would first rank programs according to the city as there's 2-3 cities I would really like to live in, another 2 that are ok, and then there's the rest. I highly value life outside medicine so this is key, and I'm glad you brought that up.

 

I am in the process of selecting electives and you gave me a bit more confidence w regards to my strategy (just do them where you want to live, and then see first hand what's up). Of course I'm still early in the learning process and need to do more research.

 

thanks

 

The best and worst program for you, is going to depend on you, where your interests are both academically and non-academically.

 

Knowing you will finish a competent emerg doc from whatever Canadian program you complete, you also need to consider other factors. Such, as significant other, family, hobbies etc.

 

You'll be in that residency program for 5 years, which is a fairly long time. So you have to be happy with your life during that time. For example, I horseback ride and so I would have been miserable in say Montreal or Toronto where I would have had to have given this up. So there are certainly considerations outside of academics.

 

Other considerations are how well people get along in the program etc. This won't be found on a piece of paper handed to you by someone listing pros and cons of a program. It's something you have to just get a feel for and you do this on your electives. So do electives in the places you think you want to go to, and see how you feel when you do them. Do the residents seem happy? etc.

 

Along the lines of academics, see where you interests are - is it research? simulation? teaching? etc. And see which programs are stronger in these areas.

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One more thing to add to what Satsuma is saying...

 

When considering FRCP EM you should think of the fellowship options. This is a major difference between the two streams. The two streams share similarities, yes they both do emergency medicine. But there are big differences when it comes career options beyond and within EM. FRs tend to work in more academic centers and can specalize in EM related fields. For example it is not uncommon to see an FRCP splitting his time between the ED, ICU, being involved in toxicology or EMS etc etc.

 

I would not just do electives where you want to live. Sure if you can't stand a place and are not applying there then sure... But FRCP is pretty competitive. I would keep a pretty open mind when it comes to location if you can only see yourself doing FRCP EM. There are some particularly key scholols to visit and some programs have more spots than others. I would look at those places pretty seriously when it comes to electives.

 

That's my two cents.

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That's a key reason I'm interested in the FRCP route - the options that extend even beyond ER is a very attractive feature. I'm pretty sold on the FRCP route and I'm just debating on whether I'll have to do one or two FM electives to show that I can contrast the two streams come interview time.

 

would you mind sharing which schools are the key schools? I currently don't know which ones require an on-site elective and which don't.

 

Also, does the number of spots/program matter alot, or a little? What i mean is, is there less demand for schools with less spots so the applicant:spots ratio is the same?

 

Currently I'm planning on electives at my home school, and then at: UBC, UT, UWO, and perhaps McGill and Ottawa as well. If I hit McGill, that's 4 provinces. Obviously I'd apply to every program I could but the above listed ones are cities that I'd enjoy for sure.

 

thanks for the insight - very much appreciated.

 

One more thing to add to what Satsuma is saying...

 

When considering FRCP EM you should think of the fellowship options. This is a major difference between the two streams. The two streams share similarities, yes they both do emergency medicine. But there are big differences when it comes career options beyond and within EM. FRs tend to work in more academic centers and can specalize in EM related fields. For example it is not uncommon to see an FRCP splitting his time between the ED, ICU, being involved in toxicology or EMS etc etc.

 

I would not just do electives where you want to live. Sure if you can't stand a place and are not applying there then sure... But FRCP is pretty competitive. I would keep a pretty open mind when it comes to location if you can only see yourself doing FRCP EM. There are some particularly key scholols to visit and some programs have more spots than others. I would look at those places pretty seriously when it comes to electives.

 

That's my two cents.

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That's a key reason I'm interested in the FRCP route - the options that extend even beyond ER is a very attractive feature. I'm pretty sold on the FRCP route and I'm just debating on whether I'll have to do one or two FM electives to show that I can contrast the two streams come interview time.

 

1 FM elective is enough. This will bag you a bunch of FM interviews. Basiclly if you apply to FM you get an interview. More than 2 weeks will take away from the higher yeild FRCP EM time in my opinion.

 

Also, does the number of spots/program matter alot, or a little? What i mean is, is there less demand for schools with less spots so the applicant:spots ratio is the same?

 

During CaRMS you will find that there will be a core group of ~50 applicants who are super competitive. They will interview at pretty much every program. During interviews you see them again and again etc. You want to be part of this group. So every place is competitive. Larger programs may translate into better odds. Ottawa has somthing like 9 spots, Queens has 2 if I recall correctly. I don't have any evidence to back this strategy up but logicaly I would assume bigger programs may provide more chances for acceptance.

 

Currently I'm planning on electives at my home school, and then at: UBC, UT, UWO, and perhaps McGill and Ottawa as well. If I hit McGill, that's 4 provinces. Obviously I'd apply to every program I could but the above listed ones are cities that I'd enjoy for sure.

 

thanks for the insight - very much appreciated.

 

I would visit Ottawa and UofA. UT is a pretty good choice but go for St. Mike's or Sunnybrook, better for FRCP. There are a ton of great programs. You should get multiple opinions from FRCP residents on this. You will see a wide degree of view points. Don't feel like you you need to go as many provinces as possible. Just show that you are open to going out of province by doing 1 or more electives out of province. In other words, if you would really rather go to a program in your home province I would not scarifice this expirence just to visit another program for the sake of it being in another province.

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That's a key reason I'm interested in the FRCP route - the options that extend even beyond ER is a very attractive feature. I'm pretty sold on the FRCP route and I'm just debating on whether I'll have to do one or two FM electives to show that I can contrast the two streams come interview time.

 

 

You don't have to waste time doing an FM elective just to show you can contrast the 2 routes.

 

You did a fam med core rotation right?

 

If you don't want to apply to FM, then I wouldn't waste your time.

 

If you are using it as a back up, then sure doing an FM elective.

 

Doing electives in many provinces shows you are willing to move.

 

But I would still encourage you to do electives in the places you are really interested in going. Programs don't necessarily state they "require" an elective to be considered. But come interview time, when ranking candidates, you can bet that all things being equal, those that did electives and were liked by the staff and residents during the rotation will be ranked higher, than an unknown.

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Hi Satsuma,

 

thanks for the valuable advice.

 

Yes we complete 8 weeks of FM (urban & rural) in year 3. I've been frustrated about why the need to do FM electives when you get 8 weeks already (as opposed to 0 ER weeks until 4th year) but perhaps just one elective will do as roger roger pointed out. I don't think I could sacrifice more than that from precious high value Emerg (and related) electives.

 

(As an aside, we did receive a talk from someone in FM who warned us that they can tell when applicants are just using FM to back up and would not rank these applicants well but I didn't get her point - not like they can turn away everyone who's using FM as a backup).

 

I have no interest in FM - applying to FM would be soley to pursue the +1 but from what I've heard/read, the +1 is also very competitive so I'm not sold that this option is a true "backup" if its that competitive - a misnomer perhaps. Nevermind my preference for the FRCP route. But at the cost of 1 elective, it might not be a bad idea to rank FM programs after all the FRCP ER ones.

 

I think I might have to wait and see how my Emerg electives go this year, as well as other rotations, guage how competitive I think I might be (w as much feedback as possible), and then decide if I need to backup with a FM elective. If I do very well on my core FM rotations, I think that could only solidify my desire to do just one FM elective. I'll just book all my electives in Emerg until that point to at least lock those up.

 

One question: Considering I want to visit at least 5 schools with FRCP programs incl home school, should I be doing ER at all these schools? Obviously I want to make myself known to the program and the people, but I think it looks bad to have not done things such as: Gen surg, ortho trauma, peds ER, anaesthesia. However, if I do these electives, then would I be hurting my ability to be known to the ER folks?

 

thanks again - this is very helpful!

 

 

 

 

You don't have to waste time doing an FM elective just to show you can contrast the 2 routes.

 

You did a fam med core rotation right?

 

If you don't want to apply to FM, then I wouldn't waste your time.

 

If you are using it as a back up, then sure doing an FM elective.

 

Doing electives in many provinces shows you are willing to move.

 

But I would still encourage you to do electives in the places you are really interested in going. Programs don't necessarily state they "require" an elective to be considered. But come interview time, when ranking candidates, you can bet that all things being equal, those that did electives and were liked by the staff and residents during the rotation will be ranked higher, than an unknown.

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That's great to hear about only needing to do 1 FM elective. I did not want to do any more than that but 2 wks is reasonable. Come interview time though, it must be apparent that I am interested in the 2+1 and not solely FM (given a ton of ER electives and 1 FM elective) - are the programs ok with that? Or do you have to try to sell them that you would be ok with just FM medicine if you did not get the +1?

 

your strategy makes sense. ER is so competitive, so it reasons that people apply widely, and that small programs and large ones will face similar applicant demand. thus better chances at larger programs. But if a program "requires" on site interviews, then I'd have to go. I still don't know which ones these are as I have just heard rumors.

 

Yes, I had planned on visiting UA and I think I'll choose Ottawa over McGill (reduces province count to 3 but other than McGill, Quebec wasn't going to work anyway). I actually don't plan on staying at my home school for residency, but I am planning on an elective there nonetheless - I'm a known quantity, likely easier to get research and build connections, and as a worst case I'd take it. Not sure if this is a good move or a waste of time but for now that's what i have planned.

 

thanks for the great help.

 

 

 

 

 

1 FM elective is enough. This will bag you a bunch of FM interviews. Basiclly if you apply to FM you get an interview. More than 2 weeks will take away from the higher yeild FRCP EM time in my opinion.

 

 

 

During CaRMS you will find that there will be a core group of ~50 applicants who are super competitive. They will interview at pretty much every program. During interviews you see them again and again etc. You want to be part of this group. So every place is competitive. Larger programs may translate into better odds. Ottawa has somthing like 9 spots, Queens has 2 if I recall correctly. I don't have any evidence to back this strategy up but logicaly I would assume bigger programs may provide more chances for acceptance.

 

 

 

I would visit Ottawa and UofA. UT is a pretty good choice but go for St. Mike's or Sunnybrook, better for FRCP. There are a ton of great programs. You should get multiple opinions from FRCP residents on this. You will see a wide degree of view points. Don't feel like you you need to go as many provinces as possible. Just show that you are open to going out of province by doing 1 or more electives out of province. In other words, if you would really rather go to a program in your home province I would not scarifice this expirence just to visit another program for the sake of it being in another province.

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Good question. I took it from a few years ago, when it was about 2 to 1 if I recall.

 

I didn't look at this year's numbers. Looks to be about 70% if that's the case. Still not great.

 

Yeah, i think its low 70s this year. But this for people matching into ER period right?

 

I wonder what the odds are for people matching into first choice program and city? I've gotto think a lot lower?

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FM sucks. Carms is a bloodthirsty game, and you need to play to win.

 

Don't waste your time on mickey mouse FM electives. They will net you no networking time, and no other programs in EM will be impressed by the "diversity" in your electives. In fact, no programs in anything, even FM, are impressed by FM electives.

 

 

I have to respectfully disagree but with a caveat...

 

If you do a "real" FM office based elective then I agree, it is generally useless for FRCP EM.

 

If you do a rural CCFP EM elective where you are in the ED most if not all the time then it could help you. It depends how you use your time.

 

The beautify of these sorts of electives is two fold. Firstly, you often will get lots of hands on practical experience in these rural family doc populated EDs. Get good at suturing your lacs, doing your I&Ds, splinting etc. Once you feel solid with these things rock the academic centers for FRCP EM. Second, it lends more to support to your reasoning of why FRCP EM vs CCFP EM as a career choice. During CaRMS You will be asked this question in various ways multiple times. Adding your real life experiences to your reasoning makes your rational much more powerful and personal.

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  • 2 weeks later...

in regards to the CCFP EM ... if you dont match into the +1 fellowship, how is the process for the alternative route where you work for 400 hours over a number of years and then get CCFP EM certified??? btw im a US grad, want to do 3 years of family from the states and then +1 fellowship in emerg OR do the 400 hour route. I just wanted to know which way would be better as a i hear the +1 is competitive and i dont knw if they will take foriegners

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in regards to the CCFP EM ... if you dont match into the +1 fellowship, how is the process for the alternative route where you work for 400 hours over a number of years and then get CCFP EM certified??? btw im a US grad, want to do 3 years of family from the states and then +1 fellowship in emerg OR do the 400 hour route. I just wanted to know which way would be better as a i hear the +1 is competitive and i dont knw if they will take foriegners

 

You don't even really need CCFP-EM to work in an ER, you can find them in smaller community hospitals of most major Canadian cities. That's how you get your 400 hours and then get the certification, which I've heard is pretty easy to get as long as you can pass the exams. Once you have the cert that opens up basically every ER in the country except for the most academic hospitals.

 

I think if you are doing a 3 year US residency then you can find one with a lot of elective time and focus your training on ER, that way you will be prepared.

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