Urology Residency for an IMG

[sohaloh]

Hey guys,

First post here, it took me awhile to find a canadian-centric forum but I guess I'm at the right place. Pleased to meet you all. I have a couple of questions to ask, and I hope you guys can help me out by pointing me in the right direction.

 

I'm an IMG from Pakistan, I graduated medschool in 2010. I have quite alot of family living in canada for the past 15 years so naturally I was inclined to move to Canada for further training. I busted my ass for 4 years and was accepted by the Canadian immigration authorities, so I'm moving to canada at the end of february. Since med school, I did my required house job in surgery and medicine and then worked in Urology for a year. I love Urology and hope to land a residency in Urology in canada. Now I undrstand that Urology is an extremely competitive field specially for IMG's, but I just want to kinda lay out what I'm thinking and then you guys can give me opinions on what you think.

 

I gave the MCCEE in 2010 and passed. I couldn't give the MCCQE cuz my immigration was in the process and I couldnt travel without a visa. I'm now scheduled for the 2013 MCCQE1 in April and the NAC OSCE in march. I also did an elective in Urology at Kings College London, UK. I did a research elective in neurology at University of Alberta. According to the Carms website only two universities advertise 2 IMG positions for Urology thats U of T, and University of Ottawa. Besides that there are a couple of spaces in quebec which are parallel for both canadians and IMG's. Also the statistics show that 74 IMG's applied for these 2 positions and 16 of them ranked urology at number 1. I'm just trying to figure out my odds. I thought that atleast half of these people will be older physicians who are immigrating with there families and would have graduated 5-10+ years ago. Probably a couple of returning Canadian IMG's. I feel like I'm in a unique position of being relatively younger at the age of 27 and its only been a couple of years since graduation. I hope to score stellar in both the MCCQE1 and NAC OSCE. With those I can also apply to the quebec positions by getting the certificate of equivalence. Along with all this im trying to get a shadowing opportunity somewhere with the same programs till the match so the faculty can get to know me and maybe I can squeeze out an LOR or two. Then hopefully they remember me when the time comes for the interview.

 

Anyways thats my plan. I absolutely love urology and have been into it since years. Also in the year I worked here in urology i've gained alot of experience and this is what I want to do. Am I missing something? Does this seem like a good plan? What do you guys think? Its going to be super stressful with the move and all just wondering if I'm appropriately measuring the amount of competitiveness for IMG's and whether I have a reasonable chance of ever getting in to Urology. Any feedback would be appretiated. Thanks in advance.

 

Cheers.

[brooksbane]

It would probably be easier for you to, while in Canada: go back to undergrad, get a BSc in 3 years, write the MCAT, apply to Canadian medical schools, get in and work the right angles to match into uro, than it would for you to get urology with your non-domestic residency training and MBBS.

 

Uro is hard enough for CMGs to get into. You're gonna have long odds as an IMG.

[sohaloh]

It would probably be easier for you to, while in Canada: go back to undergrad, get a BSc in 3 years, write the MCAT, apply to Canadian medical schools, get in and work the right angles to match into uro, than it would for you to get urology with your non-domestic residency training and MBBS.

 

Uro is hard enough for CMGs to get into. You're gonna have long odds as an IMG.

 

Thanks for the quick reply. That's sad to hear, I know its going to be tough but right now since I'm all prepared for the move I can't really change what I have planned. Maybe you could point out a couple of things which would make my chances better. Also, I was slightly optimistic because one of my aunts who lives in canada matched and completed residency in OBGYN. OBGYN is also as competitive if the statistics are anything to go by. I know two other similar cases. That gave me hope, Oh well all I can do is find out first hand. Thanks for the reply though!

[PilotMD]

sohaloh,

 

It is, as you know, a very competitive process for foreign trained physicians to match to any residency in Canada (this includes Canadians studying abroad), let alone matching to urology. However, you will never know until you apply - there are two spots set aside for IMG's as you have stated (+/- some other spots in Quebec), so two IMG's will match to urology each year. You could be one of those two - you definitely won't be if you don't apply. The odds are against you, but they aren't 0.

 

Cheers

 

PMD

[Larrivee]

Hey all,

I am not wanting to derail this thread but PilotMD's response got me curious... are these IMG urology positions reserved for IMGs, or do the IMGs compete against CMGs for these spots. I'm curious why spots would be set aside, in a specialty where there are more CMG applicants than spots, for IMGs who Canada has not invested in. It would make more sense if there were a maximum of 2 IMGs for Urology and that if they were more competitive applicants than CMGs competing for the same spot THEN they would be awarded. Just curious. If anyone knows please respond, and then let's bring the focus back to the OP.

[NLengr]

Hey all,

I am not wanting to derail this thread but PilotMD's response got me curious... are these IMG urology positions reserved for IMGs, or do the IMGs compete against CMGs for these spots. I'm curious why spots would be set aside, in a specialty where there are more CMG applicants than spots, for IMGs who Canada has not invested in. It would make more sense if there were a maximum of 2 IMGs for Urology and that if they were more competitive applicants than CMGs competing for the same spot THEN they would be awarded. Just curious. If anyone knows please respond, and then let's bring the focus back to the OP.

 

Because for Ontario the schools are under tremendous pressure to open IMG spots by the provincial government. This is 100% driven by political points. The government wants to say to the public that they are solving the "doctor shortage" by letting more IMGs practice/train (never mind that none of that helps any of the problems in Canada right now). So the schools tell programs to create IMG spots. Schools create them wherever. Some put them all in less desirable specialties, some spread the pain over all specialties.

 

Then the schools force the programs to take extra IMGs even if it means:

1. Training quality declines due to too many residents.

2. A CMG goes unmatched/under matched (meaning the government just wasted $200k on training that med student).

 

It's the same for many specialties. It's really awesome when the government and schools create new IMG spots in specialties where there aren't even enough jobs for Canadians finishing residency (ex. Plastics, Ortho, Uro, Nephro etc.).

 

So the short answer to your question is that the government is too stupid to think beyond each re-election cycle and cares more for optics than solving the system problems. Governments,medical groups, schools and physicians don't know of or don't care about solving the massive physician employment crisis that is ongoing/looming in this country by doing a BARE MINIMUM of human resources planning. It's incredibly depressing when you think about it.

 

To the OP: I second repeating med school and rematching as a CMG. Without some kind of connections/exposure to those spots, you are highly unlikely to match. A better idea would be trying the USA or training as a urologist in your home country, then coming over. Better yet: Go to dental or business school.

[PilotMD]

Hey all,

I am not wanting to derail this thread but PilotMD's response got me curious... are these IMG urology positions reserved for IMGs, or do the IMGs compete against CMGs for these spots. I'm curious why spots would be set aside, in a specialty where there are more CMG applicants than spots, for IMGs who Canada has not invested in. It would make more sense if there were a maximum of 2 IMGs for Urology and that if they were more competitive applicants than CMGs competing for the same spot THEN they would be awarded. Just curious. If anyone knows please respond, and then let's bring the focus back to the OP.

 

From the CARMS website

 

Application Process

 

First Iteration: There will be two parallel streams - Canadian Medical Graduate (CMG) and International Medical Graduate (IMG), with designated positions for each stream. There will be no crossovers or transfers between the two streams.

 

Cheers

 

PMD

[leviathan]

It's the same for many specialties. It's really awesome when the government and schools create new IMG spots in specialties where there aren't even enough jobs for Canadians finishing residency (ex. Plastics, Ortho, Uro, Nephro etc.).

I assume there are jobs available in rural/remote areas, where IMGs are required to work after finishing residency.

[sohaloh]

sohaloh,

 

It is, as you know, a very competitive process for foreign trained physicians to match to any residency in Canada (this includes Canadians studying abroad), let alone matching to urology. However, you will never know until you apply - there are two spots set aside for IMG's as you have stated (+/- some other spots in Quebec), so two IMG's will match to urology each year. You could be one of those two - you definitely won't be if you don't apply. The odds are against you, but they aren't 0.

 

Cheers

 

PMD

 

Thankyou for your encouraging words PilotMD. Both you and the previous poster have encouraged me in two different ways by showing me that its extremely difficult and will require hard work but its not impossible. I'll keep updating this thread and share my progress with you guys. Lets see how it goes and lets hope for the best. Cheers.

 

Hey all,

I am not wanting to derail this thread but PilotMD's response got me curious... are these IMG urology positions reserved for IMGs, or do the IMGs compete against CMGs for these spots. I'm curious why spots would be set aside, in a specialty where there are more CMG applicants than spots, for IMGs who Canada has not invested in. It would make more sense if there were a maximum of 2 IMGs for Urology and that if they were more competitive applicants than CMGs competing for the same spot THEN they would be awarded. Just curious. If anyone knows please respond, and then let's bring the focus back to the OP.

 

I think I can answer this question for you.

 

1) Once you go through the Canadian Immigration process you realise that Canada is a country that truly values diversity, multi-culturalism, tolerance and equality for all. That being said Canada is a country that actively recruits foreign nationals from all walks of life. If you look at the statistics Canada is very sparsely populated at 33.9 mil people, compare that to just a city in the US like new york which is 9 mil people in just one city. Anyways I think they create a couple of spots here and there to encourage immigration of highly skilled workers and to promote diversity in the workforce.

 

2) IMG physicians who do get matched are usually required to sign a return of service agreement. This usually lasts 5 years. For investing money into the training of an IMG the canadian government produces a specialist who can work in more underserved areas of the community compared to a canadian graduate who would not be more accomodating to moving around.

 

3) Its at the programs descretion whether or not they choose an IMG to match. If that year the IMG candidates do not meet the required standards they dont have to rank them which leaves that position open in the second iteration for all candidates that may have remained unmatched.

 

4) The last point I guess is that the immigration process is grueling and it takes alot of time and money but once you are accepted you have made a commitment to the canadian people and the canadian government to serve and become part of the society. I understand how people may feel that IMG's hijack opportunities from born Canadian nationals but I don't feel that is necessarily true. Most IMG's are hard working and contribute to Canadian society fully and the processes they have to go through truly filter the ones that are worthy of working in these positions in the first place.

 

Hope that answers your questions. And heres to being Canadian!

[NLengr]

I assume there are jobs available in rural/remote areas, where IMGs are required to work after finishing residency.

 

For many specialties there are less jobs per year opening up than grads. And those rural jobs you ask about are quickly filling up as everyone realizes your choices are:

Work in underserved location (and there is no guarantee of this. Multiple people need jobs)

Do a second or third fellowship while waiting for someone to retire/die

Work as a clinical associate (aka wage slave) for a group of baby boomer docs who take the money for your hard work

Repeat entire residency and enter geriatrics or other understaffed field

Declare bankruptcy. Restart career in non medicine field.

 

See the Ortho article in McCleans last year for a good example of way too many grads for very few jobs.

 

Again, you are assuming the government, medical lobby group and schools are actually engaged in meaningful human resources planning. They are not.

[brooksbane]

For many specialties there are less jobs per year opening up than grads. And those rural jobs you ask about are quickly filling up as everyone realizes your choices are:

Work in underserved location (and there is no guarantee of this. Multiple people need jobs)

Do a second or third fellowship while waiting for someone to retire/die

Work as a clinical associate (aka wage slave) for a group of baby boomer docs who take the money for your hard work

Repeat entire residency and enter geriatrics or other understaffed field

Declare bankruptcy. Restart career in non medicine field.

 

See the Ortho article in McCleans last year for a good example of way too many grads for very few jobs.

 

Again, you are assuming the government, medical lobby group and schools are actually engaged in meaningful human resources planning. They are not.

 

I thought student loans were not dischargeable through bankruptcy, leaving this option off of the table.

[NLengr]

I thought student loans were not dischargeable through bankruptcy, leaving this option off of the table.

 

Government loans aren't. I "think" the private bank lines of credit are. That's the majority of most people's debt for most people I know.

 

It's still a terrible option. But then again, all the listed options aren't very good.

[Knightmd]

Let me put it that way: I know a med student from one of Canada's top 3 medical schools, and home to one of its best Urology programs- who wasn't able to match in Urology. Granted he seems to have been an immigrant, with a heavy accent, and not with the sharpest social skills and possibly not an ideal application, but it's quite telling. Urology is ridiculously competitive. Your best shot is to not waste time and do medical school again, knowing that by the time you're done, your chances of getting into Urology won't be high. To make your chances higher, sit for the USMLEs during your medical school, and score high... Getting into Urology in the USA as a Canadian grad is easier than matching in CaRMS. After you're done with your residency, even if it's in Bum**** Nowhere, USA, you'll be able to practice as a Urologist in Canada... however, and here's the kicker, there won't be Uro jobs left in the country and you'll have to practice in the US, which is why almost all programs unanimously asked their applicants to do the USMLEs during their residency at Urology Fair this year, to have an easier time finding a job later.

[thebouque]

Let me put it that way: I know a med student from one of Canada's top 3 medical schools, and home to one of its best Urology programs- who wasn't able to match in Urology. Granted he seems to have been an immigrant, with a heavy accent, and not with the sharpest social skills and possibly not an ideal application, but it's quite telling. Urology is ridiculously competitive. Your best shot is to not waste time and do medical school again, knowing that by the time you're done, your chances of getting into Urology won't be high. To make your chances higher, sit for the USMLEs during your medical school, and score high... Getting into Urology in the USA as a Canadian grad is easier than matching in CaRMS. After you're done with your residency, even if it's in Bum**** Nowhere, USA, you'll be able to practice as a Urologist in Canada... however, and here's the kicker, there won't be Uro jobs left in the country and you'll have to practice in the US, which is why almost all programs unanimously asked their applicants to do the USMLEs during their residency at Urology Fair this year, to have an easier time finding a job later.

 

1) Even if a ranking of medical schools in Canada existed (top 3 or wtv), it has no influence for Carms. CF the numerous threads about matching etc.

 

2) If the ''immigrant with a heavy accent'' managed to get into this top tier med school, then his background shouldn't stop him from landing a residency position.

 

3) How do you know that there will be no uro jobs left in Canada? That's simply a false statement. Even though the market might be tighter in some academic centers, it's far from dismal.

 

4) Quite a few urology programs tell their students to take the USMLEs. However, it's a piece of advice given by a lot of residency programs and it's not because of the job market in Canada, it's mostly for fellowships.

 

5) You're right that getting into urology as an img in Canada is extremely hard but why do you have to back up this true statement with a pile of ****?

[thesummoned]

Urology is considered one of the top competitive surgical specialties in Canada and the US. As IMGs, we have it a lot worst, but still even CMGs who aim to enroll in this specialty, they face a difficult time, however have a higher success rate in comparison. If you're aiming to secure one the two spots (Ottawa and Toronto) you need to invest heavily in research (particularly for UofT) not to mention, need to build connections with the faculty members. This rule generally applies to multiple programs, but for a competitive specialty such as Urology, and in Canada, you really do need to know the right persons who will increase your chances of securing a seat. There are a few things that will help such as:

 

- Doing 1-2 elective that is centre-specific, i.e don't do urology elective in Saskatchewan if they're not even offering spots. Although this helps a little, you should aim to do it in the right place.

 

- Research Research Research (UofT is research-oriented, and one abstract isn't good enough). You have to demonstrate your devotion as a researcher as well as a clinician.

 

- UofT states that for LORs they would like to have them selected from "specific" clinicians. This means you need to get the Right letters from the Right individuals

 

- Prepare a great MSPR. This is something where you actually have the power to make yourself an appealing applicant

 

- Even if you have all of the above, you're 50% in. The rest is the interview.

 

Goodluck,

[thesummoned]

Let me put it that way: I know a med student from one of Canada's top 3 medical schools, and home to one of its best Urology programs- who wasn't able to match in Urology. Granted he seems to have been an immigrant, with a heavy accent, and not with the sharpest social skills and possibly not an ideal application, but it's quite telling. Urology is ridiculously competitive. Your best shot is to not waste time and do medical school again, knowing that by the time you're done, your chances of getting into Urology won't be high. To make your chances higher, sit for the USMLEs during your medical school, and score high... Getting into Urology in the USA as a Canadian grad is easier than matching in CaRMS. After you're done with your residency, even if it's in Bum**** Nowhere, USA, you'll be able to practice as a Urologist in Canada... however, and here's the kicker, there won't be Uro jobs left in the country and you'll have to practice in the US, which is why almost all programs unanimously asked their applicants to do the USMLEs during their residency at Urology Fair this year, to have an easier time finding a job later.

 

I think the purpose of the USMLEs is to secure a fellowship position, as they are limited in Canada. And if that's the case, you really don't need high USMLE score, just enough to pass and practice as it's required by some centres in order to practice (along with the J1 visa)

Urology isn't as bad a Radiation oncology, where recent graduates are going to the US for jobs.

[leviathan]

If you're applying for fellowships in the US, I imagine they're going to want people with high USMLE scores.

[NLengr]

If you're applying for fellowships in the US, I imagine they're going to want people with high USMLE scores.

 

Non medicine fellowships are much more about connections.