CAN FM vs. USA FM

[herewego]

As a prospective FM resident, I was wondering if anyone had any insight to CAN FM vs. USA FM. Please note, I am married to a US Citizen and can apply for my US Citizenship anytime while in Canada, so I don't have to worry about visas.

 

If I am looking to relocate to the states longterm, is it better to apply for US Residency during CAN medical school, take the appropriate USMLE's, and go through the US Match (I understand there is a lack of IMG spots but I wouldn't qualify as that if I obtain residency, would I?)? Or wait until I am finished my FM residency, apply for a FM fellowship in the states (after obtaining residency), and take any necessary exams? Or finish my FM residency, take the optional 3rd in year in (blank), then relocate to the states and take any necessary exams?

 

The obvious con in the former is not being prepared for the USMLE due to Canadian med school curriculum/learning objectives (somewhat subjective, but from what I have read there is an apparent difference which constitutes in Canadians needing more time to prepare for the USMLE). There is no rush for my family to relocate to the US so it is more or less just a question about which process is "easier".

[Mashmetoo]

As a prospective FM resident, I was wondering if anyone had any insight to CAN FM vs. USA FM. Please note, I am married to a US Citizen and can apply for my US Citizenship anytime while in Canada, so I don't have to worry about visas.

 

If I am looking to relocate to the states longterm, is it better to apply for US Residency during CAN medical school, take the appropriate USMLE's, and go through the US Match (I understand there is a lack of IMG spots but I wouldn't qualify as that if I obtain residency, would I?)? Or wait until I am finished my FM residency, apply for a FM fellowship in the states (after obtaining residency), and take any necessary exams? Or finish my FM residency, take the optional 3rd in year in (blank), then relocate to the states and take any necessary exams?

 

The obvious con in the former is not being prepared for the USMLE due to Canadian med school curriculum/learning objectives (somewhat subjective, but from what I have read there is an apparent difference which constitutes in Canadians needing more time to prepare for the USMLE). There is no rush for my family to relocate to the US so it is more or less just a question about which process is "easier".

 

I'd be more concerned with your earning potential in the US vs Canada.

Family medicine tops out at around 225 - 250k, at most 300k in the US.

 

From what I understand, Canada is much more lucrative for FM.

[Lactic Folly]

The obvious con in the former is not being prepared for the USMLE due to Canadian med school curriculum/learning objectives (somewhat subjective, but from what I have read there is an apparent difference which constitutes in Canadians needing more time to prepare for the USMLE).

If you have some free time in the summer, it shouldn't be a huge deal to fill in the gaps. I took 6 weeks to study for Step 1, aiming for a good score, and it was fine.

[herewego]

I'd be more concerned with your earning potential in the US vs Canada.

Family medicine tops out at around 225 - 250k, at most 300k in the US.

 

From what I understand, Canada is much more lucrative for FM.

 

I thought Canada was average $170,000 before overhead & taxes... According to my knowledge and hearsay, US FM docs make substantially more than CAN FM docs. Anyone confirm this?

[herewego]

If you have some free time in the summer, it shouldn't be a huge deal to fill in the gaps. I took 6 weeks to study for Step 1, aiming for a good score, and it was fine.

 

Study for it between Year 2 and Year 3 after obtaining US residency (not obtaining residency would ruin any chance of obtaining a spot considering IMG spots are being abolished)? Is it worth it to spend 6 weeks studying for an exam instead of just waiting until after Canadian residency? Given that you did the opposite, what was the justification for your route?

[thebouque]

Step 1 requires to study for 4-6 wks during med school, usually between 3rd and 4th year. You dont need to study for the other steps since they are similar and even slightly easier than their canadian counterparts (step 3 doesnt exist in canada but people usually dont take time off to study for it).

 

Also are u a canadian grad/future grad? If so u wouldnt be considered img in the us

[Lactic Folly]

Study for it between Year 2 and Year 3 after obtaining US residency (not obtaining residency would ruin any chance of obtaining a spot considering IMG spots are being abolished)? Is it worth it to spend 6 weeks studying for an exam instead of just waiting until after Canadian residency? Given that you did the opposite, what was the justification for your route?

 

I wrote at the end of second year (pre-clerkship), on the same timeline as the Americans. This was the easiest time to write, since we had the summer off, and most of the material was fresh in my mind after the comprehensive exam covering the first two years of medical school. You don't apply to residency until fourth year of medical school, so not sure what your question means (are you referring to permanent residency?).

 

You could wait until later, but I think it would be even harder, since you may not have that amount of time off to study during residency/fellowship. Plus, you may need more time to relearn the material as all of that biochem/micro/physiology will no longer be fresh several years out. People have written the USMLE during residency, but I don't see the advantage to waiting until then if you are sure you are going to do it eventually in any case.

 

I can't really comment on moving to the US as I am not in that situation, but it's generally easier to obtain your training where you want to practice, as your training will always meet the requirements of that location, even if policies change over time. Having your training assessed for portability can also work, but you'd have to talk to someone who knows about FM certification... or ask the licensing board in the state where you want to work.

[leviathan]

There are no "IMG spots" in the US. All residency positions are available to people graduating from medical school anywhere in the world, as long as it's listed on the WHO/FAIMER. If you have US citizenship and graduate from an LCME accredited medical school, you should have little problems securing a family med residency in 4 years. You might have trouble scoring high on the USMLE but if all you want is FM, it shouldn't be a problem. The best time to do Step 1 is before clerkship, as that's when you finish all of the basic science curriculum that the step 1 covers. You might want to do a review course before writing it.

 

If you're looking to move to the states you'd probably be better off training in the states. It just makes things easier when it comes to writing the ABFM exam, getting board certified and so on. It sounds like you already understand that if you train in Canada, you'd have to apply for a 3rd year of residency training somewhere, which would probably be a hassle. You'd also have to write the ABFM, which although I'm sure the training is similar in the US and Canada, it might still be different enough that it would be a pain trying to learn things the 'American' way.

 

To answer your Q about income, it's difficult to find a definitive answer especially with the big changes that are about to happen in the US with ACA. Anecdotally though, family physicians are much better compensated in Canada based on everyone I've talked to.

[herewego]

Thank you for everyone's responses! I am interested in Sports Medicine so even if FMs make less in the US I would be prudent to head south considering Sports Med in Canada isn't as established as its counterpart in the US. I know lowbudget is an expert on this and I have read his plethora of responses.

[Mashmetoo]

I thought Canada was average $170,000 before overhead & taxes... According to my knowledge and hearsay, US FM docs make substantially more than CAN FM docs. Anyone confirm this?

 

I read that the average Canadian FM with their personal clinic has an income of around 350k a year.

 

In the US, The highest number I've heard so far is 300k a year, this was one person with incredible connection and was well liked by his program director. Most people tend to range between 170 - 225, at most 250k.

[herewego]

If you have some free time in the summer, it shouldn't be a huge deal to fill in the gaps. I took 6 weeks to study for Step 1, aiming for a good score, and it was fine.

 

Lactic Folly, did you just apply to US Residency Programs and not participate in CaRMS since a match in CaRMS withdraws you from the US match?

[Lactic Folly]

No, as I said, I'm not going to the US. I never applied to US residencies. I just wanted to respond to your comment that Canadian medical students weren't prepared for the USMLE.

[Satsuma]

I read that the average Canadian FM with their personal clinic has an income of around 350k a year.

 

In the US, The highest number I've heard so far is 300k a year, this was one person with incredible connection and was well liked by his program director. Most people tend to range between 170 - 225, at most 250k.

 

Don't forget to factor in cost of living when comparing US to Canadian incomes. The cost of living is less in the US, minimum wage is less etc. More taxes in Canada etc.