Working in the US

[AsYouWish]

I've heard lots of conflicting information about this, so I would like input from those who know more about the system.

 

I would love to work in the states (specifically in Texas), but do I need to do my fellowship there or can I do that in Canada and then move?

If I do need to do a fellowship there, do I need to score high on the USMLEs or can I just pass them?

If I can do my fellowship in Canada, do I need high USMLE scores or just a pass?

How easy is it to get a fellowship in the US after residency in Canada?

[burrb]

I'll do my best to answer some of your questions. Personally I'm very likely going to do a fellowship after internal medicine in the States so I've looked into this a bit.

 

Not all fellowships even require USMLE scores, but they are required for licensing purposes so it is in your best interest to write them (and for step 1 and step 2, the earlier the easier imo). As far as the scores are concerned, passing is sufficient. Very high scores may be minorly helpful.

 

As for how easy it is to get a fellowship in the US, I think it largely depends on what you're aiming for. For example within medicine, a cardiology fellowship is extremely competitive even for Americans, so you'd have to stand out quite a bit as a Canadian. Rheumatology on the other hand is much less competitive and chances are you can land a pretty good fellowship with less effort.

 

Have you tried perusing SDN? The forum is huge and a great resource, though not super active..

[ACHQ]

Not all fellowships even require USMLE scores, but they are required for licensing purposes so it is in your best interest to write them (and for step 1 and step 2, the earlier the easier imo). As far as the scores are concerned, passing is sufficient. Very high scores may be minorly helpful.

 

Not all States require USMLE scores for licensing either, but I heard that there can be visa issues if you don't have your USMLE's done

[coastalslacker]

I'm doing fellowship in the US now and will be staying here to work.

 

Three orthopods from my program have moved to Texas in the last several years. One did a fellowship in Canada, fellowship in the US and then got a job in Texas. One did two US fellowships (not in Texas) and now has an academic job in a big city in Texas. One did a fellowship in a big city in Texas and was offered a number of jobs in the area during that year, one of which he happily took. You don't need to do fellowship in Texas, but the conventional wisdom on fellowships is either do it at a very prestigious program or close to the geographic area you want to be in.

 

Whether you need to score well on the USMLEs is controversial. Some, but not all, fellowship programs consider this in their application process. My strategy was to just pass as I was writing them as a resident. Future employers will not look at USMLE scores, the only benefit would be for US fellowship applications (and again, many of them don't care). The USMLE makes visa issues much more straightforward in the future, I highly recommend getting the tests done. They aren't hard.

 

It has been very common for Canadians to do fellowships in the US. How difficult it is depends, I suppose, on the speciality. In orthopedics I wouldn't be surprised if almost half of the Canadian grads from any one year were heading to the States for fellowship.