Your thoughts? A CSA opinion.

[advair250]

Not sure I follow you on that one. It's about having the choice to select the best physicians. Someone who doesn't go to medical school at all because of financial constraints is not a doctor. Also you don't have to be from means to go to medical school abroad, there are many affordable medical schools. I'm certainly not a person from 'means', although most CMGs I meet are generally from upper class families and spent their summers doing volunteer trips to Kenya and dropping thousands of dollars on Kaplan prep courses, etc.

 

 

So when the northern residency stream is ranking residents, why would they choose the IMG from Ireland who grew up in Toronto over the local guy from Thunder Bay who went to med school locally? It's a non-issue.

 

 

-Sorry, I was referring to the choice of going abroad for medical school.

 

Affordable foreign medical schools don't necessarily correlate to the good quality ones that consistently match in NA for residency. Even the cheapest ones that have half-decent match stats in the Carrib, are 150K+ total cost for tuition alone. Add on living expenses, numerous flights, double renting for away clinicals, examinations, and etc.

 

So i'm not sure where poor kids are going to be able to afford even the cheapest reputable foreign medical schools. Sure you can go to Poland where tuition fees are lower, or some of the super low end carrib schools - but good luck with the match optics from those.

 

"I'm certainly not a person from 'means', although most CMGs I meet are generally from upper class families and spent their summers doing volunteer trips to Kenya and dropping thousands of dollars on Kaplan prep courses, etc."

 

Please, while I agree that those exist, that is not a supporting argument against students of means being the majority of CSA's. A poor student has ani infinitely higher chance of being able to afford a Canadian Medical school than a Foreign medical school, no contest. Canadian tuition being relatively dirt cheap comparatively, and garaunteed LOCs, with most cases not even needing a cosigner for CMGs.

[ralk]

Not sure I follow you on that one. It's about having the choice to select the best physicians. Someone who doesn't go to medical school at all because of financial constraints is not a doctor. Also you don't have to be from means to go to medical school abroad, there are many affordable medical schools. I'm certainly not a person from 'means', although most CMGs I meet are generally from upper class families and spent their summers doing volunteer trips to Kenya and dropping thousands of dollars on Kaplan prep courses, etc.

 

 

So when the northern residency stream is ranking residents, why would they choose the IMG from Ireland who grew up in Toronto over the local guy from Thunder Bay who went to med school locally? It's a non-issue.

 

CMGs are disproportionately from wealthy families, but CSAs are even more disproportionately from wealthy families. I don't know your situation, but you're living oversees for multiple years and paying tens of thousands of dollars a year in tuition - you must have resources not available to the average Canadian student. Those things don't pay for themselves.

 

As for putting regional preferences on residency, it's a possibility, but its not likely to be all that effective. As I said, CSAs are far more likely to be from overserviced areas. We do still want quality residents, so there may not be many people who fit that requirement, especially given the preferences already in place for them at Canadian Med Schools. When there's already preferences in place at one stage, introducing them at another is difficult without degrading quality.

[leviathan]

CMGs are disproportionately from wealthy families, but CSAs are even more disproportionately from wealthy families. I don't know your situation, but you're living oversees for multiple years and paying tens of thousands of dollars a year in tuition - you must have resources not available to the average Canadian student. Those things don't pay for themselves.

The resources = student loans from the bank and government. My tuition was about $25,000 per year. Also I don't know where this evidence exists that CSAs are more disproportionately from wealthy families? You mean the voluntary CaRMS survey that was held in 2009, which was completely unscientific?

 

As for putting regional preferences on residency, it's a possibility, but its not likely to be all that effective. As I said, CSAs are far more likely to be from overserviced areas. We do still want quality residents, so there may not be many people who fit that requirement, especially given the preferences already in place for them at Canadian Med Schools. When there's already preferences in place at one stage, introducing them at another is difficult without degrading quality.

I don't know what evidence you're using to prove that CSAs are "far more likely to be from overserviced areas". CSAs and CMGs alike are logically going to be more likely from overserviced areas, since that's where most of the population lives.

 

I'm not sure what you were trying to say at the end there; are you implying the only qualified residents are the ones who get into Canadian schools? Are you implying the admissions system is not completely flawed, or that there are not 3 times as many equally qualified applicants as there are seats?

[advair250]

The resources = student loans from the bank and government. My tuition was about $25,000 per year. Also I don't know where this evidence exists that CSAs are more disproportionately from wealthy families? You mean the voluntary CaRMS survey that was held in 2009, which was completely unscientific?

 

 

So 25,000 per year, + living expenses, flights etc. A conservative 45,000$/ year?

 

OSAP gives you only the federal portion for funding, max of $210/wk.

 

All banks will require a cosigner for bank loans for international schools, and like I said, not everyone's parents can cosign(the case is with poorer families, or even middle class families in urban environments).

 

 

If you don't think $180,000 (more likely $250K for the average schools, and even higher than $300k for some), is a lot of money and would be out of reach for many Canadian families...then I'm not sure what I can say.

[A-Stark]

When asked for any conflict of interest to declare, the author, in her response, wrote the following:

 

"As stated in the article, I am the president of the Society for Canadians Studying abroad. I got involved in SOCASMA because I have a child who is a CSA. I cannot help my child. I work for SOCASMA because I believe that a free and democratic society allows its citizens to choose their educational path. I believe that diversity in education builds a strong and rich society. I believe that advancement should be determined by open competition to all Canadians on their merits. I have worked as a personal injury lawyer and have a disabled child. As such have had many very positive experiences and some very negative experiences with the Canadian medical system. I hold 2 degrees from UBC and believe that UBC is a good university. I believe that UBC and all other Canadian graduates have good cause to be proud of their education, but that does not give them the right to avoid competition from other Canadians who chose a different path. If there are any issues in respect to the facts in the article, I would be pleased to forward verification.

Rosemary Pawliuk"

 

Hope that clears things up.

 

I really don't think she understands that folding the IMG spots into the overall match is unlikely to be favourable to IMGs.

[advair250]

I really don't think she understands that folding the IMG spots into the overall match is unlikely to be favourable to IMGs.

 

It could potentially? The IMGS who do make it back are generally the strongest of the Canadians who go abroad, (big generalization since luck etc).

 

It could make that difference between the super strong IMG and the rare CMG who just scrapes by on the mentality of P=MD=residency.

 

But the more likely scenario is it wouldn't help much, if at all, and probably make it harder.

[ellorie]

"choose their own educational path" - I genuinely am curious to know how many CSAs chose to go to school abroad because they really wanted to versus not being able to get in here or thinking that they couldn't get in here.

[jfdes]

"choose their own educational path" - I genuinely am curious to know how many CSAs chose to go to school abroad because they really wanted to versus not being able to get in here or thinking that they couldn't get in here.

 

From the way the article is written, presumably all of them

[ellorie]

From the way the article is written, presumably all of them

 

That was kind of the impression I got when I read it

[daftjustice]

I concur. That's why when they campaigned for less barriers for CSAs to return, it 's questionable whether they are doing it for the good of society (that Canada deserves the best doctors) or for their own self-interests.

 

hamham,

 

I may be mistaken in following out your logic so my apologies if I misinterpret what you said.

 

Let's accept the premise that Canada deserves the best doctors. Wouldn't it be logical that all Canadians with medical degrees are able to compete on fair ground for postgraduate training? To me, it seems like erecting barriers for these CSAs runs counter to our initial premise if we also accept the reasonable idea that at least some CSAs would make excellent doctors. Why should those CSAs be so heavily restricted in the specialties they can apply for? What if a CSA might make a better ENT than a CMG? (....Did any of you reading that last sentence just snort in laughter aha? )

 

Now, I have checked out SOCASMA and am not fully in favour of how they present some of their information. That being said, however, the fundamental point the author of the article is making is that CSAs should be able to fairly compete for residencies --- it's not like she's demanding her child gets a dermatology residency without having earned it.

 

CMGs that deserve their residencies will get them and I doubt that the majority of CMGs will be usurped by CSAs. It's interesting to see how disparaging some posters (not necessarily in this thread) are towards CSAs and their educations. Why be scared of CSAs taking a CMG's residency away if it's thought that most CSAs aren't that great anyways?

 

Sure, CSAs may have extra resources (probably from family) allowing them to attend a school abroad, but I wouldn't reserve a special level of disdain for those using that advantage to take the next step towards a medical education...I similarly wouldn't begrudge rural applicants using their geographical advantage, an advantage bestowed to many of them by dint of where they were born. Really, both advantages are strokes of luck that in many cases people are simply born into.

 

 

The real issue boils down to the circumvention by CSAs of admissions policies put in place to control medical education in Canada, at the undergraduate level and beyond. Some of the policies are designed to address physician distribution problems in Canada, a laudable goal. Many of the policies are excellent, others are flawed. (Maybe I'm thinking too cynically, but I feel that the good of society isn't what certain canadian medical students really care about, compared to the risk of having their current excellent chances of getting SOME residency SOMEwhere reduced by open competition from CSAs....but I digress, everyone acts and argues out of self-interest, whether you're a CMG, CSA or, generally speaking, a human being.)

 

Many of my friends are now CMGs, several are CSAs, and many others have moved away from the idea of medicine. Admittedly, several of the CSAs I know are abroad because they would never be able to get in in Canada, purely from a meritocratic standpoint. Some of my other, more capable CSA friends are disillusioned by the admissions process here and would rather try their luck abroad than lose an additional 2-4 years trying to be admitted to a canadian school. Many of my friends in this last situation tend to be white, from a higher SES and from urban centres. Certainly not attributes that favourably align them with some of the admissions policies. But guess what? Several of them has GPAs 3.7+ and MCAT 33+..Sure those stats aren't the best of the best but we should really ask ourselves if that means that someone with numbers like that is intellectually incapable of learning medicine.

 

As someone who is waiting to hear back from two interviews in Canada and is sitting on and Irish med school offer, this thread has been of considerable interest.

[advair250]

Let's accept the premise that Canada deserves the best doctors. Wouldn't it be logical that all Canadians with medical degrees are able to compete on fair ground for postgraduate training? To me, it seems like erecting barriers for these CSAs runs counter to our initial premise if we also accept the reasonable idea that at least some CSAs would make excellent doctors.

 

No, because CMGs are heavily funded by the government for their educational seats.

 

Full stop.

 

If you want to make it a free for all, where everyone is equal, then you have to stop subsidizing the seats for CMGs.

 

There is a lot more to the situation, then the "fair grounds" and "choosing the best doctors" and using illogical fallacies to try and counter-argument them doesn't help the situation.

[daftjustice]

No, because CMGs are heavily funded by the government for their educational seats.

 

Full stop.

 

If you want to make it a free for all, where everyone is equal, then you have to stop subsidizing the seats for CMGs.

 

There is a lot more to the situation, then the "fair grounds" and "choosing the best doctors" and using illogical fallacies to try and counter-argument them doesn't help the situation.

 

advair250,

 

Firstly, I was responding to another poster's comment, and exploring their logic. I honestly am undecided as to where I sit on this issue, I just like to explore all sides of an issue. Please don't quote me out of context, it's twisting the first bit of my post a little bit. I am simply expanding on hamham's comment.

 

You do bring up a point I wish to understand further however. Can you explain why making residency spots fair game would necessitate halting subsidization of CMG medical education?

 

Also, most importantly, please direct me to my (il)logical fallacies...at the very least, I will not learn to improve my critical thinking unless someone more adept at picking them out won't show me where they are.

 

Much appreciated:)

[advair250]

advair250.

 

Firstly, I was responding to another poster's comment, and exploring their logic. I honestly am undecided as to where I sit on this issue, I just like to explore all sides of an issue. Please don't quote me out of context, it's twisting the first bit of my post a little bit. I am simply expanding on hamham's comment.

 

You do bring up a point I wish to understand further however. Can you explain why making residency spots fair game would necessitate halting subsidization of CMG medical education?

 

Also, most importantly, please direct me to my (il)logical fallacies...at the very least, I will not learn to improve my critical thinking unless someone more adept at picking them out won't show me where they are.

 

Much appreciated:)

 

Sorry, I didn't mean to imply you specifically were being illogical - i meant that many of the arguments in favour of this "free for all" type CMGs/CSAs are illgoical.

 

Because the process of getting a residency seat is not fully objective. If for some reason or another, a CMG who had a funded seat is not accepted to a residency spot(by means of only applying to a specific hard specialtiy, not applying broadly enough, or being a weak candidate), then that would be a LARGE amount of wasted funding of tax dollars.

 

"To me, it seems like erecting barriers for these CSAs runs counter to our initial premise if we also accept the reasonable idea that at least some CSAs would make excellent doctors."

 

This specifically is somewhat of an illogical notion, because that only takes into account that we are focusing on the metric of the "best doctor". When really, the finances and economics of our medical education system is also very important, given that funding is finite. Any funding or monetary investment into our system that becomes inneffective or innefficient ultimately leads to loss from the system as a whole, and directly impacts patient health care outcomes through diminished funding and trickle down effects.

 

Additionally, it seems that, they use the metric of "best doctor" as a deciding factor of who gets into medical school. It obviously is completely flawed due to supply and demand alone, but once they enter the subsidized system, there is every intent to make sure that they get into residency and become competent physician who can then go on to carry out their training in practice. If we move up the "best doctor" deciding factor to residency, then it would be illogical to make CMG training subsidized since you run the risk of losing out on your "investments" that don't make it to residency. It is pure conjecture if this would increase that much, or if at all, if it was free for all for residency - the system would adapt, and the weaker CMGs would over time have to adapt and lose the mantra of "p=md".

 

 

Additionally, if it was just a free-for-all, why would we then spend a large amount of funding to train physicians, when we can get just as many excellent physicians who train abroad on their own dime? This is a bit of an extreme statement, but somewhat realistic since there are far more qualified applicants than seats for medical students. Of course this would never happen, since then the medical infrastructure present also relates to hospital systems, research, community health networks and a myriad of other health-related facets.

 

That was all just ramble to show how complicated it is, that a simple proposition of why "xyz" is hardly useful.

[daftjustice]

Sorry, I didn't mean to imply you specifically were being illogical - i meant that many of the arguments in favour of this "free for all" type CMGs/CSAs are illgoical.

 

Because the process of getting a residency seat is not fully objective. If for some reason or another, a CMG who had a funded seat is not accepted to a residency spot(by means of only applying to a specific hard specialtiy, not applying broadly enough, or being a weak candidate), then that would be a LARGE amount of wasted funding of tax dollars.

 

"To me, it seems like erecting barriers for these CSAs runs counter to our initial premise if we also accept the reasonable idea that at least some CSAs would make excellent doctors."

 

This specifically is somewhat of an illogical notion, because that only takes into account that we are focusing on the metric of the "best doctor". When really, the finances and economics of our medical education system is also very important, given that funding is finite. Any funding or monetary investment into our system that becomes inneffective or innefficient ultimately leads to loss from the system as a whole, and directly impacts patient health care outcomes through diminished funding and trickle down effects.

 

 

Additionally, if it was just a free-for-all, why would we then spend a large amount of funding to train physicians, when we can get just as many excellent physicians who train abroad on their own dime? This is a bit of an extreme statement, but somewhat realistic since there are far more qualified applicants than seats for medical students. Of course this would never happen, since then the medical infrastructure present also relates to hospital systems, research, community health networks and a myriad of other health-related facets.

 

That was all just ramble to show how complicated it is, that a simple proposition of why "xyz" is hardly useful.

 

 

Thanks for the response, much appreciated:)

 

The tax dollars issue is a good thinking point advair250, never fully considered that.

 

I wonder if that is an issue that can apply more broadly to premedical postsecondary education. Consider how many people there are in premed/healthsci/biology programs, doing degrees with limited applicability outside of medicine and/or research (although yes, not all premeds come from biological science backgrounds). I'm not sure, but I am under the impression that undergrad degrees are also subsidized a certain amount by the gov't; at least in Québec this happens. (I could be drastically wrong on this for other Canadian universities!) Not all premeds get into medical school and I wonder if subsidizing their UG tuition costs is an acceptable cost to incur. (It would be interesting to see what an economist/policy analyst would have to say about this.) Either way, I'm guess that subsidizing a single UG degree is not nearly as expensive as subsidizing an MD is, but there are definitely more premeds than their are med students.

 

This is super interesting by the way, hope I'm not coming across as argumentative.

[advair250]

Thanks for the response, much appreciated:)

 

The tax dollars issue is a good thinking point advair250, never fully considered that.

 

I wonder if that is an issue that can apply more broadly to premedical postsecondary education. Consider how many people there are in premed/healthsci/biology programs, doing degrees with limited applicability outside of medicine and/or research (although yes, not all premeds come from biological science backgrounds). I'm not sure, but I am under the impression that undergrad degrees are also subsidized a certain amount by the gov't; at least in Québec this happens. (I could be drastically wrong on this for other Canadian universities!) Not all premeds get into medical school and I wonder if subsidizing their UG tuition costs is an acceptable cost to incur. (It would be interesting to see what an economist/policy analyst would have to say about this.) Either way, I'm guess that subsidizing a single UG degree is not nearly as expensive as subsidizing an MD is, but there are definitely more premeds than their are med students.

 

This is super interesting by the way, hope I'm not coming across as argumentative.

 

Not argumentative at all, sorry If I came off the same.

 

Undergraduate degrees across the board are provincially funded, and that would be a non-issue with regards to premeds, since all undergrads are generally subsidized the same(more or less).

 

And the magnitude of difference is much larger, and the purposes of both are very, very different. An undergraduate degree serves a different purpose than a medical degree, which is with a specific end goal and relevant training in mind. An undergraduate degree is open-ended, typically, and not specific to a certain job or purpose(excluding things such as engineers, dieticians, pharmacists, lawyers etc).

[A-Stark]

The real issue boils down to the circumvention by CSAs of admissions policies put in place to control medical education in Canada, at the undergraduate level and beyond. Some of the policies are designed to address physician distribution problems in Canada, a laudable goal. Many of the policies are excellent, others are flawed. (Maybe I'm thinking too cynically, but I feel that the good of society isn't what certain canadian medical students really care about, compared to the risk of having their current excellent chances of getting SOME residency SOMEwhere reduced by open competition from CSAs....but I digress, everyone acts and argues out of self-interest, whether you're a CMG, CSA or, generally speaking, a human being.)

 

The issue is that medical education is a continuum of both undergraduate and postgraduate training programs. It is impossible to specifically accommodate CSAs - whatever their reason for going abroad - because the system exists to train physicians and surgeons according to local/provincial priorities. This does include some spots for IMGs which is justified through the use of ROS contracts to meet provincial health human resource priorities.

 

Rolling IMG spots into a common first iteration will NOT eliminate ROS spots and may not be of benefit to IMGs. CMGs will continue to have the greatest ease with networking and commonality of training, and their advantage will remain. It still won't be about "merit" because that's not really how the match process works for CMGs and hasn't since the advent of pass/fail transcripts, stripped-down ITERs, and lack of standardized testing. To take an example, an IMG will need high MCCEE/USMLE scores even to get considered for an interview, whereas a comparable CMG will not be held to any kind of academic standard apart from a lack of red flags (like failing a rotation or unit).

 

There are a lot of problems with the current match process. I don't think there's any compelling rationale to alter it to make it theoretically more favourable to IMGs, particularly where many specialties are actually looking at (or already have) contracting positions in view of poor job markets. There is absolutely a case to be made for the continued funding of IMG spots in family medicine - that's where the need remains and will remain - but elsewhere the justification is a lot less compelling and becoming less so. Otherwise, the only way of improving IMG/CSA prospects would be to expand spots, something that isn't going to happen.

[hamham]

hamham,

 

I may be mistaken in following out your logic so my apologies if I misinterpret what you said.

 

Let's accept the premise that Canada deserves the best doctors. Wouldn't it be logical that all Canadians with medical degrees are able to compete on fair ground for postgraduate training? To me, it seems like erecting barriers for these CSAs runs counter to our initial premise if we also accept the reasonable idea that at least some CSAs would make excellent doctors. Why should those CSAs be so heavily restricted in the specialties they can apply for? What if a CSA might make a better ENT than a CMG? (....Did any of you reading that last sentence just snort in laughter aha? )

 

Now, I have checked out SOCASMA and am not fully in favour of how they present some of their information. That being said, however, the fundamental point the author of the article is making is that CSAs should be able to fairly compete for residencies --- it's not like she's demanding her child gets a dermatology residency without having earned it.

 

CMGs that deserve their residencies will get them and I doubt that the majority of CMGs will be usurped by CSAs. It's interesting to see how disparaging some posters (not necessarily in this thread) are towards CSAs and their educations. Why be scared of CSAs taking a CMG's residency away if it's thought that most CSAs aren't that great anyways?

 

Sure, CSAs may have extra resources (probably from family) allowing them to attend a school abroad, but I wouldn't reserve a special level of disdain for those using that advantage to take the next step towards a medical education...I similarly wouldn't begrudge rural applicants using their geographical advantage, an advantage bestowed to many of them by dint of where they were born. Really, both advantages are strokes of luck that in many cases people are simply born into.

 

 

The real issue boils down to the circumvention by CSAs of admissions policies put in place to control medical education in Canada, at the undergraduate level and beyond. Some of the policies are designed to address physician distribution problems in Canada, a laudable goal. Many of the policies are excellent, others are flawed. (Maybe I'm thinking too cynically, but I feel that the good of society isn't what certain canadian medical students really care about, compared to the risk of having their current excellent chances of getting SOME residency SOMEwhere reduced by open competition from CSAs....but I digress, everyone acts and argues out of self-interest, whether you're a CMG, CSA or, generally speaking, a human being.)

 

Many of my friends are now CMGs, several are CSAs, and many others have moved away from the idea of medicine. Admittedly, several of the CSAs I know are abroad because they would never be able to get in in Canada, purely from a meritocratic standpoint. Some of my other, more capable CSA friends are disillusioned by the admissions process here and would rather try their luck abroad than lose an additional 2-4 years trying to be admitted to a canadian school. Many of my friends in this last situation tend to be white, from a higher SES and from urban centres. Certainly not attributes that favourably align them with some of the admissions policies. But guess what? Several of them has GPAs 3.7+ and MCAT 33+..Sure those stats aren't the best of the best but we should really ask ourselves if that means that someone with numbers like that is intellectually incapable of learning medicine.

 

As someone who is waiting to hear back from two interviews in Canada and is sitting on and Irish med school offer, this thread has been of considerable interest.

 

Thanks for your insight daftjustice.

 

B/c the issue at hand is one that concerns my school, I have decided to NOT take sides in any of the discussions in this thread (if you haven't already noticed, I have not and will not expressed my views on whether CSAs deserves a better chance at CaRMS in this thread).

 

When I made the remark that questioned the objectivity of the author (whether she was doing all these for the good of the healthcare system in general or for her self-interest), I was doing it on the belief that it is impossible for one to make a truly impartial decision for the benefit of society when the issue at hand is one that he/she stands to gain from. Human beings are naturally self-serving. Thus, when the issue at hand is one that she stands to benefit from (since her child is a CSA who may potentially benefit if she gets her way), I like to think that there is a natural tendency for her to campaign for the policy that suits her (or her child's) needs best. In light of the above, I strongly feel that she is certainly not in the right position to advocate for the matter. Whether or not CSAs deserve a better shot at Canadian residency is a completely different matter, and I will not comment further on the issue due to personal reasons as mentioned above.

[leviathan]

So 25,000 per year, + living expenses, flights etc. A conservative 45,000$/ year?

 

OSAP gives you only the federal portion for funding, max of $210/wk.

 

All banks will require a cosigner for bank loans for international schools, and like I said, not everyone's parents can cosign(the case is with poorer families, or even middle class families in urban environments).

 

 

If you don't think $180,000 (more likely $250K for the average schools, and even higher than $300k for some), is a lot of money and would be out of reach for many Canadian families...then I'm not sure what I can say.

I'm not sure why you're referring to an "OSAP" as if I'm from Ontario. Typical centrist Ontario thinking. Alberta for instance offers up to $150,000 in funding towards training in medicine. It's not difficult for a middle or even potentially low income family to cosign a LOC for the difference, even in Ontario.

[leviathan]

The investment in CMGs has been discussed before. No investment is perfect, and occasionally you end up making a bad investment in a CMG when a superior IMG shows up to the door. We don't waste any money though because the IMGs fund their own training, and we simply ended up with a better doctor at the end of the day.

 

If you question the objectivity of someone who is fighting for anything, you will not get very far. Anyone who argues for anything always has something to gain from it. We can still make our own decisions if their arguments hold any weight.

[filter105]

As a person who has considered going abroad... if you went to school abroad, why not stay there? Because you are learning the medical way in that country so you would be a better doctor in their system...unless there wasn't a choice...

 

 

On average, $750,000 of tax payer's money goes into educating a CMG(!!). So the country itself has invested in CMG...that's why the admission is quite rigorous and they require such high calibre applicants...and that's why they get the first dibs. As a country they invested in these doctors and they are getting ROS. CMGs thus have a responsibility to practice in Canada for Canadians, since Canadians paid for their education. This is just a simple fact.

 

Regarding volunteer work and poor students with 90% GPA not getting in because of lack of.......while there are disproportionally large number of 'rich', high SES ppl in medicine in general, this disproportaion is actually greater with CSA (I think someone already mentioned that). Also, many of them 'easily' come back to Canada because their parents are often so well- connected. If you lack these connection you shouldn't even bother going abroad and then expect a position reserved for you.

 

 

 

Back to volunteer, the reason why medical school looks for these extracurriculars especially volunteering is not for the paper but because you actually do need these experiences... every day at the hospital or as a shadowing student you are traumatized little bit. The things we see are something that normal average people wouldn't.... if you at least volunteered at the hospital and remotely experienced death then these experiences kind of helps prepare for what's to come in future. In a sense its a program looking out for you to make sure that you are kind of aware what's to come and that you will be ok.....

only by experiencing you will know whether medicine is right for you not.....(although things that you see while you volunteer does not remotely come close to what you will witness)

 

 

 

 

As for if you are poor you can't get both GPA and extracurriculars... while it is difficult there are people who do it and that's all that I'm going to say. Sure if you have 'means' it's lot easier for you. You don't have to earn money for your family to survive and to worry about your mark at the same time... and more time reserved for studying so that's great and this will never be equalized.... but we have to accept that life isn't fair.... but still there are others who defy that with brilliance. I met too many.

 

 

 

I think the complaint is getting louder because it's increasingly becoming harder to come back to Canada...well it's not exactly a rosy path for CMGs either. Everything is getting competitive and residency spots were poorly planned because as more physicians who have their children abroad can't afford to retire.... this means no jobs for new grads.... and the cycle continues.... So in midst of these difficulties, it is kind of impossible to worry about CSA and that they should have a residency spot and become a doctor...unless they are willing to serve in underserved area for at least 20 years....

 

 

Its all about reasoning out the economy behind it.... I know it's unfair but life is unfair...

[ralk]

I'm not sure why you're referring to an "OSAP" as if I'm from Ontario. Typical centrist Ontario thinking. Alberta for instance offers up to $150,000 in funding towards training in medicine. It's not difficult for a middle or even potentially low income family to cosign a LOC for the difference, even in Ontario.

 

Many families are understandably unwilling to be on the hook for $150,000+ in debt, especially when there's no guarantee the student will be able to pay it off themselves in good time. If the student defaults, it's on the co-signer - that's a lot to ask, from anyone, let alone family members who might have difficulty meeting those obligations. Meanwhile, that co-signer has taken on a liability which will affect all their other debt payments. There is a significant cost and risk to being a co-signer, it's not as simple as putting down a signature (and there are certainly people who would not qualify as cosigners, based on their income and debt levels).

 

More importantly, most CSAs are paying far more than $25k a year in tuition and most are doing so primarily off family money - not through debt schemes. What's technically possible (but not likely) and what's typical are very different things. Becoming a CSA is much easier if someone is rich and we do indeed see CSAs being more likely than even CMGs (who are still, sadly, disproportionately wealthy) to come from rich families. We shouldn't be making public policy based on outliers.

 

The resources = student loans from the bank and government. My tuition was about $25,000 per year. Also I don't know where this evidence exists that CSAs are more disproportionately from wealthy families? You mean the voluntary CaRMS survey that was held in 2009, which was completely unscientific?

 

 

I don't know what evidence you're using to prove that CSAs are "far more likely to be from overserviced areas". CSAs and CMGs alike are logically going to be more likely from overserviced areas, since that's where most of the population lives.

 

I'm not sure what you were trying to say at the end there; are you implying the only qualified residents are the ones who get into Canadian schools? Are you implying the admissions system is not completely flawed, or that there are not 3 times as many equally qualified applicants as there are seats?

 

Yes, I'm using the CaRMS report, because while it certainly had some methodological weaknesses, it's about the only information available, and it squares with the incentive schemes for becoming CSAs. In a system where it's easier to become a CMG by being from underserviced areas and it's more feasible to be a CSA if you're from a wealthy family, we'd expect to see CSAs be richer and from overserviced communities (namely Toronto). That's what we see. (Tellingly, we'd also expect CSAs to be more likely to be single since it'd be tough to be married and living overseas; amazingly, that's also the case). I am hoping that the upcoming CaRMS report will address some of the flaws of its predecessor, but no survey is ironclad.

 

When pushing for policies that act in your favour, it's very convenient to be able to dismiss evidence against those policies - without any data, you can justify just about anything.

 

As for what I'm saying at the end there: any policy preference for individuals not based on merit will carry forth a penalty in quality. Regional preferences at Medical Schools have that affect. However, because (as you point out) the number of qualified applicants greatly exceeds the number of spots, the trade-off in quality at that stage is small-to-negligible. Adding another point of regional preference at the residency stage, however, means giving an advantage to those who were already rejected at the point Medical School applications. Basically, they've already been rejected based on quality (and not geographic preference), so the trade-off at the second point, the residency stage between geography and quality may not be as benign as the first trade-off, at the Medical School stage.

 

Completely a moot point, however, as the AFMC points out (https://www.afmc.ca/pdf/datapoint/DATAPOINT-nov2012-Eng.pdf) that making any preference between CSAs and IMGs, such as consideration of where they came from, would be a violation of the Canadian Charter. No point debating a policy that couldn't be passed in the first place.

[NLengr]

Thanks for the response, much appreciated:)

 

The tax dollars issue is a good thinking point advair250, never fully considered that.

 

I wonder if that is an issue that can apply more broadly to premedical postsecondary education. Consider how many people there are in premed/healthsci/biology programs, doing degrees with limited applicability outside of medicine and/or research (although yes, not all premeds come from biological science backgrounds). I'm not sure, but I am under the impression that undergrad degrees are also subsidized a certain amount by the gov't; at least in Québec this happens. (I could be drastically wrong on this for other Canadian universities!) Not all premeds get into medical school and I wonder if subsidizing their UG tuition costs is an acceptable cost to incur. (It would be interesting to see what an economist/policy analyst would have to say about this.) Either way, I'm guess that subsidizing a single UG degree is not nearly as expensive as subsidizing an MD is, but there are definitely more premeds than their are med students.

 

This is super interesting by the way, hope I'm not coming across as argumentative.

 

All universities and most colleges and trade schools are heavily subsidized in Canada.

[NLengr]

I'm not sure why you're referring to an "OSAP" as if I'm from Ontario. Typical centrist Ontario thinking. Alberta for instance offers up to $150,000 in funding towards training in medicine. It's not difficult for a middle or even potentially low income family to cosign a LOC for the difference, even in Ontario.

 

You are delusional if you think low income families would have an easy time , or even a moderately hard time consigning a loan of the magnitude that would be required. Even for a middle class family, it would be a serious decision.

 

Like it or not, going abroad for medicine is an option that is much more available to the children of the well off.

[BoyInTheBubble]

Maybe the delusion is thinking that subsidizing the cost of a CMG's medical education is relevant. Or the cost of anyone's education.

 

You can train in one province...and then move to another for work.

You can train in one province...and then move to America - or any country.

You can train in one province...and just choose to not work.

 

No one asks those people (or anyone in most fields, despite that all degrees are subsidized) to do a return of service (exclude perhaps the military!)

 

CMG's don't go rural, for the most part. No one (IMG or CMG) goes rural for the most part. That's rural life. Some people do their 5 years and leave, which is better than 0 years but hardly a good solution!

 

Clearly the CSA's mother has her child's interest in mind.

[Edict]

I think it truly is deplorable that a mother would try to use propaganda to change the rules so her child can come home. It was your child's decision to go abroad, and i'm sure they are doing what they can to achieve their goals but to have a parent use underhanded tactics like this is a disgrace.

 

Honestly, the points don't even make sense and the article is so full of B.S. its made me realize that most newspaper articles and especially opinion articles are full of B.S. its just the average reader doesn't know enough about it to call it out.

 

Even worse the mother's main aim is wrong headed. She wants CSAs to compete directly with CMGs. The reality is it would only result in fewer spots for CSAs although it might be a more fair process. On the other hand her organization is probably the same one lobbying against true IMGs, its just a little too selfish. Just because these parents are doctors doesn't mean their children have an automatic right to become one as well.