Untrained And Unemployed: Medical Schools Churning Out Doctors Who Can't Find Residencies And Full Time Positions

[...]

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[ralk]

Dearest ralk, my position is that IMGs contribute to the diversification of perspectives and academic pedigrees among our residents. In turn that translates to a more capable set of physicians that go on to care for Canadians and teach the next set of Canadian medical students. Perhaps the hop from the former to the later isn't a priori true but it is a popular perspective. I'm not setting the standard at "irreplaceable," and I haven't stated that "they bring knowledge and skills in a way that isn't replicated by other methods." You're confusing what you'd like me to be saying with what I'm actually saying but no worries mate, I'm chuffed we're conversing. Simply put IMGs are valuable because they diversify our college while still being held to the rigorous standards we expect of practicing physicians.

 

I'm not a legal guy but it seems to me the legal arguments against singling out CSAs would melt away if we legislated the reasoning for IMGs as I've lain out above. (I'm available for consults Stephen, or Justin, or whomever, just kidding Thomas.) They can still come back if they spend a few years practicing out there and can show they can diversify our Canadian physicians.

 

Argumentum ad populum - just because an opinion is popularly held doesn't make it true. I agree that IMGs contribute to diversification of perspectives (and by the very definition of IMGs, they contribute to a diversity of academic pedigrees), but whether that diversity IMGs bring translates to a more capable set of physicians is a conclusion that requires a bit of justification. Accepting homeopaths into physician residency programs would increase diversity of perspectives and academic pedigrees too, but that wouldn't improve the quality of our physicians (before anyone jumps on me for this, I'm not saying IMGs are in any way comparable to homeopaths, just pointing out the flaws in the logic presented and asking for additional reasoning/evidence in support of the position taken).

 

Besides, I question the claim that your's is a popularly held opinion, at least among physicians. Every IMG residency program has the choice between CSAs and non-CSA IMGs, yet in the majority of instances, they choose CSAs. In addition, a common complaint from IMGs is that some IMG residency positions are intentionally held unfilled in the first round in the hopes of securing a CMG in the second. If physicians believed IMGs' unique educational background or training made their programs better, why are so many programs electing not to accept them when given the opportunity?

 

As for the legal side of things, discrimination based on country of origin violates the Canadian Constitution - if you can figure out a way around that little problem, all power to you.

 

Also, CSAs generally can't obtain a residency position outside of Canada and the US and so can't practice abroad unless they happen to have dual citizenship. You've suggested a pathway for them that largely doesn't exist.

[...]

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[ralk]

Correct on the logical math but it's pendatic and I pointed it out in advance. I can't prove that a better set of physician follows from diversification tonight but it's an interesting segue.

 

 

Another miqsuote, let's play fair please. I'm not stating it's widely head by physicians only that it's popular. Diversity is certainly part of the Canadian value system. It's enshrined in our Charter of Rights and Freedoms!   It's also a hot topic here in Montreal. I don't know why program directors are not selecting IMGs over CSAs. Maybe the same reason that diversity has been such a difficult push.

 

 

I suspect the first statement is a little hasty.

 

As for the second, I'm not interested in suggesting paths for CSAs, if we legislate change they should get ample warning but that is all. I'm more interested in convincing you of the intrinsic values of IMGs. There's a second argument but I'll save it.

 

Sorry for the point parsing, I'm rushing this, enjoy the weekend all.

 

I'll look forward expectantly for a more detailed support of your position

[Edict]

The majority of top deserving medical applicants, no matter where they are from, do in fact get in.  It's the borderline people that do not always get in.  Even if one took a harder program and only got a 3.90 GPA - with a solid MCAT they stand a fantastic chance at Queen's, McMaster, and Western.  And with 2 or so shots - almost everyone I know with a decent GPA and MCAT got into medical school.  And most into more than 1 school (that is why waitlists do move quite a lot - the top students get into multiple schools). There is a borderline category type person - and some of those will get in, and some won't. 

 

In regards to Canada not being a meritocracy - the provinces fund their own health care systems, and in regards to admissions - are pretty much separate countries.  So of course it might be easier for someone in Saskatchewan to get into medical school than Ontario (though their mark cutoffs seem higher than some Ontario schools).  These are different places with different taxpayers subsidizing the education.   Some, like Quebec, are so different, I'm still amazed that they even use CaRMS (they used to not used CaRMS - or at least the francophone schools, until relatively recently). 

 

Canada does not need a million cookie cutter unoriginal Toronto and Vancouver kids that are doing medicine so their parents can boast about them in their home countries doing medicine, and then not caring about the vast segments of Canada that do not have long term doctors anyways. 

 

And lastly, Older, Canada should be fully self sufficient at producing it's own physicians.  We should not depend on OTHER countries, and should not let Canadians BUY their degrees.  If the Canadian medical admissions seems unfair to you - it is sort of unfair to almost everyone (whether rich or poor).  CSAs ruin any sort of meritocracy we already have - it's the 1% passing on the 1% to their children, often grossly unworthy, simply because they have money.

 

If Ontario taxpayers are subsidizing our medical education, how come most of our medical schools do not reserve spots for Ontario students? I think at the core of it, there is injustice. Part of it is the area code lottery. 

 

Its very unfair to assume people "buy their degrees", even in the Caribbean many people don't graduate because they don't put in enough work. Lastly, its unfair to assume CSAs are all rich people. 

 

There seems to be a sort of disdain for anyone who has succeeded in life (aka by being rich), or somehow "had it easy" by being born into a wealthy family. There is a disdain for those from big cities all the while those same people defend their rights to move to a big city. It would be blasphemous to stop rural people from moving to a school like Toronto for medicine, but its not blasphemous to stop urban people from moving anywhere outside of their province for medical school. Why don't we actually stop limiting movement in this country, instead, if rural doctors were paid significantly more than urban doctors (which is the case in America), this might be a significant solution to the problem without having to constantly adjust laws and regulations to changing demographics and essentially being unfair to a lot of people with rules like "residency requirements" and "quotas". 

 

Instead of telling people what they can and cannot do based on criteria they can't easily change (aka being born in a specific area or going to high school in a specific area), why can't we give people incentives to live where they want to live? I'm sure if you told someone they could work in Toronto making 200k or work in Thunder Bay making 500k you will find some sort of equilibrium where the market is happy.  

 

I sometimes feel like in medicine we try to pigeon hole people into places and in the process we use stereotypes to place people in boxes. I feel like the whole quota process ends up making it a very us vs them sort of situation and doesn't really solve the problem. 

[amichel]

If Ontario taxpayers are subsidizing our medical education, how come most of our medical schools do not reserve spots for Ontario students? I think at the core of it, there is injustice. Part of it is the area code lottery.

 

Its very unfair to assume people "buy their degrees", even in the Caribbean many people don't graduate because they don't put in enough work. Lastly, its unfair to assume CSAs are all rich people.

 

There seems to be a sort of disdain for anyone who has succeeded in life (aka by being rich), or somehow "had it easy" by being born into a wealthy family. There is a disdain for those from big cities all the while those same people defend their rights to move to a big city. It would be blasphemous to stop rural people from moving to a school like Toronto for medicine, but its not blasphemous to stop urban people from moving anywhere outside of their province for medical school. Why don't we actually stop limiting movement in this country, instead, if rural doctors were paid significantly more than urban doctors (which is the case in America), this might be a significant solution to the problem without having to constantly adjust laws and regulations to changing demographics and essentially being unfair to a lot of people with rules like "residency requirements" and "quotas".

 

Instead of telling people what they can and cannot do based on criteria they can't easily change (aka being born in a specific area or going to high school in a specific area), why can't we give people incentives to live where they want to live? I'm sure if you told someone they could work in Toronto making 200k or work in Thunder Bay making 500k you will find some sort of equilibrium where the market is happy.

 

I sometimes feel like in medicine we try to pigeon hole people into places and in the process we use stereotypes to place people in boxes. I feel like the whole quota process ends up making it a very us vs them sort of situation and doesn't really solve the problem.

I don't think anyone is showing disdain for the categories you mention, only trying to say that people who are from lower SES families or rural areas might not have the same advantages.

[ralk]

If Ontario taxpayers are subsidizing our medical education, how come most of our medical schools do not reserve spots for Ontario students? I think at the core of it, there is injustice. Part of it is the area code lottery. 

 

Its very unfair to assume people "buy their degrees", even in the Caribbean many people don't graduate because they don't put in enough work. Lastly, its unfair to assume CSAs are all rich people. 

 

There seems to be a sort of disdain for anyone who has succeeded in life (aka by being rich), or somehow "had it easy" by being born into a wealthy family. There is a disdain for those from big cities all the while those same people defend their rights to move to a big city. It would be blasphemous to stop rural people from moving to a school like Toronto for medicine, but its not blasphemous to stop urban people from moving anywhere outside of their province for medical school. Why don't we actually stop limiting movement in this country, instead, if rural doctors were paid significantly more than urban doctors (which is the case in America), this might be a significant solution to the problem without having to constantly adjust laws and regulations to changing demographics and essentially being unfair to a lot of people with rules like "residency requirements" and "quotas". 

 

Instead of telling people what they can and cannot do based on criteria they can't easily change (aka being born in a specific area or going to high school in a specific area), why can't we give people incentives to live where they want to live? I'm sure if you told someone they could work in Toronto making 200k or work in Thunder Bay making 500k you will find some sort of equilibrium where the market is happy.  

 

I sometimes feel like in medicine we try to pigeon hole people into places and in the process we use stereotypes to place people in boxes. I feel like the whole quota process ends up making it a very us vs them sort of situation and doesn't really solve the problem. 

 

We don't really need to give protections to Ontario students (though 4 schools do to an extent) - the large majority of students in Ontario schools are from Ontario. Not to mention the out-province spots in other schools, many of which go to Ontario students.

 

There are some gaps in the regional preferences in Ontario - applicants from mid-sized cities in eastern Ontario and just outside of the Golden Horseshoe are disadvantaged for no real reason - which is the unfortunate consequence of schools looking out for their own areas. It would be great to see a more comprehensive, province-wide strategy.

 

There already is a decent financial incentive to work in rural areas. I know rural family docs making twice what an urban family doc would, often with fewer hours. It still doesn't seem to be enough. Turns out, it's fairly hard to bribe people to live where they really don't want to live when they can make an easy 6 figures regardless of location. It's also a fairly expensive strategy - not only do you have to bump pay for the physicians you're incentivizing to live there, but you have to bump the pay for the physicians already willing to work there. It also requires constant adjustment as physicians respond to those incentives, which can be very difficult politically. Let's say a community has higher physician pay, but then hits a relatively good level of physician supply. Do those incentives now get cut, resulting in political blowback? Do you maintain those incentives and let the community become oversaturated? These are not hypothetical concerns - it's happening in Ontario right now with family health teams and capitation models of compensation.

 

As amichel says, the idea isn't to punish the wealthy or those from larger cities, which we shouldn't do. But, by the same token, we shouldn't punish people from lower SES or rural areas either - they can't change who they were born to or where they grew up either. There is injustice in the system, and it's towards the latter group, not the former. Despite the quotas and everything else, wealthier and urban students are over-represented in medicine.

[567765]

The fact that you can have another opportunity for medicine is a nice thing, it's nice to have a second shot. It's nice thing to be allowing people the opportunity of being physicians when they can't be here. But then comes the rich vs. poor argument.

Well the reason the poor can't study overseas is because of the Canadian banks. They require a co-signor who has to be very well paid for at least two years. Why require a co-signor, why not give loans to student studying overseas? why limit opportunity for those of low socioeconomic status? It's the banks that are placing the burden on the poor.

 

Why not be like the American banks giving loans to any student who needs assistance with their education. This is one reason why the bank of Canada needs to allow American banks to open up their branches in Canada and not have monopoly between the 4 big Canadian banks. We can't have the Canadian banks control the economy to this extent - as this is clearly hurting those of low SES by requiring strict guidelines for student loans, undesirable mortgage offers .. etc,  

 

If you want to have people of low socioeconomic status to study overseas, then you have to have influence on the institutional level (force bank of Canada to accept American banks). It's not the fault of the wealthy that the Canadian banks are biased toward them.

My point is that CSA should be allowed to practise med in Canada as this is giving them an opportunity to contribute to the health care system. The concept of giving others opportunity is great but the concept of poor not affording it is not relevant as this is an institutional problem.

[Edict]

The fact that you can have another opportunity for medicine is a nice thing, it's nice to have a second shot. It's nice thing to be allowing people the opportunity of being physicians when they can't be here. But then comes the rich vs. poor argument.

Well the reason the poor can't study overseas is because of the Canadian banks. They require a co-signor who has to be very well paid for at least two years. Why require a co-signor, why not give loans to student studying overseas? why limit opportunity for those of low socioeconomic status? It's the banks that are placing the burden on the poor.

 

Why not be like the American banks giving loans to any student who needs assistance with their education. This is one reason why the bank of Canada needs to allow American banks to open up their branches in Canada and not have monopoly between the 4 big Canadian banks. We can't have the Canadian banks control the economy to this extent - as this is clearly hurting those of low SES by requiring strict guidelines for student loans, undesirable mortgage offers .. etc,  

 

If you want to have people of low socioeconomic status to study overseas, then you have to have influence on the institutional level (force bank of Canada to accept American banks). It's not the fault of the wealthy that the Canadian banks are biased toward them.

My point is that CSA should be allowed to practise med in Canada as this is giving them an opportunity to contribute to the health care system. The concept of giving others opportunity is great but the concept of poor not affording it is not relevant as this is an institutional problem.

 

Ok i don't know if this is going a bit out of topic but the whole reason for the massive global recession and the financial crisis in 08 was because US banks gave out loans too easily, to at risk people. The whole reason Canada weathered the crisis so well was because our banks were much more cautious with giving out mortgages and loans. Fewer people default in Canada because Canadian banks don't lend you money unless they think you can pay it back. 

 

So i don't agree with Canadian banks instituting the US style policy of loans for everyone. 

[ralk]

The fact that you can have another opportunity for medicine is a nice thing, it's nice to have a second shot. It's nice thing to be allowing people the opportunity of being physicians when they can't be here. But then comes the rich vs. poor argument.

Well the reason the poor can't study overseas is because of the Canadian banks. They require a co-signor who has to be very well paid for at least two years. Why require a co-signor, why not give loans to student studying overseas? why limit opportunity for those of low socioeconomic status? It's the banks that are placing the burden on the poor.

 

Why not be like the American banks giving loans to any student who needs assistance with their education. This is one reason why the bank of Canada needs to allow American banks to open up their branches in Canada and not have monopoly between the 4 big Canadian banks. We can't have the Canadian banks control the economy to this extent - as this is clearly hurting those of low SES by requiring strict guidelines for student loans, undesirable mortgage offers .. etc,  

 

If you want to have people of low socioeconomic status to study overseas, then you have to have influence on the institutional level (force bank of Canada to accept American banks). It's not the fault of the wealthy that the Canadian banks are biased toward them.

My point is that CSA should be allowed to practise med in Canada as this is giving them an opportunity to help the health care system. The concept of giving others opportunity is great but the concept of poor not affording it is not relevant as this is an institutional problem.

 

Second chances are important, when it comes to education virtually no mistake should be permanent. However, most second chances involve demonstrating that past shortcomings have been corrected, not getting a promotion despite those shortcomings. CSAs do give a second chance of sorts, but do so by letting individuals move to the next stage before they can demonstrate that they are the best candidates. That's pretty far removed from a meritocratic approach to medical education.

 

Besides, true second chances already exist for unsuccessful candidates in Canada - between second undergrads, MCAT rewrites and improved ECs, even the worst candidate can work their way back into solid contention. The wealthy are still advantaged by this route, but anyone pursuing this pathway has to show they are a strong candidate before getting into medical school, not afterwards.

 

As for Canadian banks, giving a large loan to a student with no income without a co-signor is an anomaly. The only reason MD students get one is because they are near-guaranteed to have a high enough income to pay it back. That's not the case for CSAs, not even close, which is why they insist on a co-signor for CSAs. That has nothing to do with monopoly power, bias towards the rich, or anything else - banks will not loan large sums of money without a reasonable likelihood of being able to collect on that loan. 

[567765]

ralk

 

CSA who passed medical education overseas did put in a lot of effort to pass through their education (did have the merit)

 

Second chances you talk (second undergrad + mcat + ecs) about consume time (time could be spent as an MD not a nobody)

 

People by their nature choose the pathway that is most comfortable for them. This is true of rich and poor people. People are also free to choose whatever pathway they want to choose - it doesn't have to be merit-based or anything - We live in democratic country, not a communist one. People have the freewill to do anything they want. There doesn't have to be reason to justify why person x should do x instead of y. The person is free to do x or y.

 

There is a lot of arbitration in your argument as well. You say that one has to prove himself to be good candidate before med school. But anyone has the freewill to do what they want - not what you want. You think it should merit-based before med school, others just want to be doctors really, they don't want to put in more effort as they may not see that it maybe worth it or whatever their reason is, they're free to choose whatever they want to choose.

 

I talked about the reason why poor people cannot study overseas and you seem to defend the banks that block poor people from studying overseas. This is just morally wrong.

 

You say and banks say as well that it is huge risk, well, why do American banks take the risks and pay for one's education overseas?

 

Why not give the money to study overseas and then if the person failed to become doctor in Canada, he/she will work in other careers to pay back the loan.

 

The point is the banks have to accommodate the people, the Canadian banks do not. When you do not accommodate the people, you limit them from opportunities they could be having.

[...]

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[ralk]

ralk

 

CSA who passed medical education overseas did put in a lot of effort to pass through their education (did have the merit)

 

Second chances you talk (second undergrad + mcat + ecs) about consume time (time could be spent as an MD not a nobody)

 

People by their nature choose the pathway that is most comfortable for them. This is true of rich and poor people. People are also free to choose whatever pathway they want to choose - it doesn't have to be merit-based or anything - We live in democratic country, not a communist one. People have the freewill to do anything they want. There doesn't have to be reason to justify why person x should do x instead of y. The person is free to do x or y.

 

There is a lot of arbitration in your argument as well. You say that one has to prove himself to be good candidate before med school. But anyone has the freewill to do what they want - not what you want. You think it should merit-based before med school, others just want to be doctors really, they don't want to put in more effort as they may not see that it maybe worth it or whatever their reason is, they're free to choose whatever they want to choose.

 

I talked about the reason why poor people cannot study overseas and you seem to defend the banks that block poor people from studying overseas. This is just morally wrong.

 

You say and banks say as well that it is huge risk, well, why do American banks take the risks and pay for one's education overseas?

 

Why not give the money to study overseas and then if the person failed to become doctor in Canada, he/she will work in other careers to pay back the loan.

 

The point is the banks have to accommodate the people, the Canadian banks do not. When you do not accommodate the people, you limit them from opportunities they could be having.

 

Well, pretty sure I'm getting trolled now, but here goes.

 

Second chances do consume time. That's a consequence of not having a strong enough application the first time around. Doing a second undergrad is not being a nobody - in addition to providing that second chance at medical school, they can and should (if approached correctly) provide another career pathway if an applicant's medical school desires don't work out, which an MD overseas largely does not.

 

American banks do not take those risks on their IMGs - heck, they don't take those risks on most USMGs. Cosigners (or even loans directly to a student's parents) are quite common for private loans in the US. The deal CMGs get from Canadian banks is considerably better than anything American private institutions provide. The financing options available to CSAs are comparable to what is available in the US. Interesting that in a single post you rally against communism while advocating for banks to be compelled to make risky, unprofitable loans.

 

People are free to do whatever they want with their careers (short of impinging on the rights of others'), but there is no requirement for anyone or any institution to accommodate those choices.

[567765]

My dear ralk, you're not being trolled. This is just a conversation.

 

Look here

internationalstudent.com/loans. American citizens can study overseas without the need of a co-signor.

 

You said the opposite.

 

These are not unprofitable loans - there is interest rate on the loan taken - the banks benefit in taking back its money plus the money taken through charging the interest rate.

 

It's risky but American banks do it, why can't the Canadian ones do it too. Ultimately I think the goal of CSA is to come back and practise and thus can eventually pay back their loan. If they can't pay back their loans they will have bad credit rating which is legitimate reason for them to start paying back their loans.  

 

You guys are the ones complaining that the poor does not benefit from studying overseas, yet you guys seem to ignore the reason why they can't study overseas - in fact you guys justify the reason why they can't study overseas. Are you really helping the poor here?

 

You defend second degrees. Well this is your opinion. Others prefer to study overseas. People are free to choose what they want to choose.

[ralk]

My dear ralk, you're not being trolled. This is just a conversation.

 

Look here

internationalstudent.com/loans. American citizens can study overseas without the need of a co-signor.

 

You said the opposite.

 

These are not unprofitable loans - there is interest rate on the loan taken - the banks benefit in taking back its money plus the money taken through charging the interest rate.

 

It's risky but American banks do it, why can't the Canadian ones do it too. Ultimately I think the goal of CSA is to come back and practise and thus can eventually pay back their loan. If they can't pay back their loans they will have bad credit rating which is legitimate reason for them to start paying back their loans.  

 

You guys are the ones complaining that the poor does not benefit from studying overseas, yet you guys seem to ignore the reason why they can't study overseas - in fact you guys justify the reason why they can't study overseas. Are you really helping the poor here?

 

You defend second degrees. Well this is your opinion. Others prefer to study overseas. People are free to choose what they want to choose.

 

The site you linked indicates that US citizens are not required to have a cosigner for a loan application, but that one is still often necessary to actually get the loan or to obtain a good rate on the loan. For the amount of money needed to study medicine, steady income or collateral would be necessary, which undergrads typically don't have, let alone undergrads from low SES backgrounds. Also, the site explicitly says that most US citizens will require a cosigner to study abroad and does not list several common IMG destinations as approved schools for financing.

 

Without a cosigner, these loans are typically not profitable, which is why banks don't offer them. Modern-day banks have their flaws, but making money for themselves is not one of them - if they thought these loans were profitable, they would offer them. There is an interest rate attached to these loans, but that does not make these loans profitable - when people default on their loans, the banks lose money and MDs without a residency are at high risk to default. At typical rates offered to CSAs with the amount of debt necessary to finance medical school, a 30-year amortization would cost over $15k a year, a very difficult sum for someone to pay off who isn't earning a physician's salary.

 

Besides, getting access to credit doesn't make going abroad affordable. As a few posters have noted, it is possible for middle-income individuals to obtain a line of credit to study abroad, even with a cosigner. But $200k+ for a 30-50% chance to become a physician in Canada isn't a risk most people would take unless they are able to absorb such a loss with relative ease. Lower-income families do not have $200k to lose. The banks could act exactly as you advocate (which they won't) and CSAs would still be predominantly wealthier students.

[SEAL]

Some posters here need to realize that IMG's are canadian citizens ....... CaRMS does not allow non-Canadians to apply for residency positions.

 

I have the feeling that some people are talking about IMG's as 'slaves' who we bring from other countries to 'serve' us.

 

Take into account most of those IMG's have been practicing for years.

 

An OB/GYN who has been delivering babies for 10 years in his/her home country is much better than a newly graduated canadian med student who doesn't have half of that experience and both are entering residency together.

 

While CMG's barely pass the LMCC exams ........ IMG's study heavily for those exams to obtain high scores.

 

They are an addition to Canada's doctor workforce and not slaves.

 

Of course if somebody signs a contract they should definitely stick to it ......... but some people here are talking about torturing the slaves if they refuse to work .........

 

CAREFUL PLEASE !

 

Another thing, how is applying a ROS to IMG's even legal from a human rights perspective ?

 

An IMG is a canadian who has completed his/her medical training abroad.

 

Upon arrival to Canada, this person has been thoroughly evaluated and has had to meet even higher standards than CMG's (there are very few spots and a lot more applicants in the IMG stream) to be deemed competent to enter residency.

 

How is it legal that this person is forced to work in certain areas while CMG's are free to go wherever they want ?

 

If Canada is facing a healthcare issue then all CANADIANS should work TOGETHER to solve this problem.

 

Hell. rural applicants are allowed to get into med school with a GPA of 3.3 and we can't even force them to work where they grew up. Big privelages .... No obligations.

 

But a qualified IMG is forced to adapt to an environment he has never lived in !

[GrouchoMarx]

Some posters here need to realize that IMG's are canadian citizens ....... CaRMS does not allow non-Canadians to apply for residency positions.

 

I have the feeling that some people are talking about IMG's as 'slaves' who we bring from other countries to 'serve' us.

 

Take into account most of those IMG's have been practicing for years.

 

An OB/GYN who has been delivering babies for 10 years in his/her home country is much better than a newly graduated canadian med student who doesn't have half of that experience and both are entering residency together.

 

While CMG's barely pass the LMCC exams ........ IMG's study heavily for those exams to obtain high scores.

 

They are an addition to Canada's doctor workforce and not slaves.

 

Of course if somebody signs a contract they should definitely stick to it ......... but some people here are talking about torturing the slaves if they refuse to work ......... 

 

CAREFUL PLEASE !

 

Another thing, how is applying a ROS to IMG's even legal from a human rights perspective ?

 

An IMG is a canadian who has completed his/her medical training abroad.

 

Upon arrival to Canada, this person has been thoroughly evaluated and has had to meet even higher standards than CMG's (there are very few spots and a lot more applicants in the IMG stream) to be deemed competent to enter residency.

 

How is it legal that this person is forced to work in certain areas while CMG's are free to go wherever they want ?

 

If Canada is facing a healthcare issue then all CANADIANS should work TOGETHER to solve this problem.

 

Let's not give IMGs too much credit.

 

Just because an IMG has been a physician in their home country for a particular amount of time does not mean they are 1. good at it 2. inherently exceptional 3. able to learn new things. In countries like China, physicians are quite low on the social ladder and as such there is very little interest or competition for such positions. The barriers to entry are lower and as a result so is the caliber of physician.

 

I'm in pathology and some of my co-residents were so-called pathologists in their home countries, yet when placed against the standards we have here, simply do not measure up. It's no stretch to say that a strong medical student, or average off-service resident, easily outpaces some of these IMG physician residents.

 

IMG standards should be stricter.

[SEAL]

So 10 years of experience doesn't give you even a little advantage over someone who just completed a core rotation in med school .....

 

That's interesting ....

[567765]

To ralk - Well the site says it is recommended to have a co-signor so there could be the possibility of those getting loan without a co-signor.

 

If individuals were to default on their loan, they will get bad credit rating, which will prevent them from getting mortgages or car loans. This wouldn't be a wise move and thus many will be training for other careers to pay back their student loan. No one wants to be renting a place for the rest of their lives. So the banks will eventually get back its money + the interest.

 

My other point is that it is wrong to blame CSAs because they were able to afford it. You can't say the system is unfair to those of low SES because as you know, it is the banks that are the reason why low SES individuals can't study overseas. It is the fault of the banks, not the fault of the system. The system is fair as it gives people the freedom to choose whether to study medicine in  Canada or abroad.

[amichel]

What is going on in this thread all of a sudden....

[ralk]

To ralk - Well the site says it is recommended to have a co-signor so there could be the possibility of those getting loan without a co-signor.

 

If individuals were to default on their loan, they will get bad credit rating, which will prevent them from getting mortgages or car loans. This wouldn't be a wise move and thus many will be training for other careers to pay back their student loan. No one wants to be renting a place for the rest of their lives. So the banks will eventually get back its money + the interest.

 

My other point is that it is wrong to blame CSAs because they were able to afford it. You can't say the system is unfair to those of low SES because as you know, it is the banks that are the reason why low SES individuals can't study overseas. It is the fault of the banks, not the fault of the system. The system is fair as it gives people the freedom to choose whether to study medicine in  Canada or abroad.

 

There is the possibility of getting a loan without a co-signer - if you have significant collateral and/or income and a solid credit rating. Virtually no lower SES individuals have that.

 

No one wants to default on their loans, they simply don't have the money to pay for it. How do you expect a 20-something with minimal career prospects to cover $15k a year without family support? Even if they get a reasonable, middle-class job quickly, that's about a quarter of total income going just to Med School debt. Again, if banks made money off those loans without co-signers, they'd make them - banks don't tend to pass on deals that make them money.

 

CSAs don't need to be blamed for being able to afford taking that route, but they shouldn't be rewarded either. And no, it is not the banks' fault - low SES individuals have difficulty studying overseas because it is very expensive and risky, neither of which are the fault of banks. Lastly, to be clear, the overwhelming reason CSAs study abroad in an inability to enter Med School in Canada. This issue isn't about freedom of choice.

[567765]

Low SES can still pay his/her bills on time and thus have good credit rating.

 

How much is the tuition for Canadian med school, lets say 45k per year. The tuition for school overseas lets say is 70 k. The bank pays for the Canadian one and not the overseas one, here the low SES individuals is screwed over costs that are a bit higher than here in Canada. My point is going to med school is expensive whether it is Canadian med school or overseas one.

 

Yes it is the bank's fault. If they paid for the low SES individual, he/she would afford it.

 

We already talked about this, you could try again or you could go overseas - here where freedom of choice exist.

 

Yes the system needs to reward them just like it rewards Canadian med students. CSAs left their families and are in huge debt load for career they perceive themselves to be in. You said their chance of coming back is already 30-50 %, is the system here rewarding to them?

[amichel]

Low SES can still pay his/her bills on time and thus have good credit rating.

 

How much is the tuition for Canadian med school, lets say 45k per year. The tuition for school overseas lets say is 70 k. The bank pays for the Canadian one and not the overseas one, here the low SES individuals is screwed over costs that are a bit higher than here in Canada. My point is going to med school is expensive whether it is Canadian med school or overseas one.

 

Yes it is the bank's fault. If they paid for the low SES individual, he/she would afford it.

 

We already talked about this, you could try again or you could go overseas - here where freedom of choice exist.

 

Yes the system needs to reward them just like it rewards Canadian med students. CSAs left their families and are in huge debt load for career they perceive themselves to be in. You said their chance of coming back is already 30-50 %, is the system here rewarding to them?

Your posts make zero sense. And tuition here is half of that, actually.

[makingfetchhappen]

Low SES can still pay his/her bills on time and thus have good credit rating.

 

How much is the tuition for Canadian med school, lets say 45k per year. The tuition for school overseas lets say is 70 k. The bank pays for the Canadian one and not the overseas one, here the low SES individuals is screwed over costs that are a bit higher than here in Canada. My point is going to med school is expensive whether it is Canadian med school or overseas one.

 

Yes it is the bank's fault. If they paid for the low SES individual, he/she would afford it.

 

We already talked about this, you could try again or you could go overseas - here where freedom of choice exist.

 

Yes the system needs to reward them just like it rewards Canadian med students. CSAs left their families and are in huge debt load for career they perceive themselves to be in. You said their chance of coming back is already 30-50 %, is the system here rewarding to them?

It's called bankruptcy.

 

If you were to owe $250K in student loans from going overseas to study med, but you failed to graduate or get a residency position, what sort of money would you be making? Maybe $60K a year before taxes if you are lucky? 

 

Anyone in that situation would probably be nuts not to declare bankruptcy. Having $250K in loans discharged, and after 6 years, you can start to rebuild your credit. That is $250,000/6 years = $41,666 a year that you would not be repaying in principal alone, not to mention interest. That would be about 100% or more of your after tax income!

 

If banks gave everyone $250K of unsecured loans, a lot of people would be doing that. The normal unsecured loan for an adult with a steady job and no real estate is a $10K credit card, because banks here know you would be stupid to throw away your credit rating for $10K. 

 

On the other hand, if you become a doctor in Canada, not only would you be silly to throw away your credit and good reputation on that $250K, but also, the courts wouldn't let you. You cannot just declare bankruptcy when your credit to income ratio isn't even 100%.

 

When you are $250K in the hole and making $60K (or more likely, much less in the situation we are describing), yes, you would probably have no problem.

[indefatigable]

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