Application Process for J1 Statement of Need

[bishmike]

Hey

I have a couple of questions concerning the J1 visa application process for a Canadian citizen obtaining an undergraduate medical education abroad. Primarily if I am sincerely interested in returning home to British Columbia after completing a family practice residency program in the United States how do I ensure that the Collage of Familly Physicians of Canada recognizes the specific program I am interested in? I can not find the information any where on the collage web site.

Also of concern to me is the time frame involved in the application process. As stated on the health Canada web site I need to apply for and be denied a family practice residency position in my home province of British Columbia prior to being eligible for the J1 visa. Will this process of applying first to carms or another provincial program delay my statement of need application by an entire year in the event that my application to carms or another provincial program is not successful? Or can I apply to both carms and nrms in the simultaneously?

Finally due to the limited eligibility to receive a statement of need in support of family practice is an applicant more likely to receive the statement of need if they peruse a different line of postgraduate training Internal Medicine for example. In other words am I unlikely to receive the statement of need in support of family practice because there is a limited number of letters dispensed each year and they are general dispensed to applications in support of medical specialties in need in Canada.

.Thx, any body else trying to go this route?.

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[f_w]

how do I ensure that the Collage of Familly Physicians of Canada recognizes the specific program I am interested in? I can not find the information any where on the collage web site.

I found that contacting these kinds of institutions in canada in writing usually gets you a written answer.

Finally due to the limited eligibility to receive a statement of need in support of family practice is an applicant more likely to receive the statement of need if they peruse a different line of postgraduate training Internal Medicine for example.

My understanding of the CARMs is that most of the residency positions that remain open tend to be in the northern portion of the respective provinces and tend to be in family practice or neuropathology. So from that aspect, you might have a better shot towards a SON from health canada if you pursued a specialty traditionally hard to get.
Once you are on a J1, you are allowed to change specialties once after a maximum of 2 years. So, you could start out with a medicine residency and switch to FP after internship (and probably get a couple months worth of credit for your IM training). Now, the problem with this approach is that you will need an updated SON for this change in specialty. Don't know what health canada's rules for a change in specialty would be.

otoh
-- If you are aiming for FP, you should have a decent shot at an H1b. Why bother with the J1 in the first place ?

 

[avenirv]

I found that contacting these kinds of institutions in canada in writing usually gets you a written answer.



My understanding of the CARMs is that most of the residency positions that remain open tend to be in the northern portion of the respective provinces and tend to be in family practice or neuropathology. So from that aspect, you might have a better shot towards a SON from health canada if you pursued a specialty traditionally hard to get.
Once you are on a J1, you are allowed to change specialties once after a maximum of 2 years. So, you could start out with a medicine residency and switch to FP after internship (and probably get a couple months worth of credit for your IM training). Now, the problem with this approach is that you will need an updated SON for this change in specialty. Don't know what health canada's rules for a change in specialty would be.

otoh
-- If you are aiming for FP, you should have a decent shot at an H1b. Why bother with the J1 in the first place ?

because you need all 3 USMLEs for H1B

 

[f_w]

because you need all 3 USMLEs for H1B

And what (except for the timing) is the problem with that ? If you listened up in medical ethics and read the Swansons, Step3 is a formality.

You need step3 when the I129 petition is 'ripe' for adjudication (if they don't have your step3, they don't deny it, they just send a request for evidence). You might have to negotiate a later starting date, but if you have good credentials you should be able to find an FP residency willing to wait for a month or two (until your graduation has been confirmed by your medschool and the step3 score is back).

H1B OR NOT TO BE !

 

[avenirv]

how many years do you need to get all 3 USMLEs ?
is there a specific calendar for this ?
thank you.

 

[bulgethetwine]

how many years do you need to get all 3 USMLEs ?
is there a specific calendar for this ?
thank you.

That's the rub. To get an H1b, you have to have already PASSED the step 3. And you can't REGISTER the step 3 until you have a medical diploma. Ergo, the only way to get an H1b is to sit out a year, and do the step 3 during that year. Expensive year.

 

[driedcaribou]

That's the rub. To get an H1b, you have to have already PASSED the step 3. And you can't REGISTER the step 3 until you have a medical diploma. Ergo, the only way to get an H1b is to sit out a year, and do the step 3 during that year. Expensive year.

I would like to add that you need to do all 3 Steps within 7 years in most states.

 

[deschutes]

I would like to add that you need to do all 3 Steps within 7 years in most states.

Just to clarify: The 7-year-rule for passing USMLEs applies to requirements for independent licensing after graduating from residency. If one was convinced that one wasn't going to be staying in the US after residency, this would not be an issue. If I am not mistaken, most residencies only require that the resident have passed Steps 1 & 2 CK/CS before admission, and Step 3 after.

Still, it's a good idea to get them done as soon after each other as humanly possible. 7 years is a decently long time.

 

[NewCanadian]

Hey

I have a couple of questions concerning the J1 visa application process.....
.
how do I ensure that the Collage of Familly Physicians of Canada recognizes the specific program I am interested in? .......

Also of concern to me is the time frame involved in the application process. As stated on the health Canada web site I need to apply for and be denied a family practice residency position in my home province of British Columbia prior to being eligible for the J1 visa. Will this process of applying first to carms or another provincial program delay my statement of need application by an entire year in the event that my application to carms or another provincial program is not successful? Or can I apply to both carms and nrms in the simultaneously?

Finally due to the limited eligibility to receive a statement of need in support of family practice ........
.Thx, any body else trying to go this route?.

Finding out what kind of program the CFPC recognizes is a no brainer. Go to the College website again, click on Exams and Certification, click on Eligibility Requirements and General Information, read Residency Eligibility Requirements, section B.


Quote:
"B) Graduates of Family Medicine Residency Programs Accredited by the Accreditation Council for Graduate Medical Education (ACGME)

1. All applicants who are graduates of ACGME accredited family medicine residency programs who are seeking eligibility to sit the Certification Examination in Family Medicine must either be members of the College of Family Physicians of Canada or must submit an application for membership at the time they apply to sit the examination. They must be members at the time they sit the examination.
2. Applicants must provide proof of registration in an ACGME-accredited residency training program in Family Medicine.
3. Applicants from ACGME accredited family medicine residency programs are eligible to sit the examination during the last six months of their training programs.
4. Certification in the College of Family Physicians of Canada (CCFP)will be granted when the candidate has:
* a) Successfully completed the CFPC Certification Examination in Family Medicine;
b) Successfully completed ACGME accredited post-graduate training in family medicine as verified by the family medicine postgraduate director;
c) Become a Diplomate of the American Board of Family Practice."

Thus, the College recognizes ACGME accredited programs. All you have to show for the Statement of Need is evidence it is ACGME accredited.

As for eligibility, if you try in CARMS or any provincial process, and you are not successful, then you are eligible to apply for the Statement of Need directly from Health Canada. It doesn't have to be just in BC. But you arex expected to prove you actually made the effort. Nevertheless, you can still contact the BC representative directly, and discuss your plans. Chances are the BC rep will agree to your request, and inform Health Canada to issue a Statement of Need for you. Try it.

 

[Knight_MD]

So before I can apply for the J1 visa, I first need to take the MCCEEs, apply for a residency in CARMS, not be successfull, THEN I'll be eligible for the J1 visa?

If that's how it is, taking Step 3 sounds much better...

 

[driedcaribou]

So before I can apply for the J1 visa, I first need to take the MCCEEs, apply for a residency in CARMS, not be successfull, THEN I'll be eligible for the J1 visa?

If that's how it is, taking Step 3 sounds much better...

Sorry, are you a Canadian student? If you're a Canadian student, you don't have to take the MCCEE. Dirty IMGs like I have to.

 

[Knight_MD]

Nope not a Canadian graduate... I'm a Canadian FMG...
So I really need to take the MCCEE, apply in CARMS, not match, and then get the J1 visa??? Seriously?

Why wouldn't everyone take Step 3 instead? It takes more than a year to do that other sequence of events...

 

[DrLight]

Nope not a Canadian graduate... I'm a Canadian FMG...
So I really need to take the MCCEE, apply in CARMS, not match, and then get the J1 visa??? Seriously?

Why wouldn't everyone take Step 3 instead? It takes more than a year to do that other sequence of events...

Hey everyone....I'm going for the 2008 match...I've cleared MCCEE in order get a J1...
so I have to register in CARMS in order to eligible for the letter of need???
I wasn't planning to bother with CARMS since I would rather apply for the American match...

 

[DrLight]

Hey everyone....I'm going for the 2008 match...I've cleared MCCEE in order get a J1...
so I have to register in CARMS in order to eligible for the letter of need???
I wasn't planning to bother with CARMS since I would rather apply for the American match...

Okay I decided to do a little research rather than waiting for a response!

[FONT=verdana, helvetica]Application categories for the Statement of Need:
.http://www.hc-sc.gc.ca/hcs-sss/pubs/hhrhs/2007-postgrad-postdoct/2007-med/index_e.html#17
[FONT=verdana, helvetica]
Necessary documents for a Canadian IMG to apply for a Statement of Need

.http://www.hc-sc.gc.ca/hcs-sss/pubs/hhrhs/2007-postgrad-postdoct/2007-med/index_e.html#40

 

[NewCanadian]

Hey everyone....I'm going for the 2008 match...I've cleared MCCEE in order get a J1...
so I have to register in CARMS in order to eligible for the letter of need???
I wasn't planning to bother with CARMS since I would rather apply for the American match...

Trying to get a position in Canada first is only important if you want to train in Family Medicine. If you're going for a RCPSC recognized specialty, you don't have to go thru carms in 2008. If you're going for family medicine, you'll have to go thru carms and not be matched, before you'll get a Statement of Need.

 

[driedcaribou]

Trying to get a position in Canada first is only important if you want to train in Family Medicine. If you're going for a RCPSC recognized specialty, you don't have to go thru carms in 2008. If you're going for family medicine, you'll have to go thru carms and not be matched, before you'll get a Statement of Need.

Thanks for clearing that up!

 

[TraumaCheers]

Trying to get a position in Canada first is only important if you want to train in Family Medicine. If you're going for a RCPSC recognized specialty, you don't have to go thru carms in 2008. If you're going for family medicine, you'll have to go thru carms and not be matched, before you'll get a Statement of Need.

This is absolute bulls*^%. The relevant Canadian agency that administers this is leaving itself WIDE open to class action lawsuit due to this rule. They're to getting more and more brazen with the hoops they make you jump through to get a Statement of Need.

Keep it up, Canada.

 

[f_w]

The relevant Canadian agency that administers this is leaving itself WIDE open to class action lawsuit due to this rule.

On what grounds ?

 

[TraumaCheers]

On what grounds ?

Because the alternative to the Statement of Need is indentured servitude to practice in a rural community for 5 years - and not just any rural community (i.e. of the physician's choice as long as it is rural) but one in the northern regions of, for example, Ontario, at the discretion of the government. They can force you to Sudbury even if you're from a town in Eastern Ontario which might also be underserviced. This 5 year return-of-service is what could easily be challenged under fair labor laws.

If they dropped the five year return of service, then fair enough. Or, if they said "must practice in an underserviced area of the physician's choice for 5 years (similar to an H1B job in the U.S.) then, well, even that would be palatable (if not a rather harsh length of time).

But currently, what the government is doing is essentially black-mailing the Canadian IMG into submitting to remote region practice, using the Statement of Need as a wedge. No other country exploits the Return in Service agreement the way Canada does.

The other thing is, Canada turns away the best of the IMGs -- the ones who have the opportunity to train elsewhere. As a result of policies such as these and other lengthy, bureaucratic red tape with regard to credentialing (of which you and I have discussed many times, F_w), Canada ends up settling for the IMGs who have no other choice but to play by Canada's rules (fortunately, these are also good docs) but the ones with other opportunities go elsewhere.

And someday, a physician who is independently wealthy is gonna challenge them on these points and win. I hope it's class action.

 

[f_w]

This 5 year return-of-service is what could easily be challenged under fair labor laws.

Good luck suing your goverment.

It can work, but you will be old and grey before you prevail:

Here in the US, the immigration service screwed a bunch of physicians out of their green-cards by 're-interpreting' a law congress passed in a way that made it close to impossible for them to avail themselves of its benefits. A group of 8 docs sued in 1998 and prevailed: IN 2007 !!! The case went to the US court of appeals and back twice. (In the meantime, the case for 5 of them had gone moot due to the fact that they got their green-card some other way.) In the end, the docs prevailed and managed to get these unlawful misinterpretations overturned. Millions of dollars of attorneys fees where expended by the plaintiffs and their backers (I listened to the appeals courts arguments, priceless. the appeals court judge stopped short of calling the goverments attorney a ****** but only barely).

No other country exploits the Return in Service agreement the way Canada does.

Well, australia uses it as a 'steering instrument', but they don't seem to be as mean-spririted as the canadian medical establishment.

The other thing is, Canada turns away the best of the IMGs --

Their loss.

Years ago, when I looked at the canadian option they frustrated the hell out of me. Now I pull a private practice (radiology) attending salary in the US and my motivation to go north has naturally fizzled a bit.

And someday, a physician who is independently wealthy is gonna challenge them on these points and win. I hope it's class action.

Nah, they'll just stay in the states and fly up to see their folks every couple of weeks

 

[TraumaCheers]

Good luck suing your goverment.

It can work, but you will be old and grey before you prevail:

Here in the US, the immigration service screwed a bunch of physicians out of their green-cards by 're-interpreting' a law congress passed in a way that made it close to impossible for them to avail themselves of its benefits. A group of 8 docs sued in 1998 and prevailed: IN 2007 !!! The case went to the US court of appeals and back twice. (In the meantime, the case for 5 of them had gone moot due to the fact that they got their green-card some other way.) In the end, the docs prevailed and managed to get these unlawful misinterpretations overturned. Millions of dollars of attorneys fees where expended by the plaintiffs and their backers (I listened to the appeals courts arguments, priceless. the appeals court judge stopped short of calling the goverments attorney a ****** but only barely).



Well, australia uses it as a 'steering instrument', but they don't seem to be as mean-spririted as the canadian medical establishment.



Their loss.

Years ago, when I looked at the canadian option they frustrated the hell out of me. Now I pull a private practice (radiology) attending salary in the US and my motivation to go north has naturally fizzled a bit.



Nah, they'll just stay in the states and fly up to see their folks every couple of weeks

As usual, you are on point on all your retorts!

 

[NewCanadian]

Because the alternative to the Statement of Need is indentured servitude to practice in a rural community for 5 years - and not just any rural community (i.e. of the physician's choice as long as it is rural) but one in the northern regions of, for example, Ontario, at the discretion of the government. They can force you to Sudbury even if you're from a town in Eastern Ontario which might also be underserviced. This 5 year return-of-service is what could easily be challenged under fair labor laws.

If they dropped the five year return of service, then fair enough. Or, if they said "must practice in an underserviced area of the physician's choice for 5 years (similar to an H1B job in the U.S.) then, well, even that would be palatable (if not a rather harsh length of time).

But currently, what the government is doing is essentially black-mailing the Canadian IMG into submitting to remote region practice, using the Statement of Need as a wedge. No other country exploits the Return in Service agreement the way Canada does.

The other thing is, Canada turns away the best of the IMGs -- the ones who have the opportunity to train elsewhere. As a result of policies such as these and other lengthy, bureaucratic red tape with regard to credentialing (of which you and I have discussed many times, F_w), Canada ends up settling for the IMGs who have no other choice but to play by Canada's rules (fortunately, these are also good docs) but the ones with other opportunities go elsewhere.

And someday, a physician who is independently wealthy is gonna challenge them on these points and win. I hope it's class action.

I don't know that blackmail was the intent, so it's interesting you see it that way.
Apparently, the intent of the policy is to ask new IMGs to apply for the family medicine training positions in Canada, rather than go to the US and come back to Canada without first hand knowledge/experience of the Canadian healthcare system. The intent is to promote the opportunities that do exist in Canada. Not all the fam med positions were filled last year. Any return in service issues that come with family medicine training in Canada were probably not a factor in deciding whether or not to issue Statements of Need for family medicine.

 

[TraumaCheers]

I don't know that blackmail was the intent, so it's interesting you see it that way.
Apparently, the intent of the policy is to ask new IMGs to apply for the family medicine training positions in Canada, rather than go to the US and come back to Canada without first hand knowledge/experience of the Canadian healthcare system. The intent is to promote the opportunities that do exist in Canada. Not all the fam med positions were filled last year. Any return in service issues that come with family medicine training in Canada were probably not a factor in deciding whether or not to issue Statements of Need for family medicine.

hahahahhahahahahahah

To "ask" IMGs to apply for the family medicine?!?

Ha. It's a blatant ploy to strong arm people into doing family med in Canada despite the fact that the U.S. has better weather, better pay, and a fairer system (everyone writes the same USMLEs, not this bullsh*t about evaluating exams, unpaid probationary periods, etc.).

And if familiarity with the system in Canada is the real issue, how exactly is that solved by a 5 year return in service in remote Canada?!?!

What did you mean by this statement?:

"Any return in service issues that come with family medicine training in Canada were probably not a factor in deciding whether or not to issue Statements of Need for family medicine."

Uh, that's EXACTLY the factor -- by refusing to provide Statements of Need, you get forced into accepting a 5 year return in service to rural Canada and doing family med in Canada because you can no longer get a J1 without the Statement of Need.

 

[hopeful26]

Hey everyone. I was reading this forum and i have to say that i feel like canada is making this really difiicult. I have a question for anyone who knows about this, please let me know. Im an international medical graduate, who is a canadian citizen, if i take the mccee and pass and apply for the j1 visa (im doing my usmles right now) ,does anyone know how difficult it is later on to get a J1 waiver later on, like after residency? From this discussion It looks like its not that easy to get? is this correct? I appreciate any help, thank you

 

[nycheartdoc]

J1 waiver has nothing to do with the Canadian letter service of need. If a VA hospital wants you, they are not going to care want Health Canada wants because US's interest trumps Canadian.

Now, it may be trickier if you signed a return of service agreement. But if you decide to stay in US, what is Canada going to do? Sure they can sue you, but they are bureaucrats and it is difficult (but not impossible) to serve you with a claim from a Canadian court while you are in the US.

 

[f_w]

J1 waiver has nothing to do with the Canadian letter service of need. If a VA hospital wants you, they are not going to care want Health Canada wants because US's interest trumps Canadian.

The VA might not care, a number of state health departments participating in the Conrad30 program DO care. They ask for a 'letter of no objection' from your home country stating that they relieve you from the service obligation you incurred in your home country when you got sponsored for the J1 in the first place. This is to avoid catching flak from their liberal minded do-gooder citizens who want to avoid a 'brain-drain' in other countries.

 

[f_w]

how difficult it is later on to get a J1 waiver later on, like after residency? From this discussion It looks like its not that easy to get? is this correct?

The US is experiencing a shortage of primary care physicians, particularly in non-suburban areas. Also, the number of J1 physicians has dropped a bit over the last couple of years (and the number of waiver slots has gone up). At least in primary care, waivers are allways available. In specialties this is a lot harder, but certainly not impossible. For the individual, it depends a lot on the strength of the labor market for ones specialty.