Denied a Statement of Need for Radiology residency in the US

[Psoralin]

My wife and I have couples matched into a Radiology program in the US but Canada will not provide us with a Statement of Need saying their quota of FIVE has been reached for 2014.

The expect us to sit out a year, cancel contracts with two programs (a Transitional Year and our Radiology program), lose roughly $100 000 in income and all because apparently the country doesn't need us??

This is crazy and I'm wondering if anybody has any advice or help they could offer us in this situation. I truly hate Canada at this moment.

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[Psoralin]

The SON is a requirement to get the J1 Visa. It is basically stating that Canada needs doctors in certain fields and apparently they only need 5 radiologists for the whole country. The Statement is easy to get if you're in Family Med or a few other "needed" specialties - but if you achieve your goal and match into a competitive specialty the country can screw you over and not provide you with a Statement because whatever quota they have set for the year has been reached.

We Matched our top choice in Radiology as a couple! It's an incredible achievement considering we thought we might have to spend five years apart. Now that we've done it the Government is telling us to cancel our contracts and try again next year - or hey, maybe switch to psych?? I can't handle this.

 

[Psoralin]

We've been trying but so far the response has been an unreasonable No. Despite our pleas with the Ministry they have only responded with quotes from their guidelines, and have not once acknowledged any of the specific details of our current circumstance. To say we feel helpless is an understatement.

 

[MontereyMD]

Now you know how concrete thinking, inflexible, obsessed with the process Canadian government and Canadian institutions are....where did you graduate from medical school? Are you an IMG? If you have citizenship from another country you should ask that other country for a J-1 visa.
If you are an IMG then you don't have much hope as the Canadian medical system is micromanaged by Health Canada and there are already too many Canadian medical graduates.

 

[Biohazard1]

I agree with the above statement, the whole system seems to be unsympathetic to such situations, I would contact your MP ( who hopefully is a conservative) who maybe can put some pressure on the health ministry. In addition I would contact your provincial government.

I assume you applied category b? If I recall correctly the quota does not apply to category A applicants (CMG), which in my opinion is discriminatory.

Perhaps you can make a case that in addition to your personal circumstances that as per nrmp you are obligated to show up.

What makes the situation even more annoying is that they only release the yearly quota list very late, by that time every body has already applied to respective specialities and have gone on interviews.

The whole process pisses me off.

I wish I could me of more help.

 

[Old_Mil]

Talk to your government and see if they will negotiate a prisoner exchange: me, a board certified EM attending for you two budding radiologists. We can even trade passports at the border.

Alternatively, just come in on a visitor visa and over stay it. The US government will probably grant you amnesty during residency along with the 25 million other people already here.

Sent from my Z10 using Tapatalk

 

[NewCanadian]

.... I would contact your MP ( who hopefully is a conservative) who maybe can put some pressure on the health ministry. In addition I would contact your provincial government.

Asking an MP won't help because an MP is federal. the decision maker is the provincial ministry of health, not the federal ministry.
Contacting the MPP might help if the MPP cares about health care.
A 'conservative' MP and MPP agree with the conservative policy of downsizing health care. I don't see any help coming from them but...

Why was the OP not first in line?

 

[Biohazard1]

The statement of need is given out by health canada, the list is also put out out by health canada.

The reason I said "conservative mp" was because the conservatives are in power; but yes the appeal process maybe better handled by the provincial counterparts.

 

[NewCanadian]

We've been trying but so far the response has been an unreasonable No. Despite our pleas with the Ministry they have only responded with quotes from their guidelines, and have not once acknowledged any of the specific details of our current circumstance. To say we feel helpless is an understatement.

I looked at the website and the list, and it clearly explains the list is prepared by the provincial ministries of health. It is posted on the health canada website because that's who issues the Statement on behalf of the provinces.

The 'conservatives' are responsible for the current situation in health care delivery.

 

[Biohazard1]

Yes it is prepared with input from all of the health ministries at the provincial levels, however the quotas put in place stand for all of canada.

But as stated he should appeal to his provincial authority. But I would put pressure at the federal level as well.

 

[NewCanadian]

When you write 'federal level' what you you think of? pressure on who or what?
federal government? that would be Harper.
federal 'conservative' MP? that would be someone who does what Harper says.
federal minister of health? nope, the minister is only vaguely aware of the program.
federal ministry of health, ie. health canada? it's a processing center, not a decision making center.

if the provincial ministry of health says there is no need, why wouldn't someone show evidence otherwise?

 

[docnotsopc]

.

 

[Psoralin]

My wife and I went to school in Europe making us IMG's. We know the difference between H1 and J1 very well, and we opted for J1 because supposedly it was "easier" to get, and not many programs that offer fellowships sponsor the H1. After we matched we sent our documents to Health Canada as fast as we could but it was already too late.

This is where the real insanity of this lies. They wait until you Match, and then enforce their quota. That is so crazy. Not only that, they released the Specialties in Need on November 7th 2013. That was two months after we started the application process and already had interviews. Were we supposed to just throw that all away? I cannot accept no as an answer in this case. There is literally nothing stopping anybody in my provincial health ministry from offering us a Statement of Need, they're just stubbornly saying no at the moment - but they could, if they wanted.

 

[NewCanadian]

.... and not many programs that offer fellowships sponsor the H1. After we matched we sent our documents to Health Canada as fast as we could but it was already too late..... Not only that, they released the Specialties in Need on November 7th 2013. ... There is literally nothing stopping anybody in my provincial health ministry from offering us a Statement of Need, they're just stubbornly saying no at the moment - but they could, if they wanted.

So you knew there was a quota. did you send your paperwork to healthcanada on the same day as the match or did you wait and send it in later? umm, did you try showing there is a need somewhere the ministry people don't know about?

[I don't see how a later fellowship is relevant, but that's just my ignorance I suppose. ]

 

[NewCanadian]

... If I recall correctly the quota does not apply to category A applicants (CMG), which in my opinion is discriminatory..

would you please explain why you see this as discriminatory.

I could only guess you might think the 'quota' should apply to all applicants regardless what category is being used. I don't know, so I'm asking.

 

[Medstart108]

OP, you still haven't answered where you went to school? Are you an IMG? or a CMG at a US school? (FYI, going to a carribean, Irish, Australian med school and completing your clinical years in american does NOT make you a Canadian Medical Grad. Only going to a school on American soil does in the eyes of CaRMS)

You and your wife both applied to a program granting J1, not an H1B. Im shocked at how many Canadians studying medicine abroad dont know the difference and their limits. It's a really unfortunate situation, and no matter how rude I sound, you should have done your research before investing in a 4 year, multiple hundred thousand dollar investment. Myself and the other Canadians I know studying in US knew this information before we even started medical school.

Your only option will be to take the year off as someone suggested, or scramble into a field as deemed in need by the ministry of health. (if you can even scramble anymore). Sorry for sounding harsh, but its the truth.

Damn man, I think this is overly harsh. You are basically telling a guy and his wife who's world just imploded and did everything right, clearly did good on exams, did good in interviews and matched into a dream match that he should have regretted decisions he made 4+ years ago?

Also, you are expecting a guy to have "done his research", how could he have predicted this chain of events 4 years ago. Hmm, i know, i'm going to do very well in medical school, decide I like radiology and match in my dream match in Radiology as a couple and then get shafted by the Canadian government. If anyone had foresight like that he would be sitting atop a mountain of wealth just by playing the stock market.

You cannot blame this guy for not working hard enough, you can't blame this guy for not doing his research, you can't blame this guy for anything really. Worst of all the person who rejected you is a faceless bureaucrat and you can really do nothing about it.

To be honest, even if the Canadian gov doesn't need another radiologist, I don't see why they can't just give you a J1. I mean most J1s just stay here for 2 years and can easily return back to the US for a job if they can't find a job in Canada. Technically you could even just do another degree to occupy your time and then return to the US.

If you can't even feel some sympathy for a guy who basically did as good as any IMG can do, (I believe he scored 99.5 percentile on his MCCEE but didn't match in Canada}, got matched in the US as a couple and got rejected at the end by the bureaucrats in Canada, I worry how you could feel any sympathy for a patient that has a self inflicted illness.

 

[Psoralin]

Thank you for that, sincerely.

 

[PteFabulous]

Hey man,

It sucks that you are in this situation. I feel for you. I have no experience with SoN's, but I would recommend calling anyone and everyone that could possible have any sway over the situation. So your provincial rep, MP, and others as people have already stated above. How I see it, you don't have anything to loose and sometimes the only way to get things done is by annoying the right people. Good luck.

 

[Psoralin]

For anybody still following this thread - you might be interested in this as well. It's Ontario's Population Needs-Based Physician Simulation Model from 2010:

http://www.healthforceontario.ca/Us...hers/needs-based-model-report-oct-2010-en.pdf

It is from the same Ministry that is denying us the Statement of Need and it clearly shows a dire need for Radiologists across the board in Ontario well into the future. They are ignoring their own report and destroying our lives in the process.

 

[Substance]

For anybody still following this thread - you might be interested in this as well. It's Ontario's Population Needs-Based Physician Simulation Model from 2010:

http://www.healthforceontario.ca/Us...hers/needs-based-model-report-oct-2010-en.pdf

It is from the same Ministry that is denying us the Statement of Need and it clearly shows a dire need for Radiologists across the board in Ontario well into the future. They are ignoring their own report and destroying our lives in the process.

The spreadsheet-makers at the MOH will not be of any help to you. They are powerless clock-punchers.

You need to consult the MPP and state your cases (and your intention to return to Canada, of course).You need to be persistent in this. The needs-based-assessment does state that radiologists will be in high demand in Ontario, so the people you have been speaking to either are stupid, have no idea of this document, or are sadistic anti-doctor *****s. If that doesn't work, go to the press (Deb Matthews ***** government denying Ontario physicians!). Furthermore, Ontario is not the only province in Canada. If Ontario is being unreasonable (as they often are), try one of the lesser-desirables like New Brunswick or Manitoba.

I think I know exactly who you are speaking to at the Ontario MOH, and trust me, you will get nowhere.

 

[MontereyMD]

This is situation has happened before and it shows how Canada is such a laughing stock of the medical world for Canada's obsession with the process.

Same thing happened to a neighborhood friend and it ruined his life.

It's called the native born Canadian disadvantage as ironically someone with two citizenships can get a J-1 visa.

The friend who was Canadian born went to RCSI and graduated in 2006. His family spent $250-300K on all the living expenses, tuition, travel in Ireland. He did all the exams USMLE and MCC exams, scored really well. Then he matched with hard to get into ER residency at Johns Hopkins. Everything was going great and he traveled to Baltimore to rent a condo and assumed that the J-1 application was a formality after all that hard work but NO, the Health Canada department stonewalled him and refused to give him the statement of need. He had to withdraw and resign from the match and the employment agreement. As he was a Irish graduate he ended up going to Australia and now lives near Sydney. But that was when it was relatively easy to get into Australia.

Ironically, he told me, a fellow RCSI graduate who grew up in Trinidad but somehow got Canadian citizenship through a relative and never actually had ever lived in Canada also matched in the US with a FM residency. She was able to get a J-1 visa through Trinidad, did her US residency then went to Toronto after graduating in 2009 and now works in Toronto! Can you believe it! Someone who had never ever lived in Canada but has a Canadian passport is now able to work in Canada as a physician while the native born Canadian, who grew up in Canada, went to school and University in Canada, paid all those taxes for years is now exiled to the other side of the world thanks to some mundane rule. Its really sad too because my friend missed a lot of his family life and his mother died while he was in Australia....the guy is really bitter about it.

Now someone who faces this same problem is really screwed as it is really difficult to get into Australia or remain in Ireland.

 

[almirbhf]

I believe that MoH issues unlimited statements of need for Family Medicine. ^

 

[Substance]

I believe that MoH issues unlimited statements of need for Family Medicine. ^

I'm not surprised by this. Family medicine is considered the most "in need" specialty and thus gets the most attention.

I guess the government rightly thinks that the only way to get people into that turd is to force it upon them.

Are you sure the SON is federally determined? I had thought SONs are determined provincially. If I am correct, try other provinces.

 

[Psoralin]

The SON is handed out by Health Canada as that is a US requirement, but they derive their quota from conversations with the provinces/territories about what specialties they need. The only problem with this is that they have no way of checking (or if I'm correct after my conversations with them) they have stopped checking to see if the first-come-first-served applicants are from the province that actually needs their specialty, so it's pointless.

In the past people in my situation were able to shop around to other provinces but this year most provinces are telling us they will only give a SON to a resident. But believe me, we are trying everything possible in our power to get a statement, even if it means going to the Territories we'll do it, there's far too much on the line to let it go simply because some poorly thought out quota system and faceless bureaucrats are telling us to.

 

[Medstart108]

I'm not surprised by this. Family medicine is considered the most "in need" specialty and thus gets the most attention.

I guess the government rightly thinks that the only way to get people into that turd is to force it upon them.

Are you sure the SON is federally determined? I had thought SONs are determined provincially. If I am correct, try other provinces.

FM is not turd dude.

 

[Substance]

FM is not turd dude.

In all cases no, but rural remote family med can be a very undesirable job for a lot of people, which explains why retention and recruitment is so dismal.

 

[Psoralin]

Truth be told, it's the US that is requiring the SoN. The problem is Canada pretending there is 'no need' for specialists, or if there is a need, the quota is laughably small (only two Cardiac Surgeons, really Canada??).

I have come to the realization that the quota Canada comes up with is based on Staffing needs, not population needs. Maybe they only need two cardiac surgeons because that's all there's room for in hospitals, but that doesn't mean wait times still aren't outrageously long. Basically, the government can't afford to have more doctors in the country because they would be billing the system more and therefore costing them more money. So providing ****ty access to healthcare is actually in the governments best interest because it's cheaper for them.

 

[Substance]

Truth be told, it's the US that is requiring the SoN. The problem is Canada pretending there is 'no need' for specialists, or if there is a need, the quota is laughably small (only two Cardiac Surgeons, really Canada??).

I have come to the realization that the quota Canada comes up with is based on Staffing needs, not population needs. Maybe they only need two cardiac surgeons because that's all there's room for in hospitals, but that doesn't mean wait times still aren't outrageously long. Basically, the government can't afford to have more doctors in the country because they would be billing the system more and therefore costing them more money. So providing ****** access to healthcare is actually in the governments best interest because it's cheaper for them.

Bingo. Rationing is the name of the game in our great nation!

I'd go all out with the MPPs, MPs, and other provinces. Seriously, try NS or MB. Be persistent. Call their politicians too. Get your name in for an ROS. If they are stonewalling, make the terms extremely favorable for them (and bad for you; long term, high interest rate on the payback should you leave etc)

 

[Psoralin]

The provinces are only providing SoN for residents of that province - which I have also come to learn is a violation of the Canadian Charter of Rights and Freedoms by preventing movement and access throughout the country. The SoN is a document that states I will be returning to Canada - not Ontario, Alberta or any other province so what right do they have in restricting my access to it if they have a need.

 

[Psoralin]

Health Canada is telling applicants for the SoN that their First-Come First-Served system is fair. How can it be a fair system if I am physically unable to apply for a SoN before somebody else because of life circumstances? What if I was at a funeral? What if I was hit by a car and in the hospital? What if I am a fourth year medical student and on Match day I am working in Intensive Care. Should I drop everything and leave because I need to rush my application for a SoN to Health Canada? Should everything I've worked for over the past 4 years be thrown in the toilet because I wasn't able to send my application in fast enough? It's like they never gave it any thought.

Imagine applications for med school worked the same way. Screw your MCAT scores, your volunteer work and your university transcript. First to apply gets in. It's laughable, but for some reason the people who came up with this policy at Health Canada think it's an appropriate method for people to get into residency. Unbelievable.

 

[NewCanadian]

OP: Advocacy is a difficult task. It requires the person speaking for you to represent you and speak with your sense of integrity. A good advocate would not twist the facts to suit them.

I hope you choose someone who speaks with integrity. It reflects on you.

best of luck.

 

[Psoralin]

In this case the facts are quite clear and there is no need to twist anything. The provinces and territories in Canada have come together to implement a poorly thought out policy that is unfair and also violates a number of Canadian Charter rights. If anything, I'm extremely pissed to be in this position in the first place, wasting my time with this nonsense when I could be doing literally anything else.

 

[Luckydoc19]

Psoralin, I went through this last year and got my letter of need. If you want some advice fell free to private message me.

 

[AStark]

In this case the facts are quite clear and there is no need to twist anything. The provinces and territories in Canada have come together to implement a poorly thought out policy that is unfair and also violates a number of Canadian Charter rights. If anything, I'm extremely pissed to be in this position in the first place, wasting my time with this nonsense when I could be doing literally anything else.

While this is an extremely unfortunate situation (and hopefully will work out), I'd like to know just which sections of the Charter this pertains to. No one is entitled to any kind of regulatory endorsement to get a visa to train and work in another country. The US can discriminate against non-citizens in any way it wants. This does serve as something of a cautionary tale for would-be IMGs.

Otherwise @MontereyMD , Health Canada in no way "micromanages" any aspect of the health care system. Residency training is administered and funded entirely at the provincial level, and health human resources planning *at best* consists of a patchwork of provincial organizations.

 

[Psoralin]

The government policy of allowing Ontario residents to only appeal to their own province violates Section 6 of the Charter of Rights and Freedoms. In additoin, it further violates the Agreement on Internal Trade Chapter 7 (2009) which regulates internal movement and which Ontario is signatory to.

 

[NewCanadian]

The government policy of allowing Ontario residents to only appeal to their own province violates Section 6 of the Charter of Rights and Freedoms. In addition, it further violates the Agreement on Internal Trade Chapter 7 (2009) which regulates internal movement and which Ontario is signatory to.

I don't agree.

After training in the United States, you can apply for a medical licence in any jurisdiction. You are not prohibited from working anywhere in Canada if the home province - Ontario in your situation - is the one to approve your application for a Statement of Need.

Mobility Rights
Marginal note:Mobility of citizens

• 6. (1) Every citizen of Canada has the right to enter, remain in and leave Canada.
  
  
• Marginal note:Rights to move and gain livelihood
  (2) Every citizen of Canada and every person who has the status of a permanent resident of Canada has the right
  
  • (a) to move to and take up residence in any province; and
    
    
  • (b) to pursue the gaining of a livelihood in any province.
    
• Marginal note:Limitation
  (3) The rights specified in subsection (2) are subject to
  
  • (a) any laws or practices of general application in force in a province other than those that discriminate among persons primarily on the basis of province of present or previous residence; and
    
    
  • (b) any laws providing for reasonable residency requirements as a qualification for the receipt of publicly provided social services.
    
• Marginal note:Affirmative action programs
  (4) Subsections (2) and (3) do not preclude any law, program or activity that has as its object the amelioration in a province of conditions of individuals in that province who are socially or economically disadvantaged if the rate of employment in that province is below the rate of employment in Canada.
  

About the AIT and licensed physicians: (available on the websites of the College of physicians and Surgeons of Ontario and the College des medicins )
If you possess a medical licence and you want to apply for a medical licence in another province or territory, you can do so more easily due to the AIT. Whichever province approves a Statement of Need has no effect whatsoever on where you seek a medical licence.
One example:
If you have RCPSC (or CFPC) certification and LMCC and a 'standard canadian medical licence' in Quebec, then you can apply for a medical licence in Ontario more easily.
Another example:
If you have a 'restricted' medical licence in Ontario, and you want to apply for a licence in another province or territory, it is up to the licensing authority to decide how to view your credentials.

I get it that you're angry and you're searching for reasons to blame others for violating what you assume is your right - to obtain a United States visa (permit) to enter the United States, but from what I have read, you did choose the type of visa to ask for.

There is advice on this thread and possibly the other thread on valuemd, and I have to wonder why you are not taking it.

 

[Medstart108]

While this is an extremely unfortunate situation (and hopefully will work out), I'd like to know just which sections of the Charter this pertains to. No one is entitled to any kind of regulatory endorsement to get a visa to train and work in another country. The US can discriminate against non-citizens in any way it wants. This does serve as something of a cautionary tale for would-be IMGs.

Otherwise @MontereyMD , Health Canada in no way "micromanages" any aspect of the health care system. Residency training is administered and funded entirely at the provincial level, and health human resources planning *at best* consists of a patchwork of provincial organizations.

I don't think its the US discriminating its the Canadian government. The US just requires a visa, J1 or H1B. With H1B you need the step 3 and most programs don't sponsor H1Bs. With the J1, Canada needs to provide you with a statement of need.

Considering that after J1 you return to Canada for only 2 years, if you can't find a job then you can always go back to the US after those 2 years or try and find a way of working rural for 3 years RoS in the US. I don't see why the gov should be putting such arbitrary limits. One of the few times Canadian citizenship holds you back. For example, for IM there is an unlimited number, but for Gen Surg there are only 6. For Cardiology, there is an unlimited number of J1s and for Gastro there is a very small limit.

I'm sure there are Canadian residents who want to move to the US for fellowship, has this J1 requirement ever held any of them back before?

 

[Luckydoc19]

Medstart is correct, the US is more than happy to provide the J1 visa to incoming foreign physicians. The issue here is the CANADIAN government refusing to say "yes this is ok, you can go train there then come back to your home country". The US will give the permit immediately upon receipt of the SON (barring any huge, immigration red flags), as it's essentially promising the US government you have a home to return to. The funny thing is the visa from the US only requires you to return to your home country for 2 years. So essentially the Canadian government is ruining the livelihood of a doctor b/c for 2 years they feel they don't have the funding for them (which is laudable given that these quotas change yearly and will be completely different in 5 or so years when the above physician is done training).

 

[MontereyMD]

While this is an extremely unfortunate situation (and hopefully will work out), I'd like to know just which sections of the Charter this pertains to. No one is entitled to any kind of regulatory endorsement to get a visa to train and work in another country. The US can discriminate against non-citizens in any way it wants. This does serve as something of a cautionary tale for would-be IMGs.

Otherwise @MontereyMD , Health Canada in no way "micromanages" any aspect of the health care system. Residency training is administered and funded entirely at the provincial level, and health human resources planning *at best* consists of a patchwork of provincial organizations.

If Health Canada isn't micromanaging all aspects of health care in Canada then what the f are they doing denying this medical graduate an opportunity to complete a residency in the US. Health Canada government workers have a lot of free time on their hands to enforce directives from above. What else would all these aging Canadian government workers who are just a couple of years away from a fully indexed taxpayer funded pension after 20 years service be able to do anyway except screw peoples lives up. Its the Canadian inferiority complex to drag successful Canadians back down to the Canadian mediocre state of affairs...that's why high achieving and successful Canadians whether they are scientists, scholars, musicians, celebrities move overseas or to the US as soon as possible to prevent being stiffled by Canadian mediocrity...Canadians are the only people on earth who would rather screw their fellow citizens than help them achieve success

 

[Medstart108]

If Health Canada isn't micromanaging all aspects of health care in Canada then what the f are they doing denying this medical graduate an opportunity to complete a residency in the US. Health Canada government workers have a lot of free time on their hands to enforce directives from above. What else would all these aging Canadian government workers who are just a couple of years away from a fully indexed taxpayer funded pension after 20 years service be able to do anyway except screw peoples lives up. Its the Canadian inferiority complex to drag successful Canadians back down to the Canadian mediocre state of affairs...that's why high achieving and successful Canadians whether they are scientists, scholars, musicians, celebrities move overseas or to the US as soon as possible to prevent being stiffled by Canadian mediocrity...Canadians are the only people on earth who would rather screw their fellow citizens than help them achieve success

Canada has tall poppy syndrome.

 

[Psoralin]

I don't agree.

After training in the United States, you can apply for a medical licence in any jurisdiction. You are not prohibited from working anywhere in Canada if the home province - Ontario in your situation - is the one to approve your application for a Statement of Need.

Mobility Rights
Marginal note:Mobility of citizens

• 6. (1) Every citizen of Canada has the right to enter, remain in and leave Canada.
  
  
• Marginal note:Rights to move and gain livelihood
  (2) Every citizen of Canada and every person who has the status of a permanent resident of Canada has the right
  • (a) to move to and take up residence in any province; and
    
    
  • (b) to pursue the gaining of a livelihood in any province.

Why should Ontario have to approve me. The J1 Visa requires I return to Canada, not any specific province. The policy preventing me from being endorsed by another province blocks my ability to pursue the gaining of a livelihood there after training through a Return-of-Service agreement which in the opinion of several lawyers (which I believe you are not) violates the Charter.

This is all aside from the following facts as well:

1) there IS a Demonstrated NEED for Radiologists in the Province of Ontario, and Canada as a whole (yes we have proof of this)
2) the only publicly available data on the physician job market in Ontario shows a huge need for radiologists. The Canadian Medical Association references this exact report on its profile page for Diagnostic Radiology when speaking about the large predicted need for these specialists well into the future.
3) Health Canada released their List of Needed Specialties almost TWO MONTHS after the US residency application period started and they expect students to be able to do something about it at this point when it is WAY too late to change anything.
4) That Statements of Need are handed out first-come first-served which is bad for Canadian patients as there is no judgement of the applicants merit before giving out the Statements, so who knows if the best people are being trained? In addition, they are given after the Match, so those unfortunate enough to miss out on the quota are forced to wait another year potentially before they can try again with no future guarantees.

So please, tell me again why I shouldn't be upset to be treated like this by my country and province? Especially considering they have contributed nothing to my medical education and will contribute nothing to my residency training? It means nothing to the bureaucrats to say No; their life goes on the same. However, by saying No they can take away everything from me even though it has no impact on their jobs whatsoever. But I shouldn't be upset according to your logic. I think you should have more empathy to people in this situation and advocate for change rather than suggest ways to fight the system or work loopholes around these obviously flawed policies.

 

[Psoralin]

@MontereyMD - Can you please send me a PM, I want to ask you something.

 

[PistolPete]

OP, so terribly sorry you have to go through this. I had to deal with even more bull**** as a DO when I applied and thank god I matched at a program on an h1b visa, and your story above is one of the reasons why the Canadian graduate medical education is so screwed up. You could sue the ministry of health but it'll be in a government court that will no doubt just side with the government, but maybe talk to a lawyer and see what your options are. Other than that I don't have many ideas for you. If you graduated from a US med school you could use optional practical training for intern year, but this wouldn't apply if you're a Canadian medical grad (didn't read all the posts above).

 

[Psoralin]

Update: We got our SoN, but this is going to happen again next year for sure and that's not right. More Canadians studying abroad need to know that a quota will be released two months after they've already applied to the US, and they have no control over the numbers. Worst of all, most of the quotas affect specialties that are highly competitive adding insult to injury. Beyond anything in their control, they may be shut out before the Match even happens. There needs to be change to the policy but I'm doubtful anybody cares enough to get it done.

 

[almirbhf]

Update: We got our SoN, but this is going to happen again next year for sure and that's not right. More Canadians studying abroad need to know that a quota will be released two months after they've already applied to the US, and they have no control over the numbers. Worst of all, most of the quotas affect specialties that are highly competitive adding insult to injury. Beyond anything in their control, they may be shut out before the Match even happens. There needs to be change to the policy but I'm doubtful anybody cares enough to get it done.

Out of curiosity, how did you end up managing to get a SoN out of them? Congrats btw !

 

[NewCanadian]

Update: We got our SoN, but this is going to happen again next year for sure and that's not right. More Canadians studying abroad need to know that a quota will be released two months after they've already applied to the US, and they have no control over the numbers. Worst of all, most of the quotas affect specialties that are highly competitive adding insult to injury. Beyond anything in their control, they may be shut out before the Match even happens. There needs to be change to the policy but I'm doubtful anybody cares enough to get it done.

I am disappointed to read you are "...this is going to happen again next year for sure..." and you are "doubtful anybody cares enough to get it done".
My guess is you don't really know how many people were involved and who made the decision to issue your letter and why.

 

[Substance]

I am disappointed to read you are "...this is going to happen again next year for sure..." and you are "doubtful anybody cares enough to get it done".
My guess is you don't really know how many people were involved and who made the decision to issue your letter and why.

This is rich...some admin coming on here and getting snippy.

Thank you for your tireless efforts to maintain the numerous bureaucratic barriers that make the system more expensive and less effective than it could be.

 

[Psoralin]

My guess is you don't really know how many people were involved and who made the decision to issue your letter and why.

You would be correct because after everything we went through, and after everything we argued there was not a single response from either Health Canada or the MOHLTC that directly addressed the problems with the current policy that put us in the position to be denied a Statement of Need. No acknowledgement that it is wrong to release the quota two months after the US Match opens. No acknowledgement that it is wrong to put in place a quota based on data that is not publicly available to medical students trying to plan their future careers. No acknowledgement that it is grossly unfair to issue the Statements of Need on Match Day on a first-come first-served basis with no regard for the students merit, or the fact that they will be shut out for an entire year and potentially screw over their entire future careers in the process. It is almost as if they don't want to admit any fault on their behalf...

It would have been nice to know how many people were involved, and who made the decision to issue our letter, and why. Instead, in the end, the MOHLTC made it seem like they finally gave us the Statements because we were able to provide them photocopies of our Ontario drivers licenses - like that's all that was missing and it was no big deal. I have no reason not to believe this wont happen again, and there has been no indication given from Health Canada, the MOHLTC or any other provincial health ministry that changes will be made to the process that screwed us over so badly. If I was a Canadian studying medicine abroad I would be raising hell with anybody who is willing to listen to ensure this doesn't happen again.

And you also raise another good point - how many people were involved? How many bureaucrats, how many students, how many lawyers? How much money did this whole debacle cost? Tens of thousands of dollars charged to Canadian tax payers over the governments mistakes, not their own.

 

[NewCanadian]

I can't see why health canada would offer you an explanation of why ontario issued your letter. did you yourself ask ontario why it issued your letter? they might answer you if you asked, although they might not tell you what you want to hear.

I don't understand your proposal to issue statement of need before you match because you can only apply for a statement once you have a training position. Students who find a training position outside the match can apply for a statement for family medicine and psychiatry - no limits on those. What's wrong with that?

I don't understand your proposal that the administrator at health canada should decide on your merit. How can a person who is not a physician decide on your merit?

Here's what I guess they mjght do. Some of it is clearly tongue-in-cheek.

You yourself have to prove there is a need for your services in the future.
Only the really high need fields like family medicine and psychiatry would be on the list of needs. Otherwise, you prove there is a need for your specialty.
Return-in-service contracts !
You have to prove you live in Canada.
Pass canadian medical examinations to extend your visa.
Lists of needs sent to all program directors across the US. Post on NRMP. Post on ECFMG.
Have a list of needs in the same way quebec does it: only certain fields are supported, no exceptions, ever.
Have a list of needs valid for five years.

I don't know how many people were involved in your case. Wish I did.

"Some admin"

 

[Substance]

I can't see why health canada would offer you an explanation of why ontario issued your letter. did you yourself ask ontario why it issued your letter? they might answer you if you asked, although they might not tell you what you want to hear.

I don't understand your proposal to issue statement of need before you match because you can only apply for a statement once you have a training position. Students who find a training position outside the match can apply for a statement for family medicine and psychiatry - no limits on those. What's wrong with that?

I don't understand your proposal that the administrator at health canada should decide on your merit. How can a person who is not a physician decide on your merit?

Here's what I guess they mjght do. Some of it is clearly tongue-in-cheek.

You yourself have to prove there is a need for your services in the future.
Only the really high need fields like family medicine and psychiatry would be on the list of needs. Otherwise, you prove there is a need for your specialty.
Return-in-service contracts !
You have to prove you live in Canada.
Pass canadian medical examinations to extend your visa.
Lists of needs sent to all program directors across the US. Post on NRMP. Post on ECFMG.
Have a list of needs in the same way quebec does it: only certain fields are supported, no exceptions, ever.
Have a list of needs valid for five years.

I don't know how many people were involved in your case. Wish I did.

"Some admin"

I sense a great deal of sour grapes from you, what with the repeated mention of family medicine and psychiatry, both fields that are in need because they're not very good options. The OP wants to do radiology, which according to the MOH is in more need than either of the above.

Administrators do no noble task. They sop up taxpayer money to check boxes and make life more difficult for others.

I hope the conservatives win the election and trim the vestiges from the government positions. If you're one of them, maybe you'll have to go back to nursing - there's certainly a need for nurses.