Going back to Canada with MD from US

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When the Moon Forgot

When the Moon Forgot

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Dear all,

Got in one of my dream schools. Will hopefully be graduating from a top 5 medical school in the US few years down the road. I'm thinking of returning to Canada ultimately to practice for personal reasons. I am also a Canadian citizen.

Hope to pursue IM followed by a fellowship such as cardiology, endocrinology, infectious diseases, or heme/onc. Ob/gyn is also a possibility, and so is derm.

What are the different pathways to go about doing this?

I heard it's best for me to complete my residency and fellowship in the States before heading back. Any suggestions?

Where could I find helpful information about licensing equivalents?

Any help is sincerely appreciated. :)
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It'll be a long and complicated process, with many things out of your control. What do you know so far? What research have you done into coming back?

You'll need to know about the following:
US Visas - F1, H1B, J1, Health Canada, Statement of need
US exams: USMLEs1,2ck,cs,3
Canadian exam, MCCQE1,2
Royal college assessment process.
If Ontario - CPSO Pathway 3.

Once you know all of this, you'll begin to understand what it would take to come back.
I went through a similar path, so I know this won't be easy.
If you are feeling up for it, my book (signature) talks about exactly the things you need to know to pull this off.
 
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mashmetoo said:
It'll be a long and complicated process, with many things out of your control. What do you know so far? What research have you done into coming back?

You'll need to know about the following:
US Visas - F1, H1B, J1, Health Canada, Statement of need
US exams: USMLEs1,2ck,cs,3
Canadian exam, MCCQE1,2
Royal college assessment process.
If Ontario - CPSO Pathway 3.

Once you know all of this, you'll begin to understand what it would take to come back.
I went through a similar path, so I know this won't be easy.
If you are feeling up for it, my book (signature) talks about exactly the things you need to know to pull this off.
Click to expand...

To be fair, there's a big huge difference between trying to come back with a DO vs an MD degree. One is equivalent to Canadian education in all match-related things, the other places you as an IMG which is a whole other set of challenges/biases when most people here aren't familiar with a DO degree.

Try premed101. There's more info there. And assuming you aren't talking about a DO school, then coming back for residency is likely the simplest route
 
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ConfusedChemist said:
To be fair, there's a big huge difference between trying to come back with a DO vs an MD degree. One is equivalent to Canadian education in all match-related things, the other places you as an IMG which is a whole other set of challenges/biases when most people here aren't familiar with a DO degree.

Try premed101. There's more info there. And assuming you aren't talking about a DO school, then coming back for residency is likely the simplest route
Click to expand...

No, that is incorrect. If he wanted to match through CaRMs, then yes, it is quite different as you say. What he's talking about is moving to Canada after he has received full ACGME training in the US, which is essentially the same as what you would do as a DO trying to come back. He's not talking about residency matching in Canada. This is about getting Canadian certification/licensing after full training in the US. Whether a DO degree is well known or not in Canada has nothing to do with the question at hand.

And FYI, even if the OP was a DO trying to come back (we're talking about after completing full training in the US), it would essentially be the same as that of a MD trying to come back.

Also, regarding the comment about coming back to Canada for residency being the simplest route.. that is also unfortunately not true. In general, it is hard to get residency training in Canada without attending a Canadian med school.

http://www.carms.ca/wp-content/uploads/2016/05/Table_1_Summary_of_Match_Results_English.pdf

This year, out of 33 US MDs who attempted CaRMs, only 18 made it back. I would hardly call those odds the "simplest route".
 
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Thank you both for your insightful answers. I am open to either pathway (e.g. coming back after full licensure or for residency). Regardless of which pathway, I am more concerned about the career prospect in Canada. Of the specialties I listed, are there certain ones that I should avoid? Are there specialties that make it easier to come back due to physician shortage in those areas?

Are there websites that are good starting points for preliminary information? I basically don't know anything about this process.

I also heard that prestige of the medical school matters very little to residency programs in Canada. Successful match usually depends on performance at the "away" rotation, and going to a top MD school in the US confers no advantages. Is there any truth to this?

My preference at this stage is to stay within the US system for residency and fellowship (meaning taking the USMLE and going through residency as well as fellowship matches).

Once again, thank you both for your help.
 
mashmetoo said:
No, that is incorrect. If he wanted to match through CaRMs, then yes, it is quite different as you say. What he's talking about is moving to Canada after he has received full ACGME training in the US, which is essentially the same as what you would do as a DO trying to come back. He's not talking about residency matching in Canada. This is about getting Canadian certification/licensing after full training in the US. Whether a DO degree is well known or not in Canada has nothing to do with the question at hand.

And FYI, even if the OP was a DO trying to come back (we're talking about after completing full training in the US), it would essentially be the same as that of a MD trying to come back.

Also, regarding the comment about coming back to Canada for residency being the simplest route.. that is also unfortunately not true. In general, it is hard to get residency training in Canada without attending a Canadian med school.

http://www.carms.ca/wp-content/uploads/2016/05/Table_1_Summary_of_Match_Results_English.pdf

This year, out of 33 US MDs who attempted CaRMs, only 18 made it back. I would hardly call those odds the "simplest route".
Click to expand...

And you think that rate is equal or better for DO's?

Nothing against it, I would have considered it myself if I didn't get into canadian schools, but it is missleading to say that that it would be the exact same as a CanadianUS-MD trying to come back. Again, I don't mean to argue or say it's not possible, but it is very different only being about to apply as an IMG instead of a CMG for Carms.

Which of course I agree in that it's maybe easier to do residency in the US if you're a DO, but then there's all the visa things which is in constant flux with IM fellowships.

And the fact that finding a job in fields like Cardio often requires at least a year or two, often more, of fellowships to get a job here. Coming from a training system people here don't know/understand wouldn't help matters.
 
ConfusedChemist said:
And you think that rate is equal or better for DO's?

Nothing against it, I would have considered it myself if I didn't get into canadian schools, but it is missleading to say that that it would be the exact same as a CanadianUS-MD trying to come back. Again, I don't mean to argue or say it's not possible, but it is very different only being about to apply as an IMG instead of a CMG for Carms.

Which of course I agree in that it's maybe easier to do residency in the US if you're a DO, but then there's all the visa things which is in constant flux with IM fellowships.

And the fact that finding a job in fields like Cardio often requires at least a year or two, often more, of fellowships to get a job here. Coming from a training system people here don't know/understand wouldn't help matters.
Click to expand...

We are literally talking about different things here. I already agreed with you, if you are talking about the CaRMs match, then yes, MDs in theory have it a lot easier since they match with the CMGs, DOs with the IMGs. No question there. But the 2016 match rate was 54%, take for it what you will. I could give you the DO stats for Canada this year, but no, I'm not going to bother. The point is, if you want to train in Canada, the best way is to get into a Canadian med school. Unfortunately, not everyone is lucky enough to pull it off, so people go overseas, or the US.
If you read the OP's initial question, the question was on pathways to get back to Canada after US residency/fellowship training and licensing equivalents. No where did he mention he was interested in the CaRMs match initially, until you brought it up.
I certainly am not talking about Canadian residency matching, I am talking about getting Canadian licensure after US ACGME training. And I'm going to say this again, it is essentially the same whether you are a MD or a DO. It's not misleading, it's not some magical unobtainable object. It's simply a sequence of documents you submit to the provincial colleges/royal college to get another stamp and document that says you are now considered equivalent to a Canadian provider. When I say that it is essentially the same, I wonder what you think I mean by that? I'm not talking about the match success rate, I'm not talking about impressing some Canadian residency program, I'm talking about the paperwork you have to go through to get Canadian equivalency, which is essentially the same for both degrees.

The visa issue you speak of is not DO specific, it affects any non-US citizen doing postgraduate education in the US (MD, IMG, all are affected).
 
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Thank you for both of your help. I did a preliminary job search on each provincial health ministry's website, and was shocked to find that the job market seems pretty bleak for most specialties I'm interested in (e.g. no job openings in most provinces for cardiology and heme/onc). A few derm, ob/gyn, and ID openings in BC and Alberta. Most openings are in Ontario.

Am I pretty much limited to family medicine if I return to Canada?
 
Divine Comedy said:
Thank you for both of your help. I did a preliminary job search on each provincial health ministry's website, and was shocked to find that the job market seems pretty bleak for most specialties I'm interested in (e.g. no job openings in most provinces for cardiology and heme/onc). A few derm, ob/gyn, and ID openings in BC and Alberta. Most openings are in Ontario.

Am I pretty much limited to family medicine if I return to Canada?
Click to expand...

What's the actual job market like, though, Ontario in/near major metro areas? I keep hearing that jobs are no-where to be found near Toronto and only in the boonies, but I hear from other Canadian attendings who live in the US that jobs are amazing in Canada, so I don't know which is true?
 
PistolPete said:
What's the actual job market like, though, Ontario in/near major metro areas? I keep hearing that jobs are no-where to be found near Toronto and only in the boonies, but I hear from other Canadian attendings who live in the US that jobs are amazing in Canada, so I don't know which is true?
Click to expand...
It's bad. Really bad.

The jobs are great if you have one, but just try and look for jobs online in surgery in Canada. You won't find many.
 
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Psychiatry fares better. Just checked the number of openings for psychiatry in BC. There are 12 permanent positions and 1 locum hiring in the Greater Vancouver area (Vancouver, North Van, Richmond, Surrey etc). Job market is substantially better than IM/surgery but obviously not as great as family med.
 
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Divine Comedy said:
Psychiatry fares better. Just checked the number of openings for psychiatry in BC. There are 12 permanent positions and 1 locum hiring in the Greater Vancouver area (Vancouver, North Van, Richmond, Surrey etc). Job market is substantially better than IM/surgery but obviously not as great as family med.
Click to expand...

Cool, thanks!
 
PistolPete said:
What's the actual job market like, though, Ontario in/near major metro areas? I keep hearing that jobs are no-where to be found near Toronto and only in the boonies, but I hear from other Canadian attendings who live in the US that jobs are amazing in Canada, so I don't know which is true?
Click to expand...

Definitely the former. US attendings are not up to date on the job market in Canada, they are probably about 10-15 years behind. The job market was good back in the 00s until the great recession. Right now in IM there are jobs in GIM but i've recently met some GIM fellows who are doing sub-fellowships in hopes of finding jobs. Now they may be looking for a GTHA job, but the market is pretty much poor in all of IM except for Rheum, GIM (which may be getting worse).

The general rule is if you want to do invasive (where much of the money is) you'll find trouble getting a job.

I've come across many fellows in fields that formerly had plenty of jobs doing second or third fellowships waiting for a job to open up. I would recommend just doing your residency in the states and IM sub spec fellowship as well. At that point if you are still interested in staying in Canada you might want to do a sub-fellowship in Canada which would help you find a job, or depending on your field and job market just coming back to Canada to practice. The problem is even more acute for surgery specifically Ortho and Cardiac where jobs anywhere are short.

Also, the job market might change in 10 years when you start practicing, so keep that in mind. Especially as someone now in the States with a foot in the door in two countries, as long as you are open to where you end up (and you should be considering ur already in the states), you'll be fine with most specialties.
 
Medstart108 said:
Definitely the former. US attendings are not up to date on the job market in Canada, they are probably about 10-15 years behind. The job market was good back in the 00s until the great recession. Right now in IM there are jobs in GIM but i've recently met some GIM fellows who are doing sub-fellowships in hopes of finding jobs. Now they may be looking for a GTHA job, but the market is pretty much poor in all of IM except for Rheum, GIM (which may be getting worse).

The general rule is if you want to do invasive (where much of the money is) you'll find trouble getting a job.

I've come across many fellows in fields that formerly had plenty of jobs doing second or third fellowships waiting for a job to open up. I would recommend just doing your residency in the states and IM sub spec fellowship as well. At that point if you are still interested in staying in Canada you might want to do a sub-fellowship in Canada which would help you find a job, or depending on your field and job market just coming back to Canada to practice. The problem is even more acute for surgery specifically Ortho and Cardiac where jobs anywhere are short.

Also, the job market might change in 10 years when you start practicing, so keep that in mind. Especially as someone now in the States with a foot in the door in two countries, as long as you are open to where you end up (and you should be considering ur already in the states), you'll be fine with most specialties.
Click to expand...

Thanks! I'm actually taking an attending job here in the States, but just wanted to keep Canada in mind for the future.
 
Medstart108 said:
Definitely the former. US attendings are not up to date on the job market in Canada, they are probably about 10-15 years behind. The job market was good back in the 00s until the great recession. Right now in IM there are jobs in GIM but i've recently met some GIM fellows who are doing sub-fellowships in hopes of finding jobs. Now they may be looking for a GTHA job, but the market is pretty much poor in all of IM except for Rheum, GIM (which may be getting worse).

The general rule is if you want to do invasive (where much of the money is) you'll find trouble getting a job.

I've come across many fellows in fields that formerly had plenty of jobs doing second or third fellowships waiting for a job to open up. I would recommend just doing your residency in the states and IM sub spec fellowship as well. At that point if you are still interested in staying in Canada you might want to do a sub-fellowship in Canada which would help you find a job, or depending on your field and job market just coming back to Canada to practice. The problem is even more acute for surgery specifically Ortho and Cardiac where jobs anywhere are short.

Also, the job market might change in 10 years when you start practicing, so keep that in mind. Especially as someone now in the States with a foot in the door in two countries, as long as you are open to where you end up (and you should be considering ur already in the states), you'll be fine with most specialties.
Click to expand...

Thank you & super informative! Looks like I'll stay in the US for both residency and IM sub-specialty fellowship before making the move to head back north.
 
Divine Comedy said:
Psychiatry fares better. Just checked the number of openings for psychiatry in BC. There are 12 permanent positions and 1 locum hiring in the Greater Vancouver area (Vancouver, North Van, Richmond, Surrey etc). Job market is substantially better than IM/surgery but obviously not as great as family med.
Click to expand...
Is there centralized data or are you using province-specific sites for this info? Would it be possible to get the links from you?
 
To help out prospective docs who hope to return, I've compiled a list of provincial websites listing physician jobs:

British Columbia
https://www.healthmatchbc.org/

Alberta
http://www.doctorjobsalberta.com/

Saskatchewan
http://www.saskdocs.ca/

Manitoba
http://www.healthcareersmanitoba.ca/physicians.html

Ontario
https://hfojobs.healthforceontario.ca/en/list/?p=1

Quebec
http://www.fmrq.qc.ca/en

Nova Scotia
http://www.nshealth.ca/physician

New Brunswick
http://www2.gnb.ca/content/gnb/en/corporate/promo/careers_in_healthcare.html

Newfoundland
https://www.practicenl.ca/?/jobs/default.asp

PEI
http://www.healthjobspei.ca/index.php?number=1024780

Yukon
http://www.yukonmd.ca/

Northwest Territories
http://www.practicenorth.ca/index.php?page=physician-jobs

Nunavut
http://www.nunavut-physicians.gov.nu.ca/


Please correct me if any of 'em is erroneous.
 
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Four years of medical school
Three years of residency
Two years of fellowship

I think it is way too early to be contemplating the job market because things will change.
 
bannie22 said:
Four years of medical school
Three years of residency
Two years of fellowship

I think it is way too early to be contemplating the job market because things will change.
Click to expand...
Did you end up matching back to Canada or staying in the US?
 
Aside from the job market in Canada vs. the US, what kind of a process is there to come back to Canada after completing med school (MD) and residency in the US? I heard from someone that when you come back to Canada, there is a period of time where you have to work under some kind of supervision and aren't completely autonomous until they can verify that you're capable enough to practice on your own. Can anyone verify if this is true or not? I tried doing some searching on this but struggled to find anything concrete. I also realize this might be province dependent.
 
kegar99 said:
Aside from the job market in Canada vs. the US, what kind of a process is there to come back to Canada after completing med school (MD) and residency in the US? I heard from someone that when you come back to Canada, there is a period of time where you have to work under some kind of supervision and aren't completely autonomous until they can verify that you're capable enough to practice on your own. Can anyone verify if this is true or not? I tried doing some searching on this but struggled to find anything concrete. I also realize this might be province dependent.
Click to expand...

On the contrary, there's actually quite a few posts on the "Canada" page of this forum on the exact topic of returning to Canada after US residency training. I have personally answered this question a few times. Check out my previous posts.
 
Doing rheumatology fellowship here and don't mind taking exams to get an unrestricted license, question is how is the job market for Rheum in Canada?

Excellent by the way in the US
 
sidefx said:
If you go to medical school in the US, especially a top medical school there, then your chances are exponentially higher of getting the residency training you desire in the US, at highly reputable institutions. Even though "theoretically" graduates of US and Canadian schools are to be granted equivalent standing in residency applications and are not officially classified as IMGs, they are still treated more like IMGs in practice. You can look up detailed match statistics that show the match rates of CMGs in the US and vice versa, and their match rate is much closer to that of IMGs than it is to domestic graduates. If you go to medical school in Canada, apply to residency in Canada. If you go to medical school in the US, apply to residency in the US. Or you can just apply to both, but be aware that the match in Canada occurs first, and if you match in Canada you will automatically be removed from the US match. So in essence you can't just simply cherry pick whichever country's offer you like better if you apply to both.

When you finish residency you can practice in either country after you write your royal college / US board exams for whichever country you wish to practice in, so for you it'd be better to just take a solid US residency position and then practice in Canada afterward if that's where you're looking to end up imo.
Click to expand...
If you have an idea about how complicated the process is would mind sharing your insight about practicing in Canada for someone trained in the US residency/training?

My question is in terms of getting licenses to practice in Canada? Job market? Salaries?

Likely looking to practice in Ontario in rheumatology if that helps for a better guidance in any way?

I really appreciate any guidance
 
snarkie said:
Just FYI, please take a look at this: 2017-2018 List of Needed Specialties for Issuing Statements of Need under Category B - Canada.ca

Starting in 2017, US fellowships opportunities for Canadians are becoming very limited. You listed quite a few subspecialties under IM, but now you cannot apply for anything besides 1 year palliative and geriatrics fellowships under IM.
Click to expand...
Is that also saying that basically no fellowships after general surgery are being endorsed anymore? Either 1 or 2 years....
 
It seems the following fellowships in gen surg will not be endorsed:
  • General Surgery - Pediatric General Surgery
  • General Surgery - Thoracic Surgery
  • General Surgery - Surgical Oncology
Also, 1-year ACGME accredited; training is limited to one of: Colorectal Surgery or Surgical Critical Care will also have to go through category C starting in 2016, which also implies that they will also not be endorsed.

Sorry, I'm not very familiar with surgery fellowships in general (going into IM myself), but the above is my interpretation from the document.
 
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snarkie said:
It seems the following fellowships in gen surg will not be endorsed:
  • General Surgery - Pediatric General Surgery
  • General Surgery - Thoracic Surgery
  • General Surgery - Surgical Oncology
Also, 1-year ACGME accredited; training is limited to one of: Colorectal Surgery or Surgical Critical Care will also have to go through category C starting in 2016, which also implies that they will also not be endorsed.

Sorry, I'm not very familiar with surgery fellowships in general (going into IM myself), but the above is my interpretation from the document.
Click to expand...
Thank you for clarifying that! I was afraid it meant that only 1 year fellowships, other than CRC/crit care, would be endorsed.

This really is unfortunate-so many surgeons used to go to the US for the surg onc fellowship especially, since there are such limited options in Canada.
 
ConfusedChemist said:
Thank you for clarifying that! I was afraid it meant that only 1 year fellowships, other than CRC/crit care, would be endorsed.

This really is unfortunate-so many surgeons used to go to the US for the surg onc fellowship especially, since there are such limited options in Canada.
Click to expand...
I believe this is limited to those trained in US residency. Those in Canadian residency can still apply to any US fellowship without restrictions.
 
I think you're right, because this is for people under category B.

You can still definitely apply for Canadian fellowships without restriction. Bear in mind that at US residency graduates, you will be in a different pool than Canadian graduates, where the number of spots are significantly lower, making things much more competitive.
 
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