Internal Med IMG move to Canada

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AC_Int

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I'm a general internist practicing in the US and I may have to consider a move to Canada in the near future

Can someone help me understand how the licensing works in Ontario? I read through the website and it appears that IMGs with board certification can apply for a restricted license (supervised). Does someone know if that covers Internal Medicine Board Certification? I've heard conflicting information about that being true because my residency is only three years, as opposed to 4 years as in Canada.

I've been writing to other provincial boards and at least one (New Brunswick) said I was eligible for licensing if I land a job offer.

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I'm a general internist practicing in the US and I may have to consider a move to Canada in the near future

Can someone help me understand how the licensing works in Ontario? I read through the website and it appears that IMGs with board certification can apply for a restricted license (supervised). Does someone know if that covers Internal Medicine Board Certification? I've heard conflicting information about that being true because my residency is only three years, as opposed to 4 years as in Canada.

I've been writing to other provincial boards and at least one (New Brunswick) said I was eligible for licensing if I land a job offer.

http://www.cpso.on.ca/Policies-Publications/Policy/Pathway-4-–-IMG-with-US-Postgraduate-Training-and

For Ontario at least, it is the easiest province in the sense that with pathway 4, you don't have to do any additional Canadian exams. The provincial colleges are responsible for all physicians in that province, so yes that also includes internal medicine. On the other hand, while it might be easier to set up shop in Ontario, what you are getting is a restricted license, meaning that you need to have a supervisor (someone watching over you). This arrangement may be ok with you, or it may not. Imagine having to meet your supervisor once a week at first, then once a month (for 18 months) so they can review your patient care, go over your encounter notes with you and provide feedback to the CPSO. Then at the end of 18 months, having the CPSO assess you again. Would you be ok with that? The CPSO may give you a full license after 18 months, but there's no guarantee of that.
As for the other provinces besides Ontario, pathway 4 does not exist, meaning you have to go through a lengthy and complicated process of assessing your residency training, taking the equivalent Canadian board exams, maybe even doing extra training due to the length discrepancy between the US and Canada.
 
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Thanks so much for your reply!

Yes, I'd be agreeable to considering a 12 month supervision period. At the end of that, if I'm awarded a full license, does that come with any riders at all? For instance, does it limit where I can work or what settings?

In the US, I practice largely as an outpatient internist, with minimal hospital work. My understanding is that would be difficult in Canada. I have no trouble with a largely (or entirely) inpatient job either. I enjoy doing both. I was wondering if the license at the end of the 12 month period would restrict between inpatient vs outpatient
 
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Assuming your assessment was positive, and they give you an independent license, there should be no limits to your practice type or location. You can do in/out patient IM, but the problem with outpt internal medicine is whether you'll be able to get enough referrals from family docs in order to pay your bills. You'll likely need to supplement your outpatient work with larger volumes of inpatient work for stable income.
 
Thanks a lot- I'd be perfectly happy with just doing inpatient. I just wanted to make sure that its possible to get a license without any riders at the end of the assessment- which seems to be the case

Does having a full license in Ontario allow you to apply for licenses in other states in the future? It's unlikely I'd want to move elsewhere but just want to research my options
 
Thanks a lot- I'd be perfectly happy with just doing inpatient. I just wanted to make sure that its possible to get a license without any riders at the end of the assessment- which seems to be the case

Does having a full license in Ontario allow you to apply for licenses in other states in the future? It's unlikely I'd want to move elsewhere but just want to research my options

That would be the "Canadian Standard", which is described here. http://www.cpso.on.ca/Registering-t...Ontario/FMRAC-Agreement-on-National-Standards
It's a law that basically says that if you have a medical license in one province, then you should be able to also get a license in any other province (provided those elements for the link above are met).
In your case, with pathway 4, it's not exactly the same as obtaining a license in another province without the said pathway (you would need to go through retesting, more training, etc etc in provinces outside Ontario). So whether you can claim the Canadian standard law to get licensure in another province (after getting full license through pathway 4 in Ontario) is debatable. Perhaps calling the College of another province and ask would be advisable.
 
I don't know your reasons of moving to Canada. But this is the third thread about someone asking about how to move out of the US and hit up north!
It is sad seeing how politics is creating a wave of US trained physicians who are trained to practice in the US would rather go through all these hoops simply because the situation in the US is getting too uncomfortable

Again I have no idea about your reasons. Just an interesting observation
 
mashmetoo, would you be able to comment on referrals? I'm a Canadian citizen by birth but have lived nearly my whole life in the US. I practice outpatient only internal medicine and I'm curious what that looks like in Canada. In the USA, I'm simply a primary care provider with a much larger share of complex or geriatric patients, and I won't do any obgyn or see patients under 16 years old. It sounds like in Canada an internist does not provide primary care?
 
mashmetoo, would you be able to comment on referrals? I'm a Canadian citizen by birth but have lived nearly my whole life in the US. I practice outpatient only internal medicine and I'm curious what that looks like in Canada. In the USA, I'm simply a primary care provider with a much larger share of complex or geriatric patients, and I won't do any obgyn or see patients under 16 years old. It sounds like in Canada an internist does not provide primary care?
In canada internal medicine is a residency path to medicine sub-specialties. There is general internal medicine but it too is a fellowship for a total of 5 postgraduate years. Internal medicine specialists generally do not practice primary care, they are either inpatient/outpatient consultants or hosptialists. Pediatrics is the same for the most part. The medical system in Canada has mostly shifted to a tiered model where family medicine (and emergency docs) are your point of access to the health care system, where you are then referred on to a specialist by your primary care provider, who manages that issue for you, and reports back to the primary care provider who coordinates your overall care. General internal medicine are pretty much exclusively hosptialists, but other medicine subspecialities do outpatient consults. Note that geriatrics is its own subspeciality.
 
GIM physicians are not "pretty much exclusively hospitalists" at all. Most do some degree of inpatient work, often through community/regional ICU coverage, emerg admissions, and limited admissions as MRP. The mainstay is consultation in the outpatient and inpatient setting, stress testing, and other diagnostics, with considerable variation depending on practice settings. Some focus more on obstetrical or perioperative medicine or thrombosis.

Hospitalists are generally family medicine trained and maintain varying degrees of office practice alongside inpatient coverage.
 
I know.. it's something completely different: but how about the other way. Can a Canadian IM licensed physician get ABIM board certified? Can an ABIM BC physician get an unlimited US license to practice? I am a US physician practicing IM in Germany, since many years, thinking of moving closer to family in Chicago. It seems so complicated, oy weh!
 
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