http://www.torstarreports.com/NASApp...=1034157759167
Foreign trained doctors give up hope of Canada

http://www.workopolis.com/servlet/Co...0030108/CADOCS
Foreign trained doctors can only get a job in rural/underviced areas of Canada

http://members.tripod.com/~IMGA/index.html
Ontario International Medical Graduate Program may close

http://www.aipso.ca/doctors_in_waiting.htm
Foreign trained Doctors in Waiting in Canada

http://members.tripod.com/~donalda13/faq.html
Frequently answered questions - answered

http://www.csa-notes.com/rescan.htm
Options for Canadians who are foreign medical graduates

http://www.guelphmercury.com/healthc...528103533.html
Foreign talent wasted in Canada

http://www.canoe.ca/Health0009/25_doctors.html
Doctor shortage in Canada to be solved by increasing medical school spots

http://www.canada.com/ottawa/ottawac...8-B1640F3A0C20
In Canada doctors earn the same as factory workers

http://www.torstarreports.com/NASApp...=1034157759167
Canadian students follow medical dream by going to the U.S.

http://collection.nlc-bnc.ca/100/201...sue-8/1028.htm
Canadian Medical Association on Foreign trained doctors in Canada

http://www.globeandmail.com/servlet/...N/breakingnews
Foreign trained doctors drive taxi cabs for a living in Canada

http://www.torstarreports.com/NASApp...=1034157759167
Canadians going abroad for MD degree can't come back home

http://www.trainyourbrain.ca/uafeatu...er/medical.pdf
Canadian students gamble on a foreign medical degree

http://www.carms.ca/procedure/provrule.htm
Restrictions exist in every province for Foreign Medical Graduates

http://www.pupatello.on.ca/Frames/Ne...2/20020402.htm
Despite MD shortages, Foreign-trained doctors still can't practice in Canada

http://www.canadasbraindrain.ca/home1.html
Canada's Brain Drain - the brightest Canadians move to U.S. and never come back

Well it's obvious how anoncan feels about pursuing a medical career in Canada as an IMG. In fact, your post indicates that you have a bit of an agenda. However anoncan, my feeling is that IMGs already know that pros and cons of practicing in the Canada vs the US. That is, they are going into it with eyes open. They understand the obstacles and are willing to make some sacrifices in order to realize some substantial benefits...chief among these for many IMGs is the chance to remain close to friends and loved ones. This alone can certainly outweigh any downside.

__________________
CanIMG
Moderator - Canadian IMG and Immigration Visa Forums

In a foreign land



Doctors from other countries are turning to odd jobs as they struggle to meet
the varying standards and training required to practise in Canada



By Celia Milne



There are as many stories as there are international medical graduates (IMGs).
Dr. Luis Monterrosa, a pediatrician who fled Colombia with his family, is
sweating night and day to become a doctor in Canada. He works nights at a
factory in Guelph, Ont., days as a medical research volunteer in Hamilton,
and evenings at an intensive English course.



Dr. Slobodan Lemez, a family physician who left Bosnia for Toronto with nothing
but two suitcases, has passed all the Canadian medical exams but may never
get his licence. With four mouths to feed, he can't take a year off from
paid work to do residency training. Dr. Chafic Farhat, a well-respected thoracic
surgeon in Sao Paulo, Brazil, for 30 years, now runs a pizza restaurant in
Fredericton, N.B.



&Currently, we are wasting these untapped resources,& says John
Connors, an international health-care consultant in Stoney Creek, Ont. &At
the same time we are showing them very little respect, care and
concern.&



Connors works with IMGs from South America. Time and time again he has seen IMGs
get tripped up by the bureaucratic system. &No one, least of all these
aspiring professionals, is seeking to lower the standard. Rather, they are
seeking some understanding and assistance in achieving the same Canadian high
standard that is recognized around the globe.&



Stories of physicians' talents going to waste are poignant in a country
desperate for doctors. &We're way short of physicians,& says Dr. Rod
Crutcher, co-chair of the Canadian Taskforce on International Medical Graduate
Licensure. &Even if we weren't, there's the social justice argument that it
doesn't make sense to have so many people working below their skill
levels.&



In theory, the rules for IMGs to get licensed in Canada are loosening somewhat.
But the number of physicians who &make it& is still quite tiny. To
succeed, IMGs need not only good clinical skills, an ability to pass exams and
workable French or English, they also need a steady flow of money, endless
patience for bureaucracy, ruthless determination and, in many cases, lots and
lots of time. On the other side of the desk, those who make decisions about
IMG licensure have to balance the conflicting goals of quickly injecting new
physicians into the system while maintaining excellence and fairness.



Human rights challenges by IMGs from non-Commonwealth countries have served to
level the playing field. No matter what country physicians come from—whether
it's the Ukraine or the United Kingdom—they have to jump through the same
hoops. This has had the ironic effect of making it almost impossible for
Canadians who have studied overseas in countries like Ireland and Australia to
come home to be doctors. Only U.S. medical training is considered
equivalent.



Rules are different in each province. &The manner in which IMGs get trained
and licensed varies tremendously across the country,& says Dr. Francine
Lemire, director of the Clinical Skills Assessment and Training Program (CSAT)
run by Memorial University in Newfoundland.



Charged with making sense of it all is the Canadian Taskforce on International
Medical Graduate Licensure, of which Dr. Lemire is a member. By the end of the
year, the task force is expected to deliver recommendations on how to integrate
IMGs into the physician supply, adopt a fair and transparent process for medical
licensure and develop common guidelines for assessment.



Dr. Rod Andrew, director of the IMG program for B.C. and a member of the task
force, says uniformity across the country is desirable. &It would be ideal
to have an evaluation process in place whereby any physician from any part of
the world could be looked at. We could say, 'This person is well-trained, with
these deficits; this person clearly needs to go back to residency; this person
is not up to snuff.' But it isn't moving ahead quickly.&



Right now, B.C., for instance, only offers residencies for IMGs in family
medicine, not specialties, and there are only six spots in the whole province.
&The climate is changing but there haven't been changes,& he says.



The ebb and flow of Canadian IMGs over the years depends on policy decisions.
Canada has long relied on IMGs to meet its needs. In 1969, IMGs made up 24.3% of
Canadian physicians. In the late 1970s, this number grew to 30%. Then, in the
1980s, it looked as if there was a physician oversupply, so the percentage of
IMGs began to decline. In 2000, it was back down to 23%. Now, the need for IMGs
is strong again, and the pendulum will swing upward.



The basic path for an IMG to become licensed in Canada is to write the Medical
Council of Canada Evaluating Examination (MCCEE), follow a program in either
family medicine or in a specialty, and then pass the Medical Council of Canada
Qualifying Exam Part I and Part II. (MCCQEI and MCCQEII). Each exam costs
approximately $1,000 and residency work is largely unpaid.



The Canadian Resident and Matching Service (CaRMS), established in 1994,
operates in most provinces. It matches residents with programs and the match
occurs in two iterations. International medical graduates are able to apply to
the second round of matching.



The pass rates for both the MCCQE Parts I and II are lower for IMGs than for
Canadian graduates. Typically, on the first attempt, only 70% of IMGs pass
the MCCQEI, while fully 96% of candidates from Canadian medical school pass.
For the MCCQEII, 65% of IMGs pass the first attempt, versus 96% of Canadian
candidates.



It used to be the case that IMGs were defined as either category I or category
II, depending on where they went to medical school. Category I meant they
studied in the United States, Great Britain, Ireland, Australia, New Zealand or
South Africa. Physicians from any other country had to take additional training.
In a pivotal legal case, called Bitonti, physicians from Italy, Romania, the
Philippines and Russia who had been unable to secure employment as physicians in
B.C., argued they were discriminated against by the College of Physicians and
Surgeons of British Columbia. Category I and II distinctions were abandoned in
1993 and now all applicants for full registration must complete two years of
postgraduate training in Canada. It is the law in Canada that IMGs have their
skills assessed based on merit rather than assumption. &There shouldn't be
two classes of Canadians,& says Dr. Crutcher.



Here is a look at what happens now:



• EASTERN PROVINCES: Memorial University's CSAT program has been operating for
several years. The assessment program uses multiple choice examinations,
short-answer case-based therapeutics exams, structured oral exams, standardized
patient exams, and possibly psychological assessment to figure out whether IMGs
are ready to practise.



The program is used by other Atlantic provinces as well. Each may use the
results in a different way. For example, Dalhousie University in Halifax will
look at an IMG's CSAT results and make a decision as to whether that doctor will
be accepted into a two-year residency. In Newfoundland, if the physician is
deemed safe and competent, he or she may be given a provisional licence with up
to six months of residency training. Dr. Lemire, until a replacement is found,
is director of the CSAT program. (She has moved to Ontario from Newfoundland,
and now works at the College of Family Physicians of Canada in Mississauga.)



A big issue, says Dr. Lemire, is each province's capacity to support
postgraduate training. There is a need for much better support of doctors who
take on trainees. Dr. Lemire was a family doctor in Cornerbrook for 23 years and
remembers fondly older doctors who &held my hand and took me through&
various procedures. &Now-adays,& she says, &that mentoring
doesn't seem to be there to the same extent. It's too bad because it can make a
tremendous difference to a young doctor starting out.&



In order to practise family medicine in Nova Scotia, IMGs are required to do
undergo the Clinicians Assessment and Professional Enhancement (CAPE) process,
an evaluation tool developed at the University of Manitoba, if they do not have
at least one year of licensed clinical practice experience in North America.



• QUEBEC: It has the lowest percentage of IMGs in the country, at 12%. Quebec,
like other jurisdictions, recognizes certification of IMGs through a process
involving the MCCEE, MCCQEI and MCCQEII, as well as two years of clinical
experience. Information about additional steps can be obtained through the Collège
des médecins du Québec. Residencies are not available through CaRMS.



• ONTARIO: Over the past few years the number of available positions has
gradually increased from 24 to 50 per year. Ontario has announced with some
fanfare that it is helping advanced-level and entry-level IMGs enter the system,
but critics say so far there is more smoke than substance. Ontario's new
Eight-Point Plan, which includes 60 new advanced-level postgraduate positions
and 25 entry-level training positions to IMGs through CaRMS, is slow to take
off. &It is opening up in theory but in practice nothing has happened yet
and that announcement was four months ago. The number of positions announced has
increased but whether they get people into those is a question to me,& says
Joan Atlin, executive director of the Association of International Physicians
and Surgeons of Ontario.



In a controversial move, the government has established, as part of the
Eight-Point Plan, a fast-track process to assess and license physicians
practising outside Ontario, especially those willing to work immediately in
underserviced communities. This leaves IMGs in Ontario, like Dr. Lemez from
Bosnia, out of luck. &The eight-point program is nothing more than a
political game,& says Dr. Lemez.



Atlin estimates there are still between 3,000 and 4,000 IMGs actively seeking
an opportunity to be assessed in the province. &We don't support
fast-tracking those already in practice. There is a huge pool in Ontario already
waiting to be assessed. Also, it is unethical to be recruiting from other
under-serviced areas.&



• MANITOBA: Last year, Manitoba launched the first permanent program in Canada
to assist IMGs in obtaining medical licences. According to Dr. Ruth Simpkin,
director of the IMG program, three doctors finished the one-year enhanced
training program in January and eight more have started. Qualified doctors are
tested using the CAPE process. To qualify for the IMG program, physicians must
be Canadian citizens, have been living in Manitoba for at least a year, have
passed the MCCQEI, have a postgraduate position, and have completed a CAPE
assessment. The assessment takes three days. There is no application fee but
the assessment fee is $3,500. The four components are multiple choice
questions, structured oral interview, therapeutics assessment, and clinical and
communication skills evaluation. IMGs participating in the program agree to
practise in the sponsoring region of the province while on conditional
registration with the College of Physicians and Surgeons of Manitoba. Supervised
by a practice adviser, they have up to five years to obtain the LMCC. Another
path to practice is through CaRMS.



• SASKATCHEWAN: Saskatchewan has the highest percentage of IMGs in Canada, at
60%. It uses CAPE for assessments. Successful candidates have completed a
minimum of two years of postgraduate training, and have a minimum period of
eight weeks of that training devoted to each of internal medicine, pediatrics,
ob/gyn and general surgery. In Saskatchewan's Return of Service Agreement, the
applicant will find a practice location in an &area of need.&
Participation in the pilot project does not guarantee a physician will be
granted a licence to practise.



• ALBERTA: Dr. Crutcher, program director of the Alberta IMG program at the
University of Calgary, anticipates there will be 10 IMG residents graduating
this year. &These will be our first grads,& he says. He estimates most
if not all of them will stay in Alberta. There were approximately 50 applicants
for these positions. The top 40 write the Objective Structured Clinical
Examination (OSCE), and the top 20 candidates then advance to the interview
stage. Eight to 10 successful candidates undertake a four-month clinical
orientation leading to a residency in family medicine. The program focuses on
family medicine, internal medicine, psychiatry and selected other specialty
experience.



• BRITISH COLUMBIA: B.C.'s IMG program was established in 1992. It currently
has six IMGs going through its program, a sign of progress. &Originally
there were only two IMGs per year offered residencies in family medicine, then
four and now six,& says Dr. Andrew. In 2002, there were approximately 55
applicants for these positions. It is estimated B.C. has hundreds of unlicensed
IMGs who are working in other fields. The process involves an evaluation,
including an OSCE, and then a six- to eight-week clinical evaluation at St.
****'s Hospital. The successful candidates then take a six-month clinical
introductory program before starting a two-year family practice residency. Other
routes to practice are through an application to an under-serviced community or
through CaRMS.

<p>
Taken from:<br:
http://www.medicalpost.com/mpcontent...15_192845_3996

You mention many examples of IMG's who have emigrated to CAnada who are having a hell of a time getting in to practice. What about Canadians who go away to school and then come back; any stats on those?

By the way, I spoke to a physician, and past MLA in BC who I have known for some time and she said they are importing well trained SouthAfrican, Irish, and Australian trained into BC by the bushell load.

hmmmmm.....

Anoncan,

I am a Canadian living in the US as specified under the NAFTA. I have an American girlfriend that I have been with for 2.5 years (we met at Dalhousie). I am thinking of applying to St. George's for fall 2004 entry, assuming I get a rejection letter from Queen's this week (I'm not very confident of my chances).

1. Would I have a good chance at getting in to St George's, based on a 3.9 GPA, a 32/O MCAT, and a light to modest amount of ECs (I know that you won't know for sure, I was just wondering your opinion)

2. If I apply to Canadian schools next year too, can I work it so that I can wait to find out if I get into the Cdn schools, and then accept a St. George's offer after my chances in Canada were over?

3.If I were to get married to my girlfriend while doing my undergraduate medical degree in the Caribbean, how would this make things easier for me? Would I have to do the HB-1 step to land a residency?

THanks!

1. Would I have a good chance at getting in to St George's, based on a 3.9 GPA, a 32/O MCAT, and a light to modest amount of ECs (I know that you won't know for sure, I was just wondering your opinion)



Of course. Listen, Caribbean Medical schools will accept anyone that applies. I am not kidding.

With those numbers, you should apply to U.S. med schools. Heck what are you thinking!

Carib Med schools are the last resort. Meaning you go to one, after you have exhausted your options in U.S. and Canada.





2. If I apply to Canadian schools next year too, can I work it so that I can wait to find out if I get into the Cdn schools, and then accept a St. George's offer after my chances in Canada were over?



I'm not sure.
Just don't waste your time with repeat applications. You have obviously shown (with your grades) that you are capable and suitable for entry into med school. So you should attend as soon as possible.



3.If I were to get married to my girlfriend while doing my undergraduate medical degree in the Caribbean, how would this make things easier for me? Would I have to do the HB-1 step to land a residency?


If you marry a U.S. citizen, you can get a green card (as I am sure you know). That will make you a permanent resident of the United States. You can live and work in the U.S. forever.

Otherwise you will ne either the J-1 Visa or H-1B Visa.

Please see this post: http://www.valuemd.com/viewtopic.php?t=1588

for info on those visa's.

Do you really think I would be wasting my time with 'repeat applications', by applying to a bunch of Canadian schools again next year? I would plan on spending this year making myself more attractive as a candidate (I have no real healthcare-related volunteer experience). I applied to Toronto, Western, Queen's, and Dalhousie this year and had interviews at Queen's and Dal. I'm somewhat bitter at Dal - I traveled 1200km to my alma matter during the storm of the decade, had an awesome interview, and my rejection letter almost beat me home! The past few months have been depressing, because I had always figured that if I went to school, worked hard and got great grades, I'd be able to do what I wanted. I've been working for a year and a half now, and I feel like as time goes by my chances get slimmer. Anyway think that this is the case?
Anyway, the reason I'm asking all of this is because I don't have a full year of organic chem or a physics lab on my transcript, so it seems like I can't apply to any US schools, since every one that I've checked out has these as pre-reqs. I'd also have to write the MCAT again this August to apply in the US, because my scores are 4 years old. However, my scores are still good in Canada (they have a 5 year limit there). I've been out of school for almost 2 years, and if I screwed the MCAT up, I'd be blowing any chance of applying to any schools in North America!
Alright, I've rambled on for too long, and, frankly, no one likely cares about this stuff....I feel like I'm the guy at the bar going on about the girl who dumped him... but if anyone has any advice, I'm all ears
.... <---DEVIL EARS!

Basically, with your grades (3.9/32) You should start med school immediately.
Don't let Canadian med schools depress you.
Canadian med schools turn away (every year) highly qualified applicants. And although I can't say for sure, I have a strong suspicion that connections help those that get in.

Don't waste any time trying to fullfill pre-req's or volunteer crap.

Just go!

Where? well that's you decision. I did an enormous amount of research before deciding on the caribbean.

Then I did even more reseach to narrow it down to the school I ended up going to.

four years later, if you pass step 1, step 2, csa and toefl. You will get your ecfmg certificate and be in a position to apply for a residency in the U.S. and eligible to write usmle step 3.

Then you are set. . .for life.

hey Donald,
I totally understand your situation. I have always thought that after hard work and good grades (not as good as yours though!) that I would get into a canadian medical school. I finished my undergrad at UofT, did a masters of science at UofT and I have lots of EC's both in and out of the health care field (including overseas stuff). I also have 3publications. Needless to say that I got rejected from all 4 Ontario universities that I applied to;Not even an interview. I even applied to US schools- no such luck there either. When I called the US admission schools office they said that being a non-US applicant was becoming extremely more difficult ever since 911. Also, since i wrote my MCAT in August, I did not get my complete application in till about October/November- supposedly this is a bit too late for their rolling admissions. Anways, sorry for rambling on, but to make a long story short- I applied to SGU- got in and am going. I have thought about the same questions that you are going through- such as should I reapply again etc. But since I know that meds is what i want to do and since SGU is a great school- why not start now, since it is possible that in a year from now I will find myself in the same situation that I am in now (NO ACCEPTANCES).
These are just my two cents!
I hope that everything works out with you for Queens- good luck,
Nicola

Thanks Nicola,

Good luck at SGU! I will probably break down and call Queen's tomorrow and discover my fate - I'm living in the US, so it might take my letter another week to reach me. Thanks for the info about the MCAT and the rolling admissions in the US...I figured that it will put me at a disadvantage, but I might try anyway. I think that it might help me a bit if I apply to a few schools in my state (MA - Tufts, BU, Boston College), but being Canadian, I'm not too optimistic about my chances.
It is really unfair the way that Canadian med school admissions commitees look at grad students. It seems especially unfair in Ontario, although I would have thought that those publications would have helped you out.
Are you planning on living in the US after you finish school? Have you spend much time there? Wow, no snow for you for at least 2 years!