About halfway through Anmar Salman’s attempts to become a doctor in Canada, he almost gave up.
After studying medicine in his native Iraq and doing a master’s in public health in the U.K., he immigrated to Canada, found a job at the Ontario Ministry of Health, passed the necessary tests and applied twice to be matched to a residency. But both times he was unsuccessful.
“When I finished my exams and I wasn’t hearing back from any program, I thought, well maybe I need to be content with what I have. Because I know a lot of [foreign-trained doctors] who are doing menial jobs, driving cabs, pizza delivery,” he says.
Then a friend told him about Saskatchewan’s new recruitment program, SIPPA. He passed the exams and assessment, and is now a practising family doctor in the province.
Salman is one of many doctors trained abroad, known as international medical graduates. They are a well-established part of Canadian health care, with governments using them to add doctors to the workforce and ease shortages in underserved areas.
The landscape for them is becoming more competitive, thanks to an increase in the number of new doctors graduating from Canadian universities and rising numbers of international medical graduates trying to enter Canada. At the same time, Canadians who have gone abroad to study medicine are making up a larger percentage of the international group.
The options for international medical graduates
One quarter of Canada’s doctors trained abroad, and some provinces rely heavily on them. In 2012, international medical graduates (IMGs) accounted for 38% of Newfoundland and Labrador’s physicians, and 46% of Saskatchewan’s.
There are two routes for internationally educated doctors. Those who have completed residencies overseas can pursue restricted or full licences. However, many international graduates will need to do a residency in Canada to enter the system.
Canadian students who studied at an accredited school in the U.S. can compete directly with Canadian medical graduates for residencies. Those from other countries apply for a limited number of spots, which are often tied to return-of-service contracts that specify where in Canada they can or cannot work after they complete their residencies. The competition for these positions is handled through the Canadian Resident Matching Service (CaRMS).
The rise of IMGs in Canada
In Ontario, the first formal training program for IMGs began in 1987, with 24 designated training positions, all in family medicine. Those numbers stayed low in the 1990s, as the National Action Plan on Physician Resources Management resulted in a 10% reduction in medical school spots. But the pendulum started to swing back with the McKendry Report in 1999. IMG residency positions rose, and included specialties for the first time.
In 2004, the Canadian Task Force on the Licensure of International Medical Graduates recommended clearer standards and better integration of IMGs. That year, Ontario also increased its number of residency spots to 200. It remains there, making up almost half of the IMG positions across the country.
Those used to be second-round positions, which meant IMGs could only apply for them after Canadian graduates had gone through the first CaRMS iteration. But in 2007, IMGs were designated some spots in the first round of the match. “It gave them a broader range of career options,” says Sandra Banner, executive director of CaRMS.
‘It’s horribly competitive’
In 2011, just over 1,500 IMGs applied for the Ontario positions, but only 221 were matched. In comparison, 95 percent of new Canadian graduates matched in the first round of CaRMS in 2013. Almost all who are willing to accept any residency spot are matched after the second round.
“It’s horribly competitive [for IMGs],” says Sten Ardal, CEO of the Centre for the Evaluation of Health Professionals Educated Abroad. “They have invested money along the way – there’s a lot of investment – for a relatively small chance of actually getting accepted into the residency.”
On the whole, more IMGs now enter residency programs in Canada. In 2000, they made up 5% of first year residents; by 2011, that had increased to 15%. But because so many more now apply, the chances each will be successful has actually dropped.
Will Canada slow the flow of IMGs?
A recent CMAJ article about Canadians studying overseas suggests that as the number of doctors trained in Canada grows, it might become even more difficult for IMGs.
“In the 1970s and 1980s, government policy reactions to increasing medical cost pressures included impeding the flow of medical graduates into Canada. Given the dramatic increase in domestic training, it would not be a surprise to see new government policies with similar intent soon,” it reads.
The number of doctors in Canada has reached a high, and reports of unemployed doctors are increasingly common. Enrollment in Canadian medical schools has grown by 85% from 1997/98 to 2012/13. And physician supply increased by 4% a year between 2008 and 2012, outpacing population growth. However, the number of doctors per capita in Canada remains relatively low compared to other countries.
“You’re seeing some specialties, particularly ones that require complementary resources [such as operating room time], having trouble finding places,” says Morris Barer, co-author of the CMAJ article and professor at the Centre for Health Services and Policy Research at UBC. “My expectation is that that will spread to more specialties and become worse over time.”
Those under- or unemployed doctors might then influence government policies. “If we continue to see Canadian graduates ending up having trouble finding work, there’s going to almost inevitably be increased pressure from them to choke off the routes from outside the country,” he says.
But for many, the idea of not having IMGs feels un-Canadian.
“To us it’s a complete brain waste if we have these qualified international medical graduates who could be working within our workforce,” says Sandra MacDonald-Rencz, acting senior director for Health Canada’s health human resource policy division. “It’s important to be able to assess their credentials and integrate them if we have that need.”
The rural divide
IMGs are often used to help staff rural areas; they sign agreements to work in underserved areas for a set amount of time after their residency. But this can create a revolving door phenomenon, where doctors begin in rural areas, but soon move to urban ones. One study found nearly half of newly licenced doctors in Newfoundland and Labrador left after two years, and 87% had left by the seven year mark.
Recent information in the 2013 National Physician Survey suggests this may be more of an issue for IMGs than graduates of Canadian medical schools. IMGs are more likely to want to leave a rural area to practice in an urban area, with 19% of rural IMGs saying they intend to make the move, compared with only 9% of rural Canadian medical graduates. IMGs were also less satisfied with their personal and professional life balance than the Canadian graduates.
The rise of Canadians studying medicine overseas
The term IMG includes both immigrants and Canadians who have gone abroad for their medical degrees. The Canadian cohort has increased substantially over the past few years, with a 2011 survey suggesting more than 3,600 Canadians were studying medicine abroad.
In 2008, 12% of the IMGs in the CaRMS match were Canadians who had studied overseas. By 2011, that had increased to 25%. The shift has been so distinct that the Centre for the Evaluation of Health Professionals Educated Abroad changed its programming in response, says Ardal, the organization’s CEO.
The Canadian IMG subgroup also seems to enjoy an advantage: In 2011, they made up about 25% of IMG applicants, but obtained more than half of the first-year residency positions given to international medical graduates.
Over 90 per cent of Canadians studying abroad hope to return to Canada for their postgraduate training, and some people have even called for their preferential treatment over other IMGs. But that may be a violation of the Charter of Rights and Freedoms, since the Canadians would be getting ahead just because of their country of birth.
Adding to the confusion is the fact that many Canadians who study medicine overseas believe there is a doctor shortage in Canada. Students get their information from the media, where many articles are about shortages, says Barer. “So they will assume there are shortages, and they will assume there will be no problem getting in.”
Barer’s CMAJ article highlights the need for increased communication. “Policy makers in both government and medicine should be crystal clear” about prospects for Canadians thinking of studying medicine abroad, it reads. “Anything less seems irresponsible and invites understandable backlash.”
MacDonald-Rencz agrees that communication is an issue, adding that the Physician Resource Planning Task Force is working on the problem.
“I think many Canadian students who go overseas are surprised that they’re considered international medical graduates,” she says. “We do see that it is important that more information get out to people who are thinking of going and getting their medical education overseas, because I think many of them aren’t aware of this when they head off.”
The comments section is closed.
I’m a medical student studying in +2 right now. What are the minimum marks i need to study in canada. And what all are the courses that i can oppt. For.. Or apart from medical courses what all are the other courses i can apply for..
It’s hard to say what is the minimum marks to get into in Canada/US medical college since different universities look into different criteria.
Also it’s not like in South Asia that you must study Biology, Chemistry, Physics, Botany, Zoology ……..etc in your Advance level/High school/ +2 to get into medical college.
In US/Canada an engineer with engineering degree or singer with Art degree or salesman with business degree can get into the medical college(I know it may surprise you but it is 100% true and reality)
Your admission to medical college depends on number of factors mainly your grades(marks) from undergrad/master degrees, your experience, social/volunteer works, your referral …..etc.
As I know one of my colleague in Canada with engineering degree (A+ for 45 out of 48 courses – from university undergrad).No medical college in Canada open the door but didn’t give up, did master and worked for 4 years and finally got in. Hope this will help you …. Good luck
The limited training positions and unristricted license to practice Medicine in Canada should be reserved to Canadian citizen only not even to Permanent Resident
Privilege of practice of profession should be given first to Canadian citizen not to Canadian graduate or foreign IMG
It is ashamed to know that Canadian citizen MD is treated the same way subjected the same rules as with other foreign citizen MD in their own sovereign soil. Chasing , fighting and competing to practice their profession in their own country.
God help us so all citizen and especially our representative in Parliament to act boldly and swiftly.
Roy, I believe you misunderstood of this discussion.
There are thousands of Canadians who go abroad(IMGs) and earn MDs and expecting Canada should give privilege on hiring them(Their argument is they are Canadian citizen or PR and they need to get privilege)
But in reality Canada is treating all IMG as same ,doesn’t matter you are Canadian earn degree abroad or you are non-Canadian and immigrating to Canada with foreign degree.
There are very less % of non-Canadians (international students) get into Canadian medical college and they don’t have any issue on getting job in Canada(since they studied in Canada,did residency in Canada……….and wanted to practice in Canada,They automatically get high points if they want to become Canadian)
IMGs supplies are high and demand are low causing equation not to work
I am Canadian citizen, International Medical Graduate – Family Physician (South Africa), well experienced, and still, I find it difficult to get in the system because of the “IMG” stigma. I believe that the system should utilize these IMGs and train them formally in the Canadian universities, they should have at least one year of heavy proper training in all fields of medicine, ethics, public health and medico-legal issues in order to consider them equivalent to the Canadian Medical Graduates (CMG). The LMCC marks should be the only discriminating factor, in fact most IMGs are more experienced than CMGs when it comes to specialties, simply because they are specialists in their field. On the other hand, the number of medical students in the universities should be reduced; that will help the government to spend less money and get more doctors, which will lead, at the end, to reduce the burden on the health system by reducing some costs. How much does it cost to produce a Canadian Medical Graduate by teaching him/her 6 years? And, How much does it cost to train an International Medical Graduate one year? The difference is huge! I really feel sorry for the doctors who were told that Canada needs doctors! They should have announced, we need more cap drivers and pizza delivery people. It is sad but true!
You’ve missed the big part of this discussions. Are you telling the Canadian government and Canadian universities to limit the number of medical student to enroll its own students and import IMs’s? you should tell that to your country where you are practicing now….. Never will happen anyway here in Canada. We love Canadian “Smart students” who studied hard in our country ,challenge all obstacle and get into medical college and treat us as proud Canadian. We don’t need or welcome even any Canadian back doorers who go to Caribbean/Ireland/Russia/India and come with paid degree seeking job or any IMGs from the world
most of us confused Canadian Medical Graduate and Canadian Citizen.
Canadian medical school is to teach anybody to be a MD but not necessary a pass and the same as privilege to practice medicine in Canadian territory.
Canadian medical graduate who are not Canadian Citizen should either go to their own native land or apply to be Canadian Citizen
Limited training position and privilege to Practice Medicine is should be solely the privilege of Canadian Citizen in Canadian soil.
First and foremost, every doctor who is licensed in Canada should have to meet the same criteria that every Canadian med student trained within our borders must meet. Specifically, they must pass the Canadian qualification exam to become a certified doctor following residency. Even before that, however, they should also be required to pass a general examination before being allowed into a residency program. That being said, all preferences for Canadian born doctors should end there. If we are to maintain a high standard of quality health care, it is unrealistic to accept Canadian medical graduates from foreign institutions simply based on their country of origin. It is common knowledge, after all, that it is extremely difficult to gain admission to a Canadian medical school, and that many Canadian born would-be doctors go abroad just for that reason. Further, the Canadian medical exam for those who have completed their residency within our own borders is very stringent. Ask any newly licensed doctor who has written both the American and Canadian exams, for example, and they will tell you the American exam is not nearly as stringent. Thus, it would be unacceptable to accept Canadian born IMFs over truly foreign IMFs; the standards of accountability must rest solely on qualifications.
I agree with you Chrrah.
Also I would like to give my opinion that there must be more exam given to IMGs. Why? those people studied in Caribbean are preparing just for exam 4-5 years from 1st years and losing all fundamental of medicine. They are prepared for repeated question and answers and Canadian exams bank are not changing much every year. It’s not 1960s, my 15 years college diploma technician can do better than me with PhD, how and why?
They should assess separately and present competition is absolutely unfair . This policy will ruin IMGs life.
Canada is one of the best country in the world. It has 16 medical college and enrolment are for those smartest students. For 32M population ,16 universities are producing enough doctors. Don’t say shortage. Shortage are everywhere and not only in hospitals, rather it’s in schools, factories…etc and even 100 years later still there will be shortage.
Those Canadians who have money go abroad and earns cheapest degree does not deserve any preference to come back. Anyone who born in Canada can speak the language.They are not smart enough to treat the people in Canada and they better stays outside and treat those countries who provided the degree.
ERAS in the United states gives huge preference to Americans who studied abroad over the other IMGs and that is why it is so easy for them to get back to their home countries. I say CaRMs should do the same, because many of these canadians studying abroad have families and ties to Canada and it is disheartening to see us treated like others who never been to Canada before.
I think preference should be given to CMGs. Right now too much preference is given to IMGs.
IMGs have spots in the match specifically designated for them. However, as a practicing CMG physician who would like to retrain in another field, I cannot apply in round 1 and must wait until round 2. IMGs, however, have opportunities to apply to spots in round 1 that will certainly not go unfilled by the time round 2 comes. I think I, and other CMGs in my position, should have preference for these spots.
This is unfair. I am strongly considering going to America to pursue training in a different field. If they give me an opportunity to do so, I’ll certainly stay there after training is complete.
My fiancée is a doctor in India, and I hold a PR in Toronto.
After marriage, can she pursue masters in Medicine from any university in Canada also if she decides to practice, what is the procedure she has to follow.
Need help, Thanks
She does not need any master in Medicine at all. If she is an engineer then master will give some short of North American degree and help to find job.
Only she has to do is bring all original university degree transcript and any other related organization’s documentation….etc to proof she is IMG to Canada. She need to submit all and will be verified, prepare for the exams and write it and go from there…..It’s time consuming and lots of frustration, disappointment, peace less…….etc but if she’s smart enough ultimately she’ll be where she wanted.
Any IMG once qualifies all necessary exams , shouldn’t S/He be considered as Comparable to Canadian Medical Student ? I understand these exams are designed to challenge and test all aspects of medicine , and once a student has passed all these exams , student has demonstarted one’s skills.
If we put Canadian entry to practice system aside for a minute , which country in the world is most welcoming for a student to become a Doctor ?
I would personally, go to the country who needs me the most , I will be very happy to serve and help people of that country (who appreciates my telent rather where I aquired those) .
Any short list for name of countries ?
Help and input much appreciated.
thats pure racism! imgs tho teained and educated abroad are also canadians by immigration rules then why prefer canafia canadian educated abroad over newer canadians. Had the natives of canada done this to all the immigrants things would’ve been way different as they are now! do olease think again and vote logically and sensibly. Im an ImG striving to beat the system for last 8 years* now on the verge of nervous breakdown. please somebody explain this racial discrimination! ! canadian vs canadian
Your training may not be adequate to practice in Canada.
In those 8 years you could have attended university, obtained an undergradute degree, completed the MCAT, and applied to the medical schools across the US and Canada. Instead, you chose to whine about it.
Foreign-trained physician is not a race. The fact that you have a medical degree from a foreign country the quality of which we cannot verify does not entitle you to be a physician here. Your entitled attitude probably shows through when people are interviewing or evaluating you.
There is no racism. In fact, many Canadians who could not cut mustard to get into a domestic schools go abroad, and a lot of them are white. The opinion of them is the same as the opinion of you; their training may not be adequate to practice in Canada.
I do resent Anmar Salman stating that driving a cab or delivering pizzas are menial jobs. For some they have done their best and this is what they do proudly. I do give Salman credit for his hard work, but It seems that Salman still has a lot to learn.
lets not kid ourselves. they are memial jobs.
Hi l am an internist and nephrologist who had passed 4years of internal medicin residency and 2 years of nephrology residency period after finishing medical school (7 years) in my country. Now i am 45 and immigrate to canada. I am very attracted to work as a family doctor in canada. What should i do. Is there any possibilities for manitoba or saskachwan provience to get the licence directly or not. I would be thankfull if you guid me.
I can say only one: PLEASE confirm ,especially ,your spot to continue as medical doctor -If that’s what you are coming in).
I can say this since I see so many immigrants are disappointed by Canadian’s propaganda. A week ago met a medical doctor who was MOH (medical doctor of health) in his back home(South Asia). He has MBBS,FRCP..etc and was in charge of 2M people region and managed 7 MBBS and all other staffs. Came to Canada due to his relatives influence to immigrate and Canadian Govt’s propaganda. Now working as automotive assembly line worker in Windsor , Ontario to support the family (after tried past 14 months to practice medicine ……….still working on it……..May God help him )
Yeah saskatcjevan has newly IMG programme SIPPA
Search SIPPA and you will be directed to a link
Hey, how is everybody.
Here is my story, I worked as internist for 8 years, medical oncologist for 7 years, then I passed MCCEE, QE1, QE2, CE2, SWE, USMLE Step 1, 2 CK/CS, Step 3 & Internal Medicine postgraduate training in Qatar. I had hands-on training in the Hospitals of London, ON. I have spent 38,000.00$ on these experiences plus courses. I ended up broke & working as a research assistant.
Life is unfair for IMGs like me, match process is not transparent, nobody knows that Canada recruiting trainees from Persian Gulf countries to get money from these rich countries to make it hard for IMGs ( future Citizens making them losers in the future) & national graduates. The minority who matched into CaRMS, they made it through connections.
Why this torture and torment; just close the damn door on skilled(i.e. IMGs) immigration, especially lot of Canadians are saying that we are worthless. Unfortunate for people who are not refugee like me and spent there savings on promised lands…supposedly realizing it is a myth very late.
If Canadians think I should be driving a taxi with my MB BCh, I will stay in the USA (happily)
Thank you for sharing your story ! And would like to comment few but don’t have any intention to hurt any . You said “I am a young, smart, and hard working doctor who wants to help people”.
As I know (even many others) that majority of the people in the world are hard working and wanted to help/helping the people not only as doctors. To serve people doesn’t want to be a doctor at all and there are millions who help people deserve more than doctors. If you think you are the one (Drs) only help people then you are not deserve to be a doctor.
Well, I studied in Ireland (MB BCh BAO) and I am originally a Canadian (Calgary boy). I really feel like my country let me down – and I am a young, smart, and hard working doctor who wants to help people. I wanted to return and work in Canada but ultimately I was rejected. I’m now in residency at the Mayo Clinic. I do not anticipate returning home and am very happy to treat the many grateful Americans who are always fond of my international experience. The American system gave me the chance to compete against American MDs for spots in residency, whereas Canada essentially regarded me as a poor candidate. I see that they are happy to train middle eastern graduates without funding residency (eg. At the University of British Columbia). It is highly political and financial but due to the strong Canadian economy and new sense of nationalism, I highly doubt the system will change soon. At the end of the day, there is no funding for larger residency programs and it is the patients who suffer. I appreciate any Canadians who have the sense to see that international graduates want to return to Canada to help treat you. We have all worked tremendously hard to get where we are. Believe me when I say that studying medicine abroad (eg. Ireland, UK, Aus) is not an easily thing to do – you have to be tremendously resilient (without family supports) to travel and take the stress of board exams, rent, loans, etc. When I compare my skills to American MDs, I am certainly at par. I welcome any questions/comments.
hey Andrew shoot me an email jta7 @ live.com
Hi Andrew I am an IB Gr 12 student, planning to go to Ireland for med school. I am super stressed about the decision , reading all these comments only has increased my fear. Would you kindly contact ,me @ firstname.lastname@example.org
I have a friend who got into caribbean medical school (UMHS) with fine arts degree. Not even single biology or chemistry taken in high schools or during the university undergrad. Had tons of money to feed the admin and faculties and got the MD within 4 years, Now struggling to get residency but still hoeing money can do something. Had best respect when it come to Drs but now I need to look the biography to chose who can treat me !
No amount of money will allow your friend to acquire a residency. S/he is not a full doctor yet and so it is not right that you generalize your statement towards “all doctors.”
Not all Caribbean medical schools are the same. The students that study here study harder than any other Canadian medical student. We are required to cover everything in 25% of the time and go through a number of standardized exams to prove ourselves month after month. Some schools (UMHS) are sub-par compared to others and should not be used as a representation of all international medical schools.
Dear Carib Student: I usally don’t comment any owever like to say here:
“No amount of money will allow your friend to acquire a residency. S/he is not a full doctor yet and so it is not right that you generalize your statement towards “all doctors.”
If you say money cannot do much then you are not in this world, you should know how many smarter students than you in your high school/ university who really wanted to become doctor but did not have money forgot the dream and doing something else?
“The students that study here study harder than any other Canadian medical student”
Really, you make me to laugh, if you study hard you should have admitted in Canadian/US University, instead dumb students who has money seeking back door to become MD thru Caribbean
“We are required to cover everything in 25% of the time and go through a number of standardized exams to prove ourselves month after month”
Yes, I agree with you, you’re required to cover all in 25% ,where you are missing the foundation of real medical doctor. And 75% (even more) of the time you are taught to prepare for the licensing exams from day one of medical school.
4-5 years of preparation with repeated Q&A for licensing exams lead you to pass the exams and that’s the unfortunate of the common medical examination system.
I agree with you Raj
FYI, there are people with these kinds of backgrounds (and worse) at your best medical school (UofT)!! Shows how ignorant the average Canadian is about their own country!
A situation where someone is offered a job as sensitive as health care delivery( to care for peoples life and well being) simply because the country of birth is Canada, amounts to denying the unsuspecting public the opportunity of getting health care service from the best brains possible. It simply leaves the people with a very limited and restricted option of being attended to by the best possible doctors.
For the sake of the Canadian patients, all doctors for the Canadian Residency Match should be given a level playing field . A healthy competition between the IMG from other countries and the IMG of Canadian citizenship, will simply provide the public the best brains and hands in the care of patients. The best brains and hands should be given the opportunity serve the good people of Canada.
It is almost impossible for Canadian Students who want to become Canadian Doctors to gain entry into one to the Canadian Medical Schools as spots are so limited. For those who truly want to become Doctors they are forced to take alternative routes such as Caribbean Medical Schools. It is devastating to find out that it is almost impossible to come back to Canada, yet Canada accepts IMG’s from all other countries not giving Canadian IMG’s first chance. Most Canadian Medical Students that are IMG’s end up in United States. That is why we have a shortage of properly trained Canadian Medical Doctors. I have family living in undeserved areas and have IMG’s from various countries that have totally different value systems especially regarding women and are treated very badly by these doctors. Further they can barely speak English…people in outer areas are forced to seek proper medical treatment in the closest Urban area to where they live. No sure who is making these decisions in Canada but are medical system is going down the tubes…give our Canadian born IMG’s a hand up, not a hand out. Paying these foreign IMG’s that are not from Canada money to set up offices in rural areas only to have them leave and return to urban areas to live with their own cultures is not solving anything, only costing Canadians more in both expertise and finances.
It is unfortunate that it is so difficult for a Canadian student to be admitted into a Canadian university to study medicine. Far too many Canadian students are forced to study internationally due to the entrance requirements set in Canada. As Canadians we would be able to easily satisfy the needs of rural doctors by simply allowing quite capable Canadian students entrance into our medical schools. It makes no sense to a Canadian tax payer that our own Canadian students easily qualify to enroll into accredited medical programs internationally but cannot gain entrance to our own universities.
Nice discussion going on .
An example : one of my friends wife advised CT-scan for headache , revealed nothing , so advised MRI with appointment after almost a month , why ? because appointments were full , can you believe ? Who is responcible if that doc or hospital missed something because of MRI appointment was not there ? What if something happens to her at home ? What if something life threatening happend to her ? Who will be responcible ? Another example : On bases of blood reports (most of the times not required ) on doc prescribed medicine where another doc want to wait for 3 months – being diagnosed hypothyroidism . Is this type of MD Docs Canada producing ? In spite of strict filteration plants through CaRMS ! ! !
FMGs should not be treated same , if your family (parents/wife/husband) are paying tax to federal government then people holding PR/Citizenship should have hands on for residency . I firmly believe.
I know every country has their own rules and rugulation .
FMGs are doing fine in their home country with great responsibility .
Canada needs Doctors , but having limited FMG programs .
Canada should follow USA , limit FMGs being PR/Citizen but continue having large number of Residency Programmes for FMGs .
I will definately try my luck in MCC / CaRMS , and i am confident that i will get my residency. I will try super hard for sure .
May the best will be served good .
As a first world country why do Canada lie about so many job openings in their website especially for doctors. When you term yourself as developed and wealthy country why should you try to steal money and boast on job openings which in reality doesnt exist.
Have a clear cut picture of whom to take and whom not to allow inside. Make your borders more stringent, so that docs will not waste money and life. A learned person will do all the home work and try to stay from such countries, wherein there is a big flaw in the system on the whole. I Pity those IMGs still hoping to get their lives settled and IMGs who enroll fresh every year.
My husband has three undergraduate degrees and a Master’s degree in Neuroscience from Canafian universities. He did well on the MCAT, worked in a hospital as an orderly for 10 years, and was rejected from Canadian medical schools three times. He applied to an Australian medical school and was immediately accepted. He recently applied for the GP training program and with combined written and practical exam scores, came in first in the state for this particular program. He was personally congratulated by the head of the program. Moving to Australia also allowed me to complete a Master’s degree in Speech Pathology and I now am working in my dream career. I will soon be starting a PhD.
Australia is beautiful, has many highly ranked medical schools and well known researchers, and gave us both the opportunity to excel in our chosen fields.
Canada is a wonderful country, but our loyalties are here now. I am not afraid to say that Canada is missing out on two skilled professionals. The attitudes of some CMGs as evidenced by the comments here are disgusting and appalling.
We won’t be back.
If you read my comments a few paragraphs back, it seems Australia will be stealing two more highly educated world class graduates from Canada.
And if it’s only Australia that wants us, then so be it. We bid farewell to Canada and serve our new sunny home with the utmost loyalty.
if studying abroad makes an IMG non appropriate for integrating into the medical system here in Canada, ignoring the fact that most of us (IMGs) are specialists with quite significant amount of work experience, then why should there be a discrimination between a’ TRUE CANADIAN’ and an immigrant ( a Canadian -to- be) graduate?
My point is: Canada could make a system to assess a physician’s eligibility to practice by a period of work under observation and then a board exam. This way a huge amount of time money and energy would be saved and Canada would benefit from picking up best physicians in every specialty. Also, we all know that medical practice is not only diagnosis and treatment, but also the art of careful and sensible handling and approaching the patients and acting ethically correct. A good supervisor would have the chance to observe and assess the human side of the doctor as well as the the academic competency.
This has been an issue for a very long time now. There is simply not enough seats in Canadian medical schools and so this forces Canadians with dreams of pursuing medicine to study abroad with the hopes of being able to return to Canada to practice. However, it is simply not easy to return to Canada to work after studying medicine abroad. I myself am studying medicine abroad and hope that I will be able to return to Canada, return-of-service contract or not.
Of course Canadians who studied medicine abroad should have preferential treatment when it comes to acceptance to residency positions. Every country tends to favour choosing their own citizens over aliens when it comes to government titles and positions… Canada should be no different.
I love the unbelievably ignorant entitlement from the whiny Canadian grads who can’t handle the thought of competing with their internationally trained peers. Just shows how the Canadian system is breeding doctors where entitlement > critical thinking skills. But okay, let’s play your superficial game…..
I went to the University of Melbourne for medicine and my girlfriend graduated from Oxford University: Both are medical schools that are vastly VASTLY higher rated and internationally renowned than EVERY SINGLE Canadian medical school except maybe U of T. We were exposed to – on average – 30% more clinical cases than Canadian graduates, trained in the most cutting edge hospitals, and educated by doctors who lead the world in their fields. We graduated these schools among some of the most competitive medical cohorts on the planet. We both significantly scored higher than the average Canadian graduates on the MCCQE1 and have a vastly more dynamic and international educational experience. FURTHERMORE, we funded our education without burdening the taxpayer.
What ignoramus’s you CMG’s are to think you are more qualified to practice medicine in Canada than us. If all the Canadians studying abroad are just low achieving Caribbean grads, then what are you so afraid of? What right do you think you have over me in asking for entitlement for just passing through your med class at your regional provincial med school? What’s even worse is that Canadian medical schools admit based on location, so you could have just gotten in based on living in a province and not on merit at a national level. The whole Canadian system is a self serving farce propped up my selfish docs breeding more selfish docs.
If you’ve got the pedigree, then I am absolutely ok with that.
Nobody can challenge the quality of medical education at Oxford or Melbourne. Those are fine institutions with high standards.
The issue I have is with mediocre Canadian undergraduate students buying spots in Caribbean or second-world unverifiable medical schools later complaining that they can’t work in Canada once they’re finished. Those schools are of dubious quality and those claiming that they can be doctors because they have MDs from those schools are highly ignorant.
I also take issue with the open-door policy for immigrant foreign-trained physicians from similar unverifiable dubious medical schools. On more than one occasion I have precepted foreign-trained residents that were recruited into unpopular fields, who were so incredibly inept I wonder if they had forged their degrees.
With the above being said, I also take issue with how foreign-trained physicians are shuttled to primary care and other unpopular fields but never to radiology or dermatology – two examples of fields with severe shortages. Though this looks good on paper as a workforce balancing issue, this harms specialties in the profession that are having tough times, as if they are lower-skill, powerless fields and thus are open to physicians with unverifiable, and often inadequate, credentials against all resistance.
I’m interested in surgery and she is interested in derm…. despite having the “pedigree,” there is virtually no chance of us matching as a couple anywhere in Canada. I’m so disillusioned at how UK and Australian grads are lumped into the fold with Carribbean grads and the like while US MD’s get the pass. The Canadian Dental association has directly accredited top schools in these countries and dental grads go on to independent practice immediately! Meanwhile med students from world class institutions get the shaft for post-graduate training.
I think its 100% fair to say graduates of top institutions in the UK and Australia deserve at least equal footing with graduates from Northern Ontario School of Medicine and Ponce School of Medicine in Puerto Rico.
i dont know what else to say except thats bullshit.
plenty of mac grads are in derm now, yet an oxfordian is barred? that sounds suspiciously like a cartel.
imgs should be accepted if they have the pedigree. no caribbean, no russian, chinese, indian or middle eastern schools. high standards only.
Sir as an indian , worked in high standard indian hospital and college. Problem with USA and Canada is , they are affraid of Indians , Chinese students , students for them are like foreign reserve .
Coming from Oxford or somewhere else doesnt give you privilege , you have to compete here too , if you think you are best among all others then you will get match definately .
I am sure , average Indian or chinese graduates have 1000 times more experience then any average CMGs . Being CMG doesent mean , you are surplus . In India docs practicelike less investigations with treatment .
In USA Canada docs practice like More and More investigations with treatment which usually delays recovery . I am not saying om myself , its waht i observed .
Every indiaviduals are blessed with his/her own potential .
Many Indian / Chinese FMGs working great and faithfully , sometimes better then CMG/US Med School Grads in both the countries .
ANYWAY LEAVE IT , GOD BLESS CANADA
we cannot tell which schools in india are high quality and which ones are not. we also cannot tell which schools are corrupt and which aren’t. even then, a high-standard in india may not translate to a high canadian standard.
until we devise a way to evaluate the above, we should exercise caution in recruiting imgs from india and other developing nations.
All that aside, Indian doctors are needed IN INDIA. The poor Indian government subsidizes medical education and then doctors just desert India for more money in the west. And as you can see, WE DON’T EVEN NEED THEM HERE.
And I suppose it’s your Canadian medical students who , no matter what, are pushed out of medical school once admitted at all cost, even if it means retaking an exam 4 or 5 times, exams which are progressively made simpler to ensure they pass. Your Canadian standards are so abysmal, it’s shocking!
I am very intrigued. Was your girlfriend admitted to Oxford University for Medicine as a Canadian? Oxford accepts 1-3 internationals a year for its medicine program out of an applicant pool of over 300. This applicant pool offers very high standards with students from all over the world studying IB, A-levels competing for a very limited number of spots. If this is true that is very impressive and I am shocked that she has not been able to obtain a residency.
I went to Melbourne as a Canadian, she went to Oxford as a UK citizen and is in the process of landing permanent residency as my partner.
“The whole Canadian system is a self serving farce propped up my selfish docs breeding more selfish docs.” Very well said, especially the “farce” part!
I am Canadian. I may be considering getting a medical education in the States. I WANT to work in an underserved area. If the Canadian government will not allow me to save the lives of Canadians in an underserved Canadian area, 1) that tells you something about the Canadian government, and 2) I will go save lives in an underserved area in the States. Interestingly, the location will probably be in the same region anyway. The North.
Selection criteria for recruitment of candidates to medical schools should be streamlined and should be made more uniform for the entire country as the standards of medical practice are uniformly applied through out the country
I write on this behalf my spouse who is a qualified medical doctor from abroad, now living here as permanent resident. She has a degree in Medicine as well as a Diploma in Family Medicine and practised medicine for 15+ years.
In Canada, she has successfully completed the Evaluation exam, MCC Part I & LMCC (MCC Part II) which is the Li-censure exam. After completion, she received the ‘Certificate’ and the License and a letter to congratulate being included in the National Registry of Medical Personnel in Canada, along with a plastic card to be carried with her in her wallet/purse which is like a Driving License.
With all that, she cannot practice or work as a Doctor in Canada. What is this procedure for IMG’s? Our family came to Canada in 2008 due to her accepted qualifications and now putting her time down and studying (Same thing what she did 20 years ago) and passing all the exams, she has not seen any ‘light’ at the end of the tunnel she is in. In Deep darkness and no end of the tunnel. Is this any kind of gimmick by the authorities to make ‘money’ out of the graduates from abroad? Getting them as Migrants, indicating that Canada is short of Doctors and getting them to drive Taxi’s, factory jobs etc. etc.
To minimize the frustration by these already qualified doctor’s from abroad, why not make use of them as ‘Assistant Medical Officer’s” to help in the hospitals and send them to other undeserved areas in the North of Canada and give them some kind of ‘Light’ and get them out of the tunnel which could lead them in to serving the peoples of Canada who really need medical cadre increased and avoid those ‘unnecessary’ or minimise the wait time of a Patient.
Please my Dear Mr. Harper, the Minister of Health in Federal Government & Minister of Health of the PG, over to you and address this complication.
Thanks and may God Bless Canada.
Your spouse could go back to university, obtain the necessary prerequisites and write the MCAT, apply to a Canadian or American medical school, get in and complete it, and complete a residency. Then she will certainly be able to practice in Canada.
You might say that it would take too much time for her to do that. That’s how long it took me and my colleagues. Some of my classmates started medical school in their forties. No excuse.
You also might say that she is qualified as a physician abroad. Getting an MD from another country does not grant an automatic right to practice here. No excuse.
Immigrating to Canada is a difficult thing. One’s educational background is important because it illustrates that Canada is getting someone of “higher value” than those without it. However, being accepted into Canada due to said education does not mean that one will have the privilege of being employed in a related occupation; hence the taxi driving PhDs and MBBSs.
I have to say Dr. Brain, that was pretty harsh and undeserved. First off, the plight of immigrants is real. Most have limited finances, are in the mid-30s and dealing with English as their 2nd language. Asking them to write the MCAT and applying for admissions to a Canadian medical school is almost laughable. Someone at the age of 30, who does not understand Canadian culture and does not speak English natively is going to have a very difficult time with the Verbal section of the MCAT. They will also have trouble with financing their education and dealing with the fact that they will likely not be a physician until their mid 40s. Most people will agree that doing well on the VR is not a pre-req to being a physician, but due to competition it is being used as a benchmark.
If Canada cannot accept physicians, this needs to be made abundantly clear to immigrants so they do not need to waste their time pursuing a dream.
Someone at the age of 30, who does not understand Canadian culture and does not speak English natively is going to have a very difficult time with performing as a physician in the canadian medical system.
Fixed that for you.
So tell your heartless immigration bureaucrats to stop luring them here with false promises!!!
I’m an IMG who understands the culture (if I liked/wanted to live immersed in my native culture I would have stayed there), speaks and writes excellent English (my PhD thesis at a Canadian university needed a grand total of four reviews in the form fixing typos) and I find your comment hilariously trollish, Dr. Brain. I have met Canadians who, after several years of incessantly applying, still fail to gain admission into Canadian medical schools. They’ll get interviews from one university this year and another one next year (there’s no consistency, really, which indicates an unacceptable level of subjectivity at the admission stage). There’s nothing in their stuffed CVs and very good GPAs/MCAT scores to explain this. Yet, you want us (IMGs) to go and try to get all that stuff that can be denied even to worthy (at least by some schools’ assessments) Canadians, a process which includes, amazingly, volunteering (on oh-so-comparable-to-a-Canadian-high-school-student’s opportunities), two years of Bachelor’s, MCAT writing and tuition paying. Thank you for the helpful comment(s), it had not occurred to me to do all this!
You need to go and educate yourself about your country’s exploitative immigration industrial complex before making such callous statements!
I’m Canadian studying medicine in the UK. I went straight into the UK from high school. I don’t mind the separate streams at all.
The reality is if you were the merge streams IMGs may very well do worse than they do now. In the US, most of the university programs are 90%+ IMGs with some being all IMGs bar 1 or 2 in a class of 80 residents (MGH). In Canada in many programs the ratio of IMG to CMG spots is between 10-20%. So IMGs could probably do worse without this divide. I took a calculated risk by going abroad before undergrad.
Canadians who get into med have pretty much earned a right to a residency spot. Leaving out a few bad apples (no screening system is perfect) a match rate of 95% is something that most Canadian grads should get.
If you go abroad, you know what is going to happen. If you didn’t do your research, it is your fault. Don’t feel entitled because you were born with the right citizenship. Should we encourage more Canadians to study abroad? Definitely not. The number of Canadians going abroad has ballooned and honestly there is no chance that residency spots will be increasing. Canadian residents have having a tough time finding a job especially in fields that require OR access.
Should we keep accepting physician immigrants without fully explaining to them that their chances of actually practicing as a physician in Canada are close to 0? No. They can come to Canada for sure, but too many are given the false hope that they can work here as a doctor.
The reality is, too many Canadians want to become doctors. Doctors have very cush jobs in Canada like it or not and now for the big elephant in the room. Immigrants to Canada want their kids to become doctors at a much higher rate than existing Canadians. This is what causes the increased demand and competitiveness for medicine. I come from an immigrant family so before you shout racism, I’m just speaking the truth. Ever wonder why acceptance rates for medicine are 40% in the US and UK and only around 20% in Canada (particularly Ontario)? Canada has a high percentage of highly skilled immigrants, who have a high percentage of kids who want to become physicians. The US and UK don’t and furthermore especially in the US, they have a large number of immigrant communities that don’t produce many doctors.
We can train more doctors and see salaries and job opportunities tank. Or we can continue to see Canadians go abroad and have a majority of them emigrate. But there isn’t a real shortage of physicians in Canada, yes maybe a distribution problem, but not a shortage. Definitely not in the speciality fields.
%featured%When I or any of my family are in need of a doctor, I want the best and brightest… I don’t really care where they were born.%featured%
I have read every single comment on this page and I am appalled by this one comment that IMG’s are the rejects/degenerates who couldn’t get into medical school.
I have just finished my PhD at McMaster University and I have been accepted to 5 schools in Australia and 5 schools in the US (including Harvard). I have previously done my Masters and Bachelors- that’s almost 9.5 years of schooling. I STILL want to become a Doctor after all of this schooling. Yet every year I apply to Canadian schools I get the shaft- yet I’m good enough to get into the states… to Harvard… but somehow I’m a reject? Somehow I am paying for my degree if I go to the US or overseas? I am not smart enough to compete with anyone else? I have more education then many of these students have going into Canadian schools. I truly believe that IMGs and Canadian students should be regarded on the same level playing field and have everyone’s merits decide who will get into these placements. It shouldn’t matter WHERE you go to study, what matters is your skill as a doctor and your qualifications and grades. Bottom line.
First of all I really appreciate for the media and conserved citizen for bring the issue out for the public to comment. I believe that Canada is a country with plenty of opportunities for all its citizen equally without any difference or burdens put on based on where they get their training. I can only speak on behalf of my fellow citizens and my self whom spent the precious time in school with huge price behind. They didn’t go oversea thinking about the demand of doctors in their country or just for fun of it. They pursue the the path after so many attempt and so many interviews but no luck in the country. If this is crime then bringing wealthy south African doctors or non PR could be hideous crim than anything else. Look closely at your policy; if a Canadian graduated medical doctor could have that chance of munching 95% as you have said it rightly so, how is that hard to acomidate the other hand; in this case the forign train Canadian doctors to see them slight better than the non Canadian non PR or simply from those who actually get entry visa as student at different university? Well I will leave that to the plebeian and law makers to give valid answer.
In fact all Canadian forign medical graduates didn’t hesitate to call Canada their own future place to practice medicine, they didn’t abandon their country for money or other opportunities, insted they come right home after their respective studies. If this do not deserve applauding then what could be? If this couldn’t rewarded and given the chance that deserves who could be? I’m not sure what could a citizen do besides thinking to his/her country in providing the best profession that he/she acquires?
To me the human right issue that has been reflected in this matter is nothing but nonsense. No Country in the glob sees it’s own citizen same footage as that of non citizen. .what is the advanteg to say I have a country if that country dose not differentiate between others ten? Then it will be just for the passport but nothing else.
So the bottom line is treat your own with privilege and dignity.
There are plenty of rooms to accommodate Canadian precisely according to their training. See what SIPA is doing never given to the citizen a post it is just for those who got their way here to study MPH or non PR SA doctors as they have the pre requisite of 2-3 year practice in place. Well Canadians do not have the same work exposure as the non Canadian as they move immediately after their graduation. But again think of that all Canadian forign medical graduates had one or two degrees prior to their MD, not only that , they had worked with the system prior to their study.
In my final comment please come up with sound decision to make sure that all Canadia nice get the access to secure their future fates in their own country.
My biggest concern is that there are spots in Carms reserved for IMGs in round 1 that Canadian graduates cannot access. If IMGs have access to them, CMGs should as well.
After clearing all the exams set by MCC and not been able to obtain even a single interview, I believe Canadian healthcare system is totally flawed. They talk about competition but how can one compare a person who has taken only MCCEE and NAC with someone who has cleared EE, QE1, NAC and QE2?? So does that mean the other two exams hold no value?? Also the rules get changed every year, until how long do we expect that? I agree that CMGs should have their own quota since they have worked hard to secure positions earlier in med school but I believe that selection criteria should be based more on capability instead of merely good score on two exams compared to someone who is holding LMCC. Also the old grads keep getting older if no one offers any interview! I believe I will be trying one final time this year before departing Canada for good. I think Canada will keep losing its IMGs with LMCC for no one can keep waiting for a chance to prove their capability.
What I don’t understand is that if IMGs are “equal” to CMGs, then why are they essentially barred from obtaining any “competitive” residency positions? It seems that IMGs are relegated to family, psych, and path for the most part. You rarely see IMGs in derm, plastics and opthalmology.
CaRMs results indicate that around 40% of new IMGs match successfully (including both iterations), whereas 15% or fewer of previous years’ graduates are matched into any programs. This is based upon my cursory review of published data tables: https://www.carms.ca/en/r-1-match-reports.
This suggests that the level of competition is far less fierce for new graduates, but also that more than half of new IMGs are being added to a backlog of students with a very low success rate. I don’t suppose anyone has analyzed the rate at which this backlog is growing currently?
A major issue with the “free competition” model of letting CMGs/CSAs/IMGs compete for residencies is the following:
While residencies are “training programs” for recent graduates, from the perspective of the program director, residents are the major work-horses of the hospital. With the free competition model of residency placement, hospitals and program directors have a major incentive to take foreign-trained practicing IMGs over CMGs or CSAs because the IMGs can potentially already have vast experience in a certain specialty. For example, as a neurosurg program director, why would I take fresh graduates of Canadian medical schools that have only had the time to do electives and summer research projects in neurosurg when I can just take internationally trained grads that have already been practicing neurosurgeons in their home countries for 5-10 years?
Downstream, the issue is that we don’t know how this will affect Canadian medicine in general. If you suddenly shut out Canadian grads from pursuing certain specialties, by setting up a system where they have to compete against foreign-trained docs with an extra decade of experience, how does this affect the type of students that choose to go into medicine? What happens to bright, young, ambitious Canadian students if they suddenly can’t train to be surgeons or radiologists or oncologists, because program directors would rather have experienced IMGs running their service.
We know that historically, CMGs that go into specialty residencies in Canada end up doing graduate degrees, clinical fellowships at top-tier institutions, and finally end up as world-class academic physicians in Canada, treating the Canadian public. We don’t know what’ll happen in a system where we open up the floodgates and allow IMGs to pursue these specialized residencies. Heck, we don’t even know what’ll happen to the current Canadian med school applicant pool if the career prospects in Canadian medicine change.
Is the 40 year old IMG resident going to extend his/her 5 year training to 8 years, with a 2 year Master’s degree and a 1 year clinical fellowship in USA, when he/she has multiple children at home? Probably not. But young CMGs do just that.
You shouldn’t frame the CMG vs IMG pool debate as protecting the CMGs against better candidates (because frankly even the gold medalist out of UofT Med is going to be a less competent first year resident than an IMG with 10 years of experience). You have to look at it as protecting the long-term potential of CMGs.
I’m a current Canadian studying abroad in the Caribbean and some outlooks in this thread really dishearten me. I did not get accepted into a Canadian school, despite a decent application. What I lacked in GPA (3.7) I made up with my resume and dedication towards becoming a doctor. A lot of my friends, with lesser field, clinical, volunteering, etc. experience got into med school based on a higher GPA, while I didn’t even score an interview… so, does this make me someone unworthy of becoming a doctor? No on thinks about the dedication and sacrifice it requires for many people to go to the Caribbean and live in less than ideal situations (my particular island has food problems, water shortage problems and electricity problems, possibility of never being able to come back to Canada, just to name a few), just so they can achieve their dream of becoming a doctor? Not only do we have to prove that we are just as good as Canadian trained docs, but we always have to struggle against restrictive laws and attitudes. It should not matter where I achieved my training, as long as I have scores that are competitive to Canadian graduates and I’ve consistently proven myself during rotations. This past match year, graduates from our school matched in many sought after residences (ex. UofT Neuro), so it’s not like that graduates of Caribbean schools don’t have the ability. We are all Canadian citizens, so why shouldn’t we have the same fair chance towards a residency spot and chance at practising in our home country?
Most certainly. What kind of a rule is this that denies Canadian doctors studying abroad to be denied a placement in their own country. We should be proud to have them come home to their place of birth. This is the most ridiculous thing I have ever heard. I would really like to know who made this rule, obviously not a Canadian .
The authors have identified a hot topic at the moment. With the rise in Canadian medical student seats, the rise in Canadians studying abroad (CSA) with a stagnant number of residency position the situation is complicated to say the least.
However, there are two issues that are being ignored. Even though I would admit these are minor issues I feel they warrant a comment. It is difficult to argue that modern transportation has made migration significantly easier and more affordable. I would argue that migration is becoming more of a norm for students, travelling across the country,or even outside the country, for third level education. What are there motives for doing this in the medical education context? Barer et al. and many of the replies suggest that this is largely due to not being able to gain acceptance into medical school. I would like to propose a theory that every year there is a larger proportion of student applying to foreign medical schools that apply straight from secondary school, without every applying to a Canadian medical school. Being offered admission into a 5-6 year medical course straight out of secondary school is a very attractive offer. Although the “brain drain” is a concept that has been around for some time, I believe that we may now start to see a phenomenon where there will be large flows of student migration leading to a “student brain drain”.
The second issue is that no one has mentioned the benefits of international collaboration that IMGs, Canadians or not, bring with them. Or the personal experiences and characteristics that develop because of international travel and studies. There ARE benefits, unfortunately they are frequently overlooked.
Img with canadian passport has no difference from people went abroad trained medicine
Immigrant physicians are also either permanent residents or citizens of Canada. They deserve an equal treatment as other Canadians. In fact, they deserve additional attention if you consider the equity principles. The immigrant community experiences many social disadvantages, which has to be corrected.
This is where career counselling becomes important. For a person to say they chose not to go to a Canadian school implies they are aware how difficult it will be to come back, which I think is often the case. This is obviously in direct contrast to the people who are unsuccessful in their first attempt to get admitted to a Canadian school and then decide to go abroad. That shows a lack of commitment and effort to improve on their deficiencies.
A CaRMS survey indicated that most CSAs did not know how difficult it would be to come back when they made their decision. If you are raised in a free and democratic society, why would you think that one group of qualified Canadians would be guaranteed entry level jobs and another group would be restricted to limited opportunity stream? Why would you not think that you would be free to compete against your peers on individual merit? Why in a global society wouldn’t we be encouraging Canadians to study in reputable universities to foster a variety of ideas, a variety of approaches, and to gain life experience? And all that aside, what does volunteer work which carries more weight than the MCAT at UBC have to do with deficiencies? I would venture it has more to do with socio-economic status than aptitude for medicine. I spoke to a doctor who was on the admissions committee of a medical school in Canada. He advised that there are some people who are clearly not competitive and some people that have absolutely amazing credentials but there are a huge number that are for all intents and purposes indistinguishable. He says that whether someone from this group is accepted or not is basically luck. He thinks that it would be better if at this stage there was just a lottery to avoid those that do not get in from feeling that there they were “deficient”. As a taxpayer I have no interest in paying someone to get their Masters or PhD when it adds nothing to their ability to succeed at medical school.
I’ve never heard this before – is it the taxpayer who pays… so that medical school candidates can get a MSc/PhD?
The question should be: should CMGs have preferential treatment over IMGS? One of the principles of a free and democratic society is the freedom of choice of education. Does it make any sense that a Canadian Rhode’s scholar should have limited opportunity in Canada because (s)he or he chose to study in what is recognized as the best medical school in the world? All Canadians are entitled to equal opportunity. If a Canadian or permanent resident has passed the exams proving the requisite standard of knowledge, it goes against the most fundamental principles of our country that they should be second class to other Canadians who attended the “right” schools. Many professions have more graduates than there are jobs. There is a free and open competition for those jobs with the best candidates who have proven themselves AFTER studying their profession. No other profession in Canada, except medicine, basically guarantees entry level jobs to students BEFORE they have taken their first professional course. Free and open competition for entry level jobs for ALL qualified Canadian candidates is consistent with a free society. It also benefits the public and the profession by advancing the best and weeding out the less able. A two stream system of competition that prohibits competition on merit creates first class and second class Canadians.
Canadians who studied medicine abroad will get the same academic medical education that any IMG, the difference is just a nationality, why they have to have preferences?
I would be interested to learn a bit more about the demographic that makes up the students in the Canadian medical schools. Is there a %age breakdown of Canadian residents/citizens versus international students available? And is this a ratio that is maintained intentionally or through selection of the best candidate? I am curious because if we specify the number of international versus domestic students we accept the logic may follow to specify the number of international versus domestic residents we accept.
This is a discussion and article that I find personally relevant. I was studying in Germany at the beginning of the year and spoke with great pride to other international students about how open and accepting Canada is. We pride ourselves on our diversity and this should be maintained. On the other hand I also have many bright, hardworking friends that have been dedicated from a young age to become a physician. Those who were unable to get into Canadian medical schools are now studying abroad (Ireland) and are coming to terms with the fact that they might not be able to return home (easily) to practice medicine.
Great debate is happening and I enjoy reading it. Thank you all.
“I was studying in Germany at the beginning of the year and spoke with great pride to other international students about how open and accepting Canada is. We pride ourselves on our diversity and this should be maintained” Lolz!!! So funny, you sound like a CIC shill, nothing could be further from the truth……..
%featured%Speaking as a Canadian studying medicine abroad, I think it’s fair fair to say that many of us are aware of how challenging it is to return to Canada as an IMG%featured% (for those of us who did our research before deciding to study abroad). Those “rejects” who end up at Caribbean schools often don’t make it through the immense level of competition in these schools, where the attrition rate and minimum passing grades are higher than Canadian schools. In addition, studying abroad in a different country, separated from friends and family proves to be a testing environment where the most determined individuals succeed.
I think it is also worth mentioning that many of us Caribbean students have exposure to health care systems in both developing and developed countries, providing us with a unique perspective on global health care. Given that multiculturalism is encouraged and even celebrated in Canada, I think Canadians studying abroad bring something different to the table.
Furthermore CSAs typically apply to both CARMS and NRMP, given the few number of residency positions for IMGs and the sheer competition. This means that we have to write numerous standardized exams – both U.S. (Step 1, 2, 3) and the Canadian qualifying exams. The fact that Caribbean students hoping to match in Canada not only pass but score well on these standardized exams and have the burden of overcoming the stigma associated with being a Caribbean student, just shows how resilient we are. We recognize we have to work harder, smarter, and longer to be on the same playing field as our Canadian counterparts. I think given this arduous path, those who persevere, more than deserve a Canadian residency position.
Could not agree more.
%featured%While I commend those Canadian IMG’s who work hard enough to have a shot at a Canadian residency, becoming a doctor is a privilege not a right. %featured%To say a Canadian IMG deserves the residency position more than an immigrant IMG, is not in the best interest of Canada. It was the Canadian IMG’s choice to do their schooling abroad, and as such, they should compete with those equally bright and hard working immigrant IMG’s wishing to come to Canada.
So true: becoming a doctor is a privilege not a right. So why are Canadian medical school graduates given positions essentially as of right? Why don’t they have to compete on their merits against all Canadians so that Canada has the best doctors available? When I need a surgeon, I want the Rhodes scholar who graduated from Oxford or a person who graduated at the top of his class regardless of where he went to school rather than the Canadian graduate who managed to just pass in a Canadian medical school.
Canadian Medical Student – Do you think that Canadian medical school admissions are the upper echelon of superiority in deterring who will be a good physician? You are inferring this with your comments.
Canadians who study abroad should not get preferential treatment. They were not willing to put in the work it requires to obtain entrance into a Canadian medical school. If we allow them to compete with students that did work hard enough to obtain admission here in Canada, what sort of message are we sending?
So are you suggesting that Canadian medical school admissions are the upper echelon of superiority and are without flaws? If a Canadian who studied abroad in Ireland for example gets a residency spot in Canada do you really think they are incompetent?
Yes they are incompetent, as they are only new graduates and they even have not the minor experience compared to an IMG who has at least 5 year experience in his speciality and post-graduate credential in that speciality.
The only thing that they have is an english language without an accent which is obvious in IMG.
If these foreign graduates are so inferior to you why is it even a threat? If Canadian medical students are so much smarter, hard working and better, then this should not even be an issue. Clearly the “message” you are sending is that your judgment has been impaired by your own sense of inadequacy.
That is a fallacy. The original poster did not suggest Canadian IMGs were a threat. They simply stated that Canadian IMGs should not have preferential treatment to return to Canada over other IMGs, in which I agree. It was the Canadian student’s decision to train abroad, rather than tough it out for entrance at a Canadian school. That is not to suggest that Canadian IMG’s are not as smart or hard working, but rather, if they made the choice to train abroad, then it is fair game to compete with other IMG’s. Becoming a doctor is a privilege, not an entitlement and it’s in Canada’s best interest to get the best talent trained abroad. Canadian IMG’s should not have preferential treatment simply because they are Canadian.
Why should a Canadian have to attend a Canadian school? Why can’t they study where they want? Why should the future Canadian doctors be chosen before they take their first medical school class?
It is quite interesting that a few Canadian medical graduates are stating that Canadians trained abroad are rejects. I find this interesting considering that quite a few never actually applied to Canadian medical schools. Even if someone was rejected from a Canada and attained admission to an offshore school it is quite disgusting to imply that they are rejects. A physician regardless of country trained is looked up to in society as being respectful and humble. %featured%My impression is that it is far more about the individual student then about where the medical degree was attained.%featured% Competence is not bred by attending medical school in a specific country whether that be in Canada, Ireland, Australia, Grenada, Japan etc. Judge people based on their merits not whether they received their medical education in a particular country. I would also like to point out that countries such as the UK and Ireland were training doctors before Canada was even a country. I don’t think it is as simple for those Canadians who went abroad for medical education to “pay their way into an offshore medical school and get a medical diploma like something out of a cereal box”. Students studying in these countries have to show competence based on defined educational standards in order to graduate and receive their medical degrees. If they don’t show competence they don’t graduate, it is as simple as that.
Who cares where someone graduates from. Canadian grads, US grads, CSAs and True IMGs all have to participate in audition rotations lasting anywhere between 2-4 weeks long, or observerships if they have already graduated from medical school, and should be selected as suitable residents in their specialties of interest based on their fit with the program, their performance during their rotations, their board scores and their letters of reference – just like it is for any other professional applying for a job.
There should be no sense of entitlement by any medical student from any university, and there is no such thing as a bought MD degree if a candidate is in the running for a residency position as he/she has had to jump through the same hoops as any of their colleagues immaterial of which university they graduated from and had to sit for the same board exams.
Ultimately the quality of a physician lies with the character of the individual and not necessarily the institution that he/she graduated from.
George Doodnaught (http://www.cbc.ca/news/canada/toronto/dr-george-doodnaught-victim-recalls-anesthesiologist-s-attack-1.2559010) graduated from the University of Glasgow’s medical school
and Danny Grossi (http://www.thestar.com/news/canada/2013/01/18/charges_laid_in_fraudulent_auto_injury_claims_investigation.html) graduated from the University of Toronto’s medical school.
The main questions to be asked and problems to be solved is how to improve Canada’s health care delivery system and to reduce Ontario’s $15 billion health care deficit and do without overpaid health care administrators (who continually complain about physician incomes) http://www.ctvnews.ca/politics/hudak-vows-to-turn-health-care-decision-making-over-to-doctors-nurses-1.1847200
First of all I do not think that anything will be changed,since many years we hear the same phrases and sentences and it became worse!!! There are 7000 International graduated doctors ( please read the article on the IWC journal of September 2012) not involved in the system in Ontario only!!! Hundreds of those passed the required exams. When everybody passed the Evaluating Exam we were told it either you pass or fail and no scores for this exam. They did not keep their promise and they sent scores !!! which they use in Carms selection in a horribly competitive selection. As we were tricked by the medical council which does not allow you even to re-take the exam to improve your scores. Even those with high scores have no chances except in general labor jobs!!! If you have any chance after 2 or 3 years you will be told sorry ,you are away from practice for 2-3 years you can not join any program!!!! you have to go somewhere else and practice medicine for 1 or 2 years and come back to Canada to start over and over again!!!! While the ministry of Immigration requires you in the near future to sign an intent to reside in Canada, washing dishes!!! This is insane. To immigrate as skilled federal doctor is insane. I met many doctors who came to Canada as refugees and through many agencies here in Canada they could pass all exams while they taking all exams fees and even pocket money from these societies and go to competitions financially and emotionally in great comfort. While the skilled federal doctors pay thousands of dollars for the exams and has to go for general labor to cover their daily expenses. Nothing will change in this prospective.!!!!
I completely agree with all you mentioned.Nobody cares about us and wants to solve this problem.They need us to come over here and pay too much money for this long process to MCC account.if there is no guarantee to get through this process for all, why they set up those exams?
They just know this word: sorry, we are so sorry !!!!!!!!!!!!
If a Canadian doctor accepts to come to my country and work as a cab driver or labour, I will stay here and do the same job.The whole system here is lying.We have to think about ourselves.
There is complete dissociation between the Immigration system and the medical bodies responsible for license in Canada. %featured%The ministry of Immigration brings a huge number of doctors every year promising them to work and settle down in Canada while there are hundreds of doctors who are ready to work and passed many exams but they are not integrated in the job market %featured%. I think the process of immigration of doctors should be left to the employers and medical licensing bodies in Canada to determine and be responsible in the same time about the process. There is no initiatives to solve the problems of those already in Canada who search for jobs. The government does not care about them at all, and in the same time nobody cares about these areas which in sever needs of doctors. As Canada is in need of mainly to Family medicine doctors there should be special programs to integrate those Internationally graduated doctors in the family medicine with a limited license to work in the most needed areas which in fact are not preferred by the Canadian doctors. In fact those who came to Canada to work as doctors ( I am one of them) and finally found themselves in a very embarrassing and odd situation are victims of the system. No body cares about those either to wash dishes or clean floors,and if they go back after many years in Canada they are accused to be not attached to Canada!!!
Well said Sameh,yes there is complete dissociation between the immigration system and the medical bodies and lastly nobody care what we are doing(as am one of IMG as well ) !!!!
Well said ..I passed my exams and scored high (404) in the MCCEE and 557 in the mccqe1 and also passed the NAC osce .i have no job .and i have a family .they accepted me in Canada and abandoned me
Your question is provocative, and the answer should be “NO”. Nevertheless, from my perspective this is a widespread practice in Canada when people are faced with discrimination, even though, the government doesn’t like this word. It is related to your nationality, a place of birth, or age, even the Charted of Freedom and Rights exists. No doubt, that managers (doesn’t matter in which professional areas they are) prefer hiring people with the same nationality that they belong, or they prefer younger employees. I know that canadiens by place of birth are more welcomed in obtaining of job positions. My personal experience confirms that. Actual data show that Canadian medical lobby counteracts to internationally trained doctors (ITDs) in adaptation to their professional life in Canada. There is a lot of examples to illustrate this statement. Firstly, look at the much better situation with professional adaptation of ITDs in the USA or Europe. Secondly, the probability becoming a physician in Canada has gotten worse from 1990-th, hence we may state that the problem is growing not from qualification of ITDs, but is rooted in medical society and MOHLTC. How the problem should be treated?
I do agree with the comments above that no preferential treatment should be given to Canadians going abroad for medical education by choice. To ensure we are all on the same page, there is currently no preferential treatment for those students. All IMGs are assessed based on the same criteria, and that criteria is becoming more and more rigorous with increasing applicants. However, the reality is that more Canadians Studying Abroad (CSAs) are securing positions perhaps for the following reasons. First, CSAs have more opportunities to arrange electives in Canada while in medical school. This is a great opportunity to obtain reference letters from Canadian physicians, etc. These letters could be vital to the application. Second, CSAs are more familiar with the Canadian system, so the program may consider it to be an easier transition.
I do believe that the increase in CSAs has really disadvantaged the true IMG physician community. Nevertheless, competition remains extremely fierce for all internationally trained physicians. No CSA is let into the system without having to jump through many different hoops to prove that they in fact will be an asset to the Canadian medical system. It is our responsibility, as medical professionals, to assess every applicant based on their merits and experiences.
After the 1st iteration of CaRMs I was completing an elective at a program which had several unfilled positions. I overheard the program director talking about which IMG’s they would be selecting for round 2 interviews. They expressed their preference for Canadian students studying abroad over foreign born physicians. This was discrimination, but would be difficult to change…
Um….if the Canadian has the necessary qualifications, SHOULDN’T the fact that they want to come HOME (i.e. the country they grew up in, where their family is, etc.) be taken into account??????? Yes, they should be considered over a non-Canadian. They did what they had to to pursue a dream that they want to benefit their country with. They shouldn’t be treated as aliens.
What’s new? That’s par for the course in Canada……….in every sector and field!
Majority of immigrant IMGs have years of experience under their belt, bringing this experience to Canada is the point. Also, many of them have utilized resources from their home countries and bringing the pure benefit to their new home. Some Canadians Studying Abroad (CSAs), especially the ones who study in the Caribbean, need to pay huge tuition out of their own pockets (which is Canada’s) or through loans which is also a burden. Canada was built by immigration and providing opportunities for immigrant IMGs will attract many of those highly qualified people to immigrate to our country.
To the point of rural services, why the article does not show the percentage of immigrant IMGs in rural areas!!!
Also, if in 2011 the Canadian who studied abroad formed 25% of the accepted pool of applicants, I think they now make the majority because the reports on CaRMS’s website show dramatic increase AFTER 2012 with more than 3,000 applicants competed in this year (2014) cycle.
Having separate streams for immigrant IMGs only might be reasonable because they’re simply not comparable to the studying abroad.
%featured%Canadians who studied medicine abroad often did so because they were not competitive enough to get a spot in a Canadian medical school. %featured% To allow them to practice medicine in Canada through the ‘back door’ is totally unfair to the Canadians who worked hard to get into Canadian medical schools. They should not have any more claim to Canadian residency spots than your run-of-the-mill IMG. IMG’s who trained in their native countries were often top students back home, whereas Canadian IMG’s are essentially the dregs/rejects of Canada’s system. If anything, they should have lower priority when it comes to filling residency spots.
totally agree with you CMG
I completely agree. I know several individuals so under qualified they could not even secure an interview at a Canadian medical school, then essentially purchased MDs from the Carribean, Ireland etc. These people now feel it is their “right” to practice in Canada. I would rather an IMG who earned their degree, than a Canadian doctor who bought theirs overseas.
Please stop talking about what you don’t know. There is no way that you can “purchase” an MD degree from the Caribbean – to say that just showcases your ignorance. Caribbean graduates have to write and excel in multiple exams that Canadian medical students just have to pass. While it is known that many of these Caribbean students start out with lower qualifications, the students that do make it have to jump through numerous hoops and are more than qualified to practice medicine anywhere. The influx of these doctors would only increase the diversity of medicine in Canada.
I felt the need to comment and apologize for the ignorance and narcissism displayed by apparent “CMGs”. I have many close friends who are colleagues of mine studying medicine abroad. %featured%And as a CMG 2015 myself, I would argue that the competitive environment which CSAs/IMGs need to deal with produce quality physicians.%featured% As the post above stated, they need to do well on exams where we just need to pass. They may feel “behind” when comparing themselves with CMGs and will work harder than us CMGs. To put it into perspective, many of them spend their own hard earned money/take out lines of credit in order to fund their education, while we CMGs are graciously funded by tax-payers.
Let’s talk about entitlement. I think its safe to assume that most CMGs feel entitled to their separate CMG stream first round carms positions (which are provided for in most provinces). We feel entitled because we’ve worked oh so hard to get into medical school while those who didn’t get in must not have worked so hard, or they were not smart enough. Thus, they won’t be as good doctors as we will be. Well the same argument follows for CSAs, they’ve worked hard or even more so than us in their respective schools, if getting a residency position should be based on one’s own merits, why not let everyone (CMGs/CSAs/IMGs) compete for the same position and have the best candidate win? Oh but what about the tax payer’s money? Well don’t they deserve the best candidate as a their future doctor? Entitlement is silly, it goes against the very culture of medicine where doctors served because there was a need not because they thought they were better than others.
Thank you. Your defense of us IMGs who work our freaking butts off, and are no less intelligent or capable than the next lucky CMG (and yeah, a lot of that is luck) is much appreciated.
To the rest: As a Canadian born citizen doing just as good or better than any AMG or CMG that I have ever met, you can bet that I want to come back to practice in Canada, and you can bet that I def would appreciate having a leg up over someone who isn’t a citizen. But whatever.
It was not that long ago that every Canadian, whether citizen or permanent resident, was entitled to compete on his or her individual merits. When the system was changed prohibiting IMGs to compete against CMGs, the prejudice against those who chose a different educational route has become rampant as we see above. I find it abhorrent that a Canadian who chooses a different educational route in medicine should be criticized for doing so and penalized by being prevented from competing for entry level jobs on the basis of individual merit in one of the most prestigious occupations in our country . Rhodes scholars are CSAs. The highest Canadian internationally ranked school is the University of Toronto at number 15. Here is the $1 million question: If CMGs are so superior, why is it necessary for the system to protect them against competition against their peers? I believe that the Canadian medical schools provide an excellent education. I believe that Canadians are entitled to choose where they go to school. And I believe that Canadian medical school admissions do the best that they can to choose the best candidates, but they do not have a crystal ball, and they reject good people and accept people when put to the test are less suitable. The fact that a person finds an alternate route when not accepted is a testament to the strength of his dream and his dedication. Why would we stop this person from competing for jobs in Canada after he has graduated from a recognized medical school? If he is truly second rate, he won’t make the cut in the competition. The only reason to keep him out of the competition is to protect CMGs who are not as good as he is. The current system fosters prejudice that CMGs are better than CSAs and other IMGs. I have had the opportunity to speak to CMGs, CSAs, and other IMGs and it saddens me as a Canadian who believes in freedom and equality to see the attitude of entitlement in some and the effect that growing societal prejudice has had on others’ dignity and self-confidence. No other profession protects graduates from Canadian schools. They have it right.
To be fair in this discussion, it might be necessary to recognize that many IMGs are indeed considered highly qualified under the current system. At present, more than a third of new IMGs who apply to CaRMs are accepted into Canadian residency positions. I don’t have data on the specific nationalities or abilities of these individuals, but it seems likely that they are among the best candidates from the IMG stream.
Of course, the fact that international graduates are likely to be a diverse population of individuals with varying abilities only further questions the opinions of those who attempt to criticize the qualifications of all Canadian IMGs en masse.
Shameful! Not to mention completely inaccurate. I’m a Canadian who studied abroad and I’m currently completing my electives at Canadian schools with students at Schulich, UofT and my alma mater, McGill. I was pleasantly surprised with how I faired compared to any student from those programs – in fact, many of them were disappointing in terms of their medical knowledge.
As an IMG we know all odds are stacked against us so we learn the medical content inside-out for all the US board exams and Canadian entrance exams. Not to mention that the majority of us are self-taught because teaching overseas is often sub-par. Lastly, (particularly true given your moving statement above) – we don’t have egos.
Moral of the story: %featured%Might be easier to get into an international school but it’s far more difficult to graduate from one! %featured%It’s virtually impossible to fail out of a Canadian school – and most of the students I’ve met thus far are content with simply coasting by because they know they will match!
Your attitude only makes us more desirable
Please keep up the good work, Jackass!
“It’s virtually impossible to fail out of a Canadian school – and most of the students I’ve met thus far are content with simply”
Wow! so shocking and so true! Even at the so-called best medical school in Canada, (UofT) just because the old boys who decide on who gets in behind closed doors do not like to be wrong!
And having graduated from McMaster U and worked as a TA for its health sciences programs, i know several health science students who practically were getting straight 4.0 because the professor “felt” that anything less would not be in line with the program “expectations”. So please stop with the whole CMGs are smart and deserve those med school positions. And i agree that hard work goes a long way in securing a spot but a large part of it is still numbers game and whether you played your cards right during the undergrad. I know that this might be specific to one school but that sense of entitlement does exist even at the undergrad level.
Wow! I thought two of the qualities that physicians would display would be empathy and logic- both of which seem to be sadly lacking in these comments. If you read blogs and comments by various Canadian medical school deans you will see it freely acknowledged that given the number of highly qualified applicants to canadian medical school there is a certain amount of luck involved in the human decisions made to accept some and not others. So please do not give yourselves so much credit- yes, you are bright and I am sure fully deserving of your places- but you are also, to some degree, fortunate. You would also accept other IMG’s but not canadian IMG’s because you know that with the right of residency the canadian IMG’s directly threaten your future opportunities rather than an IMG who is not a citizen. You make disparaging remarks about Canadian IMG’s who “buy” their degrees- yet how can you possibly distinguish between them and a foreign IMG who probably studied at the same institutions. Plus, how do you know so initmately the details of programs followed such that you can make these outrageous claims. My daughter had no offers from canadian unversities but has been accepted at a British university which ranks considerably higher in medical school rankings than the majority of canadian medical schools. She will be working in a clinical setting from day one in a busy teaching hospital. She would like to return to practice in Canada but she knows it will not be an easy task. She is philosophical about her situation and does not gripe about being paassed over in Canada – just gets on with it. When I read comments such as those posted by “Canadian Grad” I am dismayed that the system in place allows these views to be commonly held. These are not qualities worthy of those who wish to practice medicine in Canada.
The entry requirements for europeans into Irish medical schools are just as high and very difficult to get into, so i’m not sure you are educated enough on the topic to make a remark like that.
What about those Canadians who never applied to a Canadian medical school but chose to go abroad to places like the UK, Ireland and Australia ? I am quite surprised at your comments considering that a physician is someone who is looked up to in society and is held in high regard. Your comments are suggesting that these Canadians who went abroad are all rejects and are “second rate” simply because they trained elsewhere. I think it is more about the individual and less about the country of medical training. Just because you are a Canadian trained MD does not mean you will be a competent physician. The same goes for physicians trained in the UK, Ireland or Australia. Do you think that Canadians receiving medical degrees from the UK, Ireland and Australia are in mickey mouse programs and are getting a diploma out of a cereal box? It is also interesting to note that places like the UK and Ireland were training doctors before Canada was even a country. Judge people on their merits not whether they went to Canadian medical school.
Agree with you 100%. There was a study in the U.S. several years ago comparing outcomes of CHF patients who had either 1) U.S. born and trained physicians vs 2) Foreign born IMG’s vs 3) Americans who trained overseas. The foreign born IMG’s and American born + trained has similiar outcomes. Americans who trained overseas (aka Carribean grads) had worse outcomes. Although this was just one study (and American), I think our policies need to take a more evidence based approach to these dilemmas. I also think we should study this in Canada and see if we observe the same results.
Here is the study I mentioned above:
Evaluating the quality of care provided by graduates of international medical schools (2010). Norcini JJ et a.
(I apologize for not using any standard reference practice, but you should be able to find the article with the information I provided).
I would disagree that Canadians who study medicine abroad are’ the dregs/rejects of Canada’s system’. When a Canadian medical school has 100 seats each year and 3,000 apply, are you saying that the 2900 who did not get in are the ‘dregs/reject’? Hardly. If someone has a passion to pursue their dream of becoming a doctor, then they will often go to great lengths to fulfill that dream. I am sure you would think differently if you had a friend or relative who didn’t get into a Canadian medical, but you did and they are pursuing their dream overseas. Would you tell that friend/brother/sister/cousin that they are the ‘dregs/rejects’ and should go to the back of the line. I think not.
You certainly are not someone I would want to have as my doctor. You sound like an over privilege spoiled brat. Canada has barely increased medical school spots in the last twenty odd some years, making it almost impossible for those who really want to become Doctors to look elsewhere to realize their dreams. Just because you are a Canadian trained Doctor doesn’t mean you are better than anyone else. In fact the Canadian Medical Exam pales in comparison to the USMLE’s. Why do 99 per cent of all Canadian Medical Students become doctors? Is is that they don’t fail people. Canadian IMG’s should be given the same opportunity to apply for the same jobs. They were not spoon fed. They had to go study in less desirable circumstances and yet succeeded. Have passed all of the requirements, and should be given a fair opportunity.
“Why do 99 per cent of all Canadian Medical Students become doctors? Is is that they don’t fail people?” The answer is a shameful and resounding YES! Didn’t you know?
The issue with IMGs originally from Canada feeling entitled to come back is that they are taking spots from internationally trained physicians looking to immigrate to Canada, fostering our diversity and wealth of knowledge from around the world. Canadian born IMGs could have gone to Canadian schools to complete their training. Without speaking generally, of course, the IMG route has been taken by those students who cannot gain acceptance to Canadian schools, and choose to go to the Caribbean and other places, offering spots to Canadians with much lower qualifications (of course this does not apply to everyone, just, I assume, a small population of Canadian IMGs). There is a system set in place for Canadian born doctors (that is to attend a university in Canada), and a system set in place for foreign trained doctors wanting to come to Canada. Those people who take advantage of this “loop hole” (as I have heard being referred to) should not be given preference. However, I completely and wholeheartedly understand the plight of those genuine IMGs wanting to come and practice, after paying their entire way through med school (without tax subsidies).
Thanks for your comment Shelly.
I disagree with you wholeheartedly regarding CSAs (Canadian Studying Abroad) choosing to study overseas because they did not get acceptance in Canada. This makes it sound like they are less smart and more lazy, compared to Canadians who got accepted in Canadian Medical schools. My own example speaks to the point: After immigrating to Canada when I was 16, landing in Ontario, but living in Quebec and doing my high school in Quebec, when I applied to canadian medical schools out of high school, I was never accepted, even though my grades were actually higher than my fellow classmates who did get accepted to McGill Uni, University of Montreal, University of Sherbrooke. Can you fathom what the reason for that might be?
Simple…bureaucratic nonsense regarding Provincial preference. Even though I had provided documents stating I was a Quebec citizen (thereby should have had preference over non-Quebec residents, a often 90 vs. 2-3 positions ratio), they still considered me a non-Quebecer, so I wasn’t accepted. Disheartened, I applied overseas. Now I am paying over $46,000 overseas because of the ridiculous province preference system in Canada, and administrative nightmare that seems to be entrenched in Canada back home.
Does that make sense to you? You cannot pigeon-hole everyone into your categorisation just because you think canadians medical students abroad did not get into canadian medical schools because they were lazy or had bad grades in high school in the first place. That’s called prejudice.
I might add that it was not just my grades that were higher, but I had an overall better CV as well.
I second that disagreement. I tried to get into schools in Canada for 15 years. I was told by one medical school the final time I applied that I was never going to get into a Canadian school because at this point I was too old, I had too much life experience, and I wasn’t the right demographic. It has nothing to do with my intelligence (in fact I have two undergraduate degrees and a Masters – dean’s list for two), but I wasn’t “right”. So I moved, with my husband and 3 children, to study in Australia – where the road has been rocky and expensive. But we did it because it had been a dream of mine for my whole life.
We don’t go overseas to try and circumvent the Canadian rules. We go overseas because we want to be doctors for the same reason everyone else wants to be and we don’t get the opportunity in Canada. We make HUGE sacrifices to do so – the same sacrifices that doctors trained overseas and immigrate to Canada makes. What we want is an opportunity to come home and to raise our families where we were raised. We know there is a risk. Many of us write board exams in every country where we think we may be accepted as residents. I consider Shelly’s attitude very disappointing and narrow. We have gone overseas and gained an experience that Canadian trained doctors don’t have. That doesn’t make us better or worse, but expands the diversity Shelly seems to desperate for. I fully support a preferential system. My sacrifice has not been any less than anyone else’s.
Jennifer and James, You said exactly what i was thinking. Being German, getting my BA here in the US and then having to go abroad again to chase my dream of being a doctor…it is sad and frustrating how limited places are for non trad. students or foreigners.
I will be SO in debt, but i will be a doctor someday.
We need to also remember that many of the IMGs without employment are Canadian citizens or permanent residents. So, in my opinion, the question above is actually asking: should Canadian citizens born in Canada who studied medicine aboard, be given preferential access over other IMG Canadian citizens or permanent residents?
Hi Kalyani, no where in the article is it implied that IMGs of Canadian origin should receive preference over IMGs of foreign origin, barring issues of substance like competence that are assessed with the NAC-OSCE, among other exams. Rather, the piece seems to suggest that in the future all IMG streams may be partially-dammed due to the increased production of domestic institutions.
Hello everyone, thank you for your excellent summary of the current landscape for IMGs intending to practice in Canada. I especially enjoyed the discussion surrounding likelihood of continued rural practice and work-life balance satisfaction. A discussion regarding the new NAC OSCE would have rounded out the content.
Thanks, Ian – we did consider including a bit about the new NAC OSCE rules, which as I’m sure you know will mean all IMGs, including Canadians trained abroad, will have to take the test in Ontario. Should be interesting to see if that change affects the mix of successful applicants.
Those interested can find more info here: https://www.schulich.uwo.ca/medicine/postgraduate/internationalmedicalgraduates/files/Linked/NAC%20OSCE%20Communication%20-%20Final.pdf
My impression is that Canada provides proportionally fewer seats for its OWN bright young citizens in our relatively low number of Canadian public medical schools than any other developed country I can identify.
My suggestion is that Canada opens one or two more Medical Schools charging Canadian students low or free tuition in our far Far North. Outcome could be multiple benefits to building host communities ( as happened in Maastricht in Netherlands), providing local accessible 2nd level care etc etc…..why not?
There are too many medical students in Canada. My guess is we will see problems in about 10 years. The problem isn’t the number of physicians, but the distribution. Downtown Toronto has too many doctors. Nunavut too few (an understatement at best). Medical schools have been trying to recruit students from rural/remote communities because they are more likely to practice in these locations.
Latching on to comments here, but the debate needs to be more comprehensive. The rural/urban divide isn’t really about just the number of doctors. You’re basically (to be general) throwing medical professionals into rural locations without (or much less) infrastructure, better programming, specific vision for development, substantial systemization of delivery of care, etc. Then, we say med professionals in general want to leave rural locations by keeping it myopically as a mere industry numbers game. It’s a question of proximity and information and standardization of care that is so very neglected and we are not talking enough about.
To add, the Canadian IMG/”other”IMG/CMG question is also somewhat politically contentious that isn’t any helpful when people here are debating it as “entitlement”, “rights”, etc. Those are empty concepts (if potentially legally implemented or not). i.e. Being “Canadian” is by its nature a positioning of state-based privilege. So, either – we are adamantly keeping this hierarchy of citizenship (or for that matter, “medical citizenship”), or we open it up as a free for all if we’re really talking about equity here. It has (of course) got to be a balance and what’s clear is that our recruitment/admissions and delivery of care isn’t as great as we often assume it is. I doubt there are many people who really know of or can amalgamate the sheer diversity of IMGs trying to practice in Canada.