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My IMG journey to Canada

Hi everyone! Welcome to my blog. My name is T and if you are reading this, there is a good chance you are a medical student somewhere outside North America wondering about how to align your stars so you can do your residency training in Canada. Well, I have been where you are now so I want to share my story and what I learnt in the process.

I went to medical school in Pakistan and the majority of my peers were planning on going to the USA for residency training. Everyone was all about them USMLEs. The path was well-defined and there was a clear recipe on how to. I was the odd one out. I wanted to train in Canada and no one around me knew anything about it.

I was on track to graduate in Sept 2013. I didn’t want to take a gap year unless it could be helped. So I started doing my research and got my ducks in a row.

I figured out the exams I needed to ace, the work experience I needed to organise and the contacts I needed to build to make my application stand out. It took a lot of stress, sweat but mostly it took a LOT of planning.

I have done this and you can do this too. In the next few blog posts I will share more detail about each step of the process and tips to guide any potential IMG applicants out there.

How I studied for the exams – part 1

What books and resources should you be using to study for your Canadian exams? For details about what exams are needed, including recent changes being implemented by the MCC for 2019, read my previous post about Canadian exams 101.

You basically have to worry about 2 exams: the MCCQE1 (which is a written exam of MCQ and short answer question) and the NAC OSCE (which is an OSCE that tests your bed side clinical skills). Let tackle them each seperately

As the landscape changes I am guessing schools will probably put more importance on the MCCQE1 score rather than the NAC OSCE as that will give them a much larger range to work with. This is pure conjecture on my part. Nevertheless as a candidate you should treat both these exams very seriously.

This post is about how to prepare for the MCCQE1. For the NAC OSCE preperation, stay tuned for my next post. Continue reading “How I studied for the exams – part 1” →

Canadian exams 101

Another major aspect of your application for residency in Canada will be planning for and acing your Canadian qualifying exams. This is an area fraught with uncertainty, stress and lack of clear information and was probably among the most stressful times in my journey as an IMG.

The landscape about the qualifying exams for IMGs in Canada is rapidly changing in the last few years and so I want to take this opportunity to go over the most current information , curated from the MCC website in Aug 2018 and then talk about how one can go about preparing for these exams effectively and ensure you get a kick ass score! Continue reading “Canadian exams 101” →

USA vs Canada for IMGs

This is among the top 3 questions I get asked about IMG-ing: How different is the landscape for IMGs in Canada compared to the US. While this question has many facets to it including but not limited to geography, politics and personal situation, below are some facts that I have gathered to compare the two systems.

Please note that for the purposes of this article I am strictly speaking about applying for a residency position. Physicians with pre-existing post-graduate training have other avenues they can explore in Canada. Also the information below is “at a glance” and the numbers are rough, for the sake of providing an approximation. Exact numbers may be different when you decide to apply.

	Canada	USA
Number of programs	Only university programs. There are 17 medical universities in Canada that offer post grad medical training. If you exclude French programs, that shortens that number to 13-14 universities	Both universities and community hospital offer post grad training which translates to hundreds of programs available to apply to
Who can apply?	Only Canadian citizens or Permanent residents. Must be graduates of medical school on World Directory of Medical Schools published by FAIMER	Theoretically anyone who has completed the USMLEs. People can match and work on a number of visa combinations. Dont ask me more, the US visa system is too complicated for my brain
How it works	In first round, IMGs can only apply for seats earmarked for IMGs. All unmatched seats from first round are opened to both IMGs and CMGs in the second round. Please note there are some provincial differences in SK and QB	All seats are open to both IMGs and local graduates. Some programs do make distinctions on how many IMG applicants they may take in total but on paper I believe every seat is open for application
Exams required	Keeps changing. At the time of writing this article, MCCQE1 and NACOSCE are mandatory. The MCCEE is being phased out. Updates at https://www.mccevolution.ca/international-students-graduates/assessment-overview/	USMLE Step 1, Step 2 CK and CS. Step 3 is optional
Total approx exams costs	$3735 CAD	$2550 USD
Word on the street	“Impossible” to match as IMG	Hard but worth the effort
Success rate	20% IMGs matched after both rounds in 2018 as per CARMS	56.5% IMG matched as per ECFMG in 2018

What is an IMG?

IMG stands for International Medical Graduate. In the world of medicine in Canada that typically means someone applying for residency who got their medical degree from another country.

In Canada, IMGs typically fall in two big categories:

Immigrants to Canada who were physicians in their country of origin and want to get licensed to practice in Canada
Canadians, who grew up in Canada and were unable to get in to medical school in Canada so get into an international medical school and are looking to come back to Canada for post-graduate training.

There are always people who fall outside these two groups (which I have made some generalizations in) but the above will encompass the majority of people who apply to CARMS as an IMG.

In my personal opinion the above two groups are phenotypically very different people. Group 2 clearly has an advantage on group 1. They are more fluent in English and have a strong appreciation of the Canadian culture and medical system. They have more contacts in the medical education system in Canada as most have done their undergraduate degrees from Canadian universities. Perhaps for the above reasons, they are also more confident during interviews.

A question I get asked often is whether having Canadian citizenship or permanent residence puts IMGs at any added advantage in the CARMS match. This is an important point to talk about as this is a major difference between the residency application between the US and Canada. To apply for a residency position in Canada you MUST have either citizenship or PR status in Canada. It is a requirement, not an advantage. For other eligibility criteria check out https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/

CARMS typically separates IMGs and CMGs (Canadian Medical graduates) in the first round of matching. Which mean all IMGs (both group 1 and group 2 and any other IMG) are competing with each other for the few seats that are marked for IMGs only. After the first round of matching (more on this later), any unmatched seats in the IMG pool and any unmatched seats in the CMG pool get put in one group and unmatched candidates all via for them in the second round. Here its free for all and IMGs and CMGs compete with each other for these common seats.

So just by reading the above information you may have come to appreciate why Canada is a difficult land for IMGs. There are a very limited number of seats ear marked for IMGs in every speciality. There is a large number of IMGs competing for those seats. Contrast this to the USA where all seats are open to both local and IMGs so there are just much more opportunities to match as an IMG (mathematically speaking). There are some other core reasons, but more on that later.