In the preยญviยญous artiยญcle, we disยญcussed the steps you should folยญlow before immiยญgraยญtion and once you had landยญed. We also gave some tips on how to increase your chances of securยญing a posiยญtion conยญsidยญerยญing the high comยญpeยญtiยญtion in this field.
In this artiยญcle, we will disยญcuss the routes you might seek to start pracยญticยญing. Please rememยญber you might have highยญer chances in one route than othยญers based on your qualifications.
Routes
In Canaยญda ( and in most Amerยญiยญcan states ), there are sevยญerยญal routes to enter into pracยญtice. Our focus is on the Canaยญdiยญan routes, yet this can be a good guide for most Amerยญiยญcan states. You need to underยญstand the tips, then check out the criยญteยญria in each state.
1- Residency
The most comยญmon and direct route is applyยญing for a resยญiยญdenยญcy spot, yet not the easiest.
In Canaยญda, there is an annuยญal resยญiยญdenยญcy match through CaRMS, which has two iterations.
The first iterยญaยญtion ( in most provinces except one or two ) has two streamsโone stream for Canaยญdiยญan gradยญuยญates and the othยญer for interยญnaยญtionยญal medยญical graduates.
The secยญond iterยญaยญtion has one comยญpetยญiยญtive stream for all appliยญcants. Everyยญone is comยญpetยญing for the spots that did not match in the first iteration.
This route depends on your backยญground, i.e. the trainยญing you had in your home counยญtry before immiยญgratยญing. Were you a speยญcialยญist? A famยญiยญly doctor/ Genยญerยญal pracยญtionยญer? Or did you arrive directยญly after medยญical school withยญout any training?
If you had trainยญing, then you should focus on the spots matchยญing your backยญground. For examยญple, if you were a radiยญolยญoยญgist, then apply for radiยญolยญoยญgy etc.
Some speยญcialยญties, as menยญtioned, are very hard to get in because of the limยญitยญed numยญber of spots and the high comยญpeยญtiยญtion. Then you might start thinkยญing about othยญer options to make it easยญiยญer. Yet, you have to conยญvince the comยญmitยญtee of your sinยญcere interยญest. They always wonยญder why an orthopaedic surยญgeon is applyยญing for interยญnal medยญiยญcine or psyยญchiยญaยญtry, etc. ( thatโs just an example ).
Here we go back to our advice regardยญing doing some work with the group to present yourยญself well.
For examยญple, approach this proยญgram by email requestยญing observerยญship opporยญtuยญniยญties or research projects. You should ask for a meetยญing and explain why you are changยญing your route from surgery to medยญiยญcine, etc.
It is easยญiยญer to conยญvince them this way rather than just waitยญing to have your appliยญcaยญtion reviewed. Be honยญest, tell them it is hard to join plasยญtic or orthopaedic resยญiยญdenยญcy, yet you were always interยญestยญed in interยญnal medicine/family medยญiยญcine etc.
If you had not had any trainยญing back home, this might be to your advanยญtage. This allows you to apply to sevยญerยญal proยญgrams ( again after doing work with each ). I mean, you should keep yourยญself busy by doing lots of observerships/ research with sevยญerยญal groupsโfor examยญple, one with interยญnal medยญiยญcine, the othยญer with genยญerยญal surgery, third with psychiatry.
I am just givยญing examยญples of broadยญenยญing your options since you do not have a cerยญtain speยญcialยญty backยญground. You can easยญiยญly mould your perยญsonยญal letยญter for sevยญerยญal speยญcialยญties since you did not have cerยญtain speยญcialยญty training.
Our advice is to apply for the first iterยญaยญtion; you should also apply for the secยญond if you do not get matched. Why? Because the adminยญisยญtraยญtion and appliยญcaยญtions fees are paid once, you can apply for both once you pay before the deadยญline of the first iteration.
For the secยญond iterยญaยญtion, you will just be payยญing fees for each proยญgram you apply to. The fees are around 25 dolยญlars for each proยญgram. For the appliยญcaยญtion fees, you get 4 proยญgrams to apply for withยญin those fees. Please review the webยญsite for any updates or changes to those fees.
What Is Tough About Applying For Residency Match?
As menยญtioned, it is the most straightยญforยญward process, and it gives you Canaยญdiยญan trainยญing ( or Amerยญiยญcan ), so you are a gradยญuยญate of a well-recยญogยญnized resยญiยญdenยญcy proยญgram with all the advanยญtages this entails. Yet, it is very competitive.
You are comยญpetยญing with thouยญsands of likeยญwise immiยญgrants. You are also comยญpetยญing with hunยญdreds of Canaยญdiยญan-born stuยญdents who studยญied medยญiยญcine overยญseas and are applyยญing to return to Canaยญda. The comยญpeยญtiยญtion with the latยญter group is the most chalยญlengยญing and most unfair comยญpeยญtiยญtion you might have.
Assumยญing you had finยญished all your exams promptยญly, the chalยญlenge is conยญtactยญing any proยญgram to arrange observerยญship or help out in research to present yourself.
The Canaยญdiยญan stuยญdents comยญing from overยญseas usuยญalยญly have alloยญcatยญed time in their last 2 years for elecยญtives. So they conยญtact these proยญgrams offiยญcialยญly through their medยญical school and have rotaยญtions set up. Yet, the regยญuยญlar interยญnaยญtionยญal medยญical gradยญuยญate has to fight to present him/herself, and someยญtimes those requests get rejectยญed for difยญferยญent reasons.
It depends on what you are applyยญing for; you would notice how hard the comยญpeยญtiยญtion is and the numยญber of spots available.
There is only one spot availยญable in some proยญgrams, while there might be a few more in othยญers. The numยญber of appliยญcants on averยญage for each spot postยญed is between 150โ200 ( rough estiยญmate ). For each spot, usuยญalยญly, 15โ20 are called for an interยญview. Your goal is to be at least on this shortยญlist. The writer was on the shortยญlist for few proยญgrams over few years of tryยญing and was basiยญcalยญly in most of these interยญviews the only non-Canaยญdiยญan-born applicant!
So ? Do your exams quickยญly, focus on few proยญgrams you plan to apply for, conยญtact these proยญgrams to do some work with them ( preferยญably with the proยญgram direcยญtor or one of the selecยญtion comยญmitยญtee ), leave a good impresยญsion and hope for the best!
And โฆ.. Do not give up! Do it right; It might take few attempts to achieve your goals.
2- Practice Ready Assessment (Mostly For Family Medicine Practice)
Most provinces in Canaยญda have assessยญment exams for genยญerยญal pracยญtice since there is a shortยญage of famยญiยญly doctors/ genยญerยญal pracยญtiยญtionยญers in all provinces.
You do not have to be a famยญiยญly docยญtor to apply; basiยญcalยญly, you can have any backยญground if you meet the criยญteยญria. These exams difยญfer in their eliยญgiยญbilยญiยญty criยญteยญria, so they are not for everyone.
One of the most chalยญlengยญing and deterยญminยญing facยญtors to be eliยญgiยญble is the duraยญtion you have been out of pracยญtice ( hence we advised in part one of this artiยญcle to finยญish the exams as soon as posยญsiยญble while you are still in practice ).
Some provinces require a maxยญiยญmum of 2 years out of pracยญtice while othยญers allow 3 years; you need to read the criยญteยญria as they often change.
Also, some of these exams do not accept appliยญcaยญtions every year; actuยญalยญly, one of them was almost shut down for years. Once the province finds they covยญered most of the shortยญage, they inform the colยญlege to keep this exam on hold.
Please review Pracยญtice-Ready Assessยญment โ Medยญical Counยญcil Of Canaยญda.
On the right-hand side, there is a list of those examยญiยญnaยญtions. Please review the eliยญgiยญbilยญiยญty criยญteยญria and find if it fits you.
Basiยญcalยญly, those examยญiยญnaยญtions are not passed/fail exams. They are an assessยญment of how ready you are to pracยญtice in Canaยญda. Upon comยญpleยญtion, you will be givยญen a defined license to pracยญtice in this province ONLY and under cerยญtain conditions.
After 2 years of your indeยญpenยญdent pracยญtice, you may be eliยญgiยญble to apply for and write the colยญlege of famยญiยญly medยญiยญcine exam.
If you pass this exam, then you can pracยญtice as a famยญiยญly docยญtor anyยญwhere in Canada.
This route is less chalยญlengยญing than the resยญiยญdenยญcy one, yet you have to fulยญfill the criยญteยญria. The most imporยญtant is not being out of pracยญtice for a long time.
We can not stress enough the imporยญtance of startยญing your examยญiยญnaยญtions before arrivยญing in Canada.
One othยญer issue is the fees for those exams. We recall how expenยญsive they were, espeยญcialยญly for a newยญcomยญer and if you plan to try a couยญple of them to increase your chances.
Some appliยญcants had tried the same exam more than once, which can be very costยญly. In some provinces ( yet not as comยญmon now ), there are assessยญment exams for speยญcialยญties. This was more comยญmon in the past due to the demand for cerยญtain speยญcialยญties. You need to check each uniยญverยญsiยญty webยญsite to find out if they offer those assessยญments and their criteria.
You can still use the same linkโฆ Pracยญtice-Ready Assessยญment โ Medยญical Counยญcil Of Canaยญda, But go to each uniยญverยญsiยญty webยญsite and search for speยญcialยญiยญty assessยญments, if any.
3- Fellowship ( Specialists Re-Entry )
This route is a provinยญcialยญly based proยญgram and changes from time to time. Thereยญfore, you should review the provinยญcial colยญlege guideยญlines and plan accordingly.
How?
In most casยญes, you would require a letยญter from an acaยญdยญeยญmยญic superยญviยญsor to subยญmit to the colยญlege to write the royยญal colยญlege proยญgram. You can not just apply to a re-entry proยญgram on your own; othยญerยญwise, all Interยญnaยญtionยญal Medยญical Gradยญuยญates would be able to use it, and it would be an accesยญsiยญble route. Yet, the colยญlege offerยญing the re-entry proยญgram is lookยญing for those who have offiยญcial approval from an acaยญdยญeยญmยญic physician.
The only way to do so is to be a clinยญiยญcal felยญlow withยญin an acaยญdยญeยญmยญic facilยญiยญty so you can get this supยญport while applyยญing to this route.
If you are lucky to be acceptยญed for a felยญlowยญship proยญgram in your speยญcialยญty, thatโs a great accomยญplishยญment. Usuยญalยญly, a felยญlowยญship would need a sponยญsor ( to pay your salary ) if you are a forยญeign-trained physiยญcian. Yet, some proยญgrams with a shortยญage of felยญlows might try to find funds for a spot if thatโs for you great because you would hold a license.
I had seen few sucยญcessยญful stoยญries in that route. Most if not all of them had applied and got
acceptยญed in felยญlowยญship while they were still in their home counยญtry. But of course, you can start
this anyยญtime while you are in Canada.
How to start this? Again, do all exams and the lanยญguage test promptยญly, check which provinces offer this route, apply to sevยญerยญal felยญlowยญship proยญgrams, work hard for 1โ2 years as a felยญlow to present yourยญself, disยญcuss your plan with the superยญviยญsor and apply!
Again, please review each provinยญcial colยญlege criยญteยญria as this route changes a lot, and the writer nevยญer tried this route nor checked the most updatยญed criยญteยญria in each province. Still, we wantยญed to share a path where we had witยญnessed othยญers sucยญcessยญfulยญly went through and curยญrentยญly; they are pracยญticยญing in Canada.
Thatโs a link for the approved resยญiยญdenยญcy proยญgrams. It is a start to conยญtact proยญgrams askยญing for
felยญlowยญship.
Accredยญitยญed Resยญiยญdenยญcy Proยญgrams โ The Royยญal Colยญlege of Physiยญcians and Surยญgeons of Canada
4- Re-Entry To Medical School
Some uniยญverยญsiยญties offer a proยญgram for interยญnaยญtionยญal medยญical gradยญuยญates to re-enter medยญical school. This is usuยญalยญly for the last 2 years of medยญical school, so you only do 2 years as a stuยญdent. Then you are allowed to apply for the Canaยญdiยญan resยญiยญdenยญcy spots. Howยญevยญer, you can not apply to all speยญcialยญties. There is a list of speยญcialยญties you can apply for; then, you work in remote areas for few years as per the conยญtract you sign. Most of these proยญgrams still require passยญing the LMCC exams plus the NAC exam.
This proยญgram is becomยญing very comยญpetยญiยญtive, and it usuยญalยญly has very limยญitยญed spots in each uniยญverยญsiยญty per year.
5- Alternatives
For sure, not everyยญone would sucยญcessยญfulยญly go through these routes to the end for sevยญerยญal reaยญsons. There are still othยญer opporยญtuยญniยญties to work in the medยญical field, either as a physiยญcian or in othยญer posiยญtions ( research, techยญniยญcians, etc.).
For physiยญcian opporยญtuยญniยญties, sevยญerยญal provinces are offerยญing a posiยญtion called Clinยญiยญcal Assoยญciate / Assisยญtant. This posiยญtion basiยญcalยญly is a physiยญcian workยญing withยญin a cerยญtain departยญment under a defined license. You would be a Docยญtor, yet only withยญin this facilยญiยญty as your license is only valid under that superยญviยญsion. Usuยญalยญly, your responยญsiยญbilยญiยญties would be takยญing care of the inpaยญtients, their medยญical manยญageยญment, transยญfer orders, conยญsultยญing othยญer serยญvices etc.
Usuยญalยญly, it is a well-paid posiยญtion and a great start to have your feet in the sysยญtem. Also, it is a great perยญmaยญnent job if you couldnโt get into one of the preยญviยญousยญly menยญtioned routes.
Those opporยญtuยญniยญties are usuยญalยญly availยญable on the hosยญpiยญtalsโ webยญsites and/or the provinยญcial colยญlege website.
This artiยญcle was writยญten by Dr. Islam Elnaยญgar. Dr.Elnagar had immiยญgratยญed to Canaยญda years ago as a Forยญeign Medยญical Gradยญuยญate, and curยญrentยญly, he is a Canaยญdiยญan Orthoยญpeยญdic Surgeon.
In summary
There are few routes for pracยญticยญing medยญiยญcine in Canaยญda / the USA. It all depends on your speยญcial sitยญuยญaยญtion and your backยญground. You will need to careยญfulยญly read through this and decide which way you would have more sucยญcess. You could for sure seek 2 or 3 difยญferยญent routes and see which one would work out for you.
Read It Next!
Can I have the writerโs email address?
Thanks a lot for reachยญing out to us; please feel free to subยญmit your inquiries at our email address โ seizeyourlifetoday@gmail.com,โ and we will forยญward it to Dr.Elnagar; thanks!