Challenges can be scary, but you also think the greatest rewards are achieved by overcoming obstacles. You push yourself and it often leads to success.
That doesn’t mean everything is always easy. You’ve encountered some challenges while applying to medical schools despite having a good academic record. You have started looking into international schools, but you may have heard that it could be difficult to secure a medical residency in Canada if you become an international medical graduate (IMG).
As always, you’re up for the challenge. Just make sure you follow all of the necessary steps and prepare as fully as you can. Use this step-by-step guide to give yourself the best chance of securing a medical residency in Canada.
The path to medical residency in Canada
1. Make sure you meet the basic eligibility requirements
You’ll need to meet a handful of eligibility requirements no matter which residency program you hope to attend. The basics include having Canadian citizenship or permanent resident status, successfully completing exam requirements, and demonstrating language proficiency. You’ll meet the language requirements if you attended a medical school where the language used for instruction was English or French. If you attended a program that was taught in another language, you’ll need to complete an assessment.
Students need to complete the Medical Council of Canada Qualifying Examination (MCCQE) Part 1 and the National Assessment Collaboration Examination (NAC) before applying to residency programs through the Canadian Resident Matching Service (CaRMS). This process was streamlined in 2018, and IMGs are no longer required to complete the Medical Council of Canada Evaluating Examination (MCCEE).
Dr. Ivan Kamikovski, a St. George’s University grad and orthopaedic surgery resident at the University of Ottawa, says strong exam scores have traditionally been very important for those who want to pursue family medicine. He clearly knows a thing or two about how to get a residency in Canada.
2. Address province specifics
You really need to pay attention to the details when you start deciding where you want to attend residency, because different provinces have their own eligibility criteria. You may have to take additional steps to verify your medical degree, complete additional examinations, or enter into a service agreement that commits you to practicing in a particular area for a specific amount of time.
Meeting certain provincial eligibility requirements can be extremely challenging, so you should take that into account when deciding where to apply. Manitoba, Saskatchewan, and Ontario are typically the friendliest toward IMGs, according to Dr. Alexander Hart, a resident physician in emergency medicine at the University of Toronto and IMG consultant for MD Consultants. “Within those provinces, there are a lot of universities,” he says.
"Within those provinces, there are a lot of universities."
3. Make yourself stand out
Very few people would argue IMGs have it easy when attempting to match for a medical residency in Canada, so anything you can do to boost your visibility would be wise. If possible, take advantage of opportunities near where you would like to practice. “I came to Canada for a period of time to do electives and got letters of reference from here,” Dr. Hart says.
"When I came back to Canada, I would observe some of the orthopaedic surgeons."
Dr. Kamikovski similarly pursued an elective in Canada, and he also made good use of his breaks during school. “When I came back to Canada, I would observe some of the orthopaedic surgeons,” he says, “Just to kind of get my name in there.”
Building relationships with doctors and residents could be the key to securing a spot in a program later on. “In Canada, they’re more likely to take a person they know than a person who’s just on a list, a piece of paper,” Dr. Kamikovski says.
"In Canada, they’re more likely to take a person they know than a person who’s just on a list, a piece of paper."
Just remember that pursing an elective in Canada, while helpful, is not a requirement. There’s no guarantee of obtaining one of these positions since they’re offered through a lottery process.
4. Think carefully about your specialty selection
Medical students who complete their training in the US are required to obtain a Statement of Need, a form letter required for graduates who want to return to practice in Canada. Those who secure a residency in Canada can bypass this step in the process. But the "List of Needed Specialties" is still useful for seeing which fields offer a greater number of spots — typically primary care specialties. That said, some lucky IMGs have managed to secure competitive specialties.
Dr. Kamikovski decided to go the specialty route. He says there are fewer job opportunities in orthopaedic surgery, so he felt many applicants were choosing family medicine and other primary care positions. Just know instructors and other IMGs think this is a risky move.
It’s also important to note that, at least for most provinces, residency programs evaluate you separately from Canadian medical graduates.
"You’re typically competing only against other IMGs. But the spots are more restricted."
“You’re typically competing only against other IMGs,” Dr. Hart says. “But the spots are more restricted.” If you attended a quality international program, performed well on your exam, and obtained strong letters of recommendation, you stand a better chance.
5. Apply to Canadian residency programs and attend interviews
You’ll apply for residency positions using the Canadian Resident Matching Service (CaRMS). “It’s one central application system and that sends out your application to multiple schools,” Dr. Kamikovski explains.
"It’s one central application system and that sends out your application to multiple schools."
Though you can start selecting programs before you’ve gathered all of your materials, it’s important to note that everything must be completed by a specific date in November to be considered on time. The CaRMS has a timeline you may find useful for staying on track.
After programs have a chance to evaluate applications, they’ll begin to host interviews during January and February. As with medical school interviews, preparation is key. Take advantage of any mock interviews your medical school offers and make sure you do your research on individual programs.
6. Rank programs, then wait for your results
The CaRMS uses the same algorithm the National Resident Matching Program (NRMP) relies on to match applicants to programs. You can’t outsmart the system, so you will want to create a rank order list based on your true preferences. Your interviews should have provided you with most of the information you need to rank your selections.
If you start second-guessing your choices, you may want to consult with a trusted mentor. It’s also smart to remind yourself of what it is you’re looking for in a Canadian residency program. For example, Dr. Hart says the University of Toronto is a good option for those who are interested in a niche area of medicine. “That’s the kind of thing that Toronto, above all else, really provides,” he explains. Even still, you don’t want to become too aspirational.
"That’s the kind of thing that Toronto, above all else, really provides."
After you submit your rank order list, you may feel a bit anxious. It’s true that matching is difficult, but it’s not impossible. According to the Canadian Post-MD Education Registry (CAPER), hundreds of IMGs begin Canadian post-graduate medical training every year.
Take the next step
You now have a better understanding of how to get a residency in Canada. It requires some additional steps, hard work, and a certain amount of luck, but it’s not an impossible task. A medical residency in Canada could be in your future.
Also keep in mind that it’s possible to practice medicine in Canada after completing residency training in the US. While there are a few extra steps, this is a feasible path for IMGs.
If you have started looking into programs in the Caribbean as an option, you’ll want to make sure you do your research. But it can be a little tricky to know what you should believe. Make sure you’re distinguishing fact from fiction by reading our article, “The Truth About Caribbean Medical Schools: Debunking the Myths.”
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