Canadian citizens with US residencies

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Hi All. I have been asked to go to St. George’s University in Grenada to speak (on behalf of CASPR) to 150 Canadians studying there. The majority will be completing US residency and licensing exams. I told them that I would bring as much information as possible about getting licensed and privileged in Canada from as many provinces as possible. I would also like to have anecdotes from any of you that did recruit and place a Canadian/US trained physician.
Anybody?

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Posted by
Asked on 2019-08-02 10:00 pm
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Hi Brian,
This is fantastic news! It’s so important to connect with this group early on so they can make informed choices.

I can only speak from my experience working with CSA’s during my time at HealthForceOntario. Based on that, I would share a couple of things with the group –
*Research the job market for the specialties/subspecialties you’re interested in.
*Know the differences in training between the US and Canada (US training can be 1-2 years shorter in the US and this can impact eligibility for Royal College certification exams. While it’s true the CPSO has a policy (Pathway 4) for someone with an international medical degree and US training and exams, supervision is required and that can be hard to come by in some cases. Certain physician job markets are very competitive in Ontario. To be in the GTA for example, Canadian exams and an independent CPSO license is really a must have.
*Expect a delay between the completion of residency training and starting practice in Ontario. Depending on the specialty and the CPSO policy, delays of 2-6 months are typical.

One caveat, the CPSO reserves the right to change its policies and procedures at anytime without notice. Another reason why I always encouraged CSAs to complete equivalent training and write MCCQE 1&2 and CFPC or RCPSC. Not easy by any means but it helps make for a smooth transition and there are no long term licensing restrictions like there may be with restricted CPSO policies.

I hope this is somewhat helpful, good luck with the presentation!

(Marie Brook at 2019-08-02 10:48 pm)
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Good Morning Bryan! That is fantastic. I am currently in the midst of recruiting a physician who is a Canadian Citizen and doing in residency in the US. He has already written both of his Canadian equivalency exams and will finish his residency and write his American Boards in May. Once this is completed he will be able to apply for his CPSO license and will NOT be required to have supervision.

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Posted by Patti Dillabough
Answered on 2019-08-08 12:18 pm
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Hi Bryan – lucky you – I’ll carry your luggage!
I love Marie’s answer and she’s an expert on these questions. I wholeheartedly agree that residents are best to complete the Canadian exams so that supervision is not a requirement. It’s next to impossible for me to find supervisors – and if I do – they’re (usually) not at the clinics they’ll want to practice at. Definitely worth it to have the independent registration. While graduation may be at the end of June, I’ve yet to have a US resident be approved by the CPSO before November and often later on in December or January. So watch your finances as you’ll likely be 4-5 months without an income.
Another issue with supervision is the inability to work at multiple locations (even having hospital privileges and working at a clinic often isn’t allowed) and if issues arise at the clinic, it’s difficult and sometimes impossible to change supervisors.
Finally, don’t think you can do something like a 3 year internal medicine residency and return to Ontario to practice as a family doc. I had one like that who was given permission to practice, but there were so many restrictions impacting him financially (and where he could practice) that ultimately he returned to the US. He couldn’t see any one under 18, no well-women exams, no pregnant women – it was a nightmare logistically for the clinic who took him on. Bottom line to med students is to choose a residency that is easily transferable to Canada and in demand in the geographic location you’re interested in.

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Posted by Jane Walker
Answered on 2019-08-06 3:56 pm

That was excellent advice Jane, as was the input from Patti, Cindy, Laurie and Marie. I used it all when speaking to the students.

What impressed me most (besides the actual education and facilities SGU provides) is the character and resilience of many of the students I met with. They may often be painted with the brush of privileges, but what I saw in many of them is the ability to overcome adversity in their lives. Many students described their journeys to get where they are and they are not easy. Also, there are over 11,000 applications per year to St. George’s for medicine and only about 10% are accepted. It is not always ’marks’ that get them in, it is most often character. It was a very eye-opening experience.

Cathy (my wife and a fairly accomplished medical educator in her own right) was also invited along and was very impressed with what she saw and heard.

(Bryan MacLean at 2019-09-23 4:37 pm)
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Bryan do you also know about this Program??

https://www.trentu.ca/premedicalstudies/stgeorges

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Posted by Laurie Smith
Answered on 2019-08-06 2:43 pm
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I concur with my colleagues – excellent opportunity. Going to the beach for CASPR – well someone has to do it!! WE have recruited 3 Internal Medicine docs through Pathway 4. We did find the training in that specialty to be a bit of a challenge once here, but we do not hae an ICU or vented patients. As a small site, you just need to ensure you have enough supervisors. The supervisors need to be aware of any training limitations. One of our 3 docs then wrote the exam and passed, so her supervision was then finished early. It’s a great way for a community to ask for a contract in return for the work involved in the Pathway 4 avenue. We are entertaining another candidate through the same route with CPSO for next year.

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Posted by Laurie Smith
Answered on 2019-08-06 2:04 pm
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Bryan – this is great news (I have been trying, in a joking way, to have my organization send me to the Caribbean in the winter, lol). I have one family doctor in my community who trained Caribbean and then U.S. Residency. He was able to receive an independent licence by the end of October in his graduating year. He had applied for a supervised licence, however was able to submit all his documents, including a letter of exemption from CFPC, in time for the CPSO October meeting so they granted him an independent licence. In Ontario, as Marie noted, most licences issued for family doctors (I can’t speak to specialists) include supervision for 12-18 months. Looking forward to hearing how the presentation goes!

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Posted by
Answered on 2019-08-06 12:19 pm