VISA for Canadians working in the US

[redshifteffect]

I have received a lot of emails about the following question so I thought I would clarify it:

Q. As a Canadian who is thinking about going to Australia how would I go back to North America?

A. There are a couple of ways to do this. 1) After graduation from an Australian school apply for an internship. After internship apply for either a NZ or Australian PR. Apply to a residency program if granted above mentioned PR in both countries. Do your residency. You are then qualified to return to Canada. Go to a province where you are eligible to practice with a condtional license ie Newfoundland or Manitoba. Write the exams (EE, QQ1, QQ2 and board exams) and then you may be able to return to Ontario.

The other option after completing a one year internship in Aust/Nz (I recommend this since you are then qualified to work there, you get some more clinical experience and you get paid) is to write your USMLEs. There are two visas you can apply on:

H1B visa- the advantage of this visa is that it's much easier to get a green card after you finish your residency. You also do not have to return to Canada. The downside though is that this is usually capped (unless you are going to a eductional instituion, or a hospital affliated with one then this does not apply - make sure you let them know too! (new law)) and most hospitals aren't fond of this visa.

J1 visa- you will have to write the MCCEE to get this visa. After passing it you can apply for this visa and you will need a letter of "need" for the ministry of health. I think it's possible to get this (much easier than before). The bad side about this visa is you have to return to Canada for two years after your residency is completed. This is completely a waste of time because if your residency is not recognized (and for most of you it won't be) u will be sitting there doing nothing. If your residency IS recognized though this is perfect - you can take your QQ 1, 2 and board exams and go to Manitoba/Newfoundland etc to practice. Finish it up and then hopefully you will be recognized in Ontario.

Your other possible routes include going to England/Ireland to do your training. Once there you can choose to stay since the work permits there are easy to get, or you can choose to return to Canada and again complete relevant exams. You will probably have to write some British exams to get into the specialty training positions though.

*Note* for H1B visa you will need to write the USMLE step 3 before you can obtain this visa, only some states allow you to register to write this. For J1 you do not require the step 3 until you are in your residency*

As of this year the USMLE step two now has 2 parts - clinical and written. There is no more CSA. You will no longer have to write the TOEFL.

[redshifteffect]

www.valuemd.com/viewtopic.php?t=7018 (http://www.valuemd.com/viewtopic.php?t=7018)

On this site it says that the US requires that foreign grads must be qualified to be licensed in their country...does n e one know if this is true???

If this is the case, anyone in Australia must complete the 1 year internship!!

[avaid]

hey
do you know what residency programs are recognized by newfoundland and manitoba.
thanks

[redshifteffect]

If you mean what US residency programs then sadly very few.

I don't know which ones in particular but I suggest you contact the following person:


________________________________________________

Good morning Doctor:

Further to your request for information regarding the Statement of Need letter to process a J1 visa, please review the attached document.

Provided that ALL the required documentation is submitted, we will require approximately one week to process your application.

The Royal College of Physicians and Surgeons of Canada will recognize United States specialty training provided that it is undertaken as a resident in a specialty or subspecialty residency program accredited by the Accreditation Council for Graduate Medical Education. PLEASE NOTE THAT FAMILY MEDICINE IS NOT ONE OF THE SPECIALTIES RECOGNIZED BY THE ROYAL COLLEGE OF PHYSICIANS AND SURGEONS OF CANADA. You should contact Health Canada for information on how to obtain approval of Family Medicine training.

Once the training that your will undertake in an ACGME approved program is found eligible for full or partial credit towards an RCPSC recognized specialty or subspecialty, a letter will be sent to Health Canada and to you electronically. The original of the letter along with pertinent information will be sent to you by regular mail.

If you should require additional information, please do not hesitate to contact me.

Sincerely,

Maritza Boreka
Credentials Unit
Royal College of Physicians and Surgeons of Canada
Le Collège royal des médecins et chirurgiens du Canada
774 promenade Echo Drive
Ottawa, ON K1S 5N8
(613) 730-8191/1357
(613) 730-3707 (fax)
1-800-668-3740/1357 (toll free)
mboreka@rcpsc.edu
Visit the College website at:rcpsc.medical.org (http://rcpsc.medical.org)

[cradlecrotch]

Wait a second here, US residency programs WILL be accepted in Canada. All US residencies must be accredited by the ACGME, so there is no problem here. There are a couple glitches however: in the States, general internal med is 3 yrs whereas it's 4 in Canada...so an IM residency is not acceptable in Canada unless you do a 4th year.

[redshifteffect]

The above letter is from the RCPSC!!! She clearly says that even family medicine isn't accepted!!! that's a 3 year course, and the equivalent in Canada is only 2 years!!! (I couldn't believe this myself!)

So while every one says this and that is accepted, I actually contacted her myself and that is the message I got. I honestly don't know which programs are accepted or not, but I don't think that time is the only factor.

[redshifteffect]

Cradlecrotch,

I posted the above letter that I received on another forum and someone there told me that perhaps the reason that the lady is saying that family medicine is not recognized in Canada is because the RCPSC is not the licensing body for this program....so you could be right.

I really have no idea, but if anyone knows what's up with that letter I'd like to know.

[cradlecrotch]

You were told correctly, family medicine is under the auspices of the College of Family Physicians of Canada, and so it is they that will judge the acceptability of any FM training in the US. The RCPSC is strictly for the specialties. So practice in Canada is still an option!

[redshifteffect]

Cradlecrotch,

Stories like this have me really confused, can you shed some light on this??

__________________________________________________ __
www.psych.org/pnews/98-02-06/strass.html (http://www.psych.org/pnews/98-02-06/strass.html)

Problems in Canada
I read with interest in the December 5 issue that the APA Assembly is calling for an end to state medical board discrimination against non-U.S. and non-Canadian medical graduates. I also read with interest on page two about the excitement surrounding the Canadian venue for this year’s APA annual meeting. I’d like to share my experience with Canadian medicine to draw attention to its discriminatory practices in licensing U.S. citizens.

I moved to Victoria, British Columbia, almost three years ago because of family obligations. My wife, who is from Vancouver, became ill, and one of her children (all of whom live on or near Vancouver island) was having serious school problems. Before moving, I was a tenured member of a major U.S. medical school, had received substantial funding from the National Institutes of Health for clinical research, treated acutely and chronically mentally ill patients in a variety of settings, and had trained dozens of psychiatry residents and medical students. I trained at accredited U.S. universities and medical schools, and am board certified.

Since I am U.S. trained, I was told by the British Columbia medical board that I needed to take the equivalent of the U.S. National Boards of Medical Examiners (Parts I, II, and III), known as the LMCC, to be eligible for licensure in British Columbia. This is in direct conflict with the policy of most, if not all, state licensing boards, where the LMCC is accepted as a an "equivalent" to the NBME. In addition, I was told I needed to be specialty certified by the Royal College of Physicians and Surgeons before getting a license. This is also in direct conflict with state medical board policies, none of which require board certification as a requirement for state licensing. Eighteen months and nearly $1,000 later, the Royal College, after having assessed my credentials, stated that I needed to take an additional year of residency in psychiatry before I was even eligible for certification. In the meantime, to support my family, I began commuting to Washington state, where I have worked at two community mental health centers.

I have found a local psychiatrist to sponsor my application for a "temporary license" in Victoria, to help him in his practice, as there is a nine- to 12-month waiting list for nonemergency psychiatric services here. In fact, most psychiatrists have closed practices, and some are beginning to reduce their hours because of cuts in their reimbursements. However, the British Columbia board has refused to meet with me or answer my calls regarding the status of that application.

While APA is to be lauded for its efforts to aid international medical graduates in their pursuit of their chosen career in the United States, it might be of interest to focus on the plight of U.S. citizens wishing to practice medicine north of the border. If changing the licensing procedure in Canada is not practical, states may want to reconsider the ease with which Canadian medical graduates are allowed to practice in the U.S.

Rick J. Strassman, M.D.
Victoria, British Columbia

[cradlecrotch]

I'd be happy to shed light on it, it doesn't contradict what I'm saying.

You see, the Canadian medical licensing authorities make it hard but not entirely impossible. The situation is this: for an IMG to practice in Canada, not only do you need to have completed your postgraduate training in the US, England, etc., you need to write all the relevant Canadian exams. These exams are the MCCEE, MCCQE1 and MCCQE2. Passing these exams makes you a Licentiate of the Medical Council of Canada (LMCC). But you're still not done. You now must pass a 4th exam, the one that makes you "board-certified" in your particular specialty - this is the Royal College of Physicians & Surgeons exam (if you're a specialist) or the College of Family Physicians of Canada exam (if you're a family doc). After all this, you are now ready to apply for a provincial license to practice medicine somewhere in Canada...from here on the extent of my knowledge gets fuzzy. I imagine that it is entirely possible to be granted a license in some provinces, perhaps under certain conditions as you say.

The letter-writer above is complaining that he has to take all these exams. If I were in practice for many years I'd be pissed too...imagine having to go back and study the basic clinical stuff you learned in med school. That's why you gotta write the exams while in med school, when the info's fresh in your head and you've studied for the equivalent US exams anyway. Also, a psych residency in the US is 4 years, but 5 in Canada. So he would be required to do an extra year - which blows too. If you want to come back to Canada some day, make sure the length of training is at least the same length of time! Hope this clears up some questions for you.

[redshifteffect]

So if you graduate from the US you have to do an extra year...but how do you do this extra year? For example in Internal medicine after the 3 year training, do you ask to stay on for an extra year, or attempt a fellowship?

[cradlecrotch]

Not sure how feasible it is to do an extra year of residency...I would expect it to be quite possible though. The only hangup I can think of is if your hospital has a full complement of residents and not enough attendings to accomodate one extra person, but I doubt this would be a problem. Doing a fellowship is also an option. Sorry, don't have the experience yet to give you specific answers.

[redshifteffect]

Thx for the help...

If i find out more about this I will post it here.

[mb003]

hey guys... i think what you are doing is great...

i'll add the little info i do know about this topic...

the mee exam expires in 7 years
MCC QE1 does not have an expiry date

www.library.utoronto.ca/m...mg/faq.htm (http://www.library.utoronto.ca/medicine/oimg/faq.htm)

so it's advantageous to get those two over with. the qeII needs one year of pg training at least to apply for it.

has anyone heard back from the CFPC regarding liscensure? even more confusing is if one does Primary care internal meds in the states...3 year program.

btw, after completing the oimg program where does those 50 people go...i don't think there are 50 spots in ontario in the carms second round!

[redshifteffect]

With Ontario and Quebec the situation is unique...there is no 2nd round of CaRMS for their IMGs. The IMGs in these two provinces must complete @ least 1 year of post grad training through the OIMG program. If they pass this program satisfactorily then they will be allowed to apply for the spots in the IMG residency programs...however there is no guarantee that they will get them....and I think that this method is even harder to go through than the second round of CaRMS.

[mb003]

hey red,

unfortunately the oimg program is not too quick to provide information about their stats or where the grads go after completing the one year.

[redshifteffect]

mb003

yeah no one really knows what happens to those ppl...however I do know there aren't even 50 spots for residency positions solely for IMGs within Ontario (so most of those 50 don't even get a spot...at least that's what I've heard).

There are other ways to "fast track" licensing that I have read about...but these involve ppl. with training that is already recognized, ie. from Ireland etc...