Canadian Rotations: The Basics

1. The Basics… Grace Dosanjh Canadian Rotations Liason

2. Hope everyone knows already… • Start rotations after writing the step • Usually can start before you get your score • No longer have to wait for the mail…. • ECMFG website – Register for the email where you get updates and notices

3. Rotations • SUSOM requires the following: • Core rotations: 42 weeks • 12 weeks surgery • 12 weeks IM • 6 weeks pediatrics • 6 weeks obs/gyn • 6 weeks psych

4. Elective rotations: • 30 weeks total, each rotation b/t 4 and 8 weeks duration • Required: 4 week Primary Care Elective: Family Medicine, Primary Care Medicine, Ambulatory Medicine and Pediatric Medicine • Required: 4 week Internal Medicine Subspecialty Elective • Rotations in Canada are considered teaching and thus are automatically greenbook

5. Fork in the path… • Find all cores and elective rotations in Canada • Or, Complete all cores and electives rotation in the US • Or, a little of this and a little of that

6. Ok so you want to do rotations in Canada… • Good News • Totally possible • Saba grads now doing Canadian residencies • Bad News • On your own to set up • Be prepared to hear NO!! alot…..

7. “I’ve heard that if I have more than 12 weeks rotations per calendar year that will void my chance of obtaining residency or even licensure!” • Simply not true. Personal conversations with Dr. Nick Busing, CEO of Ass. of Faculties of Medicine of Canada: revealed most residence directors simply want to see you complete your rotations while displaying competency and desire. • Personal conversations with Katherine Clarke, PR at CPSO has stated that it is irrelevant to CPSO where you did your rotations, as long as you have fulfilled your degree requirements from SUSOM. Disclaimer : this information is not first hand but very reliable, ie from last semesters liasons ;)

8. 12 weeks “rule” • The 12 week rule simply does not exist…on paper. • It is an unofficial agreement among Canadian medical faculties that they can arbitrarily impose to limit international med students • The purpose of the 12 week rule is to conserve resources for Canadian medical students

9. Any hospital that has affiliations with a Canadian medical university has signed a formal affiliation agreement. This agreement stipulates that the hospital must accommodate medical students from the affiliated university.

10. But Thas not unique ….

11. “ The Nova Scotia Program” Sort of only for students originally from that area Students work thru their own contacts or those of their NS peers Dalhousie is affiliated with almost every hospital in NS, the big 3 in NB, and has an unwritten agreement with PEI. What does this mean? If you go through Dalhousie, they will only allow you 12 weeks a year for all 3 provinces. New Dal Extension in NB may change some things in 2009?

12. ROS- Nova Scotia • You will work in Nova Scotia one year for every year of residency • Based on your residency, they will tell you where you will end up • If you choose to opt out, you will repay $5000 per month opted out plus interest at 2%.

13. How to set up rotations… SANDY’S RECOMMENDATION - You should start making contacts no earlier and really no later than 4th semester. First thing : Find a preceptor. A physician that is willing to take you for the rotation… Uncle Joe Scenario Do some homework, Does the preceptor work at a university affiliated hospital? How close of an affiliation is it?

14. You might need to do paperwork for the affiliated university Formal Application Fee Processing fee ex $500, non refundable Resume/CV Transcripts Whatever else they want…. Gardner needs to be involved because Sandy needs to sign off on your paperwork Technically you’re not supposed to tell the hosp that Saba pays for the rotation If $ money comes up, you refer communication to Gardner

15. The other path.. • Perform all core rotations throughout the U.S. • Take a few elective rotations in Ontario, Manitoba, Nova Scotia, or where ever you can .. • Being a 4th year med student has its advantages • Write all USMLE exams • Take MCQE1 and MCCEE for CARMS • MCCEE (medical council of Canada evaluating exam) • US residency = take the exam in January of their match year.   • Canadian residency= take the exam by Sept of the year before Basically make yourself eligible for both systems • Residency in US if Canada doesn’t work out

16. Apply as a relocating MD via CPSO: they take USMLE exams on par as MCC equivalents, you will still have to sit for either CFPC (family practice) or RCPS (specialist)***under review.

17. VISA

18. For US rotations • Not a problem! • School gives you a letter and you hop all the way to the border ! • Only glitch maybe with time limits

19. For Residency • J-1 “Alien Physician” (ECFMG sponsored) • H1-B “Specialty Occupation Worker” • J-2 “Dependent”(Spouse of J-1 principal • But you can only stay in the country as long as you spouse is there

25. After your training, If you want to stay in the US, you can petition the H1B • Lawyers • $ • Some hospitals may support your efforts • Others may discourage

26. SAMPLE POLICY OF A HOSPITAL GROUP Policy on Foreign Medical Graduate - H-1B Visa It is the policy of the Public health Trust to accept foreign residents who wish to petition for an initial H1-B visa or a renewal of an H1-B visa to this institution.  However, the Public Health Trust will not sponsor anyone who currently has an H1-B visa and wishes to obtain permanent status (alien resident) in the U.S.A. • The Public Health Trust will not be responsible for any and all legal fees.  Any fees assessed to the employer will be the responsibility of the respective department appointing such alien physician. • The Public Health Trust will not guarantee to hold a position for a physician, pending obtaining or renewal of such visa, since there are no guarantees of acquiring or retaining an H1-B visa. • Procedure • The physician must obtain and retain legal counsel during his/her residency training for the purpose of applying, processing, transferring the H1-B visa, while still in foreign resident status. • Legal counsel for the physician will provide Physician Service Office with all necessary paperwork and documents necessary for petitioning an H1-B visa. • During the course of the residency training, it is the resident’s responsibility to perform/complete all administrative functions required to maintain H1-B visa status. • Failure to renew/maintain H1-B visa status will result in termination.

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