Postgraduate Medical Education in Canada

1. Postgraduate Medical Education in Canada Marcellina Mian Professor of Pediatrics Weill Cornell Medical College in Qatar

2. Training in Canada No conflict of interest to declare • Medical Council of Canada Qualifying Exams (MCCQE) • Residency: • Canadian Resident Matching Service (CaRMS) • Funded positions • Return of Service • Fellowship • Royal College of Physicians & Surgeons of Canada • License to practice

3. Routes to enter residencies Through match program Outside match program Must be officially sponsored by a funding source from their country of origin: government agencies, or health related charitable organizations. Private or personal funds are neither acceptable nor permissible. Must be: • Canadian Citizen, or • Permanent Resident

4. Medical Council of Canada (MCC) • Grants qualification in medicine known as Licentiate of the Medical Council of Canada (LMCC) to graduate physicians who have satisfied eligibility requirements & passed Medical Council of Canada Qualifying Examination (MCCQE) Parts I & II. • IMGs must first pass Medical Council of Canada Evaluating Examination (MCCEE). • IMGs with specialty certification in Canada or U.S. may be granted exemption from MCCEE. http://www.mcc.ca/en/exams/

5. MCCEE Preparation Study Material Self evaluation Use CanadaQbank: www.canadaqbank.com MCCEE online practice exams: http://www.mcc.ca/en/exams/self_admin.shtml Toronto Notes • Study content tested on USMLE Step 2CK • Review material in Toronto Notes: www.torontonotes.ca • Form study groups, if possible ~ USD 180

6. Canadian Resident Matching Service(CaRMS) http://www.carms.ca/eng/r1_about_intro_e.shtml When applying all applicants who plan on participating in CaRMS should read: • AFMC motion* • provincial criteria • specific program descriptions since eligibility for postgraduate training programs is ultimately determined by each Canadian medical school. *AFMC = Association of Faculties of Medicine of Canada: http://www.carms.ca/eng/R1_AFMCMotion_e.shtml

7. CaRMS Iterations • Match for entry level (R-1) postgraduate positions in all 17 Canadian medical schools is offered in 2 iterations. • First iteration includes: • All graduating students & prior-year graduates from Canada & US who meet basic eligibility criteria of CaRMS. • International Medical Graduates (IMGs) who meet basic eligibility criteria. • Second iteration offered for positions & applicants that: • were not matched in first iteration, & • applicants with previous North American postgraduate training who wish to apply for an R-1 position in Canada.

8. Eligibility for CaRMS MatchFirst Iteration • Medical student, or graduate having obtained or a medical degree by July 1 of the match year from: • A Liaison Committee on Medical Education / Committee on Accreditation on Canadian Medical Schools (LCME/CACMS) accredited school • A school of osteopathic medicine • An international medical school listed with the International Medical Education Directory (IMED), published by the Foundation for the Advancement of International Medical Education and Research (FAIMER) • Only applicants without previous postgraduate training http://www.carms.ca/eng/r1_eligibility_e.shtml

9. Summary of CaRMS intake criteria for IMGs by province P= Parallel: IMG apply to a separate stream of positions than Canadian graduates in one or more disciplines. C= Competitive: IMG apply to the same positions as Canadian graduates in all disciplines. http://www.carms.ca/eng/r1_eligibility_prov_e.shtml

10. Match Results for IMGs by Discipline Preference 2012 R-1 Main Residency Match – 1st Iteration http://www.carms.ca/pdfs/2012R1_MatchResults/12_Match%20Results%20for%20the%20IMGs%20by%20Discipline_en.pdf

11. Non-CaRMS positionsincluding Fellowships • Dependent on each institution’s determination of capacity for residency • Currently very limited in number • Each school has information on its website about quotas & program descriptions

12. Return of Service • Part of a set of strategies intended to attract physicians to underserviced communities • Varies by province*, stream & iteration • Length may be equal to number of years spent in residency • Failure to complete may result in significant monetary penalty, e.g., $5,000/month of remaining service • May be waived if there is no area of need. *e.g.: Ontario http://www.carms.ca/pdfs/OntarioROS.pdf

13. Eligibility for IMGs • Jurisdiction Approved Training • To establish eligibility to certification exam • For training done in jurisdiction that meets RCPSC criteria* & candidate deemed to have met RCPSC requirements • Practice Ready Assessment Route (PRA) • To allow IMGs to practice in Canada after RCPSC certification • Through provincial authorities for IMGs with certification from international jurisdictions • Individual Competency Assessment for IMGs • To IMGs with with competencies already achieved in an international jurisdiction, but require additional training to meet Canadian standard • Can shorten residency duration *http://www.royalcollege.ca/portal/page/portal/rc/common/documents/credentials/jurisdictions_e.html

14. Best advice if eligible to proceed… • How health care system works • How it is funded • Do background research • Check with people in Canadian system to answer your questions prior to interview. Demonstrate some understanding of Canadian medical education & health care system

15. Good luck & Bonne Chance!

16. Best advice: General Why is this program a good fit for YOU? Research as much about each program as possible including faculty, goals & unique aspects of what program offers. • Is the focus: • Research? • Specific populations of patients? • Different models of care? etc.

17. Best advice: General Demonstrate that you know as much as possible about the specialty of interest Why you want to do it? What strengths & challenges would you bring to both the specialty & the program ?

18. Best advice: General Programs will use past experiences to assess future performance Have good examples of things you have done that clearly demonstrate your strengths

19. Best advice: General Demonstrate your accomplishments & personal qualities beyond academic marks & exam scores Have good examples that demonstrate you are skilled in all areas important for practicing medicine

20. Best advice: General Know your limitations & be willing to describe them. Where do you need assistance? What sorts of areas present challenges for you?

21. Best advice: General Answer each & every question asked in application requirements. If you are not sure how to answer, ask someone