Canadians studying medicine abroad and their journey to secure postgraduate training in Canada or the United States

Abstract

Background: From national and international workforce perspectives, Canadians studying medicine abroad (CSAs) are a growing provider group. Some were born in Canada whereas others immigrated as children. They study medicine in various countries, often attempting both American and Canadian medical licensure pathways.
 Methods: Using data from the Educational Commission for Foreign Medical Graduates (ECFMG) and the Medical Council of Canada (MCC), we looked at CSAs who attempted to secure residency positions in both Canada and the United States. We detailed the CSAs’ countries of birth and medical education. We tracked these individuals through their postgraduate education programs to enumerate their success rate and categorize the geographic locations of their training.
 Results: The majority of CSAs study medicine in one of 10 countries. The remainder are disbursed across 88 other countries. Most CSAs were born in Canada (62%). Approximately 1/3 of CSA from the 2004-2016 cohort had no record of entering a residency program in Canada or the United States (U.S.). Recently graduated CSAs were most likely to secure residency training in Ontario and New York.
 Conclusion: Many CSAs attempt to secure residency training in both Canada and the U.S. Quantifying success rates may be helpful for Canadians thinking about studying medicine abroad. Understanding the educational pathways of CSAs will be useful for physician labour workforce planning

“I wish I had known what I was getting into”: a qualitative study exploring the experiences of Canadians who study medicine abroad

“…Alternatively, they may need to emigrate to work as a physician. Analyses of administrative medical education data report that less than one-third of CSA obtain a post-graduate training position in Canada [ 24 , 25 ] and that roughly one-third of CSA who apply for a residency position in North America are unable to obtain a position in either Canada or the US [ 24 ]. A recent study of Canadian medical students who did not match to a post-graduate position noted the dire financial (termination of line-of-credit), licensing (inability to continue clinical training), and mental health consequences [ 26 ].…”

Specialty preferences of studying-abroad medical students from low- and middle-income countries

“…Students from high-income countries (HICs) [3] and those from low-and middle-income countries (LMICs) [4] favour different education destinations though. Some Caribbean countries are among the most popular locations for the US and Canadian students studying medicine abroad [1,5], and Central and Eastern Europe appeal more to the British, Swedish and Norwegians [6][7][8]. Meanwhile, some countries in Eastern Asia and Eastern Europe draw a considerable number of medical students from Africa and Southeast Asia, through medical programs that are taught either in English or in the host country's language [2,9,10].…”

“…These studying-abroad students are a potential workforce for their home country's health providers as well as the international labour market after successful completion of their overseas studies [5], although their career plans vary considerably. HIC students studying medicine abroad have been observed to commonly attempt medical licensure in their homelands to practise [11][12][13][14].…”

When a Canadian is not a Canadian: marginalization of IMGs in the CaRMS match

“…This marginalization has been raised in the popular press, 2,3 and has recently been raised in a Letter to the Editor in CMEJ 4 and in a Canadian Medical Association Blog. 5 While there is little in the way of published literature that addresses this marginalization other than recent papers by Najeeb, 6 Bartman et al, 7 and Watts and colleagues 8,9 there are, however, several excellent unpublished dissertations and theses exploring this topic. 10,11 It is past time for this important equity issue to be addressed in a major professional journal.…”