Canadian Path!

Ohhhh Canada.......An Overview
By Dr. F E

With the current state of the Nigerian Health care system and the disheartening future outlook of the Medical profession in Nigeria, it is not a surprise that many Nigerian Doctors are looking for greener pastures elsewhere. Some of these choice places being looked at include USA, UK, Ireland, Australia and Canada.

I had considered a number of these places when trying to decide. For personal reasons I chose Canada. However, there was little information about the entire process online and when found it painted a picture of bleak prospects. In spite of this, it was common knowledge that Canada really needed doctors to cater for their ever increasing population and they didn’t seem to be churning out enough graduates from medical school to fill this need. There had to be a way.

With my experience having written all 3 steps of the Canadian exams and obtained the LMCC (Licentiate of Medical Council of Canada) designation and having paid the price of time wasted due to lack of adequate information, I think it would be nice to be of service to my fellow colleagues who are considering embarking on this same journey by providing some information.

Overview of the exam process

Traditionally, the Canadian License examination consists of 3 steps which are:

1. MCCEE – Medical Council of Canada Evaluating Exams
2. MCCQE1 – Medical  Council of Canada Qualifying Exam 1
3. MCCQE2 – Medical Council of Canada Qualifying Exam 2

You do not have to have completed all three exams to be able to practice in Canada. Sometimes just the MCCEE is required. However having all 3 would increase your chances.

Other exams include

4.   NASOSCE – National Assessment Collaboration Objectively Structured Clinical Examination

The examination assesses the readiness of an IMG for entrance into a Canadian residency program. It is a national, standardized examination that tests the knowledge, skills and attitudes essential for entrance into postgraduate training in Canada

 So you are thinking of Canada, here are some things you might want to consider.

CONS

1. Limited Residency slots for IMGs: This is perhaps the deterrent factor for most International Medical graduates (IMGs). Truth be told, due to Canadian health system being funded mostly by the government (tax payers money) there are few spots available for IMGs (346 IMG spots as compared to 2989 CMG spots offered on the 2014 R-1 Match First Iteration - https://www.carms.ca/en/r-1-match-reports-2014). It is therefore difficult getting into choice specialties. Also the requirement for applicants to be at least a permanent resident of Canada poses a challenge. Becoming a permanent resident can be gotten via the FSWP (Federal Skilled Workers program), Provincial Nomination program etc (for more info see www.cic.gc.ca
2. Cost: Cost is another factor considered by IMGs is the cost. Currently the costs for the examinations are as follows - MCCEE - $1695, MCCQE1 - $950, MCCQE2 - $2260. This excludes initial registration costs, preparatory materials, travel costs (as the MCCQE1 and MCCQE2 have to be written in Canada) etc.

So with these discouraging factors, why consider Canada?

Pros:

1. Clinical exams: Quite unlike the USMLEs, all steps of the Canadian exams are clinically based with no testing on Basic Medical Sciences. This is a relief for older IMGs, who dread having to study anatomy biochemistry etc all over again.
2. Transferability to other countries: One advantage of the LMCC is that it is transferable to countries like Australia. With the LMCC, one can apply for provisional registration with the Australian Medical Council (AMC) without having to write the AMC exams. This helps you to avoid putting all your eggs in one basket.
3. Direct entry to Supervised/independent practice: An alternative to entry into residency programs, this is a largely unknown alternative available to Nigerian IMGs.  The Colleges of Physicians and surgeons of some provinces have registration pathways for IMGs with some residency training in their home country (bear in mind that your housemanship year is considered as your first year of residency) and a minimum of MCCEE or both MCCEE & MCCQE1 (depending on the province). This allows the IMG to enter into either supervised/ independent practice while on a work permit, after a period of assessment. Following this, there are certain processes in place to enable one become board certified. This route works particularly well for those interested in Family Medicine although it is also open to other specialties. Benefits to this route are, bypassing the hassle of entering/starting residency in Canada all over again, being paid a consultant level salary from the get-go (rather than a resident salary  for 3-5 years), a good opportunity to be nominated for Permanent Residency by the province. (Once you become a permanent resident, you can apply for matching into any other specialty if you wish)I’d advise that you go through different provincial colleges of physicians and surgeons to check out their requirements for registration and begin to work out how to align yourself.
4. Permanent resident status: As stated above, once one is able to secure an independent practice, you would be able to apply for a Permanent resident status based on either the Canadian Experience class or Provincial nominee Program and eventually, citizenship. (Now who wouldn’t like that eh… wink).

There you have it. A brief overview, the pros and the cons. I believe this would help you make an informed decision (don’t we do that a lot as doctors). In subsequent posts, I would go more into details.
DrFc
E-mail: StrictlyDrfc@gmail.com

Edited by Kuku Kayode for Medic-ALL.Inc 2014 
medic-allinc@hotmail.com