IMGs

International medical graduates (IMGs), or doctors trained outside of North America, already make up a significant part of the North American physician workforce. According to information from the American Medical Association, in 2005, 23.3% of practicing US physicians were IMGs. Similarly, an article published on April 26, 2005, by CTV News reports that more than one in five doctors in Canada were trained abroad.

However, the road to residency, licensure, and medical practice can be a long one for IMGs.

Evaluation Exams

IMGs must complete evaluation exams in order to qualify for residency and postgraduate medical programs.

In Canada, the required test is the Medical Council of Canada Evaluating Examination (MCCEE).

In the US, IMGs must receive certification from the Educational Commission for Foreign Medical Graduates (ECFMG).

Residency

After passing their evaluation exams, IMGs must complete an accredited residency or postgraduate training program. The Canadian Resident Matching Service (CaRMS) is responsible for many residency placements in Canada, while the United States offers the National Resident Matching Program (NRMP).

Applying to residency programs usually requires additional tests, interviews, and written and oral language tests (for example, TOEFL or TSE).

State, Provincial, or Territorial Licensing

In Canada, IMGs must pass the MCCQE I and MCCQE II to qualify for a license. IMGs who wish to practice in the US must pass the three-part United States Medical Licensing Examination (USMLE).

Individual states, provinces, and territories have different licensure requirements. After completing the national licensing exams, applicants must apply to the licensing body in the state/province/territory where they intend to practice. For more information, see our articles Licensing: MDs – Canada and Licensing: MDs – USA.

The United States – The Fifth Pathway

The Fifth Pathway Program is an American-standards medical training program taught outside of the US. Eligible students complete all but their final year of training at an institution listed in the World Health Organization's World Directory of Medical Schools. Students then complete their final year of medical training in the United States, and receive a "Certificate of Completion," which acts as their medical credential. About 1% of practicing US physicians entered the workforce through The Fifth Pathway Program.

Canada

Some provinces and territories offer a special form of licensure for physicians who plan to work in under-serviced areas. For example, under the Manitoba Licensure Program for International Medical Graduates (MLPIMG), qualified individuals can apply for conditional registration with the College of Physicians and Surgeons of Manitoba. The conditional registration allows the IMG to work as a general practitioner in under-serviced areas of Manitoba, under the supervision of a medical practice advisor. The IMG must complete the MCCQE within five years and the certificate of the College of Family Physicians of Canada within seven years. The MLPIMG Program also offers additional medical training to IMGs.

Prospects

Getting into a residency program is usually the biggest hurdle for IMGs. In general, IMGs in the United States have an easier time than in Canada. According to a paper published on October 27, 2005 in The New England Journal of Medicine, the demand for residency staff exceeds the number of US medical graduates by 30%. This gap is usually filled by IMGs. Programs also exist to attract IMGs to under-serviced areas of the country.

In Canada, IMGs are considered for residency positions only after Canadian-trained graduates have already been placed. According to an August 2004 article in Reader's Digest Canada, only 10% of IMGs who applied for residency in 2003 were able to find a position in Canada.

However, the situation is improving for IMGs who wish to practice in Canada. Many Canadian politicians, professional associations, and doctors argue that making it easier for IMGs to practice in Canada will be an important step in alleviating the nation's shortage of doctors. On April 25, 2005, the Canadian government announced that $75 million dollars will be spent over the next five years to speed up the integration of IMGs into the Canadian healthcare system. Much of the money will be used to increase the number of residency positions available. In 2005, British Columbia announced plans to increase the number of residency positions for IMGs from six to 18. Ontario was even more ambitious, and increased the number of residency positions for IMGs from 65 to 200 in 2004.

Beating the Odds

Here are some tips on how to improve your chances:

Discuss This Article

Have something you'd like to say? Tell us what you think! Read and post comments for this article.

Find a Job

Choose your career:

MedHunters is the world's biggest healthcare job board. Our job directory has 16,633 jobs with 2,439 hospitals and other direct employers.

We want you to find your next job on MedHunters. Need Help? Call us at 1-888-884-8242, email us at info@medhunters.com or sign up now.