By Yale Wang, HBSc, MD (Class of 2015)

Yale obtained his HBSc and MSc in Laboratory Medicine and Pathobiology at the University of Toronto. He then completed this MD from St. Louis University in the United States, where he is currently pursuing a Dermatology residency (Class of 2020). Yale achieved a score of 260 on the USMLE (United States Medical Licensing Exam) Step 1, which placed him in the top 3rd percentile of participants. He also completed a Family Medicine residency in Toronto (Class of 2017).

A popular question I am often asked is: “Were you considered a Canadian Medical Graduate (CMG) when matching to Canada?” I am glad to tell you yes! If you are Canadian (citizen or permanent resident) and attended an LCME accredited medical school in the USA (i.e. the vast majority of schools in the continental USA) 24 , then you are considered a CMG because the LCME also accredits Canadian medical schools. It means you take the same exam as Canadian medical graduates to qualify for practice licensure. If you strongly wish to match back to Canada for residency, I would suggest you that apply to all programs that you are willing to pursue.

Another question I am asked is: “Does your USMLE score matter for residency matching?” I would say the answer is both “no” and “yes.” “No” because you are not evaluated by your USMLE score. In fact, you do not even need to report it as part of your application. Nobody would notice that you neglected to put something there, and nobody would care even if you have an amazing score. However, the answer would be “yes” in that you want to leave yourself with a backup plan in case you do not match in Canada, especially if you are applying to a competitive specialty. I have seen very competitive candidates fail to match to Family Medicine, which has the greatest number of spots in Canada. Having a strong USMLE score would significantly strengthen your residency application in the US.

One challenge of pursuing medical education in the US is that it can be very expensive (usually at least twice as expensive as Canada). To finance the high tuition fees, you can turn to government assistance, private lending, and banking institutions, for a total of usually of up to $250,000 in financial support. Not all the money is available immediately, however, and some schools may require full tuition to be paid up front.

I think my US medical education prepared me somewhat well to adapt to Canadian residency training. It has given me a stronger knowledge base in the basic sciences and in disease pathophysiology, which is heavily examined on the USMLE. As a result, I was well prepared for electives in Emergency Medicine and non-patient care specialties such as pathology, where the demands for knowledge are high. However, having trained in a different system, I find that Canadian students usually possess stronger hands-on skills and case presentation skills. I was not prepared to write daily orders, arrange admissions, and dictate consult notes when I first came back to Canada for elective rotations. Perhaps, it takes time to adjust to a new system and environment. Nonetheless, the Canadian training programs and licensure exams ensure that all candidates reach a required level of competency at the end of their training.

24  Liaison Committee On Medical Education (LCME) Medical School Directory.

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