This document explains the development of our current medical system from a historic and legal perspective. It describes the current competition streams for medical residency and why this system is inconsistent with public interests. Below, we break down the 2013 BC Residency Competition Stream for you and list the implications:
*CSAs and other IMGs can only compete for leftover positions after CMGs have completed their first round of competition.
I. CMG (Canadian and American Medical School Graduate) stream:
a. 274 residency positions :
- 107 family medicine residencies
- 167 specialty positions
b. 256 UBC graduates
c. 252 UBC graduates applied for residency in Canada.
d. 140 UBC graduates stayed to work in British Columbia residency positions.
e. 16 Leftover positions after first round (iteration)
f. Competition as of right
g. No return of service obligations. This is true even of those medical school applicants who entered UBC medical school with low MCAT scores and GPAs as low as 70% because UBC considered them good candidates for rural practice.
a.In 2013 there were about 274 residency positions in this stream. There were about 256 UBC graduates in 2013 but only 252 applied for residency in Canada. So in this stream—in which CSAs and other IMGs are not allowed to compete—there are enough positions for all UBC graduates plus around 20 extras.
b. Of the 274 positions, 107 are family medicine residencies. The others are residency positions in the various specialties. All areas of specialization are available for CMGs. They can become whatever kind of specialist they want.
c. If there are any positions left over after the CMGs have gotten their first choice, CMGs who did not get matched in the first iteration, IMGs including CSAs, and Canadian physicians who want to change their specialty can compete for the leftovers.
d. CMGs have no return of service obligations. This is true even of those medical school applicants who entered UBC medical school with poor MCAT scores and GPAs as low as 70% because UBC considered them good candidates for rural practice.
II. IMG (International Medical Graduate) stream:
a. 34 residency positions
- 28 family medicine residencies
- 6 specialty positions in 3 out of 64 recognized specialty disciplines: psychiatry, internal medicine, pediatrics.
b. Competition contingent on agreeing to return of service obligations.
c. Number of CSAs who have been successful is not available as all bodies have refused to provide this information. Few succeed in BC.
a. In 2013 there were 34 residency positions in this stream. There are hundreds of applicants for these positions.
b. Of the 34 positions, 28 were in family medicine and 6 were specialization positions. Normally there are only 3 areas of specialization offered in the IMG stream: internal medicine, pediatrics, and psychiatry. There are 65 different medical disciplines: family medicine and 64 areas of specialization. 61 out of 65 areas of practice cannot be accessed by IMGs in BC.
c. All applicants who are successful in getting a residency position in BC in the IMG stream MUST sign a return of service contract. The contract provides that the resident must work in an underserviced community as directed by the Ministry of Health, after completing residency, for as many years as the residency training. If they breach the contract, they must pay $108,000 for each year of residency up to a maximum of 3 years ie, up to $324,000. This $108,000/year is more than the cost of education (about $28,000) and salary and benefits combined. A first year resident’s salary is $50,000 plus benefits. Their pay goes up about $5000 each year.
d. It is NOT possible at this time for CSAs to compete for a residency position in BC in the year they graduate in the IMG stream. In the past, a few CSAs were able to get into BC residencies in the year they graduated in the 2nd iteration, ie, by accessing the leftover positions in the CMG stream. In 2014, in BC only, even this access will not be available because of a rule change which was made too late for CSAs to respond to the need for the NAC OSCE.
e. Few CSAs are admitted into BC residency positions.