Medical School in Canada - Post-graduate Medical Education

Post-graduate Medical Education

Students enter into the Canadian Resident Matching Service (CaRMS) in the fall of their final year. Students rank their preferences of hospitals and specialties. In turn, the programs to which they applied rank each student. Both sets of rank lists are confidential. Each group's preferences are entered into a computerized matching system to determine placement for residency positions. 'Match Day' usually occurs in March, a few months before graduation. The length of post-graduate training varies with choice of specialty. Family medicine is a 2 year program accredited by the College of Family Physicians of Canada (CFPC), and third year programs of residency training are available in various areas of practice, including Emergency Medicine, Maternal/Child, Care of the Elderly, Palliative Care or Sports Medicine. All other medical specialty residencies are accredited by the Royal College of Physicians and Surgeons of Canada; most are 5 years long. Internal medicine and pediatrics are 4-year programs in which the final year can be used to complete a fellowship in general internal medicine or general pediatrics, or used towards a longer fellowship (e.g., cardiology). A few surgical residencies, including cardiac surgery, neurosurgery, and some general surgery programs, last 6 years. Subspecialty fellowships are available after most residencies.

There are subtle differences between how residency training is organized in Canada as opposed to the United States. For example, M.D. graduates proceed directly into their residencies without the intermediate step of internship. However, this difference is somewhat superficial: for many residencies, the first postgraduate year (PGY1) in Canada is very similar to a rotating internship, with 1-2 month-long rotations in diverse fields. On the other hand, in Canada the graduate is often committed to a subspecialty earlier than a similar American graduate.

Some subspecialties are organized differently. For example, in the United States, cardiac and thoracic surgery are rolled into one fellowship (cardiothoracic surgery) following residency in general surgery. In Canada, cardiac surgery is a direct-entry residency (equivalent training can be obtained by pursuing a cardiac fellowship following residency in general surgery, but this route is far less popular). A fellowship in thoracic surgery can be pursued following residency in either cardiac or general surgery.

Unlike the United States and United Kingdom, in Canada there are no national guidelines for residents' call schedules or work hours. However, each province in which residency training takes place negotiates such details as part of a collective agreement between the authority and the provincial professional association of residents. An example of this is the Provincial Association of Internes and Residents of Ontario (http://en.wikipedia.org/wiki/Professional_Association_of_Internes_and_Residents_of_Ontario).