U.S.A. + Canada Residency Guide

DISCLAIMER: The information found below is only intended to serve as a rough guide for students wishing to pursue residency training in North America. While we try our best to ensure that the information is accurate and up to date, we can not guarantee that it is. Please use your own discretion when considering the information below, and make sure to do your own research before making any decisions.

Please note: this page does not cover the specific details on each examination, and all the nuances of being a strong applicant. Please read the specific U.S.A. and Canada pages before making use of this page

If you are a Canadian citizen, chances are you fit into this category. This is because, depending on specialty of choice, obtaining a residency position in the US can be less challenging. The following is some data (2018) on common specialties:

  • Family Medicine
    • US: IMG Applicants = 1,845. Number matched = 759
      • Match probability = 41.1%
    • Canada: IMG Applicants = 1,715. Number matched = 197
      • Match probability = 11.5%
  • Internal Medicine
    • US: IMG Applicants = 4,921. Number matched = 2,828
      • Match probability = 57.5%
    • Canada: IMG Applicants = 926. Number matched = 51
      • Match probability = 5.5%
  • General Surgery
    • US: IMG Applicants = 418. Number matched = 123
      • Match probability = 29.4%
    • Canada: IMG Applicants = 150. Number matched = 4
      • Match probability = 2.7%
  • Pediatrics
    • US: IMG Applicants = 710. Number matched = 477
      • Match probability = 67.2%
    • Canada: IMG Applicants = 351. Number matched = 18
      • Match probability = 5.1%
    • US: IMG Applicants = 231. Number matched = 93
      • Match probability = 40.3%
    • Canada: IMG Applicants = 118. Number matched = 5
      • Match probability = 4.2%

As you can see, for almost all specialties, you are almost 10 TIMES* as likely to get a spot in the United States as you are in Canada. As such, it is imprudent, as a Canadian citizen, to not apply to the US as well.

*These are raw numbers that are not stratified by recency of graduation, CSAs or IMGs status, or other factors. However, differential data does not exist, so we don’t know how different these numbers actually are. Furthermore, many people apply to multiple specialties and may be counted multiple times across different specialties despite only matching to one. This also skews the numbers. Anecdotally, Canadians who go abroad to study, as well as other recent medical graduates, can see match rates much higher than those listed above.

Do I need to take all of the exams for both countries? Yes. While rules differ by province, in most cases you will need the MCCQE 1 and NAC OSCE to apply. We strongly recommend you see individual provincial criteria for this.

When will I have the time to do both exams? Luckily, there is significant overlap between many of these. We recommend that the USMLE Step 1 should be taken first regardless, and no Canadian equivalent exists. The USMLE Step 2 CK and MCCQE Part 1 overlap considerably with regards to medical content, so taking them within the same time period is preferable (as it used to be with CK and MCCEE). The USMLE Step 2 CS and NAC OSCE also overlap quite a bit, and some even choose to take them within 1-2 weeks of each other. Note that these two exams are quite different in overall style and should be studied for individually.

Will it be difficult to complete both ERAS and CaRMS applications? Applying to both US and Canadian residencies is definitely manageable. ERAS applications generally open in early-to-mid September while CaRMS deadlines are in mid-to-late November. We are using the terms ‘opens’ and ‘deadline’ because while ERAS opens earlier, deadlines to apply to individual programs could be months later. HOWEVER, it is STRONGLY recommended to have everything ready by ERAS opening. Conversely, CaRMS has a deadline because most programs will not consider late applications and all programs have the same deadline. As such, you should have almost 2 months between them.

Won’t interviews overlap? US interviews tend to be conducted earlier, generally October to December, with some places offering interview dates in early January. Canadian interviews generally happen within a 2-3 week period starting in mid-January. As such, you should have time to attend both.