U.S.A. + Canada Residency Guide

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 is significantly easier. 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.

*Actual numbers can differ drastically between CSAs and IMGs due to multiple 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 are counted multiple times across different specialties despite only matching to one. This also skews the numbers.

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. 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, 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 many choose to take them within 1-2 weeks of each other.

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 happen within a 2-3 week period starting in mid-January. As such, there is plenty opportunity to attend both.