Personal accounts - Canada, Ontario

Ontario (Hamilton)

R6 - General Internal Medicine

ACADEMIC

Start 
  • GIM R4
Support 
  • Department head put him in touch with staff physicians in the sites identified
  • Little subsequent help
  • Each fellowship is different
  • Staff physicians often have no idea of procedures in other sites
  • It’s up to the candidate to take his own steps
Choice of site/specialization 
  • Recruited by a group of internists in a university setting
  • Discussion on site orientations and the candidate’s interests
  • Choice: thrombosis
  • Evaluation of different sites
  • Two separate applications made
Interview 
  • In person on site
  • Possibility of Skype interview, but less helpful
  • Being on site means you can see the facilities and meet with staff physicians and fellows
Exams required 
  • None
  • RCPSC certification only
Pay 
  • Quebec Association of Internal Medicine Specialists (ASMIQ) bursary
  • Bursary from the hospital where the candidate holds her PEM
  • Possibility of working as a clinical scholar
  • Moonlighting (possible in Canada through permit portability)
  • Candidates are usually asked to demonstrate that they have enough money to meet their needs during their fellowship
Prior rotation 
  • Not required 
Work permit/visa 
  • Not necessary/Apply to College of Physicians and Surgeons of Ontario (CPSO) for permit 
Visitor’s visa 
  • N/A 

PERSONAL

Health insurance 
  • Insurance through Quebec firm associated with the FMSQ in addition to Quebec Health Insurance Board (RAMQ) coverage 
Car 
  • Yes, as public transit in Hamilton is limited
  • Automobile insurance is a real headache
  • Ontario driver’s licence and address are required to obtain Ontario auto insurance
  • So provincial coverage is very costly
  • Shopped around a lot, and had to return to Quebec every 60 days to comply with coverage conditions
Bank account 
  • Make sure you have a card from a bank that has a branch on site (harder with Caisse Desjardins)
  • Just open an account and ask for an ATM card
Accommodation 
  • Complex
  • Search on several websites
  • Found a furnished apartment, and someone was able to visit it for her before she signed the lease
Driver’s licence 
  • Quebec driver’s licence accepted on certain conditions
Quebec Health Insurance Board (RAMQ) 
  • Usually transferable from one province to another 

  

ONTARIO (University of Toronto, Sunnybrook Hospital)

Abdominal Radiology 

ACADEMIC

Start 
  • End of R3 year 
Support
  • No help from his staff physicians
Choice of site/specialization  
  • His own personal choice of subspecialization
  • Applied wherever the training was given in Canada
  • Information found on the position
    https://jobs.car.ca/search
Interview 
  • On site 
Exams 
  • None required 
Pay/bursary 
  • Yes. Received a salary in line with Ontario resident doctors’ collective agreement, but paid by hospital radiologists 
Prior rotation 
  • None required 
Work permit/visa 
  • N/A
Visitors’ visa 
  • N/A

PERSONAL

Health insurance 
  • Additional health insurance through Sunnybrook Hospital, affiliated with the University of Toronto 
Car
  • Sold his car
Bank account 
  • Desjardins Group 
Accommodation 
Driver’s licence 
  • No
  • Public transit is adequate and preferable
Quebec Health Insurance Board (RAMQ) 
  • Reciprocity between Canadian provinces

 

ONTARIO (University of Ottawa)

Thrombose (1-year clinical fellowship) 

ACADEMIC

Start 
  • Spring/summer 2018 for a fellowship starting in July 2019
  • He talked at that time with different sites offering fellowships in thrombosis (McMaster and Ottawa)
  • He had a telephone interview with Ottawa in fall 2018, and received a positive response from them shortly afterward
Support
  • A staff physician put him in touch with the fellowship program directors at McMaster University and University of Ottawa
  • He took the remaining steps on his own
Choice of site/specialization
  • From personal interest and in line with the needs of his future practice site (his future site was flexible as to his choice of subspecialization)
  • The site’s worldwide reputation in the thrombosis field, positive contacts with staff physicians in the interview, financial contribution from the fellowship site, proximity of his home town, and possibility of living in Quebec while working in Ottawa
Interview
  • Telephone interview
  • He did not visit the site before starting his fellowship
Exams 
  • None required
  • Ottawa is a bilingual environment, and no English test is required
Pay/bursary
  • He is paid by his fellowship site in the form of a bursary
  • He also received a bursary from the Quebec Association of Internal Medicine Specialists (ASMIQ)
  • He moonlighted for several days during the year
  • His fellowship director put him in touch with the head of the Internal Medicine department so he could do several days’ moonlighting during the year
  • He had to obtain a permit to practise (independent practice) from the College of Physicians and Surgeons of Ontario (CPSO) as well as the necessary liability insurance coverage (see below)
  • He took steps to obtain practice privileges at the Ottawa Hospital
Prior rotation
  • No
Work permit/visa
  • A permit to practise from the College of Physicians and Surgeons of Ontario (CPSO) is required to practise in Ontario. The procedure for obtaining it is relatively straightforward.
  • He had to take out malpractice insurance (CMPA) at his own expense
Visitor’s visa
  • N/A

PERSONAL  

Health insurance
  • He was able to be covered under his spouse’s drug insurance plan, which she has through her job. Since she was on unpaid leave, the cost was higher (loss of her employer’s contribution)
Car
  • No change
Bank account
  • No change
Accommodation
  • Apartment in Gatineau
  • Visited Gatineau-area apartments in spring 2019
  • The proximity of Montreal meant they were able to visit the apartment before renting. The cost of accommodation is lower in Gatineau than in Ottawa
Driver’s licence
  • No change (SAAQ)
Quebec Health Insurance Board (RAMQ)
  • Since he lives in Quebec, there is no change to his RAMQ coverage

SPOUSE

 
  • His spouse went with him. She took a year off without pay to do so
  • No visa was necessary
  • She would have had the opportunity to work as a teacher in the region

OTHER

 
  • Performing a fellowship in Ottawa means being able to live in Quebec (Gatineau), cutting red tape (RAMQ, SAAQ, etc.)

  

ONTARIO

Colorectal Surgery

ACADEMIC

Start
  • End of R4 year (April)
Support
  • Helped by staff physicians in the site where she will be coming to work, and her program director
Choice of site/specialization 
  • Associated with her interests and strengths in the area
  • Also on the basis of positions available and the work team
  • The offer from the fellowship site matched her academic interests, and she appreciated her colleagues, and the overall work atmosphere
Interview
  • She had to undergo interviews across Canada before being selected
Exams
  • No English test required, because the fellowship was in Ottawa (bilingual city)
  • She was also selected elsewhere in Canada, and the English test would have been mandatory in the other provinces
Pay/bursary
  • Paid by the Ontario government as an R6 and R7 belonging to PAIRO
Prior rotation
  • Yes, a 1-month optional rotation, without which she is not sure she would have been given the position
Work permit/visa
  • She has to have a permit to practise issued by the College of Physicians and Surgeons of Ontario
Visitor’s visa
  • N/A

 PERSONAL

Health insurance
  • Took no special steps
Car
  • Kept her car
Bank account
  • Kept the same account
Accommodation

 

Driver’s licence

 

Quebec Health Insurance Board (RAMQ)
  • No special steps

SPOUSE

 
  • Her spouse will not go to Ontario, but will stay in Quebec for the two years of her fellowship

OTHER

   

  

TORONTO

Ehlers-Danlos Syndrome (GIM)

ACADEMIC

Start
  • Certified in Internal Medicine and General Internal Medicine. She received her 2nd certification during the fellowship
  • She began the process 15 months ahead of time
Support
  • On request, a former colleague gave her the email address of a key person for her fellowship
Choice of site/specialization
  • She spent a long time searching the Internet to find a clinic specializing in Ehlers-Danlos
  • She got in touch with the Toronto clinic after finding the name of a contact person on their website
  • She chose the specialization after talking with her recruiting site, but she completed all the steps herself
Interview
  • Telephone interview
  • She also travelled to the site to meet the team in person, although this was not required
Exams 
  • None required
  • She thought she needed to take the English test, but it was not required
Pay/bursary
  • Unpaid (no call duty)
  • Quebec Association of Internal Medicine Specialists (ASMIQ) bursary/CHUM Internal Medicine Department bursary
  • Other bursary possibilities include CHUM Foundation, medical faculty, and Royal College
Prior rotation
  • None required
Work permit/visa
  • The Ontario (CPSO) permit to practise is required
Visitor’s visa
  • N/A

 PERSONAL 

Health insurance
  • None required
Car
  • She left her car for her spouse in Montreal (no need for it at all in Toronto)
Bank account
  • N/A
Accommodation
  • Searched for accommodation using websites and on weekend visits in person
  • Many people moving to Toronto use an agency, though
  • There are also Facebook groups for fellows in Toronto that can be helpful for networking/finding an apartment, furniture, etc. (Groups : University of Toronto PGME Fellowship Forum et Fellowship in Toronto)
Driver’s licence
  • N/A
Quebec Health Insurance Board (RAMQ)
  • See section on health insurance above

SPOUSE

 
  • The candidate will go to Toronto on her own

OTHER

 
  • Even when you stay in Canada, the procedure is quite lengthy for malpractice insurance, registering at the University of Toronto, applying for a permit to practise, finding an apartment, etc.
  • It’s best to start the process ahead of time, and ask for help from people already on site

   

TORONTO

Hematology and Medical Oncology

ACADEMIC

Start
  • End of R5 year, once the PEM was confirmed
Support
  • Physician in the program
Choice of site/specialization
  • Very simple
  • A physician in the program who knew a Toronto doctor well made the first contact. The candidate then contacted the doctor in question, and the interview confirmed the fellowship
  • The choice of specialization was strongly suggested by the recruiting site
Interview
  • On site
Exams
  • None required
Pay/Bursary
  • Paid by the facility from a research budget
Prior rotation
  • Not required
Work permit/visa
  • Not needed
Visitor’s visa
  • Not needed

PERSONAL

Health insurance
  • Supplementary personal health insurance
Car
  • Not yet confirmed
Bank account
  • Quebec account is sufficient
Accommodation
  • Very expensive, between $2,500 and $3,500 per month for a furnished 3½ via airbnb. Nothing can be reserved far in advance
  • Need to reserve 4-8 weeks before the fellowship begins
Driver’s licence
  • Valid Quebec licence
Quebec Health Insurance Board (RAMQ)
  • Health insurance recognized in Ontario
  • Notify RAMQ ahead of time

  

ONTARIO (University of Toronto)

Second fellowship in a medical specialty program

ACADEMIC

Start 
  • R4
  • The candidate was offered the position by his training site at the start of his R4 year
  • First he performed a rotation in this medical specialty in a Quebec university, then decided to continue his training in that specialty
  • He suggested his approach to his recruiting site, and it was accepted
  • He applied alongside the CaRMS process, since the training is offered via CaRMS. He had to meet the same requirements and deadlines as for the medical subspecialty matching process, but without using the platform as such. This process was carried out in the fall of his R5 year
Support
  • To access a second-fellowship position in a medical faculty in Canada, it is mandatory to submit your application via the postgraduate education program in which you are registered
  • It is necessary to consult the program director, who handles internal follow-up
  • The candidate enjoyed the support of two staff physicians in his recruiting site
Choice of site/specialization
  • The choice of specialty corresponded to a special interest of the candidate’s, and not to a specific request from the site recruiting him
Interview
  • The interview was conducted in person but could have been done via Skype
Exams
  • No additional exam is required, since the fellowship is being carried out in Canada and specialist certification is recognized in all provinces
  • But it will necessary to pass another Royal College exam once this second fellowship is completed
Pay/Bursary
  • Pay for second fellowships carried out in Canada is covered by the collective agreement of the body representing resident doctors in that location, in this case the equivalent of an R6 and R7 belonging to the Professional Association of Residents of Ontario (PARO). The candidate thus enjoys the benefits of the PARO collective agreement, including work conditions, liability insurance, etc.
  • He is also receiving a bursary from his professional association
Prior rotation
  • Not required
Work permit/visa
  • Not needed, but, to moonlight in Ontario, a permit to practise in that province is mandatory
Visitor’s visa
  • N/A

PERSONAL

Health insurance  
Car
  • Using a car is not recommended. It is rarely required in Toronto
  • Most hospitals are located downtown
  • You can keep your Quebec driver’s licence
Bank account  
Accomodation
  • Housing costs in Toronto are rather high
  • The search for accommodation must be carried out 4 8 weeks before the move. Any earlier is too soon
  • There is good availability
Driver's licence  
Quebec Health Insurance Board (RAMQ)
  • RAMQ covers healthcare (outside Quebec for studies). You just have to notify them
  • Healthcare services are reimbursable in all provinces, at the rate paid by RAMQ

   

ONTARIO (University of Toronto)

Onco-nephrology

ACADEMIC

Start
  • During her R4 year
  • She completed her Nephrology residency on June 30, 2019
  • She took the Royal College Nephrology exam in September 2019
  • She worked as a nephrologist at the site which hired her until she left on her fellowship in January 2020
Support
  • Support from the entire Nephrology team at the hospital that hired her (Sacré-Cœur)
  • Several colleagues took some steps on her behalf, including getting in touch with resource persons they knew in Toronto to initiate a contact
  • Quickly, she was able to meet the person in charge of Nephrology fellowships in Toronto and organize her fellowship
  • For some more technical details after that (completing registration forms at the University, applying for a permit from the College of Physicians and Surgeons of Ontario, looking for an apartment, etc.), she was helped by friends who had previously done fellowships in Toronto
Choice of site/specialization
  • The subspecialization was a personal choice which she proposed to her home site, and they accepted right away
  • The choice of site arose organically, because it is one of the few sites, if not the only one, to offer a fellowship in that subspecialty, and the candidate had the advantage of having colleagues with contacts in Toronto
  • Potentially, there were two other options, one in New York City (a nephrologist practising in Montreal had done that training a few years ago), but the procedures are more complex for leaving Canada, and the cost of living is higher, and one in France (in a site that conducts research, but had never hosted a fellow and had no fellowship program as such)
Interview
  • An in-person breakfast meeting with the head of the host site, at the fall 2018 American Society of Nephrology Conference
  • Since this is the most important conference, most nephrologists from Canada and the U.S. attend, and it is a good time to meet. It was a somewhat informal get-together, to discuss her expectations concerning the fellowship, rather than a formal interview
Exams 
  • None required. Since the Royal College exams are Canada-wide, there are no additional exams to be taken. The University of Toronto and the College of Physicians and Surgeons of Ontario have access to your records and results via inscriptionmed.ca
  • No English test was required, either, for Canadian fellows, even if you come from Quebec
Pay/Bursary
  • She chose not to be paid by her training site, so as to be able to concentrate on her fellowship and not to have to cover General Nephrology. When paid by the site, you are an R6 and have to cover call duty and General Nephrology duties, and this cuts into the time allocated to the subspecialty
  • She received a bursary/financial assistance from her team at Sacré-Coeur Hospital. She was also able to work as a nephrologist at her practice site for a few months before leaving on the fellowship, allowing her to repay her student debt and be more financially comfortable when she left
Prior rotation
  • No
Work permit/visa
  • A permit from the College of Physicians and Surgeons of Ontario (CPSO) is required
  • A postgraduate education certificate is required in order to have practice privileges in the fellowship site only (equivalent to a training card), or a regular permit to practise medicine if you want to perform moonlighting in Ontario during the fellowship
  • She chose to apply for a certificate for fellows only, since she had no intention of working or moonlighting in Toronto during her fellowship
Visitor's visa
  • N/A

PERSONAL

Health insurance
  • Through interprovincial agreements pursuant to the Canada Health Act, healthcare in Ontario is covered by RAMQ. They have to be notified after three months’ residence in another province
Car 
  • She left her car in Montreal
  • She uses public transit in Toronto, walks, or cycles for her daily commute (the hospitals are all downtown, and public transit is highly developed)
  • For weekend trips to Montreal or vacation, the train is really great. It is also easy to fly from downtown Toronto
  • For those wishing to keep their car with them anyway, accommodation with parking can be found, but would obviously cost more. Also, auto insurance is very expensive in Toronto. She does not recommend it
Bank account
  • She had an account with a bank that has a presence in Ontario, so she did not have to change anything. Nothing to be done on this front
Accomodation
  • In Toronto, you need to use an agency to rent an apartment. They can provide access to specialized sites, enabling you to select apartments to visit in line with your criteria
  • It is best to plan one or two weekends on site to visit the selected apartments in person with the agent. Available apartments are usually listed at most 1-2 months in advance
  • But there are many steps to be completed with the agent before you can make any visits (forms to be filled out, Equifax credit check, letters of reference, proof of employment, etc.). So it is best to contact the agent a few months in advance and complete all the necessary papers, then 1-2 months before the fellowship begins, confirm the apartment visits. Thus, once on site, you will be able to make an offer immediately if an apartment interests you
  • There are many apartments available in Toronto, but also high demand and price wars at certain times of year. So you have to be ready, and have a good credit record
Driver's licence
  • She kept her Quebec driver’s licence
Quebec Health Insurance Board (RAMQ)
  • See above

SPOUSE

 
  • Her spouse is staying in Montreal for the first six months of her 1 year fellowship, and will join her for the second half. He is a teacher, and was able to take a sabbatical term in the fall to join her. He plans to work on personal projects, and will not be looking for work in Toronto. Since he is Canadian, too, he obviously will not need a visa

OTHER

 
  • Do not forget to take out liability insurance through the Canadian Medical Protective Association (CMPA) before starting your fellowship. Proof of coverage is required by the University of Toronto and the College of Physicians and Surgeons of Ontario (CPSO)

    

ONTARIO (University of Ottawa)

Knee Reconstruction Surgery 

ACADEMIC

Start
  • R4
Support
  • His program director helped him obtain an optional rotation in Ottawa
Choice of site/specialization 
  • This training site offered the only fellowship of its kind in Canada
  • Proximity to Montreal
  • Combination of personal interest and requirement of the site where he will be working with respect to the subspecialty
Interview
  • There was no formal interview because he did a 4-week optional rotation at the site 
Exams
  • No exam required 
Pay/Bursary
  • Pay set by University of Ottawa
  • Bursary from University of Montreal Surgery Department
Prior rotation
  • The rotation is not required, but helps in getting to know the fellowship staff physicians and obtaining the position 
Work permit/visa
  • Regular permit to practise from College of Physicians and Surgeons of Ontario (CPSO) 
Visitor's visa
  • N/A 

PERSONAL

Health insurance  
Car 
  • Insurance to be checked 
Bank account  
Accomodation
  • Steps needed to find accommodation in Ottawa 
Driver's licence  
Quebec Health Insurance Board (RAMQ)
  • Covered in Ontario under interprovincial agreements 

SPOUSE

 
  • No

OTHER

 

 

  

ONTARIO (University of Toronto)

Psychiatry – Drug Addiction

ACADEMIC

Start
  • Beginning of R5 year
Support
  • Support from a staff physician who had herself completed the fellowship 2-3 years ago
Choice of site/specialization
  • Personal interest
Interview
  • In-person interview (she was offered a Skype interview, but preferred to meet them in person)
Exams
  • None required
Pay/bursary
  • Paid by the training site
Prior rotation
  • No
Work permit/visa
  • Regular permit to practise from the College of Physicians and Surgeons of Ontario
Visitor's visa
  • N/A

PERSONAL

Health insurance  
Car
  • No car
Bank account
  •  Bank account in Quebec
Accomodation
  • Some colleagues referred her to a housing agency to help her find an apartment
Driver's licence  
Quebec Health Insurance Board (RAMQ)  

SPOUSE

 
  • Her spouse will accompany her for a few months
  • He will not perform a fellowship and will not work

OTHER