Sandra Banner, executive director of the Canadian Resident Matching Service (CaRMS), says excess capacity in Canada's medical postgraduate training system means that “the message should definitely go out to Canadians who have gone abroad to study to come home [see accompanying article, page 1449].”

But many of them aren't listening.

Ilana Porzecanski, 1 of the many Canadians attending medical school in Ireland (CMAJ 2000;162[6]:868-71), did not apply for the 2002 CaRMS match. Instead, she applied in the US and matched to her first choice, a residency in internal medicine in St. Louis. “So far I have found only 1 Canadian IMG [international medical graduate] here who applied to CaRMS, and he withdrew as soon as he matched to a radiology program in the US.”

Porzecanski says many of the Canadians training in Ireland feel slighted that they are not allowed to participate in CaRMS' first iteration. “It looks like Canadian IMGs are not willing to take the CaRMS leftovers when they can get their first choice in the US,” she added.

She says graduates of foreign schools, including Canadians, face roadblocks when they apply for postgraduate training here. For instance, 13 positions remain unfilled in Manitoba, but Porzecanski says these positions are “not accessible to new graduates [of foreign schools].” She says there are restrictions in other provinces too.

Canadian Myto Duong, who graduates from Trinity College in Dublin this year, missed a deadline for one of the exams required for the CaRMS match, but was matched to the pediatrics program at Dartmouth College in New Hampshire. “I was also concerned that there wouldn't be any pediatric positions available in the second round in Canada,” she adds. “But I do intend to return home eventually as long as there are positions available.”

Darren Moisey, who will graduate from the Royal College of Surgeons in Ireland this year, says Canadians who train abroad are eligible only for spots graduates of Canadian schools don't want. “I am irritated that I am not able to compete with my peers for surgical training programs in the first part of the match, while I am able to compete equally in the US and here in Ireland.” He intends to complete an internship in Ireland and will then pursue surgical training in Ireland, England or Australia. “I doubt very much that I will ever practise in Canada.”

Porzecanski is more optimistic. “My intent is to come back. At least in 5 years, with my training complete, I'll be able to take up a job where I want in Canada and on my terms.” — Patrick Sullivan, CMAJ