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Any Canadian or anyone that can help me regarding SON please

5K views 64 replies 10 participants last post by  glucagonoma 
#1 ·
Hi all,

I matched into IM this year. I'm facing a bit of a dilemma regarding my statement of need. The limit health Canada has put on for internal medicine this year is 180. I've been in touch with representatives from Health Canada and was informed that 142 spots are filled so far. I applied a little late and I agree it was my irresponsibility and lack of paying attention.
With only 38 spots remaining and over 250 MORE applications to review since March 17th, I'm not so sure about my chances of getting an SoN. I will find out next week.

Does ANYONE have ANY clue what happens if someone isn't issued a statement of need? I cannot try for H1 visa because I'm not done with step 3.
What do I do and who do I appeal to?
Is there a possibility I may not be able to start my residency at all??
 
#63 ·
Of those whom are from Canada, there is a group on Facebook called the Society of Canadians Studying Medicine Abroad whom are active advocates for Canadian IMGs whom are going to the states to do residency. They recently requested some information from the government and I'm just going to copy and paste it below:

SOMBRE NEWS for Future Access to American Residency Training:

The Facts.

In July, 2015 shortly after Health Canada announced that their intention was to eliminate unlimited endorsements for certain disciplines, to eliminate access to fellowship training for physicians trained in the USA with a few limited exceptions, and to begin the process of reducing the number of endorsements for Statements of Needs generally, SOCASMA made an Access to Information request. The documents were not provided in the time required by legislation so it was necessary for us to appeal. We received the documents today, almost 2 years later. THE INFORMATION BELOW IS BASED ON DOCUMENTS THAT WERE GENERATED IN 2014 TO JULY 2015 when the current policy was being formulated.

The documents state that the plan is to reduce access to American residency training under the J-1 by reducing Statements of Needs that will be issued.

The stated object is to control the number of physicians to align with provincial health care planning.

To diffuse the anticipated outcry, the plan is to give some warning and reduce the numbers gradually. The plan reflected in these documents is to warn of future reductions in the 2016 match but to begin the cuts for the 2017 match.

Some provinces endorsed zero Statements of Needs for the 2016 match. These included Ontario, Alberta, and P.E.I.
British Columbia was the province that endorsed the most Statements of Needs.

Ontario proposed a more "succinct" list with limits on all specialties, with decreasing limits in subsequent years and a move towards zero endorsements. (In other words shutting down American training under J-1 visas.) [Statement of Need Process Review document, December 11, 2014].

Ontario writes in early 2015: "The hope is we can then move our provincial partners to zero in 2017 for most programs."
This December 11, 2014 document provides the following "context" for substantial reduction of Statements of Needs:
a. Decreasing need for physicians across the country as many provinces fulfill their needs through domestic supply;
b. The majority of applicants are from Ontario but Ontario has very low needs for more physicians;
c. This Program is not an effective recruiting strategy for Canada;
d. Recognition that the J1 is a useful pathway for many CSAs;
e. The purpose of the Statement of Needs is to attest to the need in Canada.

Ontario states its commitment to "no exceptions" once the quota is reached.

Stock responses were prepared by Health Canada for expected communications from CSAs with the direction that it was unnecessary, and by implication undesirable. to answer all questions-"not necessary to address all elements".

There is a stock answer to any requests for exceptions in the form of a denial including a form of denial if the request for exception is "escalated". "[Health Canada or Name of Ministry] does not plan to make any exceptions."

How the system works


The J1 visa is an educational exchange program governed by American law.

One of the American requirements of a J1 visa is that the home country must provide a Statement of Need stating that there is a need for the type of physician that will be training in the US.

The provinces, territories, and Health Canada formed a committee to determine policy and how many Statements of Needs should be issued. Each province and territory gives a list of the number of each discipline that they are prepared to endorse for Statements of Need. Health Canada adds up the numbers and posts this on its website in the List of Statements of Needs published each year.

The Statements of Needs are distributed on a first come, first served basis without regard to the province of the applicant. Thus even though Ontario endorses zero Statements of Needs, the majority of Statements of Need go to Ontario residents because the majority of CSAs come from Ontario.

Discussion and Analysis

When the J1 was originally introduced Canada issued Statements of Need (SONs) to anyone who asked as is the case in all developed countries (except Canada) to this day. In the 1990s, a fear of physician oversupply developed in Canada. Therefore Health Canada required a medical graduate seeking residency training in the US to get a letter from a prospective employer in order to be granted an SON. In the early 2000s the provincial/territory/federal committee began the current system of having a List.

It appears that we are moving back into the era of fear of oversupply of physicians despite physician shortages being reported across all of Canada and despite long and growing waiting lists.

The reality is that a significant amount of each province's budget is spent on health care. The provinces seek to control the number of qualified physicians which controls public access to health care which controls health care expenditure.
"Need" is defined by what the government is prepared to spend on health care versus public need for health care.

This is a political issue. Most provinces seek to limit access to American residency training. But the most powerful force acting to shut down access to American training is in Ontario. Everyone should be concerned about this issue. What good is universal health care if you can't access it?

The ray of hope in this is that a review of the 2017 and 2018 limits do not demonstrate the dramatic decreases planned in these documents and promoted by Ontario. The increases in dermatology and emergency medicine are meaningless as it is almost impossible to match to these programs. But the increase in family medicine is real and does reflect the intense need for family physicians in Canada. Internal medicine which is the most sought after discipline is decreasing. Link for List of Statements of Needs: http://www.hc-sc.gc.ca/…/postgrad-…/cat_b-list-liste-eng.php.

We intend to make a follow up request for Access to Information to see what each province is doing.

It is our understanding that the plan reflected in these documents is the current plan. When we have advocated for change, the response has been that the provinces, territories, and Health Canada are staying the course.

SOCASMA has been researching and developing strategies that can help CSAs. The executive of SOCASMA is comprised of parents and supporters resident in British Columbia. We advocate for CSAs across the country but if the doors to American residency are to stay open we need feet on the ground in each province, especially Ontario. We need help from parents and supporters who will organize and act. CSAs do not have the time it takes. If parents and supporters from other provinces are not prepared to work to fight for access to American residency training, access to American residency will continue to recede and perhaps even close. That is the current reality.

Currently, about twice as many CSAs train in the US as in Canada.

If you can't get residency training, you won't be licensed as a physician. Tell your parents and the people who care that we need their help to help you achieve your goals.

Source:
 
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