Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Hello there,
I hope you can help on this 'medical training/qualifications' question

What evidence can a current UK salaried GP of 3 years standing provide to 'prove' competency in paediatrics and emergency medicine to the various provincial medical colleges if the said GP did not do a paediatrics or emergency medicine rotation during GPVTS training?

Rotations completed were
Medicine
Psychiatry
ENT/Opthamology
Obs and Gynae
And GP registrar year


Any advice would be appreciated especially if you've come across someone who has overcome this 'deficiency'

Thanks in advance

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

It's highly unlikely anyone on this forum would be able to answer such a question. You should contact the Phycian governing body in the Province in which you're interested. For Ontario I think that would be:-
https://www.oma.org/Pages/default.aspx

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Thanks Auld Yin for your reply
Apologies for the technical question all, I am hoping to get a reply from the likes of

Very_Optimistic
stavex
John456
GeDe
sue.robinson and
snoopdawg who I think may have suggestions

I know they may only visit the forum rarely but i'm keeping my fingers crossed

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

You called!!
Amazing the power of forums!
Amazing also that we had the exact same problem!
One of us needed paeds, the other paeds and A&E.
We were focused on BC and Healthmatch BC were the ones to help us.
The A&E was easy as OH had done orthopaedics, ENT, some maxillofacial surgery, plus medicine /surgery so we successfully had that approved but we did get a letter from his orthopaedic consultant saying how much emergency involvement there was in that job- so you would struggle.
Paediatrics!! Basically we had to do!
So for several months on any day off and one day each weekend, we would head down to our local teaching hospital ( an hour from home) and sit in clinics, do consultant ward rounds and see kids sent in by GPs just like ourselves. It was useful at times ( clinics) and useless the rest of the time- as GPs for many years, we knew far more than the junior docs but had fun with the consultants who would roll their eyes at us frequently when some over keen junior doc would suggest something.
It was very different from our training days as the consultants treated us quite differently and often asked for our opinion rather than just as a "test".
We decided we would need something in writing in case ,so kept a log of all kids seen with learning points etc.We also printed off useful information to attach to show we had done the work.
At the end we sat down with the head of the department and went through it all, he then wrote a nice letter which was accepted by the College here.
What you will need to do,is decide which Province you want to go to and negotiate with them, make it clear you already have a full time job, so what will they accept.
I'm guessing you'll get a different answer from each College- I hear Saskatchewan really needs docs!!!!
It will be a pain and will delay you a bit but you are very young and time is on your side which we didn't have. It depends how much you want to move!

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Thank you!
It's my husband. I'm a psychiatrist and you very helpfully gave me some advice about MCCEE a few months ago which I passed.

2 more questions please please...
1] Would a letter from the current lead GP about paediatric experience and competence in his current 'walk in/GMS practice' do? or one from ENT to say that most of the ENT presentations were children?
2] How long did you do the 'paediatric attachment' for?

We're looking at BC/Ontario
Thanks a lot

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Well done re the MCCEE
The rest will ok as as well!
Re the paediatrics- I can only speak for BC and things may have changed- although I doubt it!- I had been a GP for about 18 years when I moved here- it counted for nothing, OH had also been a GP for years and done ENT- again- counted for nothing when it came to paediatrics- I think it's such an important speciality they will want something from you.
How long did we do it- about 6 months!!! We took it quite seriously as we wanted it to be approved.
It was hard as we were both working- had 2 kids and a dog! OH was doing out of hours work also.
If you look you'll see a lot of people on here have had to do similar depending on their profession, it's just one of many hurdles! Three and a half years after arriving, I've still a hurdle or two to jump although I'm getting tired of them now!

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Ok
We'll roll up our sleeves and get stuck into 'hurdle jumping' then
Thanks

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Attachment 110296

I know you'll be feeling frustrated now!! So some motivational photos
View at our local ski hill a few days ago and view from our deck in the summer- it was worth it!!! ( never attached photos before so I hope it works!)
Remember also that the majority of immigrant docs are from South Africa- they are well trained, hard working and highly motivated- the colleges have no need to change things for us.
But maybe things have changed - so contact them all and see!

For Alberta
 

Congrats on Passing the MCCEE.
I had a similar problem when I was trying for BC.
In the end I opted for AB as I just could not get any Paeds jobs/attachments.
Please check the CPSA website as for AB your husband already has all the experience.
This does mean he will have to go through a 2 week assessment and 3 month supervision.
http://www.cpsa.ab.ca/Services/Regis...x#Requirements

Best of luck

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Thank you Jani123
we will follow up on your advice as well
Is the 2 month assessment/3 month supervision period in Alberta counted as employment
i.e does one get a salary?

Thank you

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

There is a 2 'WEEK' assessment which is not paid.
The 3 month supervision period you can bill as normal.

Hope this helps.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Agreed Alberta looks easier than BC but you have to decide if you want to live there.
If you do ,often communities will pay good money to attract you but you have to think why!!! You're also more likely to have to do ER,hospital maybe even OBS.When I say hospital, I mean being responsible for patients who would be in a high dependency unit in the UK and in the ER , being THE doc not just a junior etc.
I can tell you, a lot of immigrant GPs start off in the likes of rural Alberta and Saskatchewan, stay for a few years then move to BC- ( there are lots in the town I live in) there must be a reason and its not money!!
Seriously, you'll have no problem getting jobs where ever you want, so think where you want to live, lifestyle etc , then if you have to do a bit extra to get it, it'll be worth it.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

I know this thread has been quiet for a few days but it is exactly the people I am looking for advice from. I qualified recently, ensured I did the rotations during VTS and have fortunately been approved for registration by the BC college. I am nervously awaiting TWP approval (I try not to think about it...). I plan to work in metro Vancouver if it all works out - all done via Healthmatch BC.

I would really appreciate some 'home truths' from those of you GP'ing in everyday life... I may have dodged a bullet with hospital privileges - I searched an old post of snoopdawg's about this (I'm not contractually required to do this which the Health Authority are getting huffy about) but I'm not entirely sure what's expected of me other than the office based stuff. I wonder what to prep up on currently to prepare me for daily practice.

Any advice/warnings would be greatly appreciated! Thank you in advance.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

I think you will have to decide where you want to move.
Here is a link to the job ops in Alberta along with links for more information.
http://www.albertaphysicianlink.ab.ca/
Checked earlier about 42 jobs in Calgary, and 17 in Edmonton, these will 'Not' offer you any incentives to move as you will be moving to an Urban area.
Hope this helps.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Sorry, I should have made it clearer, I already have a confirmed job in metro Vancouver (I always wanted an urban post - I did actually meet with the Alberta guys too at the RCGP conference and consider Calgary/Edmonton originally). I've been approved for provisional registration with the BC College arranged (:fingerscrossed:).

I'm at the stage where I'm gearing up to actually start practice (all being well with the TWP process) and wanted advice/insights from you guys who are actually practicing as every day GP's on differences in UK and Canadian Primary Care practice - or even things that helped you transition.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

It's quite different really
First of all patients- its hard for them to get a doc so are much more appreciative of you, I think I've a better relationship here.I know so much more about the whole family- even extended family. A "family doctor" is considered important, so they will even just bring in their kids just to meet you which is nice and easy cash for a quick check up although I would bill a visit not a physical ( CPX here) !!!
Remember, you are paid differently. Per visit- look at
http://www.health.gov.bc.ca/msp/info...l-practice.pdf
before you arrive.
People expect "full physicals' one a year but generally hard to justify unless older or chronic illness.
Take note of the "chronic disease management" and "complex care" bits of the billings- these add massively to your income- these are the patients you really want!!! But you cannot cherry pick and anyway, you need younger/lighter stuff to ease the pressure.
Can bill extra for counselling- see link above- useful for the depressed /anxious people you need to spend time with.
Medication- lots of different drugs/names- we have a great little book we found at UBC book store- Canadian Drug Pocket- get one early on.
Another fantastic book is Bugs and Drugs- 2012 edition just out
Written by an amazing local microbiologist- it is so useful and you may be able to get free when you arrive via health authority but buy one if not- UTis, staph infections seem to need different antibiotics here, and they still use the equivalent of septrin- why- no idea but you'll get half your patients telling you they are "allergic" to sulfa ' drugs.
Be prepared for a million times more opiate/benzo prescribing- be shocked!!! Be very careful taking on some of these people- you can meet and greet patients and decline to take them if you feel you could not have a working relationship. I had no probs with those who indicated they would work with me on appropriate pain management and declined those who said they could only take percocet- look it up- awful drug!
Hard to get LA opiates covered- crazy ruling
Expect lots of medical marijuana requests- avoid - the CPSBC /CMA do not approve due to lack of decent medical evidence-even though Health Canada are pushing.
Medication- cost- patients pay- some have "extended health care " paid for by employers normally- pay 50-100% of drug costs, but some are really picky about drugs- and refuse to cover some great ones. People on benefits get coverage from MSP and everyone should be enrolled on fair pharmacare-
http://www.health.gov.bc.ca/pharmaca...laniindex.html
But its tough at first thinking about costs.
One thing you must know about is Special authority- it will drive you mad-
look at
http://www.health.gov.bc.ca/pharmacare/prescribe.html
Really important- you could save your patients huge amounts
Physio- generally people pay or their extended health care.
Home visits- rare as hens teeth!!!
people expect to come to you- I have some from 2 hours away!
Nursing homes- we get faxes from the nurses and deal with people that way- very rarely you might need to visit.
Repeat prescriptions- only do via fax with pharmacy if patients blister packed- our office policy- all others must see us.Repeats= refills here
Out of hours- walk in clinics until about about 9pm, after that ER ( Emerg)
Patients pay for ambulances- odd how its not abused like the UK
DNA's- no shows here- can warn pt then bill- amount depending on length of appointment-
If persists can then fire patient
DO NOT be pushed into hospital- you should find in Vancouver that most GPs do not cover
Specialists- all docs are physicians- Physicians as you know are Internal medicine physicians
And- you write to them , not a hospital- their offices are usually in the community, and they can refuse to see your patients- if busy etc
Equally , you learn who is good/bad, nice /rude and can direct your patients to the good/nice specialists
Blood tests- = blood work- in the Okanagan , we cannot order LFTs, or U&Es, has to be written individually but our EMR has templates to quicken this. Forget U&Es- not a term- just renal bloods/panel, or in hospital shortened to E5 or 7 depending on what you want.
Some levels are different- FBC= CBC,, HB 10.2= HB 102
paps-smears- you do- very few "practice nurses"- cannot bill for them so not financially viable for most- forget the team you work with in the UK
A few nurse practitioners around- mainly employed by health authority in their own clinics- seem excellent- here anyway
You need to find out about ICBC- make great notes about all car accidents- MVAs here- you will most likely need them- a lot need legal reports later and you are usually treated as an expert witness
WCB- look it up- your EMR should have the forms loaded to fill out each time you see the patient- billing complicated for ICBC/WCB- get advice when you arrive

Financially- get advice ASAP re incorporating- its a must really- get a great accountant/book keeper- Dr Medix Inc- you then employ yourself.
Watch your overheads- make a hefty dent in your billings if you aren't careful!

Which is better- NHS/MSP- both have pros and cons for docs and patients! I would love someone to see this and eliminate the cons.

There's probably so much more- but I've just come to accept them as the norm!!!You'll feel like a fish out of water initially but it quickly gets better! Patients are generally tolerant and won't mind whilst you look up/ask someone about something.
Post or PM if you want!
HTH

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

OMG Snoopdawg you are a star! That's enough to get me started. I knew there was more to to it than the glossy brochures I got from Healthmatch BC and the BCMA!

Even urban practice will come as quite a shock it seems. I've been allocated an in-house supervisor who I've yet to meet (hopefully this will ease the impact).

As I head into work, have to say the lack of home visits seems like a nice welcome and the lack of abuse re: ambulances/DNA's :thumbup:

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

If there are GP's still reading this thread, and not put off (:p) and would consider Alberta - even Cochrane - for work, I have an excellent contact. British-trained GP - has been here about five years, and like snoopdawg, can explain the non-glossy warts-and-all version of working here. Can also point you in the right direction re hoops that need to be jumped. LMO's might even be available. Send me a message. :)

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Oi! Stop trying to poach our potential GPs.

To Medix: there is a general shortage of GPs in many areas of Canada. Less so in urban areas but unless you kill off more than 10% of your first year patients you should not have too much trouble establishing a practice.

British and South African doctors seem to be respected by patients.

Yes, you should incorporate so find a lawyer and accountant with experience in this area. (I have no experience with medics and so am not touting for business.)

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

10% ... I think it's fair to say that if old Harold Shipman was still with us his indiscretions would be overlooked if he was willing to establishing a practice up this way.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

As a nurse, I hope I am allowed to add something here. I worked as a Practice Nurse in the UK before moving here. Now I work in the Canadian equivalent of the Family Planning/GU clinic.
Alas, it is true...no Practice Nurses here, because of billing.
I work alongside many Family Practice Drs that do shifts for us at the clinic. They do it as an add-on to their normal hours. They like the ease and convenience, no overheads, no admin, no paperwork. Turn up see the patients and then get paid. It keeps their skills up, and most of them enjoy the work and the seeing the patients.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Thank you all for the insights, very useful since when you are recruited from the UK they never tell you about the cons of practice.

In my particular circumstances, I did my homework 3-4 years in advance to ensure I met BC requirements (they are far pickier than some of the other provinces) and I have several GP/medic friends who are considering Alberta or SK instead because getting registered is less of an issue as other people have noticed. If you play your cards right, you can get exemption from the MCCEE as well (one less hurdle).

Snoopdawg: I may continue to pick your brain as I work my way through your info, a lot of Canadian practice seems more closely aligned with our American colleagues (eg Hb readings, CBC/panels) - I did some of my rotations as a med student in the US and it all sounds suspiciously familiar. Most of the docs recruited are placed into fee-for-service practice which seems to be the way to go. Your wisdom is most appreciated :cool:. I am actually pulling some extra shifts in A&E just to make sure I'm thick skinned to cope with any unexpected surprises in BC practice...

ann m: I may have people interested in Alberta, the trick is getting the college to recognise your training. Getting the LMO isn't too bad for physicians in most provinces - it seems to be quick since they seem to be very short staffed (then again, you lose the advantage when applying for TWP since you need a medical and additional blood tests)

JonboyE: rest assured, BC was (and remains my first choice) primarily due to climate and my liking for Vancouver (despite the incredible flak it seems to get on this forum)! Vancouver was not always on the 'demand' area list but now the entire province is considered 'area of need' for physicians. I am trying to stay positive about it all! I am moving by myself and want to live downtown/west end, and have picked a job that allows Skytrain commuting. I know Vancouver isn't everyone's cup of tea, but I really enjoyed my research trips partying away and people seem laid back (or maybe I have been misled?!). Incorporation as both you and snoopdawg have said seems a good idea, I need to get professional advice with this since it doesn't always make sense if you need to extract the money from the corporation immediately.

charlottyb: I like the idea of additional shifts (not sure I'd be allowed in the early stages). Nothing like a shift in FP/GUM to broaden one's horizons :lol: and something to think about for the future.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

No problems re brain picking!
I've never worked in the USA but I think most of Canadian levels are similar to UK with the exception of HB, I know lipids are different from the States. Its more the terminology which may be similar to them. And I would love to just write LFTs!
There are some rules re what you can order- I've never seen a list of them, but it may exist but for e.g. MSP will only pay for PSAs/lipids if medically indicated, otherwise patients pay.
Incorporation- you can get your money, you just have to pay tax!!- It makes sense, whatever you don't need , stays in the Inc and you pay business tax- 13ish% ??
If you take it out- either as wages or as a dividend you pay much higher tax. I don't know any docs here who aren't incorporated. It helped from a banking point of view also- a line of credit on a business account will be at a better rate than a personal account- I think! Our business credit card given to us on arrival in Canada had twice the credit limit than our personal one and was a pretty gold colour.
You're right about Vancouver being in need now. When we looked at moving we were told to forget Vancouver, Victoria, and probably Kelowna as they were not areas of need. Healthmatch had been set up to serve rural areas.This was fine for us as we had no desire to live in any of those places- although I love visiting both Vancouver and Victoria.
By the time we moved, over 3 years ago, Healthmatch had started to recruit for Vancouver also, so I presume everywhere is now in need. Using nurses ( esp nurse practitioners) would be the answer, they are excellent at chronic disease management, freeing our time so we can take on more patients.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

[amazing power of forums

I am so thankful for this answer, i was lacking in surgery which i did on an honorary contract and I have worked my butt off doing this job for free. my supervising consultant wrote a letter and the college accepted it. but now they want t to be source verified. i have my CCT and MRCGP verifed already and I do not know if ECFMG will source verfy ths letter. Please can you advise if they would?

i am keeping my fingers crossed that you will visit the forum soon

Thanks
UOTE=snoopdawg;10451103]You called!!
Amazing the power of forums!
Amazing also that we had the exact same problem!
One of us needed paeds, the other paeds and A&E.
We were focused on BC and Healthmatch BC were the ones to help us.
The A&E was easy as OH had done orthopaedics, ENT, some maxillofacial surgery, plus medicine /surgery so we successfully had that approved but we did get a letter from his orthopaedic consultant saying how much emergency involvement there was in that job- so you would struggle.
Paediatrics!! Basically we had to do!
So for several months on any day off and one day each weekend, we would head down to our local teaching hospital ( an hour from home) and sit in clinics, do consultant ward rounds and see kids sent in by GPs just like ourselves. It was useful at times ( clinics) and useless the rest of the time- as GPs for many years, we knew far more than the junior docs but had fun with the consultants who would roll their eyes at us frequently when some over keen junior doc would suggest something.
It was very different from our training days as the consultants treated us quite differently and often asked for our opinion rather than just as a "test".
We decided we would need something in writing in case ,so kept a log of all kids seen with learning points etc.We also printed off useful information to attach to show we had done the work.
At the end we sat down with the head of the department and went through it all, he then wrote a nice letter which was accepted by the College here.
What you will need to do,is decide which Province you want to go to and negotiate with them, make it clear you already have a full time job, so what will they accept.
I'm guessing you'll get a different answer from each College- I hear Saskatchewan really needs docs!!!!
It will be a pain and will delay you a bit but you are very young and time is on your side which we didn't have. It depends how much you want to move![/QUOTE]

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Hi
Are you applying to Canada- do you not have to use PCRC? May be things have changed but have just checked PCRC as so long ago, but yes we did submit our letter from the paediatric consultant and yes they did source verify and it was passed.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Hi

I have all the other documents verified but was not sure how to classify it. It is not a certificate and was not part of the GPVTS. And also I was concerned about HR being obstructive. If they write to the lead consultant, it should be straightforward.
I am so grateful for your help. Any advice would help.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Hi
We submitted it under Postgrad training ( after year 1)- I can't open the history- ? my mac- but looks like I put it under the hospital name. I would think that they would write to the consultant who did the letter for you.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Hi

Thank you so much. I am much relieved and reassured now.
Your replies meant a lot. Thanks

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

hi all,

Im new here but will be qualifying as a GP this year and considering BC. Im missing a paeds rotation - does anyone know if healthmatch BC/college of BC are still allowing you to make up a rotation? And can this rotation be made up outside a training post ie: arranged b/w yourself and a consultant, working for free for x amount of time, like the way snoopdawg did theirs?

Thanks in advance!

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Healthmatch are the people who help to get you over here and they really do try hard.They are incredibly helpful, email or phone them, they will tell you the CPSBC's current rules, I can't see why it should have changed.

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

thanks snoopdawg!

Just wanted to see if there was any current/recent experience with this prior to contacting healthmatch...

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

I have made extensive use of Healthmatch BC. I can say they are very helpful but the CPSBC is rigid with it's requirements. Be patient (I would allow at least a year). I managed to get exempted from MCCEE by having the correct rotations and MRCGP (which as a newly qualifying GP you should get anyway in conjunction with your CCT). The CPSBC's take is that since MRCGP holders are eligible for CCFP registration by virtue of recognition of training (called the ARC pathway), this is one way that the Medical Council of Canada will give MCCEE exemption. As far as I am aware, no other province will allow this (Alberta and SK insist upon MCCEE).

You should be able to make up the missing rotation but you MUST have it otherwise they will refuse registration. When my deanery gave me a letter, they omitted the word 'Obstetrics' from my O&G rotation and the college insisted on full and correct terminology to accept I had done my four months of O&G - so I had to get it re-typed.

As an example, of timescales, I applied in late 2011 and I am starting in a few weeks! It took even longer than I thought. Also be aware that the process of document verification with the PCRC is painfully slow - I would suggest getting started early. Good luck!

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

thanks medix!
Was it the immigration and PCRC process that took the longest?

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Yes, definitely. Once Healthmatch makes contact with the College, they are pretty quick at turning around your eligibility review and letting you know if you meet their requirements.

The slowest part is the interaction with Citizenship and Immigration Canada (CIC). PCRC themselves are reasonable in that you have to physically mail them all your paperwork, but in my case, some of the institutions (especially the deanery) took forever to acknowledge the authenticity of their own documents. Some of my documents sat on 'In Progress' for months until I hunted down the right people to check their mail to ensure they had actually acted upon the request!

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

hi
I am a UK trained GP and my husband is a Psychiatrist.We are hoping to get work in Canada and emigrate in the next 2 years. This thread has been very useful but just wondered if there is any one area we ought to concentrate where more chances of both of us getting jobs. We were thinking BC/Alberta. Any advice appreciated..
thanks

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Also if anyone knows about the 89 day locum programme in Alberta??

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Have a look at a blog below
http://gpincanada.tumblr.com/post/54...ocum-programme
or

email the coordinator direct at <snip>

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

You can also PM me if you'd like

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

Apologies christmasoompa
I should have thought

re: Chat for and with Canadian Family Practitioners/ex UK General Practitioners
 

No problem. Mgpant can PM you for the email address if s/he wishes.

:)