Mathews Maria, Kandar Rima, Slade Steve, Yi Yanqing, Beardall Sue, Bourgeault Ivy
Affiliations: Division of Community Health and Humanities (Mathews, Yi), Faculty of Medicine, Memorial University of Newfoundland, St. John's, Nfld.; Canadian Post-M.D. Education Registry (Kandar), Association of Faculties of Medicine of Canada; Royal College of Physicians and Surgeons of Canada (Slade); Health Canada (Beardall); Telfer School of Management (Bourgeault), University of Ottawa, Ottawa, Ont.
CMAJ Open. 2017 Jun 19;5(2):E476-E482. doi: 10.9778/cmajo.20160144.
International medical graduates must realize a series of milestones to obtain full licensure. We examined the realization of milestones by Canadian and non-Canadian graduates of Western or Caribbean medical schools, and Canadian and non-Canadian graduates from other medical schools.
Using the National IMG Database (data available for 2005-2011), we created 2 cohorts: 1) international medical graduates who had passed the Medical Council of Canada Qualifying Examination Part I between 2005 and 2010 and 2) those who had first entered a family medicine postgraduate program between 2005 and 2009, or had first entered a specialty postgraduate program in 2005 or 2006. We examined 3 entry-to-practice milestones; obtaining a postgraduate position, passing the Medical Council of Canada Qualifying Examination Part II and obtaining a specialty designation.
Of the 6925 eligible graduates in cohort 1, 2144 (31.0%) had obtained a postgraduate position. Of the 1214 eligible graduates in cohort 2, 1126 (92.8%) had passed the Qualifying Examination Part II, and 889 (73.2%) had obtained a specialty designation. In multivariate analyses, Canadian graduates of Western or Caribbean medical schools (odds ratio [OR] 4.69, 95% confidence interval [CI] 3.82-5.71) and Canadian graduates of other medical schools (OR 1.49, 95% CI 1.31-1.70) were more likely to obtain a postgraduate position than non-Canadian graduates of other (not Western or Caribbean) medical schools. There was no difference among the groups in passing the Qualifying Examination Part II or obtaining a specialty designation.
Canadians who studied abroad were more likely than other international medical graduates to obtain a postgraduate position; there were no differences among the groups in realizing milestones once in a postgraduate program. These findings support policies that do not distinguish postgraduate applicants by citizenship or permanent residency status before medical school.
国际医学毕业生必须实现一系列的阶段性目标才能获得完全执照。我们研究了毕业于西方或加勒比地区医学院校的加拿大和非加拿大毕业生，以及毕业于其他医学院校的加拿大和非加拿大毕业生实现阶段性目标的情况。
利用国家国际医学毕业生数据库（2005 - 2011年可用数据），我们创建了两个队列：1）2005年至2010年间通过加拿大医学委员会资格考试第一部分的国际医学毕业生；2）2005年至2009年间首次进入家庭医学研究生项目，或2005年或2006年首次进入专科研究生项目的毕业生。我们研究了3个从入学到执业的阶段性目标；获得研究生职位、通过加拿大医学委员会资格考试第二部分以及获得专科指定。
在队列1的6925名合格毕业生中，2144名（31.0%）获得了研究生职位。在队列2的1214名合格毕业生中，1126名（92.8%）通过了资格考试第二部分，889名（73.2%）获得了专科指定。在多变量分析中，毕业于西方或加勒比地区医学院校的加拿大毕业生（优势比[OR] 4.69，95%置信区间[CI] 3.82 - 5.71）和毕业于其他医学院校的加拿大毕业生（OR 1.49，95% CI 1.31 - 1.70）比毕业于其他（非西方或加勒比地区）医学院校的非加拿大毕业生更有可能获得研究生职位。在通过资格考试第二部分或获得专科指定方面，各群体之间没有差异。
在国外学习的加拿大人比其他国际医学毕业生更有可能获得研究生职位；一旦进入研究生项目，各群体在实现阶段性目标方面没有差异。这些发现支持了在医学院校之前不按公民身份或永久居留身份区分研究生申请人的政策。
