“At the mercy of some of the regulations”: the impact of the residency match and return of service requirement on the early-career decisions of international medical graduates in Canada

Mathews, Maria; Ryan, Dana; Randall, Ellen; Marshall, Emily Gard; Goldsmith, Laurie J.; Jones, Lori; Lavergne, M. Ruth; Snadden, David; Scott, Ian; Wong, Sabrina T.; Stringer, Katherine; Horrey, Kathleen; Grudniewicz, Agnes

doi:10.1186/s12960-022-00709-0

Human Resources for Health

Table 1 Mandatory ROS requirements for post-graduate medical education trainees in Canada

From: “At the mercy of some of the regulations”: the impact of the residency match and return of service requirement on the early-career decisions of international medical graduates in Canada

Province	Program Name	Trainee Type		Round*	Program		Eligibility Criteria (CaRMS Stream**)	Time Requirement	Payback amount
Province	Program Name	IMG	CMG	Round*	Family Medicine	Other	Eligibility Criteria (CaRMS Stream**)	Time Requirement	Payback amount
BC	Return of Service Program [22]	✓		1	✓		Parallel stream [23]	2 years [24,25,25]	Cost of training + interest + estimated damages (cost of replacement physician + average annual MSP billings). [22]
BC	Return of Service Program [22]	✓	✓	2	✓		Competitive stream [23]	2 years [24,25,25]
SK	International Medical Graduate Postgraduate Medical Training [26]	✓		1,2	✓	✓	Competitive stream (first and second iteration for family medicine; first iteration only for other speciality) [23]	1 year ROS/1 year of training [27]	Costs of training + interest [27]
MB	No formal title	✓		1,2	✓	✓	Parallel stream [23]	1 year ROS/1 year of training [28]	Costs of training + interest paid in one lump sum [28]
ON	IMG Return of Service Program (IMG ROS) [29]	✓		1,2	✓	✓	Parallel stream; includes subspecialty positions [24]	5 years; physicians with multiple ROS adhere to most restrictive ROS [29]	Costs of training + interest + administrative costs; may be repaid in installments [29, 30]
NL	No formal title	✓		1	✓	✓	Parallel stream [23]	1 year ROS/1 year of training [24]	Prorated cost of training based on number months of ROS unfulfilled + interest [31,32,32]
NL	No formal title	✓	✓	2	✓	✓	Competitive stream [23]	1 year ROS/1 year of training [24]
NS	No formal title	✓		1	✓	✓	Graduates of Non-LCME/CACMS-Accredited Medical Schools (GNLGAMS) parallel stream [24]	1 year ROS/1 year of training [33,34,34]	Not specified
NS	No formal title	✓	✓	2	✓	✓	GNLGAMS competitive stream [24]	1 year ROS/1 year of training [33,34,34]	Not specified
NB	No formal title	✓		1	✓	✓	GNLGAMS parallel stream [24]	1 year ROS/1 year of training [33]	Not specified
NB	No formal title	✓	✓	2	✓	✓	GNLGAMS competitive stream [24]	1 year ROS/1 year of training [33]	Not specified
PEI	No formal title	✓		1	✓	✓	GNLGAMS parallel stream [24]	1 year ROS/1 year of training [33]	Not specified
PEI	No formal title	✓	✓	2	✓	✓	GNLGAMS competitive stream [24]	1 year ROS/1 year of training [33]	Not specified

ROS return of service; CMG Canadian medical graduates; IMG international medical graduates; LCME/CACMS Liaison Committee on Medical Education/Committee on Accreditation of Canadian Medical Schools
*Round—denotes the first or second iteration of the residency matching process
**Parallel—IMGs apply to a separate stream of positions than CMGs in one or more disciplines; competitive—IMGs apply to the same positions as CMGs in all disciplines

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ISSN: 1478-4491

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