IMG in Canada : How are you surviving?

[nayr69sg]

Find 260K on average very high for NS and Quebec but there are significant expenses. Perhaps they recently got an increase. All depends on expenses. If you are a small practice admin costs can be pretty high. If they are in their own practice your expenses could be pretty high. Rent, admin, insurance, etc. all add up. Maybe I should say 120-150K if you eliminate Ontario and Alberta the pay rate goes down a lot for all physician pay..

As someone who is in the industry and know many other doctors in various provinces, your 120 to 150k per annual figure is on the low side.

Certainly not the average at all. But I am sure you are totally convinced doctors make less. As I said where did you get your numbers from? Are you in the medical field?

I agree with you that it is almost impossible (10% success rate ie for every 1 who succeeds 9 never get licenced) for IMGs to get licenced to practice in Canada. So very hard to get in.

But when you do get in the system the financial returns are very good. Not 120k a year. That's small change.

 

[nayr69sg]

You were the one who said you got lucky. No offence but many of the IMGs with experience are very accomplished in their own countries. I am not doubting you were a good candidate. There are some stories where people end up licensed as a GP in 5 years from arrival but would not say that is the norm so don’t want others to get the wrong impression. It also got harder to match because overall enrolment in Canadian medical schools increased. If anything the number of residency spots may have been cut slightly. Canadian IMGs are also fighting for priority o There are other countries where you will be guaranteed a job if you can pass the licensing exams.

You were the one who said you got lucky. No offence but many of the IMGs with experience are very accomplished in their own countries. I am not doubting you were a good candidate. There are some stories where people end up licensed as a GP in 5 years from arrival but would not say that is the norm so don’t want others to get the wrong impression. It also got harder to match because overall enrolment in Canadian medical schools increased. If anything the number of residency spots may have been cut slightly. Canadian IMGs are also fighting for priority over other IMGs. I am sure there is already some favouritism when it comes to the Canadian IMG applicant’s especially if IMGs have family in smaller Canadian communities and want to return and settle there. Still believe that Canada is not the ideal place for IMGs if there is no need to settle in Canada. There are other countries where you will be guaranteed a job if you can pass the licensing exams.

And which countries would that be? Are they first world countries?

 

[canuck78]

Thank you very much indeed. what feedback I badly need. :
a few more questions if you can answer
1. there is a gap of practice for almost more than three years now. and I am sure it will take another one year to be eligible to apply for residency program or in provinces. do gap in practice matters. and if matters how much it matters. is there any chance that i could get residency in anesthesia/critical care? or GP where ever in Canada. no matter even in Yukon or northwest territory. if I pass NACOSCE but not MCCQE2
2. I don't have basic training in surgery. ie no house job in surgery. I did a whole one year in medicine and then worked in anesthesiology and surgical ICU. I have a diploma in anesthesiology and have experience in critical care, ICU and emergency medicine. I am 49 years old and still, I would be eligible to apply for residency if all goes well I will be 50.
currently, I m doing BSc nursing and in the fifth semester. at the same time doing work in security in three different companies to earn . plus working on my NACOSCE PLAN. but i find difficulty in finding NAC OSCE material. is there any place where i can find guidance but witoht spending much money. though in ontario there are many persons who are claiming to have a crash course of one week or two eeks and but they are taking thousands of dollars. that i feel not reasonable.
hoping a swift response from you

Think you should focus on nursing school. You would be looking at 3-5 years of residency minimum. You would be mid 50s before you would be practice ready if you actually get a residency. I think that will be a huge hurdle. Most centres will look at return on investment when looking at the age of the applicant and how many years they will be able to work. At your age you will not be able to work for 25+ years. Most GP programs prefer only accepting IMGs who were GPs. in their home countries. You should certainly try based on what residencies go unmatched. On top of that there are not very many spots if any for anesthesia residencies because it is also a sought after specialty. Have you considered continuing on to be a nurse practioner? If you went to an underserviced area you have quite a lot of responsibility. Wish you the best of luck.

 

[canuck78]

As someone who is in the industry and know many other doctors in various provinces, your 120 to 150k per annual figure is on the low side.

Certainly not the average at all. But I am sure you are totally convinced doctors make less. As I said where did you get your numbers from? Are you in the medical field?

I agree with you that it is almost impossible (10% success rate ie for every 1 who succeeds 9 never get licenced) for IMGs to get licenced to practice in Canada. So very hard to get in.

But when you do get in the system the financial returns are very good. Not 120k a year. That's small change.

We are talking GPS not ophthalmologists. If you make 260K and have at least one medical secretary so 40k minimum (most have 1.5 admins probably), have an accountant, have various insurance costs, tech/equipment, clinic rent and other clinic upkeep costs, etc. You can easily accumulate over 100k in expenses. You are probably familiar with Alberta and Ontario salary levels. I did revise my take home pay estimate from 120 to 120-150k although most GPs only pay themselves what they need and keep the money in their business for tax reasons so in the end they do make more after taxes that salaried people that make 120-150k. The data is a few years old but if the average family doctor makes 274k so with expenses you can go down to 120-150k. I should probably revise my estimate to 150k but that still isn’t a huge salary,

https://secure.cihi.ca/free_products/Physicians_in_Canada_2016.pdf

In general I think there needs to be less of a difference between top earning specialties and GPs. Also think there should be another family medicine only school. Perhaps the second GTA school. There are tons of graduating specialists who can’t find jobs because the residency system doesn’t take into account what specialties are currently needed and older doctors don’t want to retire or can’t retire.

 

[nayr69sg]

We are talking GPS not ophthalmologists. If you make 260K and have at least one medical secretary so 40k minimum (most have 1.5 admins probably), have an accountant, have various insurance costs, tech/equipment, clinic rent and other clinic upkeep costs, etc. You can easily accumulate over 100k in expenses. You are probably familiar with Alberta and Ontario salary levels. I did revise my take home pay estimate from 120 to 120-150k although most GPs only pay themselves what they need and keep the money in their business for tax reasons so in the end they do make more after taxes that salaried people that make 120-150k. The data is a few years old but if the average family doctor makes 274k so with expenses you can go down to 120-150k. I should probably revise my estimate to 150k but that still isn’t a huge salary,

https://secure.cihi.ca/free_products/Physicians_in_Canada_2016.pdf

In general I think there needs to be less of a difference between top earning specialties and GPs. Also think there should be another family medicine only school. Perhaps the second GTA school. There are tons of graduating specialists who can’t find jobs because the residency system doesn’t take into account what specialties are currently needed and older doctors don’t want to retire or can’t retire.

I think you will find it hard to find clinics which have just ONE family doctor.

Most of us work in clinics that have several physicians. And many clinics are owned by a third party who more likely than not is not a physician. The physicians then pay the clinic a split of billings to cover costs.

Personally I pay a 70/30 split from the clinic I work at on Tuesdays and a 75/25 split at the clinic I work wed to fri.
If you consider a very modest gross billing of $250,000 the costs come up to $75,000 for a net of $175,000. Remember clinics have a few physicians these days. Let's say you have 4 physicians each paying $50k a year as cost share. That's $200k to pay for clinic assistants, receptionists etc. And that's a conservative figure I am giving.

I dont even bother to look at my gross billings. When I get my cheques it is already minus the cost split. The clinic does my billing for me.

My net annual income is definitely not in the 120 to 150k range. It is much higher.

Before I got into medicine in Canada I looked at those numbers you see on the articles and reports and thought it would be about $100-$150k net before income tax. I mean $250k. Cost share $100k? $150k. After taxes? and I told myself what's the big deal with going back to medicine? I was already making that kind of $80-$90k per album salary at my Project Manager position.

The reason why I wish to set this straight is because I dont want to mislead IMGs. Seriously the money is good. If you work hard you will earn around $250,000 net before taxes. Or even more. And have your prof corp. And only pay yourself what you need.

So it is worthwhile. I am lucky that I got in without much of a struggle because i wasnt going to struggle at it when I thought it was going to be $80-$90k per album. What's the point right? Well it isnt that small.

 

[steaky]

I think you will find it hard to find clinics which have just ONE family doctor.

Most of us work in clinics that have several physicians. And many clinics are owned by a third party who more likely than not is not a physician. The physicians then pay the clinic a split of billings to cover costs.

Personally I pay a 70/30 split from the clinic I work at on Tuesdays and a 75/25 split at the clinic I work wed to fri.
If you consider a very modest gross billing of $250,000 the costs come up to $75,000 for a net of $175,000. Remember clinics have a few physicians these days. Let's say you have 4 physicians each paying $50k a year as cost share. That's $200k to pay for clinic assistants, receptionists etc. And that's a conservative figure I am giving.

I dont even bother to look at my gross billings. When I get my cheques it is already minus the cost split. The clinic does my billing for me.

My net annual income is definitely not in the 120 to 150k range. It is much higher.

Before I got into medicine in Canada I looked at those numbers you see on the articles and reports and thought it would be about $100-$150k net before income tax. I mean $250k. Cost share $100k? $150k. After taxes? and I told myself what's the big deal with going back to medicine? I was already making that kind of $80-$90k per album salary at my Project Manager position.

The reason why I wish to set this straight is because I dont want to mislead IMGs. Seriously the money is good. If you work hard you will earn around $250,000 net before taxes. Or even more. And have your prof corp. And only pay yourself what you need.

So it is worthwhile. I am lucky that I got in without much of a struggle because i wasnt going to struggle at it when I thought it was going to be $80-$90k per album. What's the point right? Well it isnt that small.

Perhaps I am one of the few people who visits a one family doctor clinic.

 

[nayr69sg]

Perhaps I am one of the few people who visits a one family doctor clinic.

Economies of scale. It is a business strategy.

If you are solo then your costs are higher of course. And you earn less net. And you have to find a locum while you are away.

 

[steaky]

Economies of scale. It is a business strategy.

If you are solo then your costs are higher of course. And you earn less net. And you have to find a locum while you are away.

There were no locum while he was in vacation or away. In that case, I go to a walk-in clinic instead.

 

[nayr69sg]

There were no locum while he was in vacation or away. In that case, I go to a walk-in clinic instead.

It could be that your dr has family members helping him run the clinic. So when they close the clinic everyone is on holiday together.

If you use family members as staff it can make sense business wise.

 

[steaky]

It could be that your dr has family members helping him run the clinic. So when they close the clinic everyone is on holiday together.

If you use family members as staff it can make sense business wise.

Make sense. I've seen the doc and the receptionist go out and dine together!

 

[nayr69sg]

Make sense. I've seen the doc and the receptionist go out and dine together!

Exactly.

@canuck78 have you considered that some GPs who "pay" their staff are actually just keeping the money in the same household too.

There are ways around the costs and taxes.

So trust those figures bandied about in the data. Remember those are averages. Which means it includes those semi retired GPs who maybe work very few hours. And also the ones who work less in general. Those actively working and working hard make a lot more than the average.

 

[canuck78]

I think you will find it hard to find clinics which have just ONE family doctor.

Most of us work in clinics that have several physicians. And many clinics are owned by a third party who more likely than not is not a physician. The physicians then pay the clinic a split of billings to cover costs.

Personally I pay a 70/30 split from the clinic I work at on Tuesdays and a 75/25 split at the clinic I work wed to fri.
If you consider a very modest gross billing of $250,000 the costs come up to $75,000 for a net of $175,000. Remember clinics have a few physicians these days. Let's say you have 4 physicians each paying $50k a year as cost share. That's $200k to pay for clinic assistants, receptionists etc. And that's a conservative figure I am giving.

I dont even bother to look at my gross billings. When I get my cheques it is already minus the cost split. The clinic does my billing for me.

My net annual income is definitely not in the 120 to 150k range. It is much higher.

Before I got into medicine in Canada I looked at those numbers you see on the articles and reports and thought it would be about $100-$150k net before income tax. I mean $250k. Cost share $100k? $150k. After taxes? and I told myself what's the big deal with going back to medicine? I was already making that kind of $80-$90k per album salary at my Project Manager position.

The reason why I wish to set this straight is because I dont want to mislead IMGs. Seriously the money is good. If you work hard you will earn around $250,000 net before taxes. Or even more. And have your prof corp. And only pay yourself what you need.

So it is worthwhile. I am lucky that I got in without much of a struggle because i wasnt going to struggle at it when I thought it was going to be $80-$90k per album. What's the point right? Well it isnt that small.

If you live in a smaller community it is hard to have a clinic with a large group of physicians. In a very expensive market it is often very hard to find a large enough office at a reasonable expense so you often get 1-2 doctors per clinic. What your experience is what it is but it doesn’t mean that other will have the same income. You saw the article which said that there is 100k difference average incomes. If you cross the border and work in BC in a clinic in Vancouver your fees for service rate is much lower and costs much higher. You live in a province where billing rates are high but hard costs are reasonable. You also live a city where the market can absorb a large practice. Not the case for everyone,

 

[canuck78]

It could be that your dr has family members helping him run the clinic. So when they close the clinic everyone is on holiday together.

If you use family members as staff it can make sense business wise.

That is less common than it used to be. Many spouses of physicians have their own career aspirations.

 

[canuck78]

Perhaps I am one of the few people who visits a one family doctor clinic.

I visit a 2 doctor clinic. A large practice is relatively new and is more of a suburban phenomenon or a teaching hospital group practice.

 

[canuck78]

Exactly.

@canuck78 have you considered that some GPs who "pay" their staff are actually just keeping the money in the same household too.

There are ways around the costs and taxes.

So trust those figures bandied about in the data. Remember those are averages. Which means it includes those semi retired GPs who maybe work very few hours. And also the ones who work less in general. Those actively working and working hard make a lot more than the average.

Your are likely on the high end of billing. I would encourage you to ask few GP for NS, QC and BC how much they think average take home pay for a GP is in their province. I am sure there is a conference or CE sometime soon.