By Dr. Joy Eberhardt De Master, WCI Columnist

In the summer of 2022, I visited a friend in Canada. The move from the US had treated their family well, and it made me pause: should I do the same? A year later in the summer of 2023, I pulled a trailer with my electric car across the US to Canada. I was moving. It had happened.

As a US physician moving to Canada, here are a few steps I learned along the way.

 

The Logistics of Moving to Canada as a Physician

First, I’m assuming you are a medical professional reading this. Even if you’re not, much of what I’ve learned will apply to you anyway. Whoever you are, this is the time to immigrate to Canada. The doors are opened for thousands of immigrants. Many pathways lead forward.

Second, this column is not the why to immigrate. That is your story. Maybe someday we can share it together. In short, I decided to move to Canada for my family.

Lastly, the focus of this column is on immigrating from the US to Canada. There will be overlap for other countries, but I don’t know all that applies. Let’s get going.

Express Entry is a term you should know. It’s a rating system for people who want to immigrate. It’s based on individual details and heavily weighs connections to Canada—having studied, lived, or worked there. I had none of that! It is not related to being a physician and is open to anyone. Every year, Canada draws from this list to accept people to become permanent Canadian residents.

To apply, you need to take a language test. I did mine in San Francisco. My partner and I made a weekend trip of it. It’s a standardized exam like the USMLE (before you get stressed, know it is much easier). It does involve aspects of talking, reading, and writing. I did not study for it, and I scored high. Your test results add to your Express Entry points. Lastly, you need to do a physical examination—physical, chest X-ray, and blood work. I did mine in Seattle; we did it as a family and made a trip to Pikes Market Place (you gotta love the flying fish!).

Express Entry aside, know there are other ways to immigrate—they just take longer. That said, if you get a provincial nomination (a program based on the province’s need for employment), you get 600 points added to your Express Entry application, ensuring you will be picked in the next draw. Now, provincial nominations are a topic for another column but know that they exist. Also know they are not required, and there is more than one kind. But only one type can be added to Express Entry—that type is due to an identified worker shortage, aka physicians. I’m waiting to see if I will get it. But yes, that means you can move before getting one.

More information here:

5 Financial Considerations for American Doctors Wishing to Live Abroad

When Everything Clicks into Place: How Foreign Travel Can Make You a Better Doctor

 

Getting Licensed in Canada

The location of the US and Canada made me assume a level of professional reciprocity existed between the countries. And it does exist but not to the level I thought. Frankly, it’s easier to get licensed as a psychologist than a physician. My licensing process as a physician took about a year and required me to get a work permit before my medical license. I felt like I was trying to figure out what came first: the chicken or the egg! The process involved touches with many separate governmental bodies; these bodies don’t communicate with each other which caused me to repeat many steps over and over for each individual governmental agency.

First, your credentials are verified by the Canadian Medical Protective Association (CMPA). Then, you can both apply to the National Board Certification process and to the province of your choice. If we think about electrical circuits, the first process is in series and the next two are in parallel.

Know this: for the Royal College (aka the board certification for all but family medicine), there are only specific times a year you can apply. For me, that was in February 2023. It is now October 2023 as I write this, and they are only now finally starting to correspond with me.

Tip: Start this process when you can and don’t expect it to be started and finished quickly. If you need some cash, I recommend an emergency savings fund and/or to keep up a practice in the US during the transition.

Inside advice: You don’t have to be board-certified to be licensed in all of the provinces. Several of the provinces are opening their doors, and they have their own verification process separate from the Royal College.

More inside advice (for pediatricians): in Canada, pediatric residency is four years. This has created a barrier in the past for pediatricians trained in the US without a chief year or fellowship (aka a fourth year). I had only three years of residency and worried about getting licensed due to this. Thankfully, this is changing in some provinces, and I am now licensed. Keep hope!

Also remember that licensure is just that, a license to practice medicine. It is not a work permit. That is separate and needed if you are not a Canadian permanent resident or citizen. There are open and closed work permits. Closed permits are linked to an employer and based on you working for that specific employer. Open permits are (surprise, surprise!) open and allow you to work with any employer. They can have restrictions—no educational study and no work in the sex industry, for example. If your partner gets a work visa, you can get an open work visa through that and don’t need a job prior to moving. You likely can find one on arrival. Know that the need is great for physicians in Canada, and if you have minor children, they can get study permits to go to school with your work permit. It’s a win-win.

Make sure to talk with an immigration lawyer. They can put together your immigration paperwork or at least guide you along the way. If you want to save some money, get the guidance and then do it yourself—that’s what I did. You can also apply ahead of time for a work visa or get one (with the appropriate paperwork) upon entering Canada. I recommend the port of entry method—this means that you get all your paperwork together and show it at the Canadian border to get your work permit. It worked well for me, and the immigration lawyer also recommended it. (If you want the recommendation of the lawyer, feel free to reach out!)

More information here

Find Your Community Now — Or You’ll Regret It Later

I Sold My Rental and Changed Jobs to Save Myself

 

Learning How to Live in Canada

Speaking of kids, how do you pick schools and where to live? I loved the in-person feel for this if it's at all possible. Drive around. Meet people. See the schools. Walk the neighborhoods. Imagine your work-life balance. You know it’s the healthy choice. And why not if you are moving to a new country after all. Now is your chance to try it.

Of course, one can not write a column on moving to Canada without mentioning taxes. Taxes are high in Canada, and if you are moving (aka a settler), you can bring in your items tax-free one time. So, buy that pair of shoes now and take them with you to avoid the 15% sales tax! Also (if you can) sell your home before moving—the money you bring into Canada is not taxed the same as what you make once you're in Canada (or so I’m told).

Tip: If you decide to leave Canada before 18 months following your move, you won’t be taxed on additional investments in that time period.

OK, I have more I could share, but I think that is enough for today. I’ll post more in 2024 and share how my 2023 taxes turned out as I continue to make Canada my new home.

Have you moved to a different country as a physician? Was the process difficult? Are you happier now than you were as a US-based physician?