I am Niyi, an avid reader of your blog, so I feel telling my story is a way of giving back to IMGs. My story is super long, but it all happened in two years.
I graduated from a Nigerian University last decade and I relocated to Canada in July 2018. I started writing my licensing exams immediately. I scored 330 in MCCEE which I felt was okay, I immediately applied for NAC OSCE (Sept 2018) thinking it would the same, or better. It was a rude awakening when I found out I scored 72%, because I felt I did well. Everyone I practiced with scored between 76 and 82%. It was later that I got to understand that centre choice plays an important role, as where I took my exam was hosting for the first time, ever…
Anyway, I found out that I wasn’t eligible for CaRMS that year since my permanent residency was still under processing (I came in as a visitor). I then shifted my focus to MCCQE1 and studied 4 to 5 hours daily for 5 months using Toronto notes, First Aid and UWorld. In April 2019, one month to my MCCQE1 exam, it suddenly dawned on me that there is a ton of similarities between the MCCQE1 and USMLE 2CK. So, I added the USMLEs to the menu. I took both the USMLE 2CK and the MCCQE1 in the first week of May 2019.
The sheer difficulty and stamina needed for nine hours of USMLE made the MCCQE1 feel like a walk in the park. I scored 238 in USMLE 2CK and 260 in MCCQE1. I was satisfied with my scores especially because the USMLE was just an add on, but I had crossed the rubicon by taking USMLE2CK, so I wanted to get the exams out of the way. I hurriedly studied for step 1 in a month and scored 217, I had my focus on Canada with the US as a backup, so I wasn’t fazed.
I joined the IMG group in my province and had excellent preceptorships with CaRMS as my goal. I reapplied for NAC OSCE, and this time I was more confident, I practiced more and performed seamlessly. My preceptorships surely helped with my communication skills and I encourage all IMGs to have some sort of Canadian clinical exposure before going for the OSCEs. I scored ~ 82% (Sept 2019) on the old scale. I was invited for BC CAP and I was in the 2nd quartile, everything looked good on paper. I took the MCCQE2 in Oct 2019 and I passed! I was on fire and I felt unstoppable. I took USMLE 2CS in December 2019, and I passed it! LMCC and ECFMG certification in 7 months.
I then applied for Practice Ready Assessment as a back up of my back up, since I was super positive about my maiden CaRMS application. I got three Family Medicine interviews and they went very well. I even had some schools email me during the ranking period requesting further documents, I knew they had an interest. I got the invitation to write the January 2020 TDM exam and I almost declined it to wait for the outcome of CaRMS.
Lo and behold, on matchday, I DIDN’T MATCH. It was like the worst nightmare I wish I could wake up from. The only solace I had was that I passed the TDM exam the week before the match week. By the time I took the TDM exam in January, I was already jaded from taking too many exams in a short period that it took strong encouragement from my study partner for me to study. I instead wanted to focus on interview prep. My study partner and I both had interviews and the TDM exam to prepare for. He was honest with me and kept reminding me of how Practice Ready is the more certain route to licensure in Canada, I didn’t believe him, but thank goodness I listened!
We both passed the TDM exam and this was my emotional shock-absorber. I got an interview in the CaRMS 2nd iteration as well, but now the competition was more fierce, and due to Covid-19, I only got a 12-minute phone call interview. Of course, I didn’t match. This whole experience humbled me. I was really sad for a week: I cried and lost my appetite. Then, at my lowest point, I got the interview for Practice Ready Assessment. My study partner and I will be starting our assessment in the same cohort and I have now realized that this was probably the best route all along.
Here are some lessons I learnt.
- Try to always keep your options open till you get a confirmation. I can only imagine the anguish I would be in if I turned down the TDM exam invitation because I was confident about CaRMS. The June TDM exam which I was banking on as the next date has been postponed, and I have about 7 months of validity left on my IELTS.
- Learn to build a network with IMGs and have a study partner who is dedicated and focused. My study partner and I are not from the same country but he has become a very close friend. I met him through the provincial IMG program and we studied for NAC, QE2, BC CAP, USMLE 2CS, TDM and interviews together. Whenever one person was slacking, the other would be strong and encouraging (don’t surround yourself with negative people, it can be draining). We passed all our exams at our first attempt!
- Be ready for disappointment. You can have everything right and still fail. Don’t think less of yourself, instead take time off to cry, talk to someone and remain active towards your goals.
I hope we all find fulfillment and happiness in our journey through life because, in the end, that’s all that matters.
Sincerely,
Niyi.
Great read, thank you very much. I like what he said about having a lot of backups and being open minded.
How many years of practice did he have in Nigeria and Was he already a specialist? Thank you
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Dr Niyi says, “I had a one year internship training (house job) and 3 years of independent practice as a GP. It is possible to return to your home country to satisfy the recency requirement. I was able to finish my exams before my recency of practice expired.”
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Hi there. Thanks for your blog.
Do I absolutely need a permanent residency for the PRA?
Can I come on a work permit?
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Unfortunately yes you do
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Congratulations! This is a bit similar to my story.
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Yes you’re right. I have your story lined up for next week. Look out for it ❣️
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Congrats Dr. Niyi, best wishes in all what’s to come.
Can you please share advice on how to prepare for TDM, which sources to study from to pass?
Thank you.
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I used CTC ( Compendium of Therapeutic Choices) and Toronto Notes. I studied the most common illnesses encountered in family practice and studied with a partner. All the best
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Dear Dr Niyi,
Could you please tell us more about the TDM exam preparation. Do we need to know the dosages of all medications? Do we need to memorize all the drugs in the medication list, or the first two-three of them would be enough?
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The TDM exam was very interesting because the questions are similar to real life scenarios and I was not pressed for time.
Your tasks are clearly spelt out and you will be specifically told when dosages are required. It helps to know first lines and notable 2nd lines of common medications with dosages. CTC is quite helpful with this. You’ll find some sample questions on PRABC’s website.
All the best.
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WOW.. What an amazing commitnent and interesting story.. Almost similar to mine.
If you would like to provide me of sources to study for TDM examination. I just got the invitation and the exam is within 23 days..
good luck
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Dear Dr Niyi
what a great story
Thanks for sharing.
Would you able to give us details on to apply for PRA?
Thanks
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Thank you for sharing your story Niyi. I’m a Nigerian trained physician in the same dilemma. I had only one year of internship before leaving Nigeria four years ago. Now my recency of practice has expired. Do you think I should go back to work as a GP for some time? Do I take the QE1 and nac osce before going home? Do the exams expire?
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Hello Dr. Niyi,
Thank you for sharing your story. I am currently in the process of applying for 2021 residency match.
You said you did the BC CAP IMG. Would you be able to share your experience? What resources you used and how you prepared for it? Was it similar to the NAC?
Thanks!
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Hello Dr. Onyi,
We signed a non-disclosure agreement, so sadly I cannot give you details.
The format of the exam is changed from year to year, so my experience will likely be different. There was a preparation guide provided for us by UBC and I found it useful.
I’ll recommend taking a deep breath first and even a pause if you have to before answering the questions. The same goes for CaRMS interviews.
I wish you all the best.
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Hi Dr Niyi
I am in a similar bought though not exactly
I have passed the step 1 and step 2 ck and hoping to match in the us
In the mean time I have secured gp training in the uk
Also did my house job in Ghana where I am from and practiced for a couple of years as a GP.
I have only taken the mccqe1 and wanted to know without Nac which practise ready programs can I apply for and what are my chances so far I reached out to the Saskatoon program but I was told I need NAC exams
I was hoping if there’s a way to reach you directly for guidance especially on how to secure practise readiness
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