Brief explanation for medical residency needs in the mentioned countries . Where & How to start? How much each exam will cost? Time needed to prepare for exams? Residency duration in Germany, UK, USA, Canada? Salaries per year while residency !!

1. Road to Residency
Germany, UK & North America
By :
Abdallah El-Azanki MD ,MSc
Orthopedic Surgery
Limb Lengthening & Deformity Correction
In coordination with WSIG-LU

2.  Most suitable time to apply
• Country you are planning to join !!
• Your experience (Germany, UK, Canada Fellowship)
• Elective visits / observerships ( UK,Canada, USA)
• Your research (UK,USA,Canada)
• Extra-curricular achievements (sports, music…)
• Volunteering attitude ( very important esp for Canada )
• Application requirements
• Exams needed to sit for
Discussed later, country dependent
 Scholarships
 Feasibility and granting criteria ( available for Msc, PhD)
 Erasmus
 UK university grants

3.  Medical school grades
 If planning for top ranked institutions
 High grades alone means nothing but a nerd
 Even if high grades still you need every exam
 Do certain specialties necessitate specific requirements?
• Yes especially surgery domains
 Advices to enrich audience knowledge with based on your expertise!
• Discussed while talking
 Residency duration and what to expect
• Usually surgery 6 years
• Medicine 4-5 years
• But Fellowships are usually required (subspecialty)

4. GERMANYNo clear path, but everyone will get a chance !
Thanks for updating
Dr. Obaida AL-Adawi,
Orthopedic Surgery Recent Resident (Lübeck)

5.  German Language
 B2 Level
Homeland: exams must be at a certified center (Goethe-Institut, Telc, USD)
 Fachsprache
Medizin/ Fachsprachprüfung
Medicine language exam (OET like)
A2 can be done at home and Continue in Germany till B2
( travel on Language Visa)
Syndicate in Germany
3 parts exam :
 Documents needed: (German Embassy web)
1. Medical Degree
2. Transcript
3. Internship certificate
4. Homeland medical License
5. Good standing certificate (syndicate)
6. Police clearance
7. Passport
8. Birth Certificate
9. CV
10. Motivation Letter
11. Antrag (application)
 Bescheid (Decision)
By the State Medical Council
• Recently being asked at Embassies while applying for Visas
• Needs 3 - 6 months
• Some states are easier and faster than others (Rheinland)
• Free of charge
• anabin.kmk.org – to check your institution
History taking / Procedure explanation
Committee discussion
Medical Report

6. Medical Practice License
Berufserlaubnis
• Easy
• Temporary (2 years)
• Not counted in Residency training
• During this 2 years must sit for Kenntnisprüfung
• Kenntnisprüfung
 Oral medical knowledge exam
 2 parts exam : Task Discussion and practical clinical approach
 Must be booked early (availability: 6-18 months)
Approbation (Permanent medical License)
• Passing the Kenntnisprüfung
• Gutachter (1000 euro)
Working while Berufserlaubnis or Approbation will give almost
the same salary , but at some hospitals doctors under
Berufserlaubnis will get 10-15% less.

7.  surgery domains -- minimum 6 years
 Medicine domains – 5 years
 Salaries (fresh grad)
 Basic: 4800 Euros (2900 after tax)
 Duties:
• Regular : 100-180 Euros
• Weekends: 250-380 Euros
• Pre-Germany years of experience will be taken into
consideration, increasing the salary.
Jobs are counted as Residency training
if you belong to an accredited chief

8.  Set Multiple interviews before choosing your chief.
 Every resident will belong to a Chief
 Syndicate announces for every chief how many years he/she can grant
 Chief can grant 1- 4.5 years maximum of training.
 Preferred to change chief every 2 years
 East states and Nord Rhine are the easiest for foreigners to start

9.  Only university hospitals will grant you the full residency program (6 years)
 Hard to start here
 Busy
 Salary is higher by 10-15%
 Preferred bulky CVs (experience, research etc..)
After residency you sit for FACHARZT oral exam to be
considered a specialist
Germany is the door to Austria and Swiss

10. United Kingdom
Every qualified will get a job, even if late
Thanks for updating
Dr. Mohamad Mashali,
Orthopedic Surgery (North-Wales)

11.  Fresh Graduate and planning for UK Job?
• OET or IELTS (language exams) (390/225 $)
• PLAB 1 (240 £)
• PLAB 2 and ID check ( in UK ) (875£)
• GMC registration
Core Training
 CT1
 CT2
Specialized Training
 ST3
• mild experience needed
• less than 18 months
• Audit/Research in domain
• More difficult for IMGs
• UK experience : semester exchange / observerships
• Better chances in internal medicine (endocrinology), pediatrics,
psychiatry.
Health Education England

12.  Having Surgery experience or planning for Surgery specialty ?!
NON-Training&TrainingJobs
o MRCS part A
o MRCS part B
o OET/IELTS
o GMC Registration
o ID Check
o Apply for jobs
 ST Jobs
 Clinical /Research Fellow
Training Jobs
 Done with your residency back home or more than 3 years of experience
ST3 Training job
STR non-training job
Senior Clinical Fellow
Senior Research Fellow
Ability to turn into consultant by Caesar/Band 14 rules

13. What can improve my chance:
UK med-school exchange
UK elective hospital visits (observership)
Courses:
 BLS
 ILS
 ALS
 ATLS
 Medical Ethics
 Medical Communication
Research /Publication
Teaching jobs experience
Leaderships courses/experience

14. Salaries in UK
**After tax & pension deduction

15. United State Of
America - USAThe Clearest, Longest and Most expensive WAY…
But once you reach you are an Idol…
Thanks for updating
Dr. Mustafa Mohamed,
Research Fellow - MI

16. USMLE
Step 1
• Prep 9-12 months (while medschool)
• Score 245/Higher is preferred
• Costs around 1130$ (outside USA)
Step 2
Clinical Knowledge (CK)
• Prep 3-4 months
• 245/Higher is favored
• Usually scores higher than Step 1
• Costs 1145$ (outside USA)
Clinical Skills (CS)
• Prep 1 month
• Only in USA
• Pass or fail grades.
• Costs 1560 $
Step 3
• Not obligatory for matching
• Must be done while residency.
• Gives a better chance in matching for Surgery (IMGs)
• Only in USA
• Costs 900$
Start with ECFMG
account (100$) In 2023 Step1 will be a
pass/Fail grading system.
This will make it harder for the IMGs,
since they are known as the score
fighters

17.  After finishing Step 1, Step 2 (CK,CS) ----- ECFMG certificate
 Mid July get your account Ready (130$)
• 4 Recommendation letters(Preferred US)
• CV
• ECFMG electronic certificate (80$)
• MSPE- Medical Student Performance Evaluation
 Search for the IMGs “friendly” residency Programs, rank your options
 In September – online application starts:
• first 10 programs – 100$
• 11-20 – 15$ each
• 21-30 – 19$ each
• 31 – unlimited – 26$ each 170 x 26$ = 4420$
440$ for 30 programs To increase your matching chance
must increase your applications No. .
Usually for medicine 100-150 app
For surgery must apply for all IMG
friendly programs
200 app – 4860$

18. 15 SEPT :
 Release info to all Programs
Early OCT :
 Call for interviews
• in person interview
• Some programs book you flight and Accommodation
• Interviewers : Program director, P.D. Assistant, 2 senior residents/fellows
 Both Sides will rank the interview.
 March
• Second / Third Monday of March ---Matching email (Monday’s email)
 Friday (same week) you will get the name of the matched program .
 Supplemental Offer and Acceptance Program (SOAP)-Post matching:
• Must be on the interviews list (previously ranked, NRMP number)
• Harder to get through
• Recommendation letter plays a big role !!!

19.  What makes my chance higher for matching:
 USMLE scores (step 3 )
 Electives ( the more the better, app domain is a plus)
 Fresh graduate
 Research
 MSPE- Medical Student Performance Evaluation (dean, Hosp)
 Experience might be considered for surgery only
Easiest programs for IMGs:
 C. Pathology
 Pediatrics
 Family Medicine
 Psychiatry
 Internal Medicine
• In medicine there is 260 IMG friendly
program out of 580.
• Surgery – 330 total
• Every program is unique : some with 2 residents,
while others with 10 (check institusion)

20. The number of non-U.S. citizen IMGs who participated in the
Match increased slightly, breaking a three-year trend of decline.
In 2020, 6,907 IMGs submitted program choices, up 38 from
2019. Furthermore, 4,222 IMGs (61.1%) matched to first-
year positions, which is 2.5 percentage points higher than
2019 and the highest match rate since 1990
http://www.nrmp.org/

21. Salaries in USA

22. CanadaResidency is almost impossible for IMGs, but easy for fellowships and Professional experience
Thanks for updating
Dr. Mohamad Farouk,
Neonatal perinatal Medicine (Sunny Brook, Toronto)

23. Physicianapply.com
• Account - 298$
• Document fee - 175$
• Translation (online) – 140$ per page
• File transfer – 52$
For Medical degree
equivalence/Legalization (wall certificate).
Medical Council Certification exams for residency:
• MCCQE-1
• MCCQE-2
• NAC OSCI
No need to wait for Physicianapply’s reply to sit for
exams, once you applied/paid your for legalization
you can apply for these exams
Application for Residency Programs:
• Canadian Permanent residency
• IELTS (7.5 with min 7 in each)
• MCCQE-1
• NAC OSCI
• Electives /Observerships
• Research
Scores matter, limited seats
and high competitivity

24.  Physicians trained at Following countries wont repeat residency:
• UK
• Australia
• Ireland
• New Zealand
• USA
• South Africa
• Singapore
• Hung Kong
MCCQE-1 MCCQE-2 exams are needed only
to join the Canadian Medical Council
 In case you finished your residency outside Canada
• Clinical Fellowships
• Research fellowship
 Famous in : Toronto,Calgary, Alberta, London Ont.,British Colombia ,
Ottawa, MacMaster ,Manitoba, Western states (French).
 No need for any exams (IELTS/MCCQE)
 Physicianapply account and certificate needed
 Check every school of medicine in Canada and check the POSTGRADIUTE
MEDICAL EDUATION  IMGs FELLOWSHIPS

25. Salaries in Canada
2020 updates: 27$ per hours

26. Keep in Mind Message
• Start preparing during 6th year of medicine
 Germany  language
 USA  during 5th year’s summer Step 1
 UK  PLAB1 after internship
• Keep in mind that no path is easy
 Fulfilling the requirement is not a waste of time and money.
• Study in groups and get rid of your EGO.
• People are meant to help/Guide each other.
• Reaching your license at some countries open extra doors
 Germany  Austria & Swiss
 UK  Canada, Australia, New Zealand & Ireland
 USA  Canada

27. Thank You
dr.azanki@live.com
For any further inquiry please don’t hesitate to ask the
mentioned doctors in each country, or contact me through:
• Thanking WSIG –LU for such stimulus
• Hats off : Zainab Hammoud for such cooperation
#dr_azanki