Dr. Mariam Washington on Peace, Parenting, and Healthcare After Leaving the US Part II
Life, Licensing & Letting Go: An American Doc’s Journey to Canada
By Dr. Robert Beck, Board Certified Internist, Host of Interesting MD
It’s always a privilege to sit down with physicians who’ve taken the leap—not just to build careers, but real lives. This episode, my chat with Dr. Miriam Washington, physiatrist, was one that hit home both professionally and personally. For those of you tuning in, or just considering what life on the other side of the border might look like, I wanted to break down our conversation in a way that's both real and actionable.
First Impressions: The Shock of "Normal"
Safety Strikes First: Dr. Washington’s biggest culture shock didn’t come from medical practice but from dropping her son off at a Canadian school—without gates, without walls, and, for the first time, without worry gnawing at her gut every moment.
Relearning Childhood: Watching the doors swing open and kids pour out carefree, she realized how tightly fear had wound itself around day-to-day life in the U.S. Sometimes, what’s “normal” elsewhere really is extraordinary.
The Licensing & Immigration Rollercoaster
1. Alberta: The Fast Track
Emphasized the benefit of having a job offer—it speeds up that work permit.
Alberta’s location-specific permit is pretty smooth with a clinic job lined up.
Family can come along on open permits, but hers was locked to one site.
2. BC: More Complicated, but Manageable
Required sponsorship from Island Health and a new work permit.
Provincial Nominee Program sponsorship helps set the stage for permanent residency, though it's a bit slower.
BC’s College has actually created a fast-track path for U.S.-trained docs—which is a welcome sign for those considering making the move.
3. Pro-tip:
Have a financial reserve ready! Legal fees, paperwork, and moving costs add up fast. Getting settled and waiting for that first paycheck can stretch even the best-laid budgets.
Bringing Your Life: Packing, Shipping, & the Unexpected
Moving Mistakes: Our stories overlapped here—overpacking, under-prepping, and paying dearly for shipping items by the pound that we wished we’d left behind.
Smart Moves: For those with less attachment to "stuff," furnished apartments and minimalist packing can save a fortune.
Home Appliances: Unusual win for Canada—houses typically come with appliances (fridge, stove, washer/dryer), unlike much of the U.S.!
Practice Makes … Different
Documentation
U.S.: Drowning in paperwork, always looking over your shoulder for billing rejections.
Canada: Documentation is direct and focused on patient care, not insurance micromanagement. Four-line hospital notes that get the job done without anxiety.
Patient Care
You do what you’re trained to do—without fighting constant insurance denials.
Simple example: In the US, EMGs, carpal tunnel injections, and even Botox for spasticity are often delayed by endless authorizations and copays. In Canada, you’re trusted to make treatment decisions and just do it.
Systemic Delays
The wait times aren’t about public healthcare per se; it’s a shortage of doctors and seats in medical schools. Canada is stepping up with new medical schools and recruitment—but it’s a 10-year fix, not overnight.
Biggest Wins & Challenges
Wins
True peace of mind for the family—less worry about safety and finances.
Calmer, less frantic daily life for both physician and family.
Care is about medicine first, not money or fear.
Challenges
Navigating EMG billing and licensure in BC—still a bureaucratic headache, but hopefully temporary.
Financial planning, tax headaches (hello, dual filings), and investing as a foreigner take some getting used to.
Advice for Docs Considering the Move
Talk to Those Who’ve Done It: Not just Canadian docs, but American transplants—nobody understands the move like those who lived it.
Don’t Be a Guinea Pig Alone: There’s a growing community ready to help you avoid the most common pitfalls.
Emotional Realities: Leaving is hard. Staying can be harder. “You’re brave for leaving, but maybe even braver for staying” captures it all.
Is Alberta the Texas of Canada?
Turns out—maybe! The industry (oil, gas), rural mentality, and even the similarity between Edmonton and San Antonio make the comparison ring true. But big-city Alberta? It’s just…another city. Canadians dreaming of Texas, fair warning: everything’s bigger—including the roaches!
Final Thoughts
Moving to Canada isn’t for everyone, but for many docs and their families, it’s a pathway to a calmer, more secure life. For those considering it, remember: Canada is just familiar enough to feel like home—but different in all the ways that matter.
If you have questions or want the inside scoop, don’t hesitate to reach out. Let’s keep the door open for more doctors to build not just careers, but lives worth living.
— Dr. Rob Beck
Interesting MD