So, as background, I am a US citizen, trained in internal medicine and oncology, with a clinical focus on multiple myeloma. I have worked for several years at the University of Washington / Fred Hutch Cancer Center in Seattle WA. Earlier this year, for a variety of reasons, my family and I decided to take a leap on a new position as an oncologist treating multiple myeloma at BC Cancer Agency, in Vancouver, BC. Let’s start with the most common questions I get:
- “Why would you do this? You can make a lot more money in US. Doctors see so many patients in Canada.”
- “Do you have family in Vancouver? Why would you move there?”
- “You can’t get access to many oncology drugs in Canada, you will not be happy”
I’m not going to address all these in detail, but at a high level: 1/ Yes, I was aware that private practice oncologists make considerably more money in the US. However, I practiced in academia at a University, and so the gross pay was not dramatically different; 2/ Yes, the patient volumes are different, but the healthcare systems are also dramatically different.
Why I Made the Move: A Practical Decision, Not a Political One
When people ask why I left my previous position, they often expect a complicated answer rooted in abstract principles or politics. The truth is much simpler and more grounded.
The Honest Reasons
A Change Was Needed
I genuinely appreciated the opportunities at my prior institution—there were many. But after some time there, I felt a need for change. Part of this coincided with stepping into a leadership role, and part of it was what you might call mid-career restlessness. A change of environment seemed like it could do me good.
The People and Place
What really made the decision easy was the team itself. I was genuinely impressed by the group at BC Cancer Agency. They work hard but maintain a collegial, academically productive environment. And Vancouver? It’s one of my favorite cities in North America—right up there with Seattle. That kind of professional and personal alignment doesn’t come around often.
The Practical Considerations
Of course, I knew the challenges. The elephant in the room is Vancouver’s cost of living. Housing—both rentals and single-family homes—are dramatically more expensive than most U.S. cities, rivaling only the Bay Area and Los Angeles.
But I made the calculation and it worked.The trade-offs felt reasonable. So we took the leap.
Sometimes the biggest decisions come down to the simplest math: opportunity plus timing plus the right people, minus the financial barriers that could have stopped us. We were in a position to say yes.
How did I do this? Let me walk you through each step:
Find a job:
This is really the first step. I had been looking outside the U.S. for some time, wanting to consider either Australia or Canada – Australia as I had lived there when I was younger and had a persistent fondness for Australia. However, a position was advertised at BC Cancer Agency on ASH Job Centre, which I applied for. I interviewed and gave a presentation. I met the group and really liked all of the division faculty. Eventually, the position was offered to me and I accepted. But I’ll skip over this and focus on the key thing – how do you do this once you have a job offer and have signed it?
Licensure:
This part was quite involved, though made much easier with the passage of laws in British Columbia that allowed for much easier transfer of MD licensure from the US to Canada:
https://news.gov.bc.ca/releases/2025HLTH0071-000680
Getting Started: Gather Your Documentation
First, you’ll need to collect all required credentials. This was more challenging than I expected—I had to locate my medical school diploma, residency certificate, fellowship training documentation, and proof of board certification from a decade earlier.
Understanding Your Options
The credentialing process has two main components, with the first being degree certification. You have two possible routes:
Route 1: Medical College of Canada (Express Entry)
Using the Medical College of Canada provides ECA (Educational Credential Assessment) certification, which qualifies you for Express Entry. This accelerated pathway to permanent residency typically takes 7-8 months—significantly faster than the standard application.
Unfortunately, I wasn’t able to pursue this option due to timing constraints. Between renting out our house, maintaining a firm moving date, and delays in the ECA computer system, I didn’t receive my certification until November—after my new position’s start date.
Route 2: Credential Verification Service
This is the regular route I took, using a Credential Verification Service (FCVS – https://www.fsmb.org/fcvs/, approximately $200). After verification, I obtained my medical license, which led to a BC Provincial Nominee Program nomination and ultimately my work permit.
My Top Recommendations
- Organize Your Credentials Early
Track down all your degrees and certificates now. If you’re prone to misplacing documents like I am, consider framing your diplomas, residency certificates, and board certifications. Display them proudly—and you’ll know exactly where they are when you need them. - Get Certified Copies in Advance
If you use copies rather than originals, the issuing university must certify them. This step alone added 2-3 weeks to my timeline, especially since universities can be slow to respond during summer transitions. - Planning ahead with these steps will streamline your credentialing journey significantly.
In my next post, I’ll describe the a little bit about the things you need to do when moving from US to Canada, specifically, practical stuff. Do you pay tariffs when you cross the border? What do you do with your vehicle(s)? Do you need to pay taxes in both the US and Canada? These are well worth knowing about.