Do you know where grades really matter ? The IMG match ! Where even family medicine is competitive and most IMG's would just love to match to anything rather than just drive cabs and deliver pizzas ! Talk about double standards ! If you simply pass the exam you have 0 percent of matching to even FM. They completely ignore any medical experience you have in your home country and only evaluate 2 things: exam scores ( they want say a cardio-thoracic surgeon who has been practicing for years to study psych, ob/gyn, peds, IM again and expect him to do well in the exam) and canadian medical experience (which is impossible to get if you have been a practicing doctor for many years).