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shematoma last won the day on March 4 2019

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  1. I think this is a great point – we get so focused with the end result that we forget that the journey itself is sometimes what was so enjoyable, the anticipation of the final result was what motivated us and drove us to achieve. Sometimes getting exactly what you want can be a huge letdown when it finally happens. I have met many residents who were initially unhappy, sometimes extremely unhappy with their new program/city but later became quite content once they made new friends and relationships and adapted to their new environment. On the other hand, sometimes the opposite happens too. And I don't think it's always related to the program or city itself – life is complex and always evolving and does not pause just because you were doing your medical training in another city. By the time most of us have matched to residency, we are too far invested in this field to consider doing anything else. And no matter what happens, the best thing to do is probably to put your head down and plow through as far as you can go. At least give it a shot. When I started residency, I said I would give myself at least six months before concluding that I was going to transfer or that it wasn't for me. It takes that long at least to adapt your new life – perhaps even longer. But things worked out and I settled in a lot better than I thought I ever could.
  2. In my experience, second round CaRMS is traditionally roughly 50/50 in person vs. Skype, with some programs giving you the choice of either. Yes, that meant that people had to book flights with just a day or two's notice, which really hit the bank account hard - but what part of medical school or the match is ever cheap? However given the current circumstances I expect most will lean towards doing Skype interviews exclusively. Perhaps they will be forced extend the match deadline - these are unprecedented times.
  3. Wow. Your post strikes me as quite judgmental. Why is it necessary to characterize this person's (I will not assume their gender) feelings as a lack of resilience or gratitude? Are we not allowed to feel sad and depressed in life, even if things look great on the exterior? This person's reality is that they're about to move away from family, friends, girlfriend for 5+ years, and that's really hitting home. I think they deserve sympathy rather than scorn. Their feelings are quite valid. In fact, residents in Canada have committed suicide in very similar circumstances. Family, friends, significant others are precious, and moving away, combined with the stresses of residency, can take a serious toll on someone's mental health, to the point that it can be lethal. We need to take resident mental health seriously and not heap judgment on them. To the OP, I hope you are still here and reading this thread, and don't get discouraged by some of the very insensitive replies you are getting. You are FAR from the only one in your shoes - I can speak for myself and many others personally, but we can't come out publicly because of exactly the kind of response you see above. Your struggles are real and you have every right to feel the way you do. Now, the reality is that if you want to stay in your specialty (not knowing what it is, but regardless), you will most likely have to finish it where you matched. That is because as you can see in other threads, transfers are extremely tough unless you're willing to switch to FM, and even that is very tough and there's no guarantees. However people do move across the country all the time for jobs - you can use elective time to do rotations near your home to improve your chances of getting a job there. A lot of this depends on the exact specialty and how much demand there is for it, and if your specialty depends on being in a hospital vs. being able to open your own clinic or practice. But right now do whatever you need to take care of yourself. You still have time before you move, and if you absolutely need to, look into the transfer process down the road. Some would say you're in a very enviable position but nothing is more important than your own health and well-being, so do what you must to stay alive and well.
  4. Please share what you find out! I have been wondering the same thing. If you do a 1 year fellowship, you're still subject to the rotational requirements of the ABFM, which includes general surgery and critical care. So simply doing a palliative or sports medicine fellowship may not cut it, for instance, if your original FM residency didn't include those rotations. If going the CCFP equivalency route, I don't know how you would fulfill the 6 month residency in the US requirement and 6 month actively involved in FM requirement. Does this imply you can practice under someone else's supervision, similar to a PA, for 6 months, and then you can challenge the exam?
  5. The best part of this post.. is how you mention starting medicine at age 25... and despite this you still don't recommend it. That's not much older than the average starting age in medicine, considering how many people have to apply more than once to get in.
  6. Sorry to bump an old thread here. But if I'm getting this right, a CMG who's doing residency right now in Canada, can still apply to the NRMP match for a PGY-1 position, for instance, because they want to change specialties and there is little hope of transfer within Canada. And this is possible because we have not used an US-based funding for our residency? I've also tried to understand why USMGs, once they match to a residency through NRMP, can't apply to the NRMP a second time to change specialties or locations. Is it because they've already used up some government funding for their first residency, so they can't match to a new residency due to insufficient funding to complete it?
  7. It's a combination of grass is greener on the other side... and a matter of you don't know what you're getting into until it happens. When you go unmatched, even a residency doing family medicine in rural Newfoundland might sound great, because it's better than being unemployed for a whole year. No offense to Newfoundland. But then you actually end up in rural Newfoundland and maybe now you hate it because of how far away you are from everything you care about, and you're thinking how great life would have been if you got plastic surgery in Toronto. The CaRMS match is a many-edged sword. Unfortunately the match is for the most part a one-shot deal, it will make and break your dreams. You have to think so carefully about what you actually want, keeping in mind the tremendous risks and costs of going unmatched. There's too many variables to consider. I don't advocate blaming people for ending up in their backup choice, like #27 on their rank list, because they were really choosing between a sharp rock and very hard place. Do you go unmatched and incur another year of debt while doing a 5th year of med school? With no guarantee of matching. Or do you bite the bullet and backup to family medicine in the middle of nowhere? You've spent your whole life working hard for your dream, and now you have to choose between 28 different choices, knowing that your choice is largely irreversible. That's just not fair.
  8. Are there any other stories of successful transfers this year (outside of CaRMS)? I'm hoping to transfer and need some examples of people succeeding at this to give me some motivation.
  9. I highly agree with this. Any psych program in Canada will get you your FRCPC certification. They are all at least decent. But for a 5 year residency, location should almost be your primary consideration. Do you have family or friends in the area? Can your partner/spouse move with you and find work? You'll have lots of spare time in psychiatry (relatively speaking) so make sure you prioritize the important things and people in your life. If you're flexible on a few locations, then ask, does the program you want offer the subspecialty expertise you're looking for, assuming you want to subspecialize. Forensics isn't offered everywhere, for instance. Bigger programs like Toronto and UBC may have niche subspecialties you like, one example being neuropsychiatry - this specialty isn't officially recognized by the Royal College but is by the American Board and may be RCPSC recognized in the future. How much do you like or want to do research? Some of the smaller programs won't be as strong or offer as many resources for research. Some programs may have more call requirements than others.
  10. Thank you notes are a nice gesture but I can't see them actually making much difference to your match result unless it was so close between you and another candidate and you were the only one who said thanks. And that's probably a very rare occurrence. I think it's still nice of people to send them but let's not fool ourselves thinking it'll make or break you.
  11. This is probably true of people in most if not all specialties... how does it explain the neuro spots in particular?
  12. In the old days, graduates of the rotating internship could practice as GP's without any additional training, thus eroding the standing of family doctors since there was little benefit in specializing in family practice for 2 years if you could do the same job with just the 1 year internship. When the rotating internship was eliminated, family medicine became established as its own "specialty" and only people certified by the CFPC could practice as GP's. So if people can get an independent license with just a 1 year internship, family doctors would start having more competition. Thus, they are not keen to having the internship come back. Unless maybe family medicine becomes a 2 year specialty on TOP of doing the internship, which by itself wouldn't grant an independent license but is merely an intermediate step towards a longer specialty.
  13. To the extent you characterize people as "complainers," maybe they have good cause. Let's look at some data. In 2008, there were 2,136 CMG graduates and 2,379 positions available, for a 1.11 ratio. Last year, the same numbers were 2,923 CMG graduates and 2,974 positions available, a ratio of 1.02. As mentioned in a previous post, that includes Quebec which has a surplus of residency spots, so if you exclude Quebec the ratio is more like 0.98. And yet, over the same period, IMG positions increased from basically zero in 2006 to 343 in 2018. Clearly, the growth of positions for CMGs hasn't kept pace with the growth in numbers of CMGs, whereas IMGs went from basically no dedicated quota to having 343 spots reserved just for them. So yes these spots were "created" for IMGs, but essentially they came at the expense of expanding CMG positions to keep up with increased medical school enrollment. The government has limited money after all, and the claim is that hospitals in this country have limited training capacity. So what goes to IMGs comes at the expense of spots for CMGs.
  14. You haven't lost anything in that particular case, but you're losing out as a taxpayer by supporting a training system that regularly leaves qualified CMG candidates unmatched year after year. You could save money by cutting CMG spots and still getting the same results. That's the source of waste. If you gave those unmatched candidates just 2 more years of training in FM, they could be a fully functioning doctor rather than unemployed and unable to repay their student loans. The US has a "fully competitive" system with caveats. Last year the NRMP had ~18,000 USMD graduates apply and a total ~33,000 residency spots. There's a lot more wiggle room for IMGs and US DOs to compete for spots. In Canada last year, we had 2,965 CMG spots and 2,923 CMG applicants. And that's including Quebec, where there's a huge surplus of residency spots. If you remove Quebec, there are more CMG applicants than spots. So unlike the US, there wasn't even a theoretical possibility of all CMGs being matched because there weren't numerically enough spots. Very different than the NRMP system. If Canadian governments hugely increased residency spots so that there are almost 2x as many total spots as CMG applicants, it would be a different story and much easier to justify open season for IMGs.
  15. Looking at those Ottawa spots, they look kind of suspicious. 19 FM (English speaking) spots open is basically half of their 38 spot total quota in the first round. What's going on? Are they just being extra picky this year or is there some other motive? Saving the spots for after second iteration and giving them away in the opaque 'post match process's?
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