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uhoh99

One interview....pretty stunned right now

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So ya, read that title. Need some friendly anonymous advice right now. 

So I applied across the country for a competitive specialty, backing up with Family in Ontario. Did most of my electives in that specialty, but also one in Family. I applied to every single English speaking program and many Ontario Family programs. As it stands, I have been declined an interview at every single school, for both the competitive specialty and Family medicine (except at my own school). 

First assumption is that I have a red flag on my file. Well no professionalism stuff and my evals are quite solid, excelled in most things. I had a very unique application with ECs and life experience relevant to the specialty that likely no other candidate in the country possessed. Had our career office and colleagues review my statements and applications, no one had any concerns about what I wrote. My 3 references for the competitive specialty were different than my 3 Family references. I had a solid elective experience, with staff across the country giving me strong feedback and telling me I was made to do this specialty and would excel no matter where I matched. 

So at this point, I guess I either had a reference from each program I applied to write something profoundly negative OR in some one in a trillion chance my information was incomplete/incorrect due to a CaRMS mess up. 

Anyone with any advice for some next steps would be appreciated, because I'm pretty lost tbh...

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First of all, I am really sorry to hear that. CaRMS is a mystery.  

As a next step, I would email the PDs across the country for the competitive specialty and/or FM, inquiring if they have any feedback on your application. You can say that you received great feedback from someone at their school. Message me if you have any questions. 

 

 

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47 minutes ago, uhoh99 said:

First assumption is that I have a red flag on my file. ...So at this point, I guess I either had a reference from each program I applied to write something profoundly negative OR 

Although truly impossible to know, it would seem that one of your solid references turned out to do a nasty to you, an exceedingly rare occurrence. Remember, all it takes is one Interview for an acceptance. I had only one Interview for my surgical specialty, I was a comparative outsider to all the other competitive gunners and applicants, and Bingo, I won the lottery despite being a longshot! Chin up in this lottery! 

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So sorry friend. I think you're right about the possible reasons. I also agree, do your best to get feedback, at least one from each specialty, to narrow down the cause. 

That being said, as bad as things are, family at your home school is usually your best shot. Would you have been happy with it?

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Your options are to match family in first round, match whatever 5 year program in second round or withdraw and reapply next year.

Should probably talk with your school's advising office. They'll likely push you to match FM first round.

Definitely try to contact the programs and get a better sense of what may have gone on with your application. 

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It doesn't always have to be malice from one of the references. Some people are just bad at turning down letter requests which leads to very lukewarm letters. It could also be operator error in the sense that the reference uploaded an incomplete or draft letter. CaRMS is a black box though so you'll probably never know.

I would say in this era of matching where there are limited residency spots for Canadian grads is to give your 100% to the family spot and try to match 1st round. I have seen and read about too many stories about students unable to attain a residency spot to recommend anything else. While it isn't the perfect career for everyone it is the lesser evil in my mind compared to unmatching. 

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Sorry to hear. Nothing to lose by contacting your referees at this point. Are any of them on the selection committees for their programs?

The FM rejections could be explained by the appearance of backing up. However, I wonder about the specialty elective experiences - a lukewarm letter from an outside referee may be disregarded if the program is enthusiastic about the firsthand knowledge they have of the candidate from an elective. I would think that an actual negative letter is extremely rare, but I do wonder about people telling you that you'll excel wherever you go, instead of trying to recruit you to their own program if they really liked you. Sorry again, not trying to make you feel bad, but just trying to explore alternative possibilities. Some fields are just extremely competitive and many good applicants may be unsuccessful. Best of luck. 

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Sorry to hear that :(

It's a little disheartening to know that referees will write bad letters - if you can't write a strong reference letter/ don't believe in the candidate's capabilities, don't accept their request of a being referee. I know it's rare, but these kinds of things put so much jeopardy to the candidate's application, and CARMS is enough of a beast as it is.  

Another unfortunate part is that sometimes it depends on the referee's writing skills. They can have good intentions but if their letter is just lukewarm and they can't translate their feelings well onto paper, then the applicant did everything right and just got dealt a bad hand.

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6 hours ago, PhD2MD said:

So sorry friend. I think you're right about the possible reasons. I also agree, do your best to get feedback, at least one from each specialty, to narrow down the cause. 

That being said, as bad as things are, family at your home school is usually your best shot. Would you have been happy with it?

While Family is not what I would ideally see myself in as my life experience had me get really comfortable in a particular clinical setting, it is a a career with a lot of flexibility and there are things I could do as a Family doc that would fulfill what I am looking for. 

 

2 hours ago, Lactic Folly said:

Sorry to hear. Nothing to lose by contacting your referees at this point. Are any of them on the selection committees for their programs?

The FM rejections could be explained by the appearance of backing up. However, I wonder about the specialty elective experiences - a lukewarm letter from an outside referee may be disregarded if the program is enthusiastic about the firsthand knowledge they have of the candidate from an elective. I would think that an actual negative letter is extremely rare, but I do wonder about people telling you that you'll excel wherever you go, instead of trying to recruit you to their own program if they really liked you. Sorry again, not trying to make you feel bad, but just trying to explore alternative possibilities. Some fields are just extremely competitive and many good applicants may be unsuccessful. Best of luck. 

I know one of my referees did selection last year, not too sure about this year though. I did contact them, and while they said they were completely shocked by the news, that it's not impossible of given the subjectivity of file review. I know 2 of the Ontario schools I visited had multiple staff tell me that someone with my specific background would fit well in their program as they had multiple staff with a similar interest not commonly seen elsewhere in Canada. The Family rejections don't surprise me either as it is clear that I am backing up, my application quite literally screams "insert specialty". 

At this point, I have contacted the program for my home school to ensure my file was complete. They told me there was nothing missing. I am wondering if it is even worth contacting more programs, because I highly doubt a CaRMS error is at play here or if they will provide more specific feedback. 

I have been in contact with my school, and as many suggested, they said prep for your Family interview and see what happens.

Thanks for the advice. 

 

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Sorry to hear your referees aren't as supportive as you'd hoped. Although they might not have been successful, they could certainly have tried to lobby for you upon hearing you didn't receive an interview.

In any case, wishing you the best of luck with your family med interview. At the least you'll be able to say with 100% conviction it's your first choice.

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First, I would recommend you really prepare well for family medicine interview. You can PM me and I can help provide some advice for family medicine interview. 

 

Second, it does not hurt to contact the sub-speciality programs in a gentle and respectful tone to ensure your application and references were complete, and there was nothing missing from the file. Also, you can try asking for feedback on your application but please don't be disappointed if you get a generic answer back saying that they cannot share anything with you. And that there were multiple competitive applicants for limited number of spots.  

 

I have faith that you are an excellent candidate and would do well in any residency you choose. CaRMS is not a perfect process and sometimes on surface it does look unfair. Unfortunately, neither you or me can do anything about it right now so best not to get yourself in negative thinking cycle. 

 

Prepare well for the family medicine interview. 

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Unfortunately, this kind of stuff does happen. I suspect it may have happened with one of my letters but i used different letters at different schools and as a result i limited the damage. Again, it can sometimes be something as innocuous as a letter that didn't sell you as strongly, some staff may say something like, this person is in the top 50% of medical students i work with. That may be true, but in this day and age, you might as well say "i don't recommend this person". This is why CaRMS is so horrible at times because it remains incredibly unpredictable. There are people who do better than expected or they deserved because they met the right person who was willing to go to bat for them, and vice versa. 

I agree with what the above posters have written, contact your referees or the programs you applied to and politely ask for more info and of course prepare for your interview as well as you can. 

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To OP, ,I am so sorry that this happened to you.

Having reviewed files for CaRMS, some reference letters are quite short- 1-2 paragraphs with generic statements, Xxx is a good medical student, did this blah blah...Which itself is not a horrible letter, but definitely could weigh you down when you read another stellar 2 page letters with statements like: Xxx is the best medical student that I have ever worked with, etc. I have never stumbled upon a negative LOR, but heard from others that it could definitely happen!

Some academic staff physicians are just too nice to turn down writing LORs if a clerk asks them, and are known to write generic letters if they are not that impressed. But it is really difficult to know if they will write a strong letter since CaRMS has so much uncertainties. 

I would still contact CaRMS to see if all your files are complete, or if they upload your files correctly. Mistakes definitely could happen.

I strongly suggest that you contact your specialty of choice's PD to ask them to give feedback on your application, or ask for reconsideration. In this stage of game, there is really nothing to lose.

Definitely prepare well for your home school's FM interview, I would even contact your home school's FM PD to let him or her know your strong interest for the program. 

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This happened to 1 guy I know and they emailed all the programs they did electives at expressing interest in interviewing. No red flags and nice person too. They ended up getting interviews and matched to their program of choice.

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It is quite uncommon to do an elective and not be invited for an interview at that site.  Most often when this happens, it's because the elective didn't go well.  To have it happen at all your electives, it means something is wrong.

I realize this advice is too late to be useful for you, but for others in upcoming years, I suggest you organize more than 3 reference letters.  If you need 3, get at least 5 and rotate them around so that all the programs don't get the same letters.  This hedges your bets against a negative letter.

I hope things work out for you; good luck.

 

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This blows.

 

You pissed off someone important. That's the most likely explanation.

 

Not matching is a real possibility. Still apply to FM though.

 

Your options are 2nd rd at that point. I hope you like pathology.

 

Another way is to hit the usmles. I'd recommend studying for them immediately. You're gonna need a great score.

 

If you can extend medschool a year for more electives and research, possibly in the USA, then I'd strongly encourage it.

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Very sorry this happened to you friend. It sounds like you invested a lot of time and energy into one goal, and now it must feel like the floor is emptying beneath you.

From the sound what you are describing, my guess is that you were applying to either dermatology, plastics, ophthalmology, or something similar i.e. the highly subspecialized, very small, exclusive, intensely competitive, and largely nepotistic programs. Every year there are tragic and heartbreaking stories of excellent candidates that put their eggs into these fragile and unreliable baskets, and things go very badly for them.

The reality is that applying to these specialities is a huge crapshoot; applicants can expect anything. For example, I have seen people match to Derm that only had one interview, and others that didn't match and had interviews across the country. I have seen people switch into Derm after one year of having been matched to a completely different program. There was someone who didn't match into ophtho, but somehow magically got into derm in the second iteration. Weird things also happen with less competitive programs. I have seen the top student in the class decked with medals of academic achievement unable to match to internal medicine at their home program - and I mean not even get an interview at their home program. I have seen an applicant with a freaking PhD in high-risk obstetrics unable to match into ObsGyn. Then there was someone who was able to switch from path into neurosurg. All mysteries of the CaRMS universe.

Every year there are baffling stories like this, and no one should ever think themselves immune. I would estimate that when it comes to extremely competitive specialities, it is 20% effort and merit, and 80% luck and circumstance. Luck in who you met in your rotations, luck in who vouches for you, luck in how you look, luck in how you walk, luck in whether your daddy is uncle of a PDs neighbor, or better yet, if they went to med school together and are good buddies, luck in whether you like Skidoos as much as the PD. A shit town of random factors you have absolutely no fucking control over. You will drive yourself into madness if you think you do.

It also very possible that someone on "your team", either advertently or inadvertently let you down. Writing a good letter of recommendation is a huge effort and an art. Some old timer MDs may have a lot of influence, but really don't know the realities of modern day residency match competitiveness. Back 30-40 years ago, you basically could do whatever you wanted to do. Also, some attendings are just way too busy. They are nice people, and they mean well, but when the deadline comes, and they are seeing 60 patients a day, they will submit the same reference letter they have been with the names in the blank changed, year after year. You may have spent 200 hours reading and re-reading and proofreading your application. A busy attending may spend no more than 15 minutes drafting your letter of recommendation. Unfair considering your entire career rides on that letter, but that is the reality.

 

 

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11 hours ago, uhoh99 said:

So update for any interested parties. I matched to Family Medicine! Always liked living life on the edge, but I'll admit this was cutting it close. I can still accomplish my goals through this route, just have to take a different path than initially intended.

Thanks for all of the advice. 

 I am happy for you, all the best!

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11 hours ago, uhoh99 said:

So update for any interested parties. I matched to Family Medicine! Always liked living life on the edge, but I'll admit this was cutting it close. I can still accomplish my goals through this route, just have to take a different path than initially intended.

Thanks for all of the advice. 

Hey congrats! One hurtle down ha. 

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15 hours ago, uhoh99 said:

So update for any interested parties. I matched to Family Medicine! Always liked living life on the edge, but I'll admit this was cutting it close. I can still accomplish my goals through this route, just have to take a different path than initially intended.

Thanks for all of the advice. 

Congratulations!! Where at??

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On 2/27/2019 at 8:44 PM, uhoh99 said:

So update for any interested parties. I matched to Family Medicine! Always liked living life on the edge, but I'll admit this was cutting it close. I can still accomplish my goals through this route, just have to take a different path than initially intended.

Thanks for all of the advice. 

Solid work! I admit I was lurking here to see the aftermath. 

Glad you didn't become a statistic in the unmatched group. Good luck!

- G

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