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2019 CaRMS unfilled spots

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3 minutes ago, sWOMEN said:

I would assume IMGs (doctors that were born and trained abroad, not those that couldnt get into a canadian med school and left) from the African countries that spoke French would thrive with the leftover spots and decreased competition of Laval Montreal and Sherbrooke - 

Absolutely, that makes total theoretical sense. But Quebec is the province with the lowest % workforce from IMGs - again presumably due to language. We do have a lot of French doctors who are coming over to Quebec. Quebec & France has a really nice reciprocity agreement where those licensed as doctors in France can easily get access to practise in Quebec. They don't need to go through the whole CaRMS fiasco, and their credentials are recognized.

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12 minutes ago, bearded frog said:

It used to be that way. A IMG sued and won.

With a previous law background, legal court decisions can be reviewed if compelling arguments can made on the basis of changes in circumstances. Does the growing year after year record # of unmatched CMGs present a "change in circumstances." Arguably yes. Also Health Canada got rid of SoNs. There have been many changes since that court case that would merit a review.

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7 hours ago, la marzocco said:

I'm interested to see how the continued streaming for CMG- and IMG-spots for Ontario & Alberta schools will play out for the 2nd iteration. Will it really improve the unmatched situation?

I am not too sure, because the unfilled spots in second iteration usually go to CMGs. 

There have been cases where some 2nd iteration spots are reserved for IMGs (whose parents or family are influential in the faculty of medicine).

I strongly encourage the governments in each province to advocate for more residency training positions for CMGs by decreasing the number of positions of IMGs. CMGs perform better in residency and in licensing exams. The taxpayers have invested a lot of money in our education, despite the increasing medical tuition fees. I don't see what's the obstacle of increasing more CMG residency training positions, knowing there are > 100 CMGs unmatched each year?!

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13 minutes ago, la marzocco said:

With a previous law background, legal court decisions can be reviewed if compelling arguments can made on the basis of changes in circumstances. Does the growing year after year record # of unmatched CMGs present a "change in circumstances." Arguably yes. Also Health Canada got rid of SoNs. There have been many changes since that court case that would merit a review.

Every legal decision has been anti-doctor the past decade. Whenever it's current status quo doctors vs X in court, X will always win. Just look at mid-levels and naturopaths and chiropractors. If anything, IMGs will win even more in court decisions if they pursue it. 

Basically, the courts favour opening up the market to everyone. 

 

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2 minutes ago, LittleDaisy said:

I am not too sure, because the unfilled spots in second iteration usually go to CMGs. 

There have been cases where some 2nd iteration spots are reserved for IMGs (whose parents or family are influential in the faculty of medicine).

I strongly encourage the governments in each province to advocate for more residency training positions for CMGs by decreasing the number of positions of IMGs. CMGs perform better in residency and in licensing exams. The taxpayers have invested a lot of money in our education, despite the increasing medical tuition fees. I don't see what's the obstacle of increasing more CMG residency training positions, knowing there are > 100 CMGs unmatched each year?!

On the net, more CMG-designated spots are filled by IMGs in the second iteration than vice versa. The change this year by Alberta, Manitoba and Ontario is a step in the right direction by preserving the quota for CMGs (of which there are barely enough for all the English speaking CMGs). But in the longer run we need at minimum to consider cutting first iteration IMG spots

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Just now, shematoma said:

On the net, more CMG-designated spots are filled by IMGs in the second iteration than vice versa. The change this year by Alberta, Manitoba and Ontario is a step in the right direction by preserving the quota for CMGs (of which there are barely enough for all the English speaking CMGs). But in the longer run we need at minimum to consider cutting first iteration IMG spots

Thank you for your information. Considering how competitive it is to get admitted to Canadian Medical Schools, the excellence & consistency of our medical training, and the amount of money that our taxpayers invest in each CMG, I think that the government should take a stance and considering adding more CMG positions in the 1st iteration. 

Of course, there has been increasing lawsuits from IMGs or pressure from the public for credentialing more IMGs. I have little empathy for Canadians who could not get into medical schools in North America, and who took a shortcut and went abroad to study medicine, and who put much pressure or threatened to sue the government for our rigorous process of credentialing IMGs.  The politicians just do whatever policy that makes them look good unfortunately. 

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5 minutes ago, LittleDaisy said:

Thank you for your information. Considering how competitive it is to get admitted to Canadian Medical Schools, the excellence & consistency of our medical training, and the amount of money that our taxpayers invest in each CMG, I think that the government should take a stance and considering adding more CMG positions in the 1st iteration. 

Of course, there has been increasing lawsuits from IMGs or pressure from the public for credentialing more IMGs. I have little empathy for Canadians who could not get into medical schools in North America, and who took a shortcut and went abroad to study medicine, and who put much pressure or threatened to sue the government for our rigorous process of credentialing IMGs.  The politicians just do whatever policy that makes them look good unfortunately. 

I think most CMGs would agree that the CMG quota needs to be increased (and at the expense of IMG spots if need be), but we've been too scared to make a fuss and too busy trying to make ourselves competitive to try and match again. The people who do match in the first iteration have no incentive to act. Now that it's finally hurting to have so many of us go unmatched, perhaps we will take up the fight in court too.

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8 minutes ago, shematoma said:

I think most CMGs would agree that the CMG quota needs to be increased (and at the expense of IMG spots if need be), but we've been too scared to make a fuss and too busy trying to make ourselves competitive to try and match again. The people who do match in the first iteration have no incentive to act. Now that it's finally hurting to have so many of us go unmatched, perhaps we will take up the fight in court too.

We definitely should. As a CMG resident, I am sick of the government intimidated by IMGs (aka Canadians who could not get into medical schools in North America- at least the majority) and their lawsuits, and act against CMGs' interests.

We could argue that it's due to the Ministry of Health's lack of funding, then the CMGs as a whole should take a stronger stance and advocate for more CMGs positions in the 1st iteration. The CFMS should take a stronger position by threatening lawsuits or negotiate with each province's ministry or health. Just my two cents. 

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5 minutes ago, sWOMEN said:

Why would we need to sue to increase CMG spots at the expense of IMG spots? IMGs do not fundamentally have a right to enter our residency spots, given the amount of investment and high, standardized quality of education CMGs receive, it is a no-brainer that the first round should be limited to CMGs only. I have absolutely no respect for premeds that fail to matriculate to a Canadian medical school and go abroad to take the easy way out and expect to match back when so many of our own struggle. Just take a look at how much of RCSI and Carib is filled of Canadians - absolutely ridiculous.

Sure we could just bury our heads and make ourselves as competitive as possible but we should also address this broken aspect of the system that can be fixed relatively easy before matching turns into an even bigger arms race of pubs and letters.

Most of us have colleagues and/or superiors who are IMGs so we have to use diplomacy.

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For those who do not match today, please do not give up. 

Please feel free to PM me, and ask for help from your medical education office for extra year of research & clinical rotations. 

Having had friends who went unmatched, I understand how the CaRMS unmatch result could take a toll on someone's life and make you doubt yourself and withdraw from your group of friends. 

Hang in there and stay strong!

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31 minutes ago, shematoma said:

Most of us have colleagues and/or superiors who are IMGs so we have to use diplomacy.

Don't forget many CMGs who are in charge or influential have kids who are IMGs. 

 

The solution is simple:

- cut med school seats --> you need to solve the backlog problem and prevent another one / we also have a backlog for specialtiy jobs which won't improve if seats are not cut

- restrict IMG spots to CSAs --> CSAs have a much stronger legal ground to stand on compared to complete foreign grads

- take medicine off the whole immigration skilled job panel, don't trick them with false hope

-  redistribute IMG spots to CMG places that don't fill but are underserved and as a result create more CMG spots that will fill

 

Of course, cutting med school seats is not a popular political headline since it will be seem as cutting future doctors to the public. And the federal government is clueless on job demand/immigrants. 

Lastly, the reality is until the unmatched rate is below that of the US (~95%), there's no reason to panic. The system is not designed to guarantee residency spots to everyone, and that is known from day 1. Programs have the right to not rank someone who is obviously backing up with their specialty. Do you want to be someone's obvious 2nd choice to the point that they almost say it to your face? And a certain small percentage of people will have very weak apps and interview very poorly, what should programs do? Education is a bell curve. But I think if there were board scores to go off of, it would provide objectively accountability. Far less people would be mad if there was some objective reason to not match. 

 

 

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19 minutes ago, medigeek said:

Don't forget many CMGs who are in charge or influential have kids who are IMGs. 

 

The solution is simple:

- cut med school seats --> you need to solve the backlog problem and prevent another one / we also have a backlog for specialtiy jobs which won't improve if seats are not cut

- restrict IMG spots to CSAs --> CSAs have a much stronger legal ground to stand on compared to complete foreign grads

- take medicine off the whole immigration skilled job panel, don't trick them with false hope

-  redistribute IMG spots to CMG places that don't fill but are underserved and as a result create more CMG spots that will fill

 

I disagree that we should restrict IMG spots to CSAs; it's discriminatory in nature by preferring IMGs who were born in Canada. If you did not do your medical school in North America, you are IMG, period. 

If you are CSA, and you could not get into North American Medical Schools, and coming back thinking that you SHOULD get a residency spot. I am sorry to say that we should not jeopardize a IMG's chance of matching over that of CMGs, who was selected among thousands of applicants, who went through 4-5 years of rigorous and excellent medical school training, and worked hard during 2 years of clerkship, compared to <<observation>> in other countries. 

I am sorry, but in any circumstance, I think that the government should prioritize the residency match success for Canadian Medical Students. 

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8 hours ago, la marzocco said:

I'm interested to see how the continued streaming for CMG- and IMG-spots for Ontario & Alberta schools will play out for the 2nd iteration. Will it really improve the unmatched situation?

Dunno if you know this, but if a CMG takes an IMG spot that is ROS, will they have to sign an ROS as well?

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12 minutes ago, LittleDaisy said:

I disagree that we should restrict IMG spots to CSAs; it's discriminatory in nature by preferring IMGs who were born in Canada. If you did not do your medical school in North America, you are IMG, period. 

If you are CSA, and you could not get into North American Medical Schools, and coming back thinking that you should get a residency position.

I am sorry, but in any circumstance, I think that the government should prioritize the residency match success for Canadian Medical Students. 

But I'm suggesting a realistic solution that could pass in court. Outside the legal domain, the public and politicians have far more sympathy for IMGs.

With that said, I do agree fully in principle. Outside the realm of american MD DO schools I don't trust training elsewhere. I know caribbean schools rotate in the US but there is major inconsistency in the training. 

And of course American grads are entitled to CMG spots because CMGs can apply to the US freely. 

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15 minutes ago, medigeek said:

Don't forget many CMGs who are in charge or influential have kids who are IMGs. 

 

The solution is simple:

- cut med school seats --> you need to solve the backlog problem and prevent another one / we also have a backlog for specialtiy jobs which won't improve if seats are not cut

- restrict IMG spots to CSAs --> CSAs have a much stronger legal ground to stand on compared to complete foreign grads

- take medicine off the whole immigration skilled job panel, don't trick them with false hope

-  redistribute IMG spots to CMG places that don't fill but are underserved and as a result create more CMG spots that will fill

 

Of course, cutting med school seats is not a popular political headline since it will be seem as cutting future doctors to the public. And the federal government is clueless on job demand/immigrants. 

Lastly, the reality is until the unmatched rate is below that of the US (~95%), there's no reason to panic. The system is not designed to guarantee residency spots to everyone, and that is known from day 1. Programs have the right to not rank someone who is obviously backing up with their specialty. Do you want to be someone's obvious 2nd choice to the point that they almost say it to your face? And a certain small percentage of people will have very weak apps and interview very poorly, what should programs do? Education is a bell curve. But I think if there were board scores to go off of, it would provide objectively accountability. Far less people would be mad if there was some objective reason to not match. 

 

 

All those solutions sound good short term, but have you seen the wait times for patients for elective orthopaedic surgery and MRI scans? Decreasing med student enrolment is not a permanent solution! We should increase residency spots and more importantly, increase healthcare infrastructure to help physicians get jobs. Taking medicine off immigration skilled job panel also sounds like we are preventing talent from other countries. With our current system, innovation is already stifled, we need to get TALENTED (not mediocre) physicians from abroad. 

We should never compare Canadian match system with the US, and the Canadian matching system is definitely at least a cause for concern. In the US, people gun for specialities, in Canada, there is a much higher focus on family medicine. US MD graduate would rather go unmatched than match into a less competitive field. I have not heard a USMD graduate who was competent, passed their boards and failed to match into family medicine. In Canada, this is not the case unfortunately. On top of that, USMDs want desirable locations, while Canadians basically get what they can get even if its ROS in an area where you have to drive an hour to get food. Don't forget, US have WAYY more residency spots compared to graduates, the match numbers never tell the whole story. 

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5 minutes ago, peace2014 said:

All those solutions sound good short term, but have you seen the wait times for patients for elective orthopaedic surgery and MRI scans? Decreasing med student enrolment is not a permanent solution!

Neither of these have to do with number of doctors. The first is due to lack of OR/support availability, the second is due to physical number of scanners/technicians.

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5 minutes ago, peace2014 said:

All those solutions sound good short term, but have you seen the wait times for patients for elective orthopaedic surgery and MRI scans? Decreasing med student enrolment is not a permanent solution! We should increase residency spots and more importantly, increase healthcare infrastructure to help physicians get jobs. Taking medicine off immigration skilled job panel also sounds like we are preventing talent from other countries. With our current system, innovation is already stifled, we need to get TALENTED (not mediocre) physicians from abroad. 

We should never compare Canadian match system with the US, and the Canadian matching system is definitely at least a cause for concern. In the US, people gun for specialities, in Canada, there is a much higher focus on family medicine. US MD graduate would rather go unmatched than match into a less competitive field. I have not heard a USMD graduate who was competent, passed their boards and failed to match into family medicine. In Canada, this is not the case unfortunately. On top of that, USMDs want desirable locations, while Canadians basically get what they can get even if its ROS in an area where you have to drive an hour to get food. Don't forget, US have WAYY more residency spots compared to graduates, the match numbers never tell the whole story. 

You do realize that elective procedures for orthopaedics and ophthalmology are capped. There is a certain alloted number of procedures per Center. This is created so that the government can keep cost down and move it to the next fiscal year. The orthopods or ophthalmologist would gladly do way more procedures which would result in shorter wait times.

 

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3 minutes ago, peace2014 said:

All those solutions sound good short term, but have you seen the wait times for patients for elective orthopaedic surgery and MRI scans? Decreasing med student enrolment is not a permanent solution! We should increase residency spots and more importantly, increase healthcare infrastructure to help physicians get jobs. Taking medicine off immigration skilled job panel also sounds like we are preventing talent from other countries. With our current system, innovation is already stifled, we need to get TALENTED (not mediocre) physicians from abroad. 

We should never compare Canadian match system with the US, and the Canadian matching system is definitely at least a cause for concern. In the US, people gun for specialities, in Canada, there is a much higher focus on family medicine. US MD graduate would rather go unmatched than match into a less competitive field. I have not heard a USMD graduate who was competent, passed their boards and failed to match into family medicine. In Canada, this is not the case unfortunately. On top of that, USMDs want desirable locations, while Canadians basically get what they can get even if its ROS in an area where you have to drive an hour to get food. Don't forget, US have WAYY more residency spots compared to graduates, the match numbers never tell the whole story. 

The thing is you need to first input *massive* funding to fix the backlog of unemployed and underemployed physicians. You don't fix wait times by pumping out physician who don't have positions to fill. Also, the amount of funding needed is extremely higher than you can imagine. If you press the government too hard they'll just cut everyone's income by 20% in return for creating more physician jobs. Not far fetched since the government's arbitration proposal involved cutting incomes by something like 30%. A fully public system that we have simply cannot do much better, we'd go broke 10x over. It's best to cut down things from the start point so that we don't have unemployed and unmatched people then build from the front out after. 

The US match also has its own growing issues with an increase of unmatched Americans. It's fair to compare numbers of last year. What you're saying is more true of ~5 years ago, it's changed since then. 

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1 minute ago, monocle said:

On paper, it is very much a merit based system and the best candidate "wins". A program will not choose a candidate they do not think is a good just because they're a CMG/IMG or whatever.

I'm aware there are other factors at play, but even those (e.g. connections/networking) are not obtained without effort. 

 

Connections and networking have little to do with "merit." That's like saying you deserved your residency because your uncle happened to be the program director.

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2 minutes ago, monocle said:

On paper, it is very much a merit based system and the best candidate "wins". A program will not choose a candidate they do not think is a good just because they're a CMG/IMG or whatever.

I'm aware there are other factors at play, but even those (e.g. connections/networking) are not obtained without effort. 

 

Sure, it is a superficial merrit base system. However, it is a system based on no objective comparison standards. 

Also the connection you speak of can reflect effort but can also be a reflection of nepotism. How do you compete with an applicant who’s parent is the program director?

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