What kind of applicant DOESN'T match?

[procrastinating]

Hey all. I know there's several (outdated) threads about how to match to X competitive specialty, and it's pretty evident that a variety of personalities/research/academic backgrounds are touted as the "key" to matching. But what kind of applicant doesn't match to, for example, ophthalmology/dermatology/plastics? Do they have to be an egregiously bad applicant, obviously ill-suited, or do mediocre applicants also get "filtered out" by CaRMS? And what exactly would constitute a mediocre applicant? If you become interested in your later years of medical school, have you failed yourself by not demonstrating profound early interest in a competitive specialty?

On that note, what are some tips for actually matching? Do you really need 20+ publications/poster presentations to be considered for a specialty like ophtho/derm/plastics?

Appreciate any and all advice. 

[Lactic Folly]

For the most competitive fields such as ophtho, many strong candidates may fail to match, simply because of the ratio of spots to applicants. 

[procrastinating]

any other takers?

[JohnGrisham]

On 10/29/2019 at 11:15 AM, Lactic Folly said:

For the most competitive fields such as ophtho, many strong candidates may fail to match, simply because of the ratio of spots to applicants. 

Yes, and this applies to moderately competitive fields even these days too, given how tight the ratios of overall spots to applicants. One could argue if you only targeted big city FM programs, that it would be plausible to have decent candidates go unmatched due to many people not wanting to go to a rural training program or certain provinces as their 1st choices.

[procrastinating]

On 10/29/2019 at 3:45 PM, Lactic Folly said:

For the most competitive fields such as ophtho, many strong candidates may fail to match, simply because of the ratio of spots to applicants. 

 

10 minutes ago, JohnGrisham said:

Yes, and this applies to moderately competitive fields even these days too, given how tight the ratios of overall spots to applicants. One could argue if you only targeted big city FM programs, that it would be plausible to have decent candidates go unmatched due to many people not wanting to go to a rural training program or certain provinces as their 1st choices.

i'm not really asking *why* people don't match, but rather, hoping to start a more nuanced discussion of what qualities are perceived as unfavorable (not just for ophthalmology but across the board). yeah, there aren't enough spots, and yeah, you might screw yourself over if you make poor ranking decisions. but assuming that an applicant is vigilant and doesn't dig their own grave, what are some reasons that they still may end up unmatched?

[Meridian]

You are asking it backwards to how people think.  Most applicants want to know how they could have the best chance against their peers -- not the best way to kill success outright.   Psychopath & Asshole are 2 easy ones.  Arrogance, apathy, abrasiveness, and not pulling their weight are all good reasons as well.    When ranking candidates a committee will spend all their effort deciding order between the top 2-3 candidates and ignore all others.  They won't spend time deciding  who is the worst of the worst. 

[IMislove]

[procrastinating]

57 minutes ago, Meridian said:

You are asking it backwards to how people think.  Most applicants want to know how they could have the best chance against their peers -- not the best way to kill success outright.   Psychopath & Asshole are 2 easy ones.  Arrogance, apathy, abrasiveness, and not pulling their weight are all good reasons as well.    When ranking candidates a committee will spend all their effort deciding order between the top 2-3 candidates and ignore all others.  They won't spend time deciding  who is the worst of the worst. 

those are questions i've already been thinking about, so i figured it could be interesting to approach it from the flip-side, just to see if anything new emerges

[GH0ST]

On 10/20/2019 at 1:44 PM, procrastinating said:

Hey all. I know there's several (outdated) threads about how to match to X competitive specialty, and it's pretty evident that a variety of personalities/research/academic backgrounds are touted as the "key" to matching. But what kind of applicant doesn't match to, for example, ophthalmology/dermatology/plastics? Do they have to be an egregiously bad applicant, obviously ill-suited, or do mediocre applicants also get "filtered out" by CaRMS? And what exactly would constitute a mediocre applicant? If you become interested in your later years of medical school, have you failed yourself by not demonstrating profound early interest in a competitive specialty?

On that note, what are some tips for actually matching? Do you really need 20+ publications/poster presentations to be considered for a specialty like ophtho/derm/plastics?

Appreciate any and all advice. 

I had amazing colleagues that didn't match not because they weren't good enough but just didn't match well compared to others on the list from other programs. 

- G

[jnuts]

Hate to say it, but other than big intra-persona red flags; the process is mostly random.  The biggest asset is having done a favorable rotation with staff active on the selection committee who will push for a given student when the final rank order decisions are made.  The process is capricious.

 

[keener12345]

On 10/20/2019 at 1:44 PM, procrastinating said:

Hey all. I know there's several (outdated) threads about how to match to X competitive specialty, and it's pretty evident that a variety of personalities/research/academic backgrounds are touted as the "key" to matching. But what kind of applicant doesn't match to, for example, ophthalmology/dermatology/plastics? Do they have to be an egregiously bad applicant, obviously ill-suited, or do mediocre applicants also get "filtered out" by CaRMS? And what exactly would constitute a mediocre applicant? If you become interested in your later years of medical school, have you failed yourself by not demonstrating profound early interest in a competitive specialty?

On that note, what are some tips for actually matching? Do you really need 20+ publications/poster presentations to be considered for a specialty like ophtho/derm/plastics?

Appreciate any and all advice. 

Are you first year? 

[bruh]

I'm not a med student yet but I do wonder if those who don't match applied only to the big cities like Toronto and Vancouver. Don't you get to apply to as many programs as you wish? I would imagine that if I'm gunning for plastic surgery, for example, I would apply to as many locations as possible because matching even to a rural residency is better than not matching at all.

[keener12345]

I have a question: for electives do we get to choose the staff member we want to work with ?

[procrastinating]

Quote

Hate to say it, but other than big intra-persona red flags; the process is mostly random.  The biggest asset is having done a favorable rotation with staff active on the selection committee who will push for a given student when the final rank order decisions are made.  The process is capricious.

how do you get someone to push for you if you've only known them for a week or two during rotations? 

[BernieMac]

-

[GH0ST]

1 hour ago, procrastinating said:

how do you get someone to push for you if you've only known them for a week or two during rotations? 

You work yourself to the bone and volunteer to do things. 

You come in ready to work, show up earlier than expected. Make yourself effective on rounds. You read around cases (and sometimes if you can try to read up lots even ahead of time to have a differential and plan). I've been in situations where I was fortunate enough to go in a day early and ask the nursing staff to help me orient myself and also get access to the list so I can read around the cases prior to my first day. 

Even then, it may not always be enough.

- G

[ZBL]

2 hours ago, RiderSx said:

I'm not a med student yet but I do wonder if those who don't match applied only to the big cities like Toronto and Vancouver. Don't you get to apply to as many programs as you wish? I would imagine that if I'm gunning for plastic surgery, for example, I would apply to as many locations as possible because matching even to a rural residency is better than not matching at all.

Pro tip: Don’t be a gunner. Staff and residents can smell the stink of a gunner, and it’s not pleasant. Make your moves towards a competitive specialty only once you know for sure what that specialty is all about and why you’d want to do it over any other. 

[JohnGrisham]

44 minutes ago, GH0ST said:

You work yourself to the bone and volunteer to do things. 

You come in ready to work, show up earlier than expected. Make yourself effective on rounds. You read around cases (and sometimes if you can try to read up lots even ahead of time to have a differential and plan). I've been in situations where I was fortunate enough to go in a day early and ask the nursing staff to help me orient myself and also get access to the list so I can read around the cases prior to my first day. 

Even then, it may not always be enough.

- G

This is what most med students already do to a degree.

[robclem21]

8 hours ago, JohnGrisham said:

This is what most med students already do to a degree.

"Most", which is why "most" students match. There are still many medical students that don't show interest, disappear for long periods of time, and have a general lack of work ethic.

That being said, the biggest thing I've seen students get "flagged" for is being arrogant, not-teachable, and having no appreciation for the limitations of their knowledge (creating unsafe situations for patients and staff). I'll also second the "don't be a gunner" sentiment. Don't go over residents heads to show off to staff. There is an important distinction between hard work, and trying to show off by being too keen.

It's important to keep in mind that staff and residents are selecting colleagues. They want someone they like and can work well with. This doesn't necessarily correlate to the smartest medical student.

[keener12345]

Hey could someone please answer my question regarding electives on the other thread please

[LostLamb]

16 minutes ago, robclem21 said:

"Most", which is why "most" students match. There are still many medical students that don't show interest, disappear for long periods of time, and have a general lack of work ethic.

That being said, the biggest thing I've seen students get "flagged" for is being arrogant, not-teachable, and having no appreciation for the limitations of their knowledge (creating unsafe situations for patients and staff). I'll also second the "don't be a gunner" sentiment. Don't go over residents heads to show off to staff. There is an important distinction between hard work, and trying to show off by being too keen.

It's important to keep in mind that staff and residents are selecting colleagues. They want someone they like and can work well with. This doesn't necessarily correlate to the smartest medical student.

This advice is excellent and applies to non-surgical specialties as well!

[procrastinating]

1 hour ago, robclem21 said:

"Most", which is why "most" students match. There are still many medical students that don't show interest, disappear for long periods of time, and have a general lack of work ethic.

That being said, the biggest thing I've seen students get "flagged" for is being arrogant, not-teachable, and having no appreciation for the limitations of their knowledge (creating unsafe situations for patients and staff). I'll also second the "don't be a gunner" sentiment. Don't go over residents heads to show off to staff. There is an important distinction between hard work, and trying to show off by being too keen.

It's important to keep in mind that staff and residents are selecting colleagues. They want someone they like and can work well with. This doesn't necessarily correlate to the smartest medical student.

Thank you so much for this answer  How important do you think research is, especially for more competitive specialties (although i suppose everything is becoming competitive these days)? Is it more of a checklist item (one or two pubs is all you need) or is it heavily considered? Does the type of research matter? 

 

Also for programs that consider undergraduate marks (ex. many derm programs), how heavily is that considered? 

[robclem21]

2 hours ago, procrastinating said:

Thank you so much for this answer  How important do you think research is, especially for more competitive specialties (although i suppose everything is becoming competitive these days)? Is it more of a checklist item (one or two pubs is all you need) or is it heavily considered? Does the type of research matter? 

 

Also for programs that consider undergraduate marks (ex. many derm programs), how heavily is that considered? 

There is no single answer to this and it certainly varies by specialty and by program. You could talk to 10 different people (even in the same program) and get 10 different answers. My opinion is, as with anything, quality over quantity. If you do research, you should be able to talk about why, what you learned, and how those skills will help you in the future.

I have no idea re: your second question.

[JohnGrisham]

13 hours ago, robclem21 said:

"Most", which is why "most" students match. There are still many medical students that don't show interest, disappear for long periods of time, and have a general lack of work ethic.

That being said, the biggest thing I've seen students get "flagged" for is being arrogant, not-teachable, and having no appreciation for the limitations of their knowledge (creating unsafe situations for patients and staff). I'll also second the "don't be a gunner" sentiment. Don't go over residents heads to show off to staff. There is an important distinction between hard work, and trying to show off by being too keen.

It's important to keep in mind that staff and residents are selecting colleagues. They want someone they like and can work well with. This doesn't necessarily correlate to the smartest medical student.

My comment was in response to the other user:Procrastinating which essentially asked "how do you get a preceptor to go to bat for you after only knowing your for 2 weeks".... and user:GH0ST responded  with the list of things to do...and my response to them was "Most students already do that".....which my point was being, most students are eager, try hard, are pleasant - yet most people aren't having preceptors go out of their way to go to bat for them.  The process is a crapshoot, and lots of luck with who you get and the circumstances surrounding your clinical rotation.

Essentially, if you're already being a strong student and doing your best, and not showing those negative attributes - you're doing the right things! Still doesnt mean you will get someone to go to bat for you, or even get a strong letter of reference, but at least you did your due diligence and best you can, to at least optimize things from your own standpoint within your control. Rest is dumb luck.

[Arztin]

1 hour ago, JohnGrisham said:

The process is a crapshoot, and lots of luck with who you get and the circumstances surrounding your clinical rotation.

Essentially, if you're already being a strong student and doing your best, and not showing those negative attributes - you're doing the right things! Still doesnt mean you will get someone to go to bat for you, or even get a strong letter of reference, but at least you did your due diligence and best you can, to at least optimize things from your own standpoint within your control. Rest is dumb luck.

A BIG part of CARMS is just luck. You can be the most deserving, hardest working,  skilled me student functionning at an R2 level, with first author papers, but if you are unlucky and someone doesn't like you for whatever reason, someone seemingly less competitive candidate will get that spot. 

Here are some real reasons some random candidate seeming less competitive or deserving might get that spot and not you: A family member knows the selection committee and they will get that spot and not you. Someone might find a candidate more attractive than you and might pick them over you. Someone else is more of a smooth talker than you. Someone has the same hobbies as the PD. The PD has a different personality and doesn't want you around. A nurse trash talked behind your back, or you got bullied by nurses. A resident blacklisted you and you will never even know it, and it might not even be a legit reason.

There sure are things that you can do to max out your chances of getting unmatched. A few true examples (I have seen students or residents at some point doing a combination of things on this list):

- never admitting your mistakes

- lie

- thinking that you know more than your residents or your staff

- being arrogant

- absolutely no sense of what your limits are

- arrive late

- repetitively show that you have absolutely no common sense

- lazy and doesn't read the few things you ask them to

- not polite

- thinking you are somehow a superhuman and applying for only 1 uber competitive program like plastics or emergency medicine and thinking that you will get that spot, but not someone else

- treating other people like shit (other med students, residents, nursing etc...)

But honestly, most unmatched folks that I know don't fit with any of the above. They were:

- unlucky

- too many candidates for the number of spots

- someone else had connections

- someone else was more charming and was a better smooth talker

- had a bad interview

etc...

At the end of the day, the entire CARMS process is a whole lot of BS. A lot of it is still luck Most unmatched candidates are just fine people. Your worth shouldn't be based on your CARMS match. You can only work hard, do your best, and hope the process doesn't screw you.