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aristarchus

Advice from a prior year unmatched student

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I just wanted to give some words of hope for students who may have been unlucky in the first round of the R1 match. Early data indicates there were 140 unmatched CMG students in 2014 compared to 130 CMG students in 2013. The number of positions available for the 2nd iteration has dropped compared to last year from 292 in 2013 to 228 in 2014. This all points to a much more competitive match due to a number of factors: IMG dedicated spots since 2007, increased medical student enrollment, larger numbers of prior year unmatched students due to increased 2nd round competitiveness combined with limited access to scramble positions due to the growth of post graduate programs across Canada, and year-to-year variation in specialty competitiveness.

 

This forum has a few active posters, but compared to the number of CMGs (~3000) applying to CaRMS each year, the forum gives only a small subset of opinions from students who were actually unmatched. If you look at the speculation found on this forum, you will think that going unmatched is a "scarlet letter" or the end of your medical dream. That is a gross exaggeration and is just unhelpful. Going unmatched means that you are up for a challenging year, and this challenge can be surmounted. I was unmatched in 2013, and was able to match to my top specialty/location in 2014.

 

Some suggestions:

(1) If you haven't already, try to get in contact with your student affairs office. They can help you determine what type of MD office supports are available and any department requirements.

(2) Try to come to terms with being unmatched and make the most of this opportunity. The most common reason people are unmatched are: applied to only one specialty, did not rank enough locations, weak interview performance (sort of a result of not applying to enough specialties) and random chance. What does randomness mean in CaRMS, it means several things, some individuals try to read patterns in CaRMS trends and pick less competitive specialties, making that specialty more competitive, or a group of like minded people across the country all want the same specialty in excess of the number of spots available at their home school, etc.

(3) Do some soul-searching. Looking back at your clerkship rotations, did any fields make you think twice, but you felt locked in due to prior electives? These are specialties you should be applying to!

(4) Apply to the 2nd iteration. It might be a requirement for most MD office assistance. There is a ~50% chance of matching for CMGs and on a Canada wide basis, this could reduce the number of unmatched students to ~70.

(5) If you remain unmatched after round 2 you have several options:

a) complete a course-based or research masters program, e.g., clinical epidemiology.

B) while studying for the MCCQE I, write the USMLE step 2 to give you the option of applying to the US match.

c) look for opportunities to complete additional electives through your MD office, this can involve delaying your convocation until the Fall. These electives should be used to explore new locations or specialties.

(6) Keep positive: you'll be sharing your unmatched story a lot in the next year if you are doing electives and during interviews. Most people will be very supportive and helpful. However, there will be some people who will be judgmental and rude, categorizing you in the same group as every bad medical student they have met (e.g., lack of punctuality, lack of knowledge, poor communication). Do not take it personally and try to prove them wrong by being punctual, knowledgeable, and having a great attitude. This negative generalization of the "unmatched" is just a rationalization used by people to avoid cognitive dissonance, i.e., it makes no sense why good people would go unmatched, hence the rationalization, they cannot be "good".

(7) Develop a new CaRMS strategy: interview in several specialties (2-3) and in multiple locations. Remember there are 3 weeks for CaRMS and it is possible to have an interview in a new location every day - I did :) This will be expensive.

(8) For students who are not yet in the match process, lobby the CFMS to not ignore this problem. ~5% or 1 in 20 medial students going unmatched is not acceptable, especially if one considers that 10-15% of R1 positions are dedicated to IMGs.

 

Best of luck to all entering the 2nd iteration!

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Awesome that things worked out in the end!! This is very sound - and if I can say, sage - advice otherwise.

 

As for the lobbying issue, I can see if I can add the match issue (and this year's match in particular) to the agenda of the CAIR meeting I'm attending on the weekend.

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Just wanted to thank you for this helpful and positive advice. I'll be applying to carms next year. Like many in my class, I've been troubled by the rising number of unmatched students and the apparent decrease of second round positions. It's disconcerting that even fields like FM and psych are becoming so tight that decent candidates are going unmatched, despite the need for more docs in those fields. I think we'll see similar trends next year as the size of the graduating class continues to increase. It's nice to be reminded that going unmatched doesn't mean the end of one's career.

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I just wanted to give some words of hope for students who may have been unlucky in the first round of the R1 match. Early data indicates there were 140 unmatched CMG students in 2014 compared to 130 CMG students in 2013. The number of positions available for the 2nd iteration has dropped compared to last year from 292 in 2013 to 228 in 2014. This all points to a much more competitive match due to a number of factors: IMG dedicated spots since 2007, increased medical student enrollment, larger numbers of prior year unmatched students due to increased 2nd round competitiveness combined with limited access to scramble positions due to the growth of post graduate programs across Canada, and year-to-year variation in specialty competitiveness.

 

This forum has a few active posters, but compared to the number of CMGs (~3000) applying to CaRMS each year, the forum gives only a small subset of opinions from students who were actually unmatched. If you look at the speculation found on this forum, you will think that going unmatched is a "scarlet letter" or the end of your medical dream. That is a gross exaggeration and is just unhelpful. Going unmatched means that you are up for a challenging year, and this challenge can be surmounted. I was unmatched in 2013, and was able to match to my top specialty/location in 2014.

 

Some suggestions:

(1) If you haven't already, try to get in contact with your student affairs office. They can help you determine what type of MD office supports are available and any department requirements.

(2) Try to come to terms with being unmatched and make the most of this opportunity. The most common reason people are unmatched are: applied to only one specialty, did not rank enough locations, weak interview performance (sort of a result of not applying to enough specialties) and random chance. What does randomness mean in CaRMS, it means several things, some individuals try to read patterns in CaRMS trends and pick less competitive specialties, making that specialty more competitive, or a group of like minded people across the country all want the same specialty in excess of the number of spots available at their home school, etc.

(3) Do some soul-searching. Looking back at your clerkship rotations, did any fields make you think twice, but you felt locked in due to prior electives? These are specialties you should be applying to!

(4) Apply to the 2nd iteration. It might be a requirement for most MD office assistance. There is a ~50% chance of matching for CMGs and on a Canada wide basis, this could reduce the number of unmatched students to ~70.

(5) If you remain unmatched after round 2 you have several options:

a) complete a course-based or research masters program, e.g., clinical epidemiology.

B) while studying for the MCCQE I, write the USMLE step 2 to give you the option of applying to the US match.

c) look for opportunities to complete additional electives through your MD office, this can involve delaying your convocation until the Fall. These electives should be used to explore new locations or specialties.

(6) Keep positive: you'll be sharing your unmatched story a lot in the next year if you are doing electives and during interviews. Most people will be very supportive and helpful. However, there will be some people who will be judgmental and rude, categorizing you in the same group as every bad medical student they have met (e.g., lack of punctuality, lack of knowledge, poor communication). Do not take it personally and try to prove them wrong by being punctual, knowledgeable, and having a great attitude. This negative generalization of the "unmatched" is just a rationalization used by people to avoid cognitive dissonance, i.e., it makes no sense why good people would go unmatched, hence the rationalization, they cannot be "good".

(7) Develop a new CaRMS strategy: interview in several specialties (2-3) and in multiple locations. Remember there are 3 weeks for CaRMS and it is possible to have an interview in a new location every day - I did :) This will be expensive.

(8) For students who are not yet in the match process, lobby the CFMS to not ignore this problem. ~5% or 1 in 20 medial students going unmatched is not acceptable, especially if one considers that 10-15% of R1 positions are dedicated to IMGs.

 

Best of luck to all entering the 2nd iteration!

 

) For students who are not yet in the match process, lobby the CFMS to not ignore this problem. ~5% or 1 in 20 medial students going unmatched is not acceptable, especially if one considers that 10-15% of R1 positions are dedicated to IMGs.

 

Lobby Canadian Medical school leaders to protect CMGs to get a spot. Those CMGs spend more then 8 years( first degree plus MD) for MD. And they passed MCAT, then get in Medical school. Not using Money bought.

 

Lobby program director ranking those who has been interviewed by them. even put them in last on ranking list.

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) For students who are not yet in the match process, lobby the CFMS to not ignore this problem. ~5% or 1 in 20 medial students going unmatched is not acceptable, especially if one considers that 10-15% of R1 positions are dedicated to IMGs.

 

Lobby Canadian Medical school leaders to protect CMGs to get a spot. Those CMGs spend more then 8 years( first degree plus MD) for MD. And they passed MCAT, then get in Medical school. Not using Money bought.

 

Lobby program director ranking those who has been interviewed by them. even put them in last on ranking list.

 

More importantly, taxpayers funded their education. Every med student costs the taxpayer well into the 100 thousands (875k to fully train a specialist from M1 to staff).

 

Unmatched CMG's are a waste of taxpayers money.

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More importantly, taxpayers funded their education. Every med student costs the taxpayer well into the 100 thousands (875k to fully train a specialist from M1 to staff).

 

Unmatched CMG's are a waste of taxpayers money.

 

If matched them that will not waste taxpayer's money. Then they can pay taxes every day.

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Unmatched CMG's are a waste of taxpayers money.

 

Exactly! No one is "entitled" to a residency position in the discipline/location of their choice, but it's reasonable to strive for a system that ensures that the vast majority of competent CMGs who desire residency training will receive it in a timely manner. Of course I am also self-interested when I argue this, but I feel that many in the public would agree. The taxpayer subsidizes our education under the assumption that we will return their investment as physicians. A system which fails to maximize that return is flawed at some level, whether at the undergraduate or postgraduate stage.

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) For students who are not yet in the match process, lobby the CFMS to not ignore this problem. ~5% or 1 in 20 medial students going unmatched is not acceptable, especially if one considers that 10-15% of R1 positions are dedicated to IMGs.

 

Lobby Canadian Medical school leaders to protect CMGs to get a spot. Those CMGs spend more then 8 years( first degree plus MD) for MD. And they passed MCAT, then get in Medical school. Not using Money bought.

 

Lobby program director ranking those who has been interviewed by them. even put them in last on ranking list.

 

Why should CMGs get protected a spot. I'd wager the top 25% of IMGs (aka the ones that actually match) are better prepared for residency than the bottom 5% of CMGs. Don't get me wrong, i don't believe that the people who don't get matched are actually the bottom 5% of the class, many did not apply broadly enough or to multiple specialties.

 

Also, its not "bought" by money. I'd guess most students could not get into medical school, but not all students are like that (those who enter straight from high school are becoming a more significant percentage).

 

Its a competitive process, it sucks to not get matched, but I don't see anything wrong with taking a year off.

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Why should CMGs get protected a spot. I'd wager the top 25% of IMGs (aka the ones that actually match) are better prepared for residency than the bottom 5% of CMGs. Don't get me wrong, i don't believe that the people who don't get matched are actually the bottom 5% of the class, many did not apply broadly enough or to multiple specialties.

 

Also, its not "bought" by money. I'd guess most students could not get into medical school, but not all students are like that (those who enter straight from high school are becoming a more significant percentage).

 

Its a competitive process, it sucks to not get matched, but I don't see anything wrong with taking a year off.

 

Your response is a bit schizophrenic. It is very important to note that many unmatched students are not the bottom 5% of CMGs. The politics and luck behind matching into a competitive program cannot be understated. I would wager that the majority of unmatched students are those who have the drive to aim for more competitive programs. As a result, it would not be unreasonable for these students to work hard and take advantage of their year off. The original poster gave a very nice summary of the options available. Being unmatched is not, in and of itself, a red flag.

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Why should CMGs get protected a spot. I'd wager the top 25% of IMGs (aka the ones that actually match) are better prepared for residency than the bottom 5% of CMGs. Don't get me wrong, i don't believe that the people who don't get matched are actually the bottom 5% of the class, many did not apply broadly enough or to multiple specialties.

 

Also, its not "bought" by money. I'd guess most students could not get into medical school, but not all students are like that (those who enter straight from high school are becoming a more significant percentage).

 

Its a competitive process, it sucks to not get matched, but I don't see anything wrong with taking a year off.

 

Because my (and everyone's) taxes financed the CMGs med school so I don't want that investment wasted.

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Because my (and everyone's) taxes financed the CMGs med school so I don't want that investment wasted.

 

+1 - you can argue all you want about IMG's being equal to/superior to some CMG's, but the bottom line is that the Canadian population has supported these CMG's to the tune of at least ~$200k per student by the time they match (and much more after residency). They deserve a residency spot over an IMG, regardless of their perceived skillset. I would note that there are many top quality applicants who don't match in the first round through no fault of their own.

 

My stance is that if you want to be a doctor in Canada, do your medical school in Canada. If you want to take a short-cut or immigrate from elsewhere, that's fine, but our population has financed a set number of people through the first 4 years of medical school, and they deserve to have a residency spot.

 

If we aren't offering enough CMG residency spots, we simply shouldn't be enrolling as many medical students in the first place (I also agree with this).

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Don't get me wrong, i don't believe that the people who don't get matched are actually the bottom 5% of the class.

 

You don't? Well it sure sounded like you do. And that's very wrong. As a future IMG applicant, you ought to recognize that your risk of ending up amongst the unmatched is much more likely than the average Canadian graduate. A bit of empathy and less smugness would be in order.

 

Also, its not "bought" by money. I'd guess most students could not get into medical school, but not all students are like that (those who enter straight from high school are becoming a more significant percentage).

 

I don't feel that those who bypass the usual route to medical training in Canada ought to feel entitled to a residency position. You're not. In fact, I would go further and say that it is not consistent with sound public policy to provide IMG spaces in the kind of numbers we currently do. There may be a case for continued funding of family medicine positions, but there is little to no justification of continued funding of specialty positions in light of few staff jobs for even current residents.

 

Canadian residency positions are for Canadian medical graduates.

 

Its a competitive process, it sucks to not get matched, but I don't see anything wrong with taking a year off.

 

It's something of a barbaric process, actually, and this statement suggests you don't have the slightest insight into how this process works or what the implications of the second iteration (let alone not matching in it!) are. I don't know that you understand the situation at all.

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I am a CMG, and I want to give my thought on this issue.

 

First, the un-match rate has been around 5% for the past 20 years, and it likely will not change. This is not due to a lack of CMG residency spots, as the ratio of CMG participants to CMG positions available is often around 1/1.10. The problem is rather a lack of desired residency spots. Every year a small proportion of CMG will go for those competitive specialties (namely the E-ROAD specialties) without backing up and end up unmatched. Unless, we can lobby to increase the number of positions in these highly desired specialties, there will always be people who go unmatched.

 

My second point, Canadian residency positions are for people with the greatest potential to become the best doctors to serve Canadians. During my clerkship years, I worked with quite a few residents who were IMGs. There were two that have left a lasting impression on me. They were both practicing staff physicians back in their countries. After coming to Canada, they spent a few years writing various exams, before applying for residency. Although they were both R-1 when I met them, their knowledge and skills were way above the average R-1. I learned so such from working with them. Although these are just anecdotal personal experiences, we cannot dismiss the fact that there are talents among IMGs, and these talented people deserve a chance to become physicians here in Canada.

 

To my fellow CMGs, please don’t take things for granted. Just because we got into Canadian Medical Schools that are funded by Canadian taxpayers’ money, does not mean each and every one of us deserve a residency spot that each of us wanted. Finishing med school and get matched into residency is just the end of a new beginning. There is a long and tortuous road ahead of us, and we should be prepared to face more setbacks and disappointments. Only those fortune favoured children can get through this whole process without having to struggle, and I am certainly not one of those lucky few.

 

Finally, think about this, if we or our loved ones get sick, do we really care whether the doctor treating us is a CMG or an IMG? No, at least, I don’t. All I want is a kind and competent doctor who can make me or my loved one get better.

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I am a CMG, and I want to give my thought on this issue.

 

First, the un-match rate has been around 5% for the past 20 years, and it likely will not change. This is not due to a lack of CMG residency spots, as the ratio of CMG participants to CMG positions available is often around 1/1.10. The problem is rather a lack of desired residency spots. Every year a small proportion of CMG will go for those competitive specialties (namely the E-ROAD specialties) without backing up and end up unmatched. Unless, we can lobby to increase the number of positions in these highly desired specialties, there will always be people who go unmatched.

 

My second point, Canadian residency positions are for people with the greatest potential to become the best doctors to serve Canadians. During my clerkship years, I worked with quite a few residents who were IMGs. There were two that have left a lasting impression on me. They were both practicing staff physicians back in their countries. After coming to Canada, they spent a few years writing various exams, before applying for residency. Although they were both R-1 when I met them, their knowledge and skills were way above the average R-1. I learned so such from working with them. Although these are just anecdotal personal experiences, we cannot dismiss the fact that there are talents among IMGs, and these talented people deserve a chance to become physicians here in Canada.

 

To my fellow CMGs, please don’t take things for granted. Just because we got into Canadian Medical Schools that are funded by Canadian taxpayers’ money, does not mean each and every one of us deserve a residency spot that each of us wanted. Finishing med school and get matched into residency is just the end of a new beginning. There is a long and tortuous road ahead of us, and we should be prepared to face more setbacks and disappointments. Only those fortune favoured children can get through this whole process without having to struggle, and I am certainly not one of those lucky few.

 

Finally, think about this, if we or our loved ones get sick, do we really care whether the doctor treating us is a CMG or an IMG? No, at least, I don’t. All I want is a kind and competent doctor who can make me or my loved one get better.

 

+1

 

Basically my point but said more eloquently.

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You don't? Well it sure sounded like you do. And that's very wrong. As a future IMG applicant, you ought to recognize that your risk of ending up amongst the unmatched is much more likely than the average Canadian graduate. A bit of empathy and less smugness would be in order.

 

 

 

I don't feel that those who bypass the usual route to medical training in Canada ought to feel entitled to a residency position. You're not. In fact, I would go further and say that it is not consistent with sound public policy to provide IMG spaces in the kind of numbers we currently do. There may be a case for continued funding of family medicine positions, but there is little to no justification of continued funding of specialty positions in light of few staff jobs for even current residents.

 

Canadian residency positions are for Canadian medical graduates.

 

 

 

It's something of a barbaric process, actually, and this statement suggests you don't have the slightest insight into how this process works or what the implications of the second iteration (let alone not matching in it!) are. I don't know that you understand the situation at all.

 

Ok I admit I don't know much about the process, not having been through it, but you didn't get my point which is that no one should go into the process thinking they "deserve" a spot.

 

I also don't think IMGs should be blamed if a CMG goes unmatched.

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I am a CMG, and I want to give my thought on this issue.

 

First, the un-match rate has been around 5% for the past 20 years, and it likely will not change. This is not due to a lack of CMG residency spots, as the ratio of CMG participants to CMG positions available is often around 1/1.10. The problem is rather a lack of desired residency spots. Every year a small proportion of CMG will go for those competitive specialties (namely the E-ROAD specialties) without backing up and end up unmatched. Unless, we can lobby to increase the number of positions in these highly desired specialties, there will always be people who go unmatched.

 

My second point, Canadian residency positions are for people with the greatest potential to become the best doctors to serve Canadians. During my clerkship years, I worked with quite a few residents who were IMGs. There were two that have left a lasting impression on me. They were both practicing staff physicians back in their countries. After coming to Canada, they spent a few years writing various exams, before applying for residency. Although they were both R-1 when I met them, their knowledge and skills were way above the average R-1. I learned so such from working with them. Although these are just anecdotal personal experiences, we cannot dismiss the fact that there are talents among IMGs, and these talented people deserve a chance to become physicians here in Canada.

 

To my fellow CMGs, please don’t take things for granted. Just because we got into Canadian Medical Schools that are funded by Canadian taxpayers’ money, does not mean each and every one of us deserve a residency spot that each of us wanted. Finishing med school and get matched into residency is just the end of a new beginning. There is a long and tortuous road ahead of us, and we should be prepared to face more setbacks and disappointments. Only those fortune favoured children can get through this whole process without having to struggle, and I am certainly not one of those lucky few.

 

Finally, think about this, if we or our loved ones get sick, do we really care whether the doctor treating us is a CMG or an IMG? No, at least, I don’t. All I want is a kind and competent doctor who can make me or my loved one get better.

 

To your first point -that represents a small minority of those who go unmatched. Many of those who go unmatched are not your Optho, Derm gunners who didn't back up. A lot of it comes down to luck.

 

I (we?) are not saying that a CMG deserves the residency spot they want - they most certainly do deserve some sort of residency spot. This issue is not one of competency (and for the record - I have worked with excellent IMG's throughout my clerkship, as I've worked with many excellent CMG's; I've also worked with terrible IMG's and terrible CMG's). The issue is that we're funding a certain number of medical school spots across the country. We should be ensuring that if we're spending hundreds of thousands of dollars to subsidize their medical school, there should also be a residency spot to justify that expense.

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I am a CMG, and I want to give my thought on this issue.

 

First, the un-match rate has been around 5% for the past 20 years, and it likely will not change. This is not due to a lack of CMG residency spots, as the ratio of CMG participants to CMG positions available is often around 1/1.10. The problem is rather a lack of desired residency spots. Every year a small proportion of CMG will go for those competitive specialties (namely the E-ROAD specialties) without backing up and end up unmatched. Unless, we can lobby to increase the number of positions in these highly desired specialties, there will always be people who go unmatched.

 

My second point, Canadian residency positions are for people with the greatest potential to become the best doctors to serve Canadians. During my clerkship years, I worked with quite a few residents who were IMGs. There were two that have left a lasting impression on me. They were both practicing staff physicians back in their countries. After coming to Canada, they spent a few years writing various exams, before applying for residency. Although they were both R-1 when I met them, their knowledge and skills were way above the average R-1. I learned so such from working with them. Although these are just anecdotal personal experiences, we cannot dismiss the fact that there are talents among IMGs, and these talented people deserve a chance to become physicians here in Canada.

 

To my fellow CMGs, please don’t take things for granted. Just because we got into Canadian Medical Schools that are funded by Canadian taxpayers’ money, does not mean each and every one of us deserve a residency spot that each of us wanted. Finishing med school and get matched into residency is just the end of a new beginning. There is a long and tortuous road ahead of us, and we should be prepared to face more setbacks and disappointments. Only those fortune favoured children can get through this whole process without having to struggle, and I am certainly not one of those lucky few.

 

Finally, think about this, if we or our loved ones get sick, do we really care whether the doctor treating us is a CMG or an IMG? No, at least, I don’t. All I want is a kind and competent doctor who can make me or my loved one get better.

 

I second what has been said and I would like to add a little more:

 

In regards to the sentiment that IMGs are the source of the problem, I completely absolutely disagree. I say this because of the following reasons;

 

1. As previously stated there are more CMG allocated spots then CMGs. So the notion that there should be even more, honestly just seems a little silly. I mean even in the second iteration, there are enough spots to go around for those who did not match in the first and then some. So lets just calm the talks that there should be more - there seems to be enough. Also who is supposed to foot the bill for all of these proposed seats? I mean there seems to be a pretty heavy handed discussion of tax payers and all.

 

2. IMGs are not stealing our spots. Heck unless you live in Quebec they aren't even in the same running. Parallel streams means you are only competing against other CMG's. Even in Quebec if you look closely at the number of matched IMG's, it is greatly outweighed by the number of matched CMG's. To add to that, Quebec often has seats that go unmatched, so they clearly aren't favoring IMG's as there are hoards who would give kidney for a match.

 

3. Canada runs on IMG's. I am surprised no one has stated this thus far, have you seen your provinces statistics? Lordy on average the number is 25% and in some cases almost 50%! Shutting out IMG's would be to the detriment to the Canadian health care system. Did none of you folks have and IMG preceptor? Why all the hate?

 

4. IMG's almost always get shafted the ROS contract. I don't think I need to elaborate on this fact, but I am certain that rural communities are grateful that someone is willing to work in their community for a few years.

 

5. IMG's are cheaper. I say this primarily to hush the talk that just because tax payers help foot the bill for a undergraduate medical degree that there should be some return on the investment. IMG's are trained abroad which means no tax payer money wastage. Thus lets not run to our government reps with this, I mean do you really want the public to know there is a cheaper deal out there? I know I don't.

 

6. The IMG's that match are generally pretty impressive. Of course you will get your mix of bad apples just like you would with CMGs. However those that match are actually pretty intelligent. I recently was involved with an exam called the NAC OSCE which these poor IMGs are made to schlep through. The cut off the passing score as what they expect the average CMG to receive on the exam. So basically everyone who passes, is above the average Canadian medical student score. That one just makes me feel for IMGs.

 

lastly on a side note. I think medical school try their best to find candidates that are genuine human beings that care but in the end the process isn't perfect. You're bound to recall at least 1-2 CMGs that you wonder "how in the what in the heck?" are you doing in medicine? So if those folks don't match, then so be it. I know I wouldn't want my family members under their care. Again in regards to the return of investment for tax payers, you never get 100% return and it's sometimes for the best.

 

This post is likely rife with grammatical errors/spelling errors but I am too tired to check.

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Logic 101:

 

-A residency spot should be given based on competency, NOT because student X received subsided education from tax payers.

 

Then why do we have CMG spots at all? Why don't we take all comers from across the world for our residency spots? If this was solely a competency based issue, that is what we would do. And if it was solely a competency issue, we wouldn't have location criteria on the location of residence of medical students entering medical school. This is far more complex a situation than your 'logic 101' indicates.

 

On the same point - how much of CaRMS tests competency? Answer - next to none. There are certainly red flags on some students files that could prevent them from getting a resiency spot, but this is certainly the minority of unmatched people.

 

We enrol people in medical school with the goal of training physicians for the Canadian population, by the Canadian tax payers dollars. There is an inherent obligation that if the tax payers are shelling out ~200k to put someone through medical school, they should reap the benefits of having a practising physician at the end.

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Logic 101:

 

-A residency spot should be given based on competency, NOT because student X received subsided education from tax payers.

 

If we aren't going to take steps to ensure every CMG has a residency position of some kind, then we should remove tax payer support from medical school seats. Let the med students pay for it themselves.

 

I don't care if CMGs get their choice of spot, just that they get a spot.

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Ok I admit I don't know much about the process, not having been through it, but you didn't get my point which is that no one should go into the process thinking they "deserve" a spot.

 

I also don't think IMGs should be blamed if a CMG goes unmatched.

 

No one "deserves" or is "entitled" to a particular spot, but going unmatched can radically change someone's career (and career expectations), often for reasons that have a lot more to do with luck or difficulty deciding what to do (e.g. having electives in different disciplines, which can make one look "undecided" to programs).

 

The IMG issue aside, the process has become entirely too rigid and inflexible. Either we go back to rotating internships +/- general licensure or we change to culture of PGME offices to ensure transfers are more readily doable.

 

(And in terms of IMGs, there has been a steady drop in IMGs enrolled in family medicine programs over the last several years, and it's debatable whether speciality positions should continue to exist in current numbers. I will also say that while some IMGs are very well prepared for residency, the majority I've worked with most certainly are not. Generally speaking those who trained in Ireland perform better than those from the Caribbean, and it's not always a subtle difference. But there are bad CMGs too - many of whom actually match in the first round.)

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Sigh.

 

Not sure why IMGs are even being mentioned here. There are more residency spots for CMGs than there are CMG applicants. IMGs apply in a separate pool, so it has nothing to do with it. If IMG spots all disappeared tomorrow, you wouldn't suddenly have more CMG spots, nor would you need them with the ratio already being >1:1.

 

Even IF you wanted the spots, they would come with a ROS contract attached. I don't see any CMG considering that, even though you could argue they should be required to do a return for service when their education is subsidized.

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Sigh.

 

Not sure why IMGs are even being mentioned here. There are more residency spots for CMGs than there are CMG applicants. IMGs apply in a separate pool, so it has nothing to do with it. If IMG spots all disappeared tomorrow, you wouldn't suddenly have more CMG spots, nor would you need them with the ratio already being >1:1.

 

Even IF you wanted the spots, they would come with a ROS contract attached. I don't see any CMG considering that, even though you could argue they should be required to do a return for service when their education is subsidized.

2013 second iteration match

 

CMG 80

IMG 127

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