2017 Carms Applicants

[GrouchoMarx]

4 hours ago, ralk said:

I think once you're into the 2nd round, and particularly the 2nd cycle, geographical preferences and a desire for a cheap application fee lose their merits. It's by no means fun to move children around the country or uproot a significant other. Yet is that worth the professional, economic, and emotional difficulties experienced going unmatched? Likewise, CaRMS applications can get pretty expensive, but even in a worst-case scenario, we're talking a few thousands of dollars. Contrast that against the $100k+ required to get to CaRMS applications in the first place. More importantly, a single year lost to a missed CaRMS application costs no less than $150k in lost income over the long term. This can't be the time to be frugal.

How do you suggest this be addressed? Getting programs to change their viewpoints on unmatched candidates is far easier said than done, particularly when they have sufficient current-year grads to choose from. Likewise, the only way I know about unmatched applicants is largely either through their own words, or through omission in steps that really can't be avoided. I'm at a bit of a loss as how to make going unmatched less public, since I can't think of ways anyone besides the candidate went out of their way to make it public.

It would require a huge change in how the system operates. More flexibility. Rotating internship. Things like that. CaRMS doesn't forgive.

After this awful story I expect medical students to be applying to the USA in higher numbers than before. 

[ralk]

24 minutes ago, Cain said:

It would require a huge change in how the system operates. More flexibility. Rotating internship. Things like that. CaRMS doesn't forgive.

After this awful story I expect medical students to be applying to the USA in higher numbers than before. 

I'm afraid I'm still not seeing the connection here. I'm all for increasing flexibility in the system for students, especially in the lead-up to CaRMS applications, but I'm not sure how that helps unmatched students much. Similarly, I don't see how a rotation internship helps at all on that front, and it would likely come with some non-trivial drawbacks to medical trainee well-being (I certainly wouldn't be too happy to go through it).

I'm intrigued by the idea here, but clearly missing something.

[ArchEnemy]

20 minutes ago, ralk said:

I'm afraid I'm still not seeing the connection here. I'm all for increasing flexibility in the system for students, especially in the lead-up to CaRMS applications, but I'm not sure how that helps unmatched students much. Similarly, I don't see how a rotation internship helps at all on that front, and it would likely come with some non-trivial drawbacks to medical trainee well-being (I certainly wouldn't be too happy to go through it).

I'm intrigued by the idea here, but clearly missing something.

With a 1-year rotating internship, medical graduates would be able to practice as General Practitioners without having to go through the Family Medicine residency. 

[ralk]

22 minutes ago, ArchEnemy said:

With a 1-year rotating internship, medical graduates would be able to practice as General Practitioners without having to go through the Family Medicine residency. 

While the 1-year rotating internship used to lead to becoming a GP, bringing it back wouldn't automatically provide that accreditation. No way the CFPC allows in these days (partially for political reasons, partially for patient care concerns).

[MedOncologista]

59 minutes ago, ralk said:

While the 1-year rotating internship used to lead to becoming a GP, bringing it back wouldn't automatically provide that accreditation. No way the CFPC allows in these days (partially for political reasons, partially for patient care concerns).

I wrote something similar in another thread, but perhaps allowing unmatched applicants access a funded "generalist" transition year could be an option. While this wouldn't allow them to practice and they would still have to go through CARMs the following year, it would at least allow them to complete rotations likely to be mandatory in most residency programs, and may ultimately help them be successful in the following year's match.

I also wonder if it might also be worth considering allowing applicants still unmatched after the 2nd iteration to contact programs with unmatched spots outside of the CARMs process, and potentially fill spots that would otherwise sit empty. I understand the need for transparency and why CARMs was adopted, but don't think would be a big issue at that point. 

[ralk]

10 minutes ago, MedOncologista said:

I wrote something similar in another thread, but perhaps allowing unmatched applicants access a funded "generalist" transition year could be an option. While this wouldn't allow them to practice and they would still have to go through CARMs the following year, it would at least allow them to complete rotations likely to be mandatory in most residency programs, and may ultimately help them be successful in the following year's match.

I also wonder if it might also be worth considering allowing applicants still unmatched after the 2nd iteration to contact programs with unmatched spots outside of the CARMs process, and potentially fill spots that would otherwise sit empty. I understand the need for transparency and why CARMs was adopted, but don't think would be a big issue at that point. 

I love the idea of making schools more responsible for the students they graduate who go unmatched. There's little accountability on that front and it would give them an incentive to better prepare students for the match process. I'm not sure the answer is a transition year like you describe, but it certainly would make programs have more skin in the game.

The second option actually does happen already, there's just so few spots left after the 2nd round is complete that it doesn't do much to help the situation.

[MedOncologista]

7 minutes ago, ralk said:

I love the idea of making schools more responsible for the students they graduate who go unmatched. There's little accountability on that front and it would give them an incentive to better prepare students for the match process. I'm not sure the answer is a transition year like you describe, but it certainly would make programs have more skin in the game.

The second option actually does happen already, there's just so few spots left after the 2nd round is complete that it doesn't do much to help the situation.

I didn't realize that was already happening, for some reason I recall ppl unmatched in my class mentioning they weren't allowed to access spots outside of CARMs, even post-second iteration match...perhaps I'm wrong, or maybe it's just changed since my day 

[ralk]

Just now, MedOncologista said:

I didn't realize that was already happening, for some reason I recall ppl unmatched in my class mentioning they weren't allowed to access spots outside of CARMs, even post-second iteration match...perhaps I'm wrong, or maybe it's just changed since my day 

As far as I'm aware, the "scramble", as it was called still exists and has for a while. CaRMS still lists it here. Can't imagine it's overly useful since, as I said, very few spots are left at that point and those that are can opt out of the process 

[MedOncologista]

1 minute ago, ralk said:

As far as I'm aware, the "scramble", as it was called still exists and has for a while. CaRMS still lists it here. Can't imagine it's overly useful since, as I said, very few spots are left at that point and those that are can opt out of the process 

Thanks, good to know though I'm sure you're right and it's probably not often too helpful. I've heard of the term "scramble" before in relation to the US match and it sounds terrible although likely accurate... 

[bearded frog]

Totally unrelated to the specific case mentioned here, but theoretically, does every graduating medical student deserve a residency? I'm not talking about people stuck between competitive specialties and people who were unlucky with electives and such, which I'm sure is the case 99.9% of the time, but suppose a medical school admitted someone who, for professionalism or patient safety or other reason, should not, in the opinion of residency programs, be licensed to practice medicine. A failure of the medical school admissions screening process, certainly, but what if they squeak by in medical school under the radar and make it to graduation (and perhaps fail the MCCQE but that comes after residency). Should a program, with the interests of their reputation and duty to the patients they work with, be obligated to scrape the bottom of the barrel? Again, not the case in the vast majority of unmatched, but certainly at least 1 or 2 a year?

[MedOncologista]

7 minutes ago, bearded frog said:

Totally unrelated to the specific case mentioned here, but theoretically, does every graduating medical student deserve a residency? I'm not talking about people stuck between competitive specialties and people who were unlucky with electives and such, which I'm sure is the case 99.9% of the time, but suppose a medical school admitted someone who, for professionalism or patient safety or other reason, should not, in the opinion of residency programs, be licensed to practice medicine. A failure of the medical school admissions screening process, certainly, but what if they squeak by in medical school under the radar and make it to graduation (and perhaps fail the MCCQE but that comes after residency). Should a program, with the interests of their reputation and duty to the patients they work with, be obligated to scrape the bottom of the barrel? Again, not the case in the vast majority of unmatched, but certainly at least 1 or 2 a year?

Agreed, not every student admitted to medical school necessarily deserves a residency spot, hence why I specified that I'm referring to those who successfully complete medical school. That being said, there shouldn't be such a thing as students who "squeak by in medical school under the radar"- such students should be offered remediation, or unfortunately not be able to complete the programs. I don't think passing them through medical school, allowing them to accrue further debt, and leaving them to falter in the CARMs process is the answer- hence why I think the onus should really be on medical schools to appropriately deal with students not meeting curriculum requirements, but also to ensure that those who are successful can access residency spots. 

[rmorelan]

On 6/18/2017 at 3:43 PM, MedOncologista said:

Agreed, not every student admitted to medical school necessarily deserves a residency spot, hence why I specified that I'm referring to those who successfully complete medical school. That being said, there shouldn't be such a thing as students who "squeak by in medical school under the radar"- such students should be offered remediation, or unfortunately not be able to complete the programs. I don't think passing them through medical school, allowing them to accrue further debt, and leaving them to falter in the CARMs process is the answer- hence why I think the onus should really be on medical schools to appropriately deal with students not meeting curriculum requirements, but also to ensure that those who are successful can access residency spots. 

Exactly - unprofessional students should be able to graduate in the first place. It is harsh but it is the best way to help patients downstream. When we don't do that bad things happen. 

[rosetta123]

Forgive me if this was discussed previously but I did not see anything- any thoughts on the dermatology spot still open in Ottawa after the first round? Why would this have gone unmatched? Seems so unlikely given the competitiveness- just a fluke of the process maybe?

[Snowmen]

9 hours ago, rosetta123 said:

Forgive me if this was discussed previously but I did not see anything- any thoughts on the dermatology spot still open in Ottawa after the first round? Why would this have gone unmatched? Seems so unlikely given the competitiveness- just a fluke of the process maybe?

If I recall correctly, it was an IMG spot they didn't match on purpose so they could fill it with a CMG.

[stephenpeters2]

I think what medical students fail to realize is  "Nothing is given to you in this world. You deserve nothing and nothing is guaranteed". Having a different mentality than this  will bring a lot of sorrow and sadness in your life whether  in your personal or professional life. If you secure a residency spot, Great. If not, strategize and come back stronger. 20 years into your career, you will forget about CARMS and the unnecessary stress that comes with it.  Stay woke.

 

[Snowmen]

3 hours ago, stephenpeters2 said:

I think what medical students fail to realize is  "Nothing is given to you in this world. You deserve nothing and nothing is guaranteed". Having a different mentality than this  will bring a lot of sorrow and sadness in your life whether  in your personal or professional life. If you secure a residency spot, Great. If not, strategize and come back stronger. 20 years into your career, you will forget about CARMS and the unnecessary stress that comes with it.  Stay woke.

 

I'll try to remain politically correct and say that this is the thing I've read today that was the farthest from being intelligent.

It's irresponsible to admit a student to medical school if the programs cannot guarantee further training that is required to land a job.

[silvantes]

^ agreed. It would be different if the were job prospects. I for one know with certainty there aren't. Something needs to change drastically. If there are no red flags and no academic issues you should be able to get employed, this isn't like a business degree or engineering. This is a very specialized field where you cannot get hired into something else health care due to certification, such as working as a nurse temporarily.

Some people have families they need to help support after paying medical school tuition for what? A piece of paper? And the money for carms down the drain. It's a money grab at this point.

[ArchEnemy]

8 hours ago, Snowmen said:

I'll try to remain politically correct and say that this is the thing I've read today that was the farthest from being intelligent.

It's irresponsible to admit a student to medical school if the programs cannot guarantee further training that is required to land a job.

Further training is available, but not in the specialties that they want.

[la marzocco]

.

[stephenpeters2]

On 11/27/2017 at 2:27 PM, Snowmen said:

I'll try to remain politically correct and say that this is the thing I've read today that was the farthest from being intelligent.

It's irresponsible to admit a student to medical school if the programs cannot guarantee further training that is required to land a job.

The people that admit you into medical school is not the same group that is in charge of residency positions.  A lot of factors come into play during residency season like funding (Political climate ), some dumb research paper that says "We do not need Radiologist", Which specialty is "hot " at that moment.  There are factors you can control and some you can not. 

On the issue of "Guarantee further training".  Are you talking about the assurance that you will have a spot in Gas, derm or rads waiting for you after you graduate? What if you are guaranteed that spot but there is no job like some guys in Ortho are realizing?  Where does the " Guarantee" end? 

Like I said in my previous post, Nothing is given, nothing is guaranteed in life.