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Family med more competitive this year?


1n_0ut

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I applied to family med this year along with psych. After doing a bunch of pysch electives however, I think I would prefer to do family with some component of mental health work. So initially family was my backup but now it's more my front runner, although my application really screams psych with lots of research and extra-curriculars. 

However, I've been having a hard time getting family interviews. Right now I have 4 interviews to Toronto, Western, Memorial and Montreal, with rejections from Queens, NOSM and McMaster. I'd really like to stay in Ontario, as my partner has very little flexibility outside of Ontario. Also, my french isn't really good enough to do anything except urban Montreal. 

Is anyone else finding family much more competitive this year? I feel like I'm really being burned for looking like I'm "backing up" when really - it's now my first choice! 

Also, how many family interviews is enough? If I ranked all the sites for Toronto, Western and Ottawa (if I get it) would this be a reasonable application? I'm thinking of not even ranking psych since they always say not to rank places and programs you don't want.

Is this rank suicide? 

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I can't speak to your question regarding the competitiveness of family medicine this year (CARMS is a distant memory for this guy). But the answer to your other questions are as follows (my opinion):

How many interviews is enough? Who knows - you will hear statistics like if you interview at 6 or more programs your chances of matching are over 90%, etc etc. That being said, no one can really know for sure. I had friends with ≤3 interviews total match to their first choice programs (most competitive specialties) and others that had ≥10 interviews in a given specialty go unmatched. It comes down to where you are ranked going into the interview process, how you do in the interview, and luck. The last part matters because in some respects you are at the mercy of the other applicants ranking (how they are ranked by the programs and how they rank the programs themselves). So why worry? You can't possibly know for sure - are more interviews better. Absolutely. But maybe the 4 received already have you ranked very high, you then rock the interviews and you land a spot no problem. Worrying about it now does absolutely nothing but shatter your confidence. Focus on the small victories you are making because you can't change anything at this point - all you can do is focus on finishing the application process strong (interviews). You have received invites from some good schools - congrats.

Not ranking psych - rank suicide? In my opinion, yes and no. The bottom line is you have to be prepared to sleep in the bed you make. That is, think about what option you would prefer more - not ranking psych, not matching family and therefore going unmatched in the first round (then fighting for scraps in the second round with no guarantees either). Or ranking psych, not matching family but matching pysch and therefore avoiding the 'dreaded' unmatched scenario. Neither option is ideal reading your post, but what scenario would you rather find yourself in. The choice is yours, and you have to be prepared to live with possible consequences of that choice. This will be different for everyone. If it were me, I would rank every program possible. Forgetting life outside medicine (which is a huge consideration I admit) and just focusing on residency training, if you match into psych you secure funding for five years of your training. Transferring to family medicine will be a very reasonable option for you (but not guaranteed). If you go unmatched in the first you may find yourself competing for less desirable spots in the second (and if you go unmatched here - things get even harder down the road). 

Best of luck with the match

PMD

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Did you address the fact that you have switched from psych to family in your letters? Consider reaching out and making more personal contact regarding this point - little to lose now. 

Regarding interviews, it has been said that you just need one program to rank you high enough to match. Unfortunately, looking like you are backing up is not favourable for this. Hence the first point.

Overall, I agree with what PilotMD has said. From your post, you now prefer family over psych - not that you cannot see yourself doing psych at all, and would rather go unmatched.

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11 hours ago, Lactic Folly said:

Did you address the fact that you have switched from psych to family in your letters? Consider reaching out and making more personal contact regarding this point - little to lose now. 

It wasn't in my personal letter - although I did mention how I would like to be involved in mental health as a family doc in my letter, which i do wonder if that screwed me for interviews. I'm sure they want to hear that you want to be a generalist and not sub-specialize in family.

I'm considering emailing school PD's and telling them the current situation about my late change of heart. I just wonder if I should straight up admit I've changed my mind of just request they re-assess my application? It's a weird no man's land when it comes to emailing PD's.

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10 minutes ago, 1n_0ut said:

I'm considering emailing school PD's and telling them the current situation about my late change of heart. I just wonder if I should straight up admit I've changed my mind of just request they re-assess my application? It's a weird no man's land when it comes to emailing PD's.

Maybe speak with a career counsellor at your school, a family doctor you trust, or some higher up doctor at your school involved with CaRMS to ask about this? I feel this is a unique scenario and I think it might be good to talk to someone who can also vouch for you too.

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5 hours ago, 1n_0ut said:

It wasn't in my personal letter - although I did mention how I would like to be involved in mental health as a family doc in my letter, which i do wonder if that screwed me for interviews. I'm sure they want to hear that you want to be a generalist and not sub-specialize in family.

I'm not a FM committee member, but I don't see how having an interest in a specific area would be detrimental. Nothing wrong with having some concrete career plans, such as a focus on palliative care. It's more likely that the underlying concern is that your first choice is the Royal College psychiatry program. Given that interview decisions are already well underway, I agree with the above suggestions to see who you can reach out to asap... locally is easier, and as a bonus is also where you want to stay. Good luck.

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8 hours ago, shikimate said:

I think you should still rank your psych programs and go to their interviews if possible. I feel it's lesser of a risk to try to switch from psych to family once you're a R1 than going unmatched and trying to apply again next year.

ditto. i would do the same.

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On 12/18/2017 at 7:44 PM, 1n_0ut said:

I applied to family med this year along with psych. After doing a bunch of pysch electives however, I think I would prefer to do family with some component of mental health work. So initially family was my backup but now it's more my front runner, although my application really screams psych with lots of research and extra-curriculars. 

However, I've been having a hard time getting family interviews. Right now I have 4 interviews to Toronto, Western, Memorial and Montreal, with rejections from Queens, NOSM and McMaster. I'd really like to stay in Ontario, as my partner has very little flexibility outside of Ontario. Also, my french isn't really good enough to do anything except urban Montreal. 

Is anyone else finding family much more competitive this year? I feel like I'm really being burned for looking like I'm "backing up" when really - it's now my first choice! 

Also, how many family interviews is enough? If I ranked all the sites for Toronto, Western and Ottawa (if I get it) would this be a reasonable application? I'm thinking of not even ranking psych since they always say not to rank places and programs you don't want.

Is this rank suicide? 

It's fairly easy to switch to family medicine once you matched to psychiatry. For transferring programs, always easier going from a 5 year program to a 2 year program due to funding issues. 

I think since your application screams strongly psychiatry, I would still rank psychiatry and rank them after Family Medicine, and fairly easy to switch into Family Medicine from psychiatry, as there is always need for family doctors. 

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If you are a reasonable applicant, I don't think you need that many interviews to match to family.  I only applied to four FM programs (I applied to psych as well), and many of my friends only applied to 2 or 3 programs (I actually only had one friend who did not match to one of their top 2 provinces/schools for FM and none of us were star applicants).  None of us were ever that worried about not matching.  One thing I did, was ask one of my psychiatry preceptors to write reference letters to both FM programs (specifically an FM focused letter) as well as psych programs in order to make my FM application stronger and not look like I was all in on psych.  Of course, you have to test the waters first before you ask a preceptor this as some might not be so open.

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13 hours ago, Birdy said:

All but one for me. I'm curious what the typical is. 

I got all my family interviews, except for one school (which I wasn't planning on going to anyways).

Any idea how competitive psychiatry is this year? I'm applying to psych too, and I've been having some trouble getting interviews there... 

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  • 3 weeks later...
On 12/21/2017 at 10:57 PM, medisforme said:

If you are a reasonable applicant, I don't think you need that many interviews to match to family.  I only applied to four FM programs (I applied to psych as well), and many of my friends only applied to 2 or 3 programs (I actually only had one friend who did not match to one of their top 2 provinces/schools for FM and none of us were star applicants).  None of us were ever that worried about not matching.  One thing I did, was ask one of my psychiatry preceptors to write reference letters to both FM programs (specifically an FM focused letter) as well as psych programs in order to make my FM application stronger and not look like I was all in on psych.  Of course, you have to test the waters first before you ask a preceptor this as some might not be so open.

I agree you don't need a lot of interviews to match to FM if you are a reasonable candidate.

But I think OP is concerned about being rejected from multiple FM programs even before the interview. If one applied only to 3 schools and got 3 interviews, that's fair since you only applied to 3 schools in the first place. But if one applied to 8 schools but got only 4 interviews, one should be concerned b/c it seemed to suggest that his/her application may not be as strong as others who had more interviews. This could suggest that he/she is going into the interviews (schools where they got an invitation) with a lower pre-interview score, and might require a high interview score in order to get a good final rank.

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11 hours ago, hamham said:

I agree you don't need a lot of interviews to match to FM if you are a reasonable candidate.

But I think OP is concerned about being rejected from multiple FM programs even before the interview. If one applied only to 3 schools and got 3 interviews, that's fair since you only applied to 3 schools in the first place. But if one applied to 8 schools but got only 4 interviews, one should be concerned b/c it seemed to suggest that his/her application may not be as strong as others who had more interviews. This could suggest that he/she is going into the interviews (schools where they got an invitation) with a lower pre-interview score, and might require a high interview score in order to get a good final rank.

This is my exact concern.

The total count was 6/10 family interviews. I will be attending them all. I’ll also be ranking psych programs as well after family. 

With a 60% acceptance rate - would I be at risk of being one of those “low ranked” pre-interview family candidates??  

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20 minutes ago, 1n_0ut said:

This is my exact concern.

The total count was 6/10 family interviews. I will be attending them all. I’ll also be ranking psych programs as well after family. 

With a 60% acceptance rate - would I be at risk of being one of those “low ranked” pre-interview family candidates??  

No one can tell you for sure whether you are one of those "low-rank" pre-interview family candidates. Lots of factors come into play for interview selection. Some schools like NOSM will not consider you at all if you have no rural electives. Others like Manitoba will only consider those with ties to the province. 

The good news is that 6 interviews is pretty good for someone who is "backing up" with FM, and relatively safe (my school told us historically, one with at least 6 FM interviews will match). There is nothing you can do at this point, except to ace those 6 interviews and hope for the best. Good luck!  

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Do most family medicine programs use a percent breakdown to rank applications by simply following an algorithm? Something like choosing different criteria and adding up the scores to make their rank list? Something like 20% EC, 20% clinical rotation performance, 20% CV, 40% interview breakdown or something similar?

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On 08/01/2018 at 11:57 AM, hamham said:

No one can tell you for sure whether you are one of those "low-rank" pre-interview family candidates. Lots of factors come into play for interview selection. Some schools like NOSM will not consider you at all if you have no rural electives. Others like Manitoba will only consider those with ties to the province. 

The good news is that 6 interviews is pretty good for someone who is "backing up" with FM, and relatively safe (my school told us historically, one with at least 6 FM interviews will match). There is nothing you can do at this point, except to ace those 6 interviews and hope for the best. Good luck!  

How at risk am I if I got 2/10 family interviews and didn't do electives at any sites that offered? I have a professionalism lapse on my MSPR following a severe manic episode. 

I have noticable verbal fluency issues after all this so I'm very worried about interviews not pulling up my application 

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On 1/8/2018 at 11:24 PM, Dermviser said:

Do most family medicine programs use a percent breakdown to rank applications by simply following an algorithm? Something like choosing different criteria and adding up the scores to make their rank list? Something like 20% EC, 20% clinical rotation performance, 20% CV, 40% interview breakdown or something similar?

Because Family Medicine programs are so large, an algorithm is necessary. No chance any one person or group of people can go through every candidate and formulate a from-scratch rank list. Every program likely has their own approach, but interviews likely factor in heavily, as FM isn't known for putting too much stock in things like research or other ECs.

4 hours ago, 2018hopeful said:

How at risk am I if I got 2/10 family interviews and didn't do electives at any sites that offered? I have a professionalism lapse on my MSPR following a severe manic episode. 

I have noticable verbal fluency issues after all this so I'm very worried about interviews not pulling up my application 

Any time there is a red flag, especially a professionalism flag, it will impact your chances, more so with only two interviews. If the professionalism lapse could be explained by a manic episode, I'm a little surprised it made it onto your MSPR - that seems like something that should get expunged with appropriate medical documentation.

In any case, it doesn't affect what you do moving forward - if programs gave you an interview, they're giving you a chance for a spot. Your interview performance was going to be the deciding factor regardless of what's on your record, so do what prep you can, listen to any feedback you get, and put your best foot forward.

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On 1/14/2018 at 1:53 AM, 2018hopeful said:

How at risk am I if I got 2/10 family interviews and didn't do electives at any sites that offered? I have a professionalism lapse on my MSPR following a severe manic episode. 

I have noticable verbal fluency issues after all this so I'm very worried about interviews not pulling up my application 

Give the two you have everything you got, but I would start preparing now for second round and beyond...

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On 1/14/2018 at 0:53 AM, 2018hopeful said:

How at risk am I if I got 2/10 family interviews and didn't do electives at any sites that offered? I have a professionalism lapse on my MSPR following a severe manic episode. 

I have noticable verbal fluency issues after all this so I'm very worried about interviews not pulling up my application 

Do your best in your 2 interviews. 

If you don't match, you need to talk to your school to see if there is a way to Either: 1) remove that professionalism lapse from your MSPR or 2) obtain a Dean letter to explain that lapse was a one-time occasion and that you have learnt from your mistake. 

Like ralk mentioned, if you have an underlying medical condition that has resulted in that lapse, you should have no problems appealing to your school to get it removed. In fact, you should have done it a long time ago, before you applied for CaRMS. 

FM programs may forgive an academic red flag (i.e. failed courses, year etc), but when it comes to professionalism, they take things really seriously and have little room for forgiveness. It is highly possible that you may never ever be able to match in CaRMS unless you do one of the above. 

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5 hours ago, hamham said:

Do your best in your 2 interviews. 

If you don't match, you need to talk to your school to see if there is a way to Either: 1) remove that professionalism lapse from your MSPR or 2) obtain a Dean letter to explain that lapse was a one-time occasion and that you have learnt from your mistake. 

Like ralk mentioned, if you have an underlying medical condition that has resulted in that lapse, you should have no problems appealing to your school to get it removed. In fact, you should have done it a long time ago, before you applied for CaRMS. 

FM programs may forgive an academic red flag (i.e. failed courses, year etc), but when it comes to professionalism, they take things really seriously and have little room for forgiveness. It is highly possible that you may never ever be able to match in CaRMS unless you do one of the above. 

Given the specifics of the scenario, shame on the school for not being proactive in the first place with the student. There are not many students in this scenario, so a bit of extra resources to make sure they don't get slammed by the system come 4th year would be prudent.  Yes, its on the student to do so..but surely the school has more experience than the student themselves and should step in to offer guidance.

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On 19/01/2018 at 8:19 AM, bearded frog said:

Hard to pass judgment with only one side of the story.

Fair enough. Avoiding a self dox my school had a specific faculty member massively overstepping their bounds, breaking several regulations, and giving false statements during a period of "general administrative disarray" to the point that I actually needed to get outside legal counsel.

Granted, I was completely unhinged for about a month before I was rightly hospitalized.

Manic reactions to corticosteroids can happen to anyone. I know I'm maybe 80% of who I was before and that is the worst part.

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On 1/22/2018 at 9:19 PM, 2018hopeful said:

Fair enough. Avoiding a self dox my school had a specific faculty member massively overstepping their bounds, breaking several regulations, and giving false statements during a period of "general administrative disarray" to the point that I actually needed to get outside legal counsel.

Granted, I was completely unhinged for about a month before I was rightly hospitalized.

Manic reactions to corticosteroids can happen to anyone. I know I'm maybe 80% of who I was before and that is the worst part.

Sounds like you have a valid reason for the lapse, but like bearded frog said, it's impossible for anyone to pass judgement unless we know both sides.

You are absolutely right that drug reactions can happen to anyone. But if that reaction results in unprofessional behaviour exhibited by the MD, questions can be raised as to whether the MD is still fit to practise medicine. Such issues are very complex, and are usually taken care of by the provincial governing bodies. That is why most of us have to renew our license to practise medicine yearly by completing a questionaire, and one that is commonly asked is "Have you ever been disciplined/cautioned by a regulatory body?"

I sincerely hope that you have recovered from that manic episode, but it concerns me when you claimed that you are "80%" of who you were. W/o more specifics (and you should not share that info here since it's confidential), I cannot effectively judge your suitability/fitness to continue to practise medicine in future. The best thing you should do is to ace your interviews, and if you don't match, you need to approach your school for further assistance. 

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