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1 hour ago, marrakech said:

That makes sense - just wondering though, do you think they will be able to find more suitable candidates in the second round  - i.e. wouldn't the CMGs with dedicated FM interest have matched (or would IMGs with FM interest be preferred)?    

Not up to me to say but that logic is beyond you and me. Ottawa does that every year pretty much and ends up having empty spots for the second round. 2 friends of mine at McGill who have really solid FM profiles (involved in FM interest group, elective in adolescent medicine etc...) didn't get an interview at Ottawa. I seriously don't understand that. Having just gone through CARMS myself, now I really start to understand why many people think the whole process is very random and unfair.

 

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23 hours ago, marrakech said:

Don't mean to nitpick at all - last year Mcgill-Montreal had 10 spots, Calgary had 5 and Ottawa 9 (source).  This year McGill-Montreal had 7, Calgary had 11, Western-London 5 and Ottawa only 2 (source).  But like others have said, nothing is guaranteed, even in the second round.  I'd guess schools & programs that weren't satisfied with their R-1 results last year adjusted their selection procedure. 

In 2017, Vascular was ranked 1st by 8 people with 8 quota.

Also in 2017, anesth. was ranked first by 138 people with 100 total spots (Tables 11 & 12).

Not sure I understand what you mean; you basically re-iterated my observations with different wording.

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1 hour ago, humhum said:

Not sure I understand what you mean; you basically re-iterated my observations with different wording.

I guess your meaning wasn't clear to me - you said Calgary was the first place in half a decade with a lot of open FM spots in the second round.  I pointed out last year Mcgill-Montreal had 10 and Ottawa 9, pretty much the same as Calgary this year - unless you mean they're not "top living quality cities”?

Also, you wondered about the competitiveness of anesthesia - I gave you the breakdown in terms of numbers, suggesting that while competitive it's not quite at the 30% applicant level.  

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I was hearing through the grapevine last night that there’s around 220 unmatched CMGs from the first round. Obviously not an official number, but very concerning if true in light of there being only 228 unfilled spots total.

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19 hours ago, Arztin said:

They sere just very selective about their candidates this year. I.e. didn't rank at all people who remotely gave the impression they were backing up with FM.

I'm in favor of FM programs being increasingly skeptical of applications where it's clear that FM was not their first choice. A large part of the stigma surrounding FM today (especially coming from specialists) is the fact that it's something people "back up" with, and a general dumping ground for applicants rejected elsewhere. 

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9 minutes ago, Birdy said:

I was hearing through the grapevine last night that there’s around 220 unmatched CMGs from the first round. Obviously not an official number, but very concerning if true in light of there being only 228 unfilled spots total.

That’s what I heard too. 

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21 hours ago, Intrepid86 said:

I'm in favor of FM programs being increasingly skeptical of applications where it's clear that FM was not their first choice. A large part of the stigma surrounding FM today (especially coming from specialists) is the fact that it's something people "back up" with, and a general dumping ground for applicants rejected elsewhere. 

I disagree. What programs should evaluate is whether a given applicant would make a good/great Family Physician. I couldn't care less if they're applying to something else or not, and that goes to every single specialty. Of course, I understand it's not what happens (mainly in the ROC and McGill).

People often have interest for more than one specialty. The fact they want something more doesn't automatically means that FM programs should behave like some other programs and cut those applicants off. Also, who can affirm they know 100% that a given candidate is "only" backing up with FM? A lot of things happen between the deadline to send applications and the interview, and also until the final deadline to send ROL. People change their minds. I have friends who applied to IM, Psychiatry, and even General Surgery, got the interviews they wanted and ended up ranking FM as their 1st choice! By the way, I've always heard and thought that the humanistic side of FM is precisely one of the main characteristics and forces of the specialty.

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Back in the day, I applied to 3 fields, including FM and I would have been absolutely delighted to be accepted for residency to any one of the three fields, all in which I felt that I would have enjoyed practicing. I had to rank my choices and I put FM as my third choice, however, I would have been delighted to be accepted for FM. FM was not a "back up" rather a field of genuine interest. I would hate to think that I was not considered seriously because I also had electives in the other fields where I applied. Absolutely as MDLaval stated, "People often have interest for more than one specialty".

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Interesting that Ottawa psychiatry has three spots going into the second round. I ranked it second and was very impressed with them when I went through three years ago. 

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8 minutes ago, ellorie said:

Interesting that Ottawa psychiatry has three spots going into the second round. I ranked it second and was very impressed with them when I went through three years ago. 

A lot of my classmates matched there

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2 hours ago, Bambi said:

Back in the day, I applied to 3 fields, including FM and I would have been absolutely delighted to be accepted for residency to any one of the three fields, all in which I felt that I would have enjoyed practicing. I had to rank my choices and I put FM as my third choice, however, I would have been delighted to be accepted for FM. FM was not a "back up" rather a field of genuine interest. I would hate to think that I was not considered seriously because I also had electives in the other fields where I applied. Absolutely as MDLaval stated, "People often have interest for more than one specialty".

An important aspect for anyone going through CaRMS to consider I suppose. Probably quite normal to have more than one interest, but very unfortunate that programs (and many staff) seem to be weirded out by anyone who doesn’t show unquestioned devotion to their specialty. 

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18 minutes ago, ZBL said:

An important aspect for anyone going through CaRMS to consider I suppose. Probably quite normal to have more than one interest, but very unfortunate that programs (and many staff) seem to be weirded out by anyone who doesn’t show unquestioned devotion to their specialty. 

This is more of a sensitive topic if the field is less competitive, as suggested in one of the posts above. A competitive program seeing an applicant doing electives in another less-competitive specialty is less likely to bat an eye, and will probably assume the applicant is just backing up.

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1 hour ago, Lactic Folly said:

This is more of a sensitive topic if the field is less competitive, as suggested in one of the posts above. A competitive program seeing an applicant doing electives in another less-competitive specialty is less likely to bat an eye, and will probably assume the applicant is just backing up.

I applied into three less competitive specialties, yet not once was I pressed to explain my (very) eclectic choice of electives during the interviews. And honestly I think it makes sense - were I an interviewer I'd be much more concerned with a candidate's overall academic / clinical / professionalism than whether they spent every waking hour obsessing over my specialty.

Anyways, that was experience as a "broad-spectrum candidate".

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People obsess over what electives they took, and how many specialties they can apply to, with who they are doing research etc. and how it all gets interpreted by the selection committee.  All of these factors are absolutely dwarfed by the monstrous magnitude of one singular factor: that is, someone on the selection committee really liking you. You could have done 20 weeks of psych, and 2 weeks of plastics, and if you have one guy on the plastics selection committee that will go on the bat for you, not only are you guaranteed an interview, but you have a higher chance of matching to plastic than someone who has done 10 publications in the field. I have seen this scenario over and over- if you don't believe me, ask the residents in each competitive specialty what they did in their third and fourth year.

How do they get to like you, and be your champion? It helps if have someone on the inside who is a family member, or buddy of your mom or dad, or someone that lives in your own hood, or has early male pattern baldness like yourself, or finds you sexually attractive, or likes that you are ugly so you don't threaten their self-esteem, or maybe plays the trumpet like you, likes the sound of your voice, likes that you talk a lot, or likes that you don't, etc. etc. etc., and a million other unmodifiable factors that are pure luck and circumstance.

I'm telling you this because I have personally been on both sides of this. A selection member of a surgical specialty asked me to apply and told me point blank I would rank me top 3, and I had done nothing but be a friend of a friend. For fuck's sake, my suturing skills were poorer than the psychiatry gunner on rotation with me. (I didn't want to do that specialty so I didn't apply). Another PD point blank told me she would not write me a letter of reference, after I was basically running half her clinic independently and demonstrated I could manage her patients at an R2 level. Why? She could not even remember my name when I asked for the letter.  Another selection member wrote me a glowing letter that got me an interview at the country's most competitive program for that specialty, but I didn't even get an interview at my own home university. Why? Because on the first day we talked about our love of indie music, and didn't stop talking about it for next 4 weeks. On one of the interviews, the interviewers sounded shocked I had actually done an elective with them just three months prior. They had no recollection of me whatsoever. That program was my number 1 rank. I didn't match to it, but my classmate who had it as one of his bottom choices, matched to it. At the end I matched to my second choice program, but had not even done an elective there. And you can guess why I got in.

This is why you have to hedge your bets, and pay attention to the stats. If you apply to FM, Internal, and Psych, across the country, you are guaranteed a match. Based on the stats, it is nearly impossible not to match - short of showing up naked at the interviews.  But if you are applying to Derm/Plastics/Emerg, etc, you better do a very realistic appraisal of yourself: do you have someone to be your champion on the inside? No amount of studying, elective time, volunteer call hours, and publications will make up for this. If you bust your ass, maybe you can make it to the interview. But from those 30 they are interviewing for the 1 spot, they will pick the one they like in their gut over the forgettable contender, no matter if the latter can clinically perform at a level of an R2. 

Which brings me to my last point, if you are an MSI1/MSI2/MSI3 reading this, find a back-up and learn to LOVE it. Better yet, stop calling it back-up. It is your parallel plan. How on earth do people do 4 years of med-school, and decided at the end of it, they rather risk going unmatched than do something like FM or IM? It is all a matter of finding a charismatic mentor in any field to convince you that at the end, the work becomes the same crap - the impact and meaning is what you bring into it, not the speciality. It is idiotic for a urology gunner to think 10 years from now, doing their billionth DRE in a row of their 70th patient of the day is somehow more glamorous than consulting a mother who just got the news that they son has autism. It is all medicine.

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7 minutes ago, humhum said:

All of these factors are absolutely dwarfed by the monstrous magnitude of one singular factor: that is, someone on the selection committee really liking you. You could have done 20 weeks of psych, and 2 weeks of plastics, and if you have one guy on the plastics selection committee that will go on the bat for you, not only are you guaranteed an interview, but you have a higher chance of matching to plastic than someone who has done 10 publications in the field. I have seen this scenario over and over- if you don't believe me, ask the residents in each competitive specialty what they did in their third and fourth year.

Agree this is a powerful factor, though likely dwarfed by the converse (someone on the committee who vetoes your application). This is because there are multiple people on the selection committee, so there may be several candidates being strongly supported by someone. The rank order for a program with limited spots would then still end up being a group consensus of sorts. Although dependent on group dynamics, if there is opposition to a candidate (even if it is a minority vote), it is the path of lesser resistance for a group to go along with their colleague.

So, I think candidates should not interpret this as a reason to stop striving for excellence, as I still see people matching on the overall strength of their applications sans elective, suggesting no "connection" other than what may be formed during the interview. But do try to avoid annoying anyone. Yes, like any other job selection process, there can be a fair amount of subjectivity and 'fit'.

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2 hours ago, Lactic Folly said:

So, I think candidates should not interpret this as a reason to stop striving for excellence, as I still see people matching on the overall strength of their applications sans elective, suggesting no "connection" other than what may be formed during the interview. But do try to avoid annoying anyone. Yes, like any other job selection process, there can be a fair amount of subjectivity and 'fit'.

Absolutely. Among the ones that are serious applicants to a specialty, excellence is the norm. No one gets in with a weak application. When it comes to an absolute grading of the applications, for the top ranks it is hugely important was personal "connections" you have, either inherently or formed through some social prowess. The point being that quibbles about how many electives here and there, and what specialties it might look like you are gunning for in your app are relatively inconsequential. You need just enough electives to practice and demonstrate top tier competence and knowledge.

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3 hours ago, humhum said:

People obsess over what electives they took, and how many specialties they can apply to, with who they are doing research etc. and how it all gets interpreted by the selection committee.  All of these factors are absolutely dwarfed by the monstrous magnitude of one singular factor: that is, someone on the selection committee really liking you. You could have done 20 weeks of psych, and 2 weeks of plastics, and if you have one guy on the plastics selection committee that will go on the bat for you, not only are you guaranteed an interview, but you have a higher chance of matching to plastic than someone who has done 10 publications in the field. I have seen this scenario over and over- if you don't believe me, ask the residents in each competitive specialty what they did in their third and fourth year.

How do they get to like you, and be your champion? It helps if have someone on the inside who is a family member, or buddy of your mom or dad, or someone that lives in your own hood, or has early male pattern baldness like yourself, or finds you sexually attractive, or likes that you are ugly so you don't threaten their self-esteem, or maybe plays the trumpet like you, likes the sound of your voice, likes that you talk a lot, or likes that you don't, etc. etc. etc., and a million other unmodifiable factors that are pure luck and circumstance.

I'm telling you this because I have personally been on both sides of this. A selection member of a surgical specialty asked me to apply and told me point blank I would rank me top 3, and I had done nothing but be a friend of a friend. For fuck's sake, my suturing skills were poorer than the psychiatry gunner on rotation with me. (I didn't want to do that specialty so I didn't apply). Another PD point blank told me she would not write me a letter of reference, after I was basically running half her clinic independently and demonstrated I could manage her patients at an R2 level. Why? She could not even remember my name when I asked for the letter.  Another selection member wrote me a glowing letter that got me an interview at the country's most competitive program for that specialty, but I didn't even get an interview at my own home university. Why? Because on the first day we talked about our love of indie music, and didn't stop talking about it for next 4 weeks. On one of the interviews, the interviewers sounded shocked I had actually done an elective with them just three months prior. They had no recollection of me whatsoever. That program was my number 1 rank. I didn't match to it, but my classmate who had it as one of his bottom choices, matched to it. At the end I matched to my second choice program, but had not even done an elective there. And you can guess why I got in.

This is why you have to hedge your bets, and pay attention to the stats. If you apply to FM, Internal, and Psych, across the country, you are guaranteed a match. Based on the stats, it is nearly impossible not to match - short of showing up naked at the interviews.  But if you are applying to Derm/Plastics/Emerg, etc, you better do a very realistic appraisal of yourself: do you have someone to be your champion on the inside? No amount of studying, elective time, volunteer call hours, and publications will make up for this. If you bust your ass, maybe you can make it to the interview. But from those 30 they are interviewing for the 1 spot, they will pick the one they like in their gut over the forgettable contender, no matter if the latter can clinically perform at a level of an R2. 

Which brings me to my last point, if you are an MSI1/MSI2/MSI3 reading this, find a back-up and learn to LOVE it. Better yet, stop calling it back-up. It is your parallel plan. How on earth do people do 4 years of med-school, and decided at the end of it, they rather risk going unmatched than do something like FM or IM? It is all a matter of finding a charismatic mentor in any field to convince you that at the end, the work becomes the same crap - the impact and meaning is what you bring into it, not the speciality. It is idiotic for a urology gunner to think 10 years from now, doing their billionth DRE in a row of their 70th patient of the day is somehow more glamorous than consulting a mother who just got the news that they son has autism. It is all medicine.

This. absolutely this. 

This should be stickied because honestly, someone should have written this to me when I was an M3/M4. 

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7 hours ago, Lactic Folly said:

This is more of a sensitive topic if the field is less competitive, as suggested in one of the posts above. A competitive program seeing an applicant doing electives in another less-competitive specialty is less likely to bat an eye, and will probably assume the applicant is just backing up.

I don't think that's necessarily true. It makes sense that programs are preoccupied about your commitment to the specialty, this is particularly true for smaller programs. They want their candidates to stay. The more electives you do, the better of an idea you'll have about whether you would be happy doing that specialty (of course, you'll never truly know what it's like to do that specialty until you're a senior resident/staff, but it's still better than someone who's only done 2 weeks of that specialty). If they only take 2 residents a year, they need everyone to cover call schedules. If a resident realizes 2 years in that they actually hate that specialty and switches out, it puts more strain on the remaining residents.

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3 minutes ago, F508 said:

I don't think that's necessarily true. It makes sense that programs are preoccupied about your commitment to the specialty, this is particularly true for smaller programs. They want their candidates to stay. The more electives you do, the better of an idea you'll have about whether you would be happy doing that specialty (of course, you'll never truly know what it's like to do that specialty until you're a senior resident/staff, but it's still better than someone who's only done 2 weeks of that specialty). If they only take 2 residents a year, they need everyone to cover call schedules. If a resident realizes 2 years in that they actually hate that specialty and switches out, it puts more strain on the remaining residents.

Sorry, it's not clear which part of my post you were referencing. Do you disagree that if an applicant has electives split between derm and family med, for example, that this will likely cause more concern in the eyes of FM committees (as per Intrepid's post above) than of the dermatology program committees? That is the point I was trying to make - obviously not a categorical statement, hence my use of "likely" and "probably."

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Sorry response unclear. I meant that it isn't necessarily just less-competitive programs that are worried about commitment to the specialty. For example if you split your electives between obs-gyn and gen surg, I would assume both specialties may be worried about your commitment. However, I think in all cases, you just need to be prepared during interviews to reassure the program that you're committed to them. I think if you're convincing, it won't necessarily put you at a significant disadvantage.

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