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Unfilled carms spots

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2 hours ago, Coby said:

Of the many CMGs that forgo second round, are their chances higher to get into their number one choice specialty (ROAD)the following year in light of the number unmatched .?

There typically aren't any competitive specialty positions left in the 2nd round, so anyone who is committed to going for one pretty much has to wait until the next year. The chances of a person on their second CaRMS cycle getting into a competitive specialty are lower than someone on their first cycle, but still decent assuming going unmatched was the only significant point against them. It's a very tough call for an unmatched grad to choose between trying for what's available in the 2nd round (often in a specialty that wasn't desired in the 1st round) or to hold off until next year to try again at the desired specialty (and accept the very real risk going unmatched twice).

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I remember hearing that there may be a filter in CaRMS for programs to see only current year applicants (excluding prior year applicants), so unfortunately that would make it easy for a competitive program to filter out applicants that way if they so choose.

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3 hours ago, Coby said:

Of the many CMGs that forgo second round, are their chances higher to get into their number one choice specialty (ROAD)the following year in light of the number unmatched .?

Almost definitely not. For the competitive specialties, usually there is a reason why they went unmatched other than not applying broadly. For competitive specialties like derm, plastics, ophtho, these are USUALLY people who have known for a long time that’s what they want to do and gun accordingly and do apply broadly knowing exactly how competitive the specialty is. They will have done electives in the specialty, and probably have done some research or extracurricular involvement related to the specialty. So by no means uncompetitive applicants on paper. So by going through CaRMS again, sure maybe they get more electives and research, but that likely wasn’t their problem in the first place - for small competitive specialties, you need to be the whole package, that is great on paper and the staff/residents have to like you and want you in their program. Having just one means going unmatched in that specialty. And if they don’t like you the first time through CaRMS, it’s probably not likely they’ll change their mind the year after given there will be a whole new wave of CaRMS virgin gunners applying. You have to remember these super competitive specialties only take ~2 people per year into their programs. 

 

EDIT* I’ll clarify that I don’t necessarily mean the program does not like you (they might though), but more likely just that they like someone else better. Also for late comers to competitive specialties, there is the disadvantage of maybe not being as competitive on paper and that’s one instance where the extra year may help. Also, grad degrees probably do count a bit more on paper for some of these competitive specialties - just an extra thing to set you apart from the sea of competitiveness. 

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6 hours ago, liszt said:

Not sure if you've all come across this already http://healthydebate.ca/2018/03/topic/medical-students-carms

Interesting activity in comment section... one of the most active posters is the mother of an IMG so not the side we hear much here

Yeah - most people will argue their self-interest.  I too would argue vehemently if I had invested a small fortune in the education of a child.  That's why the situation is unfortunate - of course her position is clear.  In any case, fortunately, her daughter looks like she might have the opportunity to match in the UK given citizenship.     

Despite her disparaging remarks, Saskatchewan is a LCME/CACMS accredited, whereas no school in the UK is (although it was recently on probation).  The UK may be a great education, but it's not the training that's approved by licensing bodies to produce Canadian doctors (not to mention the lack of accessibility), which she doesn't address.  

She could have easily resolved her conundrum by having her daughter attend a US medical school which are LCME accredited, similarly priced and USMDs are considered like CMGs for the purposes of CaRMS.  However, US schools also tend to be more selective and aspects of her daughter's application may not have been strong enough, as admission is typically closer to Canadian med schools.  

Although, UK and commonwealth physicians did make up a major part of the Canadian workforce at one point, there's no longer a shortage of domestically trained physicians and so there's been very little need to bring in physicians.  

In any case, I support the unified first round match suggestion (as I mentioned on another post), even though it's not necessarily in my best interest.  However, I feel that the IMG quota positions are a relic of the past, and the ratios for CMGs to residency positions is too low.  So without more positions or cutting seats, this is the only way to potentially to alleviate the situation, given that IMGs seem to have claims to first round matching.    

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4 hours ago, marrakech said:

Yeah - most people will argue their self-interest.  I too would argue vehemently if I had invested a small fortune in the education of a child.  That's why the situation is unfortunate - of course her position is clear.  In any case, fortunately, her daughter looks like she to have the opportunity to match in the UK given citizenship.     

Despite her disparaging remarks, Saskatchewan is a LCME/CACMS accredited, whereas no school in the UK is (although it was recently on probation).  The UK may be a great education, but it's not the training that's approved by licensing bodies to produce Canadian doctors (not to mention the lack of accessibility), which she doesn't address.  

She could have easily resolved her conundrum by having her daughter attend a US medical school which are LCME accredited, similarly priced and USMDs are considered like CMGs for the purposes of CaRMS.  However, US schools also tend to be more selective and aspects of her daughter's application may not have been strong enough, as admission is typically closer to Canadian med schools.  

Although, UK and commonwealth physicians did make up a major part of the Canadian workforce at one point, there's no longer a shortage of domestically trained physicians and so there's been very little need to bring in physicians.  

In any case, I support the unified first round match suggestion (as I mentioned on another post), even though it's not necessarily in my best interest.  However, I feel that the IMG quota positions are a relic of the past, and the ratios for CMGs to residency positions is too low.  So without more positions or cutting seats, this is the only way to potentially to alleviate the situation, given that IMGs seem to have claims to first round matching.    

The main issue I see with a unified first round match would be that powerful physicians with IMG sons and daughters would ultimately match to competitive specialties through their influence. Right now, barring a few select circumstances, much of this is avoided. 

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58 minutes ago, Edict said:

The main issue I see with a unified first round match would be that powerful physicians with IMG sons and daughters would ultimately match to competitive specialties through their influence. Right now, barring a few select circumstances, much of this is avoided. 

Could we grandfather out CSA applicants? We won't be free of issues like the BC cardiac surgery scandal until we address this. We could add in a 4 year window where they are considered but after that require either a PhD, or a prior completed residency to actually aim it at IMGs who fit the "I was a doctor in Egypt/India/Saudi/etc..." archetype the public holds.

We could also look at the model a lot of the South African doctors used coming to Canada, and avoiding displacing CMGs in CaRMS. Something like a initial qualifying exam followed by a separate match to be a "physician assistants" for X years in location Y before qualifying to write some sort of licencing exam.  

Seeing as South Africa is a powder keg right now, and one of the main arguments for IMGs is the RoS we might be able to swing something like that. Could also use them as a stop gap for the services with a disparate need for residents vs need for staff. 

Kills the stream of CSAs and all the weirdness that brings to the system

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