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What to do about CaRMS and matching in Canada


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https://www.thestar.com/vancouver/2018/04/12/doctors-without-jobs.html

“Based on the system inputs, the number of applicants and the number of available training positions, we don’t see any reason to expect significant changes to the unmatched applicant trendline,” said John Gallinger, CaRMS CEO, in a statement to StarMetro.

Am I misunderstanding this statement?

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6 hours ago, la marzocco said:

https://www.thestar.com/vancouver/2018/04/12/doctors-without-jobs.html

“Based on the system inputs, the number of applicants and the number of available training positions, we don’t see any reason to expect significant changes to the unmatched applicant trendline,” said John Gallinger, CaRMS CEO, in a statement to StarMetro.

Am I misunderstanding this statement?

I don't believe you are. I mean it is the logical conclusion of the present policy course. He is being formal about it - we can rephrase - the system as it stands will continue to mess up ever increasing numbers of medical students. 

CARMS is structured to be neutral in such things - but I am sure they still don't want bad press kicking around with respect to the match. The message is rearely "the system is broken" but usually "the CARMS system is broken". Still CARMS doesn't control the number of spots.   

 

 

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https://www.thestar.com/vancouver/2018/04/13/army-to-employ-canadas-growing-number-of-jobless-medical-graduates.html
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Vancouver—Canadian medical graduates who have not “matched” to a residency position this year may still be able to become family medical residents this July if they’re willing to do it wearing an army uniform.

Residency is the compulsory final stage of medical education in Canada, and trends suggest more Canadian medical graduates have not been offered a residency spot this year than ever before. Those graduates have medical doctor degrees, but will not be able to practise until they have completed residency.

The Canadian Armed Forces, which is currently 60 physicians short of the 250 it needs, is hoping to close that gap with a new program called the Medical Officer Training Program Surge 2018. Unmatched Canadian graduates between the ages of 17 and 47 can apply to join the army, and complete a two-year residency in family medicine through the program.

It doesn’t matter if they graduated from medical school in Canada or elsewhere. If they meet the army’s recruitment standards, and the academic requirements for a family medicine residency, they’re in.

“I know all of our folks here at the armed forces are excited about this untapped opportunity,” Colonel Pierre Morissette, director of force health protection, and a physician himself, said Friday in an interview with StarMetro.

“There are a lot of exceptional folks that we could end up recruiting and that could end up working as physicians in the armed forces,” he said.

The idea first came about last year when representatives from the Canadian Federation of Medical Students and from the army met to discus the mounting number of graduates going unmatched.

“The issue of unmatched Canadian medical graduates is top issue for our organization,” said CFMS president Henry Annan. “Understanding that this avenue might not be for everyone, we thought this was a possible opportunity for collaboration.”

Annan said about 50 graduates have already expressed interest in the program.

In B.C., the UBC Faculty of Medicine confirmed 12 graduates from this year’s medical class currently do not have a residency post lined up.

“Recognizing that the match is a highly competitive process, we are providing an array of resources and support services for this year’s 12 unmatched students, tailored to each student’s individual needs and career interests,” said Dr. Roger Wong, executive associate dean, education.

“The Family Medicine positions being offered through the Medical Officer Training Program represent an additional avenue for unmatched medical students across Canada. At UBC, we have informed our students of this additional opportunity and will be continuing to offer them support, tailored to their individual needs and career interests,” Wong said.

Morissette described how the experience of completing residency with the armed forces would be different from any other program. He’s been deployed to Afghanistan, for example, and he notes that army doctors are called in when natural disaster strikes. Canada is also preparing to send peacekeepers to the United Nations’ Mali mission.

“These are all opportunities where, if you’re wearing the uniform, you can be activated very quickly,” he said.

 

 

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I'm surprised this isn't more of a political issue. EVERY time there's an article or complaint about wait times or lack of family doctors in a region, someone should reply with something like "well there's ___ number of MDs who aren't able to train and practice because the government has provided enough residency positions".

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Kudos to the army for not being short sighted and see it as an opportunity rather than question someone's motive for joining them in the first place.

If they only lack 60, they can fill this quota very easily. And next year we are back to square one again.

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6 minutes ago, sangria said:

Kudos to the army for not being short sighted and see it as an opportunity rather than question someone's motive for joining them in the first place.

If they only lack 60, they can fill this quota very easily. And next year we are back to square one again.

I am kind of surprised it actually got that bad - I mean that is 25% of their work force. Not long ago it was extremely hard to get into that program. 

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22 minutes ago, sangria said:

Kudos to the army for not being short sighted and see it as an opportunity rather than question someone's motive for joining them in the first place.

If they only lack 60, they can fill this quota very easily. And next year we are back to square one again.

I would 100% do this over going a year unmatched.  Spending a year hoping to match to something and then potentially getting rejected again after all the effort seems like such a nightmare by comparison.

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1 hour ago, rmorelan said:

 

I am kind of surprised it actually got that bad - I mean that is 25% of their work force. Not long ago it was extremely hard to get into that program. 

In almost every field the military has been having a hard time recruiting in recent years.  Not to mention this is a 12-year commitment including 4 years of mandatory ROS which is probably more rigid than any IMG ROS that I know of, meaning the military has the option to not let you leave after 4 years (although they don't usually stop you from leaving, they might have to if we are engaged in wars).Some of the Canadian bases are in really remote locations, which could be difficult for SO and children. And you could be deployed to war zones if Canada engages in any missions and be required to bear and use weapons.  

As for the job itself, it sounds pretty good. Mostly MSK injuries and mental health issues. Most people will be young and healthy so it would almost be like a city/university clinic practice.

There are only 4 positions offered so far so I am sure they will be able to fill it given the mass number of unmatched students, but I doubt they can recruit all 60 anytime soon.

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23 minutes ago, goleafsgochris said:

I would 100% do this over going a year unmatched.  Spending a year hoping to match to something and then potentially getting rejected again after all the effort seems like such a nightmare by comparison.

I personally would too. Matching aside, I think it's still an attractive choice for the right people. People I know who are officers in the military are quite enjoying the practice conditions and let's be honest, lifestyle and benefits. They get a year's worth of paid mat leave. It's true that they can technically send you anywhere they want, but they do take into account where you want to be posted. You can easily work your way up in the officer ranks and land a sweet pension. At that point, you are free to go into civilian practice. 

 

This, however, appears to be a one off deal. We need more than this for the years ahead. 

I personally do not like the tone of the articles printed so far that seems to hint at IMGs as being the source of the issue. The root cause is that a medical degree in Canada means nothing without residency, and taking away GP licensure creates a bottleneck in the system. We shouldn't be pit against one another.

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35 minutes ago, rmorelan said:

 

I am kind of surprised it actually got that bad - I mean that is 25% of their work force. Not long ago it was extremely hard to get into that program. 

Well, on base they just hire civilians, and since Afghanistan, we haven’t had any major deployments, so having more civilian vs military doctors hasn’t been a big problem.  Now that the government has decided to deploy medical personnel on peacekeeping missions again, they are in need of more military physicians, since obviously civilians don’t deploy.

The CAF is chronically short in many MOCs.  For example, they are always short of engineering officers.  Engineers can earn more on civvie street, and not everyone wants a military lifestyle.  It’s also why a lot of military engineering officers get out after their 20 years (even though they don’t have a full pension at that point, they do have a small pension) and then get hired by civilian companies.  Their new civilian salary plus their small military pension makes for a very nice income.

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4 minutes ago, sangria said:

I personally would too. Matching aside, I think it's still an attractive choice for the right people. People I know who are officers in the military are quite enjoying the practice conditions and let's be honest, lifestyle and benefits. They get a year's worth of paid mat leave. It's true that they can technically send you anywhere they want, but they do take into account where you want to be posted. You can easily work your way up in the officer ranks and land a sweet pension. At that point, you are free to go into civilian practice.

Yes, the career managers take into account the member’s desires for a posting location, but when it comes right down to it, especially early in your career, you are sent where you are needed.  For example, if the vast majority of physicians are requesting postings to Toronto, Ottawa, or Vancouver, they obviously won’t all be accommodated.  There will still be a need for doctors in Gagetown, Petawawa, Cold Lake, Wainwright, and other places like that - you could easily end up posted there if that’s where the military decides you are needed, even if you request a posting elsewhere.

The benefits and pension are certainly nice. Lots of vacation time too.  Also, the vast majority of the time (I.e. in Canada)., physicians will be seeing mostly young, healthy, fit patients.  Some of the older individuals serving might have musculoskeletal issues from years of deployments and things like being paratroopers or combat divers, but they’ll still mostly be fit and healthy.  That can be appealing to certain individuals.  Having PT (i.e. time for exercise) built into your work day (i.e. you are expected to exercise on work time) is a nice perq for some people too.

Of course, there are also nice OUTCAN postings available, especially when you have a few years in.  Places like Germany, where the CAF Europe support base is, which has a need of military physicians and other health care professionals.

Career managers do try to take into account members’ preferences, but in the end, the military will send people where they are needed.

 

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46 minutes ago, goleafsgochris said:

I would 100% do this over going a year unmatched.  Spending a year hoping to match to something and then potentially getting rejected again after all the effort seems like such a nightmare by comparison.

Wouldn't you rather spend that year applying to FM programs in locations you would rather prefer, and not have to commit to 4 years of service post-residency?

Surely applying to CaRMS a 2nd time is better than going direct to army. But maybe thats a matter of preference.

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9 minutes ago, JohnGrisham said:

Wouldn't you rather spend that year applying to FM programs in locations you would rather prefer, and not have to commit to 4 years of service post-residency?

Surely applying to CaRMS a 2nd time is better than going direct to army. But maybe thats a matter of preference.

Well I guess it's a matter of values, personal choice etc. 

But it's nice to have a choice. 

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1 hour ago, crysally said:

In almost every field the military has been having a hard time recruiting in recent years.  Not to mention this is a 12-year commitment including 4 years of mandatory ROS which is probably more rigid than any IMG ROS that I know of, meaning the military has the option to not let you leave after 4 years (although they don't usually stop you from leaving, they might have to if we are engaged in wars).Some of the Canadian bases are in really remote locations, which could be difficult for SO and children. And you could be deployed to war zones if Canada engages in any missions and be required to bear and use weapons.  

As for the job itself, it sounds pretty good. Mostly MSK injuries and mental health issues. Most people will be young and healthy so it would almost be like a city/university clinic practice.

There are only 4 positions offered so far so I am sure they will be able to fill it given the mass number of unmatched students, but I doubt they can recruit all 60 anytime soon.

I was under the impression the 12 years (which includes training, I believe) was only for people they sponsored through medical school. Is that incorrect?

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2 minutes ago, wonka_vision said:

I was under the impression the 12 years (which includes training, I believe) was only for people they sponsored through medical school. Is that incorrect?

When I spoke with the recruiting officers this appears to apply for the surge positions as well. Of course, this includes residency and basic training.

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4 minutes ago, crysally said:

When I spoke with the recruiting officers that appears to apply for the surge positions as well. Of course, this includes residency and basic training.

Oh wow that's a pretty huge commitment. In the email I received from them it said differently. I'll confirm with my recruitment officer.

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1 minute ago, wonka_vision said:

Oh wow that's a pretty huge commitment. In the email I received from them it said differently. I'll confirm with my recruitment officer.

Please let me know! I received this information over the phone so I shall send an email to verify as well. What did your email say?

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"Qualified Medical Officers are required to sign a 5 year VIE, 12 years if your medical school is being subsidized." in the package they sent me. 

 

However, in the initial email they sent me it says "If accepted under the MOTP Entry Plan, your initial engagement (VIE) will be of 12 years (time spent in Residency are included in that 12 years) and including up to 4 years of Obligatory Service time - also included in the 12 years.  In addition, there is an expectation that you would be willing to serve anywhere in Canada.", which seems to be more in line with what you were saying. I'm not too sure what they mean by 4 years ROS versus 12 years of commitment, though. Would that mean that you have a mandatory 4 years followed by however much is left where they can call on you at any time? 

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