How do you "back up"?

[brady23]

For example, with the new 8 week cap on electives coming up: one may do 8 weeks in a desired specialty (ex: Emergency Medicine)

But what about the other 8 weeks? Let's say you want to back up with Internal or Family Medicine.

If you do the other 8 weeks in Family Medicine, does that make you look "undecided" to both Emergency Medicine and Family Medicine?

If you did 6 weeks in Family, and 2 weeks in a random specialty, wouldn't FM know you are "backing up"? Or would they just be happy you did 6 weeks with them?

 

 

 

 

[UdeMed]

I think the most important part is to prepare to defend any elective you took, and how it will help you in X residency program.

For example, you may say you like ER and want to do 2+1 FM-ER if you apply to both of these, or do some IM rotations useful for major ER cases (cardio/respirology/etc.) and defend IM is your choice because you wanted a broad exposure during rotations rather than discipline specific. 

Programs will adapt to that new 8weeks cap (which was already somehow applied in Quebec). 

[JohnGrisham]

Everyone is in same situation. Won't make any huge difference overall

 

[1D7]

For FM you can safely back up with 2 electives in it (3-4 weeks). Still possible with 1 elective. Dicey if you have 0 electives.

[Lactic Folly]

2 weeks in a random specialty wouldn't really be enough to make you look like you were going for it (when combined with 6 weeks FM) ... in anyone's eyes.

[Scorbix]

I think with the new cap in electives there is a lot of strategy that will come into play. With regards to the specific example that you mentioned (Internal and Family), if I were applying to those specialties, I might very well only do one elective in Family Medicine, if any at all. Partly because my school has a 6 week Family Medicine core rotation (unsure if all other schools do; I I am unfamiliar with the standardized core rotation policies), and also because of lot of problems a Family Medicine physician is exposed to are medicine specialist problems, and so doing rotation in CTU, Cardiology, Respirology, etc could very easily be rationalized in a personal letter for both internal medicine and family medicine. I suspect a lot of applications such as this will take a lot of skillful personal letter writing to sell one's self to similar specialites; I also think it will play to one's advantage in that one can gain a more diverse exposure, which is ultimately one of the purposes of bringing about this cap. Please keep in mind, however, that I am currently applying to neither Family Medicine nor Internal Medicine, and so my "strategy" may be completely wrong.

[shakeshake]

My prediction is that the cap will make it even more likely for people to match to programs they did an elective at. I think if you are backing up it would be wise to do 1-3 electives in your backup speciality, ideally at the specific programs you want to match to. The CaRMS data we have already tells us that most students match to programs they did an elective at. 

[1D7]

9 hours ago, shakeshake said:

My prediction is that the cap will make it even more likely for people to match to programs they did an elective at. I think if you are backing up it would be wise to do 1-3 electives in your backup speciality, ideally at the specific programs you want to match to. The CaRMS data we have already tells us that most students match to programs they did an elective at. 

While the importance of the program knowing you from electives cannot be understated, I do think that there is self-selection as well.

Students are more likely to do electives at places that they already want to do residency at. Doing an elective also gives students information about the program (like quality of training, resident morale, etc.). It's much more difficult to rank a site you never worked at highly.

[m_jacob_45]

Also just to add, for family, its preferred to do a wide range of electives with 1-2 electives in family medicine. (So no point in doing 8 family med electives). 

[shakeshake]

2 hours ago, 1D7 said:

While the importance of the program knowing you from electives cannot be understated, I do think that there is self-selection as well.

Students are more likely to do electives at places that they already want to do residency at. Doing an elective also gives students information about the program (like quality of training, resident morale, etc.). It's much more difficult to rank a site you never worked at highly.

Agreed! I'm sure it works both ways. But for the reasons you stated above, any sound match strategy includes rotating through programs you think you might want to end up at (to confirm or rule out your theory - 2-5 years is a long time!). It's not always possible (space limits, timing, etc) but you should always try! 

[JohnGrisham]

6 hours ago, m_jacob_45 said:

Also just to add, for family, its preferred to do a wide range of electives with 1-2 electives in family medicine. (So no point in doing 8 family med electives). 

Depends. Lots of people who are going for FM or went for FM do 8-10weeks of FM category electives. This includes GP-OB, hospitalist, palliative etc.

[RichardHammond]

If you only look at data about the number of electives taken in FM/IM by those who matched to FM/IM, it definitely seems possible to back up in FM and IM with 1-2 electives (see data below). However, it doesn't take to account what the rest of these applicants' CVs look like. If your application screams "I'm backing up with X", your numbers of electives might not matter much. Additionally, you gotta ask yourself how you'd feel about possibly matching to a program you never got to experience in a specialty you don't really wanna do.

2018 CMG R-1 1st Iteration Data:

Family Medicine:

• 59.2% of CMGs who matched to FM had only 0-2 electives in FM
• 53.7% of CMGs who matched to FM did not have any FM electives at their matched school

 

Internal Medicine:

• 63.0% of CMGs who matched to IM had only 0-2 electives in IM
• 53.5% of CMGs who matched to IM did not have any IM electives at their matched school

[MedP111]

19 minutes ago, RichardHammond said:

If you only look at data about the number of electives taken in FM/IM by those who matched to FM/IM, it definitely seems possible to back up in FM and IM with 1-2 electives (see data below). However, it doesn't take to account what the rest of these applicants' CVs look like. If your application screams "I'm backing up with X", your numbers of electives might not matter much. Additionally, you gotta ask yourself how you'd feel about possibly matching to a program you never got to experience in a specialty you don't really wanna do.

2018 CMG R-1 1st Iteration Data:

Family Medicine:

• 59.2% of CMGs who matched to FM had only 0-2 electives in FM
• 53.7% of CMGs who matched to FM did not have any FM electives at their matched school

 

Internal Medicine:

• 63.0% of CMGs who matched to IM had only 0-2 electives in IM
• 53.5% of CMGs who matched to IM did not have any IM electives at their matched school

Where did you find this data?

And by electives in IM, does that mean the collective of all IM subspecialties? 

[RichardHammond]

7 minutes ago, MedP111 said:

Where did you find this data?

And by electives in IM, does that mean the collective of all IM subspecialties? 

Went here:

https://www.carms.ca/data-reports/r1-data-reports/electives

Then did some quick maths.

The disclaimer on that page explains how CaRMS relies on self-reported electives from applicants but CaRMS does not confirm if the electives ultimately take place. They mention how Neuro would count toward Paeds Neuro and a couple other examples but did not mention if IM subspecialties count as IM electives. I went back to my CaRMS app and noticed that the section for inputting electives does in fact lets you specify subspecialties (e.g. nephro, heme). So nothing concrete to say that subspecialties are counted in that data but my guess is they ARE included.