Can someone alleviate my anxiety re: CV requirements for CaRMS?

[indefatigable]

3 minutes ago, ellorie said:

True - but her anecdote was from several years ago, and things certainly were different in Quebec then.

In a sense, the anecdote is potentially more applicable today as conditions are more broadly similar.  

[ellorie]

The match is also much tighter these days though, at least in English Canada.  Gets worse every year.  For most people, ranking only 3 programs is only a viable strategy if you are very prepared to go unmatched.

[indefatigable]

1 hour ago, ellorie said:

The match is also much tighter these days though, at least in English Canada.  Gets worse every year.  For most people, ranking only 3 programs is only a viable strategy if you are very prepared to go unmatched.

Excellent point - I agree that ranking only 3 programs is a riskier strategy ... although to be fair 85%+ of CMGs did match in their top three programs (outside of Quebec - slide 30 here ) and so on the whole it works to about a 10% absolute risk reduction of going unmatched (but much higher relative rate) as 95% of CMGs do match.

[Bambi]

Yes, I am from Quebec and we are going back half a decade. I can only tell my story. I had good LORs for each field. For each, I changed my Motivational Letter to suit each field. I had only 3 Interviews, 1 in each field. It was not hard to apply to these fields. This was my strategy in order to maximize my chances of matching - given I had no flexibility on city. It worked. 

[robclem21]

1 hour ago, Bambi said:

Yes, I am from Quebec and we are going back half a decade. I can only tell my story. I had good LORs for each field. For each, I changed my Motivational Letter to suit each field. I had only 3 Interviews, 1 in each field. It was not hard to apply to these fields. This was my strategy in order to maximize my chances of matching - given I had no flexibility on city. It worked. 

While it is great that this worked out for you, I do not think on a broad scale that applying to only 3 programs in a limited geographical area is a reasonable strategy unless (as others have mentioned) applicants are prepared to go unmatched. I think your situation is an outlier rather than the norm, and applicants applying to 3 programs and expecting your results are going to be largely unsuccessful. The best approach is still applying broadly to multiple specialties and then ranking everything.

It is important that people keep an open mind about matching and where they can possibly end up for residency. Obviously this can be challenging if there are strong family/spouse ties to a certain location, but as just a pure "preference", people can be happy in a lot of places.

[indefatigable]

25 minutes ago, robclem21 said:

While it is great that this worked out for you, I do not think on a broad scale that applying to only 3 programs in a limited geographical area is a reasonable strategy unless (as others have mentioned) applicants are prepared to go unmatched. I think your situation is an outlier rather than the norm, and applicants applying to 3 programs and expecting your results are going to be largely unsuccessful. The best approach is still applying broadly to multiple specialties and then ranking everything.

It is important that people keep an open mind about matching and where they can possibly end up for residency. Obviously this can be challenging if there are strong family/spouse ties to a certain location, but as just a pure "preference", people can be happy in a lot of places.

I agree that only applying to 3 programs is NOT a recommended strategy.  But, as mentioned above only ranking 3 programs (presumably after interviews) from a pure statistical point of view has less of an impact on match status than one might expect. 

Nonetheless, I think the value of the anecdote may have also been in responding and giving hope to the OP that there is a possibility of matching to a specialty without being a "gunner", as broadly conditions within and outside of Quebec are similar at the moment (besides of course language). 

[ellorie]

Yes definitely hope for that - the whole "gunner" thing is a very overt way of expressing your interest/intentions, but there are lots of other, quieter ways that are equally effective and sometimes better received.  The "gunners" are just the loudest voices in the room.

[Bambi]

2 hours ago, robclem21 said:

While it is great that this worked out for you, I do not think on a broad scale that applying to only 3 programs in a limited geographical area is a reasonable strategy unless (as others have mentioned) applicants are prepared to go unmatched. I think your situation is an outlier rather than the norm, and applicants applying to 3 programs and expecting your results are going to be largely unsuccessful. The best approach is still applying broadly to multiple specialties and then ranking everything.

It is important that people keep an open mind about matching and where they can possibly end up for residency. Obviously this can be challenging if there are strong family/spouse ties to a certain location, but as just a pure "preference", people can be happy in a lot of places.

I entirely agree with what I have put in bold above. I was absolutely prepared to go unmatched - which was preferable for me rather than accept another geographical area. My chances of not matching were high, but I beat the odds. It was an acceptable risk for me to take.  

[interestedinrads]

7 hours ago, indefatigable said:

I agree that only applying to 3 programs is NOT a recommended strategy.  But, as mentioned above only ranking 3 programs (presumably after interviews) from a pure statistical point of view has less of an impact on match status than one might expect. 

Nonetheless, I think the value of the anecdote may have also been in responding and giving hope to the OP that there is a possibility of matching to a specialty without being a "gunner", as broadly conditions within and outside of Quebec are similar at the moment (besides of course language). 

The CARMS stats are more useful for an average applicant who most likely ranks their top choice field +/- a back up and end up matching within top 3 of their ROL. That's different than someone who is ranking 3 programs from 3 different fields - harder to tailor your application and electives to convince a program that they're you're top choice.

This probably also gets skewed more because large fields like FM/IM have higher match rates, and so probably (?) higher chances of being in your top 3 choices.

[indefatigable]

1 hour ago, interestedinrads said:

The CARMS stats are more useful for an average applicant who most likely ranks their top choice field +/- a back up and end up matching within top 3 of their ROL. That's different than someone who is ranking 3 programs from 3 different fields - harder to tailor your application and electives to convince a program that they're you're top choice.

This probably also gets skewed more because large fields like FM/IM have higher match rates, and so probably (?) higher chances of being in your top 3 choices.

We're in a new era with a 8 week cap on electives across the board, not to mention all the other restrictions with the pandemic, notably essentially no visiting electives.  

Actually, on slide 30 (of the link above), shows surprisingly that the 85%+ match for top 3 programs CMGs holds across ALL disciplines except for Family medicine (where it's lower at about 75%).  Yes - there are some very competitive small disciplines, but they account only for a small proportion of applicants within the four different categories (surgical, family, internal, other non-surgical) and probably don't change the stats much.

[Redpill]

On 11/7/2020 at 7:22 AM, indefatigable said:

I agree that only applying to 3 programs is NOT a recommended strategy.  But, as mentioned above only ranking 3 programs (presumably after interviews) from a pure statistical point of view has less of an impact on match status than one might expect. 

Nonetheless, I think the value of the anecdote may have also been in responding and giving hope to the OP that there is a possibility of matching to a specialty without being a "gunner", as broadly conditions within and outside of Quebec are similar at the moment (besides of course language). 

Looking at only the statistics without context is misleading. How many of those people who matched to their top 3 ranked them all in the same discipline (or maybe two related disciplines) they were very competitive for due to a focused application? I'd imagine the vast majority, so giving advice that you can reasonably match to 3 separate disciplines because of this statistic will set medical students up for failure.

[Redpill]

On 11/7/2020 at 9:21 AM, Bambi said:

I entirely agree with what I have put in bold above. I was absolutely prepared to go unmatched - which was preferable for me rather than accept another geographical area. My chances of not matching were high, but I beat the odds. It was an acceptable risk for me to take.  

I think when you provide this anecdote on the forum you should emphasize the bolded. It will give students without much knowledge a more clear idea of their chances should they choose to use your strategy.

[indefatigable]

1 hour ago, Redpill said:

Looking at only the statistics without context is misleading. How many of those people who matched to their top 3 ranked them all in the same discipline (or maybe two related disciplines) they were very competitive for due to a focused application? I'd imagine the vast majority, so giving advice that you can reasonably match to 3 separate disciplines because of this statistic will set medical students up for failure.

I don't think anyone is giving that advice at all.  

I just said that ranking only 3 programs vs ranking many more programs doesn't change your chances of going unmatched by very much.  That's what the statistics say.  It doesn't say anything about the number of programs you'd have apply to get a number of interviews - that would probably depend on a more focused application, etc.  

I don't think it's hard to see that this year is going to be very different than previous years - maybe people will have to apply to more programs to get interviews, who knows?  But ranking more than 3, doesn't change much for the applicant.  I don't think most people would rank programs that they didn't interview at - that would screw up the stats and would definitely NOT be recommended also.  

No question some disciplines have much more unmatched applicants than others - but the rules have changed with elective caps, no away electives etc.. which hopefully prevent highly-focused, but un-successful applications in some disciplines.   

[robclem21]

On 11/17/2020 at 7:59 PM, indefatigable said:

I don't think anyone is giving that advice at all.  

I just said that ranking only 3 programs vs ranking many more programs doesn't change your chances of going unmatched by very much.  That's what the statistics say.  It doesn't say anything about the number of programs you'd have apply to get a number of interviews - that would probably depend on a more focused application, etc.  

I don't think it's hard to see that this year is going to be very different than previous years - maybe people will have to apply to more programs to get interviews, who knows?  But ranking more than 3, doesn't change much for the applicant.  I don't think most people would rank programs that they didn't interview at - that would screw up the stats and would definitely NOT be recommended also.  

No question some disciplines have much more unmatched applicants than others - but the rules have changed with elective caps, no away electives etc.. which hopefully prevent highly-focused, but un-successful applications in some disciplines.   

Stats are an outcome of the collective application strategies. If everybody in the country were to only apply to and rank 3 programs, who knows what those statistics would look like. Maybe you would see a huge spike in the number of unmatched applicants and the amount matching to their top 3 would be vastly different. Especially if those 3 programs were all from unique fields. Speaking to many PDs across Canada in a large number of specialties, the main factor leading to medical students going unmatched is not applying broadly enough. This is based on post-hoc conversations with applicants who did not match. That is not saying it's impossible to match if you do only rank 3 (because typically there would be no reason to have this conversation in that case), but proportionally, those who apply broadly are less likely to be unmatched at the end of CaRMS. When you look at situations where people take a focused approach and match, it is important to recognize that those applicants accept a level of risk that I don't necessarily think the majority of Canadian medical students are willing to take.  Even though overall its a small number of Canadian medical students, it's still too big a risk to most. All that we are saying is that is important information to have about those anecdotes, and not just that "its possible".

This year, most programs are taking the approach of interviewing more applicants since it is tougher to rule out applicants based on electives and application alone. This makes it more likely that you will interview, but decreases your chances of matching post-interview at any single location (as there are more applicants to be ranked). It is certainly important to maximize your chances by applying broadly, of course unless you are willing to accept going unmatched to be in a single location (which is totally fine, but important to recognize so that you can mentally prepare yourself for that real possibility).

In regards to your statement about ranking programs you don't interview at, there is absolutely no downside to that. The algorithm is set up to benefit the applicant. As long as you aren't holding out hope for a miracle, if that school doesn't rank you (which they most likely wont), the algorithm will simply skip over it and move to your next choice.  I definitely ranked every program I applied to (even those i didn't interview at), although they were lower on my list. As did many of my colleagues.

 

[indefatigable]

13 hours ago, robclem21 said:

Stats are an outcome of the collective application strategies. If everybody in the country were to only apply to and rank 3 programs, who knows what those statistics would look like. Maybe you would see a huge spike in the number of unmatched applicants and the amount matching to their top 3 would be vastly different. Especially if those 3 programs were all from unique fields. Speaking to many PDs across Canada in a large number of specialties, the main factor leading to medical students going unmatched is not applying broadly enough. This is based on post-hoc conversations with applicants who did not match. That is not saying it's impossible to match if you do only rank 3 (because typically there would be no reason to have this conversation in that case), but proportionally, those who apply broadly are less likely to be unmatched at the end of CaRMS. When you look at situations where people take a focused approach and match, it is important to recognize that those applicants accept a level of risk that I don't necessarily think the majority of Canadian medical students are willing to take.  Even though overall its a small number of Canadian medical students, it's still too big a risk to most. All that we are saying is that is important information to have about those anecdotes, and not just that "its possible".

This year, most programs are taking the approach of interviewing more applicants since it is tougher to rule out applicants based on electives and application alone. This makes it more likely that you will interview, but decreases your chances of matching post-interview at any single location (as there are more applicants to be ranked). It is certainly important to maximize your chances by applying broadly, of course unless you are willing to accept going unmatched to be in a single location (which is totally fine, but important to recognize so that you can mentally prepare yourself for that real possibility).

In regards to your statement about ranking programs you don't interview at, there is absolutely no downside to that. The algorithm is set up to benefit the applicant. As long as you aren't holding out hope for a miracle, if that school doesn't rank you (which they most likely wont), the algorithm will simply skip over it and move to your next choice.  I definitely ranked every program I applied to (even those i didn't interview at), although they were lower on my list. As did many of my colleagues.

 

I agree with most of what you're saying - I think it's just the absolute risk reduction of going unmatched changes very little by only ranking the "top three" programs.  I would assume that for most people these are programs that they have interviewed at - as collective behaviour has probably created that statistic.  It's indeed possible that this year the outcomes will be different and I too would caution in adopting such a tactic - only if it's absolutely necessary from the point of view of the applicant.  

I understand the algorithm fully, but I agree and think people may have a tendency to believe in this "statistic" which I think probably is more true because people do engage in certain behavioural strategies - in this case usually ranking programs that they interviewed at.  In a sense, ranking all programs in strict preference could give more accurate global data, but may lead people into the belief that they could match just based on ranking a program, which I think in most cases is highly unlikely.  

[robclem21]

13 hours ago, indefatigable said:

 I think it's just the absolute risk reduction of going unmatched changes very little by only ranking the "top three" programs.

This is assuming that applicants interview at their top 3 spots. I know many amazing people who did not get an interview at one or more of their top 3 locations. If you only apply to 3 with the hope of staying in a certain city, and don't get 1 or 2 interviews, then all of sudden your statistics don't look so hot (95+% down to <80%). There is no guarantee of interviews, particularly in competitive programs in big cities (including family medicine) and especially if your applicant is spread across multiple specialties and some look like a back-up.

[indefatigable]

1 hour ago, robclem21 said:

This is assuming that applicants interview at their top 3 spots. I know many amazing people who did not get an interview at one or more of their top 3 locations. If you only apply to 3 with the hope of staying in a certain city, and don't get 1 or 2 interviews, then all of sudden your statistics don't look so hot (95+% down to <80%). There is no guarantee of interviews, particularly in competitive programs in big cities (including family medicine) and especially if your applicant is spread across multiple specialties and some look like a back-up.

The statistic is strictly based on applicant rankings - we can assume that people rank their top three based on programs that they've had interviews, but we don't actually know.  Like I said, people could mis-interpret this statistic, which is based on prior collective behavior.  There's nothing further to interpret about the statistic - it's already been measured.  People tend to match overwhelmingly to their top three programs - ranking many more programs doesn't dramatically change the chances of applicants going unmatched.  

I've mentioned a few times that only applying to three programs is NOT recommended.  Moreover, this year is likely to be substantially different, so I wouldn't recommend relying on past trends.