Unfilled positions after R1 match 2021

[indefatigable]

12 hours ago, zoxy said:

Good point. For 2020, 42 matched to IM  as their second choice specialty and 5 matched to it as their third specialty.

Unrelated but I think with how competitive IM is getting, doing IM in the US is very feasible. Only 39 percent of IM residencies were filled by US MDs in the 2021 match. I think doing a chief IM year or a year of fellowship would make you eligible for the Royal College boards.

There's not an implied link between interview and ranking - anybody that applies to any specialty can rank it or not.  Does it make sense to rank a discipline that doesn't interview as your "first choice"?  

Everybody will have a different answer - I don't think it personally makes much sense, but that doesn't preclude people from doing it.  That's actually how the algorithm is supposed to work - ranking according to strict preference.  I suggested some questions to consider in my previous post.  

[zoxy]

2 minutes ago, indefatigable said:

There's not an implied link between interview and ranking - anybody that applies to any specialty can rank it.  Does it make sense to rank a discipline that doesn't interview as your "first choice"?  Everybody will have a different answer.   

Do you know of anyone matching (or even getting ranked) somewhere where they didn't get an interview?

[indefatigable]

On 4/23/2021 at 8:59 PM, zoxy said:

Do you know of anyone matching (or even getting ranked) somewhere where they didn't get an interview?

I think someone found something in the CaRMS stats once lol..  it's more theoretical - but would give a more accurate assessment of applicant's actual interests.  and there's absolutely nothing to lose.  would you want to miss out if it were you?  who really knows?

would the program prefer to rank people that likely have more experience in the discipline or prefer to see the second round?  

I saw a few outliers this year - anesthesia, cardiac surgery and peds (typically much more competitive than IM).  Probably a "candidate in mind".. but one never knows.    

[Edict]

5 hours ago, zoxy said:

Good point. For 2020, 42 matched to IM  as their second choice specialty and 5 matched to it as their third specialty.

Unrelated but I think with how competitive IM is getting, people should consider the US as well. Only 39 percent of IM residencies were filled by US MDs in the 2021 match. Since the Canadian match usually runs before the American one, it's a no brainer .

I think doing a chief IM year or a year of fellowship would make you eligible for the Royal College boards.

 

I think the amount of additional time and work required for applying to the US match if put into improving your Canadian application would be enough to improve your odds of matching to IM similarly. I'm not sure we are at that point yet with IM that anyone would recommend a US application. 

[bearded frog]

Now that round two is done the list of final unfilled positions is available.

• Notably, only FM and pathology went unfilled.
• Leaving out military spots, the vast majority of remaining spots are french-language.
• Outside of french-language schools (and likely french-heavy spots at McGill, and a bilingual spot in Manitoba), there was only 1 FM spot at McMaster and 3 at NOSM (2 first-nations remote and one combined public health)
• 3 of the 4 pathology spots were at UofA for some reason (the other was at UdeM)

[shikimate]

hemepath and GP are good spots for any last minute desperate people, job market is pretty good at least.

what do they usually do with those military leftover spots? I am sure there are people who would love to take them in return for some years of service.

[NoMatchNoProblem]

When can we expect the official stats for the CaRMS 2021 season as a whole now that the second iteration is complete?

[ihsh]

2 hours ago, NoMatchNoProblem said:

When can we expect the official stats for the CaRMS 2021 season as a whole now that the second iteration is complete?

The CaRMS forums will be held on May 31st, and I believe the slide deck for that (which includes some data) will be posted shortly after. However, looking at the CaRMS news archive, it seems like in previous years the full data would only be available in June-July. 

[JohnSnow2021]

The CaRMS data snapshot has been released:

https://www.carms.ca/pdfs/2021-R-1-data-snapshot.pdf

[indefatigable]

24 minutes ago, JohnSnow2021 said:

The CaRMS data snapshot has been released:

https://www.carms.ca/pdfs/2021-R-1-data-snapshot.pdf

On Slide 4 it looks like the unmatched rate is creeping up again..  Hope that isn't a trend!  

That is a tough place to be especially for CMGs that went through the second round - it does look like more are choosing to reapply in the next year.  

[MK.]

Why would someone who didn't match in 1st iteration not participate in 2nd iteration? What can a med graduate do if left unmatched?

[indefatigable]

1 minute ago, MK. said:

Why would someone who didn't match in 1st iteration not participate in 2nd iteration? What can a med graduate do if left unmatched?

It depends on the school - some can do more electives and everyone can do research.  Of course the US may be a possibility too.  

There are some success stories of applicants matching to highly-competitive programs after a year off - I think that may be why that it is creeping up!

[Storm_Bringer44]

I’m on that boat and decided to not rank 2nd iteration programs.

My plan is to improve my application through research and/or observerships and reapply.

[Storm_Bringer44]

2 hours ago, MK. said:

Why would someone who didn't match in 1st iteration not participate in 2nd iteration? What can a med graduate do if left unmatched?

I’m on that boat and decided to not rank 2nd iteration programs.

My plan is to improve my application through research and/or observerships and reapply.

[shikimate]

3 hours ago, MK. said:

Why would someone who didn't match in 1st iteration not participate in 2nd iteration? What can a med graduate do if left unmatched?

I know people who did 5th year (or more, as one person had a lot of difficulty in their personal life) of med school and more electives to match the year after.

Another person did a MPH degree and matched the year after.

I also know a poor quality candidate who decided to do some work in industry and consequently did not match again the year after.

[GH0ST]

I'm really surprised by the large number of unmatched positions at UofA... I don't recall this being so prominent in years past. 

Two years in a row there's one spot for PHPM+FM as well. UofA really is a good site and even with the lower number of applicants there aren't many PHPM+FM specific spots.

- G 

[frenchpress]

10 minutes ago, GH0ST said:

I'm really surprised by the large number of unmatched positions at UofA... I don't recall this being so prominent in years past. 

Two years in a row there's one spot for PHPM+FM as well. UofA really is a good site and even with the lower number of applicants there aren't many PHPM+FM specific spots.

- G 

I think this really shows the power of the current perceptions around the Jason Kenny government’s fight with family doctors. 

[chateau22]

Alberta/Ottawa's unfilled spots in first iteration are ironic considering they were kind of picky with FM interviews - some applicants who were clearly interested in FM didn't get interviews there but did at other more competitive schools.

[ACHQ]

On 4/23/2021 at 8:46 PM, zoxy said:

Good point. For 2020, 42 matched to IM  as their second choice specialty and 5 matched to it as their third specialty.

Unrelated but I think with how competitive IM is getting, people should consider the US as well. Only 39 percent of IM residencies were filled by US MDs in the 2021 match. Since the Canadian match usually runs before the American one, it's a no brainer .

I think doing a chief IM year or a year of fellowship would make you eligible for the Royal College boards.

 

Although IM has gotten more competitive, I don't think we are anywhere near where people have to apply to the US. I suspect that if you are an IM gunner and want only IM, and aren't a freak, you will match to IM in Canada (maybe not your top spot but a spot), especially if you apply broadly. I do think it has gotten competitive enough though that people should really think twice about backing up with it given it may not be a safe bet anymore. I also think that we are reaching a point that the only specialty that one could possibly parallel plan with IM *safely* is FM.

When I saw the IM match results this year I was shocked that there were ZERO spots left after the first iteration. For such a large program I would expect at least 5-10 spots leftover (albeit in most years most of those spots were left over in french Quebec).

I'm not nearly smart enough to determine why this happened (COVID exposing medical students more to acute IM? more people ending up with their backup in IM? generally becoming much more competitive? all the above?). I wouldn't be surprised if there is a fair number of transfers *out* of IM next year.  But at the same time I wouldn't be surprised if this is a real result. IM is a great specialty with lots of breadth and with job prospects and lifestyle better than most specialties (which I think now medical students are considering more and more, which is smart).

I suspect this will be cyclical (just like all things) and things will swing the other way for IM eventually, especially once jobs dry up in hot-to-live areas (which will happen very soon)

[ACHQ]

Just now, ACHQ said:

Although IM has gotten more competitive, I don't think we are anywhere near where people have to apply to the US. I suspect that if you are an IM gunner and want only IM, and aren't a freak, you will match to IM in Canada (maybe not your top spot but a spot), especially if you apply and do electives broadly. I do think it has gotten competitive enough though that people should really think twice about backing up with it given it may not be a safe bet anymore. I also think that we are reaching a point that the only specialty that one could possibly parallel plan with IM *safely* is FM.

When I saw the IM match results this year I was shocked that there were ZERO spots left after the first iteration. For such a large program I would expect at least 5-10 spots leftover (albeit in most years most of those spots were left over in french Quebec).

I'm not nearly smart enough to determine why this happened (COVID exposing medical students more to acute IM? more people ending up with their backup in IM? generally becoming much more competitive? all the above?). I wouldn't be surprised if there is a fair number of transfers *out* of IM next year.  But at the same time I wouldn't be surprised if this is a real result. IM is a great specialty with lots of breadth and with job prospects and lifestyle better than most specialties (which I think now medical students are considering more and more, which is smart).

I suspect this will be cyclical (just like all things) and things will swing the other way for IM eventually, especially once jobs dry up in hot-to-live areas (which will happen very soon)

 

[indefatigable]

16 hours ago, JohnSnow2021 said:

The CaRMS data snapshot has been released:

https://www.carms.ca/pdfs/2021-R-1-data-snapshot.pdf

20 hours ago, bearded frog said:

Now that round two is done the list of final unfilled positions is available.

Trying to wrap my head around this..

• A relative increase of 19 in total number of current-year unmatched CMGs compared to last year (86 from 67) including 33 unmatched CMGs that participated in Round 2 (Slide 4)
• But.. much fewer CMGs entering post-graduate training this year (2768) compared to last couple of years (2817 in 2020 and 2792 in 2019) (Slide 3)
• And.. almost twice as many unfilled positions after round 2 (94) compare to last couple of years (56 and 52), although almost all are military or French-speaking FM as described above
• aside - Fewer USMGs matched into Canada probably because of timing (10 vs 20+ previous years)  - IMG matching more or less constant (410 vs 418 last year including a large-number of reserved positions)  [Slide 3]

So .. what does this all mean?  I think QC cut the size of its med school classes which may partly explain both the decrease in the total number of CMGs and the relative increase in the number of unfilled positions after round 2.  

But, the increase in unfilled positions could also be explained if more French-speaking QC med students matched out of QC [although that's historically been very low - less than even in USMGs].

Why does this matter?  Well given that there are at most a handful of English-speaking residency positions left over and there are 33 fully-unmatched  current-year CMGs (majority likely English speakers), this shows that the match is still somewhat unstable.  

It's sometimes seen as if IMGs are unbalancing the match  - but in Round 2 there were 72 current-year CMGs that matched and 11 current-year IMGs that matched, along with a grand total of 38 prior year IMGs (5.9% success rate for that group).  In other words, IMG matching to competitive streams doesn't greatly change the balance.  The 28 CMG transfers are neutral to the total post-graduate size .. although may out-compete current year CMGs for entry level positions. 

Tl;Dr I think the long-term matching problem is far from resolved despite what should be beneficial circumstances - i.e. decreased number of CMGs, fewer USMGs matching into CaRMS and superficially more unfilled positions (which are inaccessible to the vast majority of CMGs).  I think things may continue to degrade with it being almost guaranteed that an increasing number of current-year CMGs will be unmatched each year.

The 33 current-year CMGs that participated in Round 2 want to pursue post-graduate training and likely applied/ranked broadly - it's disconcerting that they are not getting a chance and most will have to wait a year to re-apply.  They all made into/through Canadian medical school, likely have taken out large loans, etc.. this should not be happening.  The point is - I think the matching ratio is simply too low/too tight - there's no way for them to even match into the "unfilled" positions.

[bearded frog]

7 hours ago, JohnSnow2021 said:

The CaRMS data snapshot has been released:

https://www.carms.ca/pdfs/2021-R-1-data-snapshot.pdf

The increasing number of non-participants in the second round makes me wonder if the 5th year option is becoming more popular. I wish they broke down the non-current year unmatched CMG applicants into previously matched and never matched like they did with the matched applicants, I'd be interested to know how many truly didn't match two years in a row as well as what proportion if previously-matched applicants were successful.

3 hours ago, GH0ST said:

I'm really surprised by the large number of unmatched positions at UofA... I don't recall this being so prominent in years past. 

Two years in a row there's one spot for PHPM+FM as well. UofA really is a good site and even with the lower number of applicants there aren't many PHPM+FM specific spots.

- G 

The PHPM+FM wasn't at U of A, they only had 3 pathology subspeciality spots left, and I wonder if they just decided to leave them empty because its notable to have 3 left at one place... I wouldn't read too much into the politics of it.

[bread]

7 hours ago, bearded frog said:

The increasing number of non-participants in the second round makes me wonder if the 5th year option is becoming more popular. I wish they broke down the non-current year unmatched CMG applicants into previously matched and never matched like they did with the matched applicants, I'd be interested to know how many truly didn't match two years in a row as well as what proportion if previously-matched applicants were successful.

The PHPM+FM wasn't at U of A, they only had 3 pathology subspeciality spots left, and I wonder if they just decided to leave them empty because its notable to have 3 left at one place... I wouldn't read too much into the politics of it.

I know at our school, we were told that unmatched students are only eligible to do a fifth year if they participated in the second round. If not, they would graduate and be on their own for that gap year. 

[indefatigable]

1 hour ago, bread said:

I know at our school, we were told that unmatched students are only eligible to do a fifth year if they participated in the second round. If not, they would graduate and be on their own for that gap year. 

Interesting - I suppose some could try "gaming" that policy by applying and ranking say only one program.. but I doubt the majority would do that.  

I wonder how many of the 86 current-year unmatched CMGs will have any opportunities for further electives (the school that I went to for instance doesn't offer extra-electives to unmatched students under any circumstances)?  In theory, the second-round 33 participating CMGs may need the electives more to match to any post-graduate training so the policy seems to makes some sense.   

Doing  research could help for some competitive specialties, but I'm not sure how it would look to less-competitive disciplines..  it does work out for some, but it's a relatively high-risk strategy given the unmatched stigma and further time lapse between formal clinical exposure in a very-tight CaRMS match.  

[guest1993]

46 minutes ago, indefatigable said:

Interesting - I suppose some could try "gaming" that policy by applying and ranking say only one program.. but I doubt the majority would do that.  

I wonder how many of the 86 current-year unmatched CMGs will have any opportunities for further electives (the school that I went to for instance doesn't offer extra-electives to unmatched students under any circumstances)?  In theory, the second-round 33 participating CMGs may need the electives more to match to any post-graduate training so the policy seems to makes some sense.   

Doing  research could help for some competitive specialties, but I'm not sure how it would look to less-competitive disciplines..  it does work out for some, but it's a relatively high-risk strategy given the unmatched stigma and further lapse between formal clinical exposure in a very-tight CaRMS match.  

I went to a program with a high number (30+) of unmatched students my year and that is exactly what many people did. They did second iteration CaRMs, interviewed for a handful of programs, but did not rank anything. Of course, you cannot disclose to your UME that you did this but there is no way for them to see your rank list. 

Most schools now I understand have an extended clerkship option if you go unmatched. There is a really high success rate for matching to what you want the following year. Some programs (I think U of A?) have a 5th year MD/MBA option as well. 

The "unmatched stigma" is less so now I think. Most people who did the extra year received many interviews and matched to competitive specialties the following year.