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What percentage of CMG in FM programs chose FM as their first choice?


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I go to FM program in Alberta and I believe almost 50% of my colleagues did not have FM as their first choice when going through CaRMS ( the majority applied to anesth,  EM, plastics, psych, derm, peds as their first choice specialty - but did not get their first choice and they end up in FM- the majority of them are not completely happy with their specialty choice). Are most FM programs in other locations alsofilled with people who did not get their first choice specialty or is that only the case in my program ( my FM program is known to be one of the weaker programs in country and they usually can't fill seats so maybe that's case, but I am not sure..)

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We know that approx. 45% of all CMG's enter FM every year after both first and second rounds.

source for round 1: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl27e.pdf

source for round 2: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl53.pdf

 

We also know that approx. 33% of CMG's choose FM as their first choice.

source: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl11e.pdf

 

So based on this 33% of all CMG's enter FM as their first choice, and 12% of CMG's enter FM as their second (or more) choice specality.

Imagine 100 CMGs. Of that 100 - 45 (45%) will enter FM. And of that 45 - 33 (73%) had it as their 1st choice and 12 (27%) did not have it as their 1st choice.

Might be hard to understand as someone who clearly does not like FM but the vast majority of CMG's that matched to FM had it as their number one specality. 

 

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12 minutes ago, offmychestplease said:

We know that approx. 45% of all CMG's enter FM every year after both first and second rounds.

source for round 1: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl27e.pdf

source for round 2: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl53.pdf

 

We also know that approx. 33% of CMG's choose FM as their first choice.

source: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl11e.pdf

 

So based on this 33% of all CMG's enter FM as their first choice, and 12% of CMG's enter FM as their second (or more) choice specality. Might be hard to understand as someone who clearly does not like FM but the vast majority of CMG's that matched to FM had it as their number one specality. 

Imagine 100 CMGs. Of that 100, 45 (45%) will enter FM. And of that 45, 33 (73%) had it as their 1st choice and 12 (27%) did not have it as their 1st choice.

Overall, that's a large number of people entering FM when it was not their first choice... It's probably even higher in my program. Around 40% of people in my program entered FM as their second choice.

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2 minutes ago, offmychestplease said:

Thank you as I just relaized I posted 2020 data that showed 73% who got FM ranked FM as first choice. But it looks to be even higher in 2021 (78%) as posted above. 

To clarify, the table I posted is for the First round only. If we take into account applicants who matched in both rounds, there'd probably be a lower percentage of people who ranked family first. 

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6 minutes ago, offmychestplease said:

The numbers shouldn't be surprising as so many people back up with FM and obvs not everyone can get their first choice speciality. But I dont think one should back up with FM if they can't imagine matching to it.

FM is the back up for majority of people. I dont think there is any other specialty that has so many back up applicants as FM.

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4 minutes ago, carmsregrets said:

FM is the back up for majority of people.

We just showed you data that is not the case. The majority of CMG's in FM (close to 4/5th that matched FM) had it as their first choice. I said that many people who apply to 2+ fields have FM as a backup in case they don't get what they want and ideally FM is something that they would still be happy to do. Backing up with FM (despite not liking it) and matching it does not lead to a happy outcome. 

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22 minutes ago, offmychestplease said:

We just showed you data that is not the case. The majority of CMG's in FM (close to 4/5th that matched FM) had it as their first choice. I said that many people who apply to 2+ fields have FM as a backup in case they don't get what they want and ideally FM is something that they would still be happy to do. Backing up with FM (despite not liking it) and matching it does not lead to a happy outcome. 

Sorry - I understand what you are saying. I meant saying FM is the most common back up specialty out of all the other specialties ( it is not necessarily a bad thing as FM can be quite flexile and you can create your own niche).. plus, FM tends to be very easy to get into. I personally got into  FM  ( my first choice location) with absolutely no electives, no interest and CV that definitely showed it was not my first or even second choice specialty. I applied to FM because I was scared of not matching and I thought that I may grow to like it. I only did my core rotation in it and did not really dislike it but then I only spent 2 month on that service as a med student. Right now, in residency I can clearly tell that general FM is poor fit for my personality, but I am hoping to find something I like in FM or do another residency or go to the States, etc. I also have colleagues in my program who have been gunning for plastics for 2 years and did not get it and ultimately ended up in FM  despite them still having absolutely no interest in it - and they also have no plans to practice FM. They are only doing it until they have better options that suits their interests.

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yea you are completly correct in that it is the most common back up field (but not that most people who matched to it had it as their backup). Two very different things lol and wow do you mean they applied to plastics for 2 years and didn't get it so they landed in FM? That's brutal...do they like FM enough to stay or are there other avenues for them?

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2 minutes ago, offmychestplease said:

yea you are completly correct in that it is the most common back up field (but not that most people who matched to it had it as their backup). Two very different things lol and wow do you mean they applied to plastics for 2 years and didn't get it so they landed in FM? That's brutal...do they like FM enough to stay or are there other avenues for them?

 No, they are trying to leave or transfer to any surgical specialty whenever it is an option for them.  There are 3 ex-plastic surgery gunners from across Cda in my FM program. Two of them are looking for better opportunities that suits their interests - the other one has given up on medicine and no longer cares about anything ( including FM).  PD/administrators/ preceptors  are well aware that these people never intended to be in FM - but they are trying to fill their programs with any applicants.

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4 minutes ago, carmsregrets said:

 No, they are trying to leave or transfer to any surgical specialty whenever it is an option for them.  There are 3 ex-plastic surgery gunners from across Cda in my FM program. Two of them are looking for better opportunities that suits their interests - the other one has given up on medicine and no longer cares about anything ( including FM).  PD/administrators/ preceptors  are well aware that these people never intended to be in FM - but they are trying to fill their programs with any applicants.

what benefit does a program have with filling all spots - sorry might be a dumb question. And how do PDs/admin/precptors know that these people wanted plastics hard but couldn't get it - do they tell their program/make it known to their colleagues? 

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Anecdotal but I have heard of multiple cases of plastics/optho people who tried to match for two straight years and/or take research years/choose to go unmatched if they don't get plastics/optho to try again but I have NEVER heard of this happening for derm hopefulls...any reason why (as derm is the same level competitveinss at the top with plastics/optho) or it does happen I just never heard of it lol

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12 minutes ago, offmychestplease said:

 

what benefit does a program have with filling all spots - sorry might be a dumb question. And how do PDs/admin/precptors know that these people wanted plastics hard but couldn't get it - do they tell their program/make it known to their colleagues? 

I am not sure honestly- I just know that preceptors/ PD know that several residents dislike FM and they would leave if given any choice.  Maybe when these residents leave the program,they are left with additional funding ?? I don't know. Or maybe they feel bad for applicants who go unmatched several times and rank them with the hopes that they may change their mind and stay in FM. Or perhaps FM end up ranking these applicants to decrease the number of unmatched applicants... I don't know.

I honestly don't know much about derm - all I know it is based on your "fit". So if they not like you for any reason - there is not much that you can do to prove to them that you are a good "fit".

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36 minutes ago, offmychestplease said:

Anecdotal but I have heard of multiple cases of plastics/optho people who tried to match for two straight years and/or take research years/choose to go unmatched if they don't get plastics/optho to try again but I have NEVER heard of this happening for derm hopefulls...any reason why (as derm is the same level competitveinss at the top with plastics/optho) or it does happen I just never heard of it lol

Ophtho does not have an obvious backup so that contributes to it. I haven’t heard of many plastics applicants going unmatched and reapplying. I think the research fellowship is mostly unique to Ophtho. Most Derm applicants backup with internal or family as there is enough overlap between these specialities to make it a reasonable alternative. 

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The stats don't tell the whole story. FM was my first and only choice during carms, but I disliked regular FM and knew I wouldn't continue my career in that direction. More than half of my cohort had applied for a plus one to subspecialize. FM is the only path that gets you to the finish line on a reasonable timeline and lets you start your real career on your terms. That was my top priority and for many others who picked FM I suspect.

 

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On 10/9/2021 at 12:32 AM, offmychestplease said:

 

what benefit does a program have with filling all spots - sorry might be a dumb question. And how do PDs/admin/precptors know that these people wanted plastics hard but couldn't get it - do they tell their program/make it known to their colleagues? 

For the later question the common CV often makes that obvious (at least historically) as you are probably aware but just to state it. You didn't do a large number of plastics electives, have plastics research.......without there being a high probability you want plastics. You may be willing to also do FM (for some that is settling for FM, for others they really would be happy doing it about as much as the other thing they also were looking at) but you cannot easily hide the ground work for all the other field you were looking at. Plus most people by temperament that want plastics classically aren't that interested in family medicine (its surgical, and high specialized vs non-surgical and generalist. Of course you modify a FM practise to be closer to your tastes in many ways). Plus the selection committees for a program involve a lot more people that the PD. Thus many other staff and residents would likely know your interests. The world is small and things can easily spread around. 

As for filling the spots - well if people leave not as much as you would think - the big issues I think for not filling a program is the that most programs have fixed call requirements. So if spots aren't filled that has to get spread around. That isn't fun for the remaining people - particularly if the program is small etc. For FM that still is a factor - they are tasked to train X people, it doesn't look good to not train that number. It definitely does also impact the programs funding - funding follows the residents so if you are missing people you are missing funding. Plus they may honestly think that person may be willing to stay and complete things (as of course many people that back up do actually do regardless of the cases of people trying to leave. If you want to somewhat cruel about it - there is simply often no place for them to go to, and even if there was often it involves swapping into their program someone else that no longer wants some other 5 year program.)

and as i think you mentioned above and rightly so that majority of people in FM actually picked it. I mean - there is a TON of good reasons to want to go into FM. Seriously good reasons. Doesn't mean you won't get the odd random event where a particular program in a particular year has a lot of people that didn't pick FM as their first choice but ended up there. CARMS is wonderfully and scarily random. 

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On 10/9/2021 at 12:16 AM, carmsregrets said:

Sorry - I understand what you are saying. I meant saying FM is the most common back up specialty out of all the other specialties ( it is not necessarily a bad thing as FM can be quite flexile and you can create your own niche).. plus, FM tends to be very easy to get into. I personally got into  FM  ( my first choice location) with absolutely no electives, no interest and CV that definitely showed it was not my first or even second choice specialty. I applied to FM because I was scared of not matching and I thought that I may grow to like it. I only did my core rotation in it and did not really dislike it but then I only spent 2 month on that service as a med student. Right now, in residency I can clearly tell that general FM is poor fit for my personality, but I am hoping to find something I like in FM or do another residency or go to the States, etc. I also have colleagues in my program who have been gunning for plastics for 2 years and did not get it and ultimately ended up in FM  despite them still having absolutely no interest in it - and they also have no plans to practice FM. They are only doing it until they have better options that suits their interests.

good luck of course, I really hope you get something closer to what you wanted in the end. 

The carms musical chairs game is frustrating. 

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On 10/9/2021 at 12:32 AM, offmychestplease said:

Anecdotal but I have heard of multiple cases of plastics/optho people who tried to match for two straight years and/or take research years/choose to go unmatched if they don't get plastics/optho to try again but I have NEVER heard of this happening for derm hopefulls...any reason why (as derm is the same level competitveinss at the top with plastics/optho) or it does happen I just never heard of it lol

man that can create such an arms race. Eventually you end up with people routinely doing it and just stretching things out even further.  

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If you are unhappy with FM you could try to apply to a US residency in your field of interest, or failing that try to get into a decent field like radiology. Training flexibility is far better in the USA so I would devote your resources to that rather than trying to find some kind of re-entry program in Canada. On the bright side, FM residency is only two years, which isn't long and gives you something you can use in your back pocket.

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  • 1 month later...
On 10/8/2021 at 9:20 PM, offmychestplease said:

We know that approx. 45% of all CMG's enter FM every year after both first and second rounds.

source for round 1: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl27e.pdf

source for round 2: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl53.pdf

 

We also know that approx. 33% of CMG's choose FM as their first choice.

source: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl11e.pdf

 

So based on this 33% of all CMG's enter FM as their first choice, and 12% of CMG's enter FM as their second (or more) choice specality.

Imagine 100 CMGs. Of that 100 - 45 (45%) will enter FM. And of that 45 - 33 (73%) had it as their 1st choice and 12 (27%) did not have it as their 1st choice.

Might be hard to understand as someone who clearly does not like FM but the vast majority of CMG's that matched to FM had it as their number one specality. 

 

Based on the above stats, 12/ (12+33)=27% of FM residents did not choose FM as their top choice speciality. That is actually quite a high number lol

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