Jump to content
Premed 101 Forums

Where do most average medical students end up going - Do we just end up doing FM?


Recommended Posts

Did you just start? Why do you think you’re average? Most people are average, hence average. If you read around cases during your rotation, and ask questions to clarify things or learn, your knowledge base gets better as you go through the rotation. Not many people feel like a rock star in the beginning, and that’s fine. You’re meant to be learning anyways, just be helpful to the team and somewhat keen, and offer to do things and you’ll be doing great, no one expect you to know everything as a clerk.

Link to comment
Share on other sites

5 hours ago, socialjustice said:

I am currently in clerkship, and have noted clerkship to be difficult. I feel that I am average at best. I was wondering where do average medical students end up doing for specialty. Do they end up being in FM, since it is difficult to be a competitive applicant for anything else if you are just an average medical student?

 

Being average has nothing to do with matching FM, some of the smartest and brightest people in medicine pursue FM out of personal interest or reasons. If you have a particular specialty in mind, then being average has nothing to do with it. We don't even have grades in Canada, so it all comes down to how bad you want a particular specialty and how much effort you are willing to put in (a long with luck and a million other factors). Even the most exceptional students on paper might not match to what they want for many reasons outside of their medical school performance.

 

If you want to do a particular specialty, showing interest and putting in the time and effort goes much further than just being born a  naturally amazing student.

 

Being a good student ≠ being a competitive CARMs applicant

Link to comment
Share on other sites

7 minutes ago, Pakoon said:

Being average has nothing to do with matching FM, some of the smartest and brightest people in medicine pursue FM out of personal interest or reasons. If you have a particular specialty in mind, then being average has nothing to do with it. We don't even have grades in Canada, so it all comes down to how bad you want a particular specialty and how much effort you are willing to put in (a long with luck and a million other factors). Even the most exceptional students on paper might not match to what they want for many reasons outside of their medical school performance.

 

If you want to do a particular specialty, showing interest and putting in the time and effort goes much further than just being born a  naturally amazing student.

 

Being a good student ≠ being a competitive CARMs applicant

CaRMS seems like a blackbox. I have met a few residents that wanted EM ( and showed all the interest), but they still ended up in FM ( and they were not bad residents AFAIK- at least above average). It seems to me that FM is where a lot of residents end up when they don't get the specialty they initially wanted.

Link to comment
Share on other sites

2 minutes ago, socialjustice said:

CaRMS seems like a blackbox. I have met a few residents that wanted EM ( and showed all the interest), but they still ended up in FM ( and they were not bad residents AFAIK- at least above average). It seems to me that FM is where a lot of residents end up when they don't get the specialty they initially wanted.

I think that happens bc people use it as a backup for more competitive specialties, which you don't have to do

Link to comment
Share on other sites

3 hours ago, socialjustice said:

CaRMS seems like a blackbox. I have met a few residents that wanted EM ( and showed all the interest), but they still ended up in FM ( and they were not bad residents AFAIK- at least above average). It seems to me that FM is where a lot of residents end up when they don't get the specialty they initially wanted.

EM is ultra competitive and it often slips peoples mind that it's match rate isn't too far off from plastics, optho and derm (from a purely applicant/spot ration, not speaking to the actual competitiveness of applicants because I honestly do not know)

You have to be read to back up with something or go unmatched when pursuing something that competitive.

Link to comment
Share on other sites

3 hours ago, offmychestplease said:

You really need to be careful for how you word things...there are medical school gold medalists, valedictorians, MD/PhD's, etc that "end up in FM" every year at every school out of their own accord.

The top 3 students in my graduating medical class all went into FM, and they would run circles in academics and general well-roundedness compared to the top applicants to "ultra competitive specialty X".   People forget that everyone has different interests, and *gasp* you can actually desire to go into fields like FM, psych, peds etc.

Link to comment
Share on other sites

51 minutes ago, JohnGrisham said:

The top 3 students in my graduating medical class all went into FM, and they would run circles in academics and general well-roundedness compared to the top applicants to "ultra competitive specialty X".   People forget that everyone has different interests, and *gasp* you can actually desire to go into fields like FM, psych, peds etc.

this...there are no grades/class rank/standardized exams for residency/etc in Canada and matching into "ultra competitve fields" has everything to do with the connections you build up, networking, reference letters, showing interest, research, and luck. None of these things are about how "smart" someone is and could ironically be gamed by someone who is not academically strong but but willing to hustle in these other areas. It's such a shame that people make posts like this in the OP as it is a disrespect to the literal hundreds and hundreds of people like go into FM by choice, many of whom only applied to FM as well... (overall 45% of CMG's enter FM every year).

PS - I think it's funny when people bring up examples of people who go into FM as a second choice like they are settling but fail to bring up the many examples of people who get into their second choice FRCPC field and not their first choice FRCPC field (ie IM and not surgery, or gen surg and not plastics etc). I guess to some people it's only settling if the second choice field you end up in is FM...sad. If someone has no intention to do FM, don't apply/rank it. 

Link to comment
Share on other sites

1 hour ago, offmychestplease said:

this...there are no grades/class rank/standardized exams for residency/etc in Canada and matching into "ultra competitve fields" has everything to do with the connections you build up, networking, reference letters, showing interest, research, and luck. None of these things are about how "smart" someone is and could ironically be gamed by someone who is not academically strong but but willing to hustle in these other areas. It's such a shame that people make posts like this in the OP as it is a disrespect to the literal hundreds and hundreds of people like go into FM by choice, many of whom only applied to FM as well... (overall 45% of CMG's enter FM every year).

PS - I think it's funny when people bring up examples of people who go into FM as a second choice like they are settling but fail to bring up the many examples of people who get into their second choice FRCPC field and not their first choice FRCPC field (ie IM and not surgery, or gen surg and not plastics etc). I guess to some people it's only settling if the second choice field you end up in is FM...sad. If someone has no intention to do FM, don't apply/rank it. 

There are academic scholarships in medical school. Nonetheless, what matters most is clinical performance which does require some level of academic performance. A lot of it does boil down to luck (ie. just getting the right pimp questions that you know well).

 No doubt some of the smartest people in my class went into FM. But with that being said, there are many people in FM who did not want to be there initially. As you say, this happens with people that apply to multiple FRCPC fields as well.

Importantly just have respect for each other as colleagues. 

Link to comment
Share on other sites

 

11 hours ago, socialjustice said:

I am currently in clerkship, and have noted clerkship to be difficult. I feel that I am average at best. I was wondering where do average medical students end up doing for specialty. Do they end up being in FM, since it is difficult to be a competitive applicant for anything else if you are just an average medical student?

 

Average medical students end up becoming doctors.

Link to comment
Share on other sites

I think it is a more "common" sentiment because FM is a radically different career from surgery/anesthesiology/radiology, and that can lead to a lot of highly unhappy/vocal people.

On the other hand wanting to do ENT but ending in general surgery->thyroid fellowship is a lot more palatable.

Link to comment
Share on other sites

4 hours ago, offmychestplease said:

If someone has no intention to do FM, don't apply/rank it. 

Well, it is not that simple. Because the applicants who do not get their first choice specialty ( whatever it maybe), end up in 2nd iteration (applying to mainly FM or whatever else is left). I have seen people who wanted even IM and end up not getting it ( and they had to go to FM). Plus, if you talk to  academic counsellors in med school ( and tell them you are interested in anything remotely competitive), they encourage you to apply to FM to avoid being unmatched. If you go unmatched in first iteration from whatever initial specialty you applied to, one of your main option is to  pretty much apply to FM. And usually FM accepts most applicants as they have a lot of seats.

I have an appreciation for family docs, and the work they do. I am just saying that often people may end up in FM because they have loans and debts, and they cant afford to go unmatched.

Link to comment
Share on other sites

Let's be honest, CaRMS is almost a zero sum game. They are only that many spots in a fixed quantity and ratio is barely above 1:1.

So naturally there is an incentive to get something out of CaRMS. You either match or don't match, there is no "house officer" "rotating internship" or "preliminary year" such as in other countries. Which means people probably rank more programs than they actually want to rank, and some people will end up matched to programs they wouldn't want anyways, and become vocal and upset about it.

Therefore I would expect the least competitive specialties to have the most mixed bag of people who went into it because they wanted it, or those that went into it because they have no choice.

Another alternate explanation is that competitive specialties have very few residents and hence statistically produce less unwilling residents.  Say for argument sake 2% of all residents feel "mismatched". 2% of 30 dermatology spots is <1 resident per year, whereas 2% of 1000 FM resident is 20 people per year. It would be interesting to survey residents in different areas though, to see if this % of unwilling resident is different across fields and PGY years.

Link to comment
Share on other sites

Most medical students go into family medicine, so saying that most average medical students end up in family medicine is not a wrong statement. Family Medicine is orders of magnitude larger in terms of spots than the small competitive specialities. 
 

If we are comparing, we should be looking at proportions and not absolute numbers. Furthermore, there is no easy way to quantify average medical students since all the objective metrics no longer exists.

Finally, I will say that on average, Family Medicine is more community oriented and less academically oriented than FRCPC/FRCSC, and so it would be conceivable that academically inclined medical students chose these specialities over Family. 

Link to comment
Share on other sites

What specialty someone matches to has little to do with how good of a clinician he/she is and more so with luck and statistical chances (i.e. ratio of applicants to spots). No one is "average" at everything, so go find a specialty where you feel better than average and try your luck there.

FM by its large number of spots is the default for backups, nothing wrong with that. There's no med student prestige in going into FM, again nothing wrong with that.

Link to comment
Share on other sites

22 hours ago, socialjustice said:

I am currently in clerkship, and have noted clerkship to be difficult. I feel that I am average at best. I was wondering where do average medical students end up doing for specialty. Do they end up being in FM, since it is difficult to be a competitive applicant for anything else if you are just an average medical student?

 

Don’t discount yourself so soon. I started med school as a non-trad with pretty bad impostor syndrome. We have objective exams that rank our knowledge levels. For the first few, I was always about 25th percentile. Then, I ranked below 5th percentile. You can imagine how terribly stupid I felt knowing that more than 95% of my class had demonstrated more knowledge than me.

My poor score wasn’t for a lack of trying. I was studying a lot. I just wasn’t studying right; my learning methods from my previous field had not translated well to medicine. I changed my study methods. Since then, I scored 50th percentile initially, and now, I’ve been scoring near 90th percentile consistently.

I don’t say the above to show off. I genuinely don’t think medicine takes a great degree of intelligence beyond what the “average” med student already possesses (it takes a certain amount of intelligence to get in). In fact, some of the less intellectually gifted students in my cohort are applying for very competitive specialties. They all have great odds because they’re very personable and have networked very well. As for me, I guess I can now say I’m an example of an “above-average” med student going into FM. 
 

Intelligence is most likely not your obstacle. I think you can do any specialty as long as you figure out the right path to get it.

Link to comment
Share on other sites

12 hours ago, shikimate said:

Another alternate explanation is that competitive specialties have very few residents and hence statistically produce less unwilling residents.  Say for argument sake 2% of all residents feel "mismatched". 2% of 30 dermatology spots is <1 resident per year, whereas 2% of 1000 FM resident is 20 people per year. It would be interesting to survey residents in different areas though, to see if this % of unwilling resident is different across fields and PGY years.

 

In competitive fields  ( like EM, Plastics, and Optho) you have to put in a ton of effort to show you are interested, and even then there is a high chance you may go unmatched from these specialties. So I'd suspect that the rate of unwilling applicants is very low in highly competitive specialties.

Whereas, in noncompetitive fields ( like path or FM), you can match with absolutely no interest or electives ( and even a CV that shows you had an interest in another specialty).  So the no. of unwilling applicants in FM can be quite high. Also, based on this, to me at least, it seems that FM accepts  applicants that other specialties has rejected ( so it is where less competitive applicants usually go).

 

Link to comment
Share on other sites

20 hours ago, offmychestplease said:

this...there are no grades/class rank/standardized exams for residency/etc in Canada and matching into "ultra competitve fields" has everything to do with the connections you build up, networking, reference letters, showing interest, research, and luck. None of these things are about how "smart" someone is and could ironically be gamed by someone who is not academically strong but but willing to hustle in these other areas. It's such a shame that people make posts like this in the OP as it is a disrespect to the literal hundreds and hundreds of people like go into FM by choice, many of whom only applied to FM as well... (overall 45% of CMG's enter FM every year).

PS - I think it's funny when people bring up examples of people who go into FM as a second choice like they are settling but fail to bring up the many examples of people who get into their second choice FRCPC field and not their first choice FRCPC field (ie IM and not surgery, or gen surg and not plastics etc). I guess to some people it's only settling if the second choice field you end up in is FM...sad. If someone has no intention to do FM, don't apply/rank it. 

I am not trying to disrespect FM. It is very likely that is where I may end up. I am just stating the facts and experiences of others. I am sure there are a lot of strong applicants in FM, and I am sure a lot of applicants pick FM as their top choice. However, I also see a lot of applicants in FM - who are only there because they could not make it to their top choice specialty. There are not that many applicants who get into their second choice FRCPC field ( with the exception of lab medicine fields), as usually FRCPC fields are quite selective in terms of the candidates they accept.

So, I wonder if it is worth it for me to hustle and try to make it to a FRCPC field ( with a high chance of rejection) or take the easy route and match to FM?

 

Link to comment
Share on other sites

8 hours ago, socialjustice said:

I am not trying to disrespect FM. It is very likely that is where I may end up. I am just stating the facts and experiences of others. I am sure there are a lot of strong applicants in FM, and I am sure a lot of applicants pick FM as their top choice. However, I also see a lot of applicants in FM - who are only there because they could not make it to their top choice specialty. There are not that many applicants who get into their second choice FRCPC field ( with the exception of lab medicine fields), as usually FRCPC fields are quite selective in terms of the candidates they accept.

So, I wonder if it is worth it for me to hustle and try to make it to a FRCPC field ( with a high chance of rejection) or take the easy route and match to FM?

 

I think you are missing the point here a little bit from what everyone is trying to communicate to you. Allow me to try once more to summarize for you:

1. At some point, everyone in medical school is or feels average. Which, to be fair, is likely true because everyone who gets in to medical school is so far above average that compared to each other, it's tough to stand out and feel like a rockstar. You are also learning a vast amount of information thats completely unfamiliar so it will take time to adjust and become comfortable with your clerkship responsibilities. This is OKAY.

2. It does NOT matter if you are above, below, or average academically to match to any specialty. As to the point of your original post, the "average" medical student (25-75 percentile) will likely end up wherever they want. The distribution of how people perform academically is spread across all specialties and even FRCPC do not have a higher rate of "above average"medical students with respect to performance in clerkship (as long as you define average from a knowledge and grades perspective). You get 1-99 percentile in ALL specialties. There just happens to be more family medicine positions which make it a logical back-up choice for ALL applicants.

3. What is important for matching is attitude, work-ethic, networking, program fit, and honesty/integrity. Having reviewed CaRMS applications, its impossible to distinguish academically between candidates, but it is possible based on statements, interviews, and reference letters to see who I can see myself supervising and working with on a day-to-day basis. Any medical student, good or poor knowledge can have these qualities. Anyone can be taught the rest.

4. Whether you hustle and gun for a certain FRCPC or take the "easy route" with FM is a decision only you can make. You have to decide just how bad you want something and if you want to do it for the rest of your life, how much work is that worth for you.

I don't think you were ever trying to speak poorly of FM, but be careful of the way you word things because when you throw out words like average and intelligence, it can come off as arrogant and naive. From a non FM resident, it is important to always be respectful of our FM (and all) colleagues. Like anything there is a range of performance in each specialty.

Link to comment
Share on other sites

On 12/14/2021 at 12:31 AM, offmychestplease said:

this...there are no grades/class rank/standardized exams for residency/etc in Canada and matching into "ultra competitve fields" has everything to do with the connections you build up, networking, reference letters, showing interest, research, and luck. None of these things are about how "smart" someone is and could ironically be gamed by someone who is not academically strong but but willing to hustle in these other areas. It's such a shame that people make posts like this in the OP as it is a disrespect to the literal hundreds and hundreds of people like go into FM by choice, many of whom only applied to FM as well... (overall 45% of CMG's enter FM every year).

PS - I think it's funny when people bring up examples of people who go into FM as a second choice like they are settling but fail to bring up the many examples of people who get into their second choice FRCPC field and not their first choice FRCPC field (ie IM and not surgery, or gen surg and not plastics etc). I guess to some people it's only settling if the second choice field you end up in is FM...sad. If someone has no intention to do FM, don't apply/rank it. 

This is true about the super competitive specialities. I think everybody applying to them realizes it at some point. :P

Link to comment
Share on other sites

I'd say a lot of people end up in FM only because:

1) school admins want to show a high match rate, so their incentive is to make you rank more programs so you match something somewhere. Once you match and they give your MD degree they wash their hands clean. Which means there are people in lesser competitive specialties who shouldn't be there. So be wary of their incentives when taking in their advice.

2) the system is terribly set up such that people who need time to decide on their future or may need a few more years to become competitive at something are robbed of that opportunity. I would've loved to do derm and if you tell me I could spend 2-3 more years of rotating internship or house officer to become competitive I would've likely taken that opportunity. But obviously our system doesn't work that way.

3) the licensing system is a failure and operates in a cartel like manner. People who have MD but not residency cannot even function as physician assistants. That means all your bets must be placed correctly during medical school, hence people probably over hedge. I read before that in Missouri, people with MD but no residency are allowed to function as physician assistants and are regulated. That allows them to gain experience and connection for future residency positions. I would applaud a system like that. 

Link to comment
Share on other sites

20 minutes ago, shikimate said:

1) school admins want to show a high match rate, so their incentive is to make you rank more programs so you match something somewhere. Once you match and they give your MD degree they wash their hands clean. Which means there are people in lesser competitive specialties who shouldn't be there. So be wary of their incentives when taking in their advice.

That is why more schools (like Ottawa and schools in the US) should publish their match results by specialty instead of a pure match rate from CaRMS. Speaking in hyperboles, having a 100% match rate to family is not impressive but having a lower match rate but consistently sending students into the top specialties (Derm, Ophtho, Plastics, Emerg, etc) is impressive. 

Link to comment
Share on other sites

1 hour ago, CaRMS2021 said:

That is why more schools (like Ottawa and schools in the US) should publish their match results by specialty instead of a pure match rate from CaRMS. Speaking in hyperboles, having a 100% match rate to family is not impressive but having a lower match rate but consistently sending students into the top specialties (Derm, Ophtho, Plastics, Emerg, etc) is impressive. 

I agree, schools are very reluctant to publish these stats, but are very quick to brag about high match rates, and at my school are even quicker to tell people not to consider anything competitive. The fact of the matter is that I truely think it just depends on the cohort of students, the school can't help you be Uber competitive unless they literally give the spots to their students. 

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
×
×
  • Create New...