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Visiting Electives Cancelled for Class of 2023


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We just heard from our class reps that the committee of medical school deans has voted to cancel visiting electives for the Class of 2023. AFMC will be posting a formal news release in the coming days. What are everyone's thoughts about this? Personally, I think its quite understandable given the high covid cases and the strain on the healthcare system. I also think it makes elective planning easier given the need to apply only through your home school. 

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Well there go my plans to get a 2br apt in residency and rent out a bedroom to med students on visiting electives to cover my rent :p

c2023s: as a c2022, I know exactly how terrible this feels, especially if you were hoping to match outside your university. If it's reassuring at all, you'll be the second-and-a-half class that's gone through this (and unlike my class, you don't have the situation where you paid the $200 to register for the AFMC portal in anticipation of summer electives before covid became a thing, and the AFMC decided they won't refund the money, which is straight-up theft imo but who am I to say anything). Furthermore, everyone else in the class of 2023 is going through this as well, so you'll be on equal footing for residency applications. Although it feels like this hurts your chances of matching out of your school, the fact of the matter is that not everyone will rank their home program #1, so there will by necessity be inter-university movement, and, for my university at least, there was no significant difference in in-school vs out-of-school match rates. Finally, this helps those of you who are undecided, since there's less pressure to go for 8 full weeks in the specialty you decide you like, because not everyone can get multiple electives at their home school - it's easier to sell indecision on interviews as "I couldn't get more than 4 weeks". I've done some really cool electives which I wouldn't've been able to do if visiting electives were a thing, and I've saved a ton of money. All in all, I'm pretty happy with how fourth year ended up going.

I think. Ask me again how I feel on April 12 at noon.

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Isn't it a bit premature to be making this decision right now? We're 8 months away from September when most 4 year schools have the bulk of their electives. Just because the situation is dire in some provinces right now, it doesn't necessarily mean that things will remain the same 8 months from now. Of course, the medical schools and the AFMC will take the easy decision by canceling away electives. They could have given people the option of arranging both home and away electives, while telling them they're not set in stone and they'll see how things are a few months from now.

I find this bizarre as the decision was initially made to stop the spread. But we're at 29.4 percent of tests being positive nationally, that ship has long ago sailed. Triple vaxxed Medical Students can't do away electives but yesterday at Pearson there were 14 arrivals from Montreal, 11 from Vancouver, 14 from NYC, 10 from London UK, and 6 from Cancun. But god forbid if a triple vaxxed UBC student does and elective at Ottawa.

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19 hours ago, zoxy said:

Isn't it a bit premature to be making this decision right now? We're 8 months away from September when most 4 year schools have the bulk of their electives. Just because the situation is dire in some provinces right now, it doesn't necessarily mean that things will remain the same 8 months from now. Of course, the medical schools and the AFMC will take the easy decision by canceling away electives. They could have given people the option of arranging both home and away electives, while telling them they're not set in stone and they'll see how things are a few months from now.

I find this bizarre as the decision was initially made to stop the spread. But we're at 29.4 percent of tests being positive nationally, that ship has long ago sailed. Triple vaxxed Medical Students can't do away electives but yesterday at Pearson there were 14 arrivals from Montreal, 11 from Vancouver, 14 from NYC, 10 from London, and 6 from Cancun. But god forbid if a triple vaxxed UBC student does and elective at Ottawa.

sadly its the 3 year schools dragging us down. Deans want to be fair apparently

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19 hours ago, zoxy said:

Isn't it a bit premature to be making this decision right now? We're 8 months away from September when most 4 year schools have the bulk of their electives. Just because the situation is dire in some provinces right now, it doesn't necessarily mean that things will remain the same 8 months from now. Of course, the medical schools and the AFMC will take the easy decision by canceling away electives. They could have given people the option of arranging both home and away electives, while telling them they're not set in stone and they'll see how things are a few months from now.

I find this bizarre as the decision was initially made to stop the spread. But we're at 29.4 percent of tests being positive nationally, that ship has long ago sailed. Triple vaxxed Medical Students can't do away electives but yesterday at Pearson there were 14 arrivals from Montreal, 11 from Vancouver, 14 from NYC, 10 from London, and 6 from Cancun. But god forbid if a triple vaxxed UBC student does and elective at Ottawa.

COVID was a convenient excuse. They wanted these elective gone for a long time now.

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22 hours ago, zoxy said:

Isn't it a bit premature to be making this decision right now? We're 8 months away from September when most 4 year schools have the bulk of their electives. Just because the situation is dire in some provinces right now, it doesn't necessarily mean that things will remain the same 8 months from now. Of course, the medical schools and the AFMC will take the easy decision by canceling away electives. They could have given people the option of arranging both home and away electives, while telling them they're not set in stone and they'll see how things are a few months from now.

Administrators will always take the easy way out. Golden rule of medical school, and residency. Always get on their good side, so they make exceptions for you and do an ounce of work for you etc.

This is extremely premature. Could it be an issue in September? For sure! Do we know with any level of certainty right now? Not at all. Medical students are adults(mostly), let them decide if they want to take the risks of scheduling etc.

Doing away electives was a nice touch when i was a medical student, and let me realize how things are very different in some provinces(and a self-confidence boost from deep in the ruts when staff would comment on how different I was from their local home students :P).  I obviously went into FM where away electives werent necessary at all, but I can see how they would definitely be very helpful for other fields.

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3 hours ago, Pakoon said:

COVID was a convenient excuse. They wanted these elective gone for a long time now.

If that's the case do you think they'll cancel them for the class of 2024 or even 2025?

I find it very ironic that even with the high case loads in the US, they still allow away electives. Even though their residency directors have Step scores, class rank, AOA, and even sometimes grades to pick between students. We have no grades, no standardized exams, and now no away electives. It's like Canadians schools are trying to make CARMs even more arbitrary than what it already is. Congrats if that's their goal.

3 hours ago, QueenStan said:

sadly its the 3 year schools dragging us down.

Don't three year schools still have electives in September? It's only their pre-clerkship electives that would be currently impacted.

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22 minutes ago, zoxy said:

If that's the case do you think they'll cancel them for the class of 2024 or even 2025?

I find it very ironic that even with the high case loads in the US, they still allow away electives. Even though their residency directors have Step scores, class rank, AOA, and even sometimes grades to pick between students. We have no grades, no standardized exams, and now no away electives. It's like Canadians schools are trying to make CARMs even more arbitrary than what it already is. Congrats if that's their goal.

Don't three year schools still have electives in September? It's only their pre-clerkship electives that would be currently impacted.

No some students in McMaster start on electives in their first block. I imagine Calgary is the same. Also preclerkship electives? There's no such thing, unless you mean observerships?

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6 minutes ago, dragoncat said:

Why is this? I thought most residency programs preferred this as it helps them assess the candidates better.

Yea they're talking out their ass lol every single PD I've spoken to has said that they hate not having electives because it makes the process even more subjective/variable. 

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24 minutes ago, QueenStan said:

No some students in McMaster start on electives in their first block.

That's what I meant by pre-clerkship electives. The electives they take before core rotations. I didn't know what to call them as I'm not at a three year school. I guess pre-core would have been a better term since it's technically part of clerkship.

For someone at Mac what percentage of electives would be now vs in September? I know it's variable because folks are in different streams but I'm wondering about the average student.

 

24 minutes ago, dragoncat said:

Why is this? I thought most residency programs preferred this as it helps them assess the candidates better.

17 minutes ago, QueenStan said:

Yea they're talking out their ass

I think what they meant was that administrators don't like it because it creates extra work for them, not program directors. Administrators and residency directors don't share the same incentives and so that's why the administrators want to cancel them but residency program directors do not.

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10 minutes ago, zoxy said:

That's what I meant by pre-clerkship electives. The electives they take before core rotations. I didn't know what to call them as I'm not at a three year school. I guess pre-core would have been a better term since it's technically part of clerkship.

For someone at Mac what percentage of electives would be now vs in September? I know it's variable because folks are in different streams but I'm wondering about the average student.

 

33 minutes ago, QueenStan said:

No some students in McMaster start on electives in their first block. I imagine Calgary is the same. Also preclerkship electives? There's no such thing, unless you mean observerships?

No so at Mac we do summer electives several months before we end pre-clerkship. They are not "observerships" they are normal electives, but we still have more pre-clerkship content to cover after the summer electives. Then we start clerkship officially in November. Our clerkship is intermixed with electives, and for most students our clerkship electives start before we even have core rotations.

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1 hour ago, zoxy said:

I think what they meant was that administrators don't like it because it creates extra work for them, not program directors. Administrators and residency directors don't share the same incentives and so that's why the administrators want to cancel them but residency program directors do not.

Electives are such a money grab. Some cost as much as $200 per elective. And that doesn't even guarantee you a spot! Imagine how much money an IM program rakes in cash each application cycle. Let's look only at the matched applicants. 459 matched out of 891 (total) with an average of 4 electives in IM core (CTU) at $100 per application. That's $183,600 just for matched applicants who completed an elective (different than applied for one!). That doesn't even include people who did electives but didn't match, were paralleling, were curious, etc. Zooming out to all applicants (2943) doing minimum 8 electives each year, that's $2,354,400 generated each year at a minimum by applicants. The average applicant definitely applies to more than 8 electives so we could conceivably double or even triple this number but I don't have data on it. All this money and it only requires admin to randomize people on a spreadsheet, send a pre-made orientation email, and answer one or two follow-ups. And don't even get me started on the $200 AMFC portal fee that students are obligated to pay each year or not be able to complete a mandatory part of training.

So no, I don't think the admin are happy they're losing their cash cow. 

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29 minutes ago, QueenStan said:

Electives are such a money grab. Some cost as much as $200 per elective. And that doesn't even guarantee you a spot! Imagine how much money an IM program rakes in cash each application cycle. Let's look only at the matched applicants. 459 matched out of 891 (total) with an average of 4 electives in IM core (CTU) at $100 per application. That's $183,600 just for matched applicants who completed an elective (different than applied for one!).

Unless things have changed, its the AFMC which operates as its own entity that takes all this money - AFAIK local programs don't really see this money in the same way that you and I would think.

Its a bit of a muddy picture that is unclear to me still, but its been more than a few years since i was at that stage. An utter financial cash grab for sure!

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1 hour ago, QueenStan said:

Yea they're talking out their ass lol every single PD I've spoken to has said that they hate not having electives because it makes the process even more subjective/variable. 

And yet the deans voted on not having them, funny how that works right?

Last time I checked the PDs are not the ones calling the shot on this. It is more work for administrators. They were already priming us on the idea of no away electives when COVID was at it's lowest. The excuse they went with this time is that the elective portal was not up and running, before that it was the carbon footprint would be too much and even before that it was just COVID. 

Just because this information is new to you doesn't mean it's "out of my ass". Plenty of people want traveling electives, but the people who decide whether we get them or not didn't. If they did want us to have away electives, we would have them plain and simple.

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1 hour ago, Pakoon said:

And yet the deans voted on not having them, funny how that works right?

Last time I checked the PDs are not the ones calling the shot on this. It is more work for administrators.

Unfortuantely, generally Deans are more so admins themselves as well. 

The majority of decisions are made by people who don't actually have much of a clue of how things really work on the ground, and decide based on their own vested interest. Most admins want the least amount of work possible, while still doing a good enough job at what they do actually do to maintain their excellent job security. I don't blame them, its a great system for them - work an efficient number of hours, have a decent salary through a university with pension, and immense job security (very very difficult to fire admins in university settings outside of gross negligence, or if they are being too flagrent).   

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On 1/6/2022 at 1:02 PM, insomnias said:

Well there go my plans to get a 2br apt in residency and rent out a bedroom to med students on visiting electives to cover my rent :p

c2023s: as a c2022, I know exactly how terrible this feels, especially if you were hoping to match outside your university. If it's reassuring at all, you'll be the second-and-a-half class that's gone through this (and unlike my class, you don't have the situation where you paid the $200 to register for the AFMC portal in anticipation of summer electives before covid became a thing, and the AFMC decided they won't refund the money, which is straight-up theft imo but who am I to say anything). Furthermore, everyone else in the class of 2023 is going through this as well, so you'll be on equal footing for residency applications. Although it feels like this hurts your chances of matching out of your school, the fact of the matter is that not everyone will rank their home program #1, so there will by necessity be inter-university movement, and, for my university at least, there was no significant difference in in-school vs out-of-school match rates. Finally, this helps those of you who are undecided, since there's less pressure to go for 8 full weeks in the specialty you decide you like, because not everyone can get multiple electives at their home school - it's easier to sell indecision on interviews as "I couldn't get more than 4 weeks". I've done some really cool electives which I wouldn't've been able to do if visiting electives were a thing, and I've saved a ton of money. All in all, I'm pretty happy with how fourth year ended up going.

I think. Ask me again how I feel on April 12 at noon.

you should do visa charge back for services not offered for those AFMC fees (not kidding) :P 

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3 hours ago, Pakoon said:

And yet the deans voted on not having them, funny how that works right?

Last time I checked the PDs are not the ones calling the shot on this. It is more work for administrators. They were already priming us on the idea of no away electives when COVID was at it's lowest. The excuse they went with this time is that the elective portal was not up and running, before that it was the carbon footprint would be too much and even before that it was just COVID. 

Just because this information is new to you doesn't mean it's "out of my ass". Plenty of people want traveling electives, but the people who decide whether we get them or not didn't. If they did want us to have away electives, we would have them plain and simple.

Deans voted no because of COVID risks and it was a split vote not unanimous from what we've been told. I'm sure you can appreciate the COVID risk of having thousands of students traveling between hospitals. It isn't as "plain and simple" as you make it out to be. If you're a 2023 I understand why you're mad, but people want electives to happen. This isn't some conspiracy.

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Honestly, as a 2021 it will feel like the sky is falling and your plans are all screwed up (because they kind of are) but there are some positives to this:

1. you will save a ton of money
2. programs will have to be lenient on the lack of certain electives given limitations on opportunity
3. this is more equitable for students of lower SES, IMO. I never knew that doing out of pocket electives around the country was even a thing prior to entering medical school and dreaded it given how much it would cost. I feel this puts a ton of people at a disadvantage who cannot commit to random electives for 2 weeks all around the place.
4. Carms is a black box regardless. One can do everything right/to their plan and still go unmatched.

Honestly, it won't be that big of a deal. You will match, things will be fine. Deep breath, chill out.

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1 hour ago, dooogs said:

you should do visa charge back for services not offered for those AFMC fees (not kidding) :P 

 

1 hour ago, JohnGrisham said:

I'm unsurprised AFMC didn't give the 200$ back. I too would visa chargeback them if it was me.

I considered it, but the deadline on a chargeback is 45-120 days from the date of purchase (most of us purchased in December 2019, covid struck in March 2020, there were months of uncertainty until we finally knew for certain in like mid-2021 that they wouldn't happen)

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4 hours ago, JohnGrisham said:

Unfortuantely, generally Deans are more so admins themselves as well. 

The majority of decisions are made by people who don't actually have much of a clue of how things really work on the ground, and decide based on their own vested interest. Most admins want the least amount of work possible, while still doing a good enough job at what they do actually do to maintain their excellent job security. I don't blame them, its a great system for them - work an efficient number of hours, have a decent salary through a university with pension, and immense job security (very very difficult to fire admins in university settings outside of gross negligence, or if they are being too flagrent).   

Exactly this. Admin doesn't want it 

 

3 hours ago, QueenStan said:

Deans voted no because of COVID risks and it was a split vote not unanimous from what we've been told. I'm sure you can appreciate the COVID risk of having thousands of students traveling between hospitals. It isn't as "plain and simple" as you make it out to be. If you're a 2023 I understand why you're mad, but people want electives to happen. This isn't some conspiracy.

No conspiracy, they (Admin) have been trying to phase them out for a while. 2023 interviews were changed to an online format back when COVID was at a low. I personally don't mind at all (saw this coming a long time ago), I have been telling people since the early 2020 that we won't be having our electives. My advice to the 2024s is to also plan for that as well. Of course not is guaranteed, but i would put my bets on them cancelling them for good. They will have 3 years worth of data (assuming this year is no different)  supporting that the electives (generally) make no difference in the match. im sure plenty of people want them to happen, but that really doesn't mean anything.

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4 minutes ago, Pakoon said:

electives (generally) make no difference in the match

Because CARMs is pretty arbitrary anyway. It's a joke of a system that we have.

Schools take away objective methods of evaluation, which isn't a problem with the match initially because there are a lot of spots per students-> They then simultaneously increase medical school spots while decreasing residency spots, especially for competitive specialties and surgery.-> The match becomes tight and people lean heavily on a two week audition but that's not enough for good evaluation so process becomes arbitrary->Then schools cancel electives because "data shows that electives are ineffective."

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