Unmatched Programs 2022

[Redpill]

1 minute ago, quibble said:

It was such an unnecessary test. In the current situation where family medicine is becoming less and less attractive, I fail to understand why every institution in the pathway is erecting barriers to apply.

Sure, I agree. Useless test. But 6 universities used it, so I imagine anyone interested in FM would have done the test. Would people have just ranked those 6 institutions lower out of spite, otherwise I can't see how it affected their final rank list?

[quibble]

4 minutes ago, Redpill said:

Sure, I agree. Useless test. But 6 universities used it, so I imagine anyone interested in FM would have done the test. Would people have just ranked those 6 institutions lower out of spite, otherwise I can't see how it affected their final rank list?

I don't think FM-PROC impacted the applicant choice of location. I know people who were bummed out to get a lower than desired score on the FM-PROC, but it didn't ultimately alter their ranking decisions. 

[NewClerk]

10 hours ago, insomnias said:

As an applicant who interviewed at AB, two things probably affected this: the FM-PRoC, and the interview itself. I found the urban interview to be bizarre (I won't elaborate further for obvious reasons), and I have friends who shared that view. Those of us who ranked AB high did so because of location. If we didn't want to be in Edmonton, it would've been ranked much lower. Applicants from other schools probably didn't want to be in Edmonton as strongly, and so the interview brought the program lower down.

Can confirm that the interview was strange, and definitely made me rank the site a lot lower as an out of province applicant.

[carmsinoid]

On 4/12/2022 at 1:29 PM, Redpill said:

I was wondering if it was based on recent government policies.

Anecdotally as someone who went through CaRMS this year, myself and a number of classmates (Ontario school) were all very turned off by doing residency in Alberta because of how their government just seems to treat their doctors like s***. We ended up still ranking them because residency in Alberta is better than being unmatched for us, but they definitely ended up at the very bottom or pretty close to it on our list. There is literally no good reason we could come up with to move to Alberta for an average program if we had no personal ties to Edmonton, the whole physician-government relationship seems awful, and the residency contract is one of the less desirable ones across the country.

2 hours ago, quibble said:

(2) The CFPC wanting to make FM a 3-year residency. The 3-year residency is going to be the last nail in the coffin. People might as well do IM at that point.

I think all institutions have a role to play in the current situation. FM is dying by a thousand cuts. 

IM was really competitive this year, and I think last year as well - I know a lot of people in my class applying for IM ended up backing up with FM (fortunately almost all of them matched to IM). I applied (and thankfully matched) to a surgical specialty and didn't backup with FM because honestly, I just could not see myself being a family doctor and just feel like I would be absolutely miserable. I personally was ready to walk away from clinical medicine entirely than do FM. Also anecdotally, I know a number of other applicants who applied with me felt the same way about this.

[indefatigable]

10 hours ago, carmsinoid said:

IM was really competitive this year, and I think last year as well - I know a lot of people in my class applying for IM ended up backing up with FM (fortunately almost all of them matched to IM). I applied (and thankfully matched) to a surgical specialty and didn't backup with FM because honestly, I just could not see myself being a family doctor and just feel like I would be absolutely miserable. I personally was ready to walk away from clinical medicine entirely than do FM. Also anecdotally, I know a number of other applicants who applied with me felt the same way about this.

Walking away from clinical medicine is a luxury that many CMGs can’t afford.  Outside of QC, debt loads are very high and unless one is independently wealthy, there’s not a lot of other careers that offer comparable renumeration necessary to pay back debt after medical training (lines of credit can only rarely discharged - ie bankruptcy is not an option).
 

 Still, I think at least on this forum, it  seems that FM is increasingly filling due to its relatively large quota rather than med student interest. There’s a lot of hostility now towards FM.  I expect the three year training will exacerbate this trend and wonder what things will be like in 10 years with all the other changes like NPs… 

[Redpill]

45 minutes ago, indefatigable said:

Walking away from clinical medicine is a luxury that many CMGs can’t afford.  Outside of QC, debt loads are very high and unless one is independently wealthy, there’s not a lot of other careers that offer comparable renumeration necessary to pay back debt after medical training (lines of credit can only rarely discharged - ie bankruptcy is not an option).
 

 Still, I think at least on this forum, it  seems that FM is increasingly filling due to its large quota rather than med student interest. There’s a lot of hostility now towards FM.  I expect the three year training will exacerbate this trend and wonder what things will be like in 10 years with all the other changes like NPs… 

Certainly traditional outpatient family practice clinic is a disaster right now. I imagine +1s in EM or other disciplines will become more competitive, and any inpatient opportunities will be taken up quickly.

[8rue]

4 hours ago, quibble said:

For the past two years (since the elective cap has been imposed), the # of applications that IM programs have received are double what they used to be.

Unsurprising to hear that IM has become more competitive with recent changes, but double the number of applications is shocking to hear. Where did you find that data? From looking at Table 9 on the CaRMS data reports, total # of applicants to IM has been relatively stable in the past few years regardless of the electives cap (always in the 800-900 range). Perhaps each applicant is applying more broadly now since interviews have gone virtual? Curious to hear what tables you were looking at.

[zoxy]

Interesting how in Ontario there are still a ton of IMG IM spots. Historically that wasn't really an issue because IM didn't fill in the first iteration. Now you have a situation where CMGs aren't matching to IM as their first choice but Western takes 8 IMGs vs 25 CMGs, Queens takes 4 vs 15, and Ottawa takes 6 vs 23. If IM is getting this competitive, there shouldn't really be a reason for the IMG quota to be 25 percent of the CMG quota in Ontario.  A 1 to 4 ratio seems excessive for a competitive specialty.

[quibble]

16 minutes ago, zoxy said:

Interesting how in Ontario there are still a ton of IMG IM spots. Historically that wasn't really an issue because IM didn't fill in the first iteration. Now you have a situation where CMGs aren't matching to IM as their first choice but Western takes 8 IMGs vs 25 CMGs, Queens takes 4 vs 15, and Ottawa takes 6 vs 23. If IM is getting this competitive, there shouldn't really be a reason for the IMG quota to be 25 percent of the CMG quota in Ontario.  A 1 to 4 ratio seems excessive for a competitive specialty.

Nationally, IMG holds about 16% of total IM spots (52/316). I excluded Quebec's spots. 

[quibble]

One possible solution for the unmatched CMG situation really is to move IMG spots in the 1st iteration to CMG for those specialties where supply < demand (i.e., position:applicant ratio < 1). And have CMG spots moved to IMG for those specialties where supply > demand (i.e., position:applicant ratio > 1). This will probably need to be done on a seat-for-seat basis. 

For example: 6 spots in General Path can be converted from CMG to IMG, while reclaiming the following IMG spots: 1 ENT, 2 Derm, 2 Ophtho, 1 EM. 

I am using the stats from the 2021 CaRMS forum on supply and demand.

 

 

 

[carmsinoid]

20 minutes ago, quibble said:

One possible solution for the unmatched CMG situation really is to move IMG spots in the 1st iteration to CMG for those specialties where supply < demand (i.e., position:applicant ratio < 1). And have CMG spots moved to IMG for those specialties where supply > demand (i.e., position:applicant ratio > 1). This will probably need to be done on a seat-for-seat basis. 

For example: 6 spots in General Path can be converted from CMG to IMG, while reclaiming the following IMG spots: 1 ENT, 2 Derm, 2 Ophtho, 1 EM. 

I am using the stats from the 2021 CaRMS forum on supply and demand.

I thought the whole idea of the quotas in the first place was to base it loosely on population demand? Moving spots from one specialty to another to fix the CMG and IMG situation would defeat the whole purpose, and just creates a bottleneck later down the road, similar to how limiting Canadian med school spots has made people go elsewhere. Personally would rather have to cut my losses earlier on than finish residency in a specialty I want only to realize there are no job prospects.

Edit: I think I misread your example. It is way too late. Time for bed.

[Redpill]

1 hour ago, quibble said:

One possible solution for the unmatched CMG situation really is to move IMG spots in the 1st iteration to CMG for those specialties where supply < demand (i.e., position:applicant ratio < 1). And have CMG spots moved to IMG for those specialties where supply > demand (i.e., position:applicant ratio > 1). This will probably need to be done on a seat-for-seat basis. 

For example: 6 spots in General Path can be converted from CMG to IMG, while reclaiming the following IMG spots: 1 ENT, 2 Derm, 2 Ophtho, 1 EM. 

I am using the stats from the 2021 CaRMS forum on supply and demand.

 

 

 

Can't do that as many of those IMG spots have ROS attached. Unless you wanted to make CMG ROS also? That would set a dangerous precedent but I suppose there already are some spots like that now.

It's the same problem in BC, they have ~50 IMG family spots, and fill all ~120 CMG spots every year (this year being the first time they didn't fully fill in 10 years). But those 50 spots are ROS, which is why they will likely remain IMG.

[quibble]

.

[Findanus]

12 hours ago, zoxy said:

Interesting how in Ontario there are still a ton of IMG IM spots. Historically that wasn't really an issue because IM didn't fill in the first iteration. Now you have a situation where CMGs aren't matching to IM as their first choice but Western takes 8 IMGs vs 25 CMGs, Queens takes 4 vs 15, and Ottawa takes 6 vs 23. If IM is getting this competitive, there shouldn't really be a reason for the IMG quota to be 25 percent of the CMG quota in Ontario.  A 1 to 4 ratio seems excessive for a competitive specialty.

The parents of so-called CSAs have a lot of power.

[indefatigable]

On 4/14/2022 at 12:54 AM, zoxy said:

Interesting how in Ontario there are still a ton of IMG IM spots. Historically that wasn't really an issue because IM didn't fill in the first iteration. Now you have a situation where CMGs aren't matching to IM as their first choice but Western takes 8 IMGs vs 25 CMGs, Queens takes 4 vs 15, and Ottawa takes 6 vs 23. If IM is getting this competitive, there shouldn't really be a reason for the IMG quota to be 25 percent of the CMG quota in Ontario.  A 1 to 4 ratio seems excessive for a competitive specialty.

The med school admissions process is far from perfect.  And there are some strong immigrant IMG physicians who move to Canada as well as very competent Canadian-born IMGs.  But, I agree that there is a question of what should be the right balance of CMG and IMG positions especially for more competitive disciplines or programs?  From what I understand in Ontario, the ROS is almost meaningless only restricting practice from downtown TO and Ottawa.  

The AFMC and medical schools have been working hard to improve access to medicine.  But, the IMG pathway can sometimes exacerbate existing socioeconomic inequities since access to the pathway is limited for many pre-meds.  The IMG pathway has increasingly become a de facto route for some Canadian-born (vs immigrant) IMGs to sometimes obtain very highly sought residency training in Canada.  But then, from a social accountability standpoint does it make sense to preserve as many competitive positions to be exclusively IMG?  

I personally think converting competitive disciplines at programs that have both IMG & CMG spots to the Quebec "regular stream" (or "competitive stream" outside of QC) which allows IMG access does make sense in these cases.  This could be seen as a victory for CSA lobby since they would now have access to the CMG positions at those program etc.., but my belief is there is no shortage of competitive CMGs that PDs would rank highly and ahead of most IMGs (except for potential worsening nepotism which has been a known issue in the IMG pathway).  In exchange, there would be no more reserved IMG spots for these disciplines.  In Quebec, I don't believe IMGs often match to more competitive disciplines - this is also like the US.  My informal survey of some competitive programs has not shown that the matched IMGs appears any more competitive than matched CMGs.  I think in the balance there would be greater CMG matching, yet lets PDs select the most qualified applicants without regard to training.

For FM I'm not sure if the CMG vs IMG separation helps or hurts CMGs (outside of BC) - so I don't know if converting the positions to "Regular Stream" or "Competitive stream" would help the overall CMG matching situation.  Based on previous second round data, I think that it may hurt.

[shikimate]

I want to see if anyone here will be applying to Dal general pathology in 2nd round. It's too bad it has 3 unfilled spots because it doesn't get as much exposure. It's really a hidden gem. I am not affiliated with that program but in case someone is seriously considering it, I want to point out a few things:

- it's a very desirable specialty, jobs are plenty. we actually tried to recruit some of their recent grads but they got recruited to other places. When we are hiring, Dal GP is one of the first place we check. You DO NOT need a fellowship after general pathology to find a job. We offered starting remunerations of >375K.

- it's a good mix of medicine, oncology and surgical pathology. Anatomical pathology is too histology focused but general pathology gives you good exposure to hematology and clinical biochemistry which is the backbone of internal medicine and pediatrics.

- I do not live in Halifax, but my colleagues who have lived there notes many positive things about the city including relatively cheap cost of living, proximity to nature, and safe city with less crime.

- what kind of applicants would be good fit? some good skills would be visual pattern recognition (similar to derm, rad), interest in heme/onc (similar to med onc, rad onc), complex problem solving (similar to IM, peds). Some manual dexterity skills would be nice for forensics and grossing. Good communication and writing would be important as you'll be completing many reports.

[acacna]

1 hour ago, shikimate said:

I want to see if anyone here will be applying to Dal general pathology in 2nd round. It's too bad it has 3 unfilled spots because it doesn't get as much exposure. It's really a hidden gem. I am not affiliated with that program but in case someone is seriously considering it, I want to point out a few things:

- it's a very desirable specialty, jobs are plenty. we actually tried to recruit some of their recent grads but they got recruited to other places. When we are hiring, Dal GP is one of the first place we check. You DO NOT need a fellowship after general pathology to find a job. We offered starting remunerations of >375K.

- it's a good mix of medicine, oncology and surgical pathology. Anatomical pathology is too histology focused but general pathology gives you good exposure to hematology and clinical biochemistry which is the backbone of internal medicine and pediatrics.

- I do not live in Halifax, but my colleagues who have lived there notes many positive things about the city including relatively cheap cost of living, proximity to nature, and safe city with less crime.

- what kind of applicants would be good fit? some good skills would be visual pattern recognition (similar to derm, rad), interest in heme/onc (similar to med onc, rad onc), complex problem solving (similar to IM, peds). Some manual dexterity skills would be nice for forensics and grossing. Good communication and writing would be important as you'll be completing many reports.

Could I send you a PM? very interested to apply to general path next year.  

[Med2000]

Anyone have any info on Peds at MUN? Curious how so many unmatched seats and if its just a luck of the CaRMS draw type situation or if something program-specific that caused it (outside of the usual less desirable location compare to a Toronto or Van) 

[IAUDX]

42 minutes ago, Med2000 said:

Anyone have any info on Peds at MUN? Curious how so many unmatched seats and if its just a luck of the CaRMS draw type situation or if something program-specific that caused it (outside of the usual less desirable location compare to a Toronto or Van) 

Didn't apply to peds, but was told by friends the program was under review - not sure if correct? Friends who interviewed there really liked it though!

[Nowa]

Anyone know anything about the MUN unmatched obs spot ?

[Edict]

On 4/14/2022 at 1:21 AM, quibble said:

One possible solution for the unmatched CMG situation really is to move IMG spots in the 1st iteration to CMG for those specialties where supply < demand (i.e., position:applicant ratio < 1). And have CMG spots moved to IMG for those specialties where supply > demand (i.e., position:applicant ratio > 1). This will probably need to be done on a seat-for-seat basis. 

For example: 6 spots in General Path can be converted from CMG to IMG, while reclaiming the following IMG spots: 1 ENT, 2 Derm, 2 Ophtho, 1 EM. 

I am using the stats from the 2021 CaRMS forum on supply and demand.

 

 

 

This can't be done because there really is no rationale other than to benefit CMGs. In fact, it would upset a lot of stakeholders, imagine if just because your specialty has more supply than demand that now you are suddenly forced to take IMGs? What about the CMGs that want those specialties? Naturally, programs will just reduce the number of spots, ultimately harming everyone. 

That's not to mention you have no basis for doing such a thing, you can't argue you are helping the public or anything, and IMGs will complain that this is blatant discrimination, which it quite clearly is. 

[divalprohex]

Realistically, what are the odds of a current 5-year CMG matching to FM? Does anyone have insights they can share?

[frenchpress]

59 minutes ago, divalprohex said:

Realistically, what are the odds of a current 5-year CMG matching to FM? Does anyone have insights they can share?

Absolutely doable, although program dependent I am sure - I know several people who did. Cant say what the odds are though because I have no idea how many apply. 

[divalprohex]

Thanks for offering a small morsel of hope! I applied (what feels like) fairly broadly, but you just never know. Never thought I'd have to do CaRMS again . . .  too much fun. 

[McMasterMD]

1 hour ago, divalprohex said:

Realistically, what are the odds of a current 5-year CMG matching to FM? Does anyone have insights they can share?

Hey my dude/dudette, yes, it’s 100% possible. I’ve heard of many surgical residents who switched to fam and never looked back