Internal MSM match

[Joe_]

Hello,

I will be starting my first year of residency in IM this summer and I had a few questions regarding the MSM match. 

1. How to set yourself up to be competitive in the 3rd year MSM match?

2. What is expected of IM residents? How can I be an excellent resident or how to impress attendings?

3. What are important factors during the MSM match (LOR, electives, evals, CV, research?) Are medical transcripts (first-second year grades) or MSRP from medical school taken into account? 

4. Any resources/tips recommendation to start strong this coming july?

Thank you

[ameltingbanana]

1. Similar to CaRMS round 1 but with very variable levels of competition purely depending on who wants what subspecialty. All it takes is a few extra people wanting to do a small subspecialty for there to be more applicants than spots. Get exposure early on and narrow things down so you can plan your electives out well for second year. First thing to narrow down I would say is: inpatient, outpatient, or both?

2. Show up, work hard, show initiative, be safe, take on responsibility. 

3. All very important. In order of importance from what I understand: electives, LOR, evals, CV/research, with some changes depending on the school or instutition. I don't think medical transcripts factor in really

4. No specific resources. Ensure you make time for stuff outside of medicine. R1 year is draining and overwhelming because it feels like a lot of responsibility after a decent amount of time off from medicine (summer between med school and residency)

Current PGY5 here.

[Xbox Skully]

Are usmd pgy 3 allowed to apply to carms for the subspecialty? How do the streams work and do most Canadians apply in year 3 or year 4? 

[bearded frog]

On 5/25/2022 at 2:15 PM, Xbox Skully said:

Are usmd pgy 3 allowed to apply to carms for the subspecialty? How do the streams work and do most Canadians apply in year 3 or year 4? 

Requirements vary by province. For instance, Ontario will accept applicants from an ACGME accredited Internal Medicine program, compared to BC who will accept applicants who went to medical school in Canada at an ACGME accredited Internal Medicine program, or USMD at a Canadian program, but not USMD/IMG graduates at a US program. Note there are additional requirements (tests, ROS, etc.) for IMGs. Generally you have to apply in R3.

[Xbox Skully]

27 minutes ago, bearded frog said:

Requirements vary by province. For instance, Ontario will accept applicants from an ACGME accredited Internal Medicine program, compared to BC who will accept applicants who went to medical school in Canada at an ACGME accredited Internal Medicine program, or USMD at a Canadian program, but not USMD/IMG graduates at a US program. Note there are additional requirements (tests, ROS, etc.) for IMGs. Generally you have to apply in R3.

What’s the point of pgy4 in Canadian programs? Is it needed to be eligible for the exam. Would a 3 year us program be eligible? 

[bearded frog]

23 hours ago, Xbox Skully said:

What’s the point of pgy4 in Canadian programs? Is it needed to be eligible for the exam. Would a 3 year us program be eligible? 

I believe before the rise of GIM as a subspeciality you could just finish after 4 years and be a general internist, like how pediatrics works. I'm not familiar enough now with the difference between 4 years IM vs GIM subspeciality.

[ameltingbanana]

Speaking as someone finishing the 5 year GIM program - a 5 year is more or less required in most academic centers in southern ON (for sure Toronto/Mac/London). Some academic centers are fine with 4 year + an area of interest (obstetric medicine, thrombosis, periop medicine, etc)

Most community centers are fine with PGY4 and nothing additional, as the focus is more on work and clinical excellence. 

If you are coming from the States, my understanding is you need an additional year of training to be Royal College/FRCPC IM eligible (4 years IM + successful royal college). As it stands now, the 5 year GIM program is primarily to develop a niche/consolidate/research/pursue an academic interest though I believe in Quebec there is some sort of billing/payment difference between 4/5 year. And I think US PGY3s can apply to the CaRMS MSM match...but not entirely sure.

The point of the PGY4 year relative to US IM is that IM is a bit of a different field compared to the US up here. Essentially no primary care, and IM is purely consult based. More of an in-hospital presence/ICU/stepdown, and less time in clinic (though this certainly varies depending on the internist, certainly our training does not have a significant clinic component until PGY4/5).