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8 hours ago, DrOtter said:

LOL just had my worst interview this cycle so far.

One of the interviewers just kept rushing me to the next qs and cutting me off. I couldn't fully finish any of my thoughts.

Then we ended 10 minutes early - FOR A 30 MINUTE INTERVIEW.

I tried to ask a question about the program but it was still awkward at the end when we had like 6 mins to spare.

This is gonna live rent-free in my head for the foreseeable future lol :confused:

Definitely something to consider when you are making your rank order list. Sure it may have felt bad on your part performance wise, but if you also felt like you were dismissed and not given the time of day it's worth at least thinking about whether that is somewhere you want to go (taking everything else into account of course).

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i am making my rank list, and wondering if anyone here can speak to the cultures in gen surg at the schools across Canada. I'm specifically interested in if anyone here is from the more 'oldschool' programs (u of A, western, dal) and can speak to their clerkship experiences on gen surg... ty!

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18 hours ago, gensurg66 said:

i am making my rank list, and wondering if anyone here can speak to the cultures in gen surg at the schools across Canada. I'm specifically interested in if anyone here is from the more 'oldschool' programs (u of A, western, dal) and can speak to their clerkship experiences on gen surg... ty!

I did med school at UofA (wanted peds and matched to peds) but to speak to my experience on surgery: it was a mixed bag from what I observed. I felt it was actually hospital dependent, and of course staff dependent - there is a mix of very warm and friendly staff and some grouches mixed in as well, which I feel is something you'll have at every program.

the UofA hospital and Royal Alexandra hospital are the tertiary care centers in Edmonton, they see A TON of volume and its a very busy service. but that means they usually have large teams of residents and medical students as well. Grey Nuns hospital and Misericordia are the other hospitals residents will rotate through as well and tend to have a better work culture just by nature of not being trauma centers. Still a busy service as gen surg tends to be but a slightly more relaxed attitude. 

I also rotated through Peds gen surg (due to personal interest) which is at the Stollery Children's hospital and really enjoyed that. UofA gen surg is a big program and I noticed the teams tend to be large at all the hospitals, with multiple residents, usually a fellow, and a couple of med students. It made the call shifts really nice. Since they are usually running multiple ORs, even after hours, there is always need for people to assist and scrub in. 

Lots of research output, which is a trend across UofA programs as the school itself is very research oriented, so plenty of opportunity to find what you enjoy. 

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My interview ended with: "See you next year!"  How am I supposed to interpret this?

I felt that my interview went great even tough it wasn't my home school! 
Do you know if recruiters say this to multiple candidates like a form of End-of-interview cliché?
Am I overthinking it ?

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52 minutes ago, TopChef said:

My interview ended with: "See you next year!"  How am I supposed to interpret this?

I felt that my interview went great even tough it wasn't my home school! 
Do you know if recruiters say this to multiple candidates like a form of End-of-interview cliché?
Am I overthinking it ?

It probably depends on who said it/what program. I honestly haven't had anyone say something like this to me so could be a good sign. But the advice I've gotten is not to let anything anyone says about your likelihood of matching influence your rank list. So just rank the program how you would.

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It looks like applicants and programs may begin creating their rank order lists in CaRMS Online, starting today.  I am curious if anyone knows whether the programs (in particular IM or FM ) typically rank all the selected candidates they interviewed or only the top x (say they have 20 IM spots, and the program only ranks up to the top 60 candidates)? 

 

For most IM programs, the average % of applicants offered interviews is between 50-75%, which to me feel like thats a lot of candidates to consider. 

Also - curious if folks would rank the programs that you did not select for interviews. Are there any benefits to doing so?  

 

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1 hour ago, TopChef said:

My interview ended with: "See you next year!"  How am I supposed to interpret this?

I felt that my interview went great even tough it wasn't my home school! 
Do you know if recruiters say this to multiple candidates like a form of End-of-interview cliché?
Am I overthinking it ?

haha that's great news for that specific school! The closest I got was "We hope you'll consider us"

but yea just like the other poster said, I would still rank programs based on my true preference though. I'd rather match to my (true) #1 program where I'm only ranked #10 on their list, than match to my (true) #5 program where I'm ranked #1 ... if that makes sense...

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About ranking programs that I did not get interview at:

 I understand that there is no disadvantage, given the way the match works. However, I was still wondering if it was heard of? Does anyone know a resident that matched without an interview? I mostly want to get an idea of how much energy I should put in researching and ranking these programs. 

Thanks! 

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58 minutes ago, FaithPG said:

I am curious if anyone knows whether the programs (in particular IM or FM ) typically rank all the selected candidates they interviewed or only the top x (say they have 20 IM spots, and the program only ranks up to the top 60 candidates)? 

Also - curious if folks would rank the programs that you did not select for interviews. Are there any benefits to doing so?  

 

Everyone has some anecdotal story repeated in the resident lounge at 11 PM one February of this happening but I've never heard someone actually name names so who knows. Theoretically possible in disciplines like FM I suppose but some programs are careful to note they only rank interviewed applicants and if they're using a rubric it's hard to imagine someone who didn't get an interviewee AND isn't getting interview points matching. Now I am still ranking my actual #1 (which did not interview me) as my #1 mainly to send a message in match statistics. My true preference was and still is that program and so even if I match my #2 (really, my new #1) I want the match statistics to reflect that I did not get my "#1 choice" and avoid false narratives. 

https://www.carms.ca/pdfs/CMG-home-and-away.pdf suggests that for aways in FM it's generally about 80% of applicants being ranked (note this does not include interviewees only). For IM it appears that for aways it's about 70% are ranked. The lowest we see for applicant ranked program/program did not rank applicant appears to be 10% so that would suggest your floor for red flags/horrible interviews is probably somewhere around 10% of interviews. The difficulty here is this is applicants not interviewees and so the high mutual not ranking scenarios for programs like Derm and EM is really a reflection of difficulty getting interviews as well as genuine ranking behaviour. 

If we focus only on Anesthesia as a mid-range competitive specialty (tougher than IM, easier than EM) ~80% of home applicants get an interview and about 50% of aways. Now if we look at rankings about 11% of the time for home schools there was a mutual non-rank (so either horrible experience OR more likely, no interview) and in another 24% of cases the applicant did rank but the program did not reciprocate. So we can conclude from the previous 80% yield rate there's a delta of about 15% between the two for the home school. I don't think it's possible to do the same math for aways because you don't have info on the distribution of pattern (it's a stretch to assume it's normal given geographic patterns). 

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5 hours ago, TopChef said:

My interview ended with: "See you next year!"  How am I supposed to interpret this?

I felt that my interview went great even tough it wasn't my home school! 
Do you know if recruiters say this to multiple candidates like a form of End-of-interview cliché?
Am I overthinking it ?

Omg I feel this! One of the programs I interviewed at told me they couldn't wait to taste my baking next year and I was like???? Wait what?? Please don't play with my emotions like that (T-T)

But the most brutal part about the CaRMS tour is falling in love with programs before the sullen realization that there's a possibility you may never match there or get to work with those people again...

Also anyone else feel more confused at the end of the interview season than when you started? I ended up vibing with some programs way more than I expected to and less with some programs I thought I was going to vibe so well with... AHH so many decisions :blink:

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5 hours ago, FaithPG said:

I am curious if anyone knows whether the programs (in particular IM or FM ) typically rank all the selected candidates they interviewed or only the top x (say they have 20 IM spots, and the program only ranks up to the top 60 candidates)?

Probably varies by program but most places will probably rank everyone they interviewed unless they were designated as DNR

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10 hours ago, wannabdoctor said:

Omg I feel this! One of the programs I interviewed at told me they couldn't wait to taste my baking next year and I was like???? Wait what?? Please don't play with my emotions like that (T-T)

But the most brutal part about the CaRMS tour is falling in love with programs before the sullen realization that there's a possibility you may never match there or get to work with those people again...

Also anyone else feel more confused at the end of the interview season than when you started? I ended up vibing with some programs way more than I expected to and less with some programs I thought I was going to vibe so well with... AHH so many decisions :blink:

100% me to haha

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11 hours ago, wannabdoctor said:

Omg I feel this! One of the programs I interviewed at told me they couldn't wait to taste my baking next year and I was like???? Wait what?? Please don't play with my emotions like that (T-T)

But the most brutal part about the CaRMS tour is falling in love with programs before the sullen realization that there's a possibility you may never match there or get to work with those people again...

Also anyone else feel more confused at the end of the interview season than when you started? I ended up vibing with some programs way more than I expected to and less with some programs I thought I was going to vibe so well with... AHH so many decisions :blink:

Regardless if you match there, my field is so small, I recall so many familiar faces from prior carms that have come for staff job interviews or have been hired. At the end of the day residency is transient.

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3 hours ago, ChemPetE said:

Regardless if you match there, my field is so small, I recall so many familiar faces from prior carms that have come for staff job interviews or have been hired. At the end of the day residency is transient.

I will also add I have had had both a fellowship interview and a staff interview at a large centre that didn’t interview me for carms lol. 

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My advice is for people who seriously have a hard time ranking programs, is to ignore the emotional aspect and think about fellowship/job situation.

Home field advantage is true for CaRMS, but it's even more true for fellowship and jobs. If a program have an in-house candidate, they're unlikely to openly advertise their fellowship or job vacancy. Sure they'll post a "ghost ad" somewhere to comply with hiring policies but often than not somebody is already chosen. I've personally wasted money flying somewhere for fellowship interview only to realize the candidate in the group that seemed the least excited was their in house candidate lol. He already knew it was a sure shot.

Even for fields that have no shortage of jobs, the EMR you are used to, the style and pace of your work, etc all gets deeply ingrained in you during residency. So choose a place that matches your style.

 

 

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2 hours ago, shikimate said:

My advice is for people who seriously have a hard time ranking programs, is to ignore the emotional aspect and think about fellowship/job situation.

Home field advantage is true for CaRMS, but it's even more true for fellowship and jobs. If a program have an in-house candidate, they're unlikely to openly advertise their fellowship or job vacancy. Sure they'll post a "ghost ad" somewhere to comply with hiring policies but often than not somebody is already chosen. I've personally wasted money flying somewhere for fellowship interview only to realize the candidate in the group that seemed the least excited was their in house candidate lol. He already knew it was a sure shot.

Even for fields that have no shortage of jobs, the EMR you are used to, the style and pace of your work, etc all gets deeply ingrained in you during residency. So choose a place that matches your style.

 

 

What do you think about choosing between a larger program with stronger training vs a smaller more supportive program with good training 

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15 hours ago, dooogs said:

What do you think about choosing between a larger program with stronger training vs a smaller more supportive program with good training 

Depends on your personality and somewhat on what your career goals are. Also what specialty... you don't outright say but you've mentioned optho a few times in previous posts, and in surgical subspecialities you're only going to  be at relatively big centres anyway so the difference will not be as significant.

In general, larger programs are at larger academic centres, that might see more highly specialized care, "Zebras", big names in the field, research, etc. with the trade off that you might feel more like a cog in the machine amongst a bigger program, and if there are subspeciality fellowships in your field you might have less opportunity as a resident if the fellows etc. play a big role. If you're interested in academic medicine or research then this might have an advantage. It's actually not necessarily an advantage if you're interested in fellowships because the benefit of networking is often equalized out by the greater experience that residents get if there are no fellows at the training site.

Smaller programs you might see less of the cutting edge or less research, but you will work more closely alongside your staff, and likely do more as a resident without other fellows/trainees and get more 1 on 1 time with the staff, and see the full breadth of your field. This might be an advantage if you plan to work in a more rural setting and you want to have a well-rounded experience base, you prefer close working relationships. or if you feel that you might not flourish being one of many in a program.

Using my field, pediatrics, as an example, U of T/SickKids is the biggest program in the country, with the most research and probably the most cutting edge in terms of advances in the field. They also have the most pediatric subspeicality fellows, and a LOT of other various levels of trainees above residents (non-royal college fellowships for internationally trained pediatricians, for example). Certainly you get a good education there and if you were interested in groundbreaking research then that would be great. However, the program also has a reputation where the residents are seen as the bottom of the totem-pole so to speak, and a lot of training focus is on fellows, so that perhaps the residents don't have as much opportunity. There has also been some discussion about the overall quality of the residency program in the past, and that people will want to work in Toronto and be associated with SickKids, regardless of the quality of the program, and so do well in the match, which means less incentive to improve the residency program. (This was all a while back so I cannot comment on how things have changed).

Compare this to a program like Queens, which only takes 5 residents and no fellows. Yes, the sickest patients are going to be transported to bigger centres (And the residents actually do rotations in Ottawa for their PICU and some subspeicailty rotations), but for general, non-intensive acute care, stabilization, and emergency care, it's going to be you working one on one with the staff for everyone that comes through the door, meaning you're doing the intubations and LPs etc. and getting that breadth of experience. In my experience this reflects well when it comes to fellowship matching as residents from programs without fellows often have more practical experience in that field, if less research, etc.

 

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9 minutes ago, bearded frog said:

Depends on your personality and somewhat on what your career goals are. Also what specialty... you don't outright say but you've mentioned optho a few times in previous posts, and in surgical subspecialities you're only going to  be at relatively big centres anyway so the difference will not be as significant.

In general, larger programs are at larger academic centres, that might see more highly specialized care, "Zebras", big names in the field, research, etc. with the trade off that you might feel more like a cog in the machine amongst a bigger program, and if there are subspeciality fellowships in your field you might have less opportunity as a resident if the fellows etc. play a big role. If you're interested in academic medicine or research then this might have an advantage. It's actually not necessarily an advantage if you're interested in fellowships because the benefit of networking is often equalized out by the greater experience that residents get if there are no fellows at the training site.

Smaller programs you might see less of the cutting edge or less research, but you will work more closely alongside your staff, and likely do more as a resident without other fellows/trainees and get more 1 on 1 time with the staff, and see the full breadth of your field. This might be an advantage if you plan to work in a more rural setting and you want to have a well-rounded experience base, you prefer close working relationships. or if you feel that you might not flourish being one of many in a program.

Using my field, pediatrics, as an example, U of T/SickKids is the biggest program in the country, with the most research and probably the most cutting edge in terms of advances in the field. They also have the most pediatric subspeicality fellows, and a LOT of other various levels of trainees above residents (non-royal college fellowships for internationally trained pediatricians, for example). Certainly you get a good education there and if you were interested in groundbreaking research then that would be great. However, the program also has a reputation where the residents are seen as the bottom of the totem-pole so to speak, and a lot of training focus is on fellows, so that perhaps the residents don't have as much opportunity. There has also been some discussion about the overall quality of the residency program in the past, and that people will want to work in Toronto and be associated with SickKids, regardless of the quality of the program, and so do well in the match, which means less incentive to improve the residency program. (This was all a while back so I cannot comment on how things have changed).

Compare this to a program like Queens, which only takes 5 residents and no fellows. Yes, the sickest patients are going to be transported to bigger centres (And the residents actually do rotations in Ottawa for their PICU and some subspeicailty rotations), but for general, non-intensive acute care, stabilization, and emergency care, it's going to be you working one on one with the staff for everyone that comes through the door, meaning you're doing the intubations and LPs etc. and getting that breadth of experience. In my experience this reflects well when it comes to fellowship matching as residents from programs without fellows often have more practical experience in that field, if less research, etc.

 

Thank you for this thoughtful answer. I really appreciate your perspective 

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On 2/2/2024 at 10:48 PM, dooogs said:

What do you think about choosing between a larger program with stronger training vs a smaller more supportive program with good training 

The first question is how is "stronger" vs "good" measured? Is it score on the RC exam? To put it bluntly, somebody who passes RC exam with 71, have minimal research, and no fellowships, is called a "Royal College certified specialist", and let's say can bill 200$ for a consult. Someone who passes RC exam with a 91, have a PhD, and 2 fellowships, is also called a "Royal College certified specialist" and can also (only) bill $200 for the same consult code. This is not like HS or undergrad where you brag about your marks on an exam and people cared lol. 

Like the previous poster mentioned, certain things we assume to be equivalent to "strong" training, such as research output, is not necessarily perceived by your future employer, your patients, or society as general as components of being "strong". To be honest, right now our department is hiring a generalist and we don't really care how many first author papers you've published in Nature Medicine or NEJM lol. In fact, we'd be hesitant to hire someone who is extremely focused in one area because we are worried they won't do well in the 99 other things we need them to do for the work. My opinion is that residency is where you gain competency (notice I didn't say excellence) in the majority of areas in your specialty, and fellowship is where you gain excellence in a smaller area within your specialty.

This is where your career aspiration and life goals come into play, and a lot of personal reflection is needed. If your aspiration is singular towards a certain academic position, then of course a "strong" place is where you'd be able to output a lot of papers. But most people's aspirations and needs are not singular, so there needs to be some kind of trade-off, again, based on how you want to set your life. Are you trying to pay off debt fast? Build a reputation? Have an "easy job" with more leisure time? Let's use a hypothetical example to illustrate the complex interaction of these factors. 

- Program A has mandatory community rotations. During these rotations, the residents met people from various satellite hospitals and heard through the "grapevine" about impending retirements. They also got broad exposure to a variety of easy, medium, and hard cases in the community, and felt well prepared for their RC exam. Because they got to "showcase" themselves during community electives, all of A's graduates were approached by recruiters for job offers before they finished residency. Although some chose to do fellowship, it was not a pre-requisite for job placement. Program A's residents mostly practice in the community, although some practice in academic settings as well. Some residents from A felt that there wasn't enough elective to give them the "best shot" at certain prestigious fellowships, so they did other things (eg. self initiated research, attending extra conferences) to increase their exposure to their subspecialty of desire.

- Program B does not have any mandatory community rotations. Their residents tend to stay at their home institution for electives. Program B encourages research and graduate degrees, and have dedicated "research blocks". Program B certainly has outstanding international reputation for certain areas of expertise. Residents from Program B are quite fluent in the new literature and complex cases. Residents from Program B usually secures thought after fellowships, and tend to practice in select subspecialties after graduation. Some residents from Program B feel uneasy doing generalist work because they have not had a wide breath of exposure to some "routine" cases that are not usually referred to a major center. Program B's residents mostly end up practicing in academic centers, or in large cities whereby sub-specialization is possible. 

 

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12 hours ago, shikimate said:

The first question is how is "stronger" vs "good" measured? Is it score on the RC exam? To put it bluntly, somebody who passes RC exam with 71, have minimal research, and no fellowships, is called a "Royal College certified specialist", and let's say can bill 200$ for a consult. Someone who passes RC exam with a 91, have a PhD, and 2 fellowships, is also called a "Royal College certified specialist" and can also (only) bill $200 for the same consult code. This is not like HS or undergrad where you brag about your marks on an exam and people cared lol. 

Like the previous poster mentioned, certain things we assume to be equivalent to "strong" training, such as research output, is not necessarily perceived by your future employer, your patients, or society as general as components of being "strong". To be honest, right now our department is hiring a generalist and we don't really care how many first author papers you've published in Nature Medicine or NEJM lol. In fact, we'd be hesitant to hire someone who is extremely focused in one area because we are worried they won't do well in the 99 other things we need them to do for the work. My opinion is that residency is where you gain competency (notice I didn't say excellence) in the majority of areas in your specialty, and fellowship is where you gain excellence in a smaller area within your specialty.

This is where your career aspiration and life goals come into play, and a lot of personal reflection is needed. If your aspiration is singular towards a certain academic position, then of course a "strong" place is where you'd be able to output a lot of papers. But most people's aspirations and needs are not singular, so there needs to be some kind of trade-off, again, based on how you want to set your life. Are you trying to pay off debt fast? Build a reputation? Have an "easy job" with more leisure time? Let's use a hypothetical example to illustrate the complex interaction of these factors. 

- Program A has mandatory community rotations. During these rotations, the residents met people from various satellite hospitals and heard through the "grapevine" about impending retirements. They also got broad exposure to a variety of easy, medium, and hard cases in the community, and felt well prepared for their RC exam. Because they got to "showcase" themselves during community electives, all of A's graduates were approached by recruiters for job offers before they finished residency. Although some chose to do fellowship, it was not a pre-requisite for job placement. Program A's residents mostly practice in the community, although some practice in academic settings as well. Some residents from A felt that there wasn't enough elective to give them the "best shot" at certain prestigious fellowships, so they did other things (eg. self initiated research, attending extra conferences) to increase their exposure to their subspecialty of desire.

- Program B does not have any mandatory community rotations. Their residents tend to stay at their home institution for electives. Program B encourages research and graduate degrees, and have dedicated "research blocks". Program B certainly has outstanding international reputation for certain areas of expertise. Residents from Program B are quite fluent in the new literature and complex cases. Residents from Program B usually secures thought after fellowships, and tend to practice in select subspecialties after graduation. Some residents from Program B feel uneasy doing generalist work because they have not had a wide breath of exposure to some "routine" cases that are not usually referred to a major center. Program B's residents mostly end up practicing in academic centers, or in large cities whereby sub-specialization is possible. 

 

Thank you for these points. Ultimately, I gather that in either program, once you know what you want for sure you can make your own path. Especially because the programs I was looking at were fairly similar in training it seems with some differences in amount of didactics, surgical volume, pt seen on call, complexity of cases etc. I get the impression that say if program A had less surgical volume - I could do an elective in a higher volume center if I feel that I could use more cases. I guess that's why it matters to have a solid PD 

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On 2/1/2024 at 4:30 PM, an90000 said:

It probably depends on who said it/what program. I honestly haven't had anyone say something like this to me so could be a good sign. But the advice I've gotten is not to let anything anyone says about your likelihood of matching influence your rank list. So just rank the program how you would.

Program Director and Radiology at the end of the interview! It will not influence my rank list, but I was wondering the true meaning of it and if it was a common thing/how should I feel about it!

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3 hours ago, TopChef said:

Program Director and Radiology at the end of the interview! It will not influence my rank list, but I was wondering the true meaning of it and if it was a common thing/how should I feel about it!

I think it definitely means at minimum that they appreciated discussing with you during the interview. I received a similar-ish comment during one interview and I had good vibes overall. However, I don't take it as more than that and I won't assume they're ranking me highly just because of that. We never know. They could be telling that to everyone. 

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2 hours ago, 9878 said:

How is everyone passing the time until match day? I am struggling lol 

I am trying to catch up with my non-med friends,  picked up new hobbies that I always wanted to try (Including kickboxing lol) and have been cooking/baking up a storm. :P

I also scheduled my LMCC in Feb so studying for that has been keeping me busy I guess :wacko:

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