Canadian IMG question about matching

[CapnCrunch]

Not an IMG yet, but third year student at an Aus uni (our year just started in Jan). I'm interested in coming back to Canada (although undecided) but had some questions and wanted to be better prepared in case I did pursue it so wanted to get the ball rolling earlier. I'm considering all pathways from Aus, US, and Canada. Have also passed step 1 and will write S2 and MCCQE towards the end of this year probably. 

I mainly had questions about what are the most important things to stand out and then ranking order for the CaRMS application.

I was wondering what would people here deem as the more important things to maximize in order to come back between MCCQE and NAC OSCE scores, LOR/Canadian references, Aus references?, pubs, ECs, etcs. 

Is getting a high scores in MCCQE and NAC OSCEs at the top, i.e. should I be studying to do very well (like how Step 1 score used to determine fate back when it was scored) or does a high score not change much from an average one? Asking since it's probably quite a deal more effort to study to ace it vs. do average in when you can do other stuff in the meanwhile, particularly since our curriculum runs a bit differently and third year is kind of packed for us. Although I do need to get a good score for S2 so I guess in the end I will end up studying quite a bit.

Also, I will only have the option for 1 official elective in 4th year for Canadian LORs and other networking opportunities. Should I look to also do some kind of unofficial observerships during my break at the end of this year as well to boost my chances of getting Canadian references? I'm hoping to get some during the elective, but not sure if the 5 weeks I'll have will be enough, but I assume it's okay to have a good one and use others from the Aus system maybe?

For the other stuff, I don't have much in terms of pubs (only have 2nd author in a systematic review in a meh journal so far). Is this something to focus on diligently or should it be on the back burner in favor of getting good scores in the exams and references (i.e. spending time in clinics to build rapport with attendings and the like). 

I think ECs and volunteering are decent, but have not done as much since med school in Aus, although do have some committee roles, and other some such volunteering last 2 years.  

The second point is about ranking CaRMS specialties as an IMG. I know most positions are in FM, but this is probably something I'm not too interested in, as I could just do it in Aus instead really. I'm mainly looking at internal, anesthesia, neurology as these are things I imagine I like (maybe that will change once I do rotations in them though) and had a some spots for IMGs. So I was wondering how important is the ranking order? For example, neuro and anesthesia had 7 and 10 spots respectively for IMGs if I'm reading the CaRMS data correctly, so if I wanted to do neurology but also wouldn't mind getting internal medicine as there's more spots (54), would I stand much of a chance if I have IM ranked second and didn't match neurology? What if it was #3 or #4?

What I mean is do your chances (i.e. as an IMG) drop dramatically to match into a specialty you didn't rank first, and if so is it better to just rank something like IM #1 as there are more spots?  

In any case, I know there's many more spots for the US match, so that's why I'm writing steps to also apply, but would prefer Canada. Not the end of the world if I don't get Canada/US either, since I can just stay in Aus, but the issue here is training pathways are so much longer in competitive specialties, i.e. anything not FM or Psych (although better work-life balance in general). 

ETA: I am also considering finishing an intern year in Aus after med school as this grants you general registration and so might postpone CaRMS until I have already finished PGY1 here. Not sure if anyone would have an accurate answer for this but would this make me less competitive (as I'd be out of med school 1+ years) or a more competitive applicant for having attained more exposure and clinical experience? 

[an90000]

Do you know anyone from your school that matched to Canada or any IMGs that matched? Most people on this sub are prob CMGs and so won't be able to answer all of your questions that well. There is also the MCCQE **DELETED** which has a lot of IMGs on it. 

From my understanding, IMGs basically have to be stellar in all aspects of their application, especially for very competitive specialties like anesthesia. The exam scores function as a filter for programs (i.e. if you get below their threshold, they won't even review the rest of your application). The MCCQE is pretty similar, if not easier than Step 2 so if you do well on that you will do well on the MCCQE. 

You can apply to multiple specialties if you want and it won't affect your ability to match another specialty. So if you wanted neurology first but didn't match then you still have an equal chance of matching IM. Hope this helps a bit. 

[CapnCrunch]

15 hours ago, an90000 said:

Do you know anyone from your school that matched to Canada or any IMGs that matched? Most people on this sub are prob CMGs and so won't be able to answer all of your questions that well. There is also the MCCQE **DELETED** which has a lot of IMGs on it. 

From my understanding, IMGs basically have to be stellar in all aspects of their application, especially for very competitive specialties like anesthesia. The exam scores function as a filter for programs (i.e. if you get below their threshold, they won't even review the rest of your application). The MCCQE is pretty similar, if not easier than Step 2 so if you do well on that you will do well on the MCCQE. 

Most people end up staying, and don't really know those 2+ years above me, but yeah historically plenty of people from Aus matched. The stats are the best out of any country with 74% last year, which was the highest it's been, and I'm not even sure if this number does not include people who didn't go through with their app (i.e. incomplete app due to change of mind and staying in Aus or went to the US) in which case the % would be even higher. So not all doom and gloom as it's portrayed to be really. 

 

15 hours ago, an90000 said:

 

You can apply to multiple specialties if you want and it won't affect your ability to match another specialty. So if you wanted neurology first but didn't match then you still have an equal chance of matching IM. Hope this helps a bit. 

This is helpful but are you sure? I don't know exactly how many specialties you rank for CaRMS but if you get rejected in say neurology and anos, and you have them as #1 and #2, won't the IM programs see they have been ranked #3 on your app and therefore be much more hesitant to give you a spot vs. if you had just ranked them first? And thus just decreasing your overall chance to match if you put either neuro/anos first two then IM vs. if you had gone IM then anos and neuro?

 

[Psych]

6 hours ago, CapnCrunch said:

This is helpful but are you sure? I don't know exactly how many specialties you rank for CaRMS but if you get rejected in say neurology and anos, and you have them as #1 and #2, won't the IM programs see they have been ranked #3 on your app and therefore be much more hesitant to give you a spot vs. if you had just ranked them first? And thus just decreasing your overall chance to match if you put either neuro/anos first two then IM vs. if you had gone IM then anos and neuro?

 

How the CaRMS match works is you simply rank programs in order of your own preference (in any specialty) and each program ranks the candidates they interviewed, and then you get a match based on that. Programs never see your rank list, and they don't "offer" spots - you will just get a spot according to the algorithm, which favours the applicant. So all you have to do is rank based on your actual preference. (Unless the process is different for IMGs compared to CMGs which I don't think so but you can double check if you want). All this info is outlined on the CaRMS website, they even have a video that clearly explains how it works!

[CapnCrunch]

On 2/9/2024 at 12:10 AM, Psych said:

How the CaRMS match works is you simply rank programs in order of your own preference (in any specialty) and each program ranks the candidates they interviewed, and then you get a match based on that. Programs never see your rank list, and they don't "offer" spots - you will just get a spot according to the algorithm, which favours the applicant. So all you have to do is rank based on your actual preference. (Unless the process is different for IMGs compared to CMGs which I don't think so but you can double check if you want). All this info is outlined on the CaRMS website, they even have a video that clearly explains how it works!

Thanks for clarifying, yeah was previously under impression that they'd have access to your rankings. 

Also, not sure if anyone has a definite answer to this but I was also wondering if a failed residency match negatively impacts a subsequent application? 

For example if I apply but do not match the first cycle and continue here, and then re-apply again the following year. Would the CaRMS system keep track of this previous unsuccessful application and potentially lower the overall chances for next time or would it not matter? 

I'm thinking if previous programs you applied to/interviewed at see you are a repeat applicant, they'd be more reluctant to rank you, or something along those lines.

[dooogs]

2 hours ago, CapnCrunch said:

Thanks for clarifying, yeah was previously under impression that they'd have access to your rankings. 

Also, not sure if anyone has a definite answer to this but I was also wondering if a failed residency match negatively impacts a subsequent application? 

For example if I apply but do not match the first cycle and continue here, and then re-apply again the following year. Would the CaRMS system keep track of this previous unsuccessful application and potentially lower the overall chances for next time or would it not matter? 

I'm thinking if previous programs you applied to/interviewed at see you are a repeat applicant, they'd be more reluctant to rank you, or something along those lines.

I don’t think they keep track via carms but it may be the same people reviewing the apps or keep an internal list potentially 

[bearded frog]

4 hours ago, CapnCrunch said:

Also, not sure if anyone has a definite answer to this but I was also wondering if a failed residency match negatively impacts a subsequent application?

Not specifically but your year of graduation being a year behind will be a yellow flag, they assume you would have applied last year and didn't match and are reattempting this year, people typically don't delay the match after graduation from medical school (some will stay enrolled and do an extra year of rotations etc to get around this, but then the fact that your training took an extra year will be notable).

Some programs may individually keep track. For most non-FM programs the PD(s) will probably remember you or at least your application as they usually review every applicant. How it would affect you would depend on why they didn't rank you to match, and what is different this time around.

[CapnCrunch]

35 minutes ago, bearded frog said:

Not specifically but your year of graduation being a year behind will be a yellow flag, they assume you would have applied last year and didn't match and are reattempting this year, people typically don't delay the match after graduation from medical school (some will stay enrolled and do an extra year of rotations etc to get around this, but then the fact that your training took an extra year will be notable).

Some programs may individually keep track. For most non-FM programs the PD(s) will probably remember you or at least your application as they usually review every applicant. How it would affect you would depend on why they didn't rank you to match, and what is different this time around.

Do you mean it's a yellow flag pre interview as a screen determining whether programs grant you an interview or not? 

Otherwise think you can also spin it as a positive during the interview should they ask. 

[bearded frog]

23 hours ago, CapnCrunch said:

Do you mean it's a yellow flag pre interview as a screen determining whether programs grant you an interview or not? 

Otherwise think you can also spin it as a positive during the interview should they ask. 

Its a yellow flag in that the vast majority of applicants will have a later YOG. They may use it as a screen, they may want to give more scrutiny to your application, it's up to the program. I don't know how I would spin it unless you had being doing a masters or something at the same time so it doesn't seem obvious you just didn't match and are reapplying.

[CapnCrunch]

On 2/22/2024 at 3:23 PM, bearded frog said:

Its a yellow flag in that the vast majority of applicants will have a later YOG. They may use it as a screen, they may want to give more scrutiny to your application, it's up to the program. I don't know how I would spin it unless you had being doing a masters or something at the same time so it doesn't seem obvious you just didn't match and are reapplying.

The way it works here is you do a general internship year before getting onto a training program that is the equivalent of residency. The year also runs different, as you would be starting in Jan. 

So most programs here probably have an average intake at PGY3-4 before you get into "residency" officially. Downside is the extra years, upside is the better work/life balance (i.e. less hours, better hourly, and OT pay). 

In any case, the way you would spin it is by doing rotations during internship in the things you are interested in matching in as you get to pick a few electives on top of mandatory ones. So say you are interested in ED you can do more stints in ED and say you have ED experience in a system that is pretty similar to Canada's. Or IM or w.e. else you hope to match in. So unless YOG flags you at the pre-interview stage and decreases your chances to be interviewed you can spin it on how much you liked the environment, experience you gained etc.