Internal Medicine Programs

[Guest Mnarewal]

I was wondering just exactly how competitive is it to get an internal medicine spot. I will be a US graduate next year I can get a spot very easily in the US based on my USMLE however since Canadian schools don't look at this what do they look at? I know the MCC isn't taken until after the match so how do programs rank their applicants?

[Guest Ian Wong]

Internal Medicine was probably the most surprising residency in this year's CaRMS match as far as its popularity. It got dramatically harder this year to find a spot in Internal Medicine, and there were multiple people in my class, and in classes across Canada, who were applying to Internal Medicine and did not match.

 

Last year, Internal Medicine was not very competitive to enter, with 13 unfilled positions available after the first round of the CaRMS match. This year, of the 176 Internal Medicine spots, only 1 went unfilled, and that was in Sudbury Ontario (I think this was a brand new residency, and that combined with it being quite out of the loop in terms of medical school/co-resident support probably made it get shunned by the vast majority of Internal Medicine applicants, who figured they would easily match elsewhere).

 

As far as matching into IM, or any specialty in Canada for that matter, board scores are not a factor because our LMCC exams are not written until well after we've matched. For that reason, doing well on away electives and having strong letters of reference are key in matching well. Having research also demonstrates your committment to the field; although it isn't necessary, a very significant proportion of the applicant field will likely have some research in their CV. Your med school marks (particularly your clerkship marks) are of lesser importance compared with the above, although getting an honours in your Internal Medicine rotation is something you should definitely be aiming to achieve.

 

I think the rise in IM popularity is likely due to a number of people who otherwise might have gone into Family Medicine (last year Family Medicine had 90 unmatched spots after the first round, this year it was 139 unmatched spots), but chose IM for lifestyle and financial reasons. Also, there was a huge push towards specialization from this year's graduating cohort of medical students, with a large number of students choosing IM as their first choice, or perhaps as their backup specialty to another yet more competitive specialty. Because of this, I think you can expect IM to be similarly competitive next year (I don't see Family Medicine getting any more popular in the near future, nor do I see specialization getting any less attractive).

 

For this reason, if you apply to IM, apply widely to all the Canadian programs, and rank deeply (don't just rank 5-6 programs with the expectation of getting in, but rather rank every single program that you'd see yourself choosing over the alternative of going unmatched or into your backup specialty). Having a secure backup choice is also a really good idea as well.

 

If there's one message us fourth years are trying to give to the classes below us, it is that if you don't want to go unmatched, apply widely and rank deeply, both in your first choice specialty and in your backup specialty, because people who didn't do this had a really high chance of getting burned by the match.

 

Ian

[Guest princejr13]

Hey Ian,

 

Can you explain what you mean by "rank deeply?" Also, does location play a huge role in getting matched. I go to USask Med ... are my chances of landing an internal med residency in an ontario school (western, mac, ottawa) lesser than med students from ontario?

 

Thanks

[Guest faqir9]

add to that...."away" electives as in rotations in the specialty/hospital you are applying to, or do you thinks any away elective is valued more highly by virtue of being at a different school? What does a student who may only get a single 8 week elective pre carms do?

[Guest UWOMED2005]

I think what Ian is referring to by "ranking deeply" is the idea that if going unmatched would be the worst thing in the world for you, then it's pretty risky to just rank the program you are interested in. . . you should back up heavily with a number of different specialties and/or locations. This is particularly true in these times when so few people seem to want to rank family #1 and there are a few more applicants in the pool (ie more Quebec francophones entering CaRMS, Canadian US grads entering first round, increased class sizes starting next CaRMS cycle, etc.)

 

Of course if you really are dead set on a particular specialty, wouldn't be happy in almost anything else, you might feel it is worth risking going unmatched so you can pick over the second round specialties and/or reapply the next year to Canada and/or the US as well.

 

As to your chances of matching to an internal medicine program in Ontario coming from U Sask, I think they're pretty good. I know of at least one resident here at UWO that came from U of A, and I think (I'm not sure) he did the couples match, which could have made matching a bit more difficult. Internal was fairly competitive this year, but most years it's of only average to above average competitiveness and even this year it wasn't as ultra-competitive like Derm, ENT, Ophtho or Plastics are. I don't think you have to be a superstar candidate to match to Internal, but you definitely want to be pretty solid.

 

One last note about Internal Medicine at UWO - one of the profs in the program talked to my class about matching to Internal Meds here last year. He stressed that UWO Internal meds is looking for "well-rounded" candidates - supposedly 1st and 2nd year marks count for 10% of the evaluation, total (not each). The rest is is stuff ranging from clinical evaluations, reference letters, extracurriculars, and research. On the reference letters - I think you absolutely should try to do an elective at any programs you apply to and try and get letters there, but my impression is that in many/most specialties (ie PM&R, Ophtho, ENT, Radiation Oncology in particular) the communities are so small that if you're getting letters of reference from one of the senior members of the U Sask faculty, they'll be well known and respected most places in Canada. Granted, that might be a little less likely for a specialty as broad as internal medicine. . . in which case you might be interested to know the director of the internal medicine program here is a geriatrician . But seriously, your letters of reference from U Sask (if they're good!) should be fine for UWO.

 

Hope that response helps while you're waiting for Ian, Carolyn or someone else more experienced than me to answer!

[Guest princejr13]

Thanks for the info UWOMED2005!

[Guest QTeee]

Hi princejr13,

 

Just to let you know where I'm coming from, I matched to Toronto for Internal Medicine this year, and I'm a UofT student.

 

Just to elaborate on the "rank deeply", I think it's safe to say that for Internal, you might want to rank at least 7 or 8 schools. This year was unusually a bit more competitive than before and some people may have had to go that far down their list.

 

As for USask landing a spot in Ontario, I would suggest that the best way to secure one is to do an elective in Ontario. Specifically, at a program you would like to go to.

 

For the record, the program director at UWO is EXTREMELY nice and passionate about teaching. I would highly recommend her. The program there is also very solid.

 

For UofT, I wouldn't hesitate to say that things are a bit more political, and you should definitely do an elective in Toronto with someone of "influence" to improve your chances here. 25 of the 37 spots were filled by my classmates, just to give you an idea.

 

I know that Calgary and Edmonton are very open to taking out of province students. UBC, alas, is not as much so.

 

Hope this helps.

[Guest Ian Wong]

UBC this year was quite different than in previous years as far as taking out of province students. Last year, we filled an inordinate number of our IM spots with UBC grads; this year it was quite different. I wish I could give hard numbers, but since I don't know them, my estimate is that last year there were about 10 UBC students who matched UBC IM, and this year, I think there were 5.

 

A number of my classmates are going elsewhere for Internal Medicine this year; I can think of people going to Edmonton, McGill, UWO, Queens, and McMaster off the top of my head.

 

Ian

[Guest QTeee]

Two of the IM spots at UBC will be students from UofT. I heard that this is also very unusual, and that there hasn't been a UofT student at UBC for IM in MANY, MANY years.