what are considered competitive residencies?

[Alastriss]

Hi

 

I figured I'd post here because med students would probably have a better idea of residencies. I was wondering what constitutes competitive residencies. I know that cardiology is considered very competitive, while something like family medicine is probably the least competitive.

 

Where would Oncology stand? I am considering going to the states and because it can be difficult to match back in canada, i am just trying to be mindful of the future. Also, would doing electives in a Canadian hospital help in terms of becoming competitive?

 

 

Thanks!

[Ian Wong]

Both Cardiology and Oncology are fellowship-level positions, which means that you can't even apply for them straight out of medical school.

 

First, you need to complete 3 years of an Internal Medicine residency (if you want to treat adults), or 3 years of a Pediatrics residency (if you want to treat kids), and then enter into one of the above two fellowships. Typically you apply to those fellowships while in residency.

 

Cardiology is a very competitive IM fellowship, while Oncology is a moderately competitive one.

 

If you are looking to do a fellowship in Canada, it would be easiest to achieve by attending a Canadian medical school and residency, although I believe one of the new U of S cardiology fellows did his residency in Oklahoma. Doing a rotation in Canada would be better than nothing, but still probably a lot less optimal than doing your entire training in Canada.

 

As far as competitive residency positions, the CaRMS website is the best place to look for that, although it seems like they've changed the website around a lot since I've last been there. Anyone know the link to the stats page, if it's still available?

 

Typically, the most competitive residencies are Plastic Surgery and Dermatology. Just a hair behind those two are Ophthalmology, Otolaryngology (ENT), and Urology. Things like Orthopedic Surgery, Diagnostic Radiology, Emergency Medicine, and Anesthesiology are also quite competitive.

 

Whether this is a sign of the times, or perhaps just a cynical bent to it, generally, a specialty is likely to be competitive if it has relatively few available spots, and has a good income : hours worked ratio.

 

Ian

[Alastriss]

Getting into a canadian med school is much easier said than done, haha, especially when compared to some US schools. SO to get to fellowship level programs you need to do IM residency first. How hard is it to do IM residency in canada from a US school?

[Kirsteen]

I was wondering what constitutes competitive residencies.

Hi there,

 

Ian's post outlines the most competitive residencies out there. In addition, each year there are waxes and wanes of programs as well. For example, this year there were a few Ortho spots open as well as some in Anes. Radiology remained incredibly hot this year--moreso than previous years. Conversely, the typically less competitive residencies of Obs/Gyn and Gen Surg had some large swells in enthusiastic applicants this year with folks who had interviewed widely to both specialties not matching to one. In short, it can be difficult to predict these latter patterns year over year.

 

Cheers,

Kirsteen

[Bear1056]

I am not sure how difficult it is, but I went to the US for my MD (wayne State) and just matched to U of T for IM. So, it is doable, provided you have a good application.

 

Good luck

[JewelLeigh]

Congrats Bear

[Kirsteen]

Hi there,

 

This year was a bit of a nuts year in IM as there were some hard-core IM applicants out there, i.e., who completed all their electives in IM and were clear-cut IM keeners, but who still did not receive interviews across the board. UofT was one program that certainly did a lot of interesting picking and choosing this year. If anyone's interested in UofT's IM program, there are a few factors that, if you have them, certainly might strengthen your application.

 

I know a medical student this year who applied to UofT's IM program as a back-up to their first choice specialty. They had zero IM electives but they did have two key features in their application: 1) a whole lot of research experience and productivity before and during medical school; 2) a good letter of reference from a well-known UofT IM faculty member. This applicant was not only offered an interview, but was also told during the interview that the position was theirs, i.e., the interviewer would strongly vouch that they be accepted, if they could clarify their path towards IM and away from the other specialty that seemed to have application prominence. Essentially, the interviewer was trying to suss out if the candidate was, indeed, keen on an IM career given their choice of electives in other areas. During the remainder of the interview, the interviewer noted that, had it not been for the research component of the application, the applicant would not have been invited for an interview at all. Futhermore, by the interview's end the applicant was told that, based on that research as well as the clarification received during the interview, the interviewer was making a recommendation for this applicant to be accepted into an IM position at UofT if they should wish it.

 

Moral of the story: if you want to strengthen your chances at UofT, a bit of research and knowing some good folks in the program may only help to boost your application.

 

Cheers,

Kirsteen

[darknight]

Hi there,

 

This year was a bit of a nuts year in IM as there were some hard-core IM applicants out there, i.e., who completed all their electives in IM and were clear-cut IM keeners, but who still did not receive interviews across the board. UofT was one program that certainly did a lot of interesting picking and choosing this year. If anyone's interested in UofT's IM program, there are a few factors that, if you have them, certainly might strengthen your application.

 

I know a medical student this year who applied to UofT's IM program as a back-up to their first choice specialty. They had zero IM electives but they did have two key features in their application: 1) a whole lot of research experience and productivity before and during medical school; 2) a good letter of reference from a well-known UofT IM faculty member. This applicant was not only offered an interview, but was also told during the interview that the position was theirs, i.e., the interviewer would strongly vouch that they be accepted, if they could clarify their path towards IM and away from the other specialty that seemed to have application prominence. Essentially, the interviewer was trying to suss out if the candidate was, indeed, keen on an IM career given their choice of electives in other areas. During the remainder of the interview, the interviewer noted that, had it not been for the research component of the application, the applicant would not have been invited for an interview at all. Futhermore, by the interview's end the applicant was told that, based on that research as well as the clarification received during the interview, the interviewer was making a recommendation for this applicant to be accepted into an IM position at UofT if they should wish it.

 

Moral of the story: if you want to strengthen your chances at UofT, a bit of research and knowing some good folks in the program may only help to boost your application.

 

Cheers,

Kirsteen

 

 

Would that apply only for a CDN grad from a canadian med? or does it apply to CDN grads from US meds? because I hear that even with all that It can be hard for CDN grad to get a residency depending on its competitiveness, so im not sure about IM. Any thoughts?

[bay]

Formula for getting into U of T IM residency program = Getting to know key players on committee + Letters of reference from said key players + Good grades (esp. Honours in IM clerkship, if your school has it) + Research potential/academic interest. This has been made pretty clear to U of T med students since day #1.

[Alastriss]

Formula for getting into U of T IM residency program = Getting to know key players on committee + Letters of reference from said key players + Good grades (esp. Honours in IM clerkship, if your school has it) + Research potential/academic interest. This has been made pretty clear to U of T med students since day #1.

 

Thanks a lot for your input, all of you have really helped me out. So for someone whose attending a US med school and wants to do a residency in IM in canada for example, he can forget about any shot unless he does electives in some hospitals in Canada to know and get known.

[Kirsteen]

Thanks a lot for your input, all of you have really helped me out. So for someone whose attending a US med school and wants to do a residency in IM in canada for example, he can forget about any shot unless he does electives in some hospitals in Canada to know and get known.

Hi,

 

Another good way to get known aside from electives is to collaborate on some research. Clinical research can easily be done remotely. An approach that I found successful was to contact faculty in my area and program of interest who were keen on research. I started dialogue re: research projects well in advance of the elective start date. Thus, when the elective rolled around, I was able to do some work on the research while there. You can then work on the publication or presentation beyond your elective time.

 

Cheers,

Kirsteen

[darknight]

Kirsteen is right, these things can be unpredictable. We had an IM superstar in our class who ranked 10 programs and went unmatched... still not sure if something went awry with his e-CaRMS file (that's what he thought), or if he bombed his interviews. On the other hand, the only people in my class who got IM interviews at UBC (with one possible exception) were people who wanted other specialties and were CLEARLY using IM as a backup. Interestingly, these people were all honours students. Even that was impossible to predict - I was an honours student, but no UBC interview!!!

 

CaRMS is fickle. Luckily it works out for most Canadian grads.

 

 

if it works out only for most canadian grads, whats it like for canadian citizens that are US grads?

[Akane200]

I believe that there are currently very few Canadian graduates of American medical schools in internal medicine residency in Canada. I only know of perhaps one in Toronto, and there may be a few more at McGill. Whether this is because there is a preference for Canadian grads over American ones (despite being a Canadian), or whether Canadians who went to the USA don't ever want to come back, I'm not really sure.

 

Canadians in American med schools are allowed into CaRMS first round. However, given that internal medicine is a competitive specialty too (not as uber competitive as some of the above ones), and that many canadian medical students are not backing up with it, but actually want to be internists, I can see how programs will still choose Canadian graduates stilll for all of the reasons described before (known schools, homogenous quality of Canadian grad, you know what you're getting, etc).

 

There are more American grads who do do fellowships in Canada after completing 3 years of internal medicine in the USA. We had a few really good ones come through critical care in Calgary, and in former years, for subspecialties such as rheumatology, they have taken American grads. These were exceptionally good American grads with a lot of research and from top tier schools in the USA. I think landing a fellowship is harder as an American graduate in an American internal residency trying to match to a Canadian fellowship. It's also a matter of the numbers game too (need to have enough for our own residents), but it is possible for the exceptional candidates.

 

I hope that is helpful.

[Alastriss]

I think what darknight is getting at is: how is it looking for a slightly above average med student who went to an above average med school in the US and wants to come back to canada, and assuming he's done what you guys have recommended, eg electives, research? Will this sligthly above average guy fare well for IM based on its competitiveness, coming from a us school etcs, or is it not "looking so hot"

and If it is too hard to predict these things for the future, how was it like for th past few years? was it friendly to the person in the scenario? (slightly abve avrge in abve avrge med etc.)

[JewelLeigh]

There aren't that many people who have been in the scenario you describe, so it is hard to generalize. (In other words, most of us don't know anyone who has graduated in the states and wanted IM in Canada. If any, people might each know one or two in similar situations - and those who do know someone have probably already commented on it.)

 

One person has already posted that he/she succeeded, and beyond that, I think most posters have made it fairly clear that IM is moderately competitive for Canadian grads and significantly more so for Canadians who are American grads. Yes, it is possible to match to IM in Canada if you graduate from an American med school, but it is going to be tough and not guaranteed.

 

As some said, CaRMS is fickle - no one can tell you a magic formula that will get you in. Nor can anyone tell you what the odds are that you'll get in, given your somewhat unique situation. All you can do is take the fantastic advice given above, decide whether or not to give it your best shot and know that unfortunately the rest is somewhat like rolling a dice

[darknight]

There aren't that many people who have been in the scenario you describe, so it is hard to generalize. (In other words, most of us don't know anyone who has graduated in the states and wanted IM in Canada. If any, people might each know one or two in similar situations - and those who do know someone have probably already commented on it.)

 

One person has already posted that he/she succeeded, and beyond that, I think most posters have made it fairly clear that IM is moderately competitive for Canadian grads and significantly more so for Canadians who are American grads. Yes, it is possible to match to IM in Canada if you graduate from an American med school, but it is going to be tough and not guaranteed.

 

As some said, CaRMS is fickle - no one can tell you a magic formula that will get you in. Nor can anyone tell you what the odds are that you'll get in, given your somewhat unique situation. All you can do is take the fantastic advice given above, decide whether or not to give it your best shot and know that unfortunately the rest is somewhat like rolling a dice

 

 

 

Thanks a lot guys, This is truly fantastic advice. Gratz to Bear! This leads me to one more question, which I will start a new thread for. Thanks a lot guys you're very helpful

[blinknoodle]

This may be a crude way of looking at it, but I'll toss it out anyways despite it may not be the most politically correct answer. The way I see it, undoubtedly there is an element of luck for admissions into Canadian medical schools. However, if I wasn't able to gain admission into Canada and was forced to go elsewhere, people may wonder why I couldn't gain admission. You are already at a slight disadvantage in this respect. However, this can be compensated by showing your abilities by getting spectacular marks, doing ECs and research, and meeting the right people when on away electives. It is possible to match to anything but you can't just coast and expect admission. You need to show why you would be an ideal candidate, better then a Canadian candidate who may or may not, but likely doing exactly what you are doing too. Anyone training outside Canada and wants to return to Canada knows this is the route less travelled, and nothing is guaranteed. You should be prepared to work hard, and even harder if going overseas. Take my opinion with a grain of salt; it is not based on evidence rather my own thinking process.

[Sharpie*]

Is harder as a US grad (but Canadian citizen) no matter what US school you graduate from? For example, if someone gets into Johns Hopkins and also a few good Canadian schools, and wants to come back to Canada for a competitive residency (such as IM), where are they better off going? Does the name of the US school make a difference? Or would they be stuck doing US residency and then only be able to come back for fellowship?

[darknight]

Is harder as a US grad (but Canadian citizen) no matter what US school you graduate from? For example, if someone gets into Johns Hopkins and also a few good Canadian schools, and wants to come back to Canada for a competitive residency (such as IM), where are they better off going? Does the name of the US school make a difference? Or would they be stuck doing US residency and then only be able to come back for fellowship?

 

Based on what I've read/heard/seen this is what I have gathered:

 

Since US grads that are canadian go into the first iteration match, they are technically on the same playing field, but this is true theoretically. cdn us grads face a few problems, including that the panel that is interviewing them doesnt know the quality of the school. Also no one can vouch for them, so references aren't from people that are known. A canadian grad may have a reference from a guy that the interview panel might recognize because its like one country-wide club here. So from the interviewer's perspective its a "safe bet" to go with the canadian grad because u know what kind of education they've received and you know the guy whose vouching for them via reference letters. US grads don't have that, unless they go the extra mile and do electives, to get to know key players as well as prove that they are competent in the field.

I dont feel that ive gotten the impression from these forums where the panel si going to go like "oh this US grad is great, but we're not going to take him just cuz he's US grad, we'll take the canadian instead"

its just that Canadian grads don't have to go the extra mile that US grads have to take to get 'on par'; it comes naturally to the canadian grad.

 

As for the top schools, I think that they 'might' be differen than a 'noname' school. Obviously interviewers have heard of the Ivy League schools and obviously they must at least know that they are difficult to get into and of course have some of the top students. Again im not sure, but If i were an interviewer, i wouldn't really question the competence of a Harvard grad.

I don't know how valid the above assumption is, but I know of a few people (specifically 2) who have gone to top schools (JHU, Wash @ st. louis) and have matched their preference (non-FM of course)

 

Edit: all spelling mistakes and grammatical errors, wrote this when i was half asleep

[Sharpie*]

Thanks for the reply! Very helpful!

[Guest copacetic]

lets say that a person from an american med school is lucky and gets an IM residecy, with a return of service agreement. what if said person wishes to pursue a subspecialty within internal medicine. wont the return of service agreement mean that they cant pursue fellowships until they complete the ROS?

[sarup]

what about if you do your residency in the US? Is it hard to get a license to practice in Canada?