Why do people freak out for Carms?

[Mandibular]

My questions might seem out of line,and if they are, I apologize.

 

But after going threw all the Carms stats for 2009, I noticed that even the so called "competitive" specialties had very high odds of matching.

For example, radiology had 101 people who put it as first choice, out of which 80 successfully matched. Am I completely out of line when I say those are very good odds? It seems to me that you don't have to be the best in your class, you just shouldnt be in the bottm 20%.

 

Am I missing something here?

[entkeener]

Mandibular,

 

I don't think that most people "freak out" for CaRMS, but there are MANY reasons why the process is incredibly stressful.

 

For starters, there is an incredible amount of uncertainty with the match. Although the numbers may be "good" for many of the "competitive" specialties in terms of matching to specialty of choice, there is still the variable of which program you get into. Many people don't just have strong interest in their choice of field, but too have compelling reasons why a particular program or geographic location is important for them to be at or near. If you look at the numbers for matching to choice of program as opposed to specialty, the statistics become much more daunting.

 

Further building into the uncertainty is the unpredictability of what truly makes a good candidate. We all go through being told that certain things are important and make a good candidate. The three things the tend to come up most often:

 

-Someone that you could get along with I've been told many times is the most important thing

-Demonstrating interest in the specialty (doing electives and/or some research in the specialty)

-Being a hard worker/intelligent

 

Even knowing this list though, there's a few problems. First of all, every program uses their own method of deciding how they rank, so who knows what is really important. Probably more importantly, I've heard medical school referred to as the 'great homogenizer." Coming in, we're all incredibly unique, and then we're turned into this "undifferentiated physician." At the end of medical school, we all know the same algorithms for dealing with the many problems that may walk into the door (or at least we're supposed to). Most people going for "competitive" specialties do most of their electives in the specialty area. I've also seen a lot of my co-applicants (many of whom I'm now friends with) at national meetings presenting their research. The second check box will probably be filled out similarly for us. Finally, there is the criteria of being someone that you can get along with. I have done my electives and have met many other candidates applying to ENT (about 20 that I've met personally). They all seem like nice people that staff and residents in the various programs could get along with really well with. Unfortunately, I've heard many programs come right out and say they don't care much for extracurricular activities when selecting applicants (look at the message from McGill's radiology program director on http://www.radlinks.ca if you don't believe me). Also, you mentioned just needing to avoid being in the bottom 20%... most schools are Pass/Fail, so obviously grades can't be used. If that's the case how is this bottom 20% defined?

 

So then, what really lets you stand out? After four years of medical school and thinking about CaRMS for the second half of it, I don't have a good answer for you. Perhaps that is why it is so stressful?

 

There are many more reasons, but I should be packing and preparing for interviews instead of writing this.

 

I'll leave you with this thought/ analogy though...

 

When a patient has an illness that has a 90% chance of having a good outcome, that sounds pretty good at first. Unfortunately, if you do a little simple math, you may realize that even though 90% is wonderful, it ain't so hot if you're in the 10%. The problem in medicine is that we often don't know who the 10% will be. If you are in the 10% with a bad outcome, for you, the bad outcome is 100% of you're experience. CaRMS is the same way- going unmatched or being matched to a program you don't really want is an all or none event. It's not like getting 90% on a test. If you go unmatched, with rare exceptions, for the rest of your life you're doing something that wasn't your first choice.

 

Is going unmatched the end of the world? Obviously not. I know many individuals in years ahead of me that went into the second round and are quite happy with how things worked out. Was it incredibly disappointing, at least at first, for my friends? Definitely.

 

So in summary, there are many things that are stressful about the CaRMS process, and I've just given you a few examples. It appears that you're a first-year student from your signature line. I think when you get to a more senior year, you'll begin to appreciate the anxiety that is provoked by the CaRMS process.

 

I hope this helped clarify things for you.

 

Good luck with your training and your in a few years, your match!

[moo]

It may be stressful while you're going through Carms but it isnt the end of the world if you don't get what you want.

 

I know plenty of people who didn't get their first choice but ended up doing family med or psych or whatever and then eventually transferring into their first choice specialty.

[Mandibular]

Thanks Entkeener for your well detailed post

 

I guess my approach was rather simplistic: I was looking at Carms threw the eyes of someone trying to get into med school: out of the thousands of applicants, you have to be in the top 10%, whereas the Carms numbers seemed much better.

 

For the 80%, I meant you need to be in the top 80% of applicants and not grades (out of the 101 rad applicants they took 80), meaning that you have to be in the top 80% of their list.

 

You're definitely right, I'm sure in terms of programs, the odds go down drastically. But the way I figured was, if these people had 4/5 chances of getting into a specialty they applied to, it means that they would much prefer the specialty over the location of the program itself. I guess the stress in this situation would be more in terms of uncertainty of a persons whereabouts for the next 2-5 years rather than what he/she would be practicing.

 

Also, do you think that schools tend to favor their own students? what about in province applicants?

 

From what I understood threw my research on the topic, the admission process is rather subjective. As you said, we're all "homogenized" when we got in, so during our interviews/clerkship, the only thing differentiating you from the candidate next to you would be if you rub the people the wrong way or not.

 

 

Thant being said, good luck to you!

[Kinase]

Mandibular, don't forget that you are attending a french-canadian med school and that things seem a little bit different here. It's not pass/fail. We have grades (A+,A,A-, etc). And last time I checked the selection criteria on carms website, depending of the specialty, many french-canadian programs relied heavily on grades in the selection process and that included clearly pre-clinical grades. It may make the whole process less subjective in my opinion...

[A-Stark]

I'm not there yet, but this thread did get me thinking and going to look at last year's match results. It seems that I can't get entirely away from looking at competitive specialties, though as I'm moving away from surgery (still think about general...), stuff like anesthesia and emerg are coming back into the picture.

 

I don't know how I'm going to make the decision really.

[Mandibular]

They rely on grades yes but not heavily. For most ROAD specialties,it was in along the lines of 50% interview, 25% grades and 25% clerkship evaluation.

 

Also, correct me if I'm wrong, but the fact that they rely on grades at all is pure BS. How could they compare the A+ of one school to that of another?

If a person has A in med in a top school and another has A+ in another med school, how could they claim that the one with A+ is a better candidate?

[Mandibular]

This is why I think schools favor their own: in the carms stats, one of the stats shows wich school applicants ended in what schools. All the quebec schools ahd a very large retention rate of their own students

[A-Stark]

Could that be partly language-related too?

[Mandibular]

I thought about it, but the thing is that more than 90% of text books are in english.

 

If it were language based, there would have been a high provincial retention rate (which exists), but in this case, each university has a high retention rate

[lostintime]

There's also self-selection, some people who aren't into being competitive opt not to apply for ROAD and stress themselves out unnecessarily or decide too late they want ROAD and just give up. Many people in ROAD may have been prepping from day 1 of med school, it depends (of course there's variations).

[A-Stark]

Hmm. I'd thought that McGill was an exception to that.

 

Well, either way, I'm not stressing that much about it yet. I just wish I could decide what I wanted to do for certain...

[D-Rock]

Could that be partly language-related too?

 

Absolutely. English-speakers need not apply to the three French schools. So they have a limited applicant pool to rank.

[peachy]

When you're applying to medical school, yes, your odds (on paper, in terms of number of applicants) are worse than CaRMS. BUT you have complete control over what happens. Between your grades, EC, MCATs, and application, you have some idea of where you stand. When the process if over, you will get a number of acceptances and rejections, and you can choose whether to accept, to wait on a waitlist, or to skip out on the whole process altogether. If you don't get in, you can try again next year.

 

CaRMS has none of this. You apply to a bunch of programs, rank them, and then hope. Then you log on and you're told where you are going to spend (most commonly) the next five years of your life. Don't like where you matched? Tough. You just signed a contract to train there and you no longer have a choice about it. The whole process is messy and disorganized -- e.g. if you look at some threads in these forums, some programs haven't even told their applicants if they have interviews yet, and the official interview period has already started. You're also pretty much asked to lie -- you have to go to an interview for your backup specialty at your backup school and tell them with a straight face why this is absolutely your dream residency position.

 

You're also four years older and that much further along in your life -- the idea of up and moving to another city for a big chunk of time becomes less and less appealing as you want to work on other life tasks, like marriage, children, a house, etc. And, frankly, you're a lot more tired and less willing to put up with the bull**** associated with applications processes.

 

The issue of location is huge in CaRMS. Yeah, there may be a reasonable number of radiology spots in total. But if you want to live in a particular area (and most people do for whatever reason -- you have family, you've built a home, you belong to an ethnic community, etc, etc), your options are much more limited. So you end up really wanting one or two programs, and if that's a competitive program like radiology, that's only a few spots at each school. Some random resident or staff doesn't think you would be fun to drink beer with? Oh well, that's your dream spot gone.

 

Obviously I'm exaggerating a little, and some programs (particularly larger and less competitive programs) have equitable processes and most people end up in a residency that they are reasonably happy with. But that gives you a taste of why people find the process stressful.

[BlackJack]

Most people will end up matching, though not to their first choice of location. That's tolerable: one can withstand a temporary setback in order to practice in the field they enjoy.

 

Some people are applying to fields with high competition, such as radiology or plastics. Now, a good number of these people won't match to their desired field. In order to not look like a super-loser, many of these people "back up" with another field so that they still match in the first round, which has its advantages: not only do you not have to avoid your peers from match day onward out of embarrassment, but you also do not have to abide by restrictions put in place for 2nd-round matchers such as those in Ontario. So, though for the most part "backing up" requires a super-keen ability to bold-face lie to the program and to yourself, it offers a considerable advantage for the applicant to do so.

 

And if by chance you aren't successful in the first round? Then your options are limited. Since they already have your money, your school likely won't be helpful - mine wasn't. What's left over in the second round are generally spots nobody wanted for whatever reason be it location, program, the field itself, and so on. But, given your debt, and given your inability to do anything else outside of medicine, you go into another specialty at some program you never had on your radar. You lose control over your life. And then you slog through residency not because at the end you'll be doing what you've always wanted, but because you need to pay off your loans and this is stable employment.

 

This is why Carms makes people freak out. If you win, it's great. If you lose, it's the biggest kick to the crotch.

 

And, most importantly, unlike medical school applications, you have ONE shot at Carms. That's it.

[Mandibular]

oh wow, uncertainty is a b****. In terms of moving,I guess I didnt see it that way, given that all quebec universities are concentrated within a given area.

Carms really is pain then, huh

[Talon01]

My questions might seem out of line,and if they are, I apologize.

 

But after going threw all the Carms stats for 2009, I noticed that even the so called "competitive" specialties had very high odds of matching.

For example, radiology had 101 people who put it as first choice, out of which 80 successfully matched. Am I completely out of line when I say those are very good odds? It seems to me that you don't have to be the best in your class, you just shouldnt be in the bottm 20%.

 

Am I missing something here?

 

In general, med students freak out about everything.

[rmorelan]

In general, med students freak out about everything.

 

I think that is just because you got a lot of type A personalities going around or at least people who like control of things (like their own lives ). CARMS seems to be a big uncontrolled process which I would think be particularly unnerving.

 

At least they don't make you wait as long as med acceptances

[Jochi1543]

Went to this CaRMS talk by one of our deans and was rather taken aback by some of the human interest stories. The most cringe-inducing one included a very competitive department essentially enslaving a student and making him/her do stuff for them (to the point where they paged the student while s/he was working other services - convincing the student s/he was SO in) and then writing a poor rec letter because despite all that, they just didn't think s/he was going to be all that good in that particular specialty. Student didn't match, went to talk to the department as suggested by the dean, and the next day told the dean s/he would NEVER even think of going into that specialty ever again. Dean apparently had a major bone to pick with the department after, since they completely took advantage of the student.

 

Am glad I am not interested in anything competitive.

[Scholastica]

Jochi - that story sounds familiar to me. Do you go to UofA by any chance? lol

 

The majority of stress for me comes from the fact that I'm couples-matching with my bf. I can't wait till March 8 to figure out if we're gonna match together.

 

Keeping my fingers crossed!!!!!!

[Jochi1543]

You should post which department this is, so that everyone will know that they can't be trusted.

 

It's this kind of stuff that medical students need to know about so that they're not exploited. Keeping it a secret is just letting the problem continue to happen.

 

Everyone at U of A knows....no reason why people from other schools would need to know.

[Elusive]

so out of province students consider this when they book electives at u of a in this department.

[Jochi1543]

so out of province students consider this when they book electives at u of a in this department.

 

Indeed, sounds like a great idea to post some identifying details....especially if you want your dean to regret telling this to your class and you'd like to receive a disciplinary talk and a note in your file.

[BlackJack]

Indeed, sounds like a great idea to post some identifying details....especially if you want your dean to regret telling this to your class and you'd like to receive a disciplinary talk and a note in your file.

 

You could open a new account and post it anonymously. Or you could PM someone about it and they could list it under a new user name as well, giving you two degrees of separation.

 

Plus, I doubt anyone would be able to legally identify you online. Your details include: you may go to U of A. If you do, you could be any one of more than one-hundred people. I'm pretty sure you're safely anonymous.

[chemgirl]

It's a tough one. I know people probably can easily figure out who I am in the "real world" from what I post on here.

 

Besides, this department can't really exploit someone from out of province in the same way-they won't be in Edmonton beyond the length of the elective.