Matching into Family

[justletmein]

 

If competitiveness is a direct measure of competence, which tends to be the prevailing thought, then the family residencies should be happy that such competent medical students are even considering them for a backup.

 

ignorant comment.

most family programs filled up this year- except for unwanted rural spots.

i hope you go unmatched, while you expect all the family programs to be begging you to join them.

[justletmein]

It's truly a shame that you've misinterpreted the meaning of my post.

 

The rural spots are the one's that are the most crucial if rural medicine is to be serviced in an adequate way. So our current system still fails.

 

And I'm almost finished my residency, so there you go.

 

Wishing ill upon people with whom you merely have a differing opinion speaks poorly of your flexibility.

 

Whether the rural spots get filled or not has nothing to do with what you posted.

 

The prevailing opinion among med students that family is simply a fallback is insulting to those who are truly interested in family practice.... And the idea that family programs should somehow be thrilled that ophtho or derm gunners are "even considering" them as a backup is condescending.

 

I can tell you that some of the most intelligent people in my class applied only to family.

So, I'm sorry, but your idea that the competitiveness of the program one applies to correlating with their strength as a doctor is completely and utterly false.

 

I hope that you change your opinion of family doctors by the time you finish residency.

[tooty]

No, most programs encourage you to have varied electives.

 

So FM elective pre-carms is not necessary.

But if you do 3 rads electives, they will probably start asking questions.

 

I love it when FP gets all snobby because someone did electives in more competitive fields. What the hell are they smoking?

 

Nothing, it's perfectly reasonable to assume that you're backing up with family if you've done 3 rad electives unless you have a very good explanation in your personal letter.

 

Even then, there's nothing wrong with backing up with family

 

It's not about being snobby.

It's about prioritizing the students who actually want family, and ranking them higher than those who are using family as a backup.

 

Nobody wants unhappy residents who spend their time trying to find a way to switch programs.

 

I think applicants for competitive residencies are much more "snobby" with their "how many electives did YOU do?" type comments at interviews.

 

It will be painfully obvious that I'm backing up with family (3-5 electives in one specialty, 1 in family). I might even stick it out with family if I matched to it.

 

Now what's my play come interview time? Be completely up front? How successful is the 'backup' cohort in terms of matching to a family spot?

[thebouque]

Question number 1: Now what's my play come interview time? Be completely up front?

 

Question number 2 How successful is the 'backup' cohort in terms of matching to a family spot?

 

I won't answer question number 1 because I never interviewed for family medicine programs.

 

Question number 2: In my class, the 'backup' cohort was 95-99% successful. Programs expect that, they're not fools. I asked for a LOR in specialty X to a family doctor and he even told me that I should backup with family in case I changed my mind...

[HycrestJIT]

It will be painfully obvious that I'm backing up with family (3-5 electives in one specialty, 1 in family). I might even stick it out with family if I matched to it.

 

I can only speak for my program, but having ranked applicants this past CaRMs cycle, our program specifically has a "Red Flags" section in the pre-interview assessment sheet. This section includes a "Lack of electives in Family Medicine/Skewed choice of electives." As an evaluator, an application with a listing like yours would have a red flag pre-interview, and would be ranked lower as such. This topic would specifically be addressed in the interview.

 

Now what's my play come interview time? Be completely up front? How successful is the 'backup' cohort in terms of matching to a family spot?

 

Speaking only for our program, someone who uses family as a back-up doesn't get ranked - we'd rather take a second-round IMG who wants to do Family (and who trends show is also much more likely to stay locally where he/she trains when compared to a Canuck grad). How you answer is up to you - but remember it's also about how the interviewer perceives the quality (and honesty) of your answers that plays a big part. Getting caught not being totally up-front is a surefire way to not be ranked.

 

Just my $0.02

[tooty]

thanks hycrest.

 

i remember hearing that your program is particularly competitive. is that true?

[Mourning Cloak]

family programs aren't dumb, why would they want someone who has demonstrated zero interest in their specialty, when they could leave spots unfilled for the second round and fill them with people who desperately want to match?

 

The ratio of grads to spots is virtually 1:1. The programs aren't dumb - they know very well that some people end up taking second and third choices. They aren't going to leave spots unfilled out of hubris - they need bodies to do the work, and having a bunch of spots left after second round makes the strong applicants avoid the program like the plague in future years.

[Lactic Folly]

I never applied to FM, but I've heard the suggestion to approach it by explaining "yes, I like <x> specialty.. and I also like family."

[HycrestJIT]

thanks hycrest.

 

i remember hearing that your program is particularly competitive. is that true?

 

It seems like it might be, but you'd probably know more of the word on the street than I would. All I can tell you is that there are on average 10-12 applicants for every spot we have.

 

Does that mean anything? I don't even know; my CaRMS stat knowledge is nonexistent.

 

I know I'd totally do the same program again in a heartbeat were I given the choice.

[Mandibular]

Does a good clerkship evaluation in family med core guarantee you a spot in another university?

[tooty]

It seems like it might be, but you'd probably know more of the word on the street than I would. All I can tell you is that there are on average 10-12 applicants for every spot we have.

 

Does that mean anything? I don't even know; my CaRMS stat knowledge is nonexistent.

 

I know I'd totally do the same program again in a heartbeat were I given the choice.

 

I'm interested in knowing what Alastriss asked as well. For those who have a clear non-family agenda pre-interview, why would you even interview them at all? You may not get an honest answer.

[Lactic Folly]

Does a good clerkship evaluation in family med core guarantee you a spot in another university?

 

Helps, but there isn't anything in life that can be construed as a guarantee, really..

 

I'm interested in knowing what Alastriss asked as well. For those who have a clear non-family agenda pre-interview, why would you even interview them at all? You may not get an honest answer.

 

Perhaps programs need backups too?

[HycrestJIT]

Hycrest I've sent you a PM.

 

Interesting, I actually have had some friends who interviewed at UofT for FM even though they were gunning for a competitive specialty and it was painfully obvious.

 

I am curious as to whether or not the people who you flagged were interviewed at all with the intention of not ranking them or whether they were denied an interview from the get-go.

 

WIth that said, say family medicine is genuinely your second choice and you aren't able to persuade the committee of this, and you'd rather do that than anything left over in the second round. Is there any way to talk yourself into having a family medicine spot created for you in some way (with, but preferably, without, a ROS?) if you are unmatched in the second round.

 

I mean, now that we have 80 more applicants in our year + more from past years, then I'm guessing we are going to be looking at a pretty tough situation where more of us will go completely unmatched.

 

If they got an interview at all, then there was intent to rank. This year I think we interviewed close to 100 peeps for the 3 rural sites out of (?)170 applicants in the first round.

 

I'd let them know that you would be totally happy doing family med but that it's your second choice during the interview. Be straight up, especially if you liked it but you just liked something more. No worries there, that's completely understandable and very human!

 

I just mention red flags because for our program, they are a specific point to be addressed during interviews. Later on, when push comes to shove and 2 applicants are nearly identical on paper, the person with the red flag logically gets ranked lower.

 

That being said, there have been graduates from our program in the past who are now working in nearby communities as rural family docs who had no intention of ranking family first. They turned out to love it. We also have had applicants who mention gunning for a particular specialty but who would also be very happy with family medicine. We've had successful applicants who've had skewed choice of electives.

 

The key is to address and demonstrate that you would enjoy and prosper in a family medicine setting, that you would dedicate yourself to excellence in your career as a family doc and love your patients, and that you express this explicitly from the start.

 

Moreover, a big key is if you genuinely want a particular specialty but would be happy to do family, that tends to come across in either the personal letter or the interview (but there have been a lot of letters where people write generic stuff that never mentions their skewed choice of electives - big "no-no"). Remember that a personal letter is exactly that: personal.

 

Basically, a program wants people who will love their job, be good at it, be awesome to work with and who would enrich the program. PDs and residents recognize that students can be amazingly good candidates even if they desire another specialty, so long as there is a genuine interest to readily accept and make the best of family medicine were the second choice come to real fruition. In many cases, programs still rank those applicants highly because of the chance they may snatch up such a good catch.

 

Bottom-line: Red flags are also contextual. The key is that you be honest about them, and in a competitive world, yeah, they do set an applicant lower when push comes to shove. That being said, they're not absolute limiting factors.

 

I hope that made sense.

[HycrestJIT]

I'm interested in knowing what Alastriss asked as well. For those who have a clear non-family agenda pre-interview, why would you even interview them at all? You may not get an honest answer.

 

It's one thing to have a clear non-family agenda from the outset where family is merely a safety net and you don't really want to do it.

 

It's totally another to have family medicine be a second choice that you would really like to get if your first choice passion didn't work out.

 

The key isn't to have FM keeners only, but to have people who would enjoy being family docs.

 

Differentiating the two is important, and that plays significantly into ranking/non-ranking/interviews/invites/matching.

[supafield]

Very interesting thread.

Thanks for the contributions hycrest....

 

I've wondered about some of these questions myself as someone who is very fond of emerge but thinks it would be better combined with family than on its own.

 

I appreciate the insight.

[tooty]

That's reassuring hycrest. Thanks a lot.

[leviathan]

Should I even bother applying to FM if my electives are mostly all in internal med specialties?

 

I'm happy with either IM or FM, although I will be ranking IM first. As ridiculous as it sounds I was only able to get 1 family med elective because the 2nd one got cancelled. I rebooked another family med elective but it won't be until after CaRMS is over.

[thebouque]

It's one thing to have a clear non-family agenda from the outset where family is merely a safety net and you don't really want to do it.

 

It's totally another to have family medicine be a second choice that you would really like to get if your first choice passion didn't work out.

 

The key isn't to have FM keeners only, but to have people who would enjoy being family docs.

 

Differentiating the two is important, and that plays significantly into ranking/non-ranking/interviews/invites/matching.

 

Thanks, your posts clarify a lot of things

[thebouque]

Does a good clerkship evaluation in family med core guarantee you a spot in another university?

 

It's never guaranteed mandibular. But since you're at Sherbrooke, I assume that you'll apply to Quebec schools. A family medicine spot in any of the 4 Quebec schools is 99% guaranteed if you got a decent eval in your core rotation. I don't know anyone who got into family in a Quebec school and who did an elective in family. Exceptionally this year they had to refuse a few people in urban Laval, UDM and McGill (!) but it was a very exceptional situation. A few of these people had red flags in their application as well (using family as an obvious back up doesn't count as a red flag here). I like Brooksbane's expression, it's a CO2 specialty for canadian graduates.

[Mandibular]

Thanks bouque

btw, the discussion we were having about the being part of CCFP and FRCPC is also doable: one of our school administrators has the following title:

 

MD, CMFC (MU), CSPQ, FRCPC

I dunno if that means she can practice both, but this is what appears in her email signatures

[thebouque]

MD, CMFC (MU), CSPQ, FRCPC

I dunno if that means she can practice both, but this is what appears in her email signatures

 

According to what Maxime said, she probably trained in both, but cannot practice both (again this only applies to our province because we're so special )

 

EDIT: she's cmfc MU (emergency med) so it's different here:

She's a 2+1 who decided to complete a 5 years ER specialty, OR she's an old 2+1 who got grandfathered (except for McGill, the 5 years ER med programs are relatively recent in Quebec, about 12 years old if I'm not mistaken, and some old ER docs got the credentials without the training). However I don't think she can practice family medicine anymore.