Residency in a Different University/City than Medical School

[Guest UofT Student]

Hi guys,

 

If a student decides to go to a med school like Western or McMaster, but wants to return to Toronto for residency, can this be done? If so, would it be very difficult to get a residency position in a city other than your med school city? Would preference for Toronto residency positions, for example, be given to UofT med school students?

 

Thanks in advance.

[Guest LIPOSUCTIONATOR]

I hear from other people that U of T prefers their own students, thus you would have a better chance of getting a toronto residency as a U of T grad than a Western or McMaster grad. I'm also interested in the answer to this question. Maybe someone who knows what they're talking about can comment.

 

About the statement,"it doesn't matter what medical school you graduate from." That's definitely true in regards to opening your own practice but if you want to work for a hospital in Toronto (i.e. Sunnybrook or St. Mike's ER), I think they would prefer U of T students or perhaps med students who did their residency in Toronto all things being equal. Then again I know very little about how hospitals hire doctors.

[Guest Kirsteen]

Hi there,

 

My directly inexperienced leaning is that, as long as you have: 1) some elective face time within the city in which you would like to secure a residency; and/or 2) a very good interview or strong application, then you can secure a residency in a city other than that in which your medical school alma mater is located. Case in point: Carolyn, who posts here was a McMaster graduate, but won an ER residency spot here in Toronto. Thus, the "feat" seemingly can be achieved.

 

Cheers,

Kirsteen

[Guest therealcrackers]

The story at UWO is that about 40% of the graduating class stays at UWO for residency. The other 60% go somewhere else: Toronto has the most residency spots, so a large number of students end up there. Last year, as an unusual example, 7 graduates matched to OB/GYN; 2 in London, 2 in Toronto, 1 in Hamilton, 1 in Edmonton, and I think 1 in Halifax.

 

Other med schools probably have a similar ratio, depending on the number of graduates they have, and how that meshes with the residency programs "offered by" the school.

 

Kirsteen is right: doing an elective in a city you wish to match to makes a big difference: you become more of a known quantity (strengths, judgement, presentation skills, etc.) than someone who has not spent any time there but merely arrives for an interview.

[Guest marbledust]

I am going to make a very big generalization because I don't have any facts or figures in front of me, but more people do residencies at different universities than where they went to medical school. I am sure data can be found by poking around the carms site if you are interested - http://www.carms.ca

 

There are many different reasons for doing so - the desire to live in a particular city, the specialty you want may not be offered as a residency program at your medical school, you may really like a particular univeristy's program over the one at your school, and, the luck (or bad luck) of the carms match means you can potenially end up in any city you offically list as a choice of program in your residency application.

 

I think being a "home" student does give you obvious advantages to landing a spot in a residency program at your own school. But as Kirsteen said, as long as you have a strong application, and can maybe get an onsite elective done so people get to know you, there is no reason why you can't successfully compete for any spot at different universities.

[Guest UWOMED2005]

To add to what crackers said for UWO, we at the least matched someone to ENT (a very competitive program) in Toronto last year and routinely send about 25-30 students overall to U of T for residency, so you can definitely match to another school for residency. But someone who does their med school in Manitoba wanting to match to Manitoba for residency has an advantage: more time and proximity to make contacts in Manitoba.

 

Also, it should be noted that both Queen's and UWO traditionally train more med students than residents, yet they have among the highest rates of specialization in the country (about 80% to specialties other than family in a typical year, from the CaRMS website stats.) How could this be possible if the UWO and Queens students were at a disadvantage for the other schools? This is balanced out by the opposite phenomenon in Toronto and some other larger centres (# residents > #med students) and the smattering of residency programs in smaller centres (ie programs in North Bay, Thunder Bay, New Brunswick.)

 

Interestingly enough, someone once gave me advice to NOT practice medicine in the same location you did your residency (at least if you specialize.) Why? Well, truth is most people are at least mildly incompetent their first year of residency and make mistakes that stick out. If you end practicing in that city, you'll always be remembered as that junior resident who put Mrs. Doe into heart failure forgetting about her IV, or missed Mr. Doe's posterior wall MI. If you go to a completely different center, you show up as a "specialist" in that field. . . maybe even THE "specialist," and nobody remembers your bumbling.

 

So if you want to PRACTICE medicine in Toronto and are worried about that minuscule disadvantage you might get from not going to med school as the same place you do residency, maybe you don't want to go to U of T for med school after all. . .

[Guest Ian Wong]

If you go to a completely different center, you show up as a "specialist" in that field. . . maybe even THE "specialist," and nobody remembers your bumbling.

I'll be honest, I doubt this is really that big of a factor. There are advantages to going away (for residency or fellowship) however, mostly in that you learn other approaches or techniques that you wouldn't otherwise have encountered if you didn't train at multiple institutions.

 

As far as geographic distribution, something that you'll hear over and over again is that your best chances of matching into a residency are at your home location. There was a great thread on this in the past in the CaRMS forum, but I can't seem to find it right now. If anyone does, please post a link here.

 

The reason is that as your home, you have that many more opportunities to make contacts, work with the residents, and in general, make yourself into a known commodity to the selections committee. Residency is a long time to be working with someone who doesn't fit in well, and the selection committees work very hard to find people who work well within the team. Still, as everyone has noted, you have a legitimate opportunity to match into virtually any residency from any Canadian medical school. Yes, there are often local politics involved or other factors outside your control, but the bottom line is that in most instances you can get to your destination from anywhere else. I therefore wouldn't make my med school decisions based on what city I hoped to do my residency. Choose your medical school based on what fits you best. Residency will take care of itself.

 

Here's a useful link to some CaRMS statistics, with a breakdown of which cities each medical school's graduating class matched into. For example, Toronto had 167 people in this last year's match, and 99 of them ended up staying in Toronto. In contrast, only 19 of 92 UWO grads stayed in London for their residency.

 

www.carms.ca/stats/pgy-1_2003/page13_table32.htm

 

Ian