How to 'rank deep'?

[Guest dddd]

I was wondering how it is possible to apply for, and expect to have a shot at, a residency spot if you have never done an elective at the school.

 

From what I understand, there is only time for 3 or so electives, so if you do them at your top three schools of interest, doesn't that basically exclude you from getting a spot elsewhere? I guess what I'm asking is how is it possible to rank 'deep' in a given specialty, if you can't do electives at more than 3 or 4 schools?

 

Thanks.

[Guest cheech10]

You can still apply for and land residency spot at places where you haven't done electives, it's just that if you really want a spot at a particular school, you really should do an elective there.

[Guest UWOMED2005]

Yeah, a lot depends on how competitive the specialty is we're talking about.

 

Matching to plastics at Dalhousie without doing an elective there is exceedingly unlikely. They've only got 1 spot to fill, they've probably had 4-10 students do an elective there, and surely one of those students is going to be solid and have ranked Dal high enough to be matched there. Why wouldn't they take that known quality over some random person with perhaps a good CV but no direct exposure to the Dal plastics team.

 

On the flipside, Toronto Family Medicine has to fill 70 spots. There might not even be 70 people doing family medicine electives in Toronto this fall. Of those doing electives, more still might just be using family med as a backup or might choose to go somewhere else. So Toronto family med will almost surely accept a large number of med grads who never did an elective in family med in T.O.

 

In the middle, UWO Internal Medicine needs to fill 17 spots. They might have had more than 17 solid applicants pass through on electives, but many of those might be picked by other programs. And in fact, UWO internal medicine doesn't really know those applicants who just did one elective (it

's a big department) so it might be worthwhile taking a risk on someone who didn't specifically do an elective at UWO. Likewise it might be worthwhile for the Internal Med keener to rank internal med programs he didn't do a specific elective at.

 

What residency program you are applying for has a great deal of impact on your strategy, and what is necessary to match!

 

Hope this helps.

[Guest dddd]

Thanks, that does help.

 

I was thinking of the more competitive residencies (ie Emergency). Like you say, it is pretty likely that a bunch of other students have done electives at a school where you haven't. So in that case, it just seemed like a lot of money and effort to apply or interview when in all likelihood you won't get ranked very highly by the program director.

[Guest avisee]

It sounds like it might be a wise idea to choose wisely the schools where you do your electives. It might be a good idea to consider the residency acceptance stats for each school and try to include one school that interests you but has comparatively less competition. Maybe this will help you, maybe it won't, but match rate could be another thing to consider when deciding where to do residency, beyond which school is located in the nicest city, or which program has the best bells and whistles.

[Guest JSS02]

Obviously if you REALLY want to match to a specific program you should do an elective there. You could also look at the CaRMS stats for "Average out-of-town applicants matched" and do an elective at a place where the numbers are lower (e.g. 42% at U of T internal, vs. 85% at Queen's internal). These are places that are more likely to keep their own students, which could suggest that having people they are already familiar with is particularly important to them. So, it might be more important for you to do an elective there so they get to know you.

[Guest Ian Wong]

As previously mentioned, this is why your best chance to match into a competitive specialty is probably at your home institution. In theory anyway, this is because you've had 4 years (or 3 years if you're at U of C/Mac) to make connections to the department you're interested in at your home medical school. Things obviously get a little more complicated if your school doesn't have a residency in that program, or if you decide on your specialty very late into medical school (and therefore haven't had the chance to make connections in that field, do research, get a few electives in with reference letters, etc).

 

It is possible to match into a program where you didn't do an elective, but there probably needs to be something in your application that they are really looking for, and whether this is research productivity (which may be important if that department is really looking to improve its academic profile of publishing), or maybe a strong letter of reference from someone well known to that department (ie. your inside connection to that program), or any number of other things. This is a big portion of why CaRMS is such a black box. Each program is completely free to set whichever criteria they want in inviting people for interviews, and to use any criteria they want in ranking people.

 

Still, each year people match into competitive specialties without doing an elective at that institution. But, it's probably quite a bit less likely than if it's either your home institution, or one at which you did an away elective.

 

Ian

[Guest dddd]

Thanks for the advice everyone.