Understanding Stats

[Guest tweep0]

Hi all,

 

I'm just a pre-Med trying to make sense of the residency stats. I have heard that a large % of McMaster's MD program graduates become family medicine residents because they CANNOT get into other specialties. Thus, you have better chances at more competitive specialties if you go to other schools. Can someone correct me on this and/or show me where I can find stats showing the residency spots taken by graduates from specific schools. Thanks

 

Tweep

[Guest DrSahsi]

I think the logic is flawed. Given the actual mechanics of the match, I don't honestly believe that students will be at any disadvantage simply because of the medical school they chose to attend. There are so many variables of greater importance that get evaluated, that the school of origin is the least of their worries.

 

Also consider the fact that there are roughly as many residency spots as there are graduating students (give or take)... and that, by default, almost half of those spots are in Family Medicine, even though applicants across the country are skewed toward other specialities -- competitive or otherwise. There will be many people who use Family Medicine as a "fall back" option -- still others choose it quite deliberately. To analyze a school based on a graduating percentage entry into Family Medicine makes a whole bucketload of assumptions.

 

Similarly, I wouldn't start making decisions about applying to schools simply because of their students performance in the residency match. Evaluate each school on its own merits.

 

- Rupinder

[Guest UWOMED2005]

Actually, mac had some of the better match statistics, from a few perspectives, last year with only one person unmatched. . . in a year where MANY people went unmatched at other schools. Many of those spots matched to Mac were quite competitive.

 

Traditionally, Mac does match more people to family than other programs. I think this has a lot to do with age. . . the average age of Mac students is quite a bit higher than many of the other schools. And to one degree or another, the older you are in 4th year, the more appealing family medicine is.

 

Why? Think of it this way: the avg age of my class at UWO in first year was 23.5. After a four year MD, the average student age is 27.5. If you choose family, you can get out at 29.5, start paying those debts off and are a few years ahead on mortgages and RRSPs. If you choose a 5 year specialty, the youngest you get out is 32, then there is the question of fellowships and even excluding those you're probably not out of the shadow of debt until at least 35.

 

That's if you're 23.5 on acceptance. What if you're 28? You're looking at getting out of the MD at 32. The ages you're looking at are 34 or 37+ (specialists often do fellowships today.) Depending on family considerations, those three (+?) extra years of residency could seem like an eon.

 

Some stuff to think about.

 

And to agree with Dr. Sahsi, it's practically impossible to get a sense of which school gives you the best shot at landing the chief resident spot in complicated ophthalmological-cardiac-neurosurgery at the House of God that you've been gunning for since you were five years old.

[Guest tweep0]

HI again,

 

I am a litle skeptical at the notion that the school doesn't matter. Mac's Med program is three years. Thats an entire year less time in electives and making connections in comparison to other med schools. It seems logical to assume that as a result of this, Mac students would have a lower chance at competitive specialties = increased family medicine.

 

P.S. Can someone tell me WHERE i can find stats that show the breakdown of residency placements of graduates from a specific school. ie what % of mac grads went into neuro? what 5 of UofT students went into cardiology etc.

 

Thanks

[Guest kosmo14]

www.carms.ca/stats/stats_index.htm

 

Visit the above link, then choose: 2003 PGY-1 Match Report, this will open a new window, scroll down to the bottom of that page and click on "First Choice for Graduates of 2003 by Discipline and Medical School(calculated in percent)"

 

That will give you match stats for each school. By your reasoning you would also be saying that UofC is at a disadvantage due to its three year program. I don't see that in the stats. It seems pretty even across the board.

 

It is not the school that determines the residency it is the student.

[Guest Ian Wong]

Those stats unfortunately don't exist in the public domain... You are essentially looking for a "match list", a breakdown of how many students from each school's graduating class went into each specialty.

 

A senior med student from UBC will know UBC's match list because he/she knows everyone in the class, but will know nothing about U of A's match list. In the US, many medical schools release their match lists as a way of publicizing how many of their students match into competitive specialties. In Canada, since all schools are publically-funded by the government, there isn't that intrinsic drive to do so.

 

I think you can match into any specialty from any medical school, provided that you are a strong and competitive applicant. Of course, if you are trying to match into ENT, and your medical school doesn't have an ENT residency program, that will make things tougher for you, but it can still be done.

 

At first glance, I'm not a big fan of doing med school in three years, but then again, I've never been to Mac, and there are certainly some advantages to doing it their way instead.

 

Ian

[Guest Ian Wong]

Just as a quick comment on kosmo14's message. That link, describing the "First Choice for Graduates of 2003 by Discipline and Medical School(calculated in percent)" does exactly that.

 

It tells you how many people from a given medical school were going for each specialty, but not whether those people were actually successful in getting that residency.

 

Ian

[Guest UWOMED2005]

Yeah, if you're checking the 2003 stats, don't forget to check the 2002 stats. And 2001. 2000, 1999, 1998. . . etc. Hopefully you get the picture or maybe medicine is not right for you (just kidding.)

 

But seriously, how the schools match varies WILDLY year to year. I've seen two matches from UWO. They're both pretty solid and have the same number of unmatches, but other than that they're as different as a pulmonary embolism and cirrhosis. I remember thinking UWO wasn't that strong a place for med students wanting ENT because noone matched two years ago. Oops - we matched 3 last year, pretty much the most of any school. Reciprocally, we matched 4 to emerg in 2002 but either 1 or 0 last year.

 

Pick the school based on where you think YOU will fit in. Trying to find the "best" med school for "everyone," ie one that will benefit its students the most, is ridiculous.

 

But obviously, UWO students do the best in the match. . .

[Guest cracked30]

Since this is a pretty active thread, I have a thought.

 

The number of medical school positions has risen considerably in Ontario, I cannot comment on any other province. However, there has not been an equivalent increase in the number of residency positions.

 

Starting with this years clerkship class, there are going to be many "Unmatchables"

 

By the way DrSashi, when are we getting that video?

[Guest darklord]

Starting with this years clerkship class, there are going to be many "Unmatchables"

 

 

The above statement are you referring to this years graduating class ie 2004 or the class just entering clerkships.

[Guest UWOMED2005]

I am 99.999% confident that there will still be MORE residency spots than med grads this year. Why?

 

1) Up until last year (an aberration) there was always a fair bit of a buffer of spots over apps. So if nothing changes, it'll be tight but it will work. IMGs might feel the squeeze.

 

2) In an era of high publicity for GP and specialist shortages, it would be political suicide to not fund residency spots for grads. They spent $100k + to train us, and now they're going to let us rot when the public is crying for docs? No way.

 

What I could see happening is the government opening an extra couple hundred spots. . . all in family. We'll all match, but if we match to that complicated neuroplasticangiographic surgery spot we all want is another question.

[Guest cracked30]

Well, I didn't come up with that idea on my own. I was reading the Medical Post last night and the CMA is claiming that the numbers don't add up.

 

It will make the competetive specialties super-competetive. Lots more people will end up in family medicine who don't want to be there, that is probably not a good thing.

 

Great time to be in medical school! F>ck!

[Guest Ian Wong]

In an era of high publicity for GP and specialist shortages, it would be political suicide to not fund residency spots for grads. They spent $100k + to train us, and now they're going to let us rot when the public is crying for docs?

Doing anything to the health care system these days amounts to political suicide... Keeping the status quo is suicide, cost-cutting even more to keep up with the annually increasing demand is suicide, raising taxes or going more two-tier is suicide. This year there were over 110 med students that went unmatched; I have exactly zero confidence in the government reacting this quickly to what is currently only a "one-year blip."

What I could see happening is the government opening an extra couple hundred spots. . . all in family.

My prediction is that because of the huge number of unmatched people this year (most of whom ended up scrambling into a Family Medicine residency), most people will no longer be backing up their primary choice just with Internal Medicine/General Surgery, but also Family Medicine as well.

 

In that way, you at least have the opportunity to compete for the Family Medicine location that you really want in the first round of CaRMS, rather than the second. I suspect that lots of people were caught off-guard this year, and next year's class will be much more enthusiastic in pursuing one or more backup specialties. For that reason, I wouldn't be surprised if there were less than 110 med students unmatched next year.

 

However, since people are still going after specialties in a big way, many of them will still end up without specialty spots and will end up in Family as a backup. So even if the total number of unmatched students is down, that's not necessarily a great thing because the reason for the decrease in unmatched students will be that many of them will get into a backup specialty in the first round (so they still might not be happy with their match, but it's still better than going completely unmatched...)

 

Ian

[Guest cracked30]

Completely unmatched, that would suck.

 

Can you imagine having to do an extra year of medical school? It would be all electives, of course, but you would need to, so there were no gaps in your CV.

[Guest cracked30]

In an era of high publicity for GP and specialist shortages, it would be political suicide to not fund residency spots for grads. They spent $100k + to train us, and now they're going to let us rot when the public is crying for docs?

 

 

I don't think the government pays that much to train you. You pay a pretty penny, the hospital doesn't pay a cent. Where does the 100k figure come from. Have you not been trying to refute that figure since deregulation of tuition?

[Guest UWOMED2005]

Did you actually think that tuition you payed was even CLOSE to the cost of your training?!? I've heard the figure $35k bandied about for the cost of your training per year. Times four years is $80 000. Add in about $5k/yr for undergrad (I think it's roughly $10k for undergrad depending on the program, less $5k in tuition) for 4 years undergrad and you got $100k to train a med student before residency.

 

Rough estimate, but the actual total is in that ballpark.

 

Ian - aren't you talking about the first round only? There is the second round as well. I'm pretty sure those 110 people you've cited are those who didn't match in the first round. But in the very end, I doubt many people didn't match at all with the exception of those who chose not to match for a year and reapply.

 

As to not matching, my understanding is that there is tons you can do, as long as you can find $$ to pay interest and fund your year. You could volunteer overseas, do research electives or clinical electives to improve your CV.

 

My impression is that many of the people who unfortunately fail to match are in fact outstanding candidates who just decided to apply only to something competitive without backing up. This is often actually a CaRMS strategy: say you are going for Cardiac surgery and realize you wouldn't be happy in Gen Surg, Thoracics, Medicine or any other backup. You might decide you'd be happier applying only to the 7 Cardiac Sx programs and not back up. . . because if you do backup and don't get choice #1 you're stuck in a career you don't like. If you don't get #1 and you don't match, theoretically you could improve your CV over the year and maybe get lucky with less people applying the next year. In reality, this might have been a wise strategy for 2002. . . 14 people listed Cardiac #1 for 7 spots, making it really competitive, whereas in 2003 I think only 7 people listed it #1 for the 7 spots.

 

And if you don't match and rethink your decisions, you can always try to match in the 2nd round - you wouldn't have had that option backing up.

[Guest Ian Wong]

Ian - you're neglecting the second round. I'm pretty those 110 people you've cited are those who didn't match in the second round.

Nope. Of the twelve people who went unmatched at UBC this year after the first round, only 4 are still unmatched and seeking residencies for this upcoming year. The other eight have all started residencies (seven in Family, and one in Pathology).

 

I believe the situation is similar for many of the other med schools. The 110+ unmatched students from this year's CaRMS iteration was definitely the tally after the first round. After the second round, I wouldn't be surprised if there weren't only some 30-40 students still unmatched (with the remaining 70-80 students scrambling into vacant Family Medicine spots in the second round).

 

Ian

[Guest McMastergirl]

I just want to correct an earlier post in this thread that said Mac's program is a year shorter... considering we don't get summer holidays and 4-year schools do, the actual time spent in med school is roughly the same. Clerkship is a bit abbreviated, but we have just as much elective time, plus more time during the year to do electives "horizontally" - that is, while "attending classes."

I've seen excellent Mac grads at other schools as chief residents and in competitive specialties. Trust me, the med school makes NO difference.

[Guest cracked30]

Meds2005, have you hear of METTA? Well, the bunch of folks that were around before that, in 1997, before deregulation. Names like John Gillis, Danielle Martin fought long and hard to get the university to PROVE that it cost that much per student. No one ever did. What came to light was that they took the anual budget of the faculty of medicine and divided it by the number of medical students to come to that figure.

 

But, guess what we pointed out? There were at least a thousand students from other faculties taking courses funded by the faculty of medicine, and graduate research, and graduate student salaries were covered under that figure too.

 

So, really, where do you think this huge cost is coming from? You sit in the same room all day and lecturers come to visit you, heck, Dr. Colby's time with you is unpaid. Maybe all those photocopies?

 

Get real, just because someone "bandied about" some numbers doesn't mean they're true. I hope you're more tenacious in finding the truth when trying to diagnose.

[Guest UWOMED2005]

Of course I've heard of METTA - I was pretty involved with them in my first year (before you got to UWO even?) until I became too busy and a tad bit disillusioned with the movement, though I do readily acknowledge much of the research they've done has been invaluable in debunking myths about tuition deregulation. I knew Danielle quite well in first year - she always took the time to stop and chat with me in he halls despite the fact I was only in first year, and I actually share most of her political views. While John Gillis had graduated on to head PAIRO (am I correct?) I played rugby with guys who'd played rugby with him and heard some great stories about the days when he played rugby for the Ivey-meds.

 

I fully agree that what we're being charged is too much. Any government wanting to have 21st century standards of healthcare should not be charging penniless youth $10-15k or more to learn how to pull them out of congestive heart failure at 76 yo after 3 MIs secondary to stuffing their face on Big Macs for thirty years. It's ridiculous to saddle someone with such little life experience with such debt. . . it could easily warp their priorities from the patient to the billing fee.

 

And METTA is right to point out that the Faculty of Medicine's number is flawed. It is a complete over-simplification.

 

But I still figure we cost close to that $35k figure, as a ROUGH estimate, which is what I said in the first place. Why? It's bloody difficult to get a true gauge on what we cost the university due to the interconnectedness of the medical school with everything else in both UWO and the London Hospitals. To get a true estimate would be impossible. True, Microbiology and Physiology students use some of the same facilities we do (not many though!!! DS1002, M146, the LRC, and anatomy labs are almost always dedicated to medicine.) But we also use their profs (Sims, Madrenas, etc) and the libraries. . . I doubt these were included in the FOMD calculations. And it's not like the Physicians teaching us (ie Colby, Sugimoto, etc) aren't getting renumeration in some form for teaching us - they still cost the government money. Coming up with an exact figure would be impossible.

 

I'm taking that $35 000 figure as a VERY ROUGH estimate based on a) the fact I've heard students from other schools claim roughly the same figure Tuition the US at a private school is at least that or more. . . so I thought it sounded pretty reasonably based on that c) combine a and b and what the FoMD at UWO might be reasonable, despite the flawed methodology. So the gov't chipping in $20 k I think is very reasonable.

 

I have nothing better to go on, but I would be willing to cut off my left pinky finger if it cost less than our $15k tuition to train us.

 

And please don't be rude - if you found my last post aggressive please realize I was post call and 35+ hours without sleep when I made that last post if you're reacting to that and found it aggressive. I also don't find it that aggressive. Or. . . cracked30 - have you lost your whip?

 

Ian - whoops! Sorry, I messed up some words in my last post - note my comment about being post call. I've edited since then.

[Guest cracked30]

Well, you did seem agressive.

 

I still think they overinflate the cost of teaching a medical student. Especially when you think, in years 3 and 4, you are performing a service for free. Now the hospital has to cover your butt with liability insurance and that costs a bit. But there is no true remuneration for clinicians time with you on the wards, and students slow down community guys. They mostly do it because they like to teach.

 

Someone has to sit down and actually work out the cost of a medical education before we can talk numbers.

 

What service are you on? Must be surgery, enjoying it?

[Guest phantom8]

Just because the renumeration of clinicians is a fraction of what they would be making if they were actually seeing patients, doesn't mean that there still isn't a "cost" involved. The cost instead becomes all the patients that the clinician was unable to see because they had to devote time to teaching. These are still costs that would have to be included when trying to determine how much it costs to train a med student.

[Guest UWOMED2005]

Unfortunately, I don't think it would be possible to come up with a truly realistic number due to all the intangibles.

 

I was under the impression clinicians billed for the services we as students were providing?

 

Yeah, they are getting free work out of us. But then again, we take a lot of the nurses, RT and physician's time.

 

I'm not on surgery - yet. I'm on medicine. But I keep getting told my the meds residents that I seem like a surgeon. Fortunately the patients are saying I seem like a medicine type.