Did not match! What can I do?

[AnxiousBoy]

I will begin by saying our postgraduate education system is unacceptably flawed.

 

It is not enough to suggest that second round losers 'just do family' because, as we see here, that might not be an option. Not to mention suggesting mediocrity over excellence runs counter to the philosophies of medicine.

 

You have experienced how unhelpful your pg dept. will be. If you want a position this year, you're gonna have to get on the horn and call around. You will still probably not get one.

 

I suggest writing the usmle and going to the states next year, coupled with performing publishable!!! research with a big wig.

 

If this is how Canada wants to treat its medical students, it deserves to lose them.

 

I second the flawed PG Ed sentiment. Macroeconomics speaking, it makes absolutely no sense. If you're going to invest so much in developing and training a valuable commodity, you would think the system would be as efficient as possible to get back your ROI.

 

I will confirm that CARMS rules prevent offering unfilled spots after second round, at least officially. This was the most cited response from PD's whom I contacted. I tried all the tricks too including ROS and even offering to pay myself my own 2 years worth of salary. Excuses like too many resident diluting educational experience, it costs 3X more than salary to training residents, cannot find rotation time,... blah blah blah... it was quite clear that I was chasing my own tail. While I'm sure exceptions can always be made with a big wig pushing things around on your behalf, I was just a nobody making an out of the blue calls to these PD's.

 

On the bright side, I wonder whether you would really want these 2nd iteration positions. Most of those positions are for rural areas where you would be the only resident there. I wonder if you would be happy going through the process by yourself because I know I wouldn't.

 

Prepare for next year, keep yourself busy whatever it is you do, and realize the reality of the situation you are now in, and go for in the 1st iteration a nice comfortable position you would be happy being in for the next few years.

[NLengr]

So let me get this straight:

 

We spend tens to hundreds of millions of dollars expanding the number of med school seats (new schools, extra students, more profs, more lab equipment etc.). The public complains there aren't enough family docs in rural areas (which is true in big portions of the country).

 

We then fail to create enough CaRMS spots so the med students into whom we invested over $100,00 dollars of taxpayers money per student can become docs. We don't even make it so that we set up 3rd round ROS family spots to FORCE them to become the much needed family docs in rural areas (which they would take rather then be un-employed and in massive debt).

 

We then create extra IMG seats in many provinces. Those seats cannot be filled by CMG's. We pay to educate people that the taxpayers had no role in funding, and who may or may not have strong ties to the country. We hang our own grads out to dry.

 

Awesome. Good to know. Excellent work everyone.

[tooty]

lol ^

[rmorelan]

So let me get this straight:

 

We spend tens to hundreds of millions of dollars expanding the number of med school seats (new schools, extra students, more profs, more lab equipment etc.). Then the public complains there aren't enough family docs in rural areas (which is true in big portions of the country).

 

We then fail to create enough CaRMS spots so the med students into whom we invested over $100,00 dollars of taxpayers money per student can become docs. We don't even make it so that we set up 3rd round ROS family spots to FORCE them to become the much needed family docs in rural areas (which they would take rather then be un-employed and in massive debt).

 

We then create extra IMG seats in many provinces that cannot be filled by CMG's so we can educate people that the taxpayers had no role in funding, and who may or may not have strong ties to the country.

 

Awesome. Good to know. Excellent work everyone.

 

You can never FORCE a hospital to take someone. They would simply balk at that idea - they may feel there are very good reasons not to let someone into their program (they may have already rejected them twice to start with). I don't think we would also really want to force a particular medical student to take a position in any area they didn't want to go into. Some would prefer to wait a year and try again for something they are truly interested (particularly because transferring between specialties is very hard). In the long run that is probably a better outcome for the health care system.

 

There are enough CARMS spots - but there isn't enough to guarantee placement of very applicant into the fields they want. There realistically never can or should be either - that would make rural family medicine even less likely to be filled. If every applicant at least backed up broadly with family medicine in round 1 there would virtually no unmatched people but of course some people seemed don't want that field (not that realistically or practically that would ever happen). There are really a very small number, as tragic as it is, that don't match by the end of round two.

 

That being said closing off those remaining few spots for a round "3" sounds stupid to me though - even if it is informal those spots should be still listed/available so if someone wants to apply to them they can. What is the true point of locking those down other than shear convenience of saying the cycle is over?

[rmorelan]

CMG, not matched, so upset, so upset. No words could describe. My PG is no help, nothing, nada.

 

gezzz I am sorry to hear that - just when you need the support the most.

[NLengr]

You can never FORCE a hospital to take someone. They would simply balk at that idea - they may feel there are very good reasons not to let someone into their program (they may have already rejected them twice to start with). I don't think we would also really want to force a particular medical student to take a position in any area they didn't want to go into. Some would prefer to wait a year and try again for something they are truly interested (particularly because transferring between specialties is very hard). In the long run that is probably a better outcome for the health care system.

 

There are enough CARMS spots - but there isn't enough to guarantee placement of very applicant into the fields they want. There realistically never can or should be either - that would make rural family medicine even less likely to be filled. If every applicant at least backed up broadly with family medicine in round 1 there would virtually no unmatched people but of course some people seemed don't want that field (not that realistically or practically that would ever happen). There are really a very small number, as tragic as it is, that don't match by the end of round two.

 

That being said closing off those remaining few spots for a round "3" sounds stupid to me though - even if it is informal those spots should be still listed/available so if someone wants to apply to them they can. What is the true point of locking those down other than shear convenience of saying the cycle is over?

 

Well considering the Govt controls most of the funding for both hospitals and the universities, they could easily force any issue by withdrawling X amount of funding if the organization doesn't toe the line. Make X big enough and they will do whatever they are told.

 

You aren't forcing students to take the ROS. You'd offer the ROS with the third round spot. People can take them if they want them. Not that I think it's a good idea. It was more a comment about how stupid it is to cut the spots off to interested residents when it would benifit the public to let them be distributed to interested parties. You could even go as far as to force docs to go rural if you wanted to.

 

Again, I don't think it's a good idea, but it's even stupider to not fill all spots in areas of need if good people are available

[simpy]

Well considering the Govt controls most of the funding for both hospitals and the universities, they could easily force any issue by withdrawling X amount of funding if the organization doesn't toe the line. Make X big enough and they will do whatever they are told.

 

You aren't forcing students to take the ROS. You'd offer the ROS with the third round spot. People can take them if they want them. Not that I think it's a good idea. It was more a comment about how stupid it is to cut the spots off to interested residents when it would benifit the public to let them be distributed to interested parties. You could even go as far as to force docs to go rural if you wanted to.

 

Again, I don't think it's a good idea, but it's even stupider to not fill all spots in areas of need if good people are available

 

Interesting perspective, Nlengr. For anyone reading the rest of this post please note that I am only discussing CMGs.

 

I think an issue though is that realistically, almost any CMG can match in the first round if they want to. Everyone can back up with a handful of the less desirable family medicine spots and rank them at the end.

 

My understanding of those who don't match is that for the most part they either don't back up or don't rank enough programs. There's nothing wrong with this, but people who follow these strategies are explicitly stating that they would rather choose to go unmatched than take an alternative.

 

I'm not sure to what extent there's an onus on the system to provide an out for people in this position. If someone didn't rank FM because they'd rather be unmatched than do FM, should the system be responsible for creating an FM spot for someone when they don't match? This process would be redundant and might actually encourage people to rank things riskier.

 

Aside from people in this position, there are probably a few people each year who have substantial red flags and/or horrible interview skills. I think this is a tremendous waste of everybody's time and money; but if someone applies to dozens of uncompetitive programs and doesn't match anywhere is medicine the career for them? I think this is something that's really more of a case-by-case question and I'm certain people have been unfairly judged, but it might be better rather than suggesting that everyone deserves to match to instead advocate for some sort of counselling +/- safety-net process to help people transition to careers outside of medicine (i.e. working for insurance companies etc) if that would be more suitable.

 

Also, I am making generalizations here and fully realize that there are unmatched people for whom none of the above apply. I don't mean to be offensive with the above.

 

Anyway. This all goes back to a question of why this process exists in the first place rather than a rotating internship and a general license. I'd be curious to see some large-scale work done on whether people (administrators, physicians, residents and med students) are happy with the current system versus the older one.

[fallenoak]

There are enough CMG spots for residency. Like another poster mentioned people going for competitive specialties are often the ones who remain unmatched.

 

CMGs can fill IMG spots, in fact many do get IMG spots in 2nd round. Some schools even purposely leave IMG spots unfilled in first round so that CMGs can match to them. One of the East coast Internal Medicine programs, for instance, is holding a special seat for one of their CMGs to transfer into from another program.

 

IMGs are required to spend 3-5 years in underserviced areas for their ROS. For someone who has worked so hard to achieve their dreams, we are ecstatic to match and think "whatever i'll deal with an ROS". But we then end up in a province where we do not have our loved ones and that too during a stressful period of time, it chips away at you. Then you realise you have to go to Stevenville or Port-aux-Baques or Sudbury, etc for the next 5 years and it's a bitter pill to swallow. And then people judge you for having a difficult time adjusting and wanting to leave this new province to to be near your loved ones because "you now owe this province".

 

So now when we see people becoming bitter about our IMG spots, it's like you are rubbing salt in our wounds. Everyone has a story of why they didn't get into a canadian medical school and it's not always we didn't try hard enough or weren't smart enough, cuz if you look at the LMCC results, IMGs drive up the pass mark.

 

So please, the next time you feel bitter about IMGs and their special seats, consider this: Would you spend the next 5 years after your residency training is done putting your family life on hold and at the same time be treated like an outsider because you miss home?

 

Please don't take my post as an angry reply, I know a lot of people are unaware of the IMG/CSA side of the story and this was my way of advocating for the little people

 

So let me get this straight:

 

We spend tens to hundreds of millions of dollars expanding the number of med school seats (new schools, extra students, more profs, more lab equipment etc.). The public complains there aren't enough family docs in rural areas (which is true in big portions of the country).

 

We then fail to create enough CaRMS spots so the med students into whom we invested over $100,00 dollars of taxpayers money per student can become docs. We don't even make it so that we set up 3rd round ROS family spots to FORCE them to become the much needed family docs in rural areas (which they would take rather then be un-employed and in massive debt).

 

We then create extra IMG seats in many provinces. Those seats cannot be filled by CMG's. We pay to educate people that the taxpayers had no role in funding, and who may or may not have strong ties to the country. We hang our own grads out to dry.

 

Awesome. Good to know. Excellent work everyone.

[mavrik13]

I've posted this before, but there is a real problem with the number of residency spots. On first glance, it looks like there are many more residency spots for CMG's - but you have to consider that a disproportionate number are in Quebec, and require fluency in French.

 

There will always be a number of residents from Quebec who will do a residency in another province, but the rest of us are limited in trying to match to these spots in Quebec. There isn't a lot of room for error, as you might think when you look at the number of CMGs to total number of residency spots.

 

It would be interesting to know how many specialties/programs people applied to who didn't match. Ultimately, there is a reason people don't match. The candidate could be undesirable (various reasons), or they didn't rank programs appropriately. I know many residency programs would rather go unmatched than take a less-than-desirable candidate, and rightly so in my opinion.

[A-Stark]

I think an issue though is that realistically, almost any CMG can match in the first round if they want to. Everyone can back up with a handful of the less desirable family medicine spots and rank them at the end.

 

My understanding of those who don't match is that for the most part they either don't back up or don't rank enough programs. There's nothing wrong with this, but people who follow these strategies are explicitly stating that they would rather choose to go unmatched than take an alternative.

 

I'm not sure to what extent there's an onus on the system to provide an out for people in this position. If someone didn't rank FM because they'd rather be unmatched than do FM, should the system be responsible for creating an FM spot for someone when they don't match? This process would be redundant and might actually encourage people to rank things riskier.

 

You're right insofar as CaRMS is much more about the choices we make (and ability to network) than anything inherent to our abilities. That, actually, is the problem, and a further issue is that people sometimes get bad or outdated advice. For example, Dal IM was rarely anything approaching competitive for Dal graduates, at least until 2012 when it suddenly was. I don't disagree that everyone should back up regardless, but it's not as though a good "strategy" is always stable from year-to-year.

 

People also don't consider ending up unmatched as an "alternative" to applying to FM because it is overall still not that likely. I'm not sure that this should say anything about also being unmatched in the second iteration. The system is completely unable to deal with that problem.

 

Aside from people in this position, there are probably a few people each year who have substantial red flags and/or horrible interview skills. I think this is a tremendous waste of everybody's time and money; but if someone applies to dozens of uncompetitive programs and doesn't match anywhere is medicine the career for them? I think this is something that's really more of a case-by-case question and I'm certain people have been unfairly judged, but it might be better rather than suggesting that everyone deserves to match to instead advocate for some sort of counselling +/- safety-net process to help people transition to careers outside of medicine (i.e. working for insurance companies etc) if that would be more suitable.

 

I think this is an ignorant comment from someone who is still well away from the match. Perhaps a few people have red flags, but programs will not rank you (or rank you lower) for entirely spurious reasons like having too many electives in another specialty or making judgements about your "commitment" to X specialty based on marginal factors. It is not a merit-based process nor even one that protects against bad applicants who tend to make themselves known early on in their PGY-1.

 

Also, I am making generalizations here and fully realize that there are unmatched people for whom none of the above apply. I don't mean to be offensive with the above.

 

Anyway. This all goes back to a question of why this process exists in the first place rather than a rotating internship and a general license. I'd be curious to see some large-scale work done on whether people (administrators, physicians, residents and med students) are happy with the current system versus the older one.

 

I doubt you'd find any older physicians who favour this system, especially as many of them worked for a while as a GP and then went back to specialize in something else. As it's been explained to me, it essentially comes down to money and work, i.e. organizing rotating internships was difficult and programs were more unstable in numbers when residents could switch more fluidly and easily.

 

The issue is really quite simple - if postgraduate training is going to be determined by factors that are almost entirely non-academic, there is little justification for making it a more-or-less one-shot deal in the first iteration of CaRMS.

 

There are enough CMG spots for residency. Like another poster mentioned people going for competitive specialties are often the ones who remain unmatched.

 

CMGs can fill IMG spots, in fact many do get IMG spots in 2nd round. Some schools even purposely leave IMG spots unfilled in first round so that CMGs can match to them. One of the East coast Internal Medicine programs, for instance, is holding a special seat for one of their CMGs to transfer into from another program.

 

Uh, I'm quite sure that the "East coast Internal Medicine" program that actually has IMG spots filled them this year and does pretty much every year. Many programs have re-entry spots or else space for switchers, but these are not included in CaRMS quotas.

 

So now when we see people becoming bitter about our IMG spots, it's like you are rubbing salt in our wounds. Everyone has a story of why they didn't get into a canadian medical school and it's not always we didn't try hard enough or weren't smart enough, cuz if you look at the LMCC results, IMGs drive up the pass mark.

 

IMGs most certainly do not drive up the LMCC pass marks. I don't know what gave you that idea, particularly since the Canadian pass rate is on the order of 97.5% or higher. No one required you to go to a foreign medical school, and there is even evidence that CMGs on average applied more times to get in to a Canadian school than IMGs/CSAs, to say nothing of the quarter or so of CSAs who never applied at all and/or went straight from high school.

[rogerroger]

I've posted this before, but there is a real problem with the number of residency spots. On first glance, it looks like there are many more residency spots for CMG's - but you have to consider that a disproportionate number are in Quebec, and require fluency in French.

 

If you think residency spots are problematic then look at the actual staff job prospects... At each tier of training a certain percentage is being locked out.

 

Even if you match into a residency program many specialties are producing too many physicians and surgeons in specialty X. In residency you don't make enough to greatly alter the debt carried over from med school. So after your training is all over and done with you could be looking at a situation that is pretty bleak as well... Just talk to some super fellows in Ortho, they are the experts on this topic...

 

You can't increase residency positions without increasing healthcare funding across the board. However, when you look at the massive proportion of provincial budgets already going into healthcare the difficulty of the overall situation becomes more apparent. There so no quick fix. We are living in crappy financial times with an ever aging population while medical technology and therefore costs increases at a breakneck pace.

[rogerroger]

 

IMGs most certainly do not drive up the LMCC pass marks. I don't know what gave you that idea, particularly since the Canadian pass rate is on the order of 97.5% or higher.

 

Very very true. The real numbers absolutely contradict any claims that say otherwise.

[rogerroger]

I've been saying it for years. We need to bring back the rotating internship.

 

It seems as if the system exists for the convenience of the system.

 

Unemployed CMG MDs represent an inexcusable waste of resources and manpower.

 

Two steps, that's all it takes:

 

1. Rotating internship leading to general practice rights

2. Open up CaRMS round 1 to everyone with a CMG MD

 

Done.

 

Yeah, I recall you advocating for the old rotating internship. I gotta say that I'm more or less converted to the idea. It is unfortunate that it treads into a political #%&$ storm...

[BoyInTheBubble]

Brooksbane,

you need to clarify your statement.

 

Countries, like UK and Australia, that have a rotating internship that leads to 'general practice rights' does not mean they can open an office and run a family doc ("GP") office. It gives them medical registration and the opportunity to find employment opportunities, under supervision, whether it is part of a training program or not.

 

Going back to the old system - 1 year intern then off to GPland and start up your clinic is never going to happen. You might as well get it out of your head. Whether it's reasonable or not, that ship has sailed.

 

In those two countries, the 1 year internship is mandatory for everyone. You can't even apply to a training program (eg residency) until your second year out. Many people take a few years of working, either generally or in the field of their choice, before getting on to a program.

 

Programs in the USA offer both categorical (essentially the full residency spot) and preliminary (1 year spot requiring re-application to get complete training).

 

I think a reasonable solution for Canadian programs, would be to have a preliminary year offered in among the other already established programs. It would cover both people that are unsure of the field they want and those people that don't get in to the program of their choice. They can be working as a PGY1, like most programs, floating through. How many programs first year includes some general medicine, some general surgery, some emergency med, etc etc.

 

 

With respect to your second point, the IMG spots are funded differently. I suspect, despite a handful more people matching to certain specialties, it wouldn't dramatically change the landscape of those not matching at all. My view is that ALL the spots from both CMG and IMG stream should go to the best applicant. Return of service is bull****, and slowly disappearing. And the argument that the "government funds medical students and residents, blahblahblah" is also useless. Regardless of which province pays for medical school, and then residency for a CMG, there is nothing keeping them in the country, let alone funding province, to work. They can never work a day in their life after residency, go to another province/country, etc and no one collects the money back.

[BoyInTheBubble]

I like most of the points in your post, except this one.

 

It's my belief that the ship has never sailed on primarily bureaucratic matters. Things don't change because people aren't disruptive enough, or haven't made the alternative look profitable. The whole reason we ended up in our current mess is because a very specific subgroup of pracititoners were loud. I think its high time the rest of us get louder and push back.

 

Our old system was plain better. Therefore, we should return to it.

 

Good luck to you in dismantling and de-credentialing the college with the highest proportion of doctors in it!

[fallenoak]

 

Uh, I'm quite sure that the "East coast Internal Medicine" program that actually has IMG spots filled them this year and does pretty much every year. Many programs have re-entry spots or else space for switchers, but these are not included in CaRMS quotas.

 

Actually this east coast program DOES NOT have any IMG spots in first round and usually matches their applicants completely in first round. I said East Coast not Maritimes....that apparently doesn't mean the same thing. And the other part of my sentence about leaving spots empty is about mainly Ontario programs. Residents from a few programs in ON have mentioned this is does happens...didn't say they all do it.

 

 

IMGs most certainly do not drive up the LMCC pass marks. I don't know what gave you that idea, particularly since the Canadian pass rate is on the order of 97.5% or higher. No one required you to go to a foreign medical school, and there is even evidence that CMGs on average applied more times to get in to a Canadian school than IMGs/CSAs, to say nothing of the quarter or so of CSAs who never applied at all and/or went straight from high school.

 

And what I was referring to about driving up the pass marks did not mean how many CMGs pass...I am referring to how what gets determined as a minimum grade to pass the LMCC goes up in the fall session. The UGME dean at a Canadian Medical School mentioned that it is easier to pass the spring session of the LMCC rather than the fall session because more IMGs write in the. And these IMGs who did that are usually the ones who were doctors for 15 years in their own countries. I'm not talking about the idiots who went straight from highschool (which is actually normal medical education pretty much everywhere else in the world but Canada and the US).

 

Yes there are a lot of people who go straight out of high school or just don't apply in Canada. But then there are significant number of us who applied 2 years in a row and decided to take a shot abroad. And yes as I had mentioned before this was we realize the chance we take going abroad and that none of this was an angry response. I was just trying to get the other side of the story out!

 

I don't understand why the "no one required you to go to a foreign medical school" crap...we get it...we have a chip on our shoulders already that we are the "idiots who went abroad" and get looked as "incompetent" by CMGs, attendings, nurses, etc. And YES I know there is a reason for this image...there are a lot of idiots who earn us this reputation.

 

I'm sure y'all have had terrible experiences and some not so bad experiences with IMG/CSAs but there is no need for hatred...we are all going to be working together.

 

Hope no one takes offense or things what I'm saying is ridiculous...everyone has their side to the story and I was just trying to provide that

[cdnmaple]

cdn it wouldn't hurt to share

 

It could, actually. I've thought about this carefully and I half-started several posts on the subject, only to delete them because I felt I couldn't caveat everything enough.

 

So basically, it can hurt. We don't know that what I did in my year off was any advantage whatsoever, and may have even been harmful if it weren't for the sheer weight of my background history -- successful completion of PG training (with all that entails clinically, academically, etc.), voluntarily switching career tracks. My situation is only relevant to someone who has also (1) finished North American residency training and yet (2) never held an independent license. That's far too rare a situation. If there is someone in that situation, they can PM me and we can talk.

 

Some generic advice I'd share would be to be open-minded. Look at the your application, or get someone else to, with the perspective of the residency admissions committee, and find the areas of weakness, areas to improve upon. Think of it like a checklist, same as for premed, only now with more emphasis on concepts like: are you pleasant to be around, team player, leader, teacher, dedicated to patient care, realistic, able to look after yourself (hobbies, blowing off steam healthily), and of course still academics, research where relevant, and clinical experience. Try and find ways to tick off multiple boxes with the same activity, be it volunteering or working, to be efficient. Try not to get caught up in something that is so rigidly scheduled that you can't get out there and network and take advantage of opportunities that may only come at the last minute. Think outside the box -- you may as well, you're already outside it.

 

And work hard at it. Stay focused, if this is what you want.

 

And don't pay too much attention to what people say on forums. Get out there and ask the actual post-grad offices what they REQUIRE and what they PREFER to see from someone in YOUR specific situation, and try to cater to that.

 

And act fast. Applications for Masters and other things are already closing, if not already closed. Every minute matters. Procrastination will not help.

 

For those who are medical students and are unmatched, SURELY your school has somebody who can help advise you what to do next. Ask everybody, even the people whose job title isn't specifically to guide you. This isn't a new thing, it does happen every year. If your school isn't being helpful for some reason, try contacting another school's guidance office. Sure, they aren't obliged to help you, but the worst thing they can say is "No."

 

And try to rock your MCCQE1 if you haven't already done it. Henceforth, that score will be on your application, so the usual attitude of pass/fail doesn't apply anymore.

 

I also have my opinions about requiring people like me to go back through full training for family medicine. While I am very happy for the chance to switch, I don't agree with forcing residency programs to choose between someone like me (or a transfer) and an unmatched medical student. It should not be the same stream. And no, I don't think I need two full years to retrain competently (even better than competently) in family medicine. A rant for another thread, perhaps.

[leviathan]

there is even evidence that CMGs on average applied more times to get in to a Canadian school than IMGs/CSAs, to say nothing of the quarter or so of CSAs who never applied at all and/or went straight from high school.

Canadian applicants apply multiple times because they usually have high scores and are on the borderline of acceptance, so it's highly worth it to keep reapplying until they get an acceptance. Conversely, if you know your application is not competitive for a Canadian school without spending 4 years on another degree (which neither guarantees a better GPA nor an acceptance without then trying for another 2-3 years), you're more likely to save money and time and just apply directly to an international school.

[futureGP]

And what I was referring to about driving up the pass marks did not mean how many CMGs pass...I am referring to how what gets determined as a minimum grade to pass the LMCC goes up in the fall session. The UGME dean at a Canadian Medical School mentioned that it is easier to pass the spring session of the LMCC rather than the fall session because more IMGs write in the. And these IMGs who did that are usually the ones who were doctors for 15 years in their own countries. I'm not talking about the idiots who went straight from highschool (which is actually normal medical education pretty much everywhere else in the world but Canada and the US).

 

Hey.... that's unfair

[fallenoak]

Hey.... that's unfair

 

lol what's unfair? That everywhere else in the world after high school you do about 5.5 years of medicine to become a doctor? Following which you do your postgraduate training?

 

Or that I called the people who go abroad right after high school idiots? lol...I was only joking...but I've spent the past 5 years studying abroad with those students...and they do lack maturity...some but not all.

[BoyInTheBubble]

You mean the royal college?

 

By specialty. You know the ~30000 out of ~70000 Canadian docs?

 

Apart from grasping at the ivory tower entitled Royal College, the specialties within it don't really defend each other! Eg if someone suggested that dermatology only requires a 4 year residency, I doubt the general surgeons or radiologists would come running to their defence.

[BoyInTheBubble]

The quality of medical education abroad is too variable. In my opinion, to accept all of it as being equivalent is to play dice with patient safety.

 

Yet, we accept all graduates of Canadian programs as being worthy!

[BoyInTheBubble]

There is far less variability in the skills or aptitude of CMGs than in IMGs. I don't know what stage of training you're in, if you're in training at all, but you'll see the difference soon enough.

 

While you may be correct, this is purely anecdotal.

 

 

Also, the variability and quality of medical education is mostly irrelevant. You don't get credentials and a license with it. You earn those via residency - and your program director and college examiners don't care if you went to MUN, UofT or school abroad beforehand if you meet the passing standards.

 

You might be more likely to (and expected) pass with a Canadian medical education, but licensing and credentialing is in place because medical school doesn't matter - postgrad training does.

[kmartelli]

There is far less variability in the skills or aptitude of CMGs than in IMGs. I don't know what stage of training you're in, if you're in training at all, but you'll see the difference soon enough.

I haven't worked with IMGs but there's definitely a HUGE variation with CMGs too. I think the whole P=MD (and really F=MD, since everybody gets 1000 chances until they pass), explains a lot of that. If we want to start throwing mud at IMGs we should clean up our own backyard first.

[leviathan]

I totally agree. Someone here came up with an idea that medical school should follow the "many enter, few leave" model, and I think that would be a better system than our current one, where you can "always do family" if you're a dumbass.

 

Still, the variability in foreign medical school quality is broad. To depend on it as all being equal, and to distill competency to practice down to few testing periods, is a dangerous move.

I think a solution would be for the LCME to start site visits and accreditation of schools outside of Canada and the US. Trusting the WHO list is ridiculous because there is so much variability as you said. California already does this, and that's why only a few Caribbean schools made it onto their approved list. If a school was interested and had a large Canadian student body, they could apply to the LCME for recognition and maybe pay a fee. The vast majority of CSAs come from a handful of schools in Australia, Ireland, and SGU+Saba in the Caribbean, so it wouldn't be that difficult to do.