Should I be stressed about CaRMS?

[cttsay]

I'm going into 1st year med in September. I'm just trying to find out more about CaRMS and I'm somewhat confused.

 

Matching to a residency of choice is obviously a big deal since it'll be what you'll be doing for the rest of your life, but should I be stressed out over it?

I'm looking at the latest CaRMS stats and it seems that about 90% of all grads match to their first choice discipline, and the remaining 10% match to their second choice after having chosen a very competitive specialty for their first choice, and very very few people do not match... but there seem to be a disproportionate number of stories of unmatched individuals.

 

Is it really rare to be unmatched? How do people go unmatched? And should I be stressing out about this?

 

And if I were interested in a more competitive discipline like internal medicine, what should I be doing realistically to improve my chances?

[Chamilt]

I'm also going into first year so take this with a grain of salt.

 

1. Wait until you actually figure out what you want to do.

2. Wait until you get a "gauge" of where you stand relative to your classmates.

3. Internal medicine isn't that competitive (their sub-specialties may be)

4. If you are barely passing, then maybe neurosurgery (or other competitive/difficult specialty) isn't for you....

5. Of course you should be nervous as like you said this is your career.

 

 

Most important:

If you do the right things for the right reasons then everything will work out.

[costar]

not to side track this discussion, but have you guys noticed that qualifications seem to have very little to do match success?

I seem to see more people with good people skills matching well rather than people who are genuinely qualified. Thinking back I recall absolutely retarded questions (even a pre clerk would think is stupid) being asked by successful anesthesia, radiology, and derm applicants.

 

therefore, my advice is consider polishing your people skills to decrease stress...

that is not to say not working at all on your concrete qualifications. I know this sounds like fruitless advice but in my opinion up to a point, it is really how well you do at the interview. For you see, generally most people get a reasonable number of interviews.

[Lactic Folly]

I think there is a correlation between one's qualifications on paper and the amount of interviews received, particularly at schools where one has not done an elective. Of course, there is variation in the importance placed upon different aspects of the application, and subjectivity in assessing them, but generally it is not difficult to separate those who are stars on paper from those who are weak on paper.

 

Qualifications matter because unless you are already known to the committee, you need to be selected for interview to have a chance to shine. Do you have knowledge of your colleagues' overall performance outside of those questions? You don't want to be asking things you can easily look up, but it's important not to let fear of being perceived foolish get in the way of asking questions - that is how you fill the holes and become better, and best to do it now when the stakes are lower.

 

If someone did not do well on references/clinical evaluations/electives where knowledge and skills are assessed, it would likely affect their chances. Programs want to match people who will succeed in the program, not simply people with good people skills.

 

To OP: be motivated, not stressed. Stress in itself won't help you reach your goals. There are previous threads on CaRMS - yes, people do go unmatched - sometimes they don't apply widely enough, or it is just a very competitive year - sometimes there is a red flag - sometimes good people are just unlucky. But all you can do is your best - it's like applying to medical school again - the better you are in all aspects of your application, the better your chances.

[rmorelan]

not to side track this discussion, but have you guys noticed that qualifications seem to have very little to do match success?

I seem to see more people with good people skills matching well rather than people who are genuinely qualified. Thinking back I recall absolutely retarded questions (even a pre clerk would think is stupid) being asked by successful anesthesia, radiology, and derm applicants.

 

therefore, my advice is consider polishing your people skills to decrease stress...

that is not to say not working at all on your concrete qualifications. I know this sounds like fruitless advice but in my opinion up to a point, it is really how well you do at the interview. For you see, generally most people get a reasonable number of interviews.

 

side note - good people skills ARE actual genuinely important skills. It isn't because the staff are charmed that people with them get in - they all have worked with people that don't have them and that experience is really awful People with charisma actually get things done faster.

[Chamilt]

Good points. They (the hiring committee) are looking at you as someone they have to work with for at least the next 5 years and likely as a colleague in some manner for the rest of their careers. Clearly they want it to be someone they like and get along with.

 

I know several people doing their 3rd or 4th year of post-doc that have ridiculous CVs (25+ 1st authors) and worked with big name supervisors. But aren't being hired because they are huge ****s and cocky *******s.

 

Being someone who interviews "well" and comes across as genuine will go a long way in getting any job.

[tberry3]

I'm also an incoming first year so apologies for my total lack of knowledge about this stuff, but in general, how much consideration goes to your life & activities outside of medicine when it comes to these applications and interviews? Obviously your medical knowledge and proficiency will be the most important thing but I'm wondering if, like medical schools, residency programs are interested in finding well-rounded people or if that's relatively less important here.

[rmorelan]

Good points. They (the hiring committee) are looking at you as someone they have to work with for at least the next 5 years and likely as a colleague in some manner for the rest of their careers. Clearly they want it to be someone they like and get along with.

 

I know several people doing their 3rd or 4th year of post-doc that have ridiculous CVs (25+ 1st authors) and worked with big name supervisors. But aren't being hired because they are huge ****s and cocky *******s.

 

Being someone who interviews "well" and comes across as genuine will go a long way in getting any job.

 

and that is exactly what it is - it is a job. Not another application process for the next level of academic training, a transition like HS->UG->Med School/Grad School etc. You are being interviewed for an actual job.

 

In the real work people are hired based on how well they will enhance the organization. Included in that is intelligence/knowledge etc, but that is just one aspect. Going through the CARMS process you can tell every school is trying to make sure you fit in and will keep a great working environment under what is often stressful conditions. No residency director wants to accept someone that is going to cause problems. It just isn't worth it.

[costar]

and that is exactly what it is - it is a job. Not another application process for the next level of academic training, a transition like HS->UG->Med School/Grad School etc. You are being interviewed for an actual job.

 

In the real work people are hired based on how well they will enhance the organization. Included in that is intelligence/knowledge etc, but that is just one aspect. Going through the CARMS process you can tell every school is trying to make sure you fit in and will keep a great working environment under what is often stressful conditions. No residency director wants to accept someone that is going to cause problems. It just isn't worth it.

 

Exactly, just ask any interviewee how many times they were asked "what do you do for fun" vs "tell me about your research"

[rmorelan]

Exactly, just ask any interviewee how many times they were asked "what do you do for fun" vs "tell me about your research"

 

hehehehe - I mean research is a screening tool to get you to the interview but once at the interview even places like U of T didn't ask about it much.

[tooty]

What I was told by our advisors and what I had learned from my peers is that the number one reason people go unmatched is due to a bad strategy. They go for programs too competitive for their qualifications and don't rank enough safe programs. It could be that they would rather go unmatched than match to family, but I think it's more likely that they overestimate their chances post-interviews and don't bother to back up.

 

For now, learn as much as you can preclerkship so you can shine in clerkship. The most knowledgeable, hard-working, and likable clerk will earn the best reference letters and evaluations --the most important component of your application. Narrow down your disciplines of interest and start preparing for the most competitive one.

[rmorelan]

oh and when the time comes learn exactly how the match algorithm works. It is actually kind of important to understand first round vs second round and how people are placed.

[tooty]

The algorithm favours the applicants' rankings. What else is pertinent?

[Real Beef]

I'm going into 1st year med in September. I'm just trying to find out more about CaRMS and I'm somewhat confused.

 

Holy crap dude! You havent even started yet and you are starting to stress about CaRMS ... relax would ya and enjoy your summer before starting. I understand you want to do well and you want to get into some super competitive program like pediatric brain transplant robotic surgery but just relax there is time for all of that ... you will learn about CaRMS once you start school and you will learn about it over time. First wait until you start school and worry about learning how to handle the large volume of material you will be subjected to first.

 

Beef

[rmorelan]

The algorithm favours the applicants' rankings. What else is pertinent?

 

ha - well first getting even that message out I guess. Some people say to me that if they don't match in the first round they will just pick up family medicine in the second round as their backup - which if true makes no sense as you should just apply for it in the first round then based on how this works.

[tooty]

Now we're getting into the nitty gritty. That's a bit of a controversial strategy for competitive specialties. If you back up with FM in first round, you will likely match to FM if you not your choice discipline. But if your choice discipline goes into second round with leftover spots, you've excluded yourself from them because you're now bound by contract to your FM program. You can elect to not back up in first round in case there are second round spots, where you would apply again but back up with FM.

[rmorelan]

Now we're getting into the nitty gritty. That's a bit of a controversial strategy for competitive specialties. If you back up with FM in first round, you will likely match to FM if you not your choice discipline. But if your choice discipline goes into second round with leftover spots, you've excluded yourself from them because you're now bound by contract to your FM program. You can elect to not back up in first round in case there are second round spots, where you would apply again but back up with FM.

 

Your right, it is a debate If you went into your second round match and something in our competitive specialty went unmatched that means they didn't even rank you or you were silly enough to not rank a location you would actually go to if you didn't match to the others (which is actually my point again about FM - it is not logical to do that. Rank everywhere you would be willing to go). If they didn't even rank you they didn't want you at all - that isn't going to change.

[xi88]

To answer the OP's initial question, you shouldn't be stressed at all. You are starting first year. Do not think about CaRMS this year.

 

 

Most important:

If you do the right things for the right reasons then everything will work out.

 

This is not true. For example, some specialties or locations have very limited seats and have loads of applicants each year. Just based on the numbers alone, most people applying to certain specialties won't have it work out for them regardless how many things they did right.

[leviathan]

ha - well first getting even that message out I guess. Some people say to me that if they don't match in the first round they will just pick up family medicine in the second round as their backup - which if true makes no sense as you should just apply for it in the first round then based on how this works.

I see what you're saying, but it can be onerous to fill out so many applications and then go on so many interviews in the first round. I would still do it though, as you do NOT want to be in the position of scrambling for a second round spot.

[Lactic Folly]

Once the interview invites roll in, you will have a better sense of how competitive you are, and can decide how many interviews to attend - you do not need to accept them all.

[Lactic Folly]

I think it can be a valid concern. However, you cannot prevent the disclosure, nor do you know how much attention will be paid to the transcript by each program.

 

If you had extenuating circumstances, one option may be to work them into your personal statement as an overcoming adversity story, without necessarily mentioning the grades... or place more focus on your subsequent academic strengths.

[cttsay]

Thank you so much for your replies, they are very helpful.

As for the algorithm for CaRMS, isn't it simply just that you rank your specialty, then your sites? (I'm just going to guess that you can list as many specialties/sites as you want) And then you attend your interviews if you have them?

 

The OP should be proactive.

 

I have a few words of advice. Keep an open mind for what you want to do for a living, but explore the specialties early. CaRMS apps happen in 3rd year(2nd if you go to a 3-year school) so you really don't have a lot of time to see what you think you'd be happy with. Don't settle on one thing at the start, and certainly don't assume you'd be ok with family.

 

Try to write your USMLE step 1 and get an amazing score on it. There's a lot of information on SDN about how to do this. I say this because the American match has a far greater number of spots than the Canadian one, and can be used as a backup to CaRMS. Ian Wong, the founder of this site, used it to match in rads after he went unmatched for ENT in Canada. Most people don't need the USMLE, but most people don't need to wear a seatbelt either. Don't let anyone tell you not to do this.

 

Most educational activities in medical school are in my opinion timewasters. If there's anything that is not mandatory, don't go to it. Concentrate on studying for your courses and supplementing the material with USMLE-relevant topics instead. If something is mandatory, buy a Samsung tablet and read pdfs during the session.

 

You're gonna need to publish as well, preferably in the field of your choosing. But really early on, its tough to say what you'd want to do. So, my advice is to find a research supervisor that can help you put together something publishable in a few weeks/months like case series, case reports or some sort of lit review, and make sure that supervisor is in a field on the top-end of competitiveness, just in case you want to go in that direction. It doesn't have to be game-changing work; in fact, its better if it isn't - good studies take too long. Bonus points if you can make the research relevant to multiple fields.

 

When elective application time comes, apply to multiple places with overlapping times. Get as many acceptances in your hat as you can, and then cancel the ones you don't want. Don't be fair, trying not to overlap times. If you do that, you'll end up with no electives.

 

In closing I would not "stress" over CaRMS but I would absolutely not brush it off either. You need a strategy, and you need to figure out where you want to be, and that's better started early than late.

 

Thank you so much -- this was a lot of help. I hope it's okay if I ask some follow-up questions.

 

So the USMLE score is disclosed to the US hospitals? Is it the same with the MCCQE? I've also heard that as Canadians, it's difficult to go to the US for residency due to visa issues -- is that true? Is it also difficult to come back to Canada after having done residency in the US?

 

And would you recommend shadowing, ECs, volunteering, etc?

 

What do you recommend that we do over the summers?

 

Thanks!

[leviathan]

Thank you so much for your replies, they are very helpful.

As for the algorithm for CaRMS, isn't it simply just that you rank your specialty, then your sites? (I'm just going to guess that you can list as many specialties/sites as you want) And then you attend your interviews if you have them?

You apply to programs, get interviewed, then you rank the places you interviewed at. You could technically rank places where you didn't interview but there's virtually no chance that the program also ranked you.

 

So the USMLE score is disclosed to the US hospitals? Is it the same with the MCCQE? I've also heard that as Canadians, it's difficult to go to the US for residency due to visa issues -- is that true? Is it also difficult to come back to Canada after having done residency in the US?

 

And would you recommend shadowing, ECs, volunteering, etc?

 

What do you recommend that we do over the summers?

 

Thanks!

USMLE scores are sent with your transcripts to each program you're applying to in the US. In Canada the disclosure is optional as far as I know. It's harder to get a US match because of visa issues, but if you train there it can be easy or hard depending on specialty. Shadowing ECs volunteering etc all can help.

 

As for your undergrad marks, I highly highly doubt anyone would care how you did.

[Cottoncandy6827]

hm...I always thought if you are a CMG, it's pretty easy to get a residency spot esp if you wanna do family med or something, but looking through the forum, seems that quite a few CMG were unmatched (not even to family). Is it just a function of choosing too competitive of a specialty in first round? or it's actually more competitive then I thought? ie. is it like the mcat...where there a score on the MCCQE I should at least get? or not enough ECs, research, shadowing things in the summer etc...

[NLengr]

hm...I always thought if you are a CMG, it's pretty easy to get a residency spot esp if you wanna do family med or something, but looking through the forum, seems that quite a few CMG were unmatched (not even to family). Is it just a function of choosing too competitive of a specialty in first round? or it's actually more competitive then I thought? ie. is it like the mcat...where there a score on the MCCQE I should at least get? or not enough ECs, research, shadowing things in the summer etc...

 

Your LMCC part 1 scores aren't reported.

 

The vast majority of people match to their top 3. Try not to sweat it too much. Work hard, make connections and plan strategically.