Carms Results 2016

[throwaway2015]

UBC had a 96% match rate - 12 unmatched.

[psychoswim]

UBC had a 96% match rate - 12 unmatched.

How do you find that number? Through the school?

 

I personnally know of 4 at my school, including myself, but have a feeling there a quite a few more.

[indefatigable]

http://carms.ca/pdfs/8eCa7eCraChU_R1_1_OverviewByDiscipline_EN

 

213 spots unmatched from round 1 (but im not sure if some of these spots were perhaps also from the IMG round 1 iteration and carried forward also...so CMGS wouldn't have had access to them in their parralell round 1).

 

-About 70 spots in French speaking quebec(excluding McGill, assuming that leftover McGill spots are fair game for English).

 

-120/213 were family medicine spots (mix bag of rural spots in various provinces, but still quite a few spots in big cities also)

 

Other random points:

-13 IM spots in Saskatchewan

-Manitoba has quite a few spots across multiple specialties(Makes one wonder what the % match rate of Manitoba grads is to their own local residencies...or if a sizeable amount leave the province for residency training).

 

 

Broadly very similar to last year: 100 FM / 216 vacancies after R-1.  The English speaking spots after R-1 in the three major cities of Montreal, Toronto and Vancouver have gone from 13 available spots in 2015 to 8 spots (mostly UBC including IM ROS with zero in Toronto again).  

 

Last year French speaking Quebec had 88 posts left over after R-1 (now 70), so the provincial quota has likely been reduced [or more graduates and/or different matching patterns].   It seems as if more IMG slots have been put into R-2.

[Huron]

Memorial's FM program last year filled all of their spots last year. This year they have 9 spots unfilled. 

 

The graduating class match 22 to FM and 2 to FM+ER in NB. Of those 22, only 9 stayed to do FM residency at Memorial. 

 

That stings a little I think and definitely increased their unfilled spots. 

 

The 2015 MUN FM filled all seats for the first time in several years with the introduction of the different streams and then students felt massively deceived about the rotation templates that they received not matching up with the descriptions of their streams. No one doubts they produce great residents and wicked FM docs, but the moral and trust in the program is not at an all time high, which I think is what hurt their match rate this year.

[Capucine]

How do you find that number? Through the school?

 

I personnally know of 4 at my school, including myself, but have a feeling there a quite a few more.

 

I know there is at least 6 + 2 international students who did their clerkship with us

[psychoswim]

20 unmatched at UdeM, just found out. 10 last year, 20 the year before and that was a bad year.

[Capucine]

Wow, that's a lot... :/ And I remember the faculty telling us that they changed a lot of things to lower the number of students going unmatched... Looks like it didn't work very well :/

[LittleDaisy]

I think that it might have to do with the Law 20 imposed by our lovely Minister Barrette.

2016 is the only year in Québec where all the IM spots got filled in the first round. I will apply broadly for CaRMS next year and to FM. 

Wow, that's a lot... :/ And I remember the faculty telling us that they changed a lot of things to lower the number of students going unmatched... Looks like it didn't work very well :/

[psychoswim]

I think that it might have to do with the Law 20 imposed by our lovely Minister Barrette.

I don't think that really explains it as the number was just as high 2 years ago when we weren't really talking about this. Pretty sure it has more to do with the number of specialty spots growing smaller every year (with bigger classes) and the school wanting to increase the FM:specialist ratio.

[JohnGrisham]

A good number of the 2nd round spots will be IMG positions held over. A lot (though not all) of Western's remaining FM spots were IMG positions, for example.

Hmm thats odd, so essentially stating there weren't any suitable IMGs in round 1, So they carry forward for everyone to go for?

[deathvvv]

I think its is a result of overcompensation and under-selection in round 1.

 

Having been through last year and this year cycle in FM. This is what I observed:

 

For Ontario schools, in the 2015 (last year cycle): They over-invited. Mac essentially sent every CMG an interview 20 seconds after I submitted my application. My Western and U of T interviews were packed. 

 

Because they invited too many people last cycle, combined with Ontario budget cuts for doctors, I think they overcompensated and really restricted interview invitations. So because they didnt invite enough people, less desirable programs like Western and Ottawa had beaucoup of seats left after most of the applicants they rank went for greener pastures elsewhere. I think the seats that are left over are CMG spots. I thought the IMG spots for second round would have ** ROS service attached like the UBC vancouver internal medicine sites?

[JohnGrisham]

I think its is a result of overcompensation and under-selection in round 1.

 

Having been through last year and this year cycle in FM. This is what I observed:

 

For Ontario schools, in the 2015 (last year cycle): They over-invited. Mac essentially sent every CMG an interview 20 seconds after I submitted my application. My Western and U of T interviews were packed. 

 

Because they invited too many people last cycle, combined with Ontario budget cuts for doctors, I think they overcompensated and really restricted interview invitations. So because they didnt invite enough people, less desirable programs like Western and Ottawa had beaucoup of seats left after most of the applicants they rank went for greener pastures elsewhere. I think the seats that are left over are CMG spots. I thought the IMG spots for second round would have ** ROS service attached like the UBC vancouver internal medicine sites?

I think you are right about this, but hard to tell on the CaRMS data. It wouldn't make much sense for there to be left over spots(Or at the very least not too many) from the IMG match given how high of a ratio of applicants:spots. Bound to be some fits etc.

[englers]

Does anyone know if it is possible to delay graduation at this point? 

Being unmatched, the motivation to study really went down.

[NLengr]

Hmm thats odd, so essentially stating there weren't any suitable IMGs in round 1, So they carry forward for everyone to go for?

Yeah most likely. Either the program wants a CMG or they don't want anyone.

 

Part of the problem is governments/universities force programs to create IMG seats, even if the program doesn't want to (for example if the program lacks capacity to train another resident). Governments and universities don't care because first round IMG seats are pure politics. So the program reacts to protect itself by intentionally not filling the seat. The seat existed only on paper during CaRMS. It was never going to be filled.

 

It's so bad that I've heard multiple instances in multiple programs where the government/university told programs that if they didn't have capacity for an extra IMG, they would cut the number of CMGs spots in the program to make space for the IMG. I've also heard multiple programs being told that if there were no IMG candidates who met the same criteria as the CMGs to match, then the program had to lower it's standards for the IMG seat.

 

The first round IMG seats were, by and large, created to win votes from the general populace and appease influential (aka rich and connected) people who have a vested interest in ensuring that CSA's are given residency positions in Canada. 

[JohnGrisham]

Does anyone know if it is possible to delay graduation at this point? 

Being unmatched, the motivation to study really went down.

You're going to have to talk to your school, i know 2 people who have done that in the past so they  could keep doing electives.

[Ms_Sunshine]

Yeah most likely. Either the program wants a CMG or they don't want anyone.

 

Part of the problem is governments/universities force programs to create IMG seats, even if the program doesn't want to (for example if the program lacks capacity to train another resident). Governments and universities don't care because first round IMG seats are pure politics. So the program reacts to protect itself by intentionally not filling the seat. The seat existed only on paper during CaRMS. It was never going to be filled.

 

It's so bad that I've heard multiple instances in multiple programs where the government/university told programs that if they didn't have capacity for an extra IMG, they would cut the number of CMGs spots in the program to make space for the IMG. I've also heard multiple programs being told that if there were no IMG candidates who met the same criteria as the CMGs to match, then the program had to lower it's standards for the IMG seat.

 

The first round IMG seats were, by and large, created to win votes from the general populace and appease influential (aka rich and connected) people who have a vested interest in ensuring that CSA's are given residency positions in Canada. 

 

 The IMG match and spots are quite political. A couple of the Ontario FM programs with lots of spots left were actually unfilled IMG spots. Some programs are quite cautious about ranking IMGs (for a variety of good and not so good reasons). Also keep in mind that Ontario family med IMG interviews are not actually conducted by the school, there is a central interview for all programs, so schools actually have never met most of the people on the rank list they receive...

[cwang293]

So in the second round, would the school just not fill those FM spots, or CMG has a better chance of grabbing it?

[UnmatchedClub]

Yeah most likely. Either the program wants a CMG or they don't want anyone.

 

Part of the problem is governments/universities force programs to create IMG seats, even if the program doesn't want to (for example if the program lacks capacity to train another resident). Governments and universities don't care because first round IMG seats are pure politics. So the program reacts to protect itself by intentionally not filling the seat. The seat existed only on paper during CaRMS. It was never going to be filled.

 

It's so bad that I've heard multiple instances in multiple programs where the government/university told programs that if they didn't have capacity for an extra IMG, they would cut the number of CMGs spots in the program to make space for the IMG. I've also heard multiple programs being told that if there were no IMG candidates who met the same criteria as the CMGs to match, then the program had to lower it's standards for the IMG seat.

 

The first round IMG seats were, by and large, created to win votes from the general populace and appease influential (aka rich and connected) people who have a vested interest in ensuring that CSA's are given residency positions in Canada. 

 

I am quite irate about this. 

 

CMGs are going unmatched or being forced to take positions that are not congruent with their career interests. 

 

Meanwhile, IMGs have a strong lobby behind them and are given preference for competitive positions that could have gone to more qualified CMGs.

 

I have even more contempt for the system five years after going unmatched. I would assume there are others like me, but very few individuals talk about their experiences. 

[Ms_Sunshine]

So in the second round, would the school just not fill those FM spots, or CMG has a better chance of grabbing it?

 

Most schools will want to fill those spots. It's hard to say if there is a specific preference for CMGs at this stage... For second round, all programs will do their own interviews so the FM programs get to meet both their IMG and CMG applicants. I think applicants are considered on a case by case basis for second round.

[ralk]

Hmm thats odd, so essentially stating there weren't any suitable IMGs in round 1, So they carry forward for everyone to go for?

 

Obviously this changes program-to-program, but it may be part of the strategy to get the best candidates possible, not necessarily that the round 1 IMGs were unsuitable. The bottom line is that when it comes to IMGs, the programs have the advantage of numbers. There are so many IMGs applying to a small number of spots that there's little incentive to grab any but the absolute best right away - chances are a good but not stellar IMG will still be available in the 2nd round. Even if they're not, a similar candidate will be, so there's not much incentive to try to fill those slots in round 1. In 2nd round there may be some more qualified CMGs to choose from, or even some IMGs who didn't participate in the 1st round (362 IMGs did this last year). So, some programs rank a small number of candidates for IMG spots, trying to grab the cream of the crop, while using the 2nd round to fill out any remaining slots.

 

I think its is a result of overcompensation and under-selection in round 1.

 

Having been through last year and this year cycle in FM. This is what I observed:

 

For Ontario schools, in the 2015 (last year cycle): They over-invited. Mac essentially sent every CMG an interview 20 seconds after I submitted my application. My Western and U of T interviews were packed. 

 

Because they invited too many people last cycle, combined with Ontario budget cuts for doctors, I think they overcompensated and really restricted interview invitations. So because they didnt invite enough people, less desirable programs like Western and Ottawa had beaucoup of seats left after most of the applicants they rank went for greener pastures elsewhere. I think the seats that are left over are CMG spots. I thought the IMG spots for second round would have ** ROS service attached like the UBC vancouver internal medicine sites?

 

Geographic factors probably have a fair bit to do with match rates. I wonder how much home schools being a safety factor into it. For example, NOSM has an amazing match rate. However, they have relatively non-competitive residency programs and presumably anyone at NOSM would be reasonable happy staying at NOSM, so they're more likely to apply to NOSM residencies which serve as a built-in back-up (if it's not their first choice to begin with). On the flip side, U of T's residency programs are incredibly competitive and their match rate, while usually not this bad, isn't at NOSM's level. A student from U of T can't really count on their home school as a safety since it's so competitive, while they're far less likely to apply to a place like NOSM that would provide them a more reliable shot at matching first round.

 

 The IMG match and spots are quite political. A couple of the Ontario FM programs with lots of spots left were actually unfilled IMG spots. Some programs are quite cautious about ranking IMGs (for a variety of good and not so good reasons). Also keep in mind that Ontario family med IMG interviews are not actually conducted by the school, there is a central interview for all programs, so schools actually have never met most of the people on the rank list they receive...

 

I was surprised to learn that the FM programs in Ontario do collective interviews for IMG spots. It makes since, given the sheer number of applicants, but I imagine it makes schools less willing to take on an applicant they've never actually met.

[A-Stark]

Most schools will want to fill those spots. It's hard to say if there is a specific preference for CMGs at this stage... For second round, all programs will do their own interviews so the FM programs get to meet both their IMG and CMG applicants. I think applicants are considered on a case by case basis for second round.

 

 

My program ended up with a couple empty spots this time around (probably because lots of people couldn't come to interviews due to weather/flight cancellations). CMGs will be absolutely and unequivocally preferred in the second iteration. I don't think this CMG preference is at all exceptional. 

[Ms_Sunshine]

My program ended up with a couple empty spots this time around (probably because lots of people couldn't come to interviews due to weather/flight cancellations). CMGs will be absolutely and unequivocally preferred in the second iteration. I don't think this CMG preference is at all exceptional. 

 

Personally, I think there should be a preference for CMGs. However, there are some IMGs with connections that bump them up on the rank list...

 

My comment is regarding the other factors that go into applicant selection: for example, should a program take a CMG who is obviously not interested in the field over an IMG or CSA who actually wants to be there?  This may be an unfair example as lots of CMGs participating the second round are great candidates who perhaps didn't apply broadly enough or went unmatched for other reasons, but the CMG status alone is not enough to place someone above IMGs. Although if all else is equal, I would except (and hope) that CMGs are ranked higher than IMGs. 

[NLengr]

I am quite irate about this.

 

CMGs are going unmatched or being forced to take positions that are not congruent with their career interests.

 

Meanwhile, IMGs have a strong lobby behind them and are given preference for competitive positions that could have gone to more qualified CMGs.

Politicians couldn't give two shits about physicians, medical training or the healthcare system in general. Every decision they make is made from the point of view of "how does this help my re-election?".

[A-Stark]

Personally, I think there should be a preference for CMGs. However, there are some IMGs with connections that bump them up on the rank list...

 

My comment is regarding the other factors that go into applicant selection: for example, should a program take a CMG who is obviously not interested in the field over an IMG or CSA who actually wants to be there? This may be an unfair example as lots of CMGs participating the second round are great candidates who perhaps didn't apply broadly enough or went unmatched for other reasons, but the CMG status alone is not enough to place someone above IMGs. Although if all else is equal, I would except (and hope) that CMGs are ranked higher than IMGs.

We haven't begun our reviewing process yet, but CMGs are preferred because they are (more or less) known quantities.

[jnuts]

 

I just want to put a few points out there before this descends into IMG bashing again. There's a small caveate that most of this applies mostly to Ontario. I don't know very much about how it works in other provinces.

 

The IMG part is very complex. Saying that an IMG takes a spot away from a CMG is an over-simplification. Extra funding was created (actually from contributions from rural municipalities) to train additional residents with an added return of service commitment. The number of residency spots for CMGs is subject to separate political pressures from the IMG program. The second round doesn't exactly become competitive for the different funding sources. A CMG doesn't suddenly get funded from the IMG source or vice versa. The universities just start moving the two pools they get around between programs to cover the second round spots. There's always a behind the scenes negotiation between programs. Pitting IMGs against CMGs is just a superficial effect of the CaRMS administrative policies for the second round. The only way programs are encouraged to take IMGs at all is that the university's share of the funding is slightly higher for an IMG than a CMG. But as I said, it's not like that funding suddenly becomes available for a CMG in the second round. If an IMG matches in the second round to a CMG spot, the funding still comes from the IMG pool. That's why the IMG still has to sign a return of service agreement while a CMG matching to the same spot doesn't have to. Programs have more flexibiltiy to increase and decrease the number of spots they offer from year to year than you'd think; it's just a matter of negotiating the funding away from another program that may not need it anyway.

 

Programs don't run at 'capacity' and could easily get more residents through the college exams. The concept of training 'capacity' is problematic at best; there are no external metrics to determine such a thing. That's why programs will sell spots to foreign governments. CMG 'capacity' is determined by provincial funding to pay your resident salary and to pay the university to teach you. The actual numbers in each program are determined by a VERY informal and flawed estimate taking into account, how many residents are required to support the teaching staff, how many are required to cover call, how many will be able to get jobs once they finish, the total available funding, and an archaic formula that dictates by convention the ideal distribution of the physician labour force across specialties . Canada is the only developed country that doesn't have a governmental department dedicated to estimating future health labour market needs. For planning purposes, the deeper you get into this side of things the worse it gets. The lack of planning is one of the reasons the physician labour market in Canada is so volatile compared to other developed countries.