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Robert Chu--Unmatched Doctor Commits Suicide


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Anyone who believes the route that IMGs take is easy frankly has no idea what they're talking about. Getting admission to an international school may be relatively easy, but finishing and matching to

I am not sure why you mentioned diversity for IMGs. For CSAs, not immigrant-physicians, their tuition is way over our medical school LOC (300,000) at least. The majority of CSAs have supporting parent

And yet we continue to admit so many IMGs to our residency programs. I've said it before and I shall say it again: there is absolutely no valid reason for an IMG to match at the expense of a CMG, espe

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The Canadian residency pool is just too small, margins too tight to accommodate even small fluctuations in number of people applying to specialist areas. Because programs know applicants don't have too many choices, they can be more picky than some of their US counterparts. Even psychiatry, which in the past was an afterthought, is in demand these days in many locations.

 

I stand by my advice that anyone doing med school in Canada should write USMLE Step 1 even if they think they have no intention of going to US. 

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17 minutes ago, 1997 said:

That's terrible. My condolences to the family and friends. 

Why are residency programs so quick to refuse perfectly suitable candidates who have shown interest in other specialties? That doesn't make sense to me, having many interests wouldn't affect the candidate's capacity to be a good and productive doctor...

Because most of them know they can fill their spots with applicants who are primarily interested in thier specialty. 

From a program POV the person who wanted another specialty is riskier because they are more likely to switch after the match leaving the program short staffed. 

 

Residency positions are too few now. Things are too tight which leaves the system with very little flexibility. Ditch the IMG spaces and add more to get back to the 1.1:1 ratio we once had. 

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54 minutes ago, NLengr said:

Because most of them know they can fill their spots with applicants who are primarily interested in thier specialty. 

From a program POV the person who wanted another specialty is riskier because they are more likely to switch after the match leaving the program short staffed. 

 

Residency positions are too few now. Things are too tight which leaves the system with very little flexibility. Ditch the IMG spaces and add more to get back to the 1.1:1 ratio we once had. 

Makes sense. I guess from the PD`s POV, they don't want someone unhappy in their program for the 2-5 years, and then ultimately switch to their initial program of interest; or persistently be disinterested and not perform as well clinically as their colleagues.

From a medical student's POV, CaRMS is a dangerous lottery, do not risk it and apply broadly. Being unmatched the 1st year, won't guarantee you an easier access next year...Many medical schools don't allow the ''5th year'' for the unmatched applicant to do more electives...

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My sincere condolences. He seems a really bright young guy who would have made a great colleague.

I think (and hope) we can do something about this. I know inherently we are self interested in our own results and match, but I think there is an incentive to watch out and set our colleagues up to be successful as well. There is an element of selection politics that maybe programs can be more transparent and accountable as well one day. 

I think the first part is that we don't have enough residency spots for Ontario, with the cuts. That's one place to start. 

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4 hours ago, shikimate said:

The Canadian residency pool is just too small, margins too tight to accommodate even small fluctuations in number of people applying to specialist areas. Because programs know applicants don't have too many choices, they can be more picky than some of their US counterparts. Even psychiatry, which in the past was an afterthought, is in demand these days in many locations.

 

I stand by my advice that anyone doing med school in Canada should write USMLE Step 1 even if they think they have no intention of going to US. 

I agree, unfortunately this can be harder to do in the timeline of a 3 year medical school as the one Robert attended. 

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Why on earth are there residency spots reserved for foreign trained med grads who decided to take the easy way by attending Caribbean schools with questionable credentials? Why aren't Canadian students prioritized? 

 

This is what happens when you let politicians manage the healthcare system.

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1 hour ago, hamham said:

And yet we continue to admit so many IMGs to our residency programs. I've said it before and I shall say it again: there is absolutely no valid reason for an IMG to match at the expense of a CMG, especially in less competitive fields like FM. Period.

Well said. It's time to put Canadians first. All these ridiculous virtue signalling needs to stop.

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5 hours ago, NLengr said:

Because most of them know they can fill their spots with applicants who are primarily interested in thier specialty. 

From a program POV the person who wanted another specialty is riskier because they are more likely to switch after the match leaving the program short staffed. 

 

Residency positions are too few now. Things are too tight which leaves the system with very little flexibility. Ditch the IMG spaces and add more to get back to the 1.1:1 ratio we once had. 

Exactly - they aren't rejecting the other candidate - they are simply ranking higher others. Some of those have years and years of research, networking, and electives in the target specialty. 

In my mind on the big issues is that the schools are not really ready for unmatched candidates. If there was say a policy that the home school HAD TO match a candidate into something (say family) as a back up (even if it is just in the second year applying) then there would be a lot less pressure floating around. 

 

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19 minutes ago, moonlitocean said:

Having spots reserved for IMG is a way for politicians to continue their false narrative of advertising Canada as a "land of opportunity" for immigrants and to promote diversity merely for the sake of diversity.

well most of the IMG spots are targeted by CMAs. That is an entire other political firestorm with many prominent people helping their kids go elsewhere and no hoping for returns. People with the means of spending 300K plus on a foreign school usually can collectively at least muster political attention. 

We keep getting articles approaching things from all sides - CMGs are in trouble, CMAs are in trouble, IMGs are blocked........ 

hard problem - there are only so many chairs and a lot of people want to seat down. 

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29 minutes ago, moonlitocean said:

Well said. It's time to put Canadians first. All these ridiculous virtue signalling needs to stop.

again many of the IMGs ARE CMAs. 

Plus politics aside - putting Canadians first would sometimes mean FORCING someone to actually service the Canadians in places most doctors don't want to go. Exactly the places that many of these IMG spots are. 

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25 minutes ago, moonlitocean said:

Having spots reserved for IMG is a way for politicians to continue their false narrative of advertising Canada as a "land of opportunity" for immigrants and to promote diversity merely for the sake of diversity.

 

33 minutes ago, moonlitocean said:

Well said. It's time to put Canadians first. All these ridiculous virtue signalling needs to stop.

...I don't even know where to begin. Stop trying to derail the thread with your garbage

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2 minutes ago, rmorelan said:

again many of the IMGs ARE CMAs. 

Plus politics aside - putting Canadians first would sometimes mean FORCING someone to actually service the Canadians in places most doctors don't want to go. Exactly the places that many of these IMG spots are. 

I shall use UBC as an example since I schooled there. 

For the St. Paul's FM program (one of the most competitive FM programs in the country), there are actually more IMG spots than CMGs (13 vs. 12 if my memory served me right). No doubt, IMGs have to sign an ROS, but I will be perfectly honest with you, many of my CMG classmates have no problems spending 2 years working in an underserved area in BC after they finished their residencies. In another example, the IMGs who are admitted to the Surrey FM program can simply do their ROS in Surrey, which is far from being underserviced by the healthcare system. 

 

Rmorelan, I respect you a lot as a senior member of this forum, but pls refrain from claiming that IMG spots are places where CMGs don't want to go.

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2 hours ago, hamham said:

And yet we continue to admit so many IMGs to our residency programs. I've said it before and I shall say it again: there is absolutely no valid reason for an IMG to match at the expense of a CMG, especially in less competitive fields like FM. Period.

So sad. Yup these spots need to be abolished. But you think schools (especially UWO, and schools in other undesirable locations) will want to, given the $$ benefits. They're too dependent on IMGs and the kickbacks they get. 

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I don't think the IMG spots are the issue here necessarily. As it stands the process for an IMG to become a doctor in Canada is already very difficult, i don't think we should make it even more difficult. Regardless of it all, there are people who legitimately fall through the cracks with Canada's medical admissions system and there are real immigrants who could serve in our healthcare system. I think what the Ontario government should do is reverse the 25 spots cut to residency spots as every year the ratio gets closer and closer to 1 and often in effect it is at 1 due to the number of spots that are French language only in rural Quebec. 

As medical students, I think we should make sure pre-meds and others understand that medicine is not the one way ticket to a secure job as evidenced by the job market difficulties in many specialties in the last 10 years which do not seem to be going away in the near future. At the end of the day, i don't think it is healthy either to guarantee anyone anything as it does lead to complacency. 

On a side note, i do agree with what hamham said. IMG spots are not always in undesirable areas of the country, the majority probably over 50% of RCPSC specialty spots are in Toronto. In internal medicine UofT has 51 CMG spots and a whopping 12 IMG spots vs 4 at Mac/Ottawa/Queens. 

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Comments about the article:

1. I agree with everyone here that this was a very unfortunate incidence. That being said, I think there is more to this story and this individual. Not matching for 2 years, while very unfortunate, should not be the sole reason for someone committing suicide. I don't think this is either the victim's problem or the system's problem but I do hope that the school takes this seriously and considers, "did we do everything to support this individual and prevent future individuals from committing suicide?" The school may not have prepared their students for these potential outcomes, the student may not have been mentally equipped to deal with failure, etc etc.

2. I did not appreciate the way that the article made it sound like people who went unmatched is entirely a system's issue. "Chu and a growing number of others denied access to residency have found themselves..." This sounds like ALL residency programs reject applicants. It does not take into account the algorithm, and how luck plays into it all, and how it actually favours the applicants at the end. It also does not take into account how some applicants REFUSE to apply outside of specific location or province, despite repeated counselling.

3. (related to 1st part). I wonder how and why the individual decided to go from radiology to fm/psych to earning an MBA. I wonder how many decisions he made were from his own personal choices, or from strong encouragement from others (i.e. parents, school counsellors, other faculty)

Comment about residency positions (latter half of the comments):

I do think we have a problem in Canada of not addressing the problem of what we define as "IMG". We state that we offer "IMG" positions and set a quota, yet a lot of the competition involves CSAs (canadians studying abroad). This is not only misleading to IMG's, but also to the Canadian public who believe all these IMG positions go to actual immigrant physicians. I suggested this before and I want to reiterate it here: If we want to set a quota for CSA's, we should make this clear and separate this from actual IMG positions. But I doubt that this would fly politically.

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2 hours ago, moonlitocean said:

Why on earth are there residency spots reserved for foreign trained med grads who decided to take the easy way by attending Caribbean schools with questionable credentials? Why aren't Canadian students prioritized?

Anyone who believes the route that IMGs take is easy frankly has no idea what they're talking about. Getting admission to an international school may be relatively easy, but finishing and matching to a residency is difficult. There are academic checks and balances in place that help ensure quality of those accepted to residency positions. If you think the process of matching as a CMG is stressful, then you haven't seen anything yet.

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1 hour ago, YesIcan55 said:

I'm really not sure why some people in this post feel they are so high and mighty because they go to a Canadian medical school....I practised interviewing with people this past year who got an offer and I didnt, some got in. I obviously didnt. Not to throw shade at any of them but there was a couple of people who were not strong but got in. One guy got WL the past year with a 27 percentile on his MMI (since his GPA/MCAT were crazy high) and just got accepted, so his MMI score was in the low 30 percentile...for someone with a low preinterview score at this particular school they would need 65+ MMI to get in, so achieving double as the first guy would not be enough to get you in if your preMMI was very low...this is not a post about admissions but just want to humble some of you that there are so many places in the process that involves luck, even getting the interview and then on the actual MMI day too...not much separates an accepted and WL and rejected after getting an interview and what some of you forget that many of the IMGs you speak so badly of got interviews, some multiple, some multiple in multiple years and deserved a spot in your medical school just as much as you...so to treat these specific IMGs like they are so much beneath you is frankly very immature and pretentious. Don't get me started on the comment bashing diversity in Canada...

I don't feel high and mighty at all having graduated from a Canadian medical school. But I know it took me much effort to get into one, and graduate from one. I am talking about repeated applications to Canadian medical schools across the country, dealing with the disappointment each May after receiving regrets from schools where I had interviewed, doing extra courses to fulfill pre-requisites, completing extra graduate degrees to improve my applications, re-writing the MCATs b/c of unbalanced score, countless hours tackling and practising MMI and panel interview questions, taking on odds jobs after graduation to make ends meet while continuing to apply to medical schools. Even after getting in, there was a lot of hard work involved throughout my medical school years. This is especially true during the clerkship years where medical students worked hard together with residents and staff to ensure smoothing operations on and off the wards. The working hours were long and involved lots of personal sacrifices to contribute effectively to the proper functioning of Canadian healthcare system. There was a lot of sweat, blood and tears. Looking back, I felt that the reason why I continued to persevere was b/c I had faith in the Canadian medical school admissions system, and more importantly, the Canadian healthcare system. At the end of the day, I am proud of the fact that I am a CMG.

I don't deny that luck is definitely a factor, but in my case, I believe that it's more of hard work than luck. And sometimes, people deserve to have their faith rewarded. 

I did not bash IMGs in any of my posts. In fact, I do agree that most of the IMGs who made it back have proven themselves worthy. It's certainly not easy to make it back as an IMG. But let me re-iterate my point again: IMGs' interests should not come at the expense of CMGs like Dr. Robert Chu. The system should ensure that CMGs' interests are protected at all times. Again, I am sounding like a broken record, but there is absolutely no valid reason for an IMG to match at the expense of a CMG, especially in less competitive fields like FM. Period.

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1 hour ago, YesIcan55 said:

I'm really not sure why some people in this post feel they are so high and mighty because they go to a Canadian medical school....I practised interviewing with people this past year who got an offer and I didnt, some got in. I obviously didnt. Not to throw shade at any of them but there was a couple of people who were not strong but got in. One guy got WL the past year with a 27 percentile on his MMI (since his GPA/MCAT were crazy high) and just got accepted, so his MMI score was in the low 30 percentile...for someone with a low preinterview score at this particular school they would need 65+ MMI to get in, so achieving double as the first guy would not be enough to get you in if your preMMI was very low...this is not a post about admissions but just want to humble some of you that there are so many places in the process that involves luck, even getting the interview and then on the actual MMI day too...not much separates an accepted and WL and rejected after getting an interview and what some of you forget that many of the IMGs you speak so badly of got interviews, some multiple, some multiple in multiple years and deserved a spot in your medical school just as much as you... 

1. How do you define strong? Some people have stronger interpersonal skills and ace the interviews, others have higher GPA/MCATs to get them in: doesn't mean one is a "stronger" candidate than the other. A strong interview score + amazing GPA/MCAT doesn't equal the next Frederick Banting. There's so much more to what makes good future physicians than simply numbers and first impressions.

2. Who says that many of us on here negate luck in Canadian medical student admissions? Personally, I am thankful every time I come on to this forum and see the rat race I was lucky enough to get out of. Also "humble some of us"? Aren't you the one that just judged people for getting into medical school when they weren't "strong"?

3. I do feel for those who have gotten multiple interviews and did not get in, I was one of them. But can you tell me that all those IMGs that "we speak so badly of" had multiple interviews over multiple years? Because according to this chart by CaRMs, 65.7% of CSA's either did not apply to Canadian medical schools at all or only applied once before then went abroad. Reality is, there are many of the repeat interviewers who can't go abroad even if we wanted too. We can't afford it. For some schools 275k LOC doesn't even cover the tuition.

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