Matching to Family Medicine

[JohnGrisham]

Generally speaking if one is flexible with location, what exactly is it that is causing people to go unmatched in FM? Look at the stats theres 2 dozen going unmatched to FM, is it safe to say geographical restrictions? How many OOP electives is usually sufficient? 

[ralk]

6 hours ago, JohnGrisham said:

Generally speaking if one is flexible with location, what exactly is it that is causing people to go unmatched in FM? Look at the stats theres 2 dozen going unmatched to FM, is it safe to say geographical restrictions? How many OOP electives is usually sufficient? 

Geographical restrictions probably account for the bulk of people going unmatched to FM. For the few who are willing to apply very broadly, my best guess is that red flags are at play. FM programs aren't too picky, but they're not desperate either - they'll reject candidates they don't feel would be a good fit.

Can be a bit of both as well - a yellow flag with a broad application, but one still too picky to overcome what wouldn't normally be a game-breaking disadvantage. For example, it's not too uncommon for people make a last-minute switch to FM, sometimes without any FM electives or meaningful FM experience. This is very feasible to pull off, but means these candidates really need to apply very broadly, particularly to the less-competitive rural programs. Failing to do so means a reasonably capable candidate ranking FM first still goes unmatched.

In terms of OOP electives, it depends on the province. As an Ontario student, I ended up doing zero OOP electives (though not for lack of trying...), applied only to Ontario, and while I wouldn't endorse this as the best matching strategy, I had no problems matching. I imagine it would be similar in Quebec, another province with multiple medical schools and ample variety of FM programs. I'd say in general, 2-3 OOP electives would be advisable (which don't have to be FM electives), mostly to demonstrate willingness to move with CaRMS being as much about intention-signalling as anything else.

[JohnGrisham]

Thanks ralk, you are always a great source of information. Just looking at the stats, it seems there are very few English speaking CMG programs left after round1, with many remaining being in Quebec and/or positions that were initially IMG spots. But perhaps I need to take a closer look at the designations.

[MDLaval]

And at Laval's FM programs only 4 or 5 spots were filled in the 2nd round, leaving almost 30 unfilled positions after the 2nd round.

[JohnGrisham]

7 minutes ago, MDLaval2017 said:

And at Laval's FM programs only 4 or 5 spots were filled in the 2nd round, leaving almost 30 unfilled positions after the 2nd round.

If only i knew french or had the capacity to learn it.

It would be nice if we could somehow close down some of those programs and move funding in some rural english-speaking centres. 

[MDLaval]

4 minutes ago, JohnGrisham said:

If only i knew french or had the capacity to learn it.

Never too old to learn a new language and face new challenges 

[MDLaval]

8 minutes ago, JohnGrisham said:

It would be nice if we could somehow close down some of those programs and move funding in some rural english-speaking centres. 

2

Unless I'm mistaken, I was under the impression programs are provincially funded, so it wouldn't be possible to use those funds to some rural English-speaking centers in other provinces. 

[la marzocco]

12 minutes ago, MDLaval2017 said:

Unless I'm mistaken, I was under the impression programs are provincially funded, so it wouldn't be possible to use those funds to some rural English-speaking centers in other provinces. 

 

23 minutes ago, JohnGrisham said:

If only i knew french or had the capacity to learn it.

It would be nice if we could somehow close down some of those programs and move funding in some rural english-speaking centres. 

You're right. It's all determined at the provincial level. 

In a time where there are record high unmatched CMGs, 64 residency positions remained unfilled in 2017; 56 were in family medicine, all of which were in Quebec. The number of empty family medicine positions in Quebec has more than doubled since 2014, when there were 22 empty spots. Paradoxically, Quebec medical students are still choosing family medicine at some of the highest rates in the country, it is just they didn’t choose to stay in Quebec. (Source: here)

As mentioned many times on this forum, francophones are generally much more bilingual than anglophone counterparts. Anglophones are not able to access these spots bc of language reasons. There could be more language training for those who wish to take it during medical school to bolster their French skills - increasing access and likelihood of matching to these Quebec family medicine spots.

[JohnGrisham]

10 minutes ago, qnzjlo said:

 

You're right. It's all determined at the provincial level. 

In a time where there are record high unmatched CMGs, 64 residency positions remained unfilled in 2017; 56 were in family medicine, all of which were in Quebec. The number of empty family medicine positions in Quebec has more than doubled since 2014, when there were 22 empty spots. Paradoxically, Quebec medical students are still choosing family medicine at some of the highest rates in the country, it is just they didn’t choose to stay in Quebec. (Source: here)

As mentioned many times on this forum, francophones are generally much more bilingual than anglophone counterparts. Anglophones are not able to access these spots bc of language reasons. There could be more language training for those who wish to take it during medical school to bolster their French skills - increasing access and likelihood of matching to these Quebec family medicine spots.

I would gladly work towards a spot there, however I know my language abilities are not up to snuff nor would they get to a proficient level with the demands of medical school and life taking up most of the time. It's one thing to learn a language to a basic level for travelling, its another to be proficient to take care of patients in a medical setting. I don't think compromising the language requirements in this context would be at all appropriate.   

[la marzocco]

16 minutes ago, JohnGrisham said:

I would gladly work towards a spot there, however I know my language abilities are not up to snuff nor would they get to a proficient level with the demands of medical school and life taking up most of the time. It's one thing to learn a language to a basic level for travelling, its another to be proficient to take care of patients in a medical setting. I don't think compromising the language requirements in this context would be at all appropriate.   

100% agree. I grew up in Toronto and I didn't have much French under my belt before I moved to Montreal for med. There are remedial classes at McGill on the weekends for us anglophones. It's completely voluntary, but I think it is important to know the basics. We learn how to take history, explain basic concepts and make proper medical inquiries in French. I am by no means at native proficiency, but attending these voluntary workshops have definitely allowed me to speak more comfortably. I think each school should have a weekly workshop that goes through common scenarios and common medical jargon in French for those who are interested.

Granted, I am an anglophone studying in Quebec, giving me more opportunities to try my hands on using French than let's say someone at UBC would if they wanted to. But, I think learning French for a medical setting is not a far-fetched idea. It can be done. 

[indefatigable]

Another big differences between QC and ROC is that there are no dedicated IMG spots, although IMGs can apply to some of the positions.  A change like this alone would really create a difference within Ontario and BC.  OTOH, most IMGs don't speak French either.  

39 minutes ago, qnzjlo said:

In a time where there are record high unmatched CMGs, 64 residency positions remained unfilled in 2017; 56 were in family medicine, all of which were in Quebec. The number of empty family medicine positions in Quebec has more than doubled since 2014, when there were 22 empty spots. Paradoxically, Quebec medical students are still choosing family medicine at some of the highest rates in the country, it is just they didn’t choose to stay in Quebec. (Source: here)

I'm not sure "choose" is really the right term.  Quebec graduates match to their first choice discipline at a lower rate than ROC (e.g. 79% vs 93% for Ontario and 90% for Western Canada).  I would guess that this is because grades play a greater role comparatively than electives. (source - slide 22)

[indefatigable]

4 hours ago, JohnGrisham said:

I would gladly work towards a spot there, however I know my language abilities are not up to snuff nor would they get to a proficient level with the demands of medical school and life taking up most of the time. It's one thing to learn a language to a basic level for travelling, its another to be proficient to take care of patients in a medical setting. I don't think compromising the language requirements in this context would be at all appropriate.   

Even though I now have technically relatively strong French, through being in a French environment, I sometimes feel that gaining confidence & trust of a patient is not only being able to speak the language but relate on a stronger level.  Having a noticeable accent for example could be a barrier I feel.  But aside from that caveat, I think that it's possible through media and especially immersion to gain some fluency in a language.  It happens in Europe quite a bit where some countries like Germany must recruit foreign doctors.  

[JohnGrisham]

http://carms.ca/wp-content/uploads/2017/05/Table_39_Family_medicine_positions_Filled_Offered_and_Vacancies_for_CMGs_English.pdf

It looks like Ottawa, Manitoba and Dalhousie had a sizeable  # of spots leftover after round 1...am I misreading these stats? Are these perhaps concurrent positions that were reserved for IMGs but werent filled? Or just super-rural spots that people didn't want? 

 

[MDLaval]

41 minutes ago, calcan said:

I'm not sure "choose" is really the right term.  Quebec graduates match to their first choice discipline at a lower rate than ROC (e.g. 79% vs 93% for Ontario and 90% for Western Canada).  I would guess that this is because grades play a greater role comparatively than electives. (source - slide 22)

I think part of the explanation is because many of QC graduates prefer matching to a plan B specialty than matching to their 1st choice somewhere else in Canada. I know several people who did just that.

[indefatigable]

4 hours ago, qnzjlo said:

In a time where there are record high unmatched CMGs, 64 residency positions remained unfilled in 2017; 56 were in family medicine, all of which were in Quebec. The number of empty family medicine positions in Quebec has more than doubled since 2014, when there were 22 empty spots. Paradoxically, Quebec medical students are still choosing family medicine at some of the highest rates in the country, it is just they didn’t choose to stay in Quebec. (Source: here)

3 hours ago, MDLaval2017 said:

I think part of the explanation is because many of QC graduates prefer matching to a plan B specialty than matching to their 1st choice somewhere else in Canada. I know several people who did just that.

It definitely could be factor.  Looking at the same CaRMS report (slides 16 and 17) shows that the QC graduates (even McGill) overwhelmingly stay in province, in contrast to the quote above.  But still, it's not as if popular programs out of QC are any less competitive - if anything they would get far more applicants since there's no language barrier, and thus any CMG could theoretically apply.  I would guess the grades aspect with IP constraints and other factors possibly combine together.   

[ralk]

18 hours ago, JohnGrisham said:

Thanks ralk, you are always a great source of information. Just looking at the stats, it seems there are very few English speaking CMG programs left after round1, with many remaining being in Quebec and/or positions that were initially IMG spots. But perhaps I need to take a closer look at the designations.

I'd say you're pretty accurate there. Most CMG FM spots in English-speaking Canada fill first round. Despite FM being one of the least competitive specialties, it's not the guaranteed spot for CMGs some make it out to be.

[JohnGrisham]

20 hours ago, JohnGrisham said:

http://carms.ca/wp-content/uploads/2017/05/Table_39_Family_medicine_positions_Filled_Offered_and_Vacancies_for_CMGs_English.pdf

It looks like Ottawa, Manitoba and Dalhousie had a sizeable  # of spots leftover after round 1...am I misreading these stats? Are these perhaps concurrent positions that were reserved for IMGs but werent filled? Or just super-rural spots that people didn't want? 

 

Thoughts @ralk?

[ralk]

5 minutes ago, JohnGrisham said:

Thoughts @ralk?

Sorry, missed that post, I'll try to break that down case-by-case.

Ottawa was a weird one last year, they seemed to reject a lot of people pre-interview then failed to fill. I know a few people, including myself, who were set on FM, matched to first choice locations, but didn't get an interview at Ottawa at all. I think they shot themselves in the foot this past year, no idea why, but I'd expect that gets corrected this time around.

Manitoba has a lot of rural and remote spots, so it typically has a lower fill rate, particularly in the Northern Remote stream. Even Winnipeg isn't a highly-sought after location for non-Manitobans (relevant Simpsons pic), and only a quarter of the CMG FM spots there are in Winnipeg.

Dalhousie I'm less certain on, but might be a mix of the two. Their unfilled spots this year were away from Halifax at undoubtedly less popular locations, and while I have no idea what their interview invite threshold was, I do know that they were terrible in providing electives (that was across the board but particularly in FM). Hard to generate interest in the school/area/program when people get shut out of experiences there.

It was a bit of a down year for FM in general, so some of the borderline positions tipped into unfilled territory - I'm skeptical that'll last given the overall competitiveness of the match.

[psychiatry2017]

12 hours ago, ralk said:

Sorry, missed that post, I'll try to break that down case-by-case.

Ottawa was a weird one last year, they seemed to reject a lot of people pre-interview then failed to fill. I know a few people, including myself, who were set on FM, matched to first choice locations, but didn't get an interview at Ottawa at all. I think they shot themselves in the foot this past year, no idea why, but I'd expect that gets corrected this time around.

Manitoba has a lot of rural and remote spots, so it typically has a lower fill rate, particularly in the Northern Remote stream. Even Winnipeg isn't a highly-sought after location for non-Manitobans (relevant Simpsons pic), and only a quarter of the CMG FM spots there are in Winnipeg.

Dalhousie I'm less certain on, but might be a mix of the two. Their unfilled spots this year were away from Halifax at undoubtedly less popular locations, and while I have no idea what their interview invite threshold was, I do know that they were terrible in providing electives (that was across the board but particularly in FM). Hard to generate interest in the school/area/program when people get shut out of experiences there.

It was a bit of a down year for FM in general, so some of the borderline positions tipped into unfilled territory - I'm skeptical that'll last given the overall competitiveness of the match.

Agree.... Ottawa FM rejected a lot of good applicants pre-interview, mostly those backing up with no FM electives.
With the cut down of sub-specialty positions, FM CMG spots should not have too many empty spots after 1st round

[MDLaval]

On 01/12/2017 at 6:22 PM, calcan said:

It definitely could be factor.  Looking at the same CaRMS report (slides 16 and 17) shows that the QC graduates (even McGill) overwhelmingly stay in province, in contrast to the quote above.  But still, it's not as if popular programs out of QC are any less competitive - if anything they would get far more applicants since there's no language barrier, and thus any CMG could theoretically apply.  I would guess the grades aspect with IP constraints and other factors possibly combine together.   

Exactly. My personal belief is that programs in the ROC tend to be more competitive precisely because CMG from all over the country can apply without worrying about language.

And the language barrier works both ways: I have friends and colleagues who would be extremely competitive anywhere they apply, but that choose not to apply outside of QC because they think they lack English language skills.

[JohnGrisham]

11 hours ago, psychiatry2017 said:

Agree.... Ottawa FM rejected a lot of good applicants pre-interview, mostly those backing up with no FM electives.
With the cut down of sub-specialty positions, FM CMG spots should not have too many empty spots after 1st round

No FM electives at all or none at UOttawa?

[MDLaval]

3 hours ago, JohnGrisham said:

No FM electives at all or none at UOttawa?

I'd think that it's more like "none at all".

[psychiatry2017]

9 hours ago, JohnGrisham said:

No FM electives at all or none at UOttawa?

None at all!!! If you have done 1-2 FM electives, you should be able to get the majority of FM interviews (CMG)