Nervous about number of unmatched CMGs

[mew]

Hi everyone,

I know I'm getting ahead of myself here, but I want to make sure I can make an informed decision in the event I do get an acceptance this year. One of my interviews is at a 3-year school so I don't know if I could realistically write and do well on the USMLE to apply to the US match. I also don't think it's reasonable to expect the situation to get better by the time I would apply for CaRMS, but at the same time, I'm not sure I'm comfortable in just *hoping* that I'd be one of the lucky ones who does match at all, let alone to a specialty I'm actually interested in. I don't think I could bear spending all this time, effort, and money working towards an MD and then not being able to practice after everything. I also don't know how much better I'd feel if I got stuck in a specialty I didn't enjoy.

Is it even a smart decision to pursue med school with residency spots the way they are right now?

[Birdy]

I’m at Mac and have several classmates who wrote the USMLEs. I’ll let them report more on how well they did as I definitely didn’t write it but I think it was possible to do well enough. 

 

Ultimately, residency is still probably one of the best bets you’ll ever have for a job right out of a professional program. While the issue of unmatched CMGs is certainly one of concern, and you’re right that it’s not going to be fixed in short order, I think that for students who choose to keep their options open and particularly if they are willing to consider primary care, the odds of matching are sufficiently high that it should not deter them from pursuing medicine 

[Organomegaly]

1 hour ago, mew said:

Hi everyone,

I know I'm getting ahead of myself here, but I want to make sure I can make an informed decision in the event I do get an acceptance this year. One of my interviews is at a 3-year school so I don't know if I could realistically write and do well on the USMLE to apply to the US match. I also don't think it's reasonable to expect the situation to get better by the time I would apply for CaRMS, but at the same time, I'm not sure I'm comfortable in just *hoping* that I'd be one of the lucky ones who does match at all, let alone to a specialty I'm actually interested in. I don't think I could bear spending all this time, effort, and money working towards an MD and then not being able to practice after everything. I also don't know how much better I'd feel if I got stuck in a specialty I didn't enjoy.

Is it even a smart decision to pursue med school with residency spots the way they are right now?

It's not a disastrous matching situation. 97% of medical students still match after both rounds of CaRMS. Most people DO get what they want. But will you necessarily get what you want and where you want it? No -- not even for family medicine. I don't think it should deter you, however, from going to medical school if this is the career you want. Nothing in this intrinsically competitive market is guaranteed. Have you looked at the situation for law students? Way worse than us. Physicians still have it very, very good relative to what else has happened to other professions. 

[shikimate]

start studying USMLE from day 1, read FirstAid book like the gospel, visit the UWorld website more often than visiting FB, and you'll do fine on Step 1.

USMLE is not hard, it's just volume of information. They are lots and lots of online question banks to help you ace Step 1

Online question banks are your friend. 

People can say whatever they want, match rate can be 99.99%, but when you're the one that go unmatched, life SUCKS. 

Even if you fail Step 1, there's no penalty when it comes to CaRMS.

[brady23]

2 hours ago, Organomegaly said:

It's not a disastrous matching situation. 97% of medical students still match after both rounds of CaRMS. Most people DO get what they want. But will you necessarily get what you want and where you want it? No -- not even for family medicine. I don't think it should deter you, however, from going to medical school if this is the career you want. Nothing in this intrinsically competitive market is guaranteed. Have you looked at the situation for law students? Way worse than us. Physicians still have it very, very good relative to what else has happened to other professions. 

Out of curiosity, what is the situation for law students?

[Organomegaly]

4 minutes ago, brady23 said:

Out of curiosity, what is the situation for law students?

for example

http://nationalpost.com/opinion/robyn-urback-here-ontario-have-some-more-law-school-grads

 

They do not have a semblance of a centralized matching system to jobs or articling positions, and certainly less than 97% of them will find work after they finish law school. 

 

[FailureToThrive]

15 hours ago, shikimate said:

start studying USMLE from day 1, read FirstAid book like the gospel, visit the UWorld website more often than visiting FB, and you'll do fine on Step 1.

USMLE is not hard, it's just volume of information. They are lots and lots of online question banks to help you ace Step 1

Online question banks are your friend. 

People can say whatever they want, match rate can be 99.99%, but when you're the one that go unmatched, life SUCKS. 

Even if you fail Step 1, there's no penalty when it comes to CaRMS.

My med school is very focused on clinical from day one. In fact, we don't even really see basic physiology and anatomy... I've been trying to study for step 1, but find it challenging to learn the mechanisms without any background. Do you recommend any ressources that aren't 900 page textbooks which I realistically won't have time to read?

[la marzocco]

15 hours ago, Organomegaly said:

for example

http://nationalpost.com/opinion/robyn-urback-here-ontario-have-some-more-law-school-grads

They do not have a semblance of a centralized matching system to jobs or articling positions, and certainly less than 97% of them will find work after they finish law school. 

I was a practising lawyer and I can confirm this. In my cohort, only 65% got a summer articling position in their penultimate year. And about half of that got a full time offer by the time of graduation. It was pretty bad. Some ended up going into judicial research and now working towards LLM and LLD.. basically academic law research.

And now, Ryerson wants to open a law school... another 150 law grads being pumped into an already-saturated field!

[Edict]

23 hours ago, mew said:

Hi everyone,

I know I'm getting ahead of myself here, but I want to make sure I can make an informed decision in the event I do get an acceptance this year. One of my interviews is at a 3-year school so I don't know if I could realistically write and do well on the USMLE to apply to the US match. I also don't think it's reasonable to expect the situation to get better by the time I would apply for CaRMS, but at the same time, I'm not sure I'm comfortable in just *hoping* that I'd be one of the lucky ones who does match at all, let alone to a specialty I'm actually interested in. I don't think I could bear spending all this time, effort, and money working towards an MD and then not being able to practice after everything. I also don't know how much better I'd feel if I got stuck in a specialty I didn't enjoy.

Is it even a smart decision to pursue med school with residency spots the way they are right now?

I think its okay to pursue medical school, although a 3 year school may not be the best option for you. One option you can take is to do an enrichment year, which makes your program a 4 year program, but in my opinion it is better to do a 4 year program because of the fact that you get more teaching, more structured training and you stay with your class throughout the 4 years. 

Choose a 4 year program. 

[W0lfgang]

It's not random who goes unmatched. If we look into the unmatched applications in retrospect, I bet we'd find some serious strategic errors in most of them. I have heard of some really stupid things like backing up plastics with derm, the suicide match, being a douche, etc. Do you have the wherewithall and social awareness to avoid these mistakes? If so, you'll do fine in the match.

[rmorelan]

4 hours ago, W0lfgang said:

It's not random who goes unmatched. If we look into the unmatched applications in retrospect, I bet we'd find some serious strategic errors in most of them. I have heard of some really stupid things like backing up plastics with derm, the suicide match, being a douche, etc. Do you have the wherewithall and social awareness to avoid these mistakes? If so, you'll do fine in the match.

That is a big part of it - I think this is like a lot of things out there, there are personal factors (super focused on one thing, no backup, not that great at the field they want, limited social skills......) and the system overall ( unpredictable collective interest in a particular field by other residents for whatever reason , reduction in spots either globally or within particular fields, market forces......). Most people that don't match have a reason you can track down. I still know some people every year where I can cannot figure out why they didn't match. 

Most people do quite fine still, and even with the increase in non matching people it is still a relatively rare event - although the number of people not getting what they want is probably a much higher number. Even if completely true - things aren't exactly moving in the direction that benefits medical students. There has to be some counter force at some point to what they are doing. 

[indefatigable]

35 minutes ago, rmorelan said:

That is a big part of it - I think this is like a lot of things out there, there are personal factors (super focused on one thing, no backup, not that great at the field they want, limited social skills......) and the system overall ( unpredictable collective interest in a particular field by other residents for whatever reason , reduction in spots either globally or within particular fields, market forces......). Most people that don't match have a reason you can track down. I still know some people every year where I can cannot figure out why they didn't match. 

Most people do quite fine still, and even with the increase in non matching people it is still a relatively rare event - although the number of people not getting what they want is probably a much higher number. Even if completely true - things aren't exactly moving in the direction that benefits medical students. There has to be some counter force at some point to what they are doing. 

Problem is it's easy to point out "no back up", but many successful applicants have also used that strategy.  It's just a game of musical chairs - except there's fewer chairs with more applicants.  So some people will unfortunately not match.  

[rmorelan]

1 hour ago, marrakech said:

Problem is it's easy to point out "no back up", but many successful applicants have also used that strategy.  It's just a game of musical chairs - except there's fewer chairs with more applicants.  So some people will unfortunately not match.  

I am one of them - I backed up with nothing because I believed, and still do, that you should apply for and rank as many things as you can that you would rather do than go unmatched. In my case I was willing to go unmatched for radiology, wait a year and then reapply more than I was willing to do anything else. Personal choice. 

you are mentioning the systemic issue - not enough spots - and I agree there is almost a mathematical certainty that someone will go unmatched the way it is now. I view it similar to the economy I guess - it makes sense that everyone should do what ever they can to be competitive in the job market - training, working hard, develop skills, network......and yet if everyone maxed out themselves in all of those areas you STILL would have unemployment - you cannot get to zero unemployment in our economic system except theoretically. 

No matter what we do some people will realistically go unmatched (it is possible to make no mistakes and still lose)- the number is small but as the systemic forces increase that number is rising. We have to have a way of dealing with that. 

[indefatigable]

3 hours ago, rmorelan said:

I am one of them - I backed up with nothing because I believed, and still do, that you should apply for and rank as many things as you can that you would rather do than go unmatched. In my case I was willing to go unmatched for radiology, wait a year and then reapply more than I was willing to do anything else. Personal choice. 

you are mentioning the systemic issue - not enough spots - and I agree there is almost a mathematical certainty that someone will go unmatched the way it is now. I view it similar to the economy I guess - it makes sense that everyone should do what ever they can to be competitive in the job market - training, working hard, develop skills, network......and yet if everyone maxed out themselves in all of those areas you STILL would have unemployment - you cannot get to zero unemployment in our economic system expect theoretically. 

No matter what we do some people will realistically go unmatched (it is possible to make no mistakes and still lose)- the number is small but as the systemic forces increase that number is rising. We have to have a way of dealing with that. 

I think we're on the same page.  The rising number is the concern - in 2009 there were 11 vs 68 last year.  In today's climate though, I think the potential repercussions for being unmatched are possibly greater due to the closer margins.  So the risk is even higher with no parallel plan.  

I'm not sure I fully agree with your analogy though - labour market problems are often much more macro & systemic - the individual doesn't necessarily have much sway in which country or neighbourhood they're born in.  I mean moving countries can  change the unemployment rate and thus improve and individual's prospect for employment.  So there are important differences that can be made on a large scale - and these differences could bring the numbers back down from 68 to 11.

Personally, for instance,  I realized that radiology couldn't be a serious interest with max 1 permitted elective.   

[W0lfgang]

1 hour ago, marrakech said:

Problem is it's easy to point out "no back up", but many successful applicants have also used that strategy.  It's just a game of musical chairs - except there's fewer chairs with more applicants.  So some people will unfortunately not match.  

It sounds counterintuitive, but not backing can improve your chances.

[zizoupanda]

On 2018-02-14 at 2:11 PM, W0lfgang said:

It's not random who goes unmatched. If we look into the unmatched applications in retrospect, I bet we'd find some serious strategic errors in most of them. I have heard of some really stupid things like backing up plastics with derm, the suicide match, being a douche, etc. Do you have the wherewithall and social awareness to avoid these mistakes? If so, you'll do fine in the match.

That is completely unfair. I know many candidates this year applying to not necessarily competitive fields who struggled to get interviews. There are increasing medical schools spots but decreasing residency spots, a ridiculously high percentage of which are reserved for IMGs which is squeezing out CMGs. This is a reality premeds need to understand. Do the vast majority of CMGs match? Yes. But an increasing amount do not and many who do have to settle for specialities they do not want to do to get on with their lives. The match system is beginning to crack and last year a brilliant student committed suicide after constant rejection from a failing system. For a 3-4 year and >100k investment, this is important to consider. 

[jlkhhylyiluh6]

9 hours ago, zizoupanda said:

That is completely unfair. I know many candidates this year applying to not necessarily competitive fields who struggled to get interviews.

Maybe they applied to very competitive programs in non competitive specialities (ex, family med in toronto)? Maybe they just werent good candidates despite the impression they gave their peers?

[goleafsgochris]

On ‎2018‎-‎02‎-‎14 at 8:30 PM, rmorelan said:

I am one of them - I backed up with nothing because I believed, and still do, that you should apply for and rank as many things as you can that you would rather do than go unmatched. In my case I was willing to go unmatched for radiology, wait a year and then reapply more than I was willing to do anything else. Personal choice. 

 

This is really interesting, because I did the same thing when I was in med school.  The thing is it took until my first year of residency to see how terrible not matching would actually be.  I remember being in emerg seeing one of my former classmates who hadn't matched working...but for no money and without being able to sign orders!!  For the chance of matching!  She had long given up on applying to anything competitive and was hoping FM would take her...what a nightmare...

In retrospect I would have applied for as many programs as possible.  For one because I think you actually have a better chance getting into a random program and switching than getting in as a next year or second round applicant.  And for two because matching to literally any program in Canada is IMO better than not matching now that ive seen the alternative.

[bearded frog]

On 2/15/2018 at 8:48 PM, zizoupanda said:

 last year a brilliant student committed suicide after constant rejection from a failing system

Its really frustrating for people to keep bringing up this specific student as an example of "being unmatched makes people kill themselves". I'm assuming you don't know more about his specific situation than what has been in the media, but its clear the situation was complex. I have no doubt that going unmatched is extremely stressful and disheartening but there are many who successfully match in the second round or the following year.

Speaking generally, while yes, sometimes in hindsight it can be clear why people don't match, sometimes you really can't come up with a reason a particular person went unmatched who ostensibly should have done will in most metrics, which is frustrating when you cannot get feedback.

[SunAndMoon]

On 2018-02-14 at 9:12 PM, W0lfgang said:

It sounds counterintuitive, but not backing can improve your chances.

Can you develop on this?

[bearded frog]

3 minutes ago, SunAndMoon said:

Can you develop on this?

I think he implied that if you focused 100% of your electives/research/effort on one specialty you might have a better application than if you were splitting between two.

[SunAndMoon]

Just now, bearded frog said:

I think he implied that if you focused 100% of your electives/research/effort on one specialty you might have a better application than if you were splitting between two.

Ah gotcha that makes sense - for some reason i thought he meant not backing as in only ranking one specialty lol

[indefatigable]

3 minutes ago, bearded frog said:

I think he implied that if you focused 100% of your electives/research/effort on one specialty you might have a better application than if you were splitting between two.

Yeah - that was my understanding too.  Even if I wanted to use that kind of strategy, it wouldn't be permitted in my faculty - electives can't all be in the same specialty.  It's even more true with non-clinical specialties, like radiology, where it's limited to a single elective.  

[GrouchoMarx]

And if you match to the wrong thing then you're out of luck too. 

 

the fact is we are in a centralized government system that is trying to maximize return and minimize investment. by front loading medical students and not expanding residency positions they are forcing students into fields nobody wants to do. add to that the ridiculous carms rules about reapplying, and an increase in foreign medical doctor recruitment, and what i envision is a whole lot of very miserable doctors in the future. that suits the government just fine. screw them. go to the usa.

[W0lfgang]

14 hours ago, bearded frog said:

I think he implied that if you focused 100% of your electives/research/effort on one specialty you might have a better application than if you were splitting between two.

That's correct.

14 hours ago, SunAndMoon said:

Ah gotcha that makes sense - for some reason i thought he meant not backing as in only ranking one specialty lol

I do mean rank only one specialty. That's the definition of not backing up

14 hours ago, marrakech said:

Yeah - that was my understanding too.  Even if I wanted to use that kind of strategy, it wouldn't be permitted in my faculty - electives can't all be in the same specialty.  It's even more true with non-clinical specialties, like radiology, where it's limited to a single elective.  

That's insane!!!!!