The

MATCH

BOOK

An annual review of the CaRMS match by the Canadian Federation of Medical Students 20102011

Canadian Federation of Medical Students, 2010

Contact information and links For additional information pertaining to the CaRMS match, please visit the following websites: www.carms.ca www.cfms.org Please direct inquiries about CaRMS to help@carms.ca and inquiries about this publication and the CFMSs role to office@cfms.org For details regarding the 2010 match results, please visit www.carms.ca, consult the operations menu and then access the statistics menu.

Table of Contents
Acronyms ...........................................................................................................iv Executive Summary..............................................................................................v Tips from Residents.............................................................................................vi The 2010 Match A message from the Canadian Federation of Medical Students ......................1 A message from the Association of Faculties of Medicine of Canada ..............2 The CaRMS Match: Roles and Responsibilities ...................................................3 Important Dates for Medical Students .................................................................6 The Match Algorithm: How it Works ..................................................................7 Previous Year Applicant Success Rates by Discipline...........................................10

Acronyms
AFMC AWS CAIR CaRMS CFMS CMG IMG MSPR PGY PWS ROL Association of Faculties of Medicine of Canada Applicant Webstation Canadian Association of Internes and Residents Canadian Resident Matching Service Canadian Federation of Medical Students Canadian Medical Graduate International Medical Graduate Medical Student Performance Record Post-Graduate Year Program Webstation Rank Order List

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Executive Summary
The Canadian Federation of Medical Students (CFMS) is the national body representing medical students in Canada. This annual publication, which is produced by the CFMS in association with the Canadian Resident Matching Service (CaRMS), is designed for Canadian medical students of all years. The information herein is intended to help students prepare for the match and plan their career, as well as increase their understanding of the CaRMS match.

Tips from Residents

Inform yourself as to the expectations of the program and location to which youd like to match; you need to know what they prefer in terms of the quantity of electives in their specialty and the need for doing electives in their location in order to be considered. Choose your referees judiciously; ask them if theyre willing to write a strong reference letter for you, which will increase your chances of having good letters written on your behalf. Meghan Cusack, NOSM

Throughout medical school, keep your CV up to date. The fall of your final year of clerkship can be extremely busy with CaRMS applications and this is the one thing you can get out of the way before the whole process begins. Jonathan Dellavedova, McMaster

Dont think that you need to do all your electives in a specific discipline to make yourself a strong candidate. Doing different electives provides breadth and frequently makes candidates more informed about whats out there. Ivan Cacic, McMaster

When choosing a career, dont choose based on the most interesting aspects of a specialty because everything, to some extent, is interesting. Choose based on your ability to tolerate the most trying aspects of a specialty. Anonymous Resident Speak to recent grads but make sure you also speak to those with grey hair or dyed hair. Make sure theyre happy with their career choice and find out why or why not. Anonymous Resident

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The 2010 Match

A message from the Canadian Federation of Medical Students
In 2010, 98.4% of CMGs were matched in either the first iteration or second iteration of the CaRMS Match and 86% matched to one of their top three program choices (both discipline and location). These figures are similar to previous years (99% and 84% in 2009) and indicate a successful overall match for CMGs. In addition, 31.8% of CMGs chose Family Medicine as their first choice discipline, a rate similar to the 2009 rate (32.5%). The total number of IMGs matched this year (274 first round and 106 second round total 380) represents a small decline from IMG match rates from 2009. Once again this year, there is no reason to believe that the current presence of IMG matches has an overall negative effect on the matching of CMGs though this may not represent the experience of individual Canadian Medical Students but rather an holistic impression of the match. Historically, IMGs have matched to dedicated IMG spots at each university in each postgraduate program. Over the last years, some Canadian Medical Faculties have been opening all positions in the match (first and second round) to both Canadian and International graduates for open competition. Open matches such as these are being conducted in Manitoba and Quebec. Furthermore, the second round of the match in Ontario and Alberta are now entirely open to CMGs and IMGs, that is to say that all remaining positions in the second round of the match in these provinces are an open competition. In 2010, CMGs faced their worst second round match rate in the last 3 years with a rate of 56% (80% in 2009 and 75% in 2008). This highlights an increased importance on the first round match for CMGs. CMGs matching strategies should not depend on the success of the second round match. Also in 2007, a large number of residency positions were added across the country, but were followed up with significantly lower rates of added positions in 08,09 and 2010, especially when compared to the increased medical school enrollment and graduation trend over the last few years. The ratio of available residencies to CMGs has remained roughly similar in 2010 at 1.11 from 1.12 in 2009 (1.08 in 2008, 1.14 in 2007). As more and more students graduate from Canadian medical schools, it will be important that there is a corresponding increase in available residency positions to facilitate match success and re-training. The CFMS continues to advocate for additional residency positions and will continue to monitor match rates to ensure that any changes in the system do not negatively affect CMG match rates.

A message from the Association of Faculties of Medicine of Canada

The Association of Faculties of Medicine of Canada (AFMC) continues to be pleased with the CaRMS match for Canadian Medical Graduates (CMGs) and International Medical Graduates (IMGs). The 2010 match was very successful for CMGs - 96% matched in the first iteration and almost 88% to their first choice discipline. Adding to this success, 380 IMGs entered postgraduate training through the 2010 CaRMS match. These positive results speak to the strength of our medical education system in meeting the needs of CMGs while, at the same time, accommodating the IMGs need to undertake full or partial postgraduate medical training in Canada. AFMC supports the continued goal of maintaining a steady number of residency positions offered per graduating CMG. Between 2000 and 2009, there was an average of 1.09 postgraduate residency positions offered per CMG participating in the first iteration CaRMS match. In 2010, 1.12 positions were offered per CMG. Looking beyond the numbers, program directors in all of our faculties continue to work diligently to determine the eligibility of candidates for entry into postgraduate training and to ensure a good match. In addition to maintaining the postgraduate residency quota for CMGs, faculties of Medicine continue the effort to expand training options both within and outside of the traditional teaching hospitals. On an annual basis, AFMC receives reports from CaRMS which inform policy discussions between AFMC, governments, and other stakeholders. Ultimately, decisions with regard to the exact number of positions available for postgraduate training, as well as the distribution of these positions, is a negotiation that occurs between governments, faculties of medicine, and other stakeholders. Our aim continues to be to ensure the best possible opportunities for all those entering postgraduate training in Canada.

The match: roles and responsibilities

The Canadian Resident Matching Service

CaRMS is an independent not-for-profit corporation and the gateway from undergraduate to postgraduate medical education in Canada. All Canadian medical schools participate in the Match. CaRMS is governed by a Board of Directors that includes the CFMS, CAIR, AFMC, and other partners in medical education. The CEO, Executive Group and staff are responsible for the ongoing operations of the organization. CaRMS Does: 1. Provide a central, secure electronic interface for application to postgraduate education 2. Provide a computer-based match algorithm to facilitate this process 3. Administer the matching process for PGY-1 entry, in addition to the PGY-3 Emergency Medicine Match, the new R4 internal medicine match and Canadian access to the US application system for postgraduate education. CaRMS Does Not: 1. Determine a candidates eligibility for entry into postgraduate training 2. Have any role in determining the number of residency positions available in any particular discipline or in any particular location 3. Have any role in determining the level of participation of IMGs in the match or which residency positions are eligible for IMGs The match algorithm ensures that all eligible applicants are matched according to the merits of their applications in addition to the rank lists of the candidates and the postgraduate programs.

Canadian Medical Graduates (CMGs)

Graduating medical students are responsible for submitting all necessary documentation to CaRMS and meeting appropriate deadlines. The electronic Applicant Webstation (AWS) becomes available at www.carms.ca in
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early September for candidates expected to graduate the following spring. Tailored applications, program selections, and supporting documentation (personal letters, reference letters, curriculum vitae and abstracts) are submitted via AWS and direct mailing to CaRMS. Students determine which documents to submit based on the requirements of the programs, and these documents are assigned to programs accordingly. AWS users applications become available for review by PG programs as of early December. Following an application review by the postgraduate programs, interviews are granted in January and February, and these are scheduled by applicants and programs independently of CaRMS. After interviews, applicants create rank-order-lists (ROLs) of their preferred postgraduate programs to be entered into the match algorithm. Likewise, programs rank applicants. The match is then conducted in a first iteration followed by a second iteration for applicants who remain unmatched after the first. Once matched, applicants are legally obligated/bound to attend the residency program.

Medical schools
Undergraduate Medical Education programs are responsible for registering their graduating students with CaRMS prior to the student application process. They provide CaRMS with proof of good standing and proof of acquisition of the MD Degree. They also provide MSPRs, formerly known as Deans Letters.

Provincial ministries of health and education

Government ministries are primarily responsible for determining the number of positions available in each jurisdiction in each entry discipline. These are determined and funded based on a number of factors including societal need, budgetary concerns, and capacity in the medical education system. Typically there are more PGY-1 entry positions available than CMGs in order to accommodate re-training, and IMGs.

Postgraduate programs
A postgraduate program is synonymous with residency program in Canada, and each discipline at each school has a Program Director who is responsible for selections. Following the student submissions, Directors, as well as Program Administrators, use the CaRMS Program Webstation (PWS) to review applications and grant interviews to candidates. Interviews are scheduled directly with the candidates by the postgraduate programs in late January and early February. Following interviews, Postgraduate Directors create rank-order-lists (ROLs) of applicants that are entered into the match algorithm along with the student ROLs.

International medical graduates (IMGs)

In 2007, IMGs were included in the first iteration of the CaRMS Match for the first time. This decision was made by provincial governments in response to a shortage of health human resources. In most provinces, there is a set number of positions for IMGs such that they do not compete directly with CMGs. CaRMS administers this as a separate parallel match. In Manitoba and Quebec, IMGs compete directly with CMGs for the same positions. For Alberta and Ontario programs, IMGs compete for the same spots as CMGs in the second round of the match.

Important Dates for Medical Students

2011 Match
Please check these dates at www.carms.ca Operations Future Matches
September 8, 2010 The Applicant Webstation opens at www.carms.ca for 2011 graduates.

November 23, Document Assignment Milestone. 2010 November 26, The Applicant Webstation closes. All program selections and 2010 supporting documentation are due in advance of this deadline. December 1, 2010 January 22, 2011 February 13, 2011 February 24, 2011 March 7, 2011 The Program Webstation opens for review of applications. Interviews are granted and scheduled by the programs in the weeks following. National out-of-town interview period. Candidates travel to the various programs where they have accepted interviews.

Applicants Rank-Order-Lists are due. This is also the deadline for withdrawal from the Match. Match Day. Applicants log-in to the Webstation to discover which single postgraduate program they have been assigned.

The match algorithm: how it works

The computer-based match algorithm is executed following the submission of applicant rank-order-lists and program rank-order-lists. These two sets of lists are the only data input. These lists are independent of each other, meaning that the order in which applicants rank their programs has no bearing whatsoever on the order in which programs rank their applicants. So how does the algorithm actually work? In the simplest terms, an individual applicant is matched to his or her highest ranked program, provided that program is not already fully occupied by applicants who ranked higher on the program rank-order-list. If the applicants first ranked program is full, the same process is applied to the applicants second ranked program, and so on, until the applicants rank-order-list is exhausted. In this manner, the vast majority of applicants are matched to a program in the first iteration of the match. Following the first iteration, unmatched applicants can reassess their standing and apply to programs with unfilled positions in a separate second iteration. The same algorithm is applied in this smaller match. In this manner, nearly all CMG applicants are matched and nearly all programs are filled. Applicants who remain unmatched are then able to arrange interviews and placements into remaining programs independently of CaRMS in a post-match-process.

What this means for medical students

The sequence of your rank-order-list should reflect your true personal preferences Rank all those programs which are acceptable to you, and do not rank any of those programs which you find unacceptable postgraduate programs are not permitted to ask you questions about your rank intentions and you are able to decline answering such questions

Mini-match
To illustrate how the match works, lets take a look at a smaller version with applicants who have diverse career interests. This will require you to imagine that there are only 4 residency programs in the country, each with only one position available.
Applicant rank order list
Colleen Esterase 1. UBC Peds 2. McMaster Orthopedics 3. Dalhousie Family Med 4. NOSM Internal Med Mal Ignant-Hyperthermia 1. NOSM Internal Med 2. McMaster Orthopedics 3. UBC Peds 4. Cory Za 1. UBC Peds 2. McMaster Orthopedics 3. 4. Barb Orygmi 1. NOSM Internal Med 2. Dalhousie Family Med 3. UBC Peds 4. McMaster Orthopedics

Program rank order list

UBC Peds 1. Colleen Esterase 2. Cory Za 3. Barb Orygmi 4. McMaster Orthopedics 1. Colleen Esterase 2. Cory Za 3. Barb Orygmi 4. Mal Ignant-Hyperthermia Dalhousie Family Med 1. Barb Orygmi 2. Colleen Esterase 3. 4. NOSM Internal Med 1. Colleen Esterase 2. 3. 4.

Results
UBC Peds Colleen Esterase

McMaster Orthopedics Cory Za

Match
Dalhousie Family Med Barb Orygmi

NOSM Internal Med Unfilled

Play-by-play
Colleen is a strong candidate and is confident about several of her applications and interviews. She chooses to rank UBC Peds first as this is her preferred program but she also ranks the others, which she also finds acceptable, just in case. This is a wise strategy. Mel also prefers UBC Peds but does not think she has much chance of getting in to this competitive program so she ranks it last. She leaves Dalhousie Family Medicine off her list because she thinks her interview went terribly, even though she would like this program. These are both poor strategies. Cory decides after his interviews that he no longer wants to pursue a residency in Family Medicine or Internal Medicine so he leaves them off his list. This is a wise strategy. Barb Orygmi really wants to go to NOSM for Internal Medicine but does not think her application is competitive enough. She ranks it first anyway because this is her preferred program and the other programs will never know she ranked them lower. This is a wise strategy.

Previous Year Applicant Success Rates by Discipline

Discipline Anatomical pathology Anesthesia Cardiac surgery Community medicine Dermatology Diagnostic radiology Emergency medicine Family medicine General surgery Hematological pathology Internal medicine Laboratory medicine Medical biochemistry Medical genetics Medical microbiology Neurology Neurosurgery Nuclear medicine Obstetrics/gynecology Ophthalmology Orthopedic surgery Otolaryngology Pediatrics Physical medicine & rehabilitation Plastic surgery Psychiatry Radiation oncology Urology 2010 84.2% 94.2 70 81.3 56.1 74.3 74.7 98.6 80 100 94.8 80 100 100 80 80.5 94.4 66.7 74.6 64.8 86.3 77.8 85.7 100 52.8 91.6 85 60 2009 73% 77 83 71 54 83 73 97 86 100 94 83 100 100 57 94 83 62 74 59 92 66 83 90 56 92 80 88 2008 100% 87 100 70 59 73 69 97 83 n/a 93 91 n/a 100 63 88 76 100 83 65 82 80 79 80 51 97 70 74 2007 100% 87 100 70 59 73 69 97 83 100 93 94 100 100 63 88 76 100 83 65 82 80 77 80 49 97 70 74

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