How I failed to match in CaRMS

TL;DR: carpe that diem, fellow kids!

Let’s begin this narrative properly now by mentioning a sudden glimpse of introspection that had appeared in my mind not a fortnight ago — I’ve written about the Canadian medical exams which I went through in order to attempt to match to a residency program in one of the universities, but after the sentiment related to not being, in point of fact, matched diffused and relatively normal summer kicked in I’ve never even thought of not reporting on this. So, I think it would be only fair to let you in on it as far as I legally can.

But what is residency and why am I interested in it? Well, boys and girls, medical residency is most commonly the last part of the education that one has to succeed in in order to become a physician (there are licensing exams, medical boards exams et al. but that’s irrelevant for the moment). The physician in training, or a resident doctor, has to go through from 2 to up to 10 years or more of training, depending on the field of interest. In my case it would have been family medicine, which entails 24 months training in Canada. To get to that though one has to go through the CaRMS or Canadian Residence Matching Service (btw, I must warn you that their landing page might be so cheery and teehtful that some of us less endowed or on the lower part of cyclothymic cycle might find it triggering ;-)). CaRMS does pretty much what’s in their name — they match Canadian and International Medical Graduates (CMGs and IMGs) with the residency programs using arcane algorithms thus providing both sides with optimal outcomes. On the whole the service is straightforward and easy to use, especially if one compares it with its USA counterpart. Here is a link to a their Help Desk, which will likely come handy.

The Match cycle begins in July when tokes for the upcoming Match become available. If memory serves, CaRMS begins to accept supporting docs in October and the beginning of December the program selection opens.

Of the four possibilities listed on their main page the one that interests us is the green rectangle of R-1 or Main Residency Match. By clicking on it, you’ll be led onto the page that has it all, basically: eligibility criteria, deadlines, fees and so on. One has to register with them and follow the directions once logged in. To be eligible one has to:

• have successfully graduated a medical university that is either accredited by Liaison Committee on Medical Education/Committee on Accreditation of Canadian Medical Schools (LCME/CACMS), or on the World Directory of Medical Schools (World Directory)
• be a Canadian citizen or a permanent resident
• have successfully passed the NAC-OSCE end MCCQE1 before the deadline

The three above are minimal criteria and one has to subsequently read through provincial, universetarial and linguistic criteria, as well. For instance, if one IMG fancies doing residency in Alberta, one has to inform oneself on the AIMG program that is a prerequisite and there is a similar program in B.C. Both of them require prospective candidate to be a resident of the province at the time of application.

As I have been living in Montreal ever since my arrival claiming residency somewhere else was out of question. You would think then that I would have been eligible in Quebec, right? But I have failed one of the their conditions for an IMG — having graduated or being in an independent practice during last four years. As I traveled and housewifed almost a decade of my life in SE Asia this option was unlikely to yield a positive outcome, but applied anyway. So on much reading and pondering it became clear that realistically I had most chances with programs in Ontario.

What other docs did I have to prepare? To begin with an IMG has to provide the evidence of sufficient language mastery and most commonly required test for that was Academic IELTS with 7 on each test component. Next, one has to obtain:

• three reference letters, preferably from a physician within similar specialty and from Canada and US
• medical school transcript (local graduates will have to have them sent directly from the school to CaRMS, IMGs can simply upload the document themselves)
• Medical Student Performance Record (MSPR, conditions of transmission are the same as for the transcript)
• personal letter of who you are, why are you cool and why this specialty (most programs have a limit of 500 words, thus I struggled a lot)
• CV

Did I have a reference from a North American doctor? Non, monsieur, but it did not seem to hinder things. I got mine from physicians that I’ve trained and worked with at the university and during the following residency, had them translated and sent to CaRMS, and they were accepted. NB! The translated docs have to be sent by the translator with a cover letter, that you can have generated with CaRMS’s website.

Next comes the time to read the program descriptions again and to choose which ones you’d like to apply to. Note here that though there are not that many medical universities in Canada, in each faculty representing a particular specialty there are also IMG and CMG streams, as well as the different subdivisions based on the geography. For example, in Western University’s Family Medicine program there are three streams: CMG, IMG and MOTP/MMTP (the latter is dedicated for training military physicians). But then they also have nine different subdivisions: Chatham-Kent, London, Regional North, Regional West, Rural Goderich, Rural Hanover, Rural Petrolia, Stratford, and Windsor.

After having applied to programs of your choice and having submitted everything required, you wait as the file review begins. After about a month or so of pondering and deliberations, the programs begin to send interview invitations and I got one from the Ontario Board of Family Medicine. There are six medical schools in Ontario and even though you apply to each program separately, you’ll get interviewed by representatives of one of the six programs and the results of this interview will be used by each program to rank you according to their individual preferences. And, of course, you don’t get any feedback on the interview, apart from your own feelings, so you have to be able to “sell yourself well’’ without distorting facts or embellishing them. There are various services on the Internet that sell the interview preparation services, but as I have no experience with them, I could not comment on that. But some of them such as this or this also provide a lot of information pro bono publico, as it were, which might come useful . Frankly, the amount of intelligence is sufficient to make you crawl through their websites for hours, so pace yourselves and leave some time to practice regardless of whether you’ll be doing it with a paid consultant, a kind friend or a sofa cushion.

After about a fortnight’s time since the beginning of the interview period, one can begin create rank order lists on CaRMS. The website advises us to rank the programs according to our true preferences and to not forget that apart from studying and working, one will have to live in the area during this period. Don’t forget to submit the list before the deadline.

Finally, we come to the M Day and surprise-surprise: I did not match. A few weeks later came the second iteration of the Match with fewer open vacancies, thus fewer chances and I failed to match again. Nothing doing, as they say. Thus my first attempt had ended in a defeat and gaining much experience, as well as, a resolution to cast my net wider in the field of healthcare.