Written by Emily Wu (Medicine, Class of 2023)
The Match™️
To apply to residency, graduating fourth-year medical students have to go through the Canadian Residency Matching Service (CaRMS) match process. During this process, final-year students have to select residency training programs that interest them in schools across the country, send supporting documents such as CVs, letters of reference and personal statements before being invited to be interviewed by these schools. Following the interviews, students submit a list of the postgraduate programs they would like to attend, ranked in order of preference. Meanwhile, residency programs also submit a ranked list of applicants they want to accept. Both lists are then compared by the CaRMS algorithm which determines the matches between applicant and residency program that fits either’s preferences the best. The results are released on match day, when students across the country receive their residency placements at roughly the same time. Due to the COVID-19 pandemic, the CaRMS match process for the class of 2021 was done entirely virtually. As well, the timeline had to be delayed this year with match day being on April 20th 2021 while it had historically been in early March. Additional up to date information for CaRMS can be found on their website https://www.carms.ca/. The CFMS matchbook, which is updated every year, also contains very helpful information outlining the match process. The 2020-2021 version can be found here: https://www.cfms.org/files/matchbook/Matchbook_ENG_2020-2021.pdf
The match process is stressful, challenging and somewhat shrouded in mystery for lower-year students. Furthermore, this experience can be devastating for students who do not match to any program in the first iteration of CaRMS and thus do not have a residency position in a Canadian program. In 2020, 137 Canadian medical school graduates went unmatched, including 10 students from McGill. [1] Going unmatched provokes negative emotions such as disbelief, self-doubt, questioning, social isolation and uncertainty about the future. It is also associated with stigma from peers, preceptors and programs, as well as self-stigma and shame. Unmatched students are sometimes unfairly labelled by others as incompetent, causing them to hide their unmatched status. Following communication of the results, unmatched students are faced with difficult and often very time-sensitive decisions such as applying to the unfilled positions through the second iteration of CaRMS, extending clerkship (not available at McGill) and pursuing activities outside of clinical medicine such as research positions. Students are supported by different school administrative branches, such as the WELL Office at McGill, but it is nonetheless a very difficult and emotional process. [2] Match data for the 2021 cohort has not yet been released, but it would be interesting to understand the influence of the pandemic on CaRMS results.
Despite its hardships and possible bad outcomes, the match is a culmination of all the incredible work done by students throughout their medical school journey. From medical school applications to sitting through 6 hours of lectures per day in FMD to participating in complex clinical care in clerkship, match day is the completion of one of the last hurdles before obtaining the MDCM title and being able to promote health for all. Whether it’d be in-person or virtual, it is always an exciting moment when soon-to-be residents finally learn the specialty and the location of their postgraduate studies and excitedly share the news with their classmates and friends. Residency programs also participate in the news by welcoming incoming trainees via social media and showcase the amazing talent that will be joining their midst in the upcoming year. Match day is truly a celebration of the excellence of medical students, highlighting the end of a chapter and the beginning of a brighter future.
What are post-match talks?
Post-match talks are events hosted by fourth-year medical students following their CaRMS match results that attempt to uncover the unknowns surrounding the application process, give advice on how to best approach the match and attempts to alleviate the inevitable anxiety arising in lower-year students with the approach of CaRMS applications. In the weeks following match day in late April and early May, multiple student groups organized post-match talks. They are listed below with the link to the presentation slides where available (compiled from the MSS events calendar mcgillmed.com and Facebook events):
IMIG Internal Medicine Post-Match Talk - May 4th: please contact IMIG at imigmcgill@gmail.com to obtain the slides
MOIG Ophthalmology Post-match Talk - May 5th: cannot be shared (unfortunately)
ROIG Radiation Oncology Post-Match Talk - May 18th: no slides (unfortunately)
These events usually feature a handful of students who have matched to a specific specialty in different programs across the country. They usually discuss why they chose that specialty, the electives they chose throughout clerkship, their research and extra-curricular activities. Students then talk about the actual application process including letter of reference, personal statements and the interview and ranking process.
Are post-match talks useful?
These talks are often more targeted and more relevant for third-year medical students, who are looking for career planning advice as their graduation date approaches. Through these events, they can better choose their med-4 electives and start planning their CaRMS applications. As Cathleen, a med-3 student, says:
I attended post-match talks this year and found them helpful to get an overall sense of the CaRMS process and ideas on which electives to choose. It was also reassuring to hear about the many different journeys our peers have taken and know that programs aren't necessarily looking for some prototype student that fits their specialty.
Med-2s also benefit from attending these events so they can be more prepared throughout clerkship to be a competitive applicant for residency. Here is what a med-2 student had to say on the topic:
I had not attended such talks during my Med-1 year, so I learned a lot of new information regarding different ways to approach the whole CaRMS process. [...] Hearing about how upper-years successfully braved some of the struggles I feared I might have to face, especially concerning not being able to make a final choice of specialty in time for my CaRMS applications, was really helpful in alleviating some of my anxieties.
Lastly, med-1s in attendance can also learn a lot from upper-years by better understanding the CaRMS process, which can be confusing and complicated for new students, as well as start thinking about residency choices and future career goals. Here is first-year medical student Joelle's take on it:
I found it extremely useful more so for planning extracurriculars [and] what I want to get involved in over the next few years. It gave me a good idea of how I can better divide my time and dedicate my efforts [between] research, teaching, etc.
They can also be useful by showcasing students who are outside the traditional pool of CaRMS applicants, such as students applying for US residency positions and couples matching.
Although post-match talks can provide valuable information and advice for students, they may also increase stress in lower-year students who realize the complexity of the match application and the need to perform in clerkship. Also, by listening to other students who have succeeded in achieving their goals and comparing themselves, lower-year students may perceive their clinical experience, research and extracurricular involvement as being inadequate. As one students says:
[A]ttending [the events] made the eventuality of clerkship much more real and tangible, and I would be lying if I said that experience [was] anything short of terrifying. [...] Imposter syndrome is nothing new, but it really kicked in strong for me during these talks when I would imagine myself in various situations that the speakers described. [...] In hindsight, I think it was partly just fear that came as a response to the overwhelmingness of receiving such a large amount of information in such a short time period. A few weeks later, from where I stand, these talks were extremely valuable and have made me feel much more prepared to face the joy, trials and tribulations of clerkship.
It is also important to remember that these events only portray a limited number of applicants. There are often perspectives that are left out such as applicants who did not get their first-choice specialties, applicants who went unmatched, or those who struggled to find a specialty of interest. It is understandable that some of the students in such a position are uncomfortable speaking at these events, considering the emotional charge involved and the possible judgement that students who are in these positions may face.
In conclusion, post-match talks are events where fourth-year medical students discuss various aspects of the residency application process done through CaRMS. Despite the delayed timeline of the match this year, post-match talks still took place and were for the most part very useful for students to be prepared for this challenging process. Even though these events may leave out some important perspectives, they still provide valuable advice for students of all years to put their best foot forward for residency selection committees.
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References
2020 R-1 Main Residency Match- first iteration Table 2: Summary of match results by school of graduation. Canadian Resident Matching Service; 2020. Available from: https://www.carms.ca/wp-content/uploads/2020/05/2020_r1_tbl2e.pdf
Okoniewska B, Ladha MA, Ma IW. Journey of candidates who were unmatched in the Canadian Residency Matching Service (CaRMS): A phenomenological study. Canadian Medical Education Journal. 2020;11(3):e82–e91. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378156/