Helping to improve the CaRMS match

Dianne Delva

doi:10.46747/cfp.670115

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RE: Helping to Improve the CaRMS Match
Colin G. Stevenson

Published on: 17 February 2021
RE: Helping to imprrove the CaRMS Match
Stephen Ashwell

Published on: 11 February 2021
RE: Improving the CaRMS Match
Robert W Shepherd

Published on: 28 January 2021

Published on: (17 February 2021)

RE: Helping to Improve the CaRMS Match
Colin G. Stevenson, Community Family Physician, McMaster University, Hamilton
I heartily agree with Dr. Delva's article about the excessive number of CaRMS applications, and how this is often not necessary. When I applied to family medicine through CaRMS in 2002 (and admittedly, family medicine was less popular back then), I only applied to a few programs. As a result, my interview weeks were quite relaxed and even enjoyable as I truly discovered the schools and the cities in which they are located.

I would argue that it doesn't really matter where you train. A family medicine residency is only two years. You're going to be busy reading and working. You'll learn from any patients you see, and you'll learn something from any teachers you get. You'll meet new people. Even if far away from home, there are ways to stay connected to people you care about. Even in my day, there were ways! After the two years is over, you can choose to move somewhere else, or stay.

As preceptors, we might give some advice to medical students who intend to apply to family medicine: don't let the CaRMS match dominate your life !

Competing Interests: None declared.
Published on: (11 February 2021)

RE: Helping to imprrove the CaRMS Match
Stephen Ashwell, Family Physician in Oncology, BC Cancer
Thanks to Dr Delva for raising this important issue. I agree that CaRMS, while fulfilling a very important need, uses up far more resources of students and programs than is necessary. My purpose in writing this is to add the carbon/climate impact to the equation. As family physicians we expend considerable effort educating our society on public health issues like climate change but struggle to adhere to best practices in climate change mitigation ourselves. Eliminating travel for CaRMS by implementing virtual interviews would send a powerful signal that we are making changes in our culture rather than just preaching. This is not a radical proposal and would be considered normal in most other employment sectors. This would also improve some of the problems Dr. Delva lists such as student expense and time commitment. I hope Family Physicians across the country will let their residency programs and CaRMS leadership know that we support their efforts to move to a more efficient process, particularly by reducing travel requirements.

Competing Interests: None declared.
Published on: (28 January 2021)

RE: Improving the CaRMS Match
Robert W Shepherd, physician, UBC and U Vic
Dr. Delva stated that the process of applying to the Canadian Resident Matching Service puts undue burden on students. "The mean number of applications by Canadian medical graduates was 21; 98.4% of those who chose family practice as their first choice matched; and the cost of travel and accommodation for electives and interviews ranges from $20,000 to $30,000." I agree with Dr. Delva's suggestions, including the recommendation that students not apply to more than 7 programs.

I have a suggestion which could reduce the cost to students concerning program interviews: hold the interviews in 4 cities. Interviews for programs in Manitoba, Saskatchewan, Alberta, and British Columbia take place in Calgary; interviews for Ontario programs take place in Toronto; for Quebec programs, in Montreal; and for Atlantic Canada in Halifax.

Medicine is a service for people, by people. Hospitals and residency programs undergo regular assessment in order to maintain accreditation. There is no need for the student to visit the city where the program is located to get to know the people providing the program. It would save the student time and money if all the interviews took place in four cities.

Anticipate resistance from programs which are staffed by busy clinicians with duties to patients. The counter-argument is that the students are busier than the staffpeople. Students have a duty to provide care to their patients. In addition, students have...
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Dr. Delva stated that the process of applying to the Canadian Resident Matching Service puts undue burden on students. "The mean number of applications by Canadian medical graduates was 21; 98.4% of those who chose family practice as their first choice matched; and the cost of travel and accommodation for electives and interviews ranges from $20,000 to $30,000." I agree with Dr. Delva's suggestions, including the recommendation that students not apply to more than 7 programs.

I have a suggestion which could reduce the cost to students concerning program interviews: hold the interviews in 4 cities. Interviews for programs in Manitoba, Saskatchewan, Alberta, and British Columbia take place in Calgary; interviews for Ontario programs take place in Toronto; for Quebec programs, in Montreal; and for Atlantic Canada in Halifax.

Medicine is a service for people, by people. Hospitals and residency programs undergo regular assessment in order to maintain accreditation. There is no need for the student to visit the city where the program is located to get to know the people providing the program. It would save the student time and money if all the interviews took place in four cities.

Anticipate resistance from programs which are staffed by busy clinicians with duties to patients. The counter-argument is that the students are busier than the staffpeople. Students have a duty to provide care to their patients. In addition, students have to study, to perform under scrutiny, apply for a residency, and maintain personal well-being. Family practice in Canada could demonstrate an egalitarian approach to students by offering to husband their resources by streamlining the residency interviewing process into 4 cities.

I sent a draft of this proposal to my supervisor in the Family Medicine program of UBC and U Vic, where I teach, and was told that he might consider acting on the proposal. There was no follow-up.

Sincerely,

Robert Shepherd, Victoria BC
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Competing Interests: None declared.