CaRMS: Your Guide to Matching

CaRMS Residency Match Rates by School

1. Memorial University – 94.8%
2. Dalhousie University – 95%
3. Université Laval – 91.3%
4. Université Sherbrooke – 91.5%
5. Université de Montréal – 89.8%
6. McGill University – 90.6%
7. University of Ottawa – 94.7%
8. Queen’s University – 96.2%
9. Northern Ontario School of Medicine – 95.4%
10. McMaster University – 95.5%
11. Western University (Schulich) – 94.4%
12. University of Toronto – 93.4%
13. University of Manitoba – 96.3%
14. University of Saskatchewan – 93.3%
15. University of Alberta – 95.7%
16. University of Calgary – 92.5%
17. University of British Columbia – 94.4%

What Is CaRMS and How Does it Work?

The Canadian Resident Matching Service (CaRMS) is a not-for-profit organization and residency match service that works with medical schools in Canada to provide a computer-based match for students to enter into postgraduate medical training. Any medical graduate, whether they are based in Canada or abroad, must apply through CaRMS if they wish to pursue postgraduate, or residency, training in any specialty of medicine in Canada. Canadian medical graduates can also apply to residency positions in the US through the ERAS application service.

The CaRMS Process

1. CaRMS Opens for Applicants – September 20^th

2. Medical school submit your MSRP and transcripts to CaRMS

3. Your referees submit your letters of reference to CaRMS.

4. You ready your application and ensure you have submitted all the necessary documents.

5. Programs review CaRMS applications.

6. CaRMS interview invites begin to be sent.

7. Programs hold interviews.

8. Programs and graduates rank their preferred programs/applicants on the rank order list (ROLs). 

9. CaRMS Match Day.

10. Second-iteration and post-match options open.

11. CaRMS closes for the year.

CaRMS: Choosing the Best Program for You

Choosing your residency program is not exactly the same as choosing a medical school, but there are more similarities than differences. For example, one of the things that you should think about most is location, which is something that also applies to choosing the right medical school for you. Many Canadian MDs recall choosing medical schools in their hometown or close to it, so they could rely on the support of family and friends during their most difficult moments. Dr. Neel Mistry, who graduated from the University of Ottawa Faculty of Medicine, choose medical schools based on three factors:

• Location (proximity to home)
• Culture of the school
• Clinical experiences

To this list, we can add a few more things when it comes to choosing a residency program in Canada, such as:

• Career goals
• Lifestyle/salary/benefits and cost-of-living
• Competitiveness of the program
• Unique program highlights

Most residencies in Canada last for between two to three years so you have to be comfortable with being in a specific location for that length of time. This means, you should think about whether you’ll be able to get through your residency in a new city, or if you prefer to be closer to your loved ones and your support network. But what thing you should consider most is the competitiveness of the program. 

How Competitive is the Canadian Match?

The Canadian residency match is generally more favorable to Canadian medical graduates, with a match rate of over 96%, according to the latest data from CaRMS. The top residencies for Canadian graduates are the family medicine residency and internal medicine residency, which continue to have the highest match numbers. But a study done on CaRMS and the residency application process revealed certain factors that can often affect your chances of getting matched. For example, the study found that if you apply to an especially competitive program, such as an emergency medicine residency, radiology residency or a ophthalmology residency, you have an 85% chance of matching. However, if you applied to a less competitive residency program, such as family medicine or a psychiatry residency, as a first-choice discipline you have a 100% chance of matching in the first iteration.

These statistics aren’t meant to force you into applying to the least competitive residencies, but they should figure into how you choose a residency program, among many other factors. It’s not a huge revelation that it is harder to get into a more competitive programs, but if you want to match in the first-iteration and save yourself from having to reapply, then choosing a least competitive program is something you should consider.

Another factor that can affect your chances of matching through CaRMS, according to this study, is the number of applications you send. The average number of residency programs that most CMGs apply to is 17.7, although the participants in this study applied to an average of 19.5 programs. The study found that applying to a “relatively high number” of programs decreased your chances of applying by 8% for each subsequent program. But in some cases, you need to apply to as many different programs as possible, especially if you’re an IMG. One of our students, Izage Kianifar Aguilar, applied to over 270 different residency programs to increase his chances of getting matched, as IMGs typically have a harder time than US or Canadian MDs.

But if you decide to apply to an especially competitive program, you’ll also face more hurdles, compared to applying to less competitive programs. For example, this study also found that getting matched to a highly-competitive residency program will be much harder if you are a graduate of medical schools in British Columbia, medical schools in Alberta, or medical schools in Saskatchewan, basically, any medical schools in Western Canada. However, you should remember that these only apply if you apply to highly-competitive programs; if you apply to less competitive programs, then these outcomes do not apply. Conversely, graduates of medical schools in Ontario usually have the easiest time getting into even competitive residency programs. If you’re graduated from any of the medical schools in Quebec, and apply to a highly competitive program, you are 52% less likely to match to your first-choice discipline, compared to graduates from Ontario medical schools.

While these statistics seem sobering, you have to remember that not matching in the first-iteration is common, which is why the second-iteration exists. Only 1.2% of all applicants who use CaRMS remain unmatched after both iterations, which comes to only 35 applicants. So, despite what this study concluded, even if the odds are stacked against you (an applicant from Western Canada or Quebec; applicant to a competitive program; applying to a higher-than-average number of programs), you are still more likely to be matched than not. 

US medical graduates (USMG) applying to residency positions in Canada also have a generally high match rate of 63.1% International medical graduates (IMG) applying to residency in Canada are at more of a disadvantage.

Residency Match Rates in Canada

IMGs can only participate in the match if they are Canadian citizens or Canadian permanent residents. In some cases, they may be eligible with the right residency sponsorship. This means IMGs, even those Canadian citizens or permanent residents who graduated from medical school in the US or from international medical schools, have a decreased chance of matching to their top choice residency program. Besides paperwork, there are certainly other obstacles that IMGs like our student Kuchalambal face:

“Waitlisted in my first choice; the program’s feedback is that they encourage candidates to be living, and contributing in their community. And they recommend that the best option for me due to my credentials, being an IMG, would be to organically grow to be a resident in a hospital which provides it.” – Kuchalambal, BeMo student

In other words, programs want to see that you organically grow and adapt to the Canadian medical landscape as you practice and learn within the community you will be serving – something Canadian graduates have been doing since they got into medical school. Our student Kuchalambal took the advice of residency directors and is now working to acquire the necessary skills in the program where he wants to train:

“I am currently working in the hospital. Organically growing to complete residency here” – Kuchalambal, BeMo student

Specialties with highest match rates (1^st choice CMGs)

1. Family medicine – 890
2. Internal medicine – 469
3. Anesthesiology – 184
4. Psychiatry – 182
5. Pediatrics – 166
6. Emergency medicine – 121
7. Obstetrics/Gynecology – 111
8. Diagnostic radiology – 104
9. General Surgery – 97
10. Ophthalmology – 76

Specialties with highest match rates (1^st choice IMGs)

1. Family medicine – 609
2. Internal medicine – 124
3. Pediatrics – 64
4. Psychiatry – 75
5. Pathology – 28

Are you an IMG applying to Canadian residency programs?

CaRMS Eligibility

To apply through CaRMS for Canadian postgraduate medical training, you must first meet the eligibility requirements. The first requirement is that you are a Canadian citizen or permanent resident, as we’ve already discussed. To meet eligibility requirements, you must also have graduated from:

1. An accredited Canadian medical school
2. A school of osteopathic medicine
3. An international medical school listed with the World Directory of Medical Schools

There are two iterations of the CaRMS match offered each cycle: the first iteration includes the R-1 Main Residency Match, as well as separate matches for subspecialties in internal medicine, family medicine and pediatric medicine. Only applicants who have received no previous postgraduate training are eligible for the R-1 Match. The second iteration is for applicants who did not match in the first iteration and gives programs a chance to fill any remaining vacancies with applicants who went unmatched.

Fortunately, there are MCCQE prep courses for international students and help for preparing for the OSCE as an IMG so you can get a head start on exam prep.

How to prep your residency app through CaRMS

Here’s a quick guide to how the Match works for CaRMS and the steps you’ll take:

After checking that you meet all requirements, the next step is to register for the match and start uploading your documents. This will be a familiar process to the medical school application process. Here’s some more information on registering for the Match through CaRMS, depending on applicant type:

Creating Your Residency Rank Order List

Each postgraduate training program will be ranking each applicant that they have interviewed. At the same time, each CaRMS applicant will be making a residency rank order list (ROL) of each program they interviewed at. Once the CaRMS deadline for ROLs has been reached, neither programs nor applicants can change their rank orders. The CaRMS algorithm then matches applicants to programs and notifies both parties on Match Day. CaRMS match results will be released after match day in March.

Each applicant must decide which priorities are most important to them and order their ROL accordingly. For example, if you wish to be close to your family in Winnipeg but are okay with either family medicine or emergency medicine, your list may look like this:

• Family Medicine – University of Manitoba (Rural)
• Emergency Medicine – University of Saskatchewan
• Family Medicine – University of Saskatchewan (Urban)

However, if you strongly wish to practice emergency medicine and no other specialties, your ROL may look like this:

• Emergency Medicine – University of Manitoba
• Emergency Medicine – University of Saskatchewan
• Emergency Medicine – University of Toronto

By entering their preferred order of programs and not withdrawing from the CaRMS application, applicants have signified their willingness to begin postgraduate training at any program on their ROLs. If you have matched to a particular program, you must show up on July 1 to begin your residency. Do not rank any program that you absolutely do not want to complete residency training at; not even as a backup. You should only rank programs you would be OK with attending and completing a residency at. You do not have to rank every program you interviewed at so simply leave off programs you do not wish to study at.

Applicants should not feel limited in how many programs they rank. In fact, most applicants should rank a minimum of 6 programs. Although prioritizing closeness to family or friends or your preferred specialty is important, it is much more important to be matched and receive a postgraduate training position. After completing residency training, it is possible for physicians to tailor their practices so they are doing their preferred work and to move to different provinces to work. It is advisable for candidates to rank multiple programs as they will have a much higher chance of matching to one if they rank more than a couple of programs.

How to Ace the CaRMS Application

Although the match rate for CMGs is high, to get matched to the most competitive residencies in Canada and get into your top choice program you’ll need to ace the CaRMS application and interview.

Next, we’ll look at what you can expect from the CaRMS application process and how to craft a stellar application.

CaRMS Application Components

• Residency CV
• Transcripts
• Medical Student Performance Record (MSPR, or MSPE)
• CaRMS Reference letter
• Residency Personal statement

Below, you will find tips to improve each component of your CaRMS application.

#1 Residency CV

Your CV should list, in reverse chronological order, your educational and academic background, honors and awards, employment history, professional organization memberships, volunteer or extracurricular activities and any research you have completed, highlighting any publications or presentations you have completed. You can certainly include activities and experiences that are still ongoing only if you have been doing them for a prolonged period of time, like our student Joshua:

“I am applying actively [to residency programs] and maintaining observerships in my chosen field. I continue to work within health care and actively contribute to my academics.” – Johsua, BeMo student

Your CaRMS CV should also include your elective experiences. Don't be afraid to include your extracurricular activities. Activities like music and sports are unique to you and program directors are interested in seeing that you are a well-rounded individual. After drafting your CV, ensure you have formatted it so it easier to read. Residency CV editing is an easy way to ensure your resume is polished before submission.

#2 Transcripts

If you are a Canadian student, your medical school will automatically send your transcript to CaRMS. If you are an international applicant, please ensure a copy of your transcripts has been uploaded through the CaRMS Online Undergraduate Portal by the applicable deadline.

#3 MSPR

The Medical Student Performance Record is prepared and signed by the dean of your medical school. It is automatically sent by your school to CaRMS. The MSPR includes every score you received on elective or core rotations, as well as comments from each rotation preceptor.

On the last day of your rotation, you will ask your preceptor to fill out this form. Sit with your preceptor and ask them to go through each section of the MSPR form and give you feedback. You can ask them to leave some comments at the end speaking to your strengths or how well you fit with the CanMEDS roles framework. If you simply ask your preceptor to fill out the form, they may simply check off the boxes and leave short comments that do not give much insight into your abilities. Take the time on the last day of each core and elective rotations to ensure your evaluation form is filled out to your satisfaction.

#4 Reference letters

Each student should ensure they have checked each program's specific directions for how many letters to submit. It's usually 3 letters per program. At least one letter should be from a physician in that specialty, if not that particular city or location. For example, if you are applying to Emergency Medicine: University of Toronto, you may want to pick two emergency medicine physicians you have done electives or core rotations with and one family physician for your last referee.

“I would like to be approached in a polite and friendly manner; the student should highlight why I would make a good referee and provide tangible examples where they went above and beyond in a patient’s care that would warrant a LOR.” -- Dr. Neel Mistry on how to ask for letters of recommendation

“An approach that would sour me is if a student asks for a LOR despite putting an average or below-average performance during the rotation, if they feel entitled to a LOR, and if the student asks for a LOR after having worked only a few shifts with them.” -- Dr. Neel Mistry on how not to ask for letters of recommendation. 

Electives are also a great way to receive reference letters. Try to schedule your electives prior to the CaRMS deadline for having reference letters in. This way, if you have a wonderful experience and believe your preceptor can write you a strong letter, you will be able to do this prior to the CaRMS deadline. Electives are quite competitive and must be scheduled up to 6 months in advance, so you should start working on this as soon as you receive your clerkship schedule, which is typically sometime during your second year of medical school.

#5 Residency personal statement

“I focused on my journey to medicine and opportunities that I sought out along the way. Everyone’s path and validation is unique, so walking the reader through your growth to the point of application will naturally be different. I also found it helpful to give schools a “punch-line” as in I wanted them to remember 1-2 things about me that are my differentiators and I reiterated those throughout.” Dr. Monica Taneja, Harvard South Shore Psychiatry Residency, on how to stand out in a residency personal statement.

Begin by outlining your general thoughts about the experiences you have had during medical school. What experiences led you to consider this specialty? What solidified your decision to pursue residency training in this specialty? What do you foresee as challenges as a practicing physician? What do you like best about this specialty? Do you have any specific career plans you want to outline? Why would you like to attend the program you have applied to?

Just as your medical school application essays were meant to show off your personality and non-cognitive skills, you want to highlight these in your personal statements. Think about which traits you possess that complement the specialty and program you are applying to. Once you have outlined your thoughts, you can begin writing the first draft of your personal statement. Your statement should have an introduction, body, and conclusion and be free of any grammatical or spelling errors. It does not have to have any fancy words but should be written clearly, allowing anyone to follow your thoughts easily. Have as many people as you can proofread your personal statement before submitting, or have a residency application consultant give you professional feedback on your statement.

Check out this video to learn how to avoid red flags in your residency application:

How to Prepare for the CaRMS Interviews

“I found that the most important piece to residency interviews is having a natural conversation. There is a lot more in common between you and the people you are talking to then when I had medical school interviews. I made sure to know my 2-3 key talking points, but focused on just having a good conversation with my interviewer.” Dr. Monica Taneja, who completed her residency at Harvard South Shore Psychiatry. 

Now begins the fun part of CaRMS – the CaRMS interview prep. Unlike when you applied to medical schools, the programs are not just interviewing you; you are interviewing each program you visit. Remember that you will be ranking each program in your preferred order so the interview is a critical part of the CaRMS process. 

Start preparing for your interviews now. You may have an interview in person, over video chat, or over the phone.  Some of the surgical specialties are known to make applicants perform a manual dexterity task and answer questions at the same time, similar to the dental school manual dexterity question. IMG residency interview prep is critical since you are at more of a disadvantage as an international graduate. Use the residency interview to propel yourself to the top of the candidate list by showcasing why you are the best choice.

Remember that the interviewers want to get to know you, your personality, and how suitable you are for the profession. Simply speaking, you are going to be their colleague for at least the next 2-6 years, and potentially for many decades. They are hoping to get a sense that you are a mature, ethical, professional colleague who will add to their program. Think of bullet point answers for each of these questions and practice them in front of a mirror or with a friend. You want your answers to be polished but not sound rehearsed.

“To prepare for my residency interviews, I did lots of practice for a few hours every day. This would be a mix of group and individual practice. It is important to seek feedback from others as to what you can improve on, where you are going wrong, etc., and at the same time, spend time reflecting on your experiences and how they have aptly shaped you to excel in the specialty you are applying for.” Dr. Neel Mistry completed his residency in diagnostic radiology at the University of Saskatchewan College of Medicine. 

CaRMS Interview Questions

You should be prepared to answer commonly asked CaRMS interview questions like:

• Tell me about yourself.
• Describe a patient experience you learned a lot from.
• Why should we choose you for our program?
• How will you contribute to our program?
• What are your future career plans?
• Describe a time you collaborated in a group setting.
• What are your strengths and weaknesses?
• Describe a time you had to resolve a conflict.

You are also interviewing the program. You must have read up on each program you are applying to and be prepared to ask questions about the program at the end of your interview. Examples of questions you can ask include:

• Do you feel like there is a good balance between providing service and learning for your residents?
• What can a resident do to ensure success in your program?
• What are recent graduates of your program currently doing?
• What support systems are in place as residents navigate the stresses of being on-call?
• What are the research opportunities available for residents to pursue?

Once programs have invited you for interviews, make sure you first reply to their emails and thank them for the opportunities. If your interviews are to be in person, you will need to start scheduling flights and hotels for your destinations. Since most programs will start emailing you at the end of December or beginning of January, try to plan your travel so you are traveling one way across the country (east to west or west to east). This will save you a lot of flying back and forth across Canada.

CaRMS Application Timeline

Your CaRMS timeline is important for keeping yourself organized and on time throughout the application process. Below we’ve listed the important dates and deadlines you need to know about the CaRMS match.

Please note this is a guide only, as specific dates change from year-to-year. Refer to the CaRMS website for up-to-date deadlines.

What If I Go Unmatched?

“It’s hard to match as an IMG.” Oshadhi Manchanayake, who applied to 270 different programs and received only 1 acceptance. 

Although there is a second iteration of the CaRMS Match, going unmatched is a stressful, anxiety-inducing situation for any medical student to be in. Imagine you are in your final year of medical school, having accumulated so much knowledge (and debt), and you find yourself not having postgraduate training lined up. This means entering the CaRMS Match and paying the application fees again; otherwise, there is no way for you to practice medicine. The good news is, there are ways to improve your residency app after going unmatched.

The reality is that more and more Canadian medical students are finding themselves in this situation. Familiarizing yourself with the CaRMS application, preparing your documents, and practicing your interviewing skills well in advance are keys to success and will make the application process less stressful. All medical students want to match during the first iteration of CaRMS, to their first-choice specialties and programs. The second iteration matches those unmatched students with the programs that have empty spots remaining after the first round, similar to the US residency SOAP program.

Familiarity with CaRMS will only enhance these residents' applications when the time comes for them to reapply to these programs.

FAQs

To your success,

Your friends at BeMo

BeMo Academic Consulting

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