What You Will Find In This Post
- What is CaRMS?
- What is postgraduate education?
- What if I go unmatched?
- Application timeline
- Pre-clerkship years
- Clerkship Electives
- The Application
- Rank Lists
This post will explain the process of applying for postgraduate medical education in Canada. CaRMS is the online portal that applicants use to apply for a residency training position. This can feel overwhelming and intense. That is why I have put together this guide to help you and give you some insider CaRMS tips. It will also cover what medical students can do throughout their medical education to prepare for your CaRMS application. These CaRMS tips and tricks will have you on your way to a stellar application. Lastly, it will cover every aspect of the CaRMS process and suggest helpful suggestions to ensure your application is successful.
What Is CaRMS?
The Canadian Resident Matching Service (CaRMS) is a not-for-profit organization that works with medical schools to provide a computer-based match for students to enter into postgraduate training in Canada. 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. Also applying to the US? Check out the ERAS guide here.
CaRMS efficiently allows applicants to choose where to pursue residencies and residency program directors to effectively choose applicants who best fit their programs.
The CaRMS website has important information for students wishing to match to a Canadian medical postgraduate training program, including eligibility, policies, procedures, CaRMS match results, and deadlines for document submission. Every applicant to CaRMS should thoroughly review their website to ensure they are aware of this information.
What Is Postgraduate Medical Education?
Even though medical graduates have earned a Doctor of Medicine (MD) degree and the title of Doctor, they must pursue 2-6 years of residency training before they can practice medicine in Canada. During residency, you will rotate through clinical experiences in various specialties, gaining hands-on knowledge, skills, and abilities which will allow you to effectively practice medicine without supervision.
At the end of their residencies, Canadian residents must pass certifying examinations, set by the Royal College of Physicians and Surgeons of Canada or the Canadian College of Family Physicians, to be able to practice independently.
Since a medical graduate requires postgraduate training prior to being able to practice medicine in Canada, CaRMS is important. Every Canadian medical student and even prospective students should familiarize themselves with the requirements of the CaRMS application. A final-year medical student will be preoccupied with not only CaRMS but clerkship rotations, exams and being on call. Familiarize yourself with CaRMS early. It will ease the process of completing CaRMS.
What If I Go Unmatched?
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 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.
Some residents will also find they have to use the CaRMS portal to apply to subspecialty residency programs, such as internal medicine subspecialties or the family medicine enhanced skills fellowship in emergency medicine. Familiarity with CaRMS will only enhance these residents' applications when the time comes for them to apply to these programs.
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.
An applicant's medical school will input their information to their CaRMS application. CaRMS will send out login information to applicants in September prior to their graduation. Students apply to not only a specialty but also a specific program. For example, you can apply to Family Medicine: University of Alberta, Urban (Edmonton), Family Medicine: University of Alberta, Rural (Fort McMurray) and Internal Medicine: University of Alberta. Even though these are all University of Alberta programs, in the CaRMS application you will have to select each program individually you wish to send your application to. CaRMS tip: Make sure you study the timeline and pay attention to CaRMS deadlines.
- Begin working on your CV and personal statements, finalize referees
- Gain access to the CaRMS portal, ensure referees have the relevant information to send in your letters, finalize your CV(CV is due at the end of September)
- Medical Student Performance Report (MSPR) and transcripts are due
- Online application, personal statements, and reference letters are due
- CaRMS applications are sent to the programs you applied to
- Programs will contact you regarding interviews
- Interviews (most interviews occur in the last 3 weeks of January)
- Late February deadline for ranking programs in your preferred order
- MATCH DAY!
- Second Match Day
- Part 1 of the Medical Council of Canada Qualifying Examination
- Graduation! Congrats, you're a doctor!
- All residency programs begin
When a student enters medical school, they may have some thoughts about which specialty they would like to pursue. Without clinical experience, these are just thoughts. To really find out what a specialty is like, a student must shadow physicians in that specialty. The first 2 years of medicine are commonly called the pre-clerkship years, as students typically spend their time in classrooms receiving didactic lectures, or learning in small groups solving clinical cases. During this time, students will learn anatomy, physiology, pharmacology, immunology, and more, to become effective physicians.
Pre-Clerkship allows students to start learning about which specialties they may wish to apply to in CaRMS. Although you will be busy with studying you will not be completing clerkship rotations or be on-call during this time and will have some flexibility to start shadowing. Start contacting some of the professors teaching your lectures, or the doctors teaching you and ask them if you can shadow them. Keep an open mind while you are still an early medical student and try shadowing as many different specialties as you can. You may have thought you always wanted to be a dermatologist, but love the procedures you get to do in anesthesiology, or always wanted to study plastic surgery but are drawn to the complexities of internal medicine.
While shadowing, make sure you ask lots of questions, are open to learning about the specialty, and make notes about your experience. You can refer to these notes later when choosing a specialty. Creating a shadowing journal help you narrow down your choices. Choosing a specialty allows you to accommodate your preferences and personality traits. Look for a field that will display your strengths.
Reach out to senior medical students and residents you see working in the hospitals. Ask them questions about the rotation they are on. Career prospects, job flexibility, work-life balance are important as well. Speak to fellow students and residents. They are a valuable resource; they were in your shoes once too. Remember that you are not simply deciding which specialty you wish to practice in. You are also thinking about where you would like to live, how close you wish to be to family or friends, and work-life balance. Don't be afraid to ask questions and explore during your pre-clerkship years.
Clerkship rotations are completed during the last two years of medical school. All medical students rotate through clinical experiences, typically 2-8 weeks in length, in the core medical and surgical specialties (family medicine, internal medicine, and its subspecialties, emergency medicine, anesthesiology, pediatrics, psychiatry, obstetrics and gynecology, general surgery and other surgical specialties). Students apply their knowledge in practical situations while still being supervised by a physician (typically known as a preceptor or attending physician). At the end of each rotation, a student typically will have to pass a written or clinical examination, as well as receive a satisfactory score on a formal evaluation by the preceptor.
Electives are formal clerkship rotations, typically 2-4 weeks long, during which a student can choose to gain experience in whichever field of medicine she wishes. Electives can be completed at your medical school or at any medical school in the country (and sometimes internationally too). These electives can be done in any specialty. Electives show interest in a particular field on your CaRMS application. Program directors will be looking at the electives to evaluate interested in that specialty. They want to see that you have experience in the specialty and your evaluations are positive. If you are applying to family medicine but have only completed electives in psychiatry, a program director will probably think you do not have the necessary exposure to the specialty and will not make a good candidate for their program.
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. CaRMS tip: 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.
If you feel like you have had a strong rotation experience, ask your preceptor on the final day of your rotation to not only complete your evaluation but if he or she will write you a reference letter. Follow up with him or her via email following your rotation, thanking your preceptor for the experience and reminding him or her of the reference letter you will be asking for. Your preceptor will be able to start getting his or her thoughts together about your letter straight away. Preceptors are very busy and you do not want them to forget about your rotation and be unable to give you a strong letter. You will stay in regular contact with your preceptor throughout the CaRMS application process to ensure your reference letters are completed.
During the fall of your final year of medical school, you will begin the CaRMS application process. At this point, a you will have completed up to one year of core rotations and electives and have finalized which programs you are applying too. You should also have a minimum of 3 preceptors you have asked to serve as your CaRMS referees. Here are some tips for choosing referees.
The CaRMS application has five components:
- Curriculum vitae (CV)
- Medical Student Performance Report (MSPR)
- Reference letters
- Personal statements (PS)
Below, you will find tips to improve each component of your CaRMS application.
Curriculum VitaeYour 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. 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. CaRMS tip: After drafting your CV, ensure you have formatted it so it easier to read.
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 sealed copy of your transcript is sent from your medical school to CaRMS by the applicable deadline.
Medical Student Performance Report
The MSPR 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. These will be the same comments that appeared on each of your rotation evaluations. It is important to perform well on each rotation and receive the best score possible. 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 form and give you feedback. You can ask them to leave some comments at the end speaking to your particular strengths. 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.
Each student should ensure they have checked each program's specific directions for how many letters to submit. Its usually 3 letter 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. If you have completed extensive research or an advanced degree while in medical school, you can certainly consider asking your research supervisor to write a reference letter for you. If you are applying to more than one specialty, you can pick which referees you would like to assign to which programs you are applying to. Within the CaRMS system, you will be able to specify which letters go to which programs.
CaRMS tip: In general, only physicians or professors should be used as referees. Non-medical work or volunteer supervisors, or friends or family members, are not suitable referees for your CaRMS application. Medical students are responsible for ensuring their reference letters are mailed to CaRMS by the deadline. It is best to give your preceptors pre-addressed envelopes to place your letters in. You can then pick up the sealed envelopes from them and mail them to CaRMS yourself. Try to mail them using a tracking number so you can make sure they have reached CaRMS.
Each program will specify exactly what you should discuss in your personal statement. Ensure you have read not only what they are asking about but what the word or character limits are for the statement you are writing. Many programs will ask for a general personal statement outlining why you are choosing the specialty and the program you have applied to. Need some guidance? Want some help with your personal statement? Cick here.
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 particular 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 particular 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 PS before submitting. Check out some our list of outstanding sample residency personal statement examples.
InterviewsNow begins the fun part of CaRMS. 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. 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 tip: 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.
You should be prepared to answer commonly asked residency interview questions like:
- Describe a patient experience you learned a lot from.
- Why did you not do an elective at our program?
- What are your future career plans?
- Describe a time you collaborated in a group setting.
- 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?
Still looking for more help with interviews? Click here for some surprise interview questions. Most programs also schedule a time to hang out with current residents, tour the hospital and medical school and social activities. Take advantage of these so you can learn more about the program and evaluate whether you would like to spend the next 2-6 years studying at that school and with these colleagues. When you have completed your interview, write down your overall impressions of the program. You can refer to this document when working on your rank order list. More interview tips can be found here.
Click here to find out how we can help you ace your residency interview guaranteed.
Each postgraduate training program will be ranking each applicant that they have interviewed. At the same time, each applicant will be making a 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 OK 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. CaRMS tip: 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 are 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.
The CaRMS process may seem daunting. By familiarizing yourself with the process and preparing in advance, you can increase your chances of successfully matching to your preferred specialty and program. Use these CaRMS tips and you will be on your way to success. Still feel like you need some more advice or a review of your application documents? No problem!
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About the Author
Dr. Veena Netrakanti is practicing family physician and an admissions expert at BeMo.
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