The Canadian Resident Matching Service (CaRMS) is an organization that works with medical schools to provide a computer-based match for students to enter into postgraduate training in Canada. Any medical graduate, based in Canada or abroad, has to apply through CaRMS if they want to pursue postgraduate, or residency, training in any specialty of medicine in Canada. Once you’ve completed medical school and it’s time to apply for a residency program you’re one step closer to becoming a full-fledged doctor. By now you’ve completed up to one year of core rotations and electives and have decided which programs you’re applying to. To feel overwhelmed about finding the right match for you is absolutely expected – this time of your life has been stressful! Now is when you’ll need to assess your strengths and skills in order to sell yourself to the programs you’re interested in attending for residency. Unlike when you applied to medical schools, the programs aren’t just interviewing you, you are in turn interviewing each program you visit as well. The process can feel intense, but know you’re not alone. Keep reading to learn some tips and tricks from residents who’ve made it through the process.
1. Know Yourself
Remember that your interviewers are interested in getting to know you, your personality, and how good a fit you are for the profession. In their eyes, you’ll be their colleague for the next 2-6 years, if not decades more. They’re looking for a mature, ethical, professional colleague that would be an asset to their program. Therefore, it’s important for you to be confident in who you are as a person – your values, your strengths and weaknesses, what your goals are, etc. Showcase your unique personality, non-cognitive skills, and medical school experiences. Consider which character traits you have that complement the specialty and program that you are applying to. What experiences have you had that have led you to consider this specialty? What was the deciding factor for you in pursuing residency training in this specialty? What challenges do you foresee as a practicing physician? What are you most drawn to about this specialty? Are there any specific career plans you have that should be considered? Why have you chosen the particular program you’re applying to? Taking these factors into account will help you narrow down your options and choose a program that can cater to your learning style, build on your strengths, and surround you with people who can help develop your potential.
2. Take Care of Yourself First and Foremost
The CaRMS process is a stressful period in a medical student’s career. It coincides with increased debt and reduced experiential learning. Recent changes in medical education and residency training in Canada have created a shortage of residency positions, pressure to select a career path early on in medical school, and higher emphasis on exam preparation. This is leading to increased burnout among medical students.
Then there’s every medical student’s most dreaded fear – what if you go unmatched? Imagine being in your last year of medical school, having accumulated so much knowledge (and debt), only to be left without postgraduate training.
At this point, there’s no need to worry about that possibility. But another cause for burnout that is very real is student loan debt. According to the Association of Faculties of Medicine in Canada (AFMC), the average student loan debt for doctoral degrees is $100,000, with 13.6% of students graduating with over $200,000 of student loan debt. The CaRMS process contributes to this debt as a result of having to fly back and forth to in-person interviews in the search for future residency positions.
All of this being said, it’s important to take care of your physical, mental, and social well-being. Having a support system of family, friends and classmates is crucial to getting through these challenging times. Healthy habits such as balancing exercise and time to relax shouldn’t be put off until later. There’s no time like the present to adopt some self-care practices.
3. Reframe Nervousness as Excitement
The purpose of your transcript, NBME and OSCE scores is to capture your technical knowledge and the skills required for becoming a competent physician. Therefore, interview questions are designed to assess your transferable skills and competencies, in addition to convey what made you choose your specialty. Essentially, the interview team will be choosing their future colleagues through this process and will want to make sure you’re a good fit for all. Take the interview as an opportunity to highlight how you work (independently and with others), handle challenging situations (both with colleagues and patients), communicate with others, solve problems, and show initiative.
When you find the pressure expressing as nervousness – twiddling your thumbs, stroking your beard or moustache, or twirling your hair – see if you can redirect those behaviors toward excitement and eagerness for your passion. It’s not realistic to think that you’ll feel completely relaxed and calm going into your interview, but try to acknowledge that something so important to you will naturally cause your heart to beat faster and make you feel a bit jittery. Your body is responding in such a way that you’re invigorated for the responsibility ahead of you, and that’s a good thing! Take your time and maybe even admit to your interviewers that you’re feeling nervous. Naming it can help diffuse the feeling.
Remember the basics – maintain comfortable eye contact, smile naturally, and don’t be afraid to ask for some time to consider your answers if it’ll help you articulate yourself better.
4. Be Your Genuine Self
Programs are searching for residents that they can work well with. That’s why it’s important to let your personality come through in your interview. If you simply regurgitate your personal statement from memory, they won’t get an accurate portrayal of the person in front of them. They can also sense when someone is speaking from a script or not being authentic in their answers. Of course it’s recommended to rehearse sample questions in order to be prepared, but also equally important to be able to go with the flow and think on your feet.
The more you can be your true self, the more likely both you and the program will know if it’s the right fit or not.
5. Consider the Whole Package
This is the moment your whole medical school career has been hinging on! After your interviews, you’ll probably be exhausted. But before the tour turns into one big blur, take time time to reflect on everything you’ve just learned. It is time to get serious and come up with a rank order list (ROL) that maximizes your chances of getting your first choice residency. Ranking programs is a personal decision making process, because everyone has different priorities and life circumstances so you’ll want to start ranking an ROL of each program you interviewed with while your memory is fresh. At the same time, each training program will be ranking all of the applicants they’ve interviewed. As you create your ROL, make a pros/cons list and consider which priorities are most important to you. Do you want to be closer to family or friends? Does this program have an esteemed reputation for your preferred specialty? What type of geography do you prefer (urban vs rural, small vs large)? What program type would you prefer (community vs academic vs county)? Does the faculty appear to be enjoying themselves? Was the faculty interested in you as a person?
It’s also a good idea to think about the current residents in the program. Your co-residents will become your closest friends and confidants over the next 2-6 years so you should be able to picture yourself fitting in with the current team. One more thing to consider are the faculty and potential mentor experiences. Getting an idea of what the faculty have pursued during their careers will tell you what is available for residents. For example, if you dream of one day publishing, then you should look for a program that has a strong research department. Without proper guidance it can be hard to forge your own path.
CaRMS tip: Don’t rank a program if you don’t want to attend residency there, even as a backup. You can leave programs off your list even if you interviewed with them. It’s recommended to rank a minimum of 6 programs. This way, you’ll have a better chance of matching one.
Admittedly CaRMS is a stressful, daunting period of your career, but it’s also really exciting – it will determine the course of your future! Familiarize yourself with the process and prepare ahead of time to boost your possibility of matching with the best specialty and program for you and your dreams. If you remember to stay true to yourself, you’ll get through it just fine.
Dr. Nour Khatib left medical school for a finance career, but a persistent calling encouraged her to return years later and become an emergency physician.