Initial Match Stats

The initial set of CaRMS stats was published recently, available here. As always, incomplete data means an incomplete interpretation, but there are some interesting take-aways.

First and foremost, it was a competitive match this year for CMGs, more so than it has been in recent years. More people going unmatched and fewer getting their preferred discipline or location. The changes from previous years are more marginal than dramatic, but there were indications that this year's competitiveness went beyond the typical year-to-year variation.

The reasons for this higher level of competitiveness are hard to definitively pin down, but two culprits present themselves. First, there are fewer residency spots relative to medical students. The ratio this year was the tightest it's been for decades, with the exception of last year, when it was slightly tighter. Without any other changes to the system, and none look to be incoming to alleviate the situation, this appears to be the new normal - a situation where the number of residency spots tracks very closely to the number of CMGs applying for those spots.

Second, there was a definite shift away from Family Medicine as a specialty of interest and towards both surgical specialties as well as Internal Medicine. Family Medicine is pretty much the only large specialty with more residency spots than there are demand for, while surgical specialties are almost always pursued by more students than they can accommodate. The change in interest in Internal is the real factor, however, as in the last two years it basically flipped from being a specialty with a small amount of room to accommodate more interested students to one that has too much interest relative to available spots. With Internal being the second-largest specialty, that's no small factor in the competitiveness of the match overall for CMGs.

While the full data set is necessary to draw lessons for future matches for CMGs, this early CaRMS presentation tends to provide the most useful information for IMGs. Of note here is that the number of IMGs rose for the first time since the NAC OSCE was made mandatory, particularly among first-time registrants. Many of them did not end up participating in the final match, as the IMG dropout rate is typically fairly high, but it signifies that we may start returning to the higher numbers of IMGs we saw before the mandatory NAC OSCE was introduced.

The CaRMS presentation shed some new light on the country-by-country results for IMG applicants. Those from English-speaking countries, who are typically Canadian students studying abroad, did better than most, with match rates in the 40-50% range. Those from the Caribbean, who are also typically Canadians studying abroad, did quite poorly, with match rates that appear to be in the mid-to-low teens. Those who graduated from other countries, often IMG who immigrated to Canada after completing medical school, had similarly poor match rates. The lesson here is clear - going to the UK, Ireland, or Australia offers notably better chances of matching to a residency in Canada, though the match rates are still no better than a coin toss.

Overall, the picture for residency matching appears bleaker, but again, the difference is marginal. Unlike last year when Ontario cut 25 residency spots, no major changes occurred in this year's match aside from shifts in student interest. The vast majority of CMGs still match and match high on their rank order lists. IMGs continue to face tough, but relatively stable odds. The trend, however, is not favourable and no relief appears to be in sight. The CaRMS match still largely works as intended, but the buffers that kept the system in place have been worn away to the point that relatively small changes - like a minor increase in interest in something like Internal Medicine - has the potential to cause outsized ripple effects.