Exams, Electives&

The Match

1.Exams2.Electives3.Applying for residency4.Interviews5.The Match6.Paperwork7.Timeline

What We Will Cover:What We Will Cover:

Great GuideGreat Guide

ExamsExams

ExamsExams

Eeek! The Exams!Eeek! The Exams!

EXAMSEXAMS

USA: • Step 1 :

• Should be done by beginning of 3rd year - need it for electives

• Step 2 = CK & CS • To do in 4th yr• Should have for Eras Application

• Step 3 :• Can’t do until after you graduate• If take a year(s) off after 4th yr

recommended to take it before applying

Exams

CANADA: • MCCEE:– To do in 4th year (sept!)– All Canadians who want to go to N.America need to take

it

• MCCQE1:– Only offered in May & Oct – Only offered in canada– Can do it in 4th yr but must apply before you find out if

you match & NO refund!– Most ppl OK to take it in PGY-1

• MCCQE2:– Take during PGY2+ yr

Exams USA: Exams USA: Step 2 =CK & CSStep 2 =CK & CS

• CK - “Clinical knowledge” (computer based MCQ)• Format is similar to Step 1 but longer, unique Q types

• 9 hrs for 325 Q (8 blocks + 1hr break)

• Passing score now 189

• Just as hard as step 1 but ppl tend to do better• mean ~ 230, SD 30

• Material similar to shelf exams from 3rd year• In general more used to standardized tests so

less anxiety associated with it

**USMLEworld Q bank **• First Aid not as great as for Step

1 but still very useful • Kaplan Q bank – online &

textbook• Kaplan videos• Toronto notes

Exams USA: Exams USA: When to take CK?When to take CK?

• Sign up via ECFMG just like Step 1• Better to apply early to a location/region you think you’ll be in and then

can try and switch it after

• Can be stressful since you may not know where you’ll be in September until July but just stay positive, it all works out!

• Beneficial to have done it and have score back as early as possible after your 3rd year BUT important to balance with your elective schedule and study time!!

• Keep in mind that the score report can take 3-6wks to be uploaded on your ERAS application

• The earlier the score the more information the program has on you – the better

• Most ppl didn’t get interview offers until CK mark is received by programs

• Most ppl wrote it sometime during July – August – September

• Canadians consider writing MCCEE might benefit from writing the CK around the same time as the EE (i.e. September)

Exams USA: Exams USA: Step 2 = CK & CSStep 2 = CK & CS

CS – Clinical Skills (OSCE style practical)•12 stations each with a different patient actor

•15 min in each room to do a H&PE then 10 min to write up a note on the computer

•Only your best 10 stations count towards your mark

•Only Pass/Fail

•First Aid for CS is plenty – easy to get flustered so best to have a systematic approach you are comfortable with

• Once it comes time for this exam most ppl have more experience in American hospitals so a lot more comfortable with H&PE & writing up a note

• If can find a partner to practice with – www.usmleworld.com has ‘scenarios’ you can purchase which can be helpful if you have someone to do them with

Exams USA: Exams USA: When to take CS?When to take CS?

APPLY EARLY!!!• Only offered in Chicago, Atlanta, Houston, Philadelphia &

LA• Better to apply in an area you think you’ll be in & switch it later

if it doesn’t work; spots fill up quickly!!

You will most likely have to travel from your electives

It’s really an easy exam but can be stressful and weigh on you so just do it quickly and get it out of

the way!! Takes longer to get score result – 6weeks

• Not as crucial as CK result BUT programs still look for 100% completion (ie all score results & LOR & documents) before offering interviews) – do it as early as you can

Around September/October things quiet down so many ppl took it then

•Doctors are understanding if you have to take a few days off but helpful if you get a wknd; if doing a ‘letter elective’ don’t want to take too much time off •Book it with a friend & make a weekend trip out of it!

Exams USA: Exams USA: When to take CS?When to take CS?

2012 CS Schedule of Reporting Results

• Need result in before Rank List Deadline

★ ★

Testing Pd Reporting Start Reporting End

March 25-May 19 June 20 July 18

June 17- Aug 25 Oct 3 Oct 31!!!!

Aug 26 - Nov 3 Dec 5 Jan 2

Nov 4 - Dec 31 Jan 3 Feb 20

CS example:CS example:• You will face a closed door that has a short one liner introducing the scenario

• You have 1 min before the buzzer lets you know that you may enter the room.

• The note will still be there when you leave the room to type your note. “Mr. Smith is a 65y/o male that is complaining of shortness of breath.

HR: 14 RR: 19 BP: 130/90 Temp: 37 degrees”

• Once allowed to enter, knock, introduce yourself, use the patients name, shake their hand, SMILE and make eye contact! Drape them with the blanket appropriately and wash your hands before doing a physical! “Hello Mr. Smith, I am Dr. Nick Riviera & I’ll be looking after you today and would just like to ask you some questions and then perform a physical, is that alright?” (– whatever!)

• Complete your H&PE & explain to the patient what you think Is going on & the plan of actionRemember to ‘counsel’ on topics like smoking, alcohol, safe sex for teens etc – First Aid explains this wellIf you finish the H&PE early you may leave the room early and start on your patient note Say thank you, show concern & emotion & to ask if they have any questions before you leave

A lot of the exam is testing your patient interaction/communication skills so don’t get flustered if you forgot to ask questions or perform key PE tests – you will still most likely pass

First Aid is good at showing you what patient note should look like – 5ddx, 5 tests to order

Some ‘curveballs’ : patient may be on phone; only the parent will come in – angry parents, frustrated patients, overly anxious patients etc – again, testing patient interaction skills

Exams Canada: MCCEEExams Canada: MCCEEMedical Council of Canada Evaluating Exam

• The ONLY MANDATORY exam needed to apply to CaRMS• If you are Canadian & want to apply only to ERAS you still MUST take this

exam (needed for J1 visa)

• Only IMGs take this exam• Cost: $1550 – $1300 exam fee + $250 application fee• 4 hr – 180 MCQ

– No blocks, you get to decide when to take breaks within that time

– Similar to CK study material – many ppl found it easier

– Consider scheduling your CK & EE around same time if writing both

– www.canadaqbank.com - good additional Q bank with more ‘Canadian Qs’

• Only offered Jan, March, May, September & November but basically can only write it in September

– Must be in final clinical year– Schedule done via Prometrics – offered in Canada, US & Europe

APPLY EARLY!! LONG process, better to get a spot and change it later

Exams Canada: How to Apply EEExams Canada: How to Apply EE• Apply via PCRC (Physicians Credentials Registry of Canada), then apply to MCC, then can schedule

with Prometrics (same ppl you schedule with for the Steps)

• EE application steps:• http://www.mcc.ca/en/exams/ee/EeExamWizard/FirstTimeStudentApplicationSteps.shtml  

• Must registar via PCRC (www.pcrc.org)• Documents must be copied, certified and translated• Website may be a little unclear but staff very helpful so just call and ask to clarify

• Once you have been approved via PCRC - can create account with MCC-Online and apply for MCCEE• https://www.mcc.ca/MCConline/loginpage.aspx• You fill out the online application form• You will need to pay the $250 application fee at this time online via Mastercard/Visa• After submitted you will have to print the application form and send the paper version along with

the following papers. You have 10 days after making your payment to send the paper version in.• CIC = certified identity confirmation form

• Need 2x COLOUR 50mmx70mm• CERTIFED*

• Three Student Forms: Send originals (do NOT need to be certified)• “Attestation in Support of Application” – signed by school office• Attestation regarding schedule of final year clinical experience – signed by school office• Student declaration – signed by you only

• Once approved via MCCEE can go via Prometrics to schedule

Your Comprehensive Your Comprehensive Electives Guide!Electives Guide!

Electives – Across the GlobeElectives – Across the Globe

• Canadian programs expect you to apply ridiculously early; limited and hard to get but possible

• USA electives more flexible & more in numbers – each program different & has different system for organizing electives - doesn’t make your life any easier

• UK electives is a good option, esp. if thinking about the Foundation Program

• Poland – a good option to do some of your not so favorite subjects (remember the wonderful hours for surgery & obs/gyn?)

• South Africa, Switzerland, France, Norway, Nepal – ppl have done international electives in the past

Be organized, Be patient, Everything will work out!

Canadians – don’t be afraid of American electives – you can get strong letters and great experience – it ain’t so bad!

Electives – Things to ConsiderElectives – Things to Consider1. What discipline do you want to go into??

• Do the specialties that you want to apply to early in the year to get letters

• If you are in North America, try to get all your LOR from N. American doctors. Most programs directors considers those more highly than European letters

2. How much traveling do you want to do?• Most schools have 3 month limit for one student• Different location each month:

• great experience, see a lot of different working environments so have a good idea about different residency programs but can be tiring and very very $$$$$, harder to coordinate everything

3. Don’t be afraid to call/email

the coordinators!!

4. Not all schools allow international graduates to do electives

• - https://services.aamc.org/eec/students/• Check on medical school website, do your research! (ie. Queens U)

5. Most ppl matched to programs where they didn’t do an elective•Although it’s common in the States to land an interview if you do an elective in the specialty that you apply to•Some schools will give you an interview automatically if you have done an elective there (Internal at UWO in Ontario)

6. For residency, places generally require or prefer 4 or 6 months of N. American experience

• the more months of electives you do in the States and Canada, the more doors you leave open

• if you can, start your electives in July

7. NY STATE LICENCING BOARD: •IMG’s are limited to 3mnths of electives outside of their home university•a rule of the LICENSING BOARD, NOT the residency;

• (ie you may still get interview invitations but if your residency program gets audited you have the risk that the NY State may give you trouble)

Electives – Things to ConsiderElectives – Things to Consider

Electives – Things to ConsiderElectives – Things to Consider8. Each program has a slightly different application process

• U of T allows you to Apply to be considered for an elective in August. Make sure you do this right at 9am when the website opens. Very difficult to arrange these electives. Email Sheila Binns if you have a preceptor

9. In general American schools do 4wk blocks BUT not necessarily the same starting and ending 4 wks!

• So be careful not to overlap your end & start dates!• Rochester is more accommodating with 2w dates

10. Possible to do 2wk blocks in Canada

11. 11. Subinternships!Subinternships! – great if you can get one in the faculty that you want to apply to

• LOTS responsibility so don’t do in specialty that you hate• mostly offered in Fam med, but also internal & peds

12. Rochester & California via School Office

Rochester: Dr. J picks top ppl after Neuro course (12-15), interviews you and lets you know sometime in June whether you are picked – then you work with the Rochester Coordinator to set up which month you get

• Don’t necessarily bank on getting it – good to have back up!• Goes down the list of top students of who gets preference for

dates & subjects (but not really)• Limited selection of electives

California – send in CV, ref letter & interview with Dr. Laidler – don’t tell you till fairly late if you get a spot and then still have to work with individual schools to organize

• In general good for your later months for your less favorite subjects

• Get to go back to cali!

Electives – What you need Electives – What you need • 4 weeks Internal Medicine• 4 weeks Peds• 3 weeks Family Medicine• 3 weeks Surgery• 2 weeks Obs/Gyn• 4 weeks of your choice

**looks good to do one in the discipline that you want to apply to (ex. Emerg, PM&R)**

- This is minimum! Many ppl often go over, remember that some programs have 6mnth min experience required for IMG’s

- Also, check beforehand that UJ will accept the elective as credit toward the specialty you want it for (e.g. UJ accepts Peds Surg as Peds credit, and Hospice as IM even if the university you are visiting offers the electives through Surg or Fam Med.)

Electives – Where to start???Electives – Where to start???

Your first 2-3 months are most important – focus on those first!!

•Pick a specialty for a month and apply to multiple places for each month – it’s the easiest way to simplify the process

•Example:• July: 2w Family Medicine UWO

• August: 2w CTU Ottawa, 3 wks Nephro UWO

• Wrote CK

• September: 2 wks Family medicine McMaster, 2wks CTU McMaster

• Wrote MCCEE

• October: 2wk Peds Endo and 2wk FM outpatient Rochester

• Applied to American residencies• Took CS

• November: 2wk FM inpatient, 2 wk Peds Cardio Rochester

• December: 3 wks Gen Surgery UWO

• Deadline for Canadian applications

• January: 2 wk Ob/Gyn and 2wk Emerg U of Toronto

Electives – It’ll all work out!Electives – It’ll all work out!

• Only ONE example, lots of variation of how to complete your time!!

• Many factors play into it! Most important is to get enough experience in the first few months to get your LORs!

Electives Application Package 101Electives Application Package 101• Photo• Personal Statement• CV• Schools Application form (may need to be signed by school

office!)• Letter of good standing from the dean **from school office• Letter of English Proficiency**• Official Transcript **• Immunization form with documentation• USMLE step score 1• HIPPA Certification• Universal Precautions Certificate aka Blood born pathogens (?)• Personal health Care Coverage• Malpractice Insurance coverage **• Photocopy of Passport • 2 Recommendation Letters• Payment if applicable

Elective Application Package 101Elective Application Package 101• Photo : each school will have different dimension that they want

• My favourite guy is on the corner of Starowislna & Dietla – you can get one good photo of you done and put it on a USB, thereafter he can print it off for 1zl in any dimension

• Personal Statement: brief one page blurb of why you want to go to that school to do that elective, any relevant experience in that discipline, what you hope to gain etc etc - if they ask any specific questions on their website make sure to answer! This is usually not required of Canadian electives

• CV

• Schools application form: this varies, often needs to be signed by the Dean

• Letter of Good standing – ask for multiple copies from School Office

• Letter of English Proficiency – ask for multiple copies from School Office

• Official Transcript – ask for multiple copies from School Office

Electives Application Package 101Electives Application Package 101Immunization form: Probably the most annoying part! •Extensive list of what you need (not all schools require all so if you are missing one of the following check the schools that you want to apply to first before starting your scavenger hunt for documentation!)

Best is to get all these done at home over the summer or at Christmas break Titers can be drawn at: Laboratoria Medyczne, Plac Szczepanski 3 (near Scandale Royal – up one

level) Shots – at Jana Pawla Complex, building in direction of Thoracic surgery subspecialties, follow the

yellow smiley faces once you get there To translate it’s sufficient to write in English next to it before you make all your photocopies

*** start early – takes a while after you draw your blood to actually receive your titers, if they are low you have to go to get the shot, then you can’t draw your titres for a few weeks after,

then have to re-wait to get your results – can turn into a long time!*** • HepB – primary series: *bring from home; if not - titres will work usually• HepB titres/serology (Wirusowe zapalenie wątroby typu B)• HepA & Menigicoccal (often optional)• Varicella titres (Ospa)• Primary Series TdP, Polio, MMR• Td/Polio Booster, MMR booster (Measles – Odra; Mumps = Swinka; rubella =Różyczka)• TB skin test – can get done and read at Skawinska (at the registration window down the far left

hallway – 50zl – not open on wknds) (TB = Gruzlica) • If positive can get X-ray done in Rynek Glowny 37 (near Tatuum store) – bring your passport

number and the guy should be able to provide documentation in English

Elective Application Package 101Elective Application Package 101• USMLE Score report – photocopy your results• HIPPA: Do the short ‘test’ online and print & photocopy the certificate

• http://www.hipaastore.com/Products.asp• Universal Precautions: Do short test online and print & photocopy the certificate

• https://www.redcrossonlinetraining.org/Distance/Default.aspx?CID=50• Malpractice Insurance:

• Current 3rd years had to find their own insurance for next year. At least $1000 for 6 months, but can cost over $3000. Some leads:

• 1/3 Million US Policy: Peter Leone, Academic Health Professionals Insurance Association. 1250 Broadway Suite 3401. New York, NY 10001 

• Maybe more flexibility in policy and possibly coverage in Canada: Jay Carter. Carter-MGM Insurance Agency LLC. 696 Dutchess Turnpike Suite H. Poughkeepsie, NY  12603. Tel: (845)454-1500 . Fax: (845) 473-1830 . Jay@cartermgm.com

• Canadian Coverage: CreeChurch Medical Liability Insurance, or Totten Group• Personal health care coverage: photocopy of OHIP/Carecard (if Canadian), can take out

private insurance via Internet if American• Photocopy of N.American passport• 2 reference letters: from Polish professors – they use these for your MSPE as well so

worth getting good ones; ask for stamped, signed and sealed in envelopes – multiple copies (10-20). Usually not required for Canadian electives

• Payment: bring American/Canadian cheques– some need to be certified

Elective Checklist• Short white coat• Stethoscope, penlight• Massachusetts book• Maxwell book• Pharmacopeia/ Ipod Epocrates• www.uptodate.com!!

Where did we do electives?Where did we do electives?https://services.aamc.org/eec/students/

(electives arranged outside of these listings were often thanks to personal contacts)

Electives – CanadaElectives – Canada

• Dalhousie (Peds – ID, FM – inpt/outpt)

• McGill University (IM – Allergy and Immunology at Montreal General Hospital)

• University of Ottawa (IM – CTU, Peds, FM)

• Queen’s University (did not accept visiting international students)

• McMaster University (IM – heme onc/general, Peds – onc, FM)

Canada cont.

• Northern Ontario School of Medicine (IM – cardio, FM – outpt, Surg – general) $750 travel stipend and offers insurance to purchase

• University of Saskatchewan (OBGYN in Regina)

• British Columbia: need sponsor, go through Royal College of Physicians (OBGYN, Peds, IM – cardio outpt, FM outpt, Surg - orthopedics )

• University of Western Ontario (FM, IM – Nephro at Victoria Hosp, Gen Surg – rural)

Electives - USElectives - US

• Brown (Surg – neuro)

• Case Western University (FM – Sub-Internship)

• Harvard University ( Surg – ENT/neuro, Psychiatry)

• University of Illinois at Chicago (Peds – ID/neuro, IM – cardio)

• University of Illinois at Chicago – Rockford (IM – geriatrics, FM – rural outpt, Peds – GI)

• Mayo Clinic: Rochester, Minnesota (Peds – NICU, Surg – plastics)

US Cont.• Mayo Clinic: Scotsdale, Arizona (IM – heme onc)

• Methodist Hospital in Houston, Texas (Surg – thoracic)

• University of New Mexico (FM – outpt homeless health, contact UJ 2012 grad npokasuwan@gmail.com if interested)

• University of North Carolina (Psychiatry – AI, IM – AI, gen. IM/consult GI/ID, Neuroradiology, Surg – neuro) $2000 per elective, includes malpractice, excellent student reviews

• Northwestern (Peds – radio)

• Sloan Kettering (GYN Onc, Surg – Breast)

• University of South Alabama (Emergency Med, Peds – emerg, IM – cardio, Surg – trauma)

• SUNY Upstate (IM – heme onc/SI Coronary Care, GYN onc)

US cont.US cont.

• Tufts (Peds – surg, contact Dr. Chwals wchwals@tuftsmedicalcenter.org if interested)

• Tulane University (Anesth, FM dept. but UJ IM credit - Hospice and Palliative Care, IM – Heme onc, Surg - plastics)

• University of Texas HSC San Antonio (IM – med onc, FM - outpt)

• Virginia Commonwealth University (IM – nephro)

• Richmond Rocks!

US Cont.US Cont.• Apply first through UJ

• University of Rochester (OBGYN outpt, FM – inpt/outpt/rural, Peds – cardio/respirology/endo/neuro/GI/craniofacial plastic surg, IM – endo/neuro/nephro/ID/heme onc/ICU, Surg – ICU/vascular, PMR, Psych – child and adolescent)

• UC Irvine (IM – ID, Surg – vascular, Psych, Radiology)

• UCLA (IM – electrophysiology)

• UC San Diego (Peds – heme onc)

• Loma Linda University (FM – outpt)

Electives - UK and beyond...Electives - UK and beyond...

• UK (Peds at University of Cambridge)

• South Africa (Trauma at Witwaterstrand University at Johannesburg General Hospital)

• Switzerland (Surg – neuro at HUG)

• Norway (Surg – maxillofacial at St. Olav’s)

KrakowKrakow● All of these are doctor-dependent but

can be relaxed if you want them to be● Highlights according to 2011 grads

include: – Peds metabolic (mostly DM but

interesting!) – Heme with Dr. Fornagiel– GI with Dr. Zwolinska-Wcislo– Pulm at Skawinska (get treated like a

doctor)– Cardio Surg at JPII (must really love

hearts)

Electives – Do’s and Don'tsElectives – Do’s and Don'ts

• Always be on time and available

• Be courteous to everyone – patients, NURSES, residents and staff

• Be EAGER and ASK QUESTIONS! • Med students aren’t expected to know everything, but

are expected to WANT to learn everything!

• Always offer more than they expect• Be the first to come and last to leave! They will notice!• Just don't be overly keen to the point where you are

interfering with the efficiency of the hospital staff

Electives – Do’s & Don’tsElectives – Do’s & Don’ts

• Be prepared for criticism• You’re a Student and an IMG

• Never complain about being tired

• Don’t complain about others to anyone – including other med students, nurses, patients, staff, program coordinators• And ESPECIALLY our School• If you don't see anything positive about CMUJ

then why should they see anything good about you as an applicant

• Try to meet with the program director to express your interest in the program and to ask questions

Electives - LORsElectives - LORs

• Ask for them early on in the elective

• Make it VERY clear why you are there• "I am an IMG who needs a STRONG reference

letter to get back into this country for residency – you are one of my 3 referees and I'm counting on you if you say yes.“

• If they hesitate as to whether they can give you a STRONG reference – look for someone else • It's better to have a very strong LOR from

someone less important than to have a weak one from the Program Director

Electives - LORsElectives - LORsThank You!

• Get more than the required number of LORs because not all referees follow through

• Get as much face time as possible with your referees – give them something to write about and show your strengths!

• Provide the Referee with:• US: ERAS cover letter & ECFMG cover letter• Canada: CaRMS cover letter (becomes available in

September. Prior to that, you can use “Instruction Sheet for Early References” then mail in your coverletter once it becomes available

• Stamped, addressed envelope• CV• An explanation of your goals or your PS

• Don’t forget Thank You Cards!

US & Canadian Match!US & Canadian Match!

ERAS (and OASIS)

The US Electronic Residency Application Service

ERAS and OASIS

• OASIS: your “Dean’s Office” handles your documents and forwards them to ERAS• Digital Photograph – may need time to

upload• LORs via Electronic Request Forms

and Document Submission Forms (LORs must be finalized in MyERAS!)

• MPSEs (November 1)• ERAS 2012 Timeline

ERAS

MyERAS – getting set up: start early• MyERAS opened July 1st

• Need Token from ECFMG

• Get core application done early (Personal info)

• Work on CV as you do rotations up to D-Day

• Add all the rotations you will do and use the course descriptions to mention this

• Add your away rotations under “Work Experience”

ERAS

• Personal Statements• Start early• Give it its due time• Can upload more than one• It’s about you• Don’t take it for granted, have it

checked over by more than one person• To mention a school or not in the PS?

ERAS

• Submitting USMLE Scores• Two options• Authorize ECFMG to submit scores to

“Designated” programs, i.e. programs listed in your application YES

• Authorize AUTOMATIC submission of scores NO

• Retransmit Scores in ERAS when they arrive in OASIS

ERAS

• Sep 1st Send your Apps!• At least have some sent out and you

can always add more later• Also, you can register for NRMP

• Wait for interviews via email.• Wait for interviews…• Wait…• Oh, wait!

ROL

• ROL due in NRMP by Feb (Don’t forget to register!)

• Must be ECFMG certified to complete a ROL• Step 1 and both Step 2 tests• Automatic update through ECFMG

(checks every week)• How to rank? Who did you like? Who

liked you? Don’t rank what you don’t like.

ERAS – Where to Apply to??

• Difficult to decide on which programs to actually apply to!

• No right way to chose programs – do your research!

• University based vs community based vs. rural?? – fellowship afterwards don’t dismiss smaller community programs – great education, can get fellowships, friendlier environment

• Apply to ‘safety schools/programs’?? – consider the competitiveness of specialty; apply to a realistic number to secure a good number of interviews

• Family commitments?

• ‘IMG – friendly’? – www.matcharesident.com can give you a list of programs for a cost $

• Canadians – make sure programs sponsor J1 visas – most will say on website – if not email and ask before wasting $

• Look at the roster of current residents – are most grad sfrom American school? Are all grads from Tufts, Harvard, John Hopkins? Will give you a general idea of the competativeness of the program

Number of programs per a specialtyUp to 10 $75 for all 10

11-20 $8 each21-30 $15 each31 + $25 each

10 programs = $7515 = $11520 = $15530 = $30540 =$55550 = $805

60 = $1055!!!

Supplemental Offer and Acceptance Program (SOAP)

• Replaced the Scramble.• SOAP is a series of "rounds" that commence at 12:00 noon eastern time on Wednesday of Match Week. • Each "round" of SOAP lasts two hours, during which applicants can accept or reject any offers they receive.• If an applicant is determined to be SOAP-eligible AND is unmatched or partially matched, they have access

to the List of Unfilled Programs beginning at 12:00 noon eastern time (Monday) and they are able to apply to unfilled match-participating programs through ERAS

Schedule of Match Week:• Monday 12:00n Programs will begin receiving SOAP applications and conducting telephone interviews with eligible applicants • Tuesday 11:30 a.m. Programs begin entering preference lists in R3 System • Wednesday 11:30 a.m. Programs finalize preference lists in R3 System 12:00 p.m. R3 System sends first offers to applicants 2:00 p.m. First offers expire 2:30 p.m. Deadline for programs to update preference lists 2:55 p.m. ERAS updated with applicant/program offers accepted 3:00 p.m. Second round of offers sent 5:00 p.m. Second offers expire

• Thursday 9:00 a.m. Third, fourth, and fifth offer rounds Offers every 3 hours, using same schedule as Wednesday

• Friday 9:00 a.m. Sixth, seventh, and eighth offer rounds 12:00 p.m. Match Day Ceremonies 5:00 p.m. Last offers expire

NRMP – SOAP• https://www.aamc.org/download/275096/data/erassoapschedule.pdf

• 1 week, 3 Cycles:

• 30 program apps max 1st cycle (noon EST Mon – Wed AM)• 10 program apps max 2nd cycle (noon EST Wed – Thu AM)• 5 program apps max 3rd cycle (noon EST Thu – Fri AM)• All apps carry forward through the cycles.

• No additional fees.• Can reapply to programs already applied to.• Can add new LORs and new personal statements.

• do this the week before• Cannot change application (so cannot add new electives, etc)

• Illegal to contact programs. They must initiate.

The day you use SOAP

Look up the list of unfilled programs on NRMP

Apply on ERAS (programs begin downlading app’s immediately)

Wait for programs to contact you for interview

Interview + Offer? Accept/Reject

No Interview/Offer?

Rinse and repeat.

Unfilled programs NRMP

• Vast majority of spots in the Preliminary tracks• ~8 Anesthesiology Categorical• ~60 FM Cat• ~20 IM Cat• 70+ IM Preliminary• ~8 Neurology Cat• ~2 Obs Gyn Cat• 2 Gen Surg Cat• 160+ Gen Surg Prelim• ~40 Transitional yr spots

CaRMS – First IterationCaRMS – First Iteration

• Carms – NOT rolling admission

• “Milestones” are not strict deadlines, but rather way to help you stay on track

• ONE deadline- November 25. All programs get your application at the same time

• Try to send documents to ERAS & Carms at same time – ie get LOR writers to send to both Eras & Carms

• More documents need to be physically sent in so allow more time for uploading

• Don’t forget about RETURN OF SERVICE• Depends on programs & province – keep up to date as it may change!

Carms – TimelineExample of CaRMS Timeline from 2011/2012

• August 10: Request online for registration

• Sept 2: Program descriptions complete – can start to check out different programs

• Sept 6-7- Tokens given out

• Sept 7 – AWS (Application Webstation) opens• Can start your application• All same general things as with Eras

• Oct 12 – Program selection opens

• Nov 10 – Application submission milestones

• Nov 16 – Program selection milestone; MSPR Arrival due

• Nov 18- LOR milestone ***

• Nov 23 – Document Assignment Milestone

• Nov 25– AWS CLOSED – EVERYTHING NEEDS TO BE DONE!!• No changes can be made, all programs will receive your application at same

time

• December 1- File Review Begins!!!

http://www.carms.ca/eng/r1_1stIteration_e.shtml#milestone

CaRMS 2nd Iteration• http://carms.ca/eng/r1_2ndIteration_e.shtml

• Opens same week as SOAP, but lasts longer.

• Programs do not download apps until review date (Wed of SOAP).

• Only 1 cycle; fewer spots.

• Can change application, add LORs and personal statements.• Will take even more time as programs often want PSs to

be catered specifically to them.

• # of apps not limited, but there are additional fees!!$!$• First 4 programs free, then $26.00 per program, this adds

up quickly

Unfilled programs CaRMS

• ~15 Var Pathology• ~65 FM (Mostly rural, +13 BC, +43

French-speaking)• 2 Gen Surgery• 10 IM (+ 2 in BC, + 26 French-

speaking)• ~14 Psych• 7 Rad-Onc

And 1-2 spots in Cardio-surg, Radiol, EM, Lab medicine, Genetics, Microbio, Neurology, ObsGyn, Ortho Surgery, Peds, Uro, etc.

CaRMS – Second IterationCaRMS – Second IterationTimeline (it’s very quick!)

December 14- online request for second iteration opens

March 7th – List of unfilled positions available & AWS opens.

- Late request for registration for second interation

March 14th – File Review Begins

March 16th-27th – Interviews (notified via email)

• Phone or Skype Interviews

April 4rd – Rank Order List Deadline

April 18th – Wednesday noon EST - MATCH DAY!http://www.carms.ca/eng/r1_2ndIteration_e.shtml

Couples MatchCouples Match

Applying & Interviews• ERAS/NRMP– apply for Couples Match• CaRMS – check the box when submitting your

Rank List

• Apply to the same hospitals and programs in the same area

• OK to mention your partner or that you’re couples-matching in your PS

• Interviews• If one of you receives an invite – call or email the

program to inquire about the other (and remind them you’re a couple)

• If applying to the same program - can ask to have interviews on the same day (save $ on travel expenses)

Couples MatchCouples MatchCouples Rank List

• Decide ahead of time your top locations as a couple

• Fill out separate ROLs, remembering the choices will be linked

• Can rank programs more than once or choose “No Match” to make as many combinations as possible

• Can view your partner’s ROL but cannot modify it

Couples MatchCouples Match

• Couples Rank List Example

Partner 1 Partner 2

1. Univ. of Rochester

1. Univ. of Rochester

2. Case Western 2. Cleveland Clinic

3. Cleveland Clinic 3. Cleveland Clinic

4. Case Western 4. Univ. of Rochester*

5. Univ. of Rochester

5. Cleveland Clinic*

6. Case Western 6. No Match

7. No Match 7. Cleveland Clinic

*Both Partners get matched but not in the same place

American InterviewsAmerican Interviews

• Most ppl received interviews starting in October/ November – BUT continued to get then until Dec.

• Don’t be intimidated – you’ll meet US students that already have tons of interviews lined up by mid sept – yours WILL come- stay positive and continue to bust ass!

• Number of interviews varies depending on specialties, how many you applied to, becomin harder to get interviews bc more DO schools

• Ppl interviewed at 2 places and prematched – others interviewed at 15 spots (and matched!)

• For competitive fields (even Internal) consider applying to a variety of University-Affiliated/ Community programs

• Sending 60 apps won’t matter if most of them are to extremely competitive programs (Mayo, Johns Hopkins etc) and smaller programs may pleasantly surprise you

• Applying can get pricey but can be managed if you choose wisely, most of us applied to a minimum of 50 programs (up to 150)

• The rule of thirds: apply to 1/3 programs you’re not sure you can get, 1/3 you think you have a good chance, 1/3 safety

American Interviews• By mid-November if you are dissatisfied with the

amount of interviews you received, start contacting programs. This can really work!!• Kindly harass programs that you want by updating them

every time a score/document is available

• Scheduling will depend on your situation/ location• Think about where you will be after electives• Can probably book about two per week, more can get

stressful (especially with winter travel conditions!!)• If you can, schedule your top choice in the middle

• Can always cancel interview but be respectful to the coordinators (keep up the good UJ reputation!)

• Consider costs (many US programs will offer free accommodation but still can get pricey!)

American Interviews

• Most US interviews are friendly, wine and dine affairs• You can practice some of the harder questions but most will be

of the “why do you wanna come here?” nature• It’s important to research the schools ahead of time!

• Some schools employ behavioral interviewing• Ex. Describe a situation in which you had to question authority and how did that affect you.

• Just be yourself • Ask a lot of questions

• This can get tricky because you run out pretty quickly and they keep asking you if you have more questions :P

• Have some go-to’s like “Is your program more front loaded or back loaded?” or “What predictors have you found for a good resident?”

• Avoid asking tedious questions like “Will I have sick days?”, these shouldbe outlined in the package, or ask a resident not the director

Good video for advice : http://www.youtube.com/watch?v=cADapg2kjZk

American Interviews

• Try to arrive the morning before the interview• Leave room for travel delays, shower and freshen up, check out the

city (programs like hearing that you do this!)

• Night before is the resident dinner. Go to it!!! • Great for ideas on asking questions, warming up• Although not mandatory, they will notice if you’re there• Get a feeling for the other candidates – these may be your future

coworkers!!

• Day of interview• It’s early, it’s long, it’s tiring but be enthusiastic!• Starts with breakfast, talk from the program director, tour• Will have from 10-30 min interviews with 1 to 5 faculty members

• This varies a lot! The questions tend to be general, comfortable atmosphere

• Lunch with residents or faculty, may attend teaching conference• Ask lots of questions, talk to as many ppl as you can, be a polite,

bubbly version of yourself!!

Interviews up North

• A little more stiff• More standardized - Not as much shmoozing – can

be a good thing. • Ontario Family medicine is completely

standardized. You are asked 10 questions. Each question is VERY long so listen carefully. THINK before you start answering

• More standard Q (ethical, clinical)• Potential MMI – circuit of 10 stations, 10 min each

where you are asked a question and marked on how it was

• Still meet and greet• Late Jan- Early Feb

List of Questions We Were Asked:• Why FM, Internal, Peds, etc• Give an example of a conflict and how you resolved it• Give an example of leadership positions you have had• What do you think will be a major challenge for you in first year of residency• Tell me about (CV specific- make sure you know your own CV)• Why Family Medicine• Tell us about your most recent clinical post, what your responsibilities were for

the patients• Tell us of a time you were a member of a team, a conflict you came across,

how you solved it, did you ask for help• Tell us about a difficult patient, how you handled it and what the outcome was• Tell me about your program• Ethical questions (what would you do if your laptop, containing important

clinical research information, was stolen. What would be your greatest concern, whom should you notify)

• Tell me about a time when you found communication to be difficult• How do you deal with stress• Why this program?

• Why FM, Internal, Peds, etc• Give an example of a conflict and how you resolved it• Give an example of leadership positions you have had• What do you think will be a major challenge for you in first year of residency• Tell me about (CV specific- make sure you know your own CV)• Why Family Medicine• Tell us about your most recent clinical post, what your responsibilities were for

the patients• Tell us of a time you were a member of a team, a conflict you came across,

how you solved it, did you ask for help• Tell us about a difficult patient, how you handled it and what the outcome was• Tell me about your program• Ethical questions (what would you do if your laptop, containing important

clinical research information, was stolen. What would be your greatest concern, whom should you notify)

• Tell me about a time when you found communication to be difficult• How do you deal with stress• Why this program?

Pre-MatchPre-Match

• Offer made to candidate outside of NRMP match (available for IMGs, DOs, candidates already graduated)

• If candidate accepts – must withdraw from the Match before rank list deadline (don’t do this before signing letter of offer/contract!)

• Usually given time to consider offer

• Ok to ask about Prematch policy at end of/after interview

Pre-MatchPre-Match • PROS: don’t have to wait until match day to know you have a job.• If you did not get a lot of interview

(ie:5) but were offered a Prematch position- ACCEPT IT!!!

• CONS: if accept offer, cannot try to match in other programs of greater preference; if don’t accept, risk not matching at all

• CONSIDERATIONS: how much you like the program; quality of program; strength of application; number of interviews

Where We Matched!Where We Matched!

Class of 2012

Canada

USA

UK

Intentional Year off

2nd Round- Canada

Other European Countries

Canada

USA

UK

Intentional Year off

2nd Round- Canada

Other European Countries

Match StatisticsMatch Statistics• 19/28 went through a Match

• 3/6 matched in Canada • 3 Matched in First Round• 3 going through Second Round

• 2 matched in UK• 1 also accepted to USA and going there

• 11/14 matched in the US • 3 accepted PreMatch• 8 matched first round• 3 participated in the Scramble, 0 successful (very limited spots)

• 2 going through Canadian Second Round

• 4 people are voluntarily taking time off

• 5 Staying in Europe to residencies in Poland, Switzerland, Sweden, etc

Class of 2012

Canada

USA

UK

Intentional Year off

2nd Round- Canada

Other European Countries

Where We Matched!Where We Matched!

• UK Foundation Programme

• Canada

- Family Medicine

- University of Western Ontario

- McMaster University

- University of Winnipeg

Where We Matched!Where We Matched!

•United States–Pediatrics

–University of Rochester–Cleveland Clinic

–Family Medicine–University of Rochester–University of Indiana– Penn State U

Where We Matched!Where We Where We Matched!Where We Matched!Matched!

•United States–Internal Medicine

– Penn State University– Boston

–PMR –University of Rochester

–OB/GYN–University of Missouri, Kansas City School of Medicine

Places that make you wait

BC-IMGJanuary 1, 2012 Phase I: Application

 Deadline

February 1, 2012 Phase II: Application  Deadline

February 2, 2012 File Review Begins

February 15, 2012 Phase III: OSCE Seats are granted – successful candidates notified

March 20, 2012 BC NAC OSCE Orientation

March 24, 2012 BC NAC OSCE Examination

April, 2012 Phase IV: Clinical Assessment – successful candidates notified

May, 2012 Clinical Assessment Orientation Week begins

October, 2012 Clinical Assessment concludes

August, 2012 CaRMS Application Opens (1st Iteration IMG Positions; check the Carms site for 2nd Iteration timeline)

November, 2012 CaRMS Application Complete

Dec/Jan 2013 Candidates Selected for Interviews

March 2013 CaRMS notifies candidates of match results

July 2013 Resident Training PGY1 Begins

- Registration process begins in January of 4th year and ends 18 months later

- BC RESIDENTS ONLY!

- You may apply an unlimited amount of times

- Very comprehensive website: http://imgbc.med.ubc.ca/

Alberta - IMG

-Application cycle for 2012 starts on June 4th, 2012

Eligibility: continuous resident of the province of Alberta for 6 (six) or more months immediately prior to the opening of the AIMG Program application portal OR an accredited Alberta high school full time for 2 or more yearsORattended an accredited post secondary institution in Alberta full time for 2+ years- Web site: http://www.aimg.ca/

California IMG

- Application process begins in Spring of your 4th year

- The Key: PTAL letter

- Signatures from each Clinical Director from your USA electives

Web site: http://www.mbc.ca.gov/applicant/application_international.pdf

Quebec IMG -Process begins in middle of 4th year and ends 18 months later

-Requires all 3 canadian exams: EE, QE1, NAC OSCE or QE2

- Write MCCEE in November at the latest; signup for QE1 and OSCE in January.

-No french examination result requirement

Web site: www.cmq.org

Step-byp-step: http://www.cmq.org/fr/ObtenirPermis/DiplomesInternationaux/Permis/1ReconnaissanceEquivalence.aspx#PointTitle4

University Quota IMG Quota

 Memorial University of Newfoundland

14 1

 Dalhousie University 7  

 Université Laval 37  

 Université de Sherbrooke 42  

 Université de Montréal 19  

 McGill University 1  

 University of Ottawa 9  

 Queen's University 12  

 Northern Ontario School of Medicine

22  

 University of Toronto 1 1

 McMaster University 14 1

 University of Western Ontario 14 5

 University of Manitoba 2  

 University of Saskatchewan 19  

 University of Alberta 16  

 University of Calgary 11  

 University of British Columbia 19 2

 Total 259 10  

Results from past years on carms.ca

2012 – 2nd iteration

Congrats, here’s your paperwork!!

ECFMG CertificationECFMG Certification

• Some programs require this for applying for residency, however we can’t get it until after 4th year – do your research!

• The school office will provide you with necessary forms and mailing instructions before grad

• You will need:• Medical Educations Credentials Submission

Form 344• Medical School Release Request Form 345• 2 Photocopies of final medical school diploma• Passport sized color photograph

And for all you Canucks…

Which visa do I want?J1 H1B

Sponsored by ECFMG Residency Program

Moonlighting No Yes

Max Length 7 years 6 years

Once done Home for 2 years Any country for 1 year or dual intent

Spouse can work? Yes No

Possible to stay in states after J1 – must do 2-3yr work in underserved areas in USA if not want to go back to home

country for 2 yrs after residency.

J1 VisaJ1 Visa• ECFMG is your sponsor

• Main application is online now• Major requirement is Statement of Need

• Issued by Health Canada

• Tedious but doable, just stay on top of it!!

• Before coming back to Poland get Certified copies of• Passport• MCCEE - Keep this letter!!• Both are needed for Statement of Need

• Start application for J1 visa soon after the match

J1 Visa How to start?•New this year: your program starts the process online with ECMFG•Your job is to apply for Statement of Need (next slide)

What do you need for ECFMG?• Letter of Offer (from your program)• Application form (online via ECFMG)• Statement of Need (Health Canada)

• http://www.hc-sc.gc.ca/hcs-sss/hhr-rhs/postgrad-postdoc/cat_b-eng.php

• CV• Copy of Passport • $250• Return Airbill• ECFMG certificate

J1 Visa• Your job is to apply for statement of need

• Application form• Certified copy of Passport• Certified copy of MCCEE letter• Request for Endorsement (specialties other than FM)• Action plan

• Timeline of all US and Canadian exams you will need to be board certified in Canada

• Basically explain how you plan to be able to practice in Canada after residency

• RCPSC letter• Make sure your program is ACGME accredited and your specialty is on the list of

needed specialties (email for updated copy: j1visa@hc-sc.gc.ca)

• Letter of Offer• CV• Proof of provincial residence (2 government issued documents that

bear your name and permanent address)• Consent Form

Q & AQ & A

TIMELINETIMELINE

(in case you forget everything (in case you forget everything wewe’’ve said – this is what you ve said – this is what you

need to know!)need to know!)

Sept/October of 3rd year

• Canadian electives-submit applications!!!• No earlier than 9 months, but submit RIGHT at 9

months!!!• Make sure you get your vaccinations done over

the summer before you come back for 3rd year so that you can apply right away

February/MarchFebruary/March****

● Work on US electives applications and follow up with your app by email or phone, pay attention to blocks and availabilities to IMGs

● Get vaccinations/ titers/ updated transcripts!● Collect Letters of Rec from Polish profs● Work on CV/ personal statement for electives● Schedule CK and CS early!!! CS spots fill up!● Apply for MCCEE● Non-EU citizens must take PLAB to apply for

foundations● ** 2nd years prepare American checks when you go home,

maybe get titers, immunization records

AprilApril

● Continue negotiating your electives – be flexible but persistent

● Take this academic lull to organize your Step 2 study time

● Try and get stuff done now

So you can focus on neuro in May

MayMay

● Neuro with Dr. J!!!

– You will learn how to present patients for American rounds, PAY ATTENTION!

– Learn how to play the game: dress up, talk to residents, be professional

– Apply for Rochester electives, good backup (take ~ 15 students/ year)

– Approach Dr. J for a Letter of Rec – he will want your PS & CV

JuneJune

● Keep working on electives! Yes, it will take this long :-P

● Study for the Step 2

● Work on residency CV and Personal Statement (get lots of help!!)

JulyJuly

● Begin ERAS application (July 1st)

– Work on it early and often!

– It's simple but pay attention to details

● Begin electives

– Approach supervisors on 2nd or 3rd day and say you want to work hard for a strong letter

– Visit program directors if you plan to apply for res

● Keep studying for Step 2 (may write CK or CS here)

● UK Foundation Programme Eligibility Checking Period

AugustAugust

● CaRMS: Online request for registration opens for international medical graduates, United States medical graduates and prior-year Canadian medical graduates

● Keep working on ERAS– Ask for at least 4 letters, can have multiple per

elective– Put your North American elective experiences

in your CV as you go along, there's no separate spot for it in your app

● Write CK!!!● Practice for CS

SeptemberSeptember

● Submit ERAS application as soon as you can!!!

– Don't worry about completion (your parts should be done but letters are usually written in September and you can always reserve more slots if you need them)

● Do your CS (before Sept 10th = earlier reporting dates, maybe more interviews)

● Write MCCEE● Apply for CaRMS token & begin working on

CaRMS application

OctoberOctober

● Send thank-you notes to letter writers● Interview season begins – yours will likely be

Dec/ Jan– Interview tips at: www.aamc.org – Practice questions, research programs, be

yourself!● Proofread your MSPE carefully!! The School

office is very accommodating/ appreciative● Keep working on CaRMS application● UK Foundation apps due

NovemberNovember

● CaRMS documents Milestones and ONE deadline at end of November!

● Most US interview invitations have been sent out

– Mid-Nov is the time to contact programs for interviews – be polite but don't be afraid to tell them why you want their program/why they should want you. This really works!!!

● MCCEE results back from September – keep that piece of paper! You'll need it for J1 if you're applying for the States.

DecemberDecember

● Interviews!!– Try not to schedule

electives here, programs will usually only give you 1-2 days off (interviews are often conducted the first two weeks of December so taking 2 days off an elective may be feasible)

– Enjoy yourself, US interviews are fun!

● Christmas!!– If you plan ahead, you can

have lots of time off here, make up for all lost time with the fam!

JanuaryJanuary

● US interview high season– Rank schools as you go along– Don't forget to send thank-you notes to

interviewers● All scores must be in by now!● Canadian interviews late Jan/ early Feb

– Not as much fun as US– Expect content/ethical/medical questions– Let school office know now if you have

interviews past Feb. 1st and will be missing school!

FebruaryFebruary

● Back to Poland for Emerg

● Canadian Interviews first 2 weeks

● Submit rank order list for ERAS & CaRMS

– contemplate need for beta blockers :-P

MarchMarch

● Canadian Match Week (week before US)

• Monday noon EST: if and where you matched

• 2nd Round begins Tuesday

● NRMP main residency match week

• You have this week off! Travel, relax, debauchery!You have this week off! Travel, relax, debauchery!

• Monday noon EST: find out if you matched

location of unfilled positions released to participants eligible for SOAP

check http://www.nrmp.org/res_match/yearly.html

• Friday 1 pm EST: find out where you matched

SOAP concludes

• Begin working on J1/ paperwork

AprilApril

● Congrats to those of you who matched, here's your TON of paperwork! :-P

• Pay attention to due dates for your school & ECFMG

• If you're Canadian, work on your J1

● Canadian (+/- US) Second Round Results • Wednesday noon EST: if and where you matched

● Get grad photos done!● Make sure you have your indexes complete,

pay all fees to school office...

MayMay

Graduation!! Congrats, youGraduation!! Congrats, you’’re a doctor!!re a doctor!!

Thank You Thank You &&

Good Luck!!Good Luck!!