Analysis of factors affecting Canadian medical students’ success in the residency match

Abstract

Background: In North America, there is limited data to support deliberate application strategies for post-graduate residency training. There is significant interest in determining what factors play a role in Canadian medical graduate (CMG) matching to their first choice discipline and heightened concern about the number of students going unmatched altogether.
 Methods: We analyzed matching outcomes of CMGs based on seven years (2013-2019) of residency application data (n= 13,499) from the Canadian Residency Matching Service (CaRMS) database using descriptive and binary logistic regression modeling techniques.
 Results: The sample was 54% female, with 60% between the ages of 26 and 29, and 60% attended medical schools in Ontario. Applicants who received more rankings from residency programs were more likely (OR = 1.185, p < 0.001) to match. Higher research activities (OR = 0.985, p < 0.001) and number of applications submitted (OR = 0.920, p < 0.001) were associated with a reduced likelihood of matching. Number of volunteer activities and self-report publications did not significantly affect matching. Being male (OR = 0.799, p < 0.05) aged <25 (OR = 0.756, p < 0.05), and from Eastern (OR = 0.497, p < 0.01), or Western (OR = 0.450, p < 0.001) Canadian medical schools were predictors of remaining unmatched.
 Conclusions: This study identified several significant associations of demographic and application factors that affected matching outcomes. The results will help to better inform medical student application strategies and highlight possible biases in the selection process.

Modernising physician resource planning: a national interactive web platform for Canadian medical trainees

“…The CaRMS match outcomes are a testament to the shortcomings of the current top-down PRP strategy. The most recent example is the signi cant rise in the number of unmatched Canadian medical graduates (CMG), reaching a peak of 169 in 2018 after both iterations of the match [16,42]. Estimates place the taxbase investment at approximately $260,000 per medical graduate prior to entering residency, representing at least $43.9M of unrealized investment in 2018 alone [17].…”

“…Estimates place the taxbase investment at approximately $260,000 per medical graduate prior to entering residency, representing at least $43.9M of unrealized investment in 2018 alone [17]. This has led to important advocacy efforts in 2018 and action in the following year whereby the Nova Scotia Health Ministry added 25 new spots at Dalhousie University as well as $23 million invested over six years for new positions in Ontario [42,43]. Concurrently, the number of unmatched CMGs has dropped to 98 in 2019 and 67 in 2020 [44].…”

Postgraduate medical education selection in Canada: Opening the black box

“…They believe the results of their analysis will help guide medical students with their career planning and strategies. 12 Medical schools may be interested in Bakker and colleagues' study: "The relationship between regional medical campus enrollment and rates of matching to family medicine residency" which points to contextual differences between regional and main medical school campuses and then subsequently affect PG training choices. 13 We are also very pleased to see Gallinger and colleagues report: ""CaRMS at 50: Making the match for medical education" which examines the evolution of the application and matching system over the past half century, and CaRMS' role in the process.…”

“…They believe the results of their analysis will help guide medical students with their career planning and strategies. 12 …”

Unmatched medical students: a missed opportunity for the Canadian physician workforce

“…Recent evi dence suggests that these courses of action may not be useful. 5 During my short period of being unmatched, a unifying message was that such ancillary activities were ultimately useless in determining how to function as a physician, and that acting in the capacity of a junior physician (i.e., resident) was preferred for learning.…”