CaRMS -- What, When, and Cost

What is CaRMS?
I started medical school with no idea of what the next four years would have in store. I didn't know that the first two years would be spent in lectures at the university or that the final two years would be a hospital-based clerkship. Moreover, I had no concept of how medical students matched into residency programs -- the mysterious process of "CaRMS".

The Canadian Resident Matching Service (or CaRMS) is a national online application system through which fourth-year medical students apply for positions in Canadian residency programs. Basically it is like applying to medical school all over again (but easier, since it's one common application -- though you probably should tailor your personal letter to each school). You input all the routine stuff -- extracurricular involvement (which is one reason why it's important to keep up with outside interests during medical school!), work experience, awards, research experience, etc.

The trickiest part of CaRMS is deciding which programs to apply to. In every medical class there are at least a couple of students who've had their specialty picked out since before they even started medical school. For most of us though, it's far less clear. Doing third- and fourth-year clinical rotations does help to narrow down the choices -- but when everything seems new and exciting, it can be hard to differentiate between cool-to-watch (cough, surgery) and I-want-to-do-this-for-my-career. Eventually people seem to hone in on one or two (or even three) specialties, to which they submit applications.

I made CaRMS easier for myself by applying to only one specialty. This was a slightly risky putting-all-my-eggs-in-one-basket decision that horrified my medical school career advisor (no medical school wants a high unmatched rate, so medical students are strongly encouraged to "back up" with another specialty). Fortunately my chosen specialty was not a very popular one, and I made sure to apply to every program in Canada (eleven) to increase my chances of matching.

As outlined in the timeline below, the CaRMS process involves submitting an online application (to the residency programs of your choice), travelling for interviews, ranking your choice of programs (similarly, the programs rank the applicants), and hopefully getting offered a spot in a residency program (determined by a computer algorithm that compares the programs' rank lists with those of the applicants -- with the applicants' preferences being prioritized over the programs'). The main difference between CaRMS and medical school applications is that instead of being offered spots at various medical schools, on CaRMS Match Day you are offered one spot in one specific program (hopefully the one you actually wanted!).

There are two iterations to the CaRMS match. Canadian fourth-year medical students (including Canadians studying at American medical schools -- but not abroad) apply in the first iteration of the match. The vast majority of residency spots are filled with these applicants. Any leftover spots are filled in the second iteration of the match, which is much more competitive, as it has far fewer spots and is open to not just Canadian medical students who did not match the first time around, but also to international students, including Canadians trained abroad. Medical students who don't match in the second iteration wait until the following year to apply again. The fear of going "unmatched" drives most medical students to apply to plenty of programs in the first iteration.

In my experience, the best part of CaRMS was the interview tour -- I'll write about that in another post.

airplane views of a frozen Canada during CaRMS interviews, January 2014

My CaRMS Timeline

• September 4, 2013 - CaRMS online application system opens so you can start filling out your application.
• October 21, 2013 - Documents (transcript, passport, etc.) submission deadline.
• November 8, 2013 - MSPR (Medical Student Performance Record) submission deadline.
• November 15, 2013 - Reference letters submission deadline.
• November 18, 2013 - CaRMS application submission deadline -- this is it, you're done.
• December 2013 - Interview invitations trickle in (via email) over the course of the month... I was lucky to be invited to interview at ten of the eleven schools I'd applied to.
• January 18 - February 9, 2014 - Interview travel period. I travelled to ten cities across Canada, from Halifax (January 20) to Vancouver (February 6). Unexpectedly, this trip was the highlight of medical school.
• February 20, 2014 - Rank list submission deadline (you rank your choice of programs online).
• March 5, 2014 - Match Day! At 12 ET the program to which you've matched is revealed on the online application system.
• July 1, 2014 - First day of residency for all PGY-1s across the country.

Match Day at UBC (med.ubc.ca)

The Cost of CaRMS
If your medical education hasn't already bled your bank account dry, CaRMS might just be what does it. You'll type in your credit card number so many times for application fees, flights, and hotels that you'll probably have it memorized by the end of this process. Invariably you become desensitized to the amount you're spending and stop questioning what it's for (Oh, another $200? No problem, here's the Visa). Here's what I paid for CaRMS:

• CaRMS online application system registration fee (September 5, 2013): $329.70
• medical school transcript request fee (September 22, 2013): $7.50
• undergraduate transcript request fee (October 8, 2013): $10
• CaRMS program application fees (October 26, 2013): $209.45 <-- this was low for me because I only applied to 11 programs (some people apply to many more, at an additional $30 per program)
• flights, ground transportation, & hotels during interview period: variable (potentially A Lot)

If you've gone through the CaRMS process and have anything to add, feel free to comment. Also, if you have any questions about CaRMS I'd be happy to try to answer them (or it may be helpful to check out the CaRMS website).