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Decret and US Match - McGill University

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Decret and US Match - McGill University Decret and US Match - McGill University Presentation Transcript

  • Residency South of the Border
    Dr. Namta Gupta, CCFP FCFP
    May 19, 2010
  • Overview
    The QC Decrèt
    Visa options
    McGill in the U.S.
    Residency position types
    U.S. Matches
    ERAS/NRMP
    SF Match/AUA
  • The QC Decrèt
    Document released annually setting number of positions available in each discipline within QC
    Decided by the Ministère de la Santé et des Affaires Sociale
    Input from Post Grad Deans
    Various Colleges and Federations
    The Qc Decrèt
    View slide
  • The QC Decrèt
    Aims to meet the Health needs of the population
    Decrèt is released, the four Postgraduate Deans decide how the positions will be divided amongst faculties
    Certain criteria have to be followed
    Formulas have been established
    The Qc Decrèt
    View slide
  • The QC Decrèt
    Want to go elsewhere in Canada?
    Has NO bearing on you whatsoever!
    Want to go to the US (as an American)?
    Has NO bearing on you whatsoever!
    Want to go to the US (as a Foreigner)?
    Has NO bearing on you whatsoever!
    Want to go to the US (as a Canadian)?
    Here’s where it gets complicated…
    The Qc Decrèt
  • Visa Options H-1B VS. J-1
    U.S. Residencies for Non-Americans
    H-1B
    • Pros
    Easy to convert to a permanent status in US
    Does not require home country support
    Cons
    Requires residency program sponsorship
    Many programs unwilling to take this responsibility
    Requires USMLE Step 3
    Can’t write this until after grad, therefore residency start date is delayed to around Sept
    Many programs unwilling to wait
    The Qc Decrèt
  • Visa OptionsH-1B vs. J-1
    J-1
    • Pros
    The “standard" visa accepted by all U.S. institutions
    Easily obtained prior to residency start date
    Cons
    Has a 2-year home country requirement before you can receive permanent status in US
    Requires a Statement of Need from Health Canada (or your home country)
    Subject to provincial manpower regulations
    The Qc Decrèt
  • For QuebecersThe Decrèt determines whether or not you will be able to get a Statement of Need
    States which disciplines are “priority recruitment” for that match year
    Only issued mid 4th year after application and interview season are well underway
    Statement of Need only available for “priority recruitment” disciplines
    Trending toward greater restriction
    The Qc Decrèt
  • Match 2010
    Priority Recruitment Disciplines:
    Médecine familiale
    􀂃 Médecine interne
    􀂃 Chirurgie générale
    􀂃 Chirurgie orthopédique
    􀂃 Hématologie
    􀂃 Oncologie médicale
    􀂃 Pédiatrie générale
    􀂃 Anatomo-pathologie
    􀂃 Anesthésiologie
    􀂃 Psychiatrie (incluant pédopsychiatrie)
    􀂃 Radiologie diagnostique
    􀂃 Radio-oncologie
    􀂃 Obstétrique-gynécologie
    The Qc Decrèt
  • Other Canadians
    For a Statement of Need,
    you are subject to the provincial manpower regulations of your home province
    In general, less restrictive than QC
    For information on your discipline of interest and
    a Statement of Need,
    contact Health Canada
    Judith_Lewis@hc-sc.gc.ca
    The QC Decrèt
  • Internationals…
    For a Statement of Need:
    You need to apply to the
    Health Ministry
    in your
    home country
    (last place of legal residence)
    The Qc Decrèt
  • Things to consider…
    Reciprocity of Training
    Verify ACGME accreditation for programs of interest
    http://www.acgme.org/adspublic/
    Verify length of training for equivalency purposes
    i.e., Internal Medicine is 3 years in the US and 4 years in Canada
    More information is available from
    Royal College of Physicians and Surgeons of Canada http://rcpsc.medical.org/
    Collège des Médecins du Québec (for QC Residents) www.cmq.org
    Other provincial boards
    The Qc Decrèt
  • McGill in the U.S.
    McGill students consistently match to a variety of competitive programs in the U.S.
    McGill students are equivalent to “U.S. Seniors”
    McGill is an accredited member of the L.C.M.E.
  • McGill in the US Class 2010
    Massachusetts General Hospital
    Internal Medicine
    Vanderbilt University Medical Center
    Internal Medicine
    University of Illinois (Chicago)
    Medicine and Pediatrics
    Weill Cornell Medical Center
    Pediatrics
  • McGill in the US Previous years
    Sinai Hospital (Maryland)
    Obs/Gyn
    Yale University
    Anesthesia
    Diagnostic Radiology
    New England Med Centre
    Diagnostic Radiology
    Rush University
    Internal Medicine
    University of Wisconsin
    Family Medicine
    Einstein/Jacobi Medical Centre
    Peds
    UC San Diego
    Peds
    University of Vermont
    Peds
    Emory University
    Psych
    Georgetown University
    Internal Medicine
    NY Eye & Ear Infirmary
    ENT
    AMONG OTHERS…
  • Residency Position Types
    Categorical Position
    Includes all necessary years of training to be certified in the U.S. in that specialty
    Advanced Position
    Begins only after the first year of residency training (also called “PGY-2”)
    Requires completion of a preliminary (“PGY-1”) or transitional year
    Program will train you for that specialty once you are admitted
  • PGY-1 Residency Positions
    Preliminary Position
    Must be completed before you start training in an advanced specialty
    Usually surgery or internal medicine
    Always find out what your advanced position requires!
    Transitional Year Position
    A preliminary position in which you rotate through different departments, much like core clerkship
  • Be Careful…
    Do not take your prelim/transitional year for granted
    If you match to a PGY-2, you are not automatically given a preliminary year
    You must apply and interview for your PGY-1 separately
    You will have to interview at several programs, as you would for any other residency position
  • US Matches
    FREIDA
    Database of all US residency programs
    Searchable by discipline and/or location
    www.ama-assn.org/ama/pub/category/2997.html
    ERAS/NRMP
    Most US residencies
    SAN FRANCISCO MATCH
    Child Neurology, Neurosurgery, Ophthalmology, & Plastic Surgery
    AUA Urology Match
  • ERAS/NRMP
    ERAS = match application agency
    www.aamc.org/students/eras/start.htm
    Request ERAS access token from CaRMS in late June (help@carms.ca)
    Complete electronic application
    Send all supporting documentation to CaRMS for processing to ERAS
    CaRMS is your “designated Dean’s Office”
    They will charge you $235(+tx) for this service
  • ERAS/NRMP
    Unlike CaRMS, programs have access to your data as soon as you assign it to them
    The earlier the better!
  • ERAS/NRMP
    NRMP = actual matching agency
    www.nrmp.org
    Must register with both ERAS andNRMP
    NRMP registration opens August 15, 2010
    Rank order lists submitted to NRMP by
    February 23, 2011
  • SF Match-Early!
    www.sfmatch.org
    Registration/Application begins in June
    Each specialty has its own timetable
    Often only match to advanced (PGY-2) positions
    You will likely also have to apply to the NRMP for a preliminary/transitional (PGY-1) position
  • Urology runs its own
    separate match in the U.S.
    www.auanet.org/residents/resmatch.cfm
    Since applicants to this are limited each year, we won’t discuss this exhaustively, but don’t hesitate to contact us if you have questions or need assistance
    AUA Match
  • Timeline
    Depends on:
    Matching system(s) of choice
    Individual Programs
    Deadlines may differ from that of the matching systems
    Be sure to verify the deadlines for EACH program
    Some interviews offered “first-come, first-served”
    Once quota is full, additional invites are unlikely
    Your best interest to apply early
    Accept all early invitations as programs can overbook
    If you have not heard from a program of interest, call and ask about the status of your file
  • How many programs should I apply to?
    Largely dependent on you, your finances, and your level of comfort with risk
    2004 ERAS application stats:
    • 1-5 programs for combined programs (Med/Peds, etc.)
    • 40-45 programs for very competitive specialties
    • 10-20 programs for most other disciplines
    • Average of 1.54 specialties
    Applying to the US
  • Applying to the US
    How many programs should I rank?
    Dependent upon:
    Interview experiences
    Level of comfort with risk
    2007 NRMP stats:
    Average of 13 competitors for eachcompetitive specialty position
    Average of 7-9 competitors for each position in other disciplines
    Longer rank order list maximizes your chances
    No data available on average rank order list length between matched & unmatched candidates
    Single discipline applicants most often unmatched in Dermatology, Plastics, Ortho, E.N.T., Rad. Onc., Obs/Gyn
  • You and the USMLE
    Average Step 1 scores for NRMP disciplines
    www.nrmp.org
    Under “Data and Reports”, click “Charting Outcomes in the Match”
    Step 1 scores commonly used as a “Filter”
    Due to late issue date of Dean’s Letter
    “Cutoff” scores not often published
    Many programs require Step 2 before Rank Order list deadlines
    Be sure to verify this for your programs!
  • Dean’s Letter (MSPR)
    McGill follows AAMC guidelines
    Nota letter of recommendation
    More like an elaborate transcript
    Every clinical rotation is included
    ICM, clerkship, and electives
    Global category – NO numeric grades
    Meets, Exceeds, etc.
    ALL narrative comments
    Unedited except for grammar
  • Dean’s Letter (MSPR)
    MSPR Review
    In September
    Specific dates TBA via class e-mail
    Sample MSPRs can be viewed in the Career Advising Office. No electronic version of a sample can be e-mailed to a student.
  • Dean’s Letter (MSPR)
    McGill’sMSPR
    • Includes only faculty-related awards/activities
    • Faculty scholarships and research carried out through the bursary program
    • All other relevant activities should be reflected in your CV
    • Does not include overall individual class rankings since BOM is pass/fail
    U.S. MSPR
    • Includes elaborate section on
    unique attributes, abilities, and
    extra-curricular activities
    • Provides overall class ranking
    for each student
    VS.
    **Despite the fact that some US programs are not sure how to use our Dean’s Letter, as noted before, many McGill students consistently match to top competitive programs in the US
  • What happens if you don’t match…
    Don’t Panic…
    We will be here to support and assist you
    if you go unmatched
  • What happens if you don’t match…
    CaRMS
    NRMP can be used as a back-up, but only if you applied and submitted rank order lists to both systems
    2nd Iteration
    List of unfilled positions released on Match Day
    Same as 1st round but more condensed timeline
    Interviews usually by phone
  • SF Match/ AUA
    Hopefully, you have applied to a second choice discipline that you can have as a runner-up through the NRMP
    If not, there are always some available positions left-over after the match, and we can assist you in exploring these options
    What happens if you don’t match…
  • What happens if you don’t match…
    NRMP
    List of unfilled positions released for
    The Dean’s Office provides you with facilities to “scramble” in and personal support as needed
    You select interesting/suitable programs and apply manually (fax, telephone, and e-mail)
    It is a crazy and stressful process, but the outcome is usually good for those applicants who approach it with patience and pragmatism
    SCRAMBLE
  • What happens if you don’t match…
    Take a year off to do research,
    humanitarian work, etc.
    • Pros:
    Potential publications, additional references, reflection
    Cons:
    Clinical activity prohibited after graduation
    Competing against fresh batch of applicants
    Stigma of unmatched applicants
    Application process for following year match starts too early to complete meaningful research
  • And so…
    We’ve given you a lot of information, and the process
    may seem overwhelming, but the bottom line is this:
    McGill students do well, and you’re a McGill student!
    As always, contact us if you ever have questions, concerns,
    or would like us to review your CVs, personal statements, etc.
    (514) 398-5557
    namta.gupta@mcgill.ca
    or
    careeradvisor.med@mcgill.ca