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...
Aims to meet the Health needs of the population
Decrèt is released, the four Postgraduate Deans
decide how the positions w...
Want to go elsewhere in Canada?
 Has NO bearing on you whatsoever!
Want to go to the US (as an American)?
– Has NO bearin...
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
 Do...
Visa Options
H-1B vs. J-1
J-1
Pros
 The “standard" visa accepted by all U.S. institutions
 Easily obtained prior to res...
For Quebecers
The Decrèt determines whether or not you will
be able to get a Statement of Need
States which disciplines ar...
Match 2010
Priority Recruitment Disciplines:
 Médecine familiale
 􀂃 Médecine interne
 􀂃 Chirurgie générale
 􀂃 Chirurgi...
Other Canadians
For a Statement of Need,
you are subject to the provincial manpower
regulations of your home province
In g...
Internationals…
For a Statement of Need:
You need to apply to the
Health Ministry
in your
home country
(last place of lega...
Things to consider…
Reciprocity of Training
Verify ACGME accreditation for programs of
interest
http://www.acgme.org/adspu...
McGill students consistently match to a variety of
competitive programs in the U.S.
McGill students are equivalent to “U.S...
McGill in the US
Class 2010
Massachusetts General Hospital
Internal Medicine
Vanderbilt University Medical Center
Internal...
McGill in the US
Previous years
Sinai Hospital (Maryland)
Obs/Gyn
Yale University
Anesthesia
Diagnostic Radiology
New Engl...
Residency Position Types
Categorical Position
Includes all necessary years of training to be
certified in the U.S. in that...
Preliminary Position
Must be completed before you start training in an
advanced specialty
Usually surgery or internal medi...
Be Careful…
Do not take your prelim/transitional year for granted
If you match to a PGY-2, you are not automatically
given...
US Matches
FREIDA
Database of all US residency programs
Searchable by discipline and/or location
www.ama-assn.org/ama/pub/...
ERAS/NRMP
ERAS = match application agency
www.aamc.org/students/eras/start.htm
Request ERAS access token from CaRMS in
lat...
Unlike CaRMS, programs have access to
your data as soon as you assign it to them
The earlier the better!
ERAS/NRMP
ERAS/NRMP
NRMP = actual matching agency
www.nrmp.org
Must register with both ERAS and NRMP
NRMP registration opens August ...
SF Match-Early!
www.sfmatch.org
Registration/Application begins in June
Each specialty has its own timetable
Often only ma...
Urology runs its own
separate match in the U.S.
www.auanet.org/residents/resmatch.cfm
Since applicants to this are limited...
Timeline
Depends on:
Matching system(s) of choice
Individual Programs
 Deadlines may differ from that of the matching sys...
How many programs should I apply to?
Largely dependent on you, your finances, and your
level of comfort with risk
2004 ERA...
Applying to the US
How many programs should I rank?
Dependent upon:
Interview experiences
Level of comfort with risk
2007 ...
You and the USMLE
Average Step 1 scores for NRMP disciplines
www.nrmp.org
 Under “Data and Reports”, click “Charting Outc...
Dean’s Letter (MSPR)
McGill follows AAMC guidelines
Not a letter of recommendation
More like an elaborate transcript
Every...
MSPR Review
In September
– Specific dates TBA via class e-mail
Sample MSPRs can be viewed in the Career Advising Office. N...
McGill’s MSPR
Includes only faculty-related
awards/activities
 Faculty scholarships and research
carried out through the...
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 lis...
SF Match/ AUA
Hopefully, you have applied to a second choice
discipline that you can have as a runner-up through
the NRMP
...
NRMP
List of unfilled positions released for
 The Dean’s Office provides you with facilities to
“scramble” in and persona...
Take a year off to do research,
humanitarian work, etc.
Pros:
 Potential publications, additional references, reflection...
And so…
We’ve given you a lot of information, and the process
may seem overwhelming, but the bottom line is this:
McGill s...
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Decret and US Match - McGill University

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Decret and US Match - McGill University

  1. 1. Residency South of the Border Dr. Namta Gupta, CCFP FCFP May 19, 2010
  2. 2. Overview The QC Decrèt  Visa options McGill in the U.S.  Residency position types U.S. Matches  ERAS/NRMP  SF Match/AUA
  3. 3. 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
  4. 4. 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 The Qc Decrèt
  5. 5. 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 The Qc Decrèt
  6. 6. 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
  7. 7. Visa Options H-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
  8. 8. For Quebecers The 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
  9. 9. 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
  10. 10. 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
  11. 11. 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
  12. 12. 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
  13. 13. 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 U.S.
  14. 14. 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
  15. 15. 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…
  16. 16. 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
  17. 17. 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 PGY-1 Residency Positions
  18. 18. 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
  19. 19. 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
  20. 20. 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
  21. 21. Unlike CaRMS, programs have access to your data as soon as you assign it to them The earlier the better! ERAS/NRMP
  22. 22. ERAS/NRMP NRMP = actual matching agency www.nrmp.org Must register with both ERAS and NRMP NRMP registration opens August 15, 2010 Rank order lists submitted to NRMP by February 23, 2011
  23. 23. 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
  24. 24. 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
  25. 25. 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
  26. 26. 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
  27. 27. 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 each competitive 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
  28. 28. 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!
  29. 29. Dean’s Letter (MSPR) McGill follows AAMC guidelines Not a 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
  30. 30. 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)
  31. 31. McGill’s MSPR 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 VS. Dean’s Letter (MSPR) U.S. MSPR  Includes elaborate section on unique attributes, abilities, and extra-curricular activities  Provides overall class ranking for each student **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
  32. 32. What happens if you don’t match… Don’t Panic… We will be here to support and assist you if you go unmatched
  33. 33. 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
  34. 34. 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…
  35. 35. 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 What happens if you don’t match…
  36. 36. 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 What happens if you don’t match…
  37. 37. 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

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