Selecting IMGs for residency programs: Myths and · PDF fileSelecting IMGs for residency...

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Selecting IMGs for residency programs: Myths and shibboleths

Ms. Sandra Banner, Executive Director/CEO, CaRMS

Dr. Ian Bowmer, Executive Director, Medical Council of Canada

October 24, 2014

Je n’ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d’appareils médicaux ou un cabinet de communication.

I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization.

Ms. Sandra Banner, Executive Director/CEO, CaRMS

Dr. Ian Bowmer, Executive Director, Medical Council of Canada

October 24, 2014

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The International Conference on Residency Education | La conférence internationale sur la formation des résidents

Definition of an IMG

• An international medical graduate (IMG) is a student who has graduated, or will graduate, from a medical school that is not accredited by the CACMS/LCME. This term does not refer to citizenship or place of birth and is only an educational reference.

• Graduates of osteopathy schools in the US are considered IMGs.

Selecting IMGs for residency programs: Myths and shibboleths | Ms. Sandra Banner and Dr. Ian Bowmer

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Canadian graduates and available quota for R-1, 2002-2014


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500

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3500

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014Specialty positions Family Medicine positions # current year graduates

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IMGs in the match 2008-2014


Year # of active applicants # who submitted a rank order list

# matched

2014 2,888 2,318 449

2013 2,962 2,329 499

2012 2,330 1,818 407

2011 2,232 1,920 380

2010 1,784 1,368 380

2009 1,742 1,387 392

2008 1,581 1,299 353

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+


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FYI: the facts

• 1,193 (45%) of CMGs applied to only one discipline in 2013 match

• 652 or 55% of CMGs that applied to one discipline applied to only Family Medicine

• 968 (35%) of IMGs applied to only one discipline in the 2013 match

• 657 or 68% of IMGs that applied to one discipline applied to only Family Medicine

• IMGs applied to an average of 17 programs in 2.7 disciplines


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Matched international medical graduates 2013 - MCC examination status

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50

100

150

200

250

Passed MCCEE Passed MCCEE& QE1

PassedMCCEE, QE1 &

QE2

Passed NAC3OSCE

250IMGs

161IMGs

88IMGs

144IMGs

499 matched


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IMG match results by region of graduation in 2013

0% 20% 40% 60% 80% 100%

South America

Oceania/Pacific Islands

North America

Middle East

Europe

Central…

Asia

Africa

Matched


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Definition of a Canadian studying abroad (CSA)

• Canadian citizen/landed immigrant• Final year medical student• Canadian citizen or landed immigrant who had

undergraduate education in Canada• Canadian citizen or landed immigrant and obtained M.D.

from pre-defined CSA schools


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IMGs in the 2015 R-1 match


IMGs CSAs

Number of new applicants 331 472

Number of returning applicants 681 361

TOTAL 1,012 833

Numbers of international medical schools

438 145

Numbers of countries 102 62

Preliminary 2015 data: last updated October 17, 2014

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INDIA

AUSTRALIA

GHANA

SENEGAL

REPUBLIC OF KOREA

SAINT MAARTEN

ANTIGUA & BARBUDA

NETHERLANDS ANTILLES CAYMAN ISLANDS

ARUBA

BELIZE

DOMINICA

GRENADA

DOMINICAN REPUBLIC

ANGUILLA

SAINT LUCIA

TRINIDAD & TOBAGO

SAINT EUSTATIUS

BONAIRE

SABA

FRANCE

CZECH REPUBLIC

BAHRAIN

POLAND

ISRAEL

AUSTRIA

GERMANY

HUNGARYROMANIA

UNITEDKINGDOMIRELAND

SLOVAKIA

MEXICO

COOKISLANDS

IRAN

EGYPT


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Canadians studying medicine abroad (CSAs)


Number of CSA registrants

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1000

2008 2009 2010 2011 2012 2013 2014

New CSAs

ReturningCSAs


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Number of immigrant registrants 2009 – 2014 R-1 match

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400

600

800

1000

1200

1400

1600

1800

2000

2009 2010 2011 2012 2013 2014

722 772826

666 791

575

NewImmigrants

Returningimmigrants


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Matched vs. unmatched CSA/IMG scores on MCC exams EE QE1 and QE2 in 2013


CSA IMGMatched Unmatched Matched Unmatched

# Score # Score # Score # Score

MCCEE 218 368 353 326 32 343 385 311

MCCQEI 38 487 93 455 123 481 548 453

MCCQEII 2 524 6 484 86 506 332 489

NAC3 19 77 32 71 125 78 426 78

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Annual R-1 match results for CSAs and immigrant IMGs 2009 – 2014


CSA ImmigrantTOTAL

Matched Unmatched Total Matched Unmatched Total

2014 287 624 911 162 1,245 1407 2318

2013 258 518 776 241 1,312 1,553 2,329

2012 244 503 747 163 908 1,071 1,818

2011 182 291 473 198 1,249 1,447 1,920

2010 183 194 377 197 1,223 1,420 1,797

2009 136 171 307 256 1,090 1,346 1,653

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Matched location and elective location

• Of the CSAs that did at least one clinical elective and were matched:

• Same province • 54.6% did at least one elective in the same province as

where they matched• 45.4% did not do any elective in the same province as

where they matched


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Matched location and elective location

• Same university• 32.2% did at least one elective in the same university as

where they matched• 67.8% did not do any elective in the same university as

where they matched

• Same discipline• 47% did at least one elective in the same discipline as

where they matched• 53% did not do any elective in the same discipline as

where they matched


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CaRMS Online application


This page displays the following:

» Applicant name

» CaRMS ID

» Medical school: name, graduation date, accreditation type

» Citizenship status

» Current Canadian medical licensure

» Clinical practice: institution, start/end date

» Fellowship: discipline, institution, start/end dates

» Residency training: discipline, institution, current residency status, start/end dates

» MCC examinations: MCCEE, MCCQE1, MCCQE2

» NAC OSCE

» Snapshot of application status: required documents, application process

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Clinical practice experience

For the purposes of the CaRMS application, clinical practice experience is defined as actively practicing medicine as the physician of care, with an independent license without supervision. This may include paid or unpaid work.

» Country» Name of practice/institution» Primary language used when communicating with

patients» Start/end dates, or ongoing» Description


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Declaration

The declaration page contains questions on licensure to practice medicine and must be

completed in order to apply to programs.

» In order to begin postgraduate residency training, the applicant must obtain an

educational license/certificate from the medical Regulatory Authority (MRA) within

the province to which they have been matched. If they are unable to obtain an

educational license/certificate, their match will no longer be binding. The MRA will

require them to answer the following types of questions:

a. Have you ever been convicted of a criminal offence or have criminal charges

pending in Canada and/or elsewhere?

b. Have you ever been formally investigated or subject to formal disciplinary action by

another health regulatory body in Canada and/or elsewhere?

c. Do you have a health condition that may pose a risk of harm to a patient including

but not limited to: mental health conditions; physical health conditions; or blood-

borne infections?

d. Do you possess the essential skills and abilities required for the program to which

you have been matched?


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Declaration

The declaration page also contains the following questions:

» Has there ever been any disciplinary findings of guilt made against you by a medical (or any professional) authority?

» Have you ever been found unfit to practice medicine or had restrictions placed upon your practice for cause by a medical regulatory authority?

» Have you ever been found guilty of academic misconduct by a postsecondary institution?

» Have you ever been disciplined or the subject of sanctions by a professional body responsible for evaluation or certification?

» Do you currently have a Return of Service (ROS) obligation relating to previous or current postgraduate residency training that limits your ability to accept a new residency position?

» Specify the date on which you last practices medicine in a clinical setting.


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Declaration

The declaration page also contains the following statement, to which the applicant

must choose to agree or disagree:

» I understand and agree that the Canadian Resident Matching Service (CaRMS) will collect, use and disclose the information provided in this application for the purposes of verifying credentials and attempting to match applicants with the residency programs of their choice. I specifically acknowledge and agree that this information will be distributed to the programs I designate and may be used for the purpose of selecting candidates for postgraduate residency training. I understand that CaRMS’ collection, use and disclosure of personal information shall only be done in accordance with the applicable applicant contract and CaRMS’ Privacy Policy, a copy of which is available on the CaRMS website. I have provided all information about my previous medical education, training and/or examinations to allow full assessment of my application. Any information that is falsified or deliberately inaccurate will be considered as grounds for immediate removal from the match process and a breach of this contract, rendering any match null and void.


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Medical Council of Canada examinations


MCC acknowledgment:• I authorize CaRMS to provide the Medical Council of Canada (MCC) with my

name, CaRMS ID, date of birth, MCC candidate code and LMCC number (if applicable) for the purposes of retrieving my MCC examination results from the MCC.

• Once I have shared my most recent results with CaRMS on the physiciansapply.ca “Examination Results and Document Sharing” page, the MCC will send CaRMS the standing, date and total score for the shared MCC examinations (e.g. MCCEE, MCCQE part I, MCCQE Part II, CSC-FM, NAC), regardless of whether or not I was successful at the examination; and/or information regarding my shared pending MCC examination(s). CaRMS will update my application with the information received from the MCC, including MINC and LMCC numbers, if applicable.

• I acknowledge that the score and standing for any examination I have shared, for which I am awaiting results, will be posted in my CaRMS Online examination section when available. Each MCC examination result will remain permanently in CaRMS Online unless an updated standing is retrieved from the MCC.

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Medical Council of Canada examinations


Sharing consent:• If you choose not to share your results, programs will see that the

examination has been taken but that you elected not to share the results. No score or standing will be attached. Your authorization to share or not share your results cannot be changed once file review opens or between first and second iteration.

• If you have taken this exam more than once, only the most recent examination will show to programs. This includes examinations with future dates, which will show to programs unless it is found that that examination was not taken. Examinations with future dates will be identified as “MCC Confirmation Pending” until they are taken; if the pending examination is a retake, it will be identified as such.

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2014 IMG match results by IELTS score > 6


Status# w/ IELTS

# IELTS > 6

%

CSA Matched 4 3 75%

CSA Unmatched 25 24 96%

IMG Matched 27 25 93%

IMG Unmatched 325 312 96%

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2014 IMG match results by TOEFL score > 92


Status# w/

TOEFL# TOEFL >

92%

CSA Matched 10 9 90%

CSA Unmatched 44 41 93%

IMG Matched 92 92 100%

IMG Unmatched 593 559 94%

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IMG MCC exams 2014


0100200300400500600700 0 100 200 300 400 500 600 700

PASSED EE + QE1

PASSED EE + QE1 + QE2

PASSED NAC

PASSED EE

Imm CSA

Unmatched Matched

# Applicants

68% 32%7% 93%

69% 31%13% 87%

81%,19%14% 86%

15% 85% 61% 39%

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2014 IMG match results by average NAC score


Status # w/ NAC NAC average

CSA Matched 63 78.9

CSA Unmatched 99 72.8

IMG Matched 112 85.0

IMG Unmatched 620 75.5

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Immigrants* by region of graduation


Region of graduation# final

participants # matched % matchedAfrica 338 38 11%Asia 441 33 7%Central America/Caribbean 51 12 24%Europe 206 31 15%Middle East 299 29 10%North America 6 2 33%Oceania/Pacific Islands 2 2 100%South America 64 15 23%TOTAL 1407 162 12%

* All IMGs except CSAs

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CSAs by region of graduation


Region of graduation

# final participants # matched % matched

Africa 20 2 10%Asia 21 2 10%Central America/Caribbean 477 119 25%Europe 272 115 42%Middle East 34 7 21%North America 3 1 33%Oceania/Pacific Islands 79 40 51%South America 5 1 20%TOTAL 911 287 32%

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Match results of Canadians studying abroad 2008-2014 R-1 match


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1,000

2008 2009 2010 2011 2012 2013 2014

# Final CSA participants # CSA matched

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Annual match results for CSAs and immigrants 2010-2014


CSAs ImmigrantsTOTAL

Matched Unmatched Total Matched Unmatched Total

2014 287 624 911 162 1,245 1,407 2,318

2013 258 518 776 241 1,312 1,553 2,309

2012 231 516 747 176 1,233 1,409 2,156

2011 183 302 485 197 1,238 1,435 1,920

2010 183 194 377 197 1,223 1,420 1,797

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Selecting IMGs for residency programs: Myths and · PDF fileSelecting IMGs for residency...

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