Medical Council of Canada

Selecting IMGs for Residency Programs: Myths and Shibboleths

September 23, 2011
Sandra Banner CaRMS Ian Bowmer Andre-Philippe Boulais Natalie Auger Medical Council of Canada

Definition of 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.

Canadian Graduates and Available Quota for R-1

3500 3000 2500 2000 1500 1000 500 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Specialty Positions

Family Medicine Positions

# Current Year Graduates

IMGs in the Match 2007-2011

Year # of Active Applicants # Who Submitted a Rank Order List # Matched

2011 2010 2009 2008 2007

2,232 1,784 1,742 1,581 1,749

1,920 1,368 1,387 1,299 1,486

380 380 392 353 298

Type of Positions IMGs Matched to in 2010 by Province

Open / Competitive
Newfoundland Nova Scotia Quebec Ontario Manitoba Saskatchewan Alberta British Columbia Total

Open only to Preauthorized Applicants

-

Dedicated IMG Positions 8 11

-

Total 14 12 41 217 32 32 2 30 380

6 1
-

41
-

42 32 28
-

175
-

4
-

2 18 61

12 121

198

FYI: 43 % of IMGs applied to only one discipline in the 2011 match.

Matched International Medical Graduates in 2011 - MCC Examination Status

380 Matched
200 150 100 50 0
Passed MCCEE Passed MCCEE & QE1 Passed MCCEE, QE1 & QE2

184 IMGs

190 IMGs

69 IMGs

IMGs Match Results by Region of Graduation in 2011

Africa Asia Central America/Caribbean Europe Middle East North America Oceania/Pacific Islands South America 0% 20% 40% 60% 80% 100% Matched Unmatched

Matched IMGs by Year of Graduation in 2011

380 IMGs Matched
30% 25% 20% 15% 10% 5% 0%

18% 5% Before 1990 1990 to 1999

26%

23%

29%

2000 to 2008

2009 or 2010

2011

Definition of Canadian Studying Abroad (CSA)

Canadian citizen/landed immigrant Final year medical student, or Canadian citizen or landed immigrant who had undergraduate education in Canada or Canadian citizen or landed immigrant + obtained M.D. from pre-defined CSA schools

IMGs in the 2012 Match

IMGs
Current registration 2,100 including CSA 1,000 have been in previous matches

CSAs
820, of which 600 have not been in Canadian match 159 different medical schools in 40 countries around the world

IRAN
NETHERLANDS ANTILLES

AUSTRALIA SAINT LUCIA

POLAND
GRENADA
REPUBLIC OF KOREA

CAYMAN ISLANDS
AUSTRIA
GHANA

EGYPT
SAINT KITTS & NEVIS

LITHUANIA

ANGUILLA SABA SENEGAL

BAHRAIN

INDIA

SLOVAKIA
HUNGARY SINT MAARTEN
IRELAND

ANTIGUA & BARBUDA

ROMANIA

NETHERLANDS
DOMINICAN REPUBLIC

MEXICO

SINT EUSTATIUS

BELIZE
ISRAEL

DOMINICA GERMANY

COOK ISLANDS BONAIRE

ARUBA

FRANCE

CZECH REPUBLIC

UNITED KINGDOM

TRINIDAD & TOBAGO

Number of CSA Registrants

900 800 700 600 500 400 300 200 100 0 2008 2009 2010 2011 2012 New CSAs Returning CSAs

Number of Immigrant Registrants 2008 2012 R-1 Match

2000 1800 1600 1400 1200 1000 800 600 400 200 0

826 752 722 772 697 New Immigrants Returning Immigrants

2008

2009

2010

2011

2012

Matched vs. Unmatched CSA/IMG Scores on MCC Exams EE QE1 and QE2 in 2011
CSA
Matched
# Score

IMG
Matched
# Score 198 172 69

Unmatched
# Score 334 75 6 316 443 485

Unmatched
# Score 329 448 481

MCCEE MCCQEI MCCQEII

182 18

343 450

337 1,917 462 1,190 499 398

Annual Match Results for CSAs & Immigrants 2008 2011

CSA
Matched Unmatched Total

Immigrant
Total Matched Unmatched Total

2011 2010 2009 2008

182 183 136 95

291 194 171 86

473 377 307 181

198 197 256 258

1,249 1,223 1,090 1,104

1,447 1,920 1,420 1,797 1,346 1,653 1,362 1,543

Clinical Electives & Matching

84.2% 57.7% 42.3% 15.8%

At least 1 Elective No Elective

Matched n = 183

Unmatched n = 194

Average Number of Clinical Electives & Matching

2.10 1.38 Matched Unmatched

n = 377

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 1 elective in the same province as where they matched 45.4% did not do any elective in the same province as where they matched Same University 32.2% did at least 1 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 47.0% did at least 1 elective in the same discipline as where they matched 53.0% did not do any elective in the same discipline as where they matched

SAMPLE National Assessment Collaboration (NAC) Examination Statement of Results 19 March 2011
Candidate name: MCC candidate code: Examination session: Your final standing: Required score to pass: 65 Your total score: 74

March 2011 Pass

SAMPLE NAC Score Profile

Low Performance Borderline Performance High Performance

Communication Skills Data Interpretation Differential Diagnosis History Taking Investigations Language Fluency Management Organization Physical Examination Therapeutics

SAMPLE NAC Supplemental Feedback Report

The following information is for the stations in which your performance was rated as being below the level expected of a graduating student from a Canadian medical school. The system (e.g. respiratory, gastrointestinal), the discipline (e.g. Medicine, Psychiatry), and the major objective with its reference code for each station to which you had a low score are listed below. The major objective reference code is from the third edition of the MCCs Objectives for the Qualifying Examination, now available online at the MCC website (http://www.mcc.ca/Objectives_Online). Discipline Surgery Obstetrics & Gynaecology Therapeutic System Multi-System Reproductive Health Not applicable Major Objective 109-4 Trauma/Chest Injuries 113 Vaginal Discharge/ Vulvar Itch/STD Therapeutic

SAMPLE NAC OSCE

The Exercise Using the Reports in Selection of Applicants to Residency

MCCEE Interpreting the score Interpreting the report NAC OSCE Interpreting the score Interpreting the report