Exams, Electives

&
The Match
1.Exams
2.Electives
3.Applying for residency
4.Interviews
5.The Match
6.Paperwork
7.Timeline
What We Will Cover:
Great Guide
Exams

Exams

Eeek! The Exams!
EXAMS
USA:
Step 1 :
Should be done by beginning of 3
rd

year - need it for electives

Step 2 = CK & CS
To do in 4
th
yr
Should have for Eras Application

Step 3 :
Cant do until after you graduate
If take a year(s) off after 4
th
yr
recommended to take it before
applying
Exams
CANADA:
MCCEE:
To do in 4th year (sept!)
All Canadians who want to go to N.America need to take it

MCCQE1:
Only offered in May & Oct
Only offered in canada
Can do it in 4
th
yr but must apply before you find out if you
match & NO refund!
Most ppl OK to take it in PGY-1

MCCQE2:
Take during PGY2+ yr
Exams USA: Step 2 =CK & CS
CK - Clinical knowledge (computer based MCQ)
Format is similar to Step 1 but longer, unique Q types
9 hrs for 325 Q (8 blocks + 1hr break)
Passing score now 189
Just as hard as step 1 but ppl tend to do better
mean ~ 230, SD 30
Material similar to shelf exams from 3
rd
year
In general more used to standardized tests so
less anxiety associated with it

**USMLEworld Q bank **
First Aid not as great as for Step 1
but still very useful
Kaplan Q bank online & textbook
Kaplan videos
Toronto notes
Exams USA: When to take CK?
Sign up via ECFMG just like Step 1
Better to apply early to a location/region you think youll be in and then
can try and switch it after
Can be stressful since you may not know where youll be in September
until July but just stay positive, it all works out!

Beneficial to have done it and have score back as early as
possible after your 3rd year BUT important to balance
with your elective schedule and study time!!

Keep in mind that the score report can take 3-6wks to be
uploaded on your ERAS application
The earlier the score the more information the program has on you the
better
Most ppl didnt get interview offers until CK mark is received by programs

Most ppl wrote it sometime during July August
September
Canadians consider writing MCCEE might benefit from writing
the CK around the same time as the EE (i.e. September)
Exams USA: Step 2 = CK & CS
CS Clinical Skills (OSCE style practical)
12 stations each with a different patient actor

15 min in each room to do a H&PE then 10 min
to write up a note on the computer

Only your best 10 stations count towards your
mark

Only Pass/Fail

First Aid for CS is plenty easy to get flustered
so best to have a systematic approach you are
comfortable with
Once it comes time for this exam most ppl have more
experience in American hospitals so a lot more comfortable
with H&PE & writing up a note
If can find a partner to practice with www.usmleworld.com
has scenarios you can purchase which can be helpful if you
have someone to do them with
Exams USA: When to take CS?
APPLY EARLY!!!
Only offered in Chicago, Atlanta, Houston, Philadelphia &
LA
Better to apply in an area you think youll be in & switch it later
if it doesnt work; spots fill up quickly!!
You will most likely have to travel from your electives


Its really an easy exam but can be stressful and
weigh on you so just do it quickly and get it out of
the way!!
Takes longer to get score result 6weeks
Not as crucial as CK result BUT programs still look for 100%
completion (ie all score results & LOR & documents) before
offering interviews) do it as early as you can
Around September/October things quiet down so many ppl took it
then
Doctors are understanding if you have to take a few days off but helpful if
you get a wknd; if doing a letter elective dont want to take too much time
off
Book it with a friend & make a weekend trip out of it!
Exams USA: When to take CS?
2012 CS Schedule of Reporting
Results
Need result in before Rank List Deadline


Testing Pd Reporting Start Reporting End
March 25-May 19 June 20 July 18
June 17- Aug 25 Oct 3 Oct 31!!!!
Aug 26 - Nov 3 Dec 5 Jan 2
Nov 4 - Dec 31 Jan 3 Feb 20
CS example:
You will face a closed door that has a short one liner introducing the scenario
You have 1 min before the buzzer lets you know that you may enter the room.
The note will still be there when you leave the room to type your note.
Mr. Smith is a 65y/o male that is complaining of shortness of breath.
HR: 14 RR: 19 BP: 130/90 Temp: 37 degrees

Once allowed to enter, knock, introduce yourself, use the patients name, shake their
hand, SMILE and make eye contact! Drape them with the blanket appropriately and
wash your hands before doing a physical!
Hello Mr. Smith, I am Dr. Nick Riviera & Ill be looking after you today and would just like to ask you
some questions and then perform a physical, is that alright? ( whatever!)

Complete your H&PE & explain to the patient what you think Is going on & the plan of
action
Remember to counsel on topics like smoking, alcohol, safe sex for teens etc First Aid explains this well
If you finish the H&PE early you may leave the room early and start on your patient note
Say thank you, show concern & emotion & to ask if they have any questions before you leave

A lot of the exam is testing your patient interaction/communication skills so dont get
flustered if you forgot to ask questions or perform key PE tests you will still most likely
pass
First Aid is good at showing you what patient note should look like 5ddx, 5 tests to order
Some curveballs : patient may be on phone; only the parent will come in angry parents,
frustrated patients, overly anxious patients etc again, testing patient interaction skills
Exams Canada: MCCEE
Medical Council of Canada Evaluating Exam
The ONLY MANDATORY exam needed to apply to CaRMS
If you are Canadian & want to apply only to ERAS you still MUST take this
exam (needed for J1 visa)

Only IMGs take this exam
Cost: $1550 $1300 exam fee + $250 application fee
4 hr 180 MCQ
No blocks, you get to decide when to take breaks within that time
Similar to CK study material many ppl found it easier
Consider scheduling your CK & EE around same time if writing both
www.canadaqbank.com - good additional Q bank with more Canadian Qs

Only offered Jan, March, May, September & November but basically can
only write it in September
Must be in final clinical year
Schedule done via Prometrics offered in Canada, US & Europe


APPLY EARLY!! LONG process, better to get a spot and change it later
Exams Canada: How to Apply EE
Apply via PCRC (Physicians Credentials Registry of Canada), then apply to MCC, then can schedule
with Prometrics (same ppl you schedule with for the Steps)

EE application steps:
http://www.mcc.ca/en/exams/ee/EeExamWizard/FirstTimeStudentApplicationSteps.shtml

Must registar via PCRC (www.pcrc.org)
Documents must be copied, certified and translated
Website may be a little unclear but staff very helpful so just call and ask to clarify

Once you have been approved via PCRC - can create account with MCC-Online and apply for MCCEE
https://www.mcc.ca/MCConline/loginpage.aspx
You fill out the online application form
You will need to pay the $250 application fee at this time online via Mastercard/Visa
After submitted you will have to print the application form and send the paper version along with the
following papers. You have 10 days after making your payment to send the paper version in.
CIC = certified identity confirmation form
Need 2x COLOUR 50mmx70mm
CERTIFED*
Three Student Forms: Send originals (do NOT need to be certified)
Attestation in Support of Application signed by school office
Attestation regarding schedule of final year clinical experience signed by school office
Student declaration signed by you only
Once approved via MCCEE can go via Prometrics to schedule





Your Comprehensive
Electives Guide!
Electives Across the Globe

Canadian programs expect you to apply ridiculously
early; limited and hard to get but possible
USA electives more flexible & more in numbers each
program different & has different system for organizing
electives - doesnt make your life any easier
UK electives is a good option, esp. if thinking about the
Foundation Program
Poland a good option to do some of your not so
favorite subjects (remember the wonderful hours for
surgery & obs/gyn?)
South Africa, Switzerland, France, Norway, Nepal
ppl have done international electives in the past




Be organized, Be patient, Everything will work out!
Canadians dont be afraid of American electives you can get
strong letters and great experience it aint so bad!


Electives Things to Consider
1. What discipline do you want to go into??
Do the specialties that you want to apply to early in the
year to get letters
If you are in North America, try to get all your LOR from N.
American doctors. Most programs directors considers those
more highly than European letters

2. How much traveling do you want to do?
Most schools have 3 month limit for one student
Different location each month:
great experience, see a lot of different working environments so have
a good idea about different residency programs but can be tiring and
very very $$$$$, harder to coordinate everything

3. Dont be afraid to call/email
the coordinators!!

4. Not all schools allow international graduates to do electives
- https://services.aamc.org/eec/students/
Check on medical school website, do your research! (ie. Queens U)

5. Most ppl matched to programs where they didnt do an elective
Although its common in the States to land an interview if you do an elective in
the specialty that you apply to
Some schools will give you an interview automatically if you have done an
elective there (Internal at UWO in Ontario)

6. For residency, places generally require or prefer 4 or 6 months
of N. American experience
the more months of electives you do in the States and Canada, the more
doors you leave open
if you can, start your electives in July

7. NY STATE LICENCING BOARD:
IMGs are limited to 3mnths of electives outside of their home university
a rule of the LICENSING BOARD, NOT the residency;
(ie you may still get interview invitations but if your residency program
gets audited you have the risk that the NY State may give you trouble)
Electives Things to Consider
Electives Things to Consider
8. Each program has a slightly different application process
U of T allows you to Apply to be considered for an elective in
August. Make sure you do this right at 9am when the
website opens. Very difficult to arrange these electives.
Email Sheila Binns if you have a preceptor

9. In general American schools do 4wk blocks BUT not
necessarily the same starting and ending 4 wks!
So be careful not to overlap your end & start dates!
Rochester is more accommodating with 2w dates

10. Possible to do 2wk blocks in Canada

11. Subinternships! great if you can get one in the faculty
that you want to apply to
LOTS responsibility so dont do in specialty that you hate
mostly offered in Fam med, but also internal & peds
12. Rochester & California via School Office

Rochester: Dr. J picks top ppl after Neuro course (12-15),
interviews you and lets you know sometime in June whether you
are picked then you work with the Rochester Coordinator to set
up which month you get
Dont necessarily bank on getting it good to have back up!
Goes down the list of top students of who gets preference for
dates & subjects (but not really)
Limited selection of electives

California send in CV, ref letter & interview with Dr. Laidler
dont tell you till fairly late if you get a spot and then still have to
work with individual schools to organize
In general good for your later months for your less favorite
subjects
Get to go back to cali!

Electives What you need
4 weeks Internal Medicine
4 weeks Peds
3 weeks Family Medicine
3 weeks Surgery
2 weeks Obs/Gyn
4 weeks of your choice

**looks good to do one in the discipline that you
want to apply to (ex. Emerg, PM&R)**

- This is minimum! Many ppl often go over, remember that some programs
have 6mnth min experience required for IMGs
- Also, check beforehand that UJ will accept the elective as credit toward
the specialty you want it for (e.g. UJ accepts Peds Surg as Peds credit,
and Hospice as IM even if the university you are visiting offers the
electives through Surg or Fam Med.)

Electives Where to start???
Your first 2-3 months are most important focus on those first!!
Pick a specialty for a month and apply to multiple places
for each month its the easiest way to simplify the process
Example:
July: 2w Family Medicine UWO
August: 2w CTU Ottawa, 3 wks Nephro UWO
Wrote CK
September: 2 wks Family medicine McMaster, 2wks CTU McMaster
Wrote MCCEE
October: 2wk Peds Endo and 2wk FM outpatient Rochester
Applied to American residencies
Took CS
November: 2wk FM inpatient, 2 wk Peds Cardio Rochester
December: 3 wks Gen Surgery UWO
Deadline for Canadian applications
January: 2 wk Ob/Gyn and 2wk Emerg U of Toronto

Electives Itll all work out!


Only ONE example, lots of variation of how
to complete your time!!

Many factors play into it! Most important is
to get enough experience in the first few
months to get your LORs!



Electives Application Package 101
Photo
Personal Statement
CV
Schools Application form (may need to be signed by school
office!)
Letter of good standing from the dean **from school office
Letter of English Proficiency**
Official Transcript **
Immunization form with documentation
USMLE step score 1
HIPPA Certification
Universal Precautions Certificate aka Blood born pathogens (?)
Personal health Care Coverage
Malpractice Insurance coverage **
Photocopy of Passport
2 Recommendation Letters
Payment if applicable
Elective Application Package 101
Photo : each school will have different dimension that they want
My favourite guy is on the corner of Starowislna & Dietla you can get one
good photo of you done and put it on a USB, thereafter he can print it off for
1zl in any dimension

Personal Statement: brief one page blurb of why you want to go to that school to
do that elective, any relevant experience in that discipline, what you hope to gain
etc etc - if they ask any specific questions on their website make sure to answer!
This is usually not required of Canadian electives

CV

Schools application form: this varies, often needs to be signed by the Dean

Letter of Good standing ask for multiple copies from School Office

Letter of English Proficiency ask for multiple copies from School Office

Official Transcript ask for multiple copies from School Office
Electives Application Package 101
Immunization form: Probably the most annoying part!
Extensive list of what you need (not all schools require all so if you are missing one of the
following check the schools that you want to apply to first before starting your scavenger hunt
for documentation!)
Best is to get all these done at home over the summer or at Christmas break
Titers can be drawn at: Laboratoria Medyczne, Plac Szczepanski 3 (near Scandale Royal up one
level)
Shots at Jana Pawla Complex, building in direction of Thoracic surgery subspecialties, follow the
yellow smiley faces once you get there
To translate its sufficient to write in English next to it before you make all your photocopies
*** start early takes a while after you draw your blood to actually receive your titers, if
they are low you have to go to get the shot, then you cant draw your titres for a few
weeks after, then have to re-wait to get your results can turn into a long time!***
HepB primary series: *bring from home; if not - titres will work usually
HepB titres/serology (Wirusowe zapalenie wtroby typu B)
HepA & Menigicoccal (often optional)
Varicella titres (Ospa)
Primary Series TdP, Polio, MMR
Td/Polio Booster, MMR booster (Measles Odra; Mumps = Swinka; rubella =Ryczka)
TB skin test can get done and read at Skawinska (at the registration window down the far left
hallway 50zl not open on wknds) (TB = Gruzlica)
If positive can get X-ray done in Rynek Glowny 37 (near Tatuum store) bring your passport
number and the guy should be able to provide documentation in English


Elective Application Package 101
USMLE Score report photocopy your results
HIPPA: Do the short test online and print & photocopy the certificate
http://www.hipaastore.com/Products.asp
Universal Precautions: Do short test online and print & photocopy the certificate
https://www.redcrossonlinetraining.org/Distance/Default.aspx?CID=50
Malpractice Insurance:
Current 3
rd
years had to find their own insurance for next year. At least $1000 for 6
months, but can cost over $3000. Some leads:
1/3 Million US Policy: Peter Leone, Academic Health Professionals Insurance
Association. 1250 Broadway Suite 3401. New York, NY 10001
Maybe more flexibility in policy and possibly coverage in Canada: J ay Carter. Carter-
MGM Insurance Agency LLC. 696 Dutchess Turnpike Suite H. Poughkeepsie,
NY 12603. Tel: (845)454-1500 . Fax: (845) 473-1830 . Jay@cartermgm.com
Canadian Coverage: CreeChurch Medical Liability Insurance, or Totten Group
Personal health care coverage: photocopy of OHIP/Carecard (if Canadian), can take out
private insurance via Internet if American
Photocopy of N.American passport
2 reference letters: from Polish professors they use these for your MSPE as well so
worth getting good ones; ask for stamped, signed and sealed in envelopes multiple copies
(10-20). Usually not required for Canadian electives
Payment: bring American/Canadian cheques some need to be certified
Elective Checklist
Short white coat
Stethoscope, penlight
Massachusetts book
Maxwell book
Pharmacopeia/ Ipod Epocrates
www.uptodate.com!!




Where did we do electives?
https://services.aamc.org/eec/students/
(electives arranged outside of these listings were
often thanks to personal contacts)
Electives Canada


Dalhousie (Peds ID, FM inpt/outpt)

McGill University (IM Allergy and Immunology at Montreal
General Hospital)

University of Ottawa (IM CTU, Peds, FM)

Queens University (did not accept visiting international
students)

McMaster University (IM heme onc/general, Peds onc,
FM)

Canada cont.
Northern Ontario School of Medicine (IM cardio, FM
outpt, Surg general) $750 travel stipend and offers
insurance to purchase

University of Saskatchewan (OBGYN in Regina)

British Columbia: need sponsor, go through Royal
College of Physicians (OBGYN, Peds, IM cardio
outpt, FM outpt, Surg - orthopedics )

University of Western Ontario (FM, IM Nephro at
Victoria Hosp, Gen Surg rural)


Electives - US
Brown (Surg neuro)

Case Western University (FM Sub-Internship)

Harvard University ( Surg ENT/neuro, Psychiatry)

University of Illinois at Chicago (Peds ID/neuro, IM
cardio)

University of Illinois at Chicago Rockford (IM
geriatrics, FM rural outpt, Peds GI)

Mayo Clinic: Rochester, Minnesota (Peds NICU, Surg
plastics)


US Cont.
Mayo Clinic: Scotsdale, Arizona (IM heme onc)

Methodist Hospital in Houston, Texas (Surg thoracic)

University of New Mexico (FM outpt homeless health,
contact UJ 2012 grad npokasuwan@gmail.com if interested)

University of North Carolina (Psychiatry AI, IM AI, gen.
IM/consult GI/ID, Neuroradiology, Surg neuro) $2000 per
elective, includes malpractice, excellent student reviews

Northwestern (Peds radio)

Sloan Kettering (GYN Onc, Surg Breast)

University of South Alabama (Emergency Med, Peds
emerg, IM cardio, Surg trauma)

SUNY Upstate (IM heme onc/SI Coronary Care, GYN onc)


US cont.

Tufts (Peds surg, contact Dr. Chwals
wchwals@tuftsmedicalcenter.org if interested)

Tulane University (Anesth, FM dept. but UJ IM
credit - Hospice and Palliative Care, IM Heme
onc, Surg - plastics)

University of Texas HSC San Antonio (IM
med onc, FM - outpt)

Virginia Commonwealth University (IM
nephro)
Richmond Rocks!

US Cont.
Apply first through UJ
University of Rochester (OBGYN outpt, FM
inpt/outpt/rural, Peds
cardio/respirology/endo/neuro/GI/craniofacial
plastic surg, IM endo/neuro/nephro/ID/heme
onc/ICU, Surg ICU/vascular, PMR, Psych
child and adolescent)

UC Irvine (IM ID, Surg vascular, Psych,
Radiology)

UCLA (IM electrophysiology)

UC San Diego (Peds heme onc)

Loma Linda University (FM outpt)

Electives - UK and beyond...
UK (Peds at University of Cambridge)

South Africa (Trauma at Witwaterstrand
University at Johannesburg General Hospital)

Switzerland (Surg neuro at HUG)

Norway (Surg maxillofacial at St. Olavs)
Krakow
All of these are doctor-dependent
but can be relaxed if you want them
to be
Highlights according to 2011 grads
include:
Peds metabolic (mostly DM but
interesting!)
Heme with Dr. Fornagiel
GI with Dr. Zwolinska-Wcislo
Pulm at Skawinska (get treated like
a doctor)
Cardio Surg at JPII (must really
love hearts)

Electives Dos and Don'ts

Always be on time and available

Be courteous to everyone patients, NURSES,
residents and staff

Be EAGER and ASK QUESTIONS!
Med students arent expected to know everything, but
are expected to WANT to learn everything!

Always offer more than they expect
Be the first to come and last to leave! They will notice!
Just don't be overly keen to the point where you are
interfering with the efficiency of the hospital staff


Electives Dos & Donts
Be prepared for criticism
Youre a Student and an IMG

Never complain about being tired

Dont complain about others to anyone
including other med students, nurses,
patients, staff, program coordinators
And ESPECIALLY our School
If you don't see anything positive about CMUJ
then why should they see anything good about
you as an applicant

Try to meet with the program director to
express your interest in the program and to
ask questions


Electives - LORs
Ask for them early on in the elective

Make it VERY clear why you are there
"I am an IMG who needs a STRONG reference
letter to get back into this country for residency
you are one of my 3 referees and I'm counting
on you if you say yes.

If they hesitate as to whether they can give
you a STRONG reference look for
someone else
It's better to have a very strong LOR from
someone less important than to have a weak
one from the Program Director
Electives - LORsThank You!
Get more than the required number of LORs
because not all referees follow through

Get as much face time as possible with your
referees give them something to write about
and show your strengths!

Provide the Referee with:
US: ERAS cover letter & ECFMG cover letter
Canada: CaRMS cover letter (becomes available in
September. Prior to that, you can use Instruction
Sheet for Early References then mail in your
coverletter once it becomes available
Stamped, addressed envelope
CV
An explanation of your goals or your PS

Dont forget Thank You Cards!



US & Canadian Match!
ERAS (and OASIS)
The US Electronic
Residency Application
Service
ERAS and OASIS
OASIS: your Deans Office handles your
documents and forwards them to ERAS
Digital Photograph may need time to
upload
LORs via Electronic Request Forms
and Document Submission Forms
(LORs must be finalized in MyERAS!)
MPSEs (November 1)
ERAS 2012 Timeline

ERAS
MyERAS getting set up: start early
MyERAS opened July 1
st

Need Token from ECFMG

Get core application done early (Personal info)

Work on CV as you do rotations up to D-Day

Add all the rotations you will do and use the
course descriptions to mention this

Add your away rotations under Work
Experience
ERAS
Personal Statements
Start early
Give it its due time
Can upload more than one
Its about you
Dont take it for granted, have it
checked over by more than one person
To mention a school or not in the PS?

ERAS
Submitting USMLE Scores
Two options
Authorize ECFMG to submit scores to
Designated programs, i.e. programs
listed in your application YES
Authorize AUTOMATIC submission of
scores NO
Retransmit Scores in ERAS when
they arrive in OASIS
ERAS
Sep 1
st
Send your Apps!
At least have some sent out and you
can always add more later
Also, you can register for NRMP
Wait for interviews via email.
Wait for interviews
Wait
Oh, wait!
ROL
ROL due in NRMP by Feb (Dont forget to
register!)
Must be ECFMG certified to complete a
ROL
Step 1 and both Step 2 tests
Automatic update through ECFMG
(checks every week)
How to rank? Who did you like? Who
liked you? Dont rank what you dont like.
ERAS Where to Apply to??
Difficult to decide on which programs to actually apply to!
No right way to chose programs do your research!
University based vs community based vs. rural?? fellowship afterwards dont dismiss
smaller community programs great education, can get fellowships, friendlier
environment
Apply to safety schools/programs?? consider the competitiveness of specialty; apply
to a realistic number to secure a good number of interviews
Family commitments?
IMG friendly? www.matcharesident.com can give you a list of programs for a cost $
Canadians make sure programs sponsor J1 visas most will say on website if not
email and ask before wasting $
Look at the roster of current residents are most grad sfrom American school? Are all grads from Tufts,
Harvard, John Hopkins? Will give you a general idea of the competativeness of the program
Number of programs per a specialty
Up to 10 $75 for all 10
11-20 $8 each
21-30 $15 each
31 + $25 each
10 programs = $75
15 = $115
20 = $155
30 = $305
40 =$555
50 = $805
60 = $1055!!!
Supplemental Offer and Acceptance Program
(SOAP)
Replaced the Scramble.
SOAP is a series of "rounds" that commence at 12:00 noon eastern time on Wednesday of Match Week.
Each "round" of SOAP lasts two hours, during which applicants can accept or reject any offers they receive.
If an applicant is determined to be SOAP-eligible AND is unmatched or partially matched, they have access
to the List of Unfilled Programs beginning at 12:00 noon eastern time (Monday) and they are able to apply to
unfilled match-participating programs through ERAS

Schedule of Match Week:
Monday 12:00n Programs will begin receiving SOAP applications and conducting
telephone interviews with eligible applicants

Tuesday 11:30 a.m. Programs begin entering preference lists in R3 System

Wednesday 11:30 a.m. Programs finalize preference lists in R3 System
12:00 p.m. R3 System sends first offers to applicants
2:00 p.m. First offers expire
2:30 p.m. Deadline for programs to update preference lists
2:55 p.m. ERAS updated with applicant/program offers accepted
3:00 p.m. Second round of offers sent
5:00 p.m. Second offers expire

Thursday 9:00 a.m. Third, fourth, and fifth offer rounds
Offers every 3 hours, using same schedule as Wednesday

Friday 9:00 a.m. Sixth, seventh, and eighth offer rounds
12:00 p.m. Match Day Ceremonies
5:00 p.m. Last offers expire
NRMP SOAP
https://www.aamc.org/download/275096/data/erassoapschedule.pdf

1 week, 3 Cycles:

30 program apps max 1
st
cycle (noon EST Mon Wed AM)
10 program apps max 2
nd
cycle (noon EST Wed Thu AM)
5 program apps max 3
rd
cycle (noon EST Thu Fri AM)
All apps carry forward through the cycles.

No additional fees.
Can reapply to programs already applied to.
Can add new LORs and new personal statements.
do this the week before
Cannot change application (so cannot add new electives, etc)

Illegal to contact programs. They must initiate.

The day you use SOAP

Look up the list of unfilled programs on NRMP

Apply on ERAS (programs begin downlading apps
immediately)

Wait for programs to contact you for
interview

Interview + Offer? Accept/Reject
No Interview/Offer?

Rinse and repeat.
Unfilled programs NRMP
Vast majority of spots in the Preliminary tracks
~8 Anesthesiology Categorical
~60 FM Cat
~20 IM Cat
70+ IM Preliminary
~8 Neurology Cat
~2 Obs Gyn Cat
2 Gen Surg Cat
160+ Gen Surg Prelim
~40 Transitional yr spots



CaRMS First Iteration
Carms NOT rolling admission

Milestones are not strict deadlines, but rather way to help you
stay on track

ONE deadline- November 25. All programs get your
application at the same time

Try to send documents to ERAS & Carms at same time ie
get LOR writers to send to both Eras & Carms

More documents need to be physically sent in so allow more
time for uploading

Dont forget about RETURN OF SERVICE
Depends on programs & province keep up to date as it may change!

Carms Timeline
Example of CaRMS Timeline from 2011/2012
August 10: Request online for registration
Sept 2: Program descriptions complete can start to check out
different programs
Sept 6-7- Tokens given out
Sept 7 AWS (Application Webstation) opens
Can start your application
All same general things as with Eras
Oct 12 Program selection opens
Nov 10 Application submission milestones
Nov 16 Program selection milestone; MSPR Arrival due
Nov 18- LOR milestone ***
Nov 23 Document Assignment Milestone
Nov 25 AWS CLOSED EVERYTHING NEEDS TO BE DONE!!
No changes can be made, all programs will receive your application at same
time
December 1- File Review Begins!!!
http://www.carms.ca/eng/r1_1stIteration_e.shtml#milestone

CaRMS 2
nd
Iteration
http://carms.ca/eng/r1_2ndIteration_e.shtml

Opens same week as SOAP, but lasts longer.

Programs do not download apps until review date (Wed
of SOAP).

Only 1 cycle; fewer spots.

Can change application, add LORs and personal
statements.
Will take even more time as programs often want PSs to
be catered specifically to them.

# of apps not limited, but there are additional fees!!$!$
First 4 programs free, then $26.00 per program, this adds
up quickly
Unfilled programs CaRMS
~15 Var Pathology
~65 FM (Mostly rural, +13 BC, +43
French-speaking)
2 Gen Surgery
10 IM (+ 2 in BC, + 26 French-
speaking)
~14 Psych
7 Rad-Onc

And 1-2 spots in Cardio-surg, Radiol,
EM, Lab medicine, Genetics,
Microbio, Neurology, ObsGyn,
Ortho Surgery, Peds, Uro, etc.



CaRMS Second Iteration
Timeline (its very quick!)

December 14- online request for second iteration
opens
March 7
th
List of unfilled positions available &
AWS opens.
- Late request for registration for second
interation
March 14
th
File Review Begins
March 16
th
-27
th
Interviews (notified via email)
Phone or Skype Interviews
April 4
rd
Rank Order List Deadline
April 18
th
Wednesday noon EST - MATCH DAY!
http://www.carms.ca/eng/r1_2ndIteration_e.shtml

Couples Match
Applying & Interviews
ERAS/NRMP apply for Couples Match
CaRMS check the box when submitting your
Rank List

Apply to the same hospitals and programs in the
same area
OK to mention your partner or that youre couples-
matching in your PS
Interviews
If one of you receives an invite call or email the
program to inquire about the other (and remind them
youre a couple)
If applying to the same program - can ask to have
interviews on the same day (save $ on travel expenses)
Couples Match
Couples Rank List

Decide ahead of time your top locations as
a couple

Fill out separate ROLs, remembering the
choices will be linked
Can rank programs more than once or
choose No Match to make as many
combinations as possible

Can view your partners ROL but cannot
modify it

Couples Match
Couples Rank List Example
Partner 1 Partner 2
1. Univ. of Rochester 1. Univ. of Rochester
2. Case Western 2. Cleveland Clinic
3. Cleveland Clinic 3. Cleveland Clinic
4. Case Western 4. Univ. of Rochester*
5. Univ. of Rochester 5. Cleveland Clinic*
6. Case Western 6. No Match
7. No Match 7. Cleveland Clinic
*Both Partners get matched but not in the same place
American Interviews
Most ppl received interviews starting in October/ November
BUT continued to get then until Dec.
Dont be intimidated youll meet US students that already
have tons of interviews lined up by mid sept yours WILL
come- stay positive and continue to bust ass!
Number of interviews varies depending on specialties, how many
you applied to, becomin harder to get interviews bc more DO
schools
Ppl interviewed at 2 places and prematched others
interviewed at 15 spots (and matched!)
For competitive fields (even Internal) consider applying to a variety
of University-Affiliated/ Community programs
Sending 60 apps wont matter if most of them are to extremely
competitive programs (Mayo, Johns Hopkins etc) and smaller
programs may pleasantly surprise you
Applying can get pricey but can be managed if you choose
wisely, most of us applied to a minimum of 50 programs (up to
150)
The rule of thirds: apply to 1/3 programs youre not sure you
can get, 1/3 you think you have a good chance, 1/3 safety


American Interviews
By mid-November if you are dissatisfied with the
amount of interviews you received, start
contacting programs. This can really work!!
Kindly harass programs that you want by updating them
every time a score/document is available
Scheduling will depend on your situation/
location
Think about where you will be after electives
Can probably book about two per week, more can get
stressful (especially with winter travel conditions!!)
If you can, schedule your top choice in the middle
Can always cancel interview but be respectful to
the coordinators (keep up the good UJ reputation!)
Consider costs (many US programs will offer free
accommodation but still can get pricey!)


American Interviews
Most US interviews are friendly, wine and dine
affairs
You can practice some of the harder questions but most will be
of the why do you wanna come here? nature
Its important to research the schools ahead of time!
Some schools employ behavioral interviewing
Ex. Describe a situation in which you had to question
authority and how did that affect you.
Just be yourself
Ask a lot of questions
This can get tricky because you run out pretty quickly and they keep asking
you if you have more questions :P
Have some go-tos like Is your program more front loaded or back
loaded? or What predictors have you found for a good resident?
Avoid asking tedious questions like Will I have sick days?, these should
be outlined in the package, or ask a resident not the director

Good video for advice : http://www.youtube.com/watch?v=cADapg2kjZk

American Interviews
Try to arrive the morning before the interview
Leave room for travel delays, shower and freshen up, check out the
city (programs like hearing that you do this!)
Night before is the resident dinner. Go to it!!!
Great for ideas on asking questions, warming up
Although not mandatory, they will notice if youre there
Get a feeling for the other candidates these may be your future
coworkers!!
Day of interview
Its early, its long, its tiring but be enthusiastic!
Starts with breakfast, talk from the program director, tour
Will have from 10-30 min interviews with 1 to 5 faculty members
This varies a lot! The questions tend to be general, comfortable atmosphere
Lunch with residents or faculty, may attend teaching conference
Ask lots of questions, talk to as many ppl as you can, be a polite,
bubbly version of yourself!!
Interviews up North
A little more stiff
More standardized - Not as much shmoozing can
be a good thing.
Ontario Family medicine is completely
standardized. You are asked 10 questions. Each
question is VERY long so listen carefully. THINK
before you start answering
More standard Q (ethical, clinical)
Potential MMI circuit of 10 stations, 10 min each
where you are asked a question and marked on
how it was
Still meet and greet
Late Jan- Early Feb


List of Questions We Were Asked:
Why FM, Internal, Peds, etc
Give an example of a conflict and how you resolved it
Give an example of leadership positions you have had
What do you think will be a major challenge for you in first year of residency
Tell me about (CV specific- make sure you know your own CV)
Why Family Medicine
Tell us about your most recent clinical post, what your responsibilities were for the
patients
Tell us of a time you were a member of a team, a conflict you came across, how you
solved it, did you ask for help
Tell us about a difficult patient, how you handled it and what the outcome was
Tell me about your program
Ethical questions (what would you do if your laptop, containing important clinical
research information, was stolen. What would be your greatest concern, whom should
you notify)
Tell me about a time when you found communication to be difficult
How do you deal with stress
Why this program?


Pre-Match

Offer made to candidate outside of
NRMP match (available for IMGs, DOs,
candidates already graduated)

If candidate accepts must withdraw
from the Match before rank list deadline
(dont do this before signing letter of
offer/contract!)

Usually given time to consider offer

Ok to ask about Prematch policy at end
of/after interview

Pre-Match
PROS: dont have to wait until match
day to know you have a job.
If you did not get a lot of interview
(ie:5) but were offered a Prematch
position- ACCEPT IT!!!

CONS: if accept offer, cannot try to
match in other programs of greater
preference; if dont accept, risk not
matching at all

CONSIDERATIONS: how much you
like the program; quality of program;
strength of application; number of
interviews



Where We Matched!
Class of 2012
Canada
USA
UK
Intentional Year off
2nd Round- Canada
Other European
Countries
Canada
USA
UK
Intentional Year off
2nd Round- Canada
Other European Countries
Match Statistics
19/28 went through a Match
3/6 matched in Canada
3 Matched in First Round
3 going through Second Round
2 matched in UK
1 also accepted to USA and going there
11/14 matched in the US
3 accepted PreMatch
8 matched first round
3 participated in the Scramble, 0 successful (very limited
spots)
2 going through Canadian Second Round

4 people are voluntarily taking time off
5 Staying in Europe to residencies in Poland,
Switzerland, Sweden, etc


Class of 2012
Canada
USA
UK
Intentional Year off
2nd Round- Canada
Other European
Countries
Where We Matched!
UK Foundation Programme

Canada
- Family Medicine
- University of Western Ontario
- McMaster University
- University of Winnipeg



Where We Matched!

United States
Pediatrics
University of Rochester
Cleveland Clinic

Family Medicine
University of Rochester
University of Indiana
Penn State U

Where We Matched!Where We
Matched!
United States
Internal Medicine
Penn State University
Boston
PMR
University of Rochester
OB/GYN
University of Missouri, Kansas City School of
Medicine


Places that make you wait
BC-IMG
January 1, 2012 Phase
I: Application Deadline
February 1, 2012 Phase
II: Application Deadline
February 2, 2012 File Review Begins
February 15, 2012 Phase III: OSCE Seats are
granted successful
candidates notified
March 20, 2012 BC NAC OSCE Orientation
March 24, 2012 BC NAC OSCE
Examination
April, 2012 Phase IV: Clinical
Assessment successful
candidates notified
May, 2012 Clinical Assessment
Orientation Week begins
October, 2012 Clinical Assessment
concludes
August, 2012 CaRMS Application Opens
(1st Iteration IMG Positions;
check the Carms site for
2nd Iteration timeline)
November, 2012 CaRMS Application
Complete
Dec/Jan 2013 Candidates Selected for
Interviews
March 2013 CaRMS notifies candidates
of match results
July 2013 Resident Training PGY1
Begins
- Registration process begins in
January of 4
th
year and ends 18
months later

- BC RESIDENTS ONLY!

- You may apply an unlimited
amount of times

- Very comprehensive website:
http://imgbc.med.ubc.ca/
Alberta - IMG
-Application cycle for 2012 starts on June 4
th
, 2012

Eligibility: continuous resident of the province of Alberta for 6 (six) or more months
immediately prior to the opening of the AIMG Program application portal
OR
an accredited Alberta high school full time for 2 or more years
OR
attended an accredited post secondary institution in Alberta full time for 2+ years
- Web site: http://www.aimg.ca/

California IMG
- Application process
begins in Spring of
your 4
th
year

- The Key: PTAL letter

- Signatures from each
Clinical Director from
your USA electives


Web site:
http://www.mbc.ca.gov/applicant/application_international.p
df
Quebec IMG
-Process begins in
middle of 4
th
year and
ends 18 months later

-Requires all 3 canadian
exams: EE, QE1, NAC
OSCE or QE2

- Write MCCEE in
November at the latest;
signup for QE1 and
OSCE in January.

-No french examination
result requirement
Web site: www.cmq.org

Step-byp-step:
http://www.cmq.org/fr/ObtenirPe
rmis/DiplomesInternationaux/Pe
rmis/1ReconnaissanceEquivale
nce.aspx#PointTitle4
University Quota IMG Quota
Memorial University of
Newfoundland
14 1
Dalhousie University 7
Universit Laval 37
Universit de Sherbrooke 42
Universit de Montral 19
McGill University 1
University of Ottawa 9
Queen's University 12
Northern Ontario School of
Medicine
22
University of Toronto 1 1
McMaster University 14 1
University of Western Ontario 14 5
University of Manitoba 2
University of Saskatchewan 19
University of Alberta 16
University of Calgary 11
University of British Columbia 19 2
Total 259 10
Results from past years on carms.ca
2012 2
nd
iteration


Congrats, heres your
paperwork!!
ECFMG Certification
Some programs require this for applying
for residency, however we cant get it
until after 4
th
year do your research!
The school office will provide you with
necessary forms and mailing instructions
before grad
You will need:
Medical Educations Credentials Submission
Form 344
Medical School Release Request Form 345
2 Photocopies of final medical school diploma
Passport sized color photograph

And for all you Canucks
Which visa do I want?
J1 H1B
Sponsored by ECFMG Residency
Program
Moonlighting No Yes
Max Length 7 years 6 years
Once done Home for 2 years Any country for 1
year or dual intent
Spouse can work? Yes No
Possible to stay in states after J1 must do 2-3yr work in
underserved areas in USA if not want to go back to home
country for 2 yrs after residency.
J1 Visa
ECFMG is your sponsor
Main application is online now
Major requirement is Statement of Need
Issued by Health Canada

Tedious but doable, just stay on top of it!!

Before coming back to Poland get
Certified copies of
Passport
MCCEE - Keep this letter!!
Both are needed for Statement of Need

Start application for J1 visa soon after
the match



J1 Visa
How to start?
New this year: your program starts the
process online with ECMFG
Your job is to apply for Statement of Need
(next slide)

What do you need for ECFMG?
Letter of Offer (from your program)
Application form (online via ECFMG)
Statement of Need (Health Canada)
http://www.hc-sc.gc.ca/hcs-sss/hhr-
rhs/postgrad-postdoc/cat_b-eng.php
CV
Copy of Passport
$250
Return Airbill
ECFMG certificate



J1 Visa
Your job is to apply for statement of need

Application form
Certified copy of Passport
Certified copy of MCCEE letter
Request for Endorsement (specialties other than FM)
Action plan
Timeline of all US and Canadian exams you will need to be board certified in
Canada
Basically explain how you plan to be able to practice in Canada after residency
RCPSC letter
Make sure your program is ACGME accredited and your specialty is on the list of
needed specialties (email for updated copy: j1visa@hc-sc.gc.ca)
Letter of Offer
CV
Proof of provincial residence (2 government issued documents that
bear your name and permanent address)
Consent Form



Q & A

TIMELINE

(in case you forget everything
weve said this is what you
need to know!)
Sept/October of 3rd year
Canadian electives-submit applications!!!
No earlier than 9 months, but submit RIGHT at 9
months!!!
Make sure you get your vaccinations done over
the summer before you come back for 3rd year so
that you can apply right away



February/March**
Work on US electives applications and follow up
with your app by email or phone, pay attention to
blocks and availabilities to IMGs
Get vaccinations/ titers/ updated transcripts!
Collect Letters of Rec from Polish profs
Work on CV/ personal statement for electives
Schedule CK and CS early!!! CS spots fill up!
Apply for MCCEE
Non-EU citizens must take PLAB to apply for
foundations
** 2
nd
years prepare American checks when you go home,
maybe get titers, immunization records
April
Continue negotiating your electives be flexible but
persistent
Take this academic lull to organize your Step 2
study time
Try and get stuff done now
So you can focus on neuro in May
May
Neuro with Dr. J!!!
You will learn how to present patients
for American rounds, PAY
ATTENTION!
Learn how to play the game: dress up,
talk to residents, be professional
Apply for Rochester electives, good
backup (take ~ 15 students/ year)
Approach Dr. J for a Letter of Rec he
will want your PS & CV
June
Keep working on electives! Yes, it will take this long
:-P
Study for the Step 2
Work on residency CV and Personal Statement (get
lots of help!!)
July
Begin ERAS application (July 1
st
)
Work on it early and often!
It's simple but pay attention to details
Begin electives
Approach supervisors on 2
nd
or 3
rd
day and say you
want to work hard for a strong letter
Visit program directors if you plan to apply for res
Keep studying for Step 2 (may write CK or CS here)
UK Foundation Programme Eligibility Checking
Period
August
CaRMS: Online request for registration opens for
international medical graduates, United States
medical graduates and prior-year Canadian
medical graduates
Keep working on ERAS
Ask for at least 4 letters, can have multiple per
elective
Put your North American elective experiences
in your CV as you go along, there's no separate
spot for it in your app
Write CK!!!
Practice for CS
September
Submit ERAS application as soon as you
can!!!
Don't worry about completion (your parts
should be done but letters are usually written
in September and you can always reserve
more slots if you need them)
Do your CS (before Sept 10
th
= earlier
reporting dates, maybe more interviews)
Write MCCEE
Apply for CaRMS token & begin working on
CaRMS application
October
Send thank-you notes to letter writers
Interview season begins yours will likely be
Dec/ Jan
Interview tips at: www.aamc.org
Practice questions, research programs, be
yourself!
Proofread your MSPE carefully!! The School
office is very accommodating/ appreciative
Keep working on CaRMS application
UK Foundation apps due
November
CaRMS documents Milestones and ONE
deadline at end of November!
Most US interview invitations have been
sent out
Mid-Nov is the time to contact programs for
interviews be polite but don't be afraid to tell
them why you want their program/why they
should want you. This really works!!!
MCCEE results back from September
keep that piece of paper! You'll need it for
J1 if you're applying for the States.
December
Interviews!!
Try not to schedule
electives here, programs
will usually only give you 1-
2 days off (interviews are
often conducted the first two
weeks of December so
taking 2 days off an elective
may be feasible)
Enjoy yourself, US
interviews are fun!
Christmas!!
If you plan ahead, you can have
lots of time off here, make up
for all lost time with the fam!
January
US interview high season
Rank schools as you go along
Don't forget to send thank-you notes to
interviewers
All scores must be in by now!
Canadian interviews late Jan/ early Feb
Not as much fun as US
Expect content/ethical/medical questions
Let school office know now if you have
interviews past Feb. 1st and will be missing
school!
February
Back to Poland for Emerg
Canadian Interviews first 2 weeks
Submit rank order list for ERAS & CaRMS
contemplate need for beta blockers :-P
March
Canadian Match Week (week before US)
Monday noon EST: if and where you matched
2nd Round begins Tuesday

NRMP main residency match week
You have this week off! Travel, relax, debauchery!
Monday noon EST: find out if you matched
location of unfilled positions released to participants eligible for SOAP
check http://www.nrmp.org/res_match/yearly.html

Friday 1 pm EST: find out where you matched
SOAP concludes
Begin working on J1/ paperwork
April
Congrats to those of you who matched, here's
your TON of paperwork! :-P
Pay attention to due dates for your school & ECFMG
If you're Canadian, work on your J1
Canadian (+/- US) Second Round Results
Wednesday noon EST: if and where you matched
Get grad photos done!
Make sure you have your indexes complete,
pay all fees to school office...
May
Graduation!! Congrats, youre a doctor!!
Thank You
&
Good Luck!!