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What the #$%& is residency matching anyways?

(And 11 Other Questions You Might be Asking Yourself About CaRMS)

Residency matching is one of the most important parts of your medical education—in many ways, it sets the course of your entire professional career. Which might sound kind of terrifying—especially if you’re unfamiliar with how the matching process actually works. And, yeah, sure, you’ve probably heard terms like “match day” and “rank list” get thrown around from time to time—but do you know how much residency matching is going to cost you (spoiler: a lot) or what you can do during your pre-clerkship years to set yourself up for success? The truth is, it’s a complex system—and the more you know about how it works, the better prepared you’ll be to make sure that this big step in your medical career is a confident one. So here are some simple questions – and simple answers – to help you wrap your head around residency matching.  
So, what the #$%& is residency matching?
Simply put, residency matching is the way for med students to choose a residency program, and for residency programs to choose their med students. It’s kind of like Tinder, but with less beach selfies.
But I already graduated with a medical degree…?
Congratulations! But you’re not quite done yet…before you can practice medicine in Canada, you have to complete 2-6 years of residency training. It’s one of the most important components of your medical training, providing you with hands-on experience and the specialized skills that you’ll need to be a doctor. 
How does residency matching work, exactly?
After confirming that you meet the eligibility requirements for each province, you enter your background information through an online service called CaRMS (see below) and then select which programs you’d like to apply to (swipe right, basically). If those programs are interested in you, they’ll reach out to schedule an interview (aka. a first date). After you’ve gone on a few dates/interviews with a few different programs, it’s time to rank them in order of preference. The programs will do the same with all the students they’ve seen. After that, the algorithm takes over!
Algorithm? That sounds scary. Can I trust it?
The Roth-Peranson algorithm used to match students with residency programs here in Canada is essentially the same algorithm used in for matching in the United States, as well as in other disciplines, like law school, psychology, dentistry, etc. It was created by Alvin Roth from Harvard University and Lloyd Shapeley from UCLA—who happened to win the Nobel Prize in Economics in 2012 for the work they did to create it. So, yeah, it’s pretty reliable. 
Then what happens?
On Match Day, you’ll get your match results. This all happens in the banquet hall, where the Sorting Hat is placed on your head and speaks aloud the name of the program you now belong to. (Actually, you’ll find out through the CaRMS online portal.)
What if I don’t match?
Residency matching occurs in two iterations. Students that don’t get matched in the first round can enter into a second round, where they’ll have an opportunity to be matched with remaining positions.
Can I change my mind after I’m matched?
Nope. You are legally bound to attend the residency program you’ve been matched with (and, likewise, the program is legally bound to accept you). This is why it’s important to very carefully consider which programs to include on your rank list, and avoid choosing anything you won’t want to do, even if it seems like a good strategic move.
How many residency programs are there, and which schools offer them?
There are 37 residency programs available through Canada’s 17 med schools—however, not all schools offer every specialty, so make sure to check out which programs are available through which schools, and how many seats are available at each of them.  
You’ve mentioned “CaRMS” a few times – what is that?
No, it’s not a cool boutique coffee shop, or clothing brand, or delicious caramel candy—CaRMS is actually short for the Canadian Resident Matching Service, which is an independent, non-profit organization created by med students and med school faculties to facilitate the residency matching process. You will submit your application through the CaRMS online portal, they’ll oversee the process from start to finish, and then deliver your results. 
My partner is applying for residency, too, and we don’t want to do the long-distance thing…
Who does? Luckily, the ranking tools available through CaRMS allow you and your beloved to prepare and submit your rank-order-lists as a couple. In such cases, a single ranking list of paired programs will be used. Just know that, by pairing your choices, your chances of a successful match decline slightly. But that’s love, right?
For real…how much is this going to cost me?
It won’t be cheap. But, in the long run, it will definitely be worth it. Typically – with registration and test fees, travel and accommodation, and other intangibles like new clothes (because you want to look good, right?) – it can cost you between $7,000 and $10,000. One of the most important things you can do leading up to residency matching is to prepare a budget to help you get through it—and possibly even set up a meeting with a financial advisor to plan it all out.
What do I need to apply?
Applying for residency is a lot like applying for med school. Here are the primary components of your CaRMS application: 
1. A curriculum vitae that includes your academics, employment, research, awards, professional memberships, volunteer experience, and extracurricular activities.
2. Your transcripts and your Medical Student Performance Report (MSPR), both of which will be automatically sent to CaRMS by your school.
3. Reference letters from physicians or professors (usually three, but each program is different)—one of which, ideally, comes from someone within the specialty you’re applying to. Note: CaRMS will allow you to choose which reference letters go to which programs.   
4. Personal statements that outline why you’re interested in a specific program, how it will contribute to your career aspirations, and what you hope to experience while there. These types of essays are an art unto themselves, so it’s good to do a bit of research about what works and what doesn’t.
To apply as Canadian Medical Graduate (CMG) or an International Medical Graduate (IMG) in the residency match, you must be a Canadian citizen or hold a valid Canadian permanent resident card. 
What should I do next?
If you have any questions about the residency matching process – like, say, how to come up with a solid financial plan to cover all the costs – our team of MD experts is always available to help.