CaRMS: the fortress between medical school and residency

Jessica Dunkley is a PGY-4 in dermatology at UBC. She completed her family medicine residency at the University of Alberta

 

Every year, Match Day for CaRMS brings back heart wrenching memories for me.  It is a terrifying day for medical students who do not match to residency.  For many years medical students have placed all of their eggs in one basket - to get that one spot in residency.  Their entire lives of dreaming to become a doctor depend on that day. I matched to a competitive specialty only to be told that my disability – hearing loss - would not be supported in residency because it was different from medical school. 

The transition from medical school to residency is all or none.  There is no alternative unless you have a goal of becoming a non-practicing MD.  Finishing medical school without residency means you are jobless, burdened with a huge debt, and left wondering if you’re adequate.  While almost everyone celebrates Match Day, the unmatched are left feeling like discards.  All of a sudden 4 years of undergraduate studies, 4 years of medical school and countless volunteer hours comes crashing down.  People whisper about those students who didn’t match, speculating about what they must have done wrong.  That piece of diploma paper which will have your name imprinted is just another cocktail napkin; it's meaningless without residency.

Left floundering, when I matched but was immediately disappointed, I pleaded CaRMS to let me re-enter the matching process.  I was denied entry into the following year’s first round because of a technicality: I had already matched the year prior.

All of a sudden I went from being matched to my top choice to unmatched in the 2nd round for the leftover positions that were available in my 2nd year of trying.  Institutions ignored my calls for help, the same help that got me through medical school successfully.  All of a sudden, I was one of those unmatched graduates, just because of a disability, which had been accommodated during my medical training.

There was no support system in place for me to help me stay on track to try to get into residency. I was discarded into the recycling bin.  All of what was invested in me was shamefully wasted: taxpayers’ dollars down the drain.  I had never felt so alone and so wrong.

Nonetheless I pushed forward, entering a graduate program at the very same institution that denied me the chance to enter my residency.  Because that’s what some unmatched people do - they pursue graduate studies to prove that they are dedicated to becoming a resident doctor.

Another appeal to CaRMS led to a successful entry in the 1st round for the 3rd year in a row.

The night before Match Day, though, I had a restless night’s sleep.  That morning I was frantically hitting the ‘refresh’ button on the CaRMS website for what felt like hours.  A great sigh of relief came across me when I saw the computer screen say Congratulations…I successfully completed my residency and am well into my 2nd residency.

How did it happen third time around? (you may ask)

I combed through all the universities to find University of Alberta had a stellar office for medical students and residents who require accommodations. There I met a lovely dean who believed in creativity and innovation. It was then that I pursued a Public Health and Preventive Medicine residency and I completed my family medicine residency there.

The system is unfair for unmatched students. Medical school and residency are part of a continuum.  Students should not be left hanging at the half-way mark, especially when they’ve already devoted half of their lives to medicine.  We need a better solution.