CaRMS Forum John Gallinger, CEO April 17, 2016
Early days What I have learned Our intent
CaRMS commitment to you If it matters to you, it matters to us.
The values of the match process Fairness. Objectivity. Reliability. Transparency.
The values of CaRMS Collaboration. Support. Client focus. Innovation. Engagement. Partnership.
CaRMS Online by the numbers Supporting more than 25,000 unique users On R-1 first iteration Match Day, match results were checked: 20,539 times From 56 countries 116 times/second at 12:00 (noon) ET
Commitment to service and quality Some things change: paper process custom online application one employee team of 30+ PGY-1 match 4 residency matches Some things remain the same: fair, unbiased match knowledge, expertise, support focus on innovation and client value
Strategic planning We are committed to meeting our clients needs through organizational excellence. Client and stakeholder value High performing organization Internal capacity Organizational sustainability Board strategic objectives
Engaging our clients Integrating your voice into our planning processes to ensure that our products and services are meeting your needs.
CaRMS and the medical education community Engagement Collaboration Innovation
2016 R-1 Main Residency Match Outcomes and insights
Presentation goals Share data from the 2016 R-1 Main Residency Match Facilitate discussion
CaRMS by the numbers client services 5,391 registrants 1,233 documents translated for bilingual applications 11,071 emails responded to (98.2 per cent satisfaction rating) 13,071 calls to the CaRMS help desk 2016 R-1 Main Residency Match First and second iterations combined September 1, 2015 to April 4, 2016
CaRMS by the numbers applications 5,197 applicants 33,719 reference letters submitted 122,337 applications 1,052 programs 2016 R-1 Main Residency Match First and second iterations combined September 1, 2015 to April 4, 2016
Applicant pool breakdown 2016 First and second iterations combined REGISTRANTS WITHDRAWN APPLICANTS ACTIVE APPLICANTS FINAL PARTICIPANTS* CMG 3,021 25 2,984 2,968 IMG 2,305 49 2,160 1,815 USMG 65 8 53 33 *Final participants: ranked at least one program in their rank order list. Does not double count if an applicant participates in first and second iterations.
2016 R-1 Main Residency Match highlights First iteration Graduate type # matched # unmatched CMG 2,737 167 (151)* USMG 17 14 IMG 343 1,265 TOTAL 3,097 1,446 213 3097 Second iteration Graduate type # matched # unmatched CMG 96 103 (48)* USMG 1 3 IMG 65 956 TOTAL 162 1,062 51 162 *Unmatched current graduates in brackets Filled Unfilled
Summary of 2016 match results (combined first and second iterations) Applicant type # matched % matched Current year CMG 2,761 98.3% Previous year CMG 72 55.4% IMG 408 22.5% USMG 18 54.5% TOTAL 3,259 67.7% First and second iterations combined
Couples match (2013 2016) 2013 (N=107) 2014 (N=107) 2015 (N=115) 2016 (N=105) 5% 8% 2% 4% 95% 92% 98% 96% N = couples Includes couples that matched only one partner Per cent matched Per cent unmatched
Who entered postgraduate training in Canada (2011 2016) 2016 72 2,761 408 18 2015 73 2,728 421 26 2014 69 2,710 449 27 2013 74 2,571 499 25 2012 65 2,557 407 31 2011 50 2,457 380 22 0 500 1000 1500 2000 2500 3000 3500 Prior year CMGs matched Current year CMGs matched IMGs matched USMGs matched
Per cent of CMGs matched to first choice discipline (1994 2016) 100.0% 95.0% Min: 86.4% Max: 92.1% Range: 5.70% 91.4% 90.0% 2.7% 88.7% 85.0% 80.0% 75.0% 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Per cent of CMGs matched to one of their top three program choices (1994 2016) Program choice 2016 First 55.6% Second 14.9% Third 7.0% Fourth 4.8% 100.0% 95.0% 90.0% 85.0% 80.0% Min: 76.7% Max: 85.7% Range: 9.00% Fifth 2.8% Sixth 1.7% Seventh 7.5% 75.0% 70.0% 65.0% 77.5% 60.0% 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Average number of programs ranked by CMG and IMG applicants in 2016 first iteration 30 25 24.6 20 17.7 15 10 5 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 CMG IMG
Top three CMG discipline choices (1994 2016) 40% 35% 38.5% 36.2% 2.3% 30% 25% 20% 15% 10% 5% 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Family Medicine Internal Medicine Surgical disciplines
Fill performance for Family Medicine program quotas (2007 2016) 1500 1000 Filled Quota Unfilled (Filled quota) 500 0 0-50 Fill performance improving in last 10 years -100 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Fill performance for Internal Medicine program quotas (2007 2016) 400 Filled Quota Unfilled (Filled quota) 200 0 0 0-5 -10-15 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Fill performance for surgical discipline program quotas (2007 2016) 300 Filled Quota Unfilled (Filled quota) 200 100 0 0-2 -4 0-6 -8 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Supply and demand alignment: CMG quotas filled by discipline popularity in 2016* 600 600 500 96% GENSURG most preferred surgical discipline 500 400 300 99% 400 300 200 100 94% 100% 100% 100% 99% 88% 100% 200 100 0 Internal Medicine Surgical disciplines Psychiatry Pediatrics Anesthesiology Emergency Medicine Obstetrics & Gynecology Diagnostic Radiology Dermatology 0 Quota Filled Interest** * Excluding Family Medicine ** As reflected in first choice discipline
Supply and demand: CMG quotas filled for Family Medicine (2007 2016) 1400 1200 1000 80% 84% 85% 84% 86% 89% 91% 94% 94% 93% 1400 1200 1000 800 800 600 600 400 400 200 200 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Quota Filled Interest 0
Tracking Family Medicine expansion (2001 2016) 2001 2016 Quota offered 469 1,521 Number of programs 29 177 Number of applications 5,093 65,525 224% 510% 1,187% Percentage of positions filled 79% 92%
Choice of Family Medicine by sex (1994 2016) 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% Female Male Combined
Top ten first choice disciplines for CMGs (2014 2016) 2014 2015 2016 Family Medicine 38.2% 38.5% 36.2% Internal Medicine 14.2% 13.6% 15.2% Surgical disciplines 13.0% 12.5% 13.2% Psychiatry 5.70% 6.00% 6.00% Pediatrics 6.10% 5.50% 5.80% Anesthesiology 4.80% 4.80% 4.80% Emergency Medicine 3.50% 4.20% 4.40% Obstetrics & Gynecology 4.10% 3.90% 3.80% Diagnostic Radiology 3.20% 3.40% 2.60% 2016 S > D: 17 disciplines own 65.9% of first choices S < D: 13 disciplines own 33.4% of first choices S = D: 2 disciplines own 0.7% of first choices 2015 S > D: 21 disciplines own 69.7% of first choices S < D: 11 disciplines own 30.3% of first choices Dermatology 1.70% 1.80% 2.20% This data represents preference, not match.
First choice discipline compared to availability (demand > supply) DERM PLASTIC 2.21 2.17 EMERG 1.74 NEUROSURG PM&R OTOLARY OPHTHAL OBGYN ANESTH CARDSUR UROL 1.34 1.28 1.22 1.20 1.20 1.50 1.43 1.40 (Applicant first choice discipline/positions) PEDS GENSURG 1.08 1.05
First choice discipline compared to availability (demand < supply) MEDMICR VASSURG ORTHO NEUROL-PED IM PSYCH DIAGRAD NEUROL NUCMED PHPM RADONC FAM MED LABMED GENPATH ANPATH MEDGENE HEMPATH MEDBIO NEUPATH 0.00 0.00 0.20 0.38 0.46 0.50 0.57 1.00 1.00 0.93 0.89 0.87 0.86 0.85 0.84 0.75 0.75 0.75 0.69 (Applicant first choice discipline/positions)
Discussion point What may be influencing changes in applicant interest?
R-1 first iteration participation and quota, second iteration unmatched statistics (2007 2016) CMG quota IMG quota CMG participation IMG participation CMG unmatched (2nd) 3,500 60 Participation and quota 3,000 2,500 2,000 1,500 1,000 500 50 40 30 20 10 Unmatched current year CMGs 0 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 0
Increase of CMG quota and CMG participation (2006 2016) 3,500 Final participation: 50% increase Quota: 41% increase 3,000 2,500 2,000 1,936 2,101 2,000 2,274 2,134 2,379 2,313 2,595 2,438 2,717 2,528 2,778 2,886 2,921 2,973 2,984 2,971 2,672 2,695 2,847 2,862 2,904 1,500 1,000 500 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Final participation Quota - Final participation includes prior and current year CMGs - Quota includes positions dedicated to CMGs only
Quota and CMG count by year (2012 2016) Ratio of CMG quota to current year CMGs 2016 2,836 2,971 339 1.05 2015 2,830 2,984 337 1.05 2014 2,817 2,973 346 1.06 2013 2,673 2,921 340 1.09 2012 2,660 2,898 247 1.09 0 500 1,000 1,500 2,000 2,500 3,000 3,500 CMG quota IMG quota Current year CMGs
Quota and CMG count by province in 2016 NL NS QC * ON MB SK AB BC 0 200 400 600 800 1000 1200 1400 CMG IMG Current year Canadian graduates * Pre-screened IMGs can apply for all positions in Quebec
Graduate mobility: emigration at national level (2013 2016) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 2013 2014 2015 2016 Home school Same province Out of province
Graduate mobility: emigration by school of medicine in 2016 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% MUN DAL LAV SHE MON MCG OTT QUE NOS TOR MCM WES MAN SAS ALB CAL BC Home school Same province Out of province
Graduate mobility: immigration by school of residency in 2016 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% MUN DAL LAV SHE MON MCG OTT QUE NOS TOR MCM WES MAN SAS ALB CAL BC Home school Same province Out of province
Number of IMG registrants (2008 2016) 3,500 Mandatory NAC OSCE 3,000 2,500 2,000 1,500 1,000 500 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 New IMG registrants 1,077 1,145 1,263 1,424 1,579 1,614 1,600 995 954 Returning IMG registrants 985 1,103 1,183 1,357 1,508 1,551 1,564 1,526 1,351
Where IMGs are training 2.5% 14.0% 10.3% 5.1% 6.1% 10.3% 49.5% 2.2%
Regional IMG match results Region Final participation % matched Africa 258 16% Asia 373 9% Central America/Caribbean 389 20% Europe 417 41% Middle East 276 15% North America 11 27% Oceania/Pacific Islands 57 61% South America 34 12%
Where our IMGs went to medical school (408 matched) Sum matched 0 90 IE 90 43 UK IR EG 25 16 BN 18 35 # participants: 1,815 # countries: 110 # schools: 515 Each bubble represents one country. Size of bubble increases with number of participants.
Supply and demand: IMG quotas filled by discipline popularity in 2016* 200 180 160 140 120 100 80 60 40 20 0 TOTAL IMGs: 421 6% decrease since 2014 ORTHO most preferred surgical discipline 200 180 160 140 120 100 80 60 40 20 0 Quota Filled Interest** * Excluding Family Medicine ** As reflected in first choice discipline
Unfilled positions and unmatched graduates after second iteration by province Unfilled positions (51) Unmatched current graduates (48) Unmatched prior graduates (55) 1 1 3 1 2 44 1 6 4 2 2 19 11 3 6 6 4 4 29 2 3
Unfilled positions after second iteration by discipline Discipline First iteration Second iteration FAMILY MEDICINE 120 41 INTERNAL MEDICINE 20 - ANATOMICAL PATHOLOGY 11 2 PSYCHIATRY 11 - DIAGNOSTIC RADIOLOGY 10 - PHPM 7 - GENERAL PATHOLOGY 4 - MEDICAL GENETICS 4 2 RADIATION ONCOLOGY 4 - GENERAL SURGERY 3 - HEMATOLOGICAL PATHOLOGY 3 2 MEDICAL MICROBIOLOGY 3 1 NUCLEAR MEDICINE 3 - NEUROLOGY 2 1 NEUROPATHOLOGY 2 1 ANESTHESIOLOGY 1 - MEDICAL BIOCHEMISTRY 1 1 OBSTETRICS & GYNECOLOGY 1 - ORTHOPEDIC SURGERY 1 - PEDIATRICS 1 - UROLOGY 1 - Total 213 51
Per cent unmatched current year CMGs after second iteration 2.0% 2.0% 1.8% 1.6% Max: 2 % Min: 0.5 % Range: 1.5 % 1.6% 1.7% 1.6% 1.4% 1.4% 1.2% Average 1.0% 0.8% 0.8% 0.7% 0.9% 0.6% 0.4% 0.5% 0.5% 0.2% 0.0% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
5.3% Per cent unmatched current year CMGs after second iteration by school 3.6% 1.1% 0.0% 0.0% 0.0% 1.7% 0.0% 0.0% 0.0% 1.9% 3.2% 0.4% 1.2% 3.1% 0.0% 2.4% 0.0% 2.5% 0.0% 4.1% 0.0% 3.5% 0.0% 4.7% 0.0% 6.0% 0.0% 2.1% 0.4% 2.9% 0.0% 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Programs ranked in first iteration 2016: Unmatched and matched CMGs Unmatched (n=151) Matched (n=2,685) Ranked 1-3 programs Ranked 1-3 programs 18% 6% Ranked more than 10 programs 40% 21% Ranked 4-6 programs Ranked more than 10 programs 57% 17% Ranked 4-6 programs 21% 20% Ranked 7-10 programs Ranked 7-10 programs
CMG match results by first and lower choices: ROL frequency distribution 1800 1600 1400 1200 1000 800 600 400 200 0 1614 432 The majority (1,614) matched to their first choice 202 139 82 49 39 25 26 23 19 10 13 5 11 4 6 3 6 3 2 1 1 1 1 1 3 3 1 1 2 1 2 2 2 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 24 25 26 28 29 41 44 48 54 92 105 110 289 352 PREFERENCE 2 matched to their 352 nd choice 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% cumulative % # matched
Categorizing unmatched CMG applicants 5% 3% 2015 N=39 38% 54% 2016 N=46* *Excludes two applicants: one who participated in 2015 first iteration and 2016 second iteration, and one who did not submit an ROL in first iteration
Unmatched student journey 2013 Unknown journey 2013 second iteration 4 35 matched 59 unmatched 41 2014 first iteration matched 30 unmatched 5 Net unmatched: 0 Net unknown journey: 7 2 5 2015 second iteration matched 0 unmatched 1 2015 first iteration 2014 second iteration 1 1 Unknown journey matched 1 unmatched 2 matched 2 unmatched 3 1 1 2016 first iteration matched 1 unmatched 1 Unknown journey
Unmatched student journey 2014 Unknown journey 2014 second iteration matched 71 unmatched 55 2015 first iteration 11 41 7 matched 34 unmatched 7 2015 second iteration matched 4 unmatched 3 Net unmatched: 2 Net unknown journey: 13 3 2 2016 first iteration matched 2 unmatched 3 Unknown journey 1 1 2016 second iteration matched 0 unmatched 2
Unmatched student journey 2015 Unknown journey 2015 second iteration 10 28 matched 55 unmatched 39 2016 first iteration matched 22 unmatched 6 Net unmatched: 5 Net unknown journey: 12 Unknown journey 4 1 2016 second iteration matched 0 unmatched 5
Unmatched student journey: summary Year Unmatched after second iteration Matched later Per cent 2013 41 34 82.9% 2014 55 40 72.7% 2015 39 22 56.4%
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