VANCOUVER—The disconnect between graduating medical students and a health-care system desperately in need of more doctors was laid bare Tuesday.
“Match day” annually pairs approximately 3,000 graduating medical students with resident doctor positions — they can’t work as fully qualified doctors until they’ve completed a paid residency in a particular field. Family medicine, surgery or internal medicine, for example.
On Tuesday, almost all of Canada’s graduating medical students found out where they will complete their residencies. However, this year, 223 positions were left vacant. That’s 223 doctor jobs unwanted by Canada’s medical graduates — or programs that didn’t want the graduates on offer this year.
Until a second match takes place later this month, that means 170 family medicine jobs are unfilled while almost five million Canadians go without access to primary care physicians. Family doctors have patient rosters of, on average, about 1,500 people, so those 170 unfilled positions could equal about 250,000 patients without a dedicated general practitioner.
Tuesday, the Canadian Resident Matching Service (CaRMS) released data showing 223 spots have gone unfilled after the first of its two rounds of matching graduating medical students to residency spots. CaRMS said it wouldn’t release the number of unmatched graduates until after the second round later this month, but the association representing medical students across the country told The Star the number is about 150.
“It’s a difficult time (for unmatched grads) because they’re processing that they haven’t gotten matched to a program, and they have to put together an application that is competitive for the second round,” said Victor Do, president of the Canadian Federation of Medical Students.
Graduating medical students are matched to available residency positions by the nationwide Canadian Residency Matching Service (CaRMS) algorithm in two rounds. Students rank their top program choices, and medical schools, which run the residency programs, rank their top candidates. In some cases, grads were ranked too low, or not at all, by their own choices, leading them to go unmatched.
Some, but not all of the 150 unmatched graduates will get one of the vacant positions in the second round match. The difference is that now they must compete for those spots with medical graduates from around the world, including Canadians who studied abroad, in addition to the other unmatched Canadian graduates from previous years.
Last year, 65 of the 174 Canadian medical graduates who did not match after the first round remained unmatched after the second.
The phenomenon of unemployed medical grads takes a toll on both students and the health care system. Training one doctor costs provinces hundreds of thousands of dollars — a huge liability if they do not go on to serve as doctors right away.
Unmatched grads from previous years tend to apply for positions in lower rates. Some further their studies with masters degrees, others go into research, some apply for positions in the U.S. Those who go unmatched live in limbo for at least a year as they wait to see whether they will get a match in the next year. Robert Chu, 25, was passed over twice and wrote about the distress he experienced in a letter shortly before he died by suicide in 2016.
It’s a problem related to physician resource planning. For a number of reasons, each year, fewer Canadian medical student graduates apply for or are prepared for the family medicine posts that are available.
“How can we align the needs of the medical professionals with the needs of the community?” Do said. “The future of medicine is the people who matched today and the people who haven’t matched yet.”
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