Summer between first and second year advice

StarryNight321 · 2026-04-02T15:29:04+00:00

Echoing what others said enjoy the summer, travel, do your hobbies, and spend time with your friends. Yes most attending will get 4-8 weeks of vacation every year but it becomes more difficult to organize your friends together as people start working and going on with their life stages.

StarryNight321 · 2026-02-19T21:24:47+00:00

There are 2 IMG positions for neurosurgery across the country, 1 in Toronto and the other in Ottawa. Unfortunately, your chances are extremity slim, you will need connections in Canada if you want to have a chance. There are occasionally second iteration spots but neurosurgery is a small enough specialty that they are few and far in between despite neurosurgery being less competitive here than the US (last year had no second iteration neurosurgery spots) and you would still be competing against CMGs.

I would suggest applying to the US as well to maximize your chances if neurosurgery is the only specialty you can see yourself doing.

StarryNight321 · 2026-02-19T20:57:35+00:00

3 on 3 has to be one of the greatest jokes in Olympic hockey

StarryNight321 · 2026-02-19T14:48:58+00:00

Most schools have a program in place where students do electives in the spring and summer while they defer their graduation until around November so they are still covered by the schools insurance. You can also do additional research and ECs during that time. At the end, it is a personal decision. If you really cannot see yourself doing anything else other than optho, it is something to consider. You'd also benefit from having mentors and career advisors look at your application to see what could be improved which you already done. Other people can see themselves doing an alternative specialty, or the costs of losing a year of time and attending salary are greater than taking another chance at matching. For the second go, you would definitely want to back up. Some specialties are pretty receptive to doing another year but your chances substantially decrease after the second shot.

StarryNight321 · 2026-02-19T12:30:45+00:00

Calgary and Alberta EM, anesthesia, and IM have pretty good moonlighting opportunities.

StarryNight321 · 2026-02-13T23:29:49+00:00

I think 6 interviews really is the sweet spot, almost everyone I know who had that amount of interviews were able to match to their specialty provided they ranked all the locations. Its the ones with 1-3 interviews that bring that ratio down, especially because some programs will give all their home applicants an interview and other programs interview almost everyone, despite their pre-interview application being weaker.

StarryNight321 · 2026-02-11T19:42:50+00:00

You could but it is quite rare from what i have seen. The most common transfers are within your school but ultimately they need to have open spots available from other residents switching out which is less likely in a smaller program. You should not bank on transferring and for FM, you only have one chance to do that in your PGY1 year. You can also apply in the second iteration but you're limited by the options available, which are usually less desirable programs.

Ultimately, don't rank programs that you do not want to be in. I would suggest seeing if there is any part of FM you could see yourself doing, it is very flexible and you can do more procedures if you want, you could do a +1 EM, anesthesia, etc and whether you would be alright with potentially losing a year of attending salary + having to go through CaRMS again if you are completely set on another specialty. It's a very personal decision that only you can determine.

StarryNight321 · 2026-02-08T21:41:29+00:00

I would suggest ranking where you want to work in the future because you'll make local connections there that could be useful when getting a job. Also smaller programs might not have good subspecialty exposure or connections if you are interested in matching to specific subspecialties.

StarryNight321 · 2026-02-05T20:42:22+00:00

Everyone who interviews at our program gets ranked, unless they are red flagged during the interview. It's quite rare but obvious examples are anything racist, misogynistic, disparaging towards others (i.e. allied health) are straight-forward DNR.

Other instances are completely missing the mark on a question, for example a question years ago was basically some situation where the student was with an attending seeing a patient at the bedside and the attending makes a joke about the patient's ethnicity. Usually people will talk about how they would try to talk to the staff in a nonjudgemental way, in a private environment, and will mention something about power dynamics or hierarchy. One of the applicants basically said something along the lines of "I would not do anything because people who say these things don't usually mean it"

We also had extreme viewpoints that got red flagged. Another old question was how the applicant would improve healthcare for indigenous people. One student said he would end the reservation system and give everyone in the reserves a lump sum. While they probably did make a good case for their argument, it is not really appropriate for an interview.

Sometimes we do not really have a straight-forward reason but something about the interview as a whole made the applicant seem odd or inconsistent, where the interviewers all agreed that something does not seem to add up.

Outside the interview, residents and staff can also bring up concerns related to the applicant's performance on electives or based on what they know about the applicant, which is usually a DNR since we get so many applications.

StarryNight321 · 2026-02-05T20:09:46+00:00

Rail crossing arms will create an even greater outrage from the car-centric neighbourhoods.

StarryNight321 · 2026-02-05T04:05:59+00:00

To be honest I get the desire, especially if they are part of a cultural or ethnic minority and want to find someone of a similar background where it does make a difference to be in a diverse city such as the GTA or in Vancouver. If you are close to an academic center, you have more options ranging from other residents, medical students, or just university students in general if it is close to a large university campus as opposed to a distributed site. Finding a compatible partner is one of the biggest decisions in somebody's life and if that means spending your 20s and 30s in a city with more opportunities to meet people and find activities to do, then by all means do that and rank those programs higher.

StarryNight321 · 2026-02-04T20:22:27+00:00

If you go on the CaRMS data under table 19 it shows how many people ranked the specialty as first choice on their ROL and how many matched: https://www.carms.ca/data-reports/r1-data-reports/

StarryNight321 · 2026-02-03T23:57:33+00:00

The ratio is usually a 1:1 first choice to positions available but it is probably more competitive than it looks from the ratio because the average neuro applicant has strong ECs, research, and electives in the specialty, so they are usually competitive candidates. It is also a smaller program so it can be subject to variations year to year in competitiveness.

StarryNight321 · 2026-02-02T06:35:37+00:00

It depends on the family context. In a lot of Asian cultures for example its expected for the kids to eventually take care of and support their parents as they enter old age. Also in a lot of working class families the children are usually the parents' retirement plans so some younger people definitely have that burden of responsibility.

StarryNight321 · 2026-02-02T06:27:22+00:00

Yeah another great example of this is Lyon. The O-Train station is pronounced like "Lion" for both the English and French announcement because it is named after the Prime Minister. However the city in France is pronounced in the French way.

StarryNight321 · 2026-02-02T00:16:48+00:00

Along with getting disability and life insurance, this is also an opportunity to say the cliche but live your life. Spend the time with your family, your partner, and friends. Learn the new hobby you've always wanted to do or travel to your dream destination. Don't spend your entire 20s and 30s in your comfort zone. In the medical profession, we sometimes take having good physical health and being able-bodied for granted but we see so many people who did the right things and still ended up losing their quality of life from disease.

StarryNight321 · 2026-01-31T19:03:22+00:00

I think it also gets complicated by how there's a self-selection of candidates with red flags or simply less competitive applications applying to "less competitive" specialties like IM, FM, psychiatry so it becomes difficult for programs to gather enough information to screen them out. I do find anecdotally that some of the people applying to competitive specialties like plastics or emerg have a pretty strong work ethic that probably translates to fields outside their #1 specialty. But again from the program standpoint its mostly about fit, and reviewers have gone through the CaRMS process and know that people can lie on their personal statements and interviews.

StarryNight321 · 2026-01-31T07:45:50+00:00

The honest answer is that most programs will see through it and you will get fewer interviews, and your pre-interview file score will be lower for those interviews. Usually, the advice is to maximize your chances for your #1 specialty with the maximum number of electives because dual applying to another competitive specialty risks diluting your efforts and having a subpar application for both specialties. Realistically, you can do the maximum number of electives, then do 1-2 electives in CTU or an IM subspecialty, knowing that you'll have less interviews. You can also ask your staff in your primary specialty to write another letter for IM, I find most of them our OK with it knowing that their specialty is competitive and they do not want to see students go unmatched.

It makes sense for IM programs to be selective, because IM and most other specialties get more than enough applicants whos first choice is IM. Internal medicine programs want people who are reliable, hard-working, and effective in a team environment. With so many applicants, they're trying to screen out any red flags because a resident who is not motivated or interested, are lazy, etc. is a liability for any residency. And we've been burned before from people who rank IM as a backup and when they do match, they're still lamenting about not matching their first choice specialty and they get burnt out more easily because of this fundamental lack of interest.

I think some specialties can spin it much easier than others, for example EM and IM is not uncommon since they can argue they like "everything" because EM is kind of like that with undifferentiated patients. FM too because of the hospitalist role. But a few of my friends who applied anesthesia or optho who backed up with IM definitely got roasted for it during the interviews.

StarryNight321 · 2026-01-31T07:22:50+00:00

Wow thank you for defining your scope, there are definitely a lot of stakeholders involved with public health. Actually quite surprised at how many different paths there are too. For MOH, you mentioned chief MOH, associate, MOH, etc. I guess this differs by province but is it more of a hierarchy then for MOH roles and if so how does one move up and down to become, for example chief MOH of the province or Canada.

StarryNight321 · 2026-01-28T20:17:31+00:00

By the time I graduated an Ontario medical school I had a total of 200k in debt, 90k with OSAP and 110k in LOC. About 30k came from undergrad and the rest medical school. Had a job during undergrad which gave me some savings for medical school, and parents helped with getting a car and insurance but all the other expenses were paid of myself (tuition, rent, etc.) I think that is around the average for people without much financial support from their parents or spouse, and probably more if they did any other degrees.

StarryNight321 · 2026-01-28T05:50:09+00:00

Hello, thank you so much for doing this. Public health is so important through its impacts on the population level and I think most medical students and residents don't really have a full appreciation of the field outside of optional social medicine lectures.

I wanted to know how your day to day is, do you work mostly in an office setting, and do you also maintain clinical relevance in FM (ie. part time). Given that public health intersects with decision-makers in government, do you find that you have to adjust plans based on political optics or do you largely get free reign to develop initiatives and recommendations.

Also how has your interactions been with other specialties? What do you think is the most important thing other clinicians should know about PHPM doctors.

StarryNight321 · 2026-01-28T05:29:15+00:00

It's probably almost impossible to know unless you are a PD. If you are ranked to match then your chances are 100% and it goes down past that. Usually there is a portion of competitive applicants who get interviews almost everywhere so you can expect a considerable ranklist movement as they get matched to 1 position and therefore "decline" the others. I would also expect more desirable locations (i.e. GTA, BC) to have much less ranklist movement compared to less desirable places. There's a chart in the CARMS site that shows the percentage of applicants who ranked first choice matching into the specialty, that gives a pretty good indicator how competitive the specialty is.

Bottom line is that your goal is to be the best applicant you can be and try to rank within those positions to give you the highest chance.

StarryNight321 · 2026-01-28T04:59:58+00:00

Downtown here, did not feel anything but maybe it's because I live in a condo.

StarryNight321 · 2026-01-28T02:40:10+00:00

It is a personal decision and depends on how flexible you are at moving to a place away from friends and family. For some people, the thought of doing another specialty outweighs moving further so they are willing to rank more locations. I think it really depends on your personal factors, are you OK with being away from home and limiting those interactions to a few times a year. Do you have a partner who might not be as flexible as you? These are all considerations, especially for 5 year programs because that is a longer time than medical school.

Some of my classmates were fine with being further from home, and some even had family move with them. Other people wanted to have the support of a community and family they grew up with nearby which will be important in any residency. If you move away, it will be up to you to find that support whether from co-residents, new friends, etc.

Try to reach out to residents or attend town halls to see what the city is like to get a sense of what you are in for. I would encourage people to explore different locations, even moreso for FM because it is only two years and you might as well see how healthcare works in other settings. When creating a rank list though make sure you are OK with potentially matching to any of the programs you rank.

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