Making the match

Over time there has been a steady increase in the number of Canadians studying medicine outside of Canada, and especially in Ireland. These Canadians now find themselves classified as international medical graduates (IMGs), and face substantial challenges in matching back to Canadian residency programmes. Preparing for this increasingly competitive match is extremely daunting, and there is limited data on how to ensure success. The Irish medical schools have a reputation for training competent physicians who successfully match back to Canada or the United States, and in some ways are now a victim of their own success, with an increasing number of Canadians choosing to study in Ireland. The challenge for the future will be for Irish medical schools to maintain these successful match rates in order to continue to attract North American students. IMGs are physicians who have graduated from a medical school outside of the country in which they intend to practise. In Canada, this means any medical school not accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) or the Liaison Committee on Medical Education (LCME). Compared to Canadian medical graduates (CMGs), IMGs face substantial barriers when attempting to match to residency programmes in Canada. In 2017 alone, 411 (22.7%) IMGs matched to a Canadian residency programme, compared to 2,714 (96.5%) CMGs, amounting to an almost seven-fold difference in matching rates. An IMG must apply through the Canadian Resident Matching Service (CaRMS) to the small amount of designated IMG positions, which is much lower than the number that CMGs are applying to, in order to be considered for the match. CaRMS uses a specialised system – the Roth-Peranson algorithm – to match all prospective residents with postgraduate medical residency programmes throughout the country. The process of matching is two sided: prospective residents assign rank orders to their preferred programmes, while programmes simultaneously rank their preferred residents, based on written application and interview scores. The algorithm then compares the rank order lists of applicants and programmes, and determines the match outcome.