Subspecialty Programs

R4 Internal Medicine Match - Background Information

The PGY4 match in medicine was an ongoing source of debate for many years.  The old informal process had many flaws including fostering coercion and collusion and the potential of gaming the system by both residents and programs. The postgraduate deans and the professors of medicine in consultation with the internal medicine program directors agreed in 2009 to the implementation of a computerized CaRMS-style match. The Postgraduate Deans met in Edmonton, Alberta in May, 2009 and voted to proceed with a full implementation of the match for July 2010 intake (Fall 2009 match). This change was necessary and significantly improved the process for all concerned. 


The following principles have been agreed upon by the Postgraduate Deans:    
                                                                                                                                                    

1. All residents are guaranteed positions to allow completion of training and eligibility for certification in Internal Medicine.
2. All program descriptions and expected number of positions will be posted on the CaRMS website. Currently there is no central repository where prospective candidates could access information regarding programs he or she may be interested in. R-4 Positions are available to Internal Medicine Residents in Canadian training programs who are CMG or IMG graduates and who are residents of Canada. They are not available for Visa Trainees.
3. Provincial differences in IMG eligibility should be available by June 26.
4. Interview Guidelines:  It is understood that in general residents undertake fewer interviews than medical students do in the R1 match, as such the only requirement for timing of interviews would be that they occur prior to the deadline for rank order lists to occur.
5. There will be a second iteration of the match.  There will be a relatively short period between the first and second iterations of the match for this to occur.  The long period that is present in the PGY1 match would not be necessary because there will not be programs with a sudden influx of hundreds of applications.
6. If desired residents will be able to avail themselves of a couples match.
7. All positions, regardless of funding will be placed into the match pool.  Each program or Province will set the criteria for acceptance into each position.
8. A separate process will be created whereby Critical Care Medicine would offer positions to eligible residents in Anesthesia, General Surgery and Emergency Medicine.  Only positions for Internal Medicine residents in Critical Care will be included in the match.
9. CaRMS has dedicated a full time person, Mr. Ryan Kelly, to work with programs, universities and residents to ensure the understanding of the creation of algorithms and to ensure the timelines as they are set out will be met.
10. The mechanism for off cycle starts is to be determined. However residents that are off cycle 6 months or more at the time of the R-4 Match (November) may not be eligible until the following year. The residents would disclose when they will be available for starting of their subspecialty training. It will be up to each program and each university to decide whether this is acceptable.
11. All parties involved should be aware that decisions regarding number of positions available, criteria for eligibility, to whom an interview is offered and how they are ranked are the purview of each university.  CaRMS represents an algorithm that operationalizes the choices made by both universities and candidates.  CaRMS does not make decisions as to who is or is not accepted into programs.  The advantage of an instantaneous result is that candidates may rank their choice of program and if that program becomes available they will receive their first choice.

For specific program information, please view the Internal Medicine website and the CaRMS Medicine Subspecialty Match website.