Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty



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Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Author: Alexander Bilbily MD Candidate Supervisor: Dr. Robert Bleakney Date: October 20 th 2012

I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Author: Alexander Bilbily Date: October 20 th 2012

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Purpose Compare the competitiveness of Canadian residency programs as 1. perceived by medical students with 2. statistics published by CaRMS (Canadian Residency Matching Service) http://articles.mercola.com/imageserver/public/2009/april/4.18medicalstudents.jpg The International Conference on Residency Education La conférence internationale sur la formation des résidents 3

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Methods Perceived competitiveness survey administered to 4 classes of University of Toronto medical students (n=401) students were asked to rank the top 5 disciplines they perceived to be the most competitive Utilized a graded-point system http://port.mcgill.ca/sites/default/files/toronto.jpg The International Conference on Residency Education La conférence internationale sur la formation des résidents 4

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Methods CaRMS Statistics CaRMS Match Reports 2006 to 2011 competitiveness was measured using the percentage of first choice applicants gaining entry into the discipline First Choice Discipline Applicants Second Choice Third (or more) Choice The International Conference on Residency Education La conférence internationale sur la formation des résidents 5

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Results The International Conference on Residency Education La conférence internationale sur la formation des résidents 6

Rank Discipline Session/Presentation Name Presenter Name Average Rating Response Count Total Points 1 dermatology 3.87 338 1308.06 2 ophthalmology 3.83 302 1156.66 3 plastic surgery 3.3 304 1003.2 4 diagnostic radiology 2.73 178 485.94 5 anesthesiology 2.41 127 306.07 6 neurosurgery 2.63 99 260.37 7 cardiac surgery 2.46 85 209.1 8 otolaryngology 2.24 93 208.32 9 radiation oncology 2.28 74 168.72 10 orthopedic surgery 2.03 60 121.8 11 urology 2.09 57 119.13 12 internal medicine 2.79 28 78.12 13 emergency medicine 1.71 45 76.95 14 genreal surgery 2.65 26 68.9 15 obstetrics & gynecology 2.1 30 63 16 anatomical pathology 3.85 13 50.05 17 neurology + neuro paeds 2.03 23 46.69 18 family medicine 3 11 33 19 pediatrics 1.87 15 28.05 20 community medicine 2.4 10 24 21 laboratory medicine 2.88 8 23.04 22 medical genetics 2.5 6 15 23 nuclear medicine 2.17 6 13.02 24 medical microbiology 3.67 3 11.01 25 psychiatry 2 5 10 26 physical med & rehab 4.5 2 9 27 hematological pathology 2 4 8 28 neuropathology 2 3 6 29 medical biochemistry 1.67 3 5.01 30 general pathology 1 3 3 The International Conference on Residency Education La conférence internationale sur la formation des résidents 7

dermatology opthalmology plastic surgery diagnostic radiology anesthesiology neurosurgery cardiac surgery otolaryngology radiation oncology orthopedic surgery urology internal medicine emergency medicine genreal surgery obstetrics & gynecology anatomical pathology neurology + neuro paeds family medicine pediatrics community medicine laboratory medicine medical genetics nuclear medicine medical microbiology psychiatry physical med & rehab hematological pathology neuropathology medical biochemistry general pathology Total Points 0 200 400 600 800 1000 1200 1400

Dermatology Plastic Surgery Opthalmology Medical Microbiology Otalaryngology Emergency Medicine Urology Community Medicine Diagnostic Radiology Obstetrics & Gynecology Radiation Oncology Pediatrics General Surgery Nuclear Medicine Anesthesiology Neurology (adult & paedeatric) Orthopedic Surgery Neurosurgery Cardiac Surgery Anatomical Pathology Physical Med & Rehab Laboratory Medicine Internal Medicine Psychiatry Family Medicine General Pathology Hematological Pathology Medical Biochemistry Medical Genetics Neuropathology % of Accepted First Choice Applicants 0% 20% 40% 60% 80% 100% The International Conference on Residency Education La conférence internationale sur la formation des résidents 9

Rank Comparison Discipline CaRMS Students Ophthalmology 1 3 Dermatology 2 1 Plastic Surgery 3 2 ENT 4 7 Urology 5 11 Emergency Medicine 6 12 Medical Microbiology 7 30 Radiation Oncology 8 9 Anesthesia 9 5 Community Medicine 10 21 Radiology 11 4 Neurosurgery 12 6 General Surgery 13 16 Pediatrics 14 18 Anatomical Pathology 15 19 Neurology 16 17 Pediatric Neurology 17 23 Orthopedics 18 10 Obstetrics & Gynecology 19 14 Laboratory Medicine 20 22 Physical Med & Rehab 21 32 Internal Medicine 22 15 Psychiatry 23 26 Family Medicine 24 20 Cardiac Surgery 25 8 General Pathology 26 28 Hematological Pathology 27 27 Medical Biochemistry 28 29 Nuclear Medicine 29 25 Δ -2 1 1-3 -6-6 -23-1 4-11 7 6-3 -4-4 -1-6 8 5-2 -11 7-3 4 17-2 0-1 4 Pearson = 0.664 Pearson = 0.664 (Moderately strong (Moderately strong positive correlation) positive correlation) SD = 7.22 SD = 7.22

SD Difference Between Perceived and Actual Competitiveness by Subspecialty Students Overestimate the Competitiveness Students Underestimate the Competitiveness

SD Discipline Student Rank CaRMS Rank Cardiac Surgery 8 25 Orthopedics 10 18 Students Overestimate the Competitiveness Discipline Student Rank CaRMS Rank Medical Microbiology 30 7 Community Medicine 21 10 Physiatry 32 21

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Discussion Definition of competition is limited the percentage of first choice applicants gaining entry into the discipline» This definition does not take into account the quality of the applicant pool applying to the specialties» Programs with few positions or few applicants may not be fairly represented Not a representative sample» Only surveyed the students at the University of Toronto Temporal lag in information dissemination» Perhaps disciplines like CV surgery & Orthopedics were more competitive in the past The International Conference on Residency Education La conférence internationale sur la formation des résidents 13

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Conclusion There is fairly good agreement between medical student perception and CaRMS statistics with regard to residency competitiveness The discrepancies could be due to numerous factors including: an incomplete definition of competitiveness, a nonrepresentative sample, and a delay in the dissemination of information to medical students The International Conference on Residency Education La conférence internationale sur la formation des résidents 14

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Acknowledgements Dr. Robert Bleakney MSK Radiologist University of Toronto The Joint Department of Medical Imaging, Toronto The International Conference on Residency Education La conférence internationale sur la formation des résidents 15

Perceived and Actual Competitiveness of the Canadian Residency Programs by Specialty Alexander Bilbily Thank You Questions? The International Conference on Residency Education La conférence internationale sur la formation des résidents 16