Re: Choosing the right resident

I am writing to say how much I appreciated the article “Choosing the right resident” [BCMJ 2011;53:62] written by Dr Verchere. I thought this was a relevant and heartfelt article that highlighted the many issues surrounding the current resident selection process in Canada.

This article also held personal relevance, as last year I elected to delay my CaRMS match by one year in order to better understand which medical specialty I wanted to pursue. I, like many of my colleagues, felt pushed early in medical school to identify a suitable specialty. 

I thought I found mine early in second year and proceeded to devote countless hours to shadowing, research, and introductions to staff and residents. In doing so, I developed a narrow view of other specialties and lost some of the open-mindedness that I brought into medical school. 

Unfortunately, it was not until fourth year and the start of the pre-CaRMS elective period that I realized this specialty was not for me. Al­though I was interested in another specialty, the tardiness of my conclusion left me with no elective options across the country in this specialty. 

Without electives, I was sure I would not receive the recommended references letters or have an opportunity to promote myself to different residency programs and schools I potentially would be applying to in CaRMS. 

After many meetings and hours of self-reflection, I decided that the best option for me was to delay my CaRMS match by 1 year. By doing so I would give myself ample time and opportunity to explore other specialties of interest and put myself in a position where I would be an attractive applicant to residency programs across the country in my chosen specialty. At the end of the day I am happy with my decision; however, I realize that this option may not suit all candidates still searching for their place in medicine. 

We have to realize that in today’s medical curriculum there is enormous pressure being put on medical students to select a specialty early on in medical school. This is driven by the competitive nature of specialties, the need to do research in your chosen field, the encouragement of fellow students and staff, and the relative inability to change specialties once in residency. As such, I agree with Dr Verchere that it is time for the CaRMS matching process to be re-evaluated at a national level to ensure future medical students will not have the same stresses put on them as we do now.

Instead of focusing on pursuing a specific specialty, students should be learning how to be well-rounded phy­sicians. I believe a way to accomplish this would be with the reintroduction of a rotating internship year after medical school. Along with re­ducing stress levels in medical students, it would provide a more balanced approach to their educational and clinical experiences. This would allow them to ex­plore specialties and make a more mature, informed, and confident decision about their chosen field. 
—Simon Jones, MD
Richmond