To those of you stressing about CaRMS, relax. A statement that’s easy to make, difficult to act on, but accurate and necessary to hear.

The morning of 28 August 2012 felt fairly routine. I buzzed around my new apartment attending to insignificant tasks in an attempt to distract myself from the more substantial duties that lay ahead. Hunched over I spent the better part of an hour rearranging my closet, hoping to achieve some sense of order before I set off on the 7-minute trek to the UBC Life Sciences Centre to attend the first day of medical school. 

Strangers who would later become friends, acquaintances, and colleagues were scattered throughout the atrium sheepishly affixing their name tags, attempting to act occupied while standing in the otherwise-stagnant lines. Superficial conversations about majors, previous universities, and the occasional MCAT joke were common. And I was not above it. I indulged. Schedules in hand, we made our way into the lecture hall with a sense of keenness that would quickly deteriorate over the coming weeks but, for now, the newness of it all filled us with excitement.

The week of orientation had no shortage of form filling, cheque signing, and lectures, the content of which I could not confidently recall. But one speaker did stand out. Dr Mark Vu, a young and charismatic anesthesiologist, spoke about the importance of living in the moment. It was refreshingly relatable and, while the overall message was appreciated, it was this offhand remark made by the young physician that resonated with me: “And by the way, any of you in the audience who are already stressing about CaRMS, relax!”

I remained perplexed as apprehensive chuckles filled the room, suggesting an air of guilt. Taking to my phone I quickly Googled CaRMS in an attempt to absolve myself of ignorance. But I remained confused—in fact, more so. Things became much clearer following later conversations with classmates, and these conversations continue to this day, 2½ years later. Our lives have carried on in a predetermined fashion, guided by factors as random as the alphabetization of our surnames. To date we haven’t had much in the way of choice. Yet now, in the midst of clerkship, we find ourselves reclaiming agency in a misleading manner. 

My intention is not to write about the quality of the current system in which residents are chosen. Dr Cynthia Verchere covered this topic well in her editorial, “Choosing the right resident” [BCMJ 2011;53:62 [10]]. It is the steps preceding selection that are of particular interest to me.

It is unusual to get through a day without being asked what you want to specialize in upon graduation. And depending on who is asking, and who is being asked, the response may vary dramatically. Some students tout the necessity of remaining undifferentiated in an attempt to make a fully informed decision come CaRMS. But given the current system, open-mindedness can certainly be a liability. Those who think they have it figured out hold their cards close to their chest in an attempt to preserve the prospect of matching to their desired specialty, yet they’re often no better off. 

We accept anecdotes from residents as dogma. We seek out opportunities to add depth to our CVs even though we may lack enthusiasm for the given undertakings. And these practices lead to the development of a self-selecting population of applicants who have overachieved but may end up underwhelmed. Such is the consequence of the pressures associated with deciding on your professional trajectory three-quarters of the way through your education.

I have toyed with these notions extensively for the past few months and I will admit that I am none the wiser. No amount of discussion on this subject will lead to a decision cushioned by comfort. Each attempt to figure out what you want to do—and, by extension, who you are—yields frustration. But it is much more important to figure out who you are not. That is when, for the most part, who you are tends to crest the horizon.

As CaRMS approaches I am certain that many of my classmates will busy themselves with unimportant distractions to keep from choosing their desired specialty. But each student must make the decision and, regardless of how they come to it, frustration is to be expected. What brings me solace, however, is understanding that the system need not be perceived to be more than it is. In medicine we tend to be individuals who overthink every decision in fear of being wrong. But when it comes to this one decision that all of us are facing, there are no wrong answers. 

Thankfully, this helps me relax.

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This article has been peer reviewed.

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Mr Habtezion is a UBC medical student in the class of 2016.