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APPLYING FOR
RESIDENCY IN CANADA
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TABLE OF CONTENTS
Eligibility ................................................................................................................................ 3
Terms & Definitions ................................................................................................................ 3
Fourth Year Rotations ............................................................................................................. 3
Applying to Canadian electives ......................................................................................................... 4
BU’s Policies on Away Rotations ....................................................................................................... 5
Timing of Canadian Electives ............................................................................................................ 5
Residency Application ............................................................................................................ 6
Intro to CARMS ................................................................................................................................ 6
CaRMS Timeline ............................................................................................................................... 7
Getting a MINC number ................................................................................................................... 7
Canadian Board ExamS ..................................................................................................................... 8
Statistics & Trends ............................................................................................................................ 9
Interviews .............................................................................................................................. 9
Useful Resources .............................................................................................................................. 9
Pointers From BUSM Alumni .......................................................................................................... 10
Tracking Events with CANPREPP ..................................................................................................... 10
Considerations – Why Canada? ............................................................................................. 10
Contacts & Authorship ......................................................................................................... 11
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ELIGIBILITY
To complete your residency in Canada, you must be a Canadian citizen or Permanent Resident, unless
your home country is willing to sponsor you.
q I am a Canadian Citizen or Permanent Resident à Proceed
q I am not à Some schools will take US citizens without sponsorship (e.g. McGill), so check with
schools individually before proceeding.
CaRMS Eligibility: https://www.carms.ca/match/r-1-main-residency-match/eligibility-criteria/
TERMS & DEFINITIONS
Canadian Equivalent
USA Equivalent
CaRMS: Canadian Resident Matching Service
NRMP: National Resident Matching Program
ERAS: Electronic Residency Application Service
AFMC: The Association of Faculties of Medicine of
Canada
AAMC: Association of American Medical Colleges
AFMC Student Portal for Visiting Electives
VSLO: Visiting Student Learning Opportunities
MCC: Medical Council of Canada
FSMB: Federation of State Medical Boards
FOURTH YEAR ROTATIONS
If you wish to complete your residency training in Canada, it is highly advisable to complete several
fourth-year electives in Canada, ideally one of which is at the institution you want to match to. The goal
is to become exposed to your field of choice in the Canadian system and to collect a letter of
recommendation from a Canadian attending physician. In Canada’s resident selection process, there are
fewer data points available to assess an applicant’s abilities (i.e. no grades or step exams). Therefore,
letters of recommendation and network-building are very important. The network of physicians in
Canada is smaller compared to that in the USA, so there is a chance the residency program directors will
somehow be connected to the physician who wrote your letter of recommendation.
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APPLYING TO CANADIAN ELECTIVES
AFMC Student Portal for Visiting Electives: https://www.afmcstudentportal.ca/
Realistically speaking, Canadian schools will prioritize students from Canadian schools over yourself
when filling spots for fourth-year electives. This is because American medical schools fall under
“international medical schools” or “LCME-accredited” schools when it comes to elective rotations.
Therefore, apply broadly, and take what you can get, even if the rotation is two weeks long. The
paperwork for Association of Faculties of Medicine of Canada (AFMC) takes weeks to process, so start
the paperwork and begin researching Canadian electives immediately after you take Step 1.
You need to pay to access the portal and pay for each elective application. Therefore, thoroughly
research online the electives you are applying to. Policies, application eligibility, timelines, costs ($200-
$2000 CAD per school), and required documents vary drastically between schools. Examples to consider:
• McMaster has a lottery system that takes place only 2 times a year, whereas the University of
Toronto provides a directory of preceptors that you can contact yourself to set up an elective.
• McGill requires a signed attestation of your ability to communicate in French.
• Alberta institutions may require a Canadian police background check.
Note, these policies may have changed since 2019 and are only examples.
To avoid wasting money and time applying for electives that have already been filled, apply as soon as
the application for the elective opens, or contact the elective coordinators / preceptors ahead of time.
However, not all schools allow you to contact preceptors directly, as this can be considered
unprofessional. Therefore, check each school’s webpage before reaching out. Applications for electives
typically open 22-28 weeks before the start date of the elective. Again, check each institution’s page for
exact details.
Here is some general advice for choosing electives:
• Do your best to ensure continuity with a single provider or a small handful of providers who can
work closely with you throughout the rotation. This is especially relevant for outpatient
rotations.
• Ensure you have letters from physicians in the field(s) you are planning on applying into.
• Make sure your electives are early enough so that you can receive letters of recommendation
before the CaRMS deadline. Ideally, they are early enough that they appear on your MSPE/
Dean’s letter, but this may be difficult if you are also applying to ERAS and need American
letters too.
• Canadian electives do not fit our 4-week block schedule, so you will need to be flexible. You may
need to take one or two off-weeks to accommodate these away rotations. These off-weeks will
be part of the 3 off-blocks you are given in fourth year. There are 4 weeks per block, so you can
have a total of 3x4=12 weeks off.
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• If you find yourself unsure about your career in third year (as many students are), you can find
more information on Canadian residency programs at the site below. Most programs are quite
transparent about what they are like and what they are looking for in an applicant.
https://www.carms.ca/match/r-1-main-residency-match/program-descriptions/
BU’S POLICIES ON AWAY ROTATIONS
BUSM Fourth Year Schedule & Guidelines: https://www.bumc.bu.edu/busm/files/2018/01/Class-of-
2019-Fourth-Year-Schedule-Guidelines.pdf
Elective rotations: Students must complete 24 weeks of elective rotations. Eight weeks must be
fulfilled within the BU system, i.e., taken from the Fourth Year Elective Catalogue, or
independently arranged within the BU system and approved by the department chair designated
on the approval form. The other 16 weeks of elective rotations may be taken inside or outside
the BU system. Credit toward degree requirements will be granted for no more than 16 weeks
of fourth year rotations taken outside of the Boston University School of Medicine system.
Outside electives: Students may arrange electives at LCME-accredited United States medical
schools, if these electives are part of an accredited fourth year curriculum. Upon notification that
a student has been accepted for any outside elective, the student must complete an Extramural
Elective Form.
Note: Ignore the “United States medical school” portion in the previous quote. LCME-accredited
Canadian medical schools are allowable and are not considered Global Health electives. You do not need
to contact the Director of Global Health for approval for electives in LCME-accredited Canadian schools.
TIMING OF CANADIAN ELECTIVES
It may be beneficial to complete these Canadian electives as early in your fourth year as possible (i.e.
within Blocks 9-13). It would allow your supervising physician enough time to write a reference letter for
your CaRMS residency application, which is due in November.
However, there are a couple factors that may affect your decision to apply early:
• If you follow the timeline mentioned above, you will have completed only 2-3 third year
rotations before applying to Canadian away-rotations. If you are the type of student who knows
exactly what field of medicine you want to enter, great. If not, it may be difficult to pick fourth-
year elective rotations before completing third year and learning what fields you like and dislike.
• BUSM’s M4 schedule is finalized after Canadian away-rotation applications are due. In January
of your third year, there will be a class-wide lottery for the two required M4 rotations (sub-
internship & geriatrics). The lottery results will be revealed in February, and whatever rotation
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you get will determine your M4 schedule.
Here’s the dilemma. If you wait for the lottery, you will be too late to apply for Canadian away-
rotations. However, if you do not wait for the lottery, you risk receiving a mandatory M4
rotation that coincides with your Canadian away-rotation. You may need to swap rotations with
classmates or cancel away-rotations to make things work. This may be time consuming and
expensive.
At the end of the day, the decision to apply early to Canadian away-rotations is a calculated risk. If you
take this risk, you will need to be flexible and accept the possibility that your schedule may need to shift.
When and if you begin the process of applying for Canadian away-rotations, visit the registrar’s office
and notify them of your situation. To add an away rotation to your schedule, you will need to complete
and submit an Extramural Elective form that can be found on the BUSM Registrar’s webpage. Also,
remember to request the blocks you want “OFF” in the fourth year optimization. The Canadian
interviews usually happen within a 3-week window from late January to early February, so you may
want to request that block “OFF”. Those weeks usually coincide with Block 17, but check the CaRMS
website for the exact dates.
RESIDENCY APPLICATION
INTRO TO CARMS
Canadian Federation of Medical Students Match Book:
https://www.cfms.org/files/matchbook/Matchbook_ENG_2021-2022.pdf
CaRMS Costs: https://www.carms.ca/match/r-1-main-residency-match/match-fees-r1/
As mentioned above, CaRMS is the Canadian equivalent of ERAS and NRMP combined. When you visit
their website, you will notice four paths for application: R-1, MSM, FM/EM, and PSM. MSM, FM/EM, and
PSM are for physicians seeking further training after they have completed their first residency, so you can
ignore those. You will be applying via R-1, the main residency match.
Note that US medical graduates (USMGs) from an LCME / CACMS-accredited school are considered
equivalent to Canadian medical graduates (CMG). Boston University is in that pool, so you are eligible for
the same residency spots allocated to CMGs and can participate in the first match iteration (R-1).
Within R-1, there are two iterations: a first iteration which fills most residency spots, and a second
iteration to fill all the unfilled spots with students who did not match in the first iteration. Any open spots
remaining after the second iteration are “up for scramble”. It goes without saying that you want to match
in the first iteration. The second iteration is a mini-match in which you must re-apply with all required
materials, interview, and submit a rank list – all within 1 month. In other words, it is a short period of
time for a lot of things to happen. The scramble after the second iteration is similar to the old US
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scramble before there was a SOAP. Essentially, medical school deans and attendings reach out to you
without a formal process.
The contents of the CaRMS application is very similar to ERAS, as you can see below.
However, there are some key differences from ERAS:
• Each program requires a unique personal statement. Check the program descriptions on CaRMS
for each program’s essay prompts.
• You can apply to more than one specialty. Just make sure you have the correct letters of
reference.
CARMS TIMELINE
CaRMS 2022-2023 R1 Applicant Timeline: https://www.carms.ca/match/r-1-main-residency-match/r-1-
match-timeline/
The CaRMS timeline typically lags behind ERAS/NRMP. If you are applying to both Canadian and US
programs, you can participate in BUSM’s guided third/fourth year match process for ERAS, then
resubmit similar materials to CaRMS.
You can submit both CaRMS and NRMP rank lists. However, you are contractually bound to the
program you match to first, and your entire application to the other country will be dropped. For
example, if the Canadian match happens before the American match during your year, and you match to
a Canadian program first, your entire American application will be forfeited. The CaRMS match is usually
before the NRMP match, but it changes year by year. Make sure to check the match dates.
GETTING A MINC NUMBER
Every applicant needs a Medical Identification Number for Canada (MINC) from the Medical Council of
Canada (MCC). The paperwork takes several weeks to process, so do this at the start of your M4 year.
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1. Make an account with PhysiciansApply.ca.
2. Under the “Examinations” tab, select “Apply for an exam”, and select MCCQE-1. You do not
need to select a test date at this time. You just need approval to write the exam. You will need
to prepare three documents:
a. Government identification cover sheet
PhysiciansApply.ca will provide a link to this cover sheet when you click through the
“Apply for an exam” options.
b. Notarized copy of identification
BUSM Student Financial Services (Robinson 4
th
Floor) provides free notary services to
students. Email [email protected] to set up an appointment. Bring your photo
identification, instruction sheet, and identity certification form.
c. Notarized copy of identity certification form
This form requires a passport-quality photo to be taped to the form. Get this photo
taken ahead of time.
3. Email color copies of the above documents to [email protected]. You can use a scanner app on
your mobile phone. Remember to include your full name and MCC candidate code, which can be
found in PhysiciansApply.ca > Profile > Identifiers.
You do not need to request Source Verification from the MCC. Source Verifications are for doctors who
are moving to Canada. As a fourth-year student, you will be assigned a MINC when you request approval
to take the MCCQE-1.
CANADIAN BOARD EXAMS
In the USA, students typically take the USMLE Step 1 after their second year of medical school and the
Step 2 in their fourth year. When applying using CaRMS, you do not need to submit Step 1 or 2 scores,
but you may choose to do so if you did well. Some programs do not even consider Step scores in their
evaluations. In Canada, there is only one board exam equivalent to Step 1 and 2 combined: the
Medical Council of Canada Qualifying Examination (MCCQE) Part 1.
The MCCQE1 is a 1-day, computer-based, pass-fail exam. It is similar in content to USMLE Step 2. The
exam consists of two parts:
1. Multiple Choice (4 hours)
2. Clinical Decision Making: A case is presented, and you need to select or write a short answer
about the appropriate next step. Negative marking occurs if you make any dangerous decisions.
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There is a question bank (of questionable quality) for this exam. It costs $50 CAD a month and can be
found at https://www.canadaqbank.com/. It is recommended to spend between 2-4 weeks studying for
the exam depending on your confidence on the Step 2 material and the time elapsed since taking Step 2.
Canadian graduates and US graduates from an MD school do not require the MCCQE-1 to apply to
residency. You just need to pass the exam before the end of your PGY-1 year. Many students take it at
the end of their four year, after they have already matched. Others choose to take it soon after
completing Step 2, so the information is fresh in their minds. The exam is only offered during certain
times of the year, so check the MCCQE website (https://www.mcc.ca/examinations/mccqe-part-i/) to
make sure you do not miss an opportunity.
There is an option to skip the MCCQE-1 due to equivalence of the USMLEs. However, this is highly
advised against because you will not be able to sign orders in residency. You will also need to practice
under a supervising attending after residency and pass an additional assessment before the Medical
Council of Canada grants you full practicing rights. All things considered, taking the MCCQE-1 is the
easier option.
STATISTICS & TRENDS
CaRMS 2022 R1 Match Stats:
https://www.carms.ca/data-reports/r1-data-reports/
2022 Unfilled Positions after 1
st
Iteration:
https://www.carms.ca/pdfs/5ghtk65GRMw_R1_1_OverviewByDiscipline_EN.pdf
2022 Unfilled Positions after 2
nd
Iteration:
https://www.carms.ca/pdfs/5ghtk65GRMw_R1_1_OverviewByDiscipline_EN.pdf
INTERVIEWS
Programs across Canada utilize different interview formats, including traditional one-to-one, panel, and
multiple mini interviews (MMI). Check the program descriptions on the CaRMS website to see what
interview format each program uses.
USEFUL RESOURCES
MMI-Style Practice Questions:
• https://bemoacademicconsulting.com/blog/sample-mmi-practice-questions
• https://www.shemmassianconsulting.com/blog/mmi-interview
• https://www.mcgill.ca/caps/files/caps/guide_mmi-stations.pdf
• https://www.savvypremed.com/blog/250-sample-mmi-interview-questions-to-practice-in-2021
• https://multipleminiinterview.com/mmi-questions/
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POINTERS FROM BUSM ALUMNI
Family Medicine
• Rural vs city programs is a big thing to consider when thinking about your goals and what you
want out of residency. You will likely be asked about this.
• Interview styles vary from school to school. Some are 20-30 min panel interviews. Others are
modified multiple mini interviews with difficult medical and ethical scenarios.
• It is not necessary to attend all the socials. They truly are optional, so do not sweat it if you
cannot make it.
• Interview days often have “open houses” where you get to learn about all the streams the
programs have and have the option of adding streams to CaRMS. Take this opportunity to really
learn about what makes each program/site different and what the “feel” of the program and the
residents are – online everything sounds the same. You will more than likely be asked some
form of “Why our program” anyway, so if you do this before the interview, even better!
• Have a story for every CanMeds role and be ready to answer a variation of the most typical
interview questions.
Radiology
• Interviews in Canada were very technical. I read images, worked through clinical scenarios,
solved puzzles, and had to talk through ethical cases. Bottom line - be prepared! Know your
anatomy (e.g. what are the branches of the external carotid?). It’s a good idea to read through
Felson’s again.
TRACKING EVENTS WITH CANPREPP
Canadian programs use www.CANPREPP.ca to advertise information sessions, resident meet-and-greets,
and other virtual conferences. Make an account to keep track of events.
CONSIDERATIONS – WHY CANADA?
Residents in Canada are provincial health ministry employees, meaning they earn a standard salary, pay
into the EI system, and are eligible for benefits such as paid parental leave (via EI). While programs and
specialties differ for how “family-friendly” the program is, many residents in Canada choose to take a
full year for maternity leave, which is viewed as the default. USA residency programs do not have an
overarching ACGME policy, but most programs do not allow residents to be absent from patient care for
more than 12 weeks at a time.
Residency salary and benefits in Canada are set by each province. Salary and many benefits are
therefore the same, regardless of specialty, across the province with some extra minor benefits being
department and program dependent (e.g. travel for conference reimbursement, educational resource
reimbursement, dental coverage, elective rotation reimbursement).
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CONTACTS & AUTHORSHIP
Dr. Kathy Zhao
BUSM Class of 2014, McMaster Alumna (residency in Radiology)
Dr. Lauren Scott
Assistant Professor, BUSM Department of Family Medicine
BUSM Class of 2013, McMaster Alumna (residency in Family Medicine)
Dr. Mehvish Bukhari
BUSM Class of 2020
University of Calgary, Family Medicine Residency
Natasha Ng
BUSM Class of 2023
This is a living document that provides information on the application process for Canadian
medical residencies. It is meant to be updated by rising students. If you would like to update this
document, please email the new draft to Ellen DiFiore ([email protected]). Please (1) track
changes, (2) cite sources, and (3) change the footer and (4) file name to reflect the date of last
update. You may add your name and email to the bottom of the document if you are willing to
be contacted by future Canadian students.
