When a Canadian is not a Canadian: marginalization of IMGs in the CaRMS match

Abstract

This paper explores the marginalization experienced by International Medical Graduates (IMGs) in the Canadian Residency Matching Service (CaRMS) Match. This marginalization occurs despite all IMGs being Canadian citizens or permanent residents, and having objectively demonstrated competence equivalent to that expected of a graduate of a Canadian medical School through examinations such as the MCCQE1 and the National Assessment Collaboration OSCE. This paper explores how the current CaRMS Match works, evidence of marginalization, and ethnicity and human rights implications of the current CaRMS system. A brief history of post graduate medical education and the residency selection process is provided along with a brief legal analysis of authority for making CaRMS eligibility decisions. Current CaRMS practices are situated in the context of Provincial fairness legislation, and rationalizations and rationales for the current CaRMS system are explored. The paper examines objective indicators of IMG competence, as well as relevant legislation regarding international credential recognition and labour mobility. The issues are placed in the context of current immigration and education policies and best practices. An international perspective is provided through comparison with the United States National Residency Matching Program. Suggestions are offered for changes to the current CaRMS system to bring the process more in line with legislation and current Canadian value systems, such that “A Canadian is a Canadian.”

Licensing exams in Canada: a closer look at the validity of the MCCQE Part II

“…25 More troubling, however, is the potential for bias in the assessment of physicians who are racialized or identify as visible minorities, as evidenced in clerkship evaluations of undergraduate medical students 26,27 as well as in the systemic barriers many IMGs face for practice in Canada. 28 It should be noted that IMGs must pass the National Assessment Collaboration (NAC) Examination, a similar OSCE-style exam, in addition the MCCQE Part I, prior to applying for residency positions in Canada. It is, therefore, uncertain whether the lower pass rates reflect a lower level of preparedness of IMGs for standardized examinations or a potential bias in their assessment.…”

Overcrowded curriculum is an impediment to change (Part A)

“…When a Canadian is not a Canadian: marginalization of IMGs in the CaRMS match by Malcolm MacFarlane 33 presented an overview of the Canadian Residency Matching Service Match (CaRMS) system, evidence of Internal Medical Graduate (IMG) marginalization within the system, and human rights implications of the current CaRMS system. He concluded by offering suggestions for changes to the current system to bring the process more in line with Canadian values.…”

Recommendations for Improvement of Equity, Diversity, and Inclusion in the CaRMs Selection Process

“…Many residency training programs are now implementing diversity plans in their selection committees with the goal to promote a more equitable selection process. 6…”

“…Many residency training programs are now implementing diversity plans in their selection committees with the goal to promote a more equitable selection process. 6 Radiology, in addition to other medical specialties, benefits from diversity in its workforce due to the specialty's reliance on communication, teamwork, and collaboration. 6 By improving EDI in the CaRMS selection process, we can ensure a more equitable approach in selecting diverse candidates, paving the way for a more inclusive Radiology field and medical profession as a whole.…”