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We interviewed Dr. Usmani about her CARMS (Canadian Resident Matching Service) experience; here's what she had to say:
When and where did you graduate from?
I completed my undergraduate studies at Dow Medical College, DUHS in Pakistan, with my YOG being 2016.
Where did you match?
I am currently completing my residency training at the University of Toronto. I had applied to pretty much every family medicine and psych program under the sun (or, more accurately, in Quebec, Ontario, Saskatchewan, Manitoba and Dalhousie). I was called for interviews at two programs (combined Ontario universities and Quebec universities) and was waitlisted for two others.
Were you satisfied with your QE1 scores? Do you think scores matter?
I would be lying if I said I was satisfied with my Qe1 result, although it was 1 SD above the mean. My NAC results were pretty average and were a significant cause of anxiety during CaRMS season, as I had heard that only people with superior scores got interview calls.
I believe high scores are important as they impact your overall CaRMS profile and help in getting interviews, and ultimately, a match. However, they aren't the only important thing.
How did you study for QE1?
I prepared for Qe1 for 6-7 months properly with no other commitments. I had a slow start with just solving question banks and then progressed to Toronto Notes. It took around three reads of that beast of a book to feel a smidge confident finally. I then progressed to practice exams and then finally the real deal. So my schedule for studying for Qe1 was pretty much day and night by the time exams rolled around.
An essential thing for Qe1 prep is having a partner or group that you can check in with for your study schedule and mental health. I had a study partner who was very good at motivating us and kept both of us on track. Together, we realized that the only way we could achieve anything was by being persistent and ensuring we left no stone unturned in finding more information on how to give the exams. So forget being ashamed about asking for help or asking people for information regarding studying well. There's nothing more important - not even your ego - than knowing what, when and how to study.
Full disclosure: This exam is not easy, and preparing for it requires a lot of sacrifices. However, I think that's a small price to pay for good scores and a potential match to your preferred residency program.
If you could go back in time, what's that one thing that you'll change about how you prepared for QE1 and NAC OSCE?
For Qe1, I don't think I would have done anything differently.
For NAC, however, I wish I had had more time to study. It would have been better if I had done more focused practice in history taking and physical examinations. For example, rather than finding out everything and asking every question under the sun, ask what is relevant and essential for a particular case.
The best thing for NAC is practice. Find different people to practice with, including people who may have more Canadian experience than you, as it helps give an insight into how to refine your methods.
What work experience did you include in your resume?
I included all undergrad and postgrad experiences starting from internships, elective rotations, and any healthcare-related job I had done, whether paid or unpaid. I also included my volunteer experience, research experience, professional development courses, leadership experience and awards, societies or organizations that I was a part of related to the healthcare sector etc.
It's essential to have a CV /resume that touches upon all the relevant skill sets required for the residency program you're applying for while also keeping a dominant theme. For me, that dominant theme was leadership and initiatives, and by highlighting those experiences, I was also able to show my personality through my resume and hopefully appeared relatable.
Which type of work experience increases your chances of getting matched?
I think the one thing that is most important in helping you match is the recency of practice, which could be an independent practice or post-graduate training that you have done in the last two years. Another thing that programs look far, as I mentioned previously, is a well-rounded CV that shows that you are good at or at least know everything rather than a CV focused on only one thing like, for example, research.
For IMGs, it isn't easy to find jobs in Canada that will allow you to get recency of practice as most positions require a license. However, if one can get a physician assistant diploma and work as a PA, that would count towards recency, I believe. The other option is returning to your home country after exams and working there with a valid license before applying for CaRMS.
Suppose independent practice is not an option for you; don't sweat it. It's not all dark clouds for IMGs, as even the experience of working as a clinical observer in the Canadian healthcare system does have benefits.
Do you have any tips for letters of reference and how to source them?
Before starting a job/elective, talk to your preceptors about needing a LOR for CaRMS. If you plan on using letters from more remote experiences, make sure you contact your referee well in advance of CARMS application deadlines so that they can upload the LOR on time. The best LORs are those related to the specialty you are applying for. For example, internal medicine Letters for an IM residency program will always be considered superior to an OBGYN letter for an IM program. However, that doesn't mean that all your letters must be from the same specialty. You can have letters from related specialties too, like for the above example, peds, nephro, cardio, pulmo, neuro, and even derm letters would be acceptable. Before submitting letters of reference, go through the program requirements as they change every year and can be very specific in terms of the content of letters, type of letters, their dates, and who can upload them for you.
One misconception I'd like to touch upon here and clarify is that unlike what some people say, LORs from observerships also hold value in Canadian/North American programs.
Were there moments when you thought of giving up? If so, what made you pull through?
Yes, yes and yes. There always comes a point in the journey to licensure where you feel like things are hopeless. For me, it was the fear of "what if I'm wasting my time and money?" that started in the weeks before NAC. There was this concern that if I didn't match, all my struggles, sacrifices and the time and money spent on the licensure exams would go to waste. And I think that was a valid concern keeping in mind the low CaRMS matching rate for IMGs and the general doom and gloom atmosphere surrounding getting residency in Canada.
There were so many people along the way, starting from friends and family and ending at strangers, telling me that Canada was a graveyard for IMG doctors and that I would end up doing some part-time minimum wage job. And I'm pretty sure you'll meet a lot of these negative nellies too. But make sure to pay no attention to them. They are usually people who either didn't even try to get into the system or, unfortunately, didn't have proper guidance during the process and had to give up on their dreams.
The negativity and fear can sometimes be overwhelming, especially with people being the way they are sometimes but don't let them drag you down.
Final words of wisdom for Candian residency program candidates?
Don't give up! Try, try and then try again. It's easier said than done, but hard work and perseverance always pays off. It may take more time than you initially thought, but good things will come your way. Just stick to your goal and once you achieve that, remember to pave the way for the next crop of IMGs and guide them through the process.
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