And the winner of the CaRMS lottery is...

Cause that's all CaRMS is, a big honkin' lottery. CaRMS stands for Canadian Residency Matching Service, also affectionately referred to as 'the match'. It sucks. There's no other way to put it. All of the medical students in Canada (or at least, all the ones continuing on to residency the following year) apply to a big centralized application system. From there, they are offered interviews (hopefully) at the programs to which they've applied. Then, they submit ranked lists of all the programs they've interviewed at, from the one they want most to least. Every program ranks the people they interview the same way. Both lists (the medical students and the programs) are entered into a big computer, and on a designated day at a designated time you find out the course of the rest of your life. And it's binding. No room for negociation.

Lovely. And of course, everyone lives happily every after. Sigh.

In my case, the match was just supposed to be a formality. I was applying to emergency medicine... a fairly competitive specialty (the year before had seen about 45 applications for 25 spots) but not crazy competitive like dermatology or plastic surgery. And I wanted to stay at my home university. The staff knew me, and I was fairly well liked (according to the nurses and some other residents, at least). I really liked the program, and it felt like a good fit. I loved the other residents... they were such a cool bunch, and they were so close-knit. They'd have golf tournaments and retreats, and they were the type who would always be hiking or windsurfing on their days off. It was exactly the kind of life I saw for myself in the future. The program was nothing special... it wasn't any different from the other emerg programs across the country. It was more the people, and the fact that I loved the city and had made it my home. I really didn't want to leave.

And it looked like I didn't have to. The program director had become my mentor since I had first become interested in emergency medicine. In his words, the program was 'very interested in keeping me around'. He told me on a few occasions that if I had applied to the program in any previous year I'd certainly be training with them now. He met with me a few times during my final year, when I was going through the process. He advised me and counselled me and told me that if I needed to go elsewhere for personal reasons that he'd understand, but that I could expect to stay if I ranked them highly. This was even confirmed by an emergency room nurse who told me that I was one of their top two picks. And I knew I wanted to stay. There was only one other program that I liked more, but it was on the other side of the country and I didn't know if I wanted to move that far from my family.

So I went on the CaRMS tour. I was lucky enough to get interviews at nearly every place I applied. I think they were impressed by my masters (obtained in my pre-medical life) cause otherwise I didn't think that I was anything special. I had good letters, like everyone else, and a bit of research, like everyone else... who knows what they were looking for? But I did the tour. From east to west, with the same core group of people. Exhausting, but fun.

I did struggle a bit with the ranking when I came home. I was tempted to rank that far off program first... I really enjoyed the elective I did there, and I liked the city. There was another program that had impressed the hell out of me as well... but it was even further away, in a city with a crazy high cost of living.

In the end, I stayed with my original instinct. My first choice was my home school. I just couldn't ignore what a good fit it felt like. My second choice was the school on the other side of the country where I did the elective, and the third was the program that had impressed me on the tour. My fourth choice was a program I liked in a city I wasn't crazy about, and the fifth was a program I was unsure of in a city I liked (both of these cities were relatively close to my family, as well as that of my significant other). I ended up ranking 8 programs in total.

This entry is getting way too long... more on the outcome of the match later.