These students are set to bypass CaRMS and launch directly into family medicine residency
A cohort of 20 Ontario medical students have a rare opportunity to bypass the CaRMS process next year because they’re already guaranteed a residency spot in family medicine.
The whole Queen’s University-Lakeridge Health MD family medicine program was developed in the same timeline as human gestation, with funding secured in November 2022 and the program’s inaugural students starting early September 2023. Now in their clerkship year, the students have until June 15 to respond if they will keep their Queen’s family medicine residency seat, or decide to enter the match for another seat.
A few students may decide to enter the match because family or life circumstances mean they want to study elsewhere, said Dr. Michelle Gibson, associate professor and former assistant dean of curriculum for undergraduate medical education at Queen’s University. Doing residency elsewhere, but still in family medicine, is a good secondary outcome, said Dr. Richard van Wylick, vice dean of education at Queen’s University faculty of health sciences.
By bypassing the match, the students can focus on learning instead of performance, said Dr. Natasha Aziz, assistant professor and curriculum director at the Queen’s-Lakeridge Health MD Family medicine program.
The students in the Queen’s University-Lakeridge Health MD family medicine program study at Lakeridge Health in Oshawa, Ont., instead of at Queen’s University’s main campus in Kingston, Ont. While the program was quickly created quickly (“Make a baby, plan a campus, same thing,” Dr. Gibson joked), the students score the same, if not better, on the Objective Structured Clinical Tests (OSCE) as students at the Kingston campus. There was no significant difference in the OSCE scores in the first and second year. Dr. Gibson presented the results as part of the International Congress on Academic Medicine, held in Ottawa in April.
“It’s not a second-class campus,” Dr. Gibson said, adding that the third-year scores to date also look equivalent.
A new curriculum
The MD family medicine program differs from that offered at Queen’s Kingston campus. The difference is more in the order subjects are introduced. Where the Kingston students engage in learning by looking at anatomy and different human health systems one at a time, the Lakeridge Health students engage with concepts based on the human life cycle. For example, they start with young adulthood and examine medical concepts related to that stage using problem-based learning. In second year, the learning progresses looking at integrated body systems.
They may learn things in different order, but by clerkship year, the students in both campuses have the same knowledge. Clerkship at Queen’s University is a regional format with most students spending time outside of campus.
The Lakeridge Health students also get more clinical experience before clerkship. In first and second year they are engaged in community-based learning for more than a total of ten weeks a year, as opposed to the Kingston campus’s cohort one week. This is in part because these students already know what discipline they want to practice—family medicine—and the extra clinical time means they can bring their clinical learning into their classroom learning, Dr. Aziz explained.
A program that adds 20 new students every year means that the physical space is growing tight, said Dr. Aziz. The Lakeridge Health Education Resource Network, located in the Lakeridge Health Oshawa hospital, has lecture halls, a simulation lab, and other rooms.
New faculty
The program has also had to add teaching faculty as the number of students grew. “Fortunately, there was no shortage of applicants for these roles,” Dr. Gibson said. In the first year, all faculty were family physicians. Now a few family medicine-adjacent specialities are participating.
Queen’s University has run a family medicine program at Lakeridge Health since 2012 so many physicians trained through the program were keen to join in the adventure. Dr. Gibson said that the opportunity to teach helped some physicians offset burnout, with “the chance to do something new and different.” These new voices from family medicine helped guide the program with fresh ideas and enthusiasm.
“Community-based medical education works. You don’t have to centre medical education around the academic health sciences centre,” Dr. van Wylick said. “It works because physicians are skilled in knowing what it takes to practice medicine and have different perspectives in the community from the academic health sciences centre.”
The students themselves are one of the programs strengths, showing up and providing real-time feedback on curriculum so educators can adjust it.
To date, the Queen’s-Lakeridge Health MD family medicine program is the only one where students can bypass CaRMS, but more may follow. This includes a new family medicine-centred program starting at University of Ottawa in September 2026. It will include four students in the English stream and four in the French stream. Those students will study alongside their peers, with extra-curricular work exploring family medicine.
