It is possible to simultaneously submit residency applications for positions in Canada and the US. This means registering with all of the appropriate agencies in both countries, interviewing in both countries, and creating two separate rank order lists (one with CaRMS and one with the US match agency relevant to your specialty). The most important guiding principle is: the match that runs first takes precedence.

1. If you are matched to a residency position in the match that runs first, you are legally bound to that program for a minimum of one year.

2. In >95% of years, CaRMS runs before ERAS/NRMP; SFMatch and the AUA match always run prior to CaRMS.

3. You cannot “hold” a position from the first match to see if you get a better position in the second match – matching in the first system automatically withdraws you from any subsequent match process.

Other considerations:

1. Logistics – even though CaRMS will process your documentation for the CaRMS match and for the ERAS system, you need to consider them as two completely separate processes/organizations.

1. Any documentation that you are submitting in support of your applications must be submitted twice, once addressed to “CaRMS” and once addressed to “CaRMS for ERAS”.

2. Timing – the US application and interview process takes place earlier than the Canadian process.

1. You will want to do your US electives as early as possible to ensure that you can get letters of reference and to have at least one or two elective evaluations appear on the MSPR.

3. Balance – it is difficult to run a residency application through both the US and Canadian systems without diluting your competitiveness in both.

1. If possible, prioritize one system and do most of your electives in that location, with one or max two in the other system.

2. Make sure that you do your electives in both systems at the places that you most want to go that are also realistic options.

4. Expenses – between registering with all of the agencies and going to all of your interviews, applying in both systems can be extremely costly, even approaching $10,000 depending on where you apply and how many interviews you attend.

Next: Residency Application Documents