Matching Harms: Indigenous medical learners’ experiences with the Canadian Residency Matching Service (CaRMS)
Rebecca Howse, MD, CCFP
Anti-Racism, Equity, Diversity and Inclusion Faculty Co-Lead, UBC PGME
FNHA Virtual Substance Use Pathway Co-Lead
Date: Tuesday, April 14, 2026
Time: 12:00pm to 1:30pm
Hybrid: IRC Room 414 & Zoom* (Rebecca Howse will be presenting virtually)
Zoom Details: For connection details, please email ches.communications@ubc.ca.
Abstract
Problem: Medical education and training systems remain fundamentally colonial in nature. The Canadian Residency Matching System (CaRMs) matches medical trainees to residency training programs and is one such system. As an inherently colonial and structurally racist process, CaRMs’ impact on Indigenous applicants is neither acknowledged in literature nor adequately considered throughout admissions.
Methods: We invited 12 residents from UBC’s Indigenous Family Practice Site to participate in two audio-recorded sharing circles led by an Elder. During the first they reflected on: What are Indigenous learners’ experiences with the CaRMS application process? From the first sharing circle emerged the guiding reflection for the second: What would a caring system look like? Sharing circles were the primary means of data collection and narrative inquiry shaped data analysis. Grounded in Indigenous ways of knowing, principles of Respect, Relationship and Reciprocity, an Elder guided each step of this process and participants were invited to participate in analysis of their own stories.
Findings: Multiple close readings of transcripts grounded an iterative analysis resulting in both common themes from participants’ stories and preservation of each unique story’s integrity. An overarching theme of caring (or lack thereof) was present, with sub-themes of safety, respect, representation, and relationality. Participants wanted to feel safe in their Indigenous identity without concerns of discrimination and racism. Suggestions for improvement of the CaRMS system included offering a separate application process for Indigenous applicants, including Indigenous faculty at all stages of the application process, and prioritizing Indigenous applicants’ right to match to their communities.
Implications: Within the CaRMS system, Indigenous identifying applicants are unable to hide their identity, while settlers can speak without experiencing bias and/or racism. Rather than revising the current CaRMS approach, we challenge our community to envision a new, inclusive process that serves all learners equitably.
The Division of Continuing Professional Development, University of British Columbia Faculty of Medicine (UBC CPD) is fully accredited by the Continuing Medical Education Accreditation Committee (CACME) to provide CPD credits for physicians. This activity meets the certification criteria of the College of Family Physicians of Canada and has been certified by UBC CPD for up to 15.0 Mainpro+® Certified Activity credits. Each physician should claim only those credits accrued through participation in the activity. CFPC Session ID: 301903-001 to 301903-010. RCPSC ACCREDITATION: The CHES Cutting Edge Speaker Series is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.