Open Access Open Badges Research article

Factors affecting residency rank-listing: A Maxdiff survey of graduating Canadian medical students

Tao Wang1*, Benson Wong2, Alexander Huang3, Prateek Khatri4, Carly Ng5, Melissa Forgie2, Joel H Lanphear6 and Peter J O'Neill7

Author Affiliations

1 Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King's College Circle, Floor 5, Toronto, Ontario, Canada

2 Department of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, Canada

3 Department of Anesthesia, University of Toronto, Room 121, Fitzgerald Building 150 College Street, Toronto, Ontario, Canada

4 Department of Medicine, University of Toronto, Suite RFE 3-805, 200 Elizabeth St., Toronto, Ontario, Canada

5 Department of Family and Community Medicine, 500 University Avenue, Floor 5, Toronto, Ontario, Canada

6 Department of Medical Education, Northern Ontario School of Medicine, 955 Oliver Road, Thunder Bay, Ontario, Canada

7 Department of Obstetrics and Gynecology, 68 Barrie Street, Queen's University, Kingston, Ontario, Canada

For all author emails, please log on.

BMC Medical Education 2011, 11:61  doi:10.1186/1472-6920-11-61

Published: 25 August 2011



In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS). The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making.


Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test.


In total, 339 of 819 (41.4%) eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more.


Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors. The results of this survey will contribute to a better understanding of the CaRMS decision making process for both junior medical students and residency program directors.