Many Canadians in medical school abroad apply to both Canada and the United States. We know because that is what the people around us are doing, and it is what we expected to do ourselves.
It is allowed, and the two matching services have an agreement about it. What catches students out is how the agreement works and, in particular, which match runs first. In 2027 the order is the reverse of the previous year’s.
We are not advisors and the rules can change. Everything below comes from the NRMP and CaRMS pages, last checked 14 October 2026.
The Agreement
The NRMP says it has an agreement with CaRMS that lets applicants take part in both matches without matching in both countries. Whichever match runs first takes precedence, and applicants who match in that first match are removed from the other. [1]
CaRMS describes the same rule: applicants may apply in both countries but cannot match in both. [2]
What Happens in 2027
For the 2027 Match, the NRMP says the CaRMS results will be released first. The NRMP will then automatically withdraw applicants who match through the CaRMS R-1 match. [1] The CaRMS first-iteration Match Day is 2 March 2027. [3] NRMP Match Week is 15 to 19 March 2027, with Match Day on 19 March.
Practically, that means you will know your CaRMS result before your NRMP match. If you match in Canada, you are out of the American match.
There is a detail in the dates that we think matters. The NRMP rank order list certification deadline is 3 March 2027, the day after CaRMS Match Day. That means a student who is unmatched in CaRMS knows that before certifying their American list. A student who matches in CaRMS knows that they will be withdrawn from the NRMP match. We read this off the published dates and have not seen either organization describe it this way, so confirm the current dates with both.
The Second Iteration and SOAP
After the Main Residency Match ends, the NRMP sends CaRMS a list of applicants who obtained positions so CaRMS can withdraw them from its second iteration. [1]
There is also a restriction. In years when the two schedules overlap, applicants who do not match through the NRMP but submitted a CaRMS rank order list cannot participate in the NRMP’s Supplemental Offer and Acceptance Program, known as SOAP. They also lose access to the list of unfilled positions during and after SOAP, even if they match in CaRMS. [1]
That is a real cost of applying to both. It may remove a fallback option in the American system.
Last Year’s Order Was Different
In the 2023 cycle, the NRMP ran first, and CaRMS described the timing as giving applicants a different experience from earlier years, when there was more time between the two match days. [2] The point is that the order is not fixed. It has changed between cycles, and the NRMP pages say 2027 differs.
Why We Think This Needs Early Planning
Applying to both is not just two forms. It is two sets of exams (the MCCQE and NAC for Canada, and the USMLE steps and ECFMG certification for the US), two sets of fees, and two sets of deadlines that overlap in the autumn. We compare the costs in our article on what applying to residency costs.
Visas are the other piece. A Canadian matching in the US usually needs a visa sponsored by ECFMG or a program, and that has its own consequences. We wrote about J-1 versus H-1B in a separate article.
Questions to Settle Early
Which country would you rather match in? If you strongly prefer one, applying to the other costs money and may limit SOAP. If you are genuinely open to either, applying to both is a hedge, but a costly one.
Are you likely to meet both sets of exam deadlines? The NRMP requires IMGs to meet ECFMG certification exam requirements by the rank order list deadline. [4]
How many programs can you afford in each? CaRMS includes four programs in its participation fee and charges $66.26 per additional program, and ERAS charges per program too. [5]
The Bottom Line
You can apply to both CaRMS and the NRMP, and in 2027 the CaRMS results arrive first, on 2 March, with the NRMP automatically withdrawing applicants who match in Canada. The cost is a loss of SOAP access for some applicants, plus the duplicated exams, fees and deadlines.
Read the NRMP and CaRMS agreement pages yourself and confirm the dates before you commit. If you have a specific scenario, email both organizations. They answer these questions regularly. Our Resources page lists the sources we trust.
References
- NRMP. (2026). Early matches. https://www.nrmp.org/residency-applicants/get-ready-for-the-match/early-matches/
- CaRMS. (2023). 2023 R-1 match update: participation in CaRMS and NRMP matches. https://www.carms.ca/news/2023-r-1-match-update-participation-in-carms-and-nrmp-matches/
- CaRMS. (2026). 2027 R-1 match timeline, first iteration. https://www.carms.ca/match/r-1-main-residency-match/applicant/r-1-match-timeline/
- ECFMG. (2026). ERAS 2027 residency tokens now available. https://www.ecfmg.org/news/2026/06/24/eras-2027-residency-tokens-now-available/
- CaRMS. (2026). 2027 R-1 match fees. https://www.carms.ca/en/match-process/your-application/fees/