ellorie

I actually prefer Cerner but maybe that's because that's what I trained on in medical school and what I used for most of residency (Sinai and CAMH). My only gripe with it is it doesn't have integrated prescription faxing.

I've never heard of that either. I do think that the standard LOC limit is much higher now - when I started med I think it was 200k and now it's something like 350k so I suppose I could have potentially asked for a boost. Never have because I didn't think I needed the room.

I think it's a relevant but very tired and overdone theme - there wasn't much in it that felt particularly novel or interesting to me, just the usual points about balancing different aspects of patient centred care, learning to be a good listener, learning to find your own style within the physician role, how medical students can be better listeners sometimes because they have more time, the compromises we all make, etc. But I think it's very normal and healthy physician development to ponder these questions at that level of training as you're learning to balance everything, I know I did. I think I get a little bit tired of reading over and over about how doctors don't listen enough/care enough/spend enough time in the absence of acknowledgement of all of the systemic factors that set us up to practice how we do and why we have to make these kinds of compromises. The reason we are all burning out is because of constantly being expected to shoulder responsibility for all of the systems level factors that cause medicine to be practiced in ways that patients generally dislike.

That's true actually - I usually include pertinent past diagnoses in my ID up front.

The format depends a lot on the specialty and context, but the key is to be organized (people will start to get bored if the information seems like it's coming randomly and they can't see how it fits into the bigger picture), start to get a sense of the pertinent positives and negatives (i.e. omit irrelevant information even if you gathered it in the process of finding the relevant information) and also to build your case presentation as if you're building a case towards your eventual conclusion (you want to always be presenting evidence relevant to your eventual diagnosis and plan and showing your preceptor how you're thinking). You want the information you present to be in service of helping the preceptor follow your line of reasoning. It also depends a bit on your level of training and your supervisor - i.e. if they trust you that if you don't say something you've asked it and it was non-contributory, or if they want to hear everything you asked to make sure your history was complete. If your supervisor is complaining that your presentations are too long, they might want less non-contributory information. Additionally, you want to organize the information so that you are presenting it in sections and it flows logically, even if you gathered it out of order - in a psychiatric assessment, I usually present ID, chief complaint, HPI, review of systems (with only pertinent positives/negatives and safety concerns), past psych history, family and medical history, social history, then my formulation and plan. After you've done the assessment and taken your notes, you could consider looking through and circling or underlining the important points to remind you what to say and what to skip over, or organizing things onto a separate page with the information broken into categories. If I were you, I'd ask a resident if they can show you how they'd present a case so that you can get a speciality and setting specific example, and/or ask your preceptor for specific feedback on which information they'd have wanted you to leave out. When I had medical students I would usually teach them by modelling how I would present their case after they did it and that seemed to help.

My program didn't contact us until like 3-4 weeks later! But they eventually did. There isn't a huge amount to do other than start assembling everything you'll need to apply for your license.

Been a long time since I was at Western (not since med school) but agree that Mac is much better resourced. Hamilton is likely also a better place to live. Unless it's changed, call at Western and ED psych services in general have historically been a mess.

I think more about how I could put together enough money to take a long period of time off (minimum 6 months). I think about that daily, but it's not really financially possible. Being a doctor sucks right now, but I can't think of anything else that would be more viable or much better. I often think these days that if I had it to do again I might have gone into social work and just done psychotherapy in private practice, just entirely dodged the mess that is the health care system and the massive baggage that comes with psychiatry (being dumped on from every angle constantly). But of course that has its own challenges.

RBC automatically converted mine to a personal LOC at the same rate. No monthly fee.

I think this is an incredibly tone deaf post to make on a forum full of many people who are currently working on the front lines and bearing the brunt of multiple waves of trauma caused at this point largely by the choices of unvaccinated people. That's what I think.

By community, do you mean community hospital or community like outpatient clinic outside of the hospital setting?

Sure - though honestly there isn't much clarity to be had. I did go through this process though so feel free to ask me questions by PM.

Get disability insurance right now, especially if you haven’t been diagnosed or treated yet. Like, immediately. With CPSO there really is no concrete info. It’s about the diagnosis, not the treatment - they ask if you’ve ever been diagnosed with a condition that could interfere with your ability to practice medicine. It’s a personal judgment call whether to disclose for most people with psych stuff. If you’ve taken a leave you will probably end up needing to, if not it’s a conversation with your treating physician. Most people with mild to moderate depression and anxiety disorders I think choose not to disclose.

I don't know anyone who has been forced out of their program entirely (though it does happen from time to time). I do know several people who have been put on remediation for various reasons. "Professionalism" is a wide net and a vague enough term that the program can use it to nail you for almost anything they really feel like nailing you for. Most people I know who have been put on remediation have been for that reason. Actual unprofessionalism is mostly things like coming late, not showing up, not doing your paperwork, lying about things, etc but sometimes it can be because your supervisor is out to nail you and it becomes something vague like "having an attitude" or "not taking feedback". To some degree when it comes to medical errors it probably depends on the specialty and how much of the mistake was related to negligence versus inexperience. Nobody expects you to know everything but people expect you to be able to ask for help when you don't know what to do, rather than let things spiral out of control.

The problem is, in order to do FM, you have to have the talent and liking for FM - I feel like it's a mistake to think of FM as a default option. The skill set of FM I think is one that I would not be well suited for at all - I can't change tasks or mindsets very fast, I get really stressed out by the unknown, don't like ambiguity, the whole "a little about a lot" thing is very ill suited to my strengths and general personality. Plus for some things, like psych, you really can be out and done in 5 years - 3 more years isn't so many if you get to do something you're good at at the end of it. Plus psych residency is overall pretty tolerable. That said, I emerged from residency super burned out and am still super burned out so -shrug-