leviathan

Some provinces are a lot more controlling than others with respect to what kind of medicine you can practice (e.g. sorry we don't have any 'need' for more internists in this region of the province, even though theres a 2 year waitlist for IM consults). They're like that in the maritimes where they create artificial 'positions' or 'billing numbers' that need to be given out. Outside of those provinces, like BC, if you want to just do clinic you can set that up anywhere you want, regardless of if you are 4 year or 5 year trained. The only caveat would be to make sure that they aren't oversaturated with internists already, though I suspect that is not the case anywhere in the country, especially if you want to fill a specific need for that city for some particular type of referral. The benefits of the 5 year program would be an extra year to develop a particular special interest or skillset that would be useful for what you want to do for your practice. It may also be beneficial in case you do want to work in a hospital environment in a competitive city, where the trend is towards hiring 5 year GIM even in community hospitals, and wanting people who can deliver some sort of value-added service to the group to fill a need. To answer your last question, the variety of working environments for GIM in community is so diverse that there's no way to tell you what it's like. It would depend how much clinic you did, call, ICU work, whether you have privileges to do stress testing, echos, holters or other cardiology work etc. That said, as an example at my hospital in Nova Scotia, the GIM work would consist of weeks of inpatient coverage 9-5, weeks of clinic 9-5, and 3-4 overnight home call per month covering the CCU and IM inpatients + consults, but not ICU. I do ICU, not GIM, so I don't know what the pay would be for GIM. But knowing how it works, if I had to estimate it would probably be roughly 400-500k/yr for someone that just did GIM without any procedural work or more lucrative billings.

I graduated from a Caribbean medical school in 2012 and completed my residency and fellowship in Canada. It worked out for myself and the majority of my Canadian classmates, but a few went unmatched after multiple years and have given up on being a physician, now with 200-300k in debt. In retrospect, looking at these classmates they often had very low MCAT scores, undergrad GPAs, poor work ethic and study skills etc. Canadian medical schools have so few seats that they invariably reject many very qualified applicants who would do well in medical school and go on to be excellent doctors. But there are also people who aren't cut out to be doctors, for various reasons. The difficult question to ask yourself is whether you think you fall into the former or latter category.

Yikes. This is the problem going to these foreign medical schools. Even at a 'good' school like SGU, you just can't predict what will happen. I'm 99% sure this will work out okay - not rectifying this would literally destroy what is one of the biggest medical schools for the US - but it still creates a lot of unnecessary stress for the students there. I went to Saba when they were transitioning to officially joining the Netherlands , so they had to become accredited by the Netherlands instead of this caribbean group. They ended up getting accreditation, but it was somewhat stressful at the time not knowing if I'd be able to write the USMLEs.

Scotia waives my fees on the Visa automatically. The AMEX was free the first year, but this second year around I noticed they just reversed the annual fee when I told them I wanted to cancel that card.

Scotia now offers me 275k plus the Passport visa gold AND the AMEX gold with no fees. That's not standard but was able to work out a deal.

Well bring on the lower rate! My bank account would sure be happy.

So my extremely simplistic view of the situation is that the prime goes up when the economy is doing better. Since it's continuing to improve I'd expect it to only go up from here. That and the fact that it's at almost at an all-time low right now and doesn't have very much room to go anywhere besides up.

I didn't know they discontinued the score? Actually I got in the high 270s on Step 2 and my 2 digit score was only 87 or something ridiculously low. The percentile I used was based off the score distributions for applicants published on the NRMP match data.

Very good questions. I had no idea if I'd make it through the program before I started, and nobody going abroad should assume they will either. I had a lot of reasons I thought I'd do well in med school: my poor undergrad was because I majored in psych where grading is extremely subjective. I had done very well on the MCAT. I aced all my science pre-reqs and aced my physiology+pharm+biochem courses as well, and any subjects that were related to medicine. That said, I had no idea if they were valid reasons, or just excuses to hide that I wasn't cut out for medicine (like the 40% of people who didn't graduate with me). Further to that, you not only have to just graduate from medical school, you have to EXCEL academically and clinically if you want a realistic chance at matching as an IMG. Thankfully I did very well on the USMLE exams and the Canadian exams (99th percentile on all), and got great LORs in Canada, all of which helped me get a spot. But there's no way I could have known that before going. I chose Saba because it was the only international school that I could afford on a student loan, that was approved in all 50 US states, and had a good match rate in Canada (and excellent match rate in the US).

All of the banks require a cosigner, so whoever signs it (eg parents) would be responsible to pay off your loans if you failed out. The fact that you're applying to a Caribbean school in the first place suggests you don't have what it takes to survive medical school, and a good chunk of students who come to Saba do end up failing and going back home. As a Saba grad who is now training in Canada, I can probably make some comparisons with Canadian programs. If you did succeed and graduate from Saba, the didactic training is on par to the US system, which is probably more in depth than what you get in Canada. The area where there's a lot of variability (at all foreign schools) is in the clinical training, which is arguably more important. It can be on par with Canadian training but can also be vastly inferior, if you're not lucky to get a good clinical placement where you do a lot of hands-on training and have a lot of responsibilities. If you have other questions feel free to ask.

Oh maybe not, but is that for Ontario? I'm not in Ontario.

Yeah the interest relief program would be helpful except I'm married and our family income is too much to qualify for that. Our advisor is aware of that of course too, or maybe she just forgot.

Your OSAP interest is tax deductible, but the way I had calculated it you would still save more money by paying it off with your LOC. That said, I met with my financial advisor through MD Management and she seemed to think that it was a better idea to keep the student loan, but I didn't have time to ask her why.

As mentioned by someone else, I have the Scotia Passport Visa with waived annual fee (as part of my professional LOC), and then I have the Scotia AMEX Gold with $99 fee (waived the first year). I had to provide a paystub from my residency program to get approved. To be honest, I've just tried using the Amex again today and for the millionth time the place did not accept it. Most places seem to refuse the AMEX card, and even grocery stores like Superstore. Costco actually ONLY takes AMEX but it only offers you 1 point per dollar rather than the posted 4. Overall it just seems like a huge hassle and not worth it, so I'll probably be cancelling it before it's up for renewal. I haven't looked at cards in awhile but I think there's a card called Capital One World Aspire that is 2 points per dollar on everything, which I might switch to. The only catch with that card is you have to use your points in blocks.

Yep! But you have to spend at least $2500 per year in gas, groceries, restaurants to break even with the card, before you start making any money. Assuming you have the 1% back card with the waived annual fee for the rest of your purchases, that is.