zizoupanda

To do cardiology you have to do IM first so you need to be ok with doing that for 3 years. I didn't like IM but I survived it to get into my subspeciality which is also heavily procedural so it is doable. Cardiology will likely have a better lifestyle overall and you'll have the medicine aspect if you choose that. That said, keep in mind jobs and geography may come in play. Jobs in interventional cardiology to my knowledge aren't always easy to come by, I know of people doing THREE year fellowships to work in an academic center as interventional cardiologist in a large Canadian city. Talk to people about this in the field in your city if geography is important for you. That said, I think cardiac surgery is no better and likely worse in terms of job prospects.

1. The Canadian health care system is rife with nepotism so unfortunately you're right. The Royal College is an opaque and frustrating organisation. I hear Americans complaining about the ABIM, they have no idea what we have to deal with up here. 2. Yes it's the linked Toronto review course not the Toronto notes. 3. Note, the review course has a small question bank (and an oral examen practice section) that is pretty good. 4. As for guidelines, no there's no source. It's a mystery always which guidelines they prefer. I'd recommend reviewing Canadian guidelines for high yield topics: HTN, AF, HF, ... American guidelines are used when the Canadian ones are outdated or non-existant. The Review course gives a more or less complete overview of these guidelines as well tbh. 5. I don't think uWorld is completely useless. On its own maybe not enough to pass but useful. Basic IM topics like heart murmurs, JVP, MEN, vasculitis, ... all come up and those aren't guideline based anyways. I think a refresher on high yield topics would be good. Don't waste your time though on primary care stuff such as OB/GYN and psych which are not tested on the Canadian exam. 6. The internist who runs the review course is really nice and approachable. I'm sure you're not the first person to go through it like this, I would suggest after you sign up to reach out to her and ask her advice. I don't want to discourage you at all. I think it might be a bit of a challenge but at the end of the day, you're a board certified internist in the US, this is an IM exam not a surgery exam. Do with that you have; immerse yourself with the Toronto Review course, review some guidelines, and review basic IM w/uWorld and it will likely work out just fine. Because of the opaqueness of it all, I'm sorry I wish I reassure you more but I can't.

I can't answer 2 and 3 because the oral was cancelled the year I did my IM RC. To answer question 1 - I can't give you a clear answer but here's my 2cents as a Canadian IM resident who did both the RC and ABIM. In Canada, we study the Toronto Review Course (usually study previous year's pdfs until they come out with the new ones) plus the old RC questions that get passed down in addition to guidelines. The US board exam is easier than the Canadian one. I don't think UWorld (I used it personally as a refresher before my US board exam) alone is sufficient to be honest because the Canadian RC is ++ fixated with guidelines and there's a few esoteric questions that come back that I'm not sure how to answer without having seen it in previous years' exams. That being said, the RC also doesn't give out scores (unlike ABIM) so I don't how to gauge if I over studied it or studied just enough. Few Canadian IM residents fail but most study the blueprint I layed out. Those who fail usually have personal issues interfering with studying. Can you pass if you just do Toronto review + guidelines +/- uworld without the qbank? Possibly but I don't know for sure. If you know anyone in Canada personally who could connect you with an IM resident, that's your best bet. The bank isn't passed down by programs; it's passed down between residents. I think people are a bit leery these days with sharing the qbank because there were rumours last year that the RC "found out" about the qbank whatever that means (as if they didn't all use it to pass their own RCs as well..)

Recent IM grad here. PGY-1 and 2 at least at my school if you were reading anything it was MKSAP. I read a few of the books. It's a pretty decent overview, although it can lack depth sometimes. (there's pdf versions floating around the web too). I complemented with guidelines. PGY-3: Toronto Review slides + IM RC Qbanks + guidelines. Anything else is a waste of time in my opinion. RC is obsessed with guidelines. If there's a Canadian guideline, that's what you need to know. Otherwise, they default to the American guideline. For general knowledge, they are often close enough (although sometimes the Canadian ones haven't been updated in a while). You can worry about the details in PGY-3. For now general knowledge is sufficient to start.

Thanks for everyone's advice. It's +++ appreciated. I finished IM and did the IM RC last year so yeah I'm not far away from general medicine knowledge but will have to brush up on some peds, psych, ob/gyne. I'm much more worried about the step 1 (cause the pathophys) than the step 2 but maybe I'm wrong. I'll look into scheduling it; I'll try w/2-3mo of slowly studying for steps 1 and 2 each so I don't burn myself out and give myself time to do other things. I'll try doing just UWORLD +\- first aid for extra reading around topics if ever I have the time. Again my goal is literally a pass to have it in my back pocket worse case scenario. I've used UWORLD for other exams and found it perfect so I'll trust it. Hopefully it works. I'll report back when I'm done.

Thanks for the advice! Is the content on the step 2 that much different than step 1 that I would need an additional 3 months to study for it? Or is the overlap sufficient that I could do uworld x 1 quickly in between and do it 4-6 weeks later?

Hello I made the now clearly bad decision not to do my USMLEs as a med student. At least on the good side the Step 2CS was dropped in the mean time. I'm a PGY-4 in Canada. Job prospects in my speciality aren't great and at the very least I may have to go to the US for fellowship training +/- work there at least temporarily. I want to keep my options open. The problem is I haven't done my USMLEs yet... In how much time reasonably (accounting that I'll need to split my time studying for my own speciality, RC thankfully not for another year) can I complete all three steps? I'd ideally like to have all three steps done quickly before the start of 2023 (so over the next 6-7 months) but not sure how realistic this is (I'll need to start studying for my RC after in early 2023 so would like to be done before then)? I obviously just need to pass; they're pass/fail now anyways. Thanks for any help. (And if you're a med student or junior resident in a smaller field; just do them in case. You lose nothing but a 2-3000$ which is a drop in the bucket considering what we spend for med school, LMCC, RC, ...)

The data is definitely changing. The same article has a graph on new graduates: I detest the CaRMS process for its lack of transparency and nepotism more than anyone but I have not seen any evidence of gender discrimination within CaRMS. By that logic, would it be fair per the above graph to say that there is discrimination against males candidates in OB/Gyn and Peds?

I'm not really what you are proposing then @BoopityBoop. The reality is we have a perfectly transparent equal pay structure. Women and men are paid exactly the same for the exact work they do. Woman earn less than men because they choose to work in more lifestyle-friendly specialties and work fewer hours. This chart is from the US but the Canadian data is the same (https://www.cma.ca/Assets/assets-library/document/en/advocacy/policy-research/physician-historical-data/2015-06-spec-sex.pdf); women prefer specialties such as Pediatrics, FM and psych while men tend to dominate surgical fields and busier (but higher paying) IM fields like cardio and GI. I maybe do agree that we can encourage women (if they want) to pursue these fields but I don't think women are locked out of these fields right now anyways. Women just tend to have different priorities and many value strongly motherhood and making time for their children. Men biologically have more flexibility to delay conceiving a child than women. On my anesthesia rotation for example, I saw plenty of female anesthesiologists and many of them worked only part-time (~3 days/week) while nearly all their male counterparts worked full-time so obviously, the males will earn more. How do you we propose we fix that? Lower men's billing codes to even out the income? These women were brilliant at their job and found a great balance between what they value most, this should be celebrated not a source of shame for men and women. What we should pursue is equality of opportunities which I think is more or less what we have now, not the totalitarian (and very dangerous) fantasy of opportunity equality of outcome. Men and women are different and have innately different priorities at different times. Women shouldn't be shamed for valuing family over career and vice versa if they choose to. Further, women now outnumber men in medical schools and certain specialties like OB/Gyn are becoming nearly all female (new residents). Why aren't you protesting that?