Snowmen

Hi everyone, I was wondering if anyone had information about how competitive the CaRMS match for the 2-year pain medicine residency was? I tried looking at the CaRMS official reports but the information isn't presented as clearly as for the R1 match. Thank you!

I don't know about the CFPC but the FRCPC/S allows you to start accumulating CME credits when you're a PGY-5. Maybe that's why there's a fee during your last year of residency?

They're picky as hell every year from my experience. Admittedly, I wasn't a 100% IM applicant back when I did CaRMS but out of the 4 specialties I applied in (like 12-13 programs overall), they were the only one not to give me an interview despite having very strong evaluations in all my rotations (including IM, obviously).

When I was an MS2, I couldn't even remember whether sodium or potassium was the one with the "big number" so I think you're fine.

I'm not an IM resident but as a PGY-1, I took call exclusively in IM like a regular IM resident (at Laval University, not UofT, to be clear). Not once did I have to argue with an ER doctor that was being a ****. Never had an unstable patient that I felt needed to go to the ICU and didn't go so I had to manage him. Never had to fight with a surgical resident who wanted me to admit one of his patients. Wanna know why? Because they knew if I said a patient had to go to the ICU/wasn't a medicine patient/etc. and they argued, my attending would have my back.

I think he was being a bit of a troll although I would generally agree with the rest of his post.

Chances are you won't end up targeting the subspecialty you're interested in right now (or might not even end up going for IM at all) so I would do the more interesting project regardless of the subspecialty.

For MSK, not really no. For rehabilitation, it depends on where you are practicing. For instance, physiatrists in Quebec typically aren't the MRP and only act as consultants while a GP admits the patient and takes of general medical issues. This is similar to what I've seen in Toronto and possibly the rest of Ontario. In other provinces or centers, physiatrists admit the patients under their name and take care of all the general medical issues. Something to note is that even in Quebec, physiatrists handle a lot of medical issues outside of the MSK and neuro aspects. Disability is rarely limited to these systems and causes many issues in the cardiovascular, urinary, digestive, pulmonary, endocrine, etc. systems. Therefore, you would be expected to handle these issues to prevent complications. For example, a spinal cord injury specialist will handle UTIs, renal complications, osteoporosis, digestive complications, cardiovascular prevention, etc. while an acquired brain injury specialist needs to be comfortable with endocrine disorders and whatnot.

There's no debate about english vs french. There's a debate about understanding what your subspecialist is telling you, which is already confusing, vs understanding jack shit. Also, big difference between "bilingual" Montrealers being about to function in english at the "giving directions to a tourist level" vs "receiving life-changing information from the doctor that I need to take into account to make a decision that might lead to my death if I take the wrong one level".

The bolded line is ridiculous if true. It has nothing to do with nationalism or whatnot. Medical encounters with a translator are always a mess and lead to tons of misunderstanding, even in the best of cases. If a physician can't speak french, they shouldn't practice in Montreal, that's all there is to it. If McGill decided that giving medical students translators was a smart thing to do, I don't know what to say...

Let me rephrase it then. You will be unable to complete certain rotations during clerkship because McGill's teaching hospitals provide subspecialized care to the Montreal population, anglophone or francophone. If you can't speak to your patients, you can't treat them. If you can't treat them, you fail your rotations. If you fail your rotations, you end up without a job. Now, it obviously is for you to decide where you will apply.

Have you considered PM&R? If you have some interest into MSK and neuro, it could be a good option. Doesn't really have a CTU-like component (although a big part of rehab is inpatient, it's entirely different from CTU in terms of feel). Majority (up to entirety) of your work can be done outpatient. Doesn't really involve long-term follow-up in the MSK side of things (you can offer a diagnostic opinion, initiate treatment/perform needed procedure and then refer back to FM for long-term follow-up after 2-3 visits including the initial consultation) so you can fairly easily get rid of annoying patients. Contrary to popular belief, it is completely different from pain medicine. We don't prescribe narcotics, don't adjust narcotics, don't offer long-term follow-ups for chronic pain patients, etc. As mentioned above, we still often end-up seeing chronic pain patients but it's usually for a diagnostic opinion/specialized procedure and we then refer the patient back to FM/spine surgery/chronic pain/whoever sent us the patient. For the rehabilitation side of things, it varies more but there is obviously an inpatient aspect and much more long term follow-ups.

Because it is literally the highest paying specialty (in Quebec at least)? If you work at a hospital, pretty much no overhead whatsoever. Almost sounds like a bad troll, lol.

Good point that time is an issue. I'm lucky enough to be in a program with non-existent call duty so teaching basically replaces the time I would spend on call. I did teaching while in a rotation where I had to take busy call and let's just say that it wasn't fun at all.

You're basically offering to do what a billing agency and administrative staff do. I can't see how that would be an advantage for the FPs if they have to (probably) pay you more than them and give up ownership of my clinic.