MedZZZ

Would you mind sharing what your exit strategies are? Is it doing a second residency or doing other aspects of FM? and how possible is it to do either? I have heard doing a plus in ER is almost impossible after you finish your residency and if you don't have enough elective unfortunately.

Just out of curiosity, have you thought about retraining/re-entry into another residency?

I am a PGY1 in FM and I am having second thoughts about my future job security and satisfaction. I am 6 months into residency and I am having second thoughts whether I should try to switch to IM or stick to FM. This is the following reasons: 1. I don't particularly enjoy all aspect of FM like OB, GYN, PEDS, etc. However, I have done a hospitalist rotation and I can see myself working as a hospitalist in the future so this is an option. 2. So many of my preceptors seem to be unhappy with their work-life balance and they all seem to be somehow regretting choosing FM and it is really discouraging to see unhappy staff in your profession as a new resident. 3. There has been recently many articles glorifying NPs as primary care providers which is frustrating to me. And also many articles written by Family Doctors which highlights the lack of compensation, paperwork/admin stuff. Reading/hearing about these issues really scare me that I would regret my choice in the future. 4. I enjoy the patient interaction and clinical medicine but I feel that FM as an outpatient does not provide much of clinical medicine. On the other hand, IM has it's own set of challenges: 1. FIVE years of TOUGH residency (I am already in my early 30s so I will be graduating in my very late 30s) and it can be tough to look for jobs while you have other commitments at that age. **This is the number 1 reason giving me doubts.** 2. Two difficult royal college exam 3. Possibly difficult to find a job given the competition. I know it is ultimately a final decision and even transferring is not guaranteed but I just wanted to ask people who are currently residents/staff/or where in the same boat if they have any insight. I would really appreciate it as I am having difficulty making a decision.

I just wanted to say that I'm so sorry you are in this position. Have you looked at the options for transferring?

I didn't know there is a letter. I contacted my PGME office and they just set an appointment with me to discuss it next week. I don't know if it would be too late to transfer by that point or if I should contact the program director of my program interest directly?

Thank you everyone for the above reply. I am wondering if any FM residents/staff wish they did something else/transferred to a Royal College program given the situation facing FM?

Hi, FP PGY1 here, when applying to CaRMS I was mainly thinking between IM and FM and ended up ranking FM higher due the flexibility, job prospect, and ability to do +1 hospitalist. I was also very exhausted going through the stressful CaRMS process during the pandemic. Anyways, now 1/4 way through the residency, I can say that the above positive aspects of FM is nice; however, I am very concerned about the future of FM in Canada. I have heard anecdotally from other FP physicians that the government is pushing for NP/PA to fulfill FP roles because ultimately it is considered cheaper and in fact, some of the NPs working in urgent care centres are getting paid the same amount as a GP. This really concerns me and to be honest makes me somehow regret my choice ... My question is: 1. Is the threat from PA/NP real and are they going to replace FP? 2. Should I be considering transferring to another field (perhaps) now that I can potentially have the option to ta least try? I would really appreciate everyone's insight.

I think you can do the same thing for some IM sub specialties (endo, rheum, allergy & immunology)? Please correct me if I am wrong ...

It's true that you need 1-2 fellowships and/or grad degree to land a job in an urban area in lucrative specialties (e.g. GI, Cardio, Nephro, Rad); however, you can still get jobs without fellowship in other specialties like endo, rheum, allergy&immunology, and even GIM if you don't do extra fellowship/degrees. However, I don't know if the income potential for those fields justify the extra brutal 3 years and the time it takes to build up your patient base. Of course, if you are passionate about those fields, it's different story.

Thank you for your advice I have been reading a lot in this forum and it seems like everyone is saying the additional salary in IM would pay off in the next 10 years or it takes a lot of specialists decades to catch up. I am wondering if someone could clarify this as it doesn't really make sense to me?

I don't think you would make a million in FM in those extra 3 years but I agree with you that you are out sooner and can start paying your loans and invest.

I too have some regrets and maybe worries ... I was very torn between FM and IM going into CaRMS and finally decided on ranking FM higher because of short duration of residency, flexibility, and better work-life balance and perhaps I was very exhausted by the whole CaRMS process and didn't want to go through this again! I ended up matching to my first choice FM program and I am grateful for that, but I can't help that sometimes I think about "what ifs" like what if I realize that I should have done IM and I made the wrong choice! and these thoughts really bothers me ... anyways, just wanted to let you know that you can still match to your first choice and have regrets/concerns

Do programs see the actual score or just PASS/FAIL? Also, does it have any impact in case you want to transfer to another program? Thanks

Congrats! I am curious what did you match to?

Anyone has an idea about how transferring from FM ...> IM work and if it is at all possible?