gangliocytoma

You need to apply through the PGME office. Each school has their own way of doing this. The likelihood of transfer will come down to funding and this will depend on how many people transfer out, how many go out through 2nd round CaRMS, how many unfilled spots, etc. That is all up to PGME to decide even if the program likes you a lot.

not necessarily. the program needs to have enough capacity (work for you to do) and pome allocated funding

I don't think there is a quota. Transfers don't always depend on a position opening up rather, the receiving program having capacity from an educational perspective to have you. usually program slots are decided based on funding but transfers can sometimes allow for programs to access a different pot of money.

As a 2nd year student I think you still have lots of career exploration ahead of you. I would keep an open mind and talk with staff at your institution to see what things are like there. I can't provide a Quebec specific answer. also I wouldn't say there is no way out of a career in FRCPC - there are lots of fellowship and additional training options for practice outside the ED. It looks like you need to do a bit more research into this. I don't think looking at lifestyle from a perspective of CCFP EM vs FRCPC is the right way to do it. Your lifestyle will depend on how many clinical shifts you decide to take on. I would say the lifestyle of full-time FP with an average sized practice is probably busier than that of a full time ERP. Yes you may have defined hours, but you have a lot of work that follows you outside those hours such as catching up on charting, sending referrals, inbox, forms, etc. The benefit of EM is you can work as much or as little as you'd like (within specific limitations based on the group size and where you work) and you leave your work at work. I wouldn't necessarily say the shift work is unpredictable. More and more departments are moving towards metricaid based scheduling where you provide your preferences and availability. The flexibility there would depend on how big the group is and how many shifts and overnights, weekends, etc. you'd be required to cover. If you consider the average full time EM doc working 12 shifts a month, that still leaves you with lots of free time to be with family, do errands, pursue your hobbies, etc. Yes you sometimes require planning your events and booking things off ahead of time. I've also found that if something comes up last minute depending on the collegiality of the group, shift swaps are almost never an issue. From my chats with staff in my department, younger staff actually prefer the nights bc it allows them to sleep during the day when their kids are at school. Most practicing physicians don't truly get "vacation" - you basically chose to not work for a specific period of time. This may be an exception in academia. In EM you have the option of stacking your shifts together to forgo or lessen the loss of income. Please not that as a family doc taking vacation usually means you have someone covering for you, otherwise you will be having to stay on top of inbox items while you're away; both to prevent a backlog of work and secondly to ensure no critical findings on investigations you ordered go missed.

you don't need a +1 to work as a hospitalist. If you plan to do so I would recommend you try and arrange as many inpatient rotations in residencyas possible and try to get at least 1 block of ICU under your belt.

I appreciate you have reasons for wanting to be in Toronto, however, you could do everything right and still not match there. Does that mean you will not apply to programs outside of Toronto? If you match elsewhere you are legally bound to start there, otherwise you forfeit CaRMs forever. It's important to have this discussion with your partner so that they're aware. This is a tension that most couples face when going through this process. This all depends on how competitive the other specialty is. Without more info it's hard to say what the best strategy is. I'd probably do 4 weeks in the specialty and 2 weeks in FM (while doing some Fm electives elsewhere). FYI FM at UofT does not mean you will be in downtown Toronto, you may get placed in Markham, missisauga, or even further out if you apply to the non-GTA streams. Some of the McMaster teaching sites might be about the same distance to downtown Toronto.

There have been 3 years of no visiting electives and people have successfully matched outside their medical school (including to UofT). I really don't think you need 6 weeks (or more than that) to have adequate face time with a program. If you want to go there, then definitely do electives in the programs that you want to apply for, but I think doing 4 weeks should be sufficient. I understand that there may be strong personal reasons for wanting to go to Toronto, but by putting all or most of your electives to be at one school you are basically screaming to other programs that you wouldn't rank them high. If you don't match to UofT then would you prefer to go unmatched?

If you disappeared for 2 weeks you'd have a 2 week backlog of work to return to. This includes all the inbox items such as prescription renewal, labs, imaging, consult reports, forms to sift through and some of these things need to be dealt with in a timely manner. You start someone on a new antihypertensive ask them to get BW done, labs come back and they have an AKI with a potassium of 8 and you've just hopped on a plane and don't see it until you get back, pt becomes anuric and dies from a hyperkalemic arrest. Pt has Afib on apixaban and their meds run out, the pharmacy sends a prescription renewal request to you but you're gone on a wilderness retreat and not checking inbox. Patient has a disabling stroke because they've been off their anticoagulation for two weeks. Not common scenarios by any means but you'd absolutely be liable. Also, pushing back appointments 2 weeks (in addition to all the people that try and book in with you for 2 weeks) would make your wait times quite long. You are not responsible for their care 24/7, but sending patients to the ED for things that are better suited for a FP will either lead to nothing being done or them being done poorly. As an FP you'll have a ton of appointments that are booked far ahead of time to follow up people's chronic diseases like diabetes, BP, mental health issues, well baby checks, OB visits, etc. so it isn't just whoever wanted to see you because of an acute ailment that started while you were on vacation. These things will not be dealt with in the ED and you'll just a get a snarky note back from the EP. It will also teach your patients to go to the ER or UC rather than reach out to you, and perhaps use it for the wrong things. In ON your capitation fee will get chomped if they are rostered and go to walk in clinics (and I think as well if they go to ER). And while this mainly applies to FM, this would also apply to specialists with a large roster of patients they follow as well.

There are people who have gone back and retrained in another specialty whether it be FM or something else. It would often require you to go back to residency. There is a re-training/re-entry pathway that is available in Ontario but I don't know any specific details about it. In theory there are ways to "switch" practices or add additional definition to your practice without doing a residency. In Ontario the college would mandate you do some time of supervised practice and do the appropriate courses in the specific specialty/subspecialization .

YMMV depending on the individual program. Overall for nonsurgical programs I would say 80-100 hrs per week at worst, half that at best. Most programs probably ~60-75 hours with call included. Also keep in mind that residency is temporary and you will have more control over your schedule as a staff. My personal experience in residency- I have a good work-life balance and enjoy what I do. Some weeks are worse (busier) than others but I am in a program that supports resident wellness and do shift work. I imagine when I do some heavier off-service rotations next year like ICU and surgical specialties I may be saying something different, but again those are temporary. You are quite early in the process so I won't talk specifics about psych and FM but for most non surgical specialities expect 8-10 hour days with usually one 24 hour call weekly and a post call day off the next day. Sometimes that call shift might fall on a Saturday and you'd be working 6 days and your post call would be Sunday meaning you don't really get a post-call day. On the flip side, you may be on call Thurs and get Friday as a post call and therefore an early start to your weekend. At most you can get 7 call shifts in a 28 day period, but that doesn't mean you always will get 7 call shifts. Some very busy services like internal medicine need many residents on call each night so they will likely have you do closer to the 7.

Honestly not sure what the process is, it seems like there might be job postings. I'd scroll through health force Ontario website and see if there is anything there. You can certainly do it part time (dedicating 1 or more days per week). It is more common in community sites where they do not have frequent surgical residents bc in academic sites the residents typically act as the assist. And yes you can certainly do procedures as a FP. I think there are many people that completely abandon doing any procedures in their practice and the plastic surgeons at my centre get inundated with silly punch and simple excisional biopsy consults. That is more than within the scope of a FP and if you attend some courses and pursue this interest in residency you could get exposure to more advanced things like skin flaps, deep excisions etc. Whether you do this in practice would depend on availability of a surgeon near by. Procedures like various joint injections, IUD/contraceptive implant insertions, biopsies and excisions, in grown nail removals are all very much within the scope of a FP and should be something you are trained for in residency.

You can work as a surgical assist. Great money, minimal responsibility. There are some people that do that exclusively after finishing FM.

lol can't imagine doing 1 week electives at all the schools across Canada would be very conducive to learning

One of my former preceptors said that every hour of patient care generates an hour of paperwork. You don't appreciate it as much when you're in medical school because you're insulated from it but as a resident when the responsibility falls to you it starts to add up. As a FM resident I'd spend roughly 2 hrs after clinic finishing up notes, writing referrals, cleaning up inbox. Inbox becomes something that takes a large amount of your time and scales up proportionally based on the size of practice you have. I've had many preceptors that spend many evenings of their week working on the inbox and following up with patients so consider this when deciding how large a practice you hope to have. 1- referrals; these can be as short and poorly written as you'd like them to be. EMRs these days allow you to copy and paste pmhx and meds. If you write a poor and vague note expect your patient to be triaged pretty low unless you specifically state you're worried about something. The length and detail of a referral probably depends on what you want from a consultant - i.e. simple question and take over care vs complex and somewhat undifferentiated patient that you aren't sure how to manage. The consultant should do a thorough assessment nonetheless. On off-service rotations I've seen FPs send patients to derm with a note saying literally "Plz assess skin lesion" which turned out to be a skin tag vs others with 3 page extensive notes summarizing multiple previous visits relating to the problem along with a detailed physical exam and everything they've tried. I think consultants prefer brevity for the most part but sometimes too brief becomes unhelpful for everyone. Econsults tend to take more time and thoroughness bc the consultant will not see the patient in person, so to make them useful you would put more details in order to get a more useful answer. 2- notes; in practice you are responsible for your own notes. No one checks them once you are staff so you can be as thorough or short as you want. But, if for some reason you get sued (which most physicians do at least once in their career) or get a CPSO complaint lodged against you, your notes will be your only friend or your worst enemy. These can be streamlined by making templates that you fill or by dictating using software which is faster than typing/hand writing. Obviously you should document pertinent positives/negatives, physical exam findings like murmurs, absence of pulses, neuro findings etc. Another reason to have good notes is if you take time and need to hire a locum. It would be a good idea for them to know what you've done with your patient. I guess under notes you could probably include updating your EMR to make sure the pmhx, medications, preventions are all up to date. This tends to happen as inbox items come in. 3- yes forms are a pain in the ass. I found I was inundated with them. Some days it felt like all my patients were coming in just to complete forms. Sure you can charge for them but if the patient can't afford them or won't pay then what? you risk them never coming back to see you again and use walk-in clinics and eat into your capitation billings. It will very much depend on the type of patient population you have. The other question is how do you feel about charging a single mother who is off work long-term for mental health reasons coming in to get LTD insurance forms filled? Some would say it shouldn't matter, others will let it slide. It depends on where you stand ethically and morally. You could still technically bill OHIP for the visit as you'd be doing an assessment any ways and then fill the form pro-bono. Some forms like WSIB and ODSP allow you to bill directly for them avoiding having to charge the patient. Depending on how well you know your patients/how simple the issue is, these forms could be a simple 5 min task vs an extensive chart review. I personally found private insurance forms the worst because of the detail some of them required. hope that helps

anywhere from 50-60 hours depending on call, how busy clinic is, etc.