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2017 Carms Applicants


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#381 JohnGrisham

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Posted 05 May 2017 - 02:55 PM

Aside: Family docs in most provinces are required by their college to have call or ensure there patients have access to a care provider after hours. Just that most modern day docs are skirting this professional obligation and the college isn't clamping down.

#382 JohnGrisham

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Posted 05 May 2017 - 02:57 PM

Also your program seems reflective of at least my program, as they seemingly provide even less than yours. (They'll post a listing on their website saying "student x chose to not apply and is looking for a masters supervisor" and "better luck next year". This is the experience of my colleague and another who went unmatched last year.)

That makes 2 programs at least who are poorly handling things. Its always the " oh well everyone passes so we dont spend much time thinking of this" or "everyone matches by it out so make sure to have multiple back up specialities"

#383 bearded frog

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Posted 05 May 2017 - 05:42 PM

Speaking of not enough residency spots:

 

 

The B.C. Liberals want to expand the University of B.C.’s medical school from 288 graduates to 400 in only eight years.

 

http://vancouversun....-medical-school

 

lol


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#384 #YOLO

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Posted 05 May 2017 - 11:12 PM

I don't think it is just people not wanting to do family medicine just because they don't like family medicine - in Ontario the government has been playing a lot of games with family medicine lately - including consideration of some very big restrictions on new graduates (like not even really being able to set up a typical practice). A logical response would be less interest in family medicine and indirectly by making those changes (or even threatening to) the government sets out signals of now much it values family medicine and if it was being logical about (not that it always is) the current need for family doctors.  I have had a bunch of people tell they just shifted out of considering family medicine just because of that. 

The key is to get your certification...but don't practice family....alota the +1s allow you to focus just in that area, and you're not facing the cuts that normal fam clinics face or overhead concerns. 



#385 rmorelan

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Posted 06 May 2017 - 12:35 AM

The key is to get your certification...but don't practice family....alota the +1s allow you to focus just in that area, and you're not facing the cuts that normal fam clinics face or overhead concerns. 

 

That would help :) of course you would have to want to do the +1 area. I mean not everyone interested in family medicine for instance like emerg or .... - some just want to be family doctors, ha. Some of those +1s aren't exactly easy to get either. 


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#386 rmorelan

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Posted 06 May 2017 - 01:02 AM

Speaking of not enough residency spots:

 

 

http://vancouversun....-medical-school

 

lol

 

and how many residency spots are there in BC?......


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More than machinery we need humanity.
More than cleverness we need kindness and gentleness.
Without these qualities, life will be violent and all will be lost.
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#387 gsmith

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Posted 06 May 2017 - 01:43 AM

The key is to get your certification...but don't practice family....alota the +1s allow you to focus just in that area, and you're not facing the cuts that normal fam clinics face or overhead concerns. 

 

And then you wonder why no one has a family doctor! 



#388 #YOLO

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Posted 06 May 2017 - 02:11 AM

And then you wonder why no one has a family doctor! 

blame the liberal party of ontario :P
 



#389 JohnGrisham

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Posted 06 May 2017 - 02:45 AM

And then you wonder why no one has a family doctor!


They are still providing medical care, so it doesn't really matter.

Blame the govt for not putting more $$ into healthcare

#390 rmorelan

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Posted 06 May 2017 - 03:29 AM

They are still providing medical care, so it doesn't really matter.

Blame the govt for not putting more $$ into healthcare

 

It really is a tough problem - I mean more money from where exactly :) 


Our knowledge has made us cynical.
Our cleverness, hard and unkind.
We think too much and feel too little.
More than machinery we need humanity.
More than cleverness we need kindness and gentleness.
Without these qualities, life will be violent and all will be lost.
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#391 JohnGrisham

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Posted 06 May 2017 - 05:39 AM

It really is a tough problem - I mean more money from where exactly :)

Something about billion dollar outdated fighter jets ;)



#392 gsmith

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Posted 06 May 2017 - 04:34 PM

They are still providing medical care, so it doesn't really matter.

Blame the govt for not putting more $$ into healthcare

 

http://www.cbc.ca/ne...-fees-1.4100251

 

Great article illustrating the problem 



#393 rmorelan

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Posted 06 May 2017 - 04:45 PM

Something about billion dollar outdated fighter jets ;)

 

ha - more federal transfers (all though I know why originally they set it up this way, the idea that we can have a Canadian Health Act but still individual provincial control of health care seems so strange to me). 

 

Sure you can pick things like that to say my word why are are doing that? (why ARE we doing that, ha?). Still on a bigger picture the Canadian military is also not flush with cash to say the least. 

 

Provincially the budget for health care is so large that there really isn't any way to increase it further I think. They are stuck with a system with raising costs more than inflation and ever more need. Not exactly ideal. 

 

This isn't to excuse the government for some of its policies of course - but you can see where the pressure is coming from. 


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Our knowledge has made us cynical.
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We think too much and feel too little.
More than machinery we need humanity.
More than cleverness we need kindness and gentleness.
Without these qualities, life will be violent and all will be lost.
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#394 ralk

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Posted 06 May 2017 - 05:41 PM

The 2017 combined round 1 and 2 match rate was 96.5% (slide 9). The 2016/15/14/13 rates were 97.2%/97.7%/97.4%/97.5% (slide 47) respectively. There was a slight dip in 2017, but I wouldn't call that a "clear downward trend." It's actually been VERY steady since 2013 with max variability being only 1.2%!

 

Source: http://www.carms.ca/...web-deck-EN.pdf

 

Going back only until 2013 doesn't capture the full trend. Slide 43 goes back to 2007 and shows a clear rise in the unmatched rate, albeit with a less reliable statistic. Fortunately, the presentation gives enough stats to get similar numbers for 2012 and 2011 - 2012 is also around the mid-97% (at 97.3%), but 2011 is at 98.4%, a much better rate. From what I can see, the total unmatched rate started going up when the ratio of spots to applicants started narrowing from 1.10 pre-2012, to its current level below 1.03. Just because there was a pause in the 2012-2016 period shouldn't be used to obscure the broader trend.


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#395 ralk

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Posted 06 May 2017 - 06:13 PM

http://www.cbc.ca/ne...-fees-1.4100251

 

Great article illustrating the problem 

 

Eh, this only captures a minor part of the issue, which is FPs not wanting to work as outpatient care providers. Even then, that's a small issue, since the FPs working as hospitalists are generally filling a needed role. If they all went out to start outpatient practices, there'd just be a lack of hospitalists. BC's also a particularly confusing situation because the rhetoric isn't exactly backed up by the data. BC's FP-to-population ratio is fairly average for Canada as a whole and is, if anything, slightly better than average. Every other large province is doing worse on that metric, Ontario especially.

 

As much as I would love for provincial governments to start throwing more money and supports at FPs - and I still believe there are good reasons to consider increasing the relative distribution of healthcare resources towards primary care - doing so won't change much to get more patients an available FP. If demand from medical students to be an FP shot through the roof, it wouldn't change the number of FPs coming out because every English-language FP position fills, one way or another. If we want more FPs, we need more training spots for FPs. That's where the main logjam is. Changing anything but that, including fees, allied health support, or hours requirements, won't make too much of a difference.


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"The word blarg has no concrete or absolute meaning"

I wanted to start blogging but didn't know how, so I started blarging. I don't know what it is either. Please visit my Medical Blarg!


#396 rmorelan

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Posted 06 May 2017 - 06:32 PM

Eh, this only captures a minor part of the issue, which is FPs not wanting to work as outpatient care providers. Even then, that's a small issue, since the FPs working as hospitalists are generally filling a needed role. If they all went out to start outpatient practices, there'd just be a lack of hospitalists. BC's also a particularly confusing situation because the rhetoric isn't exactly backed up by the data. BC's FP-to-population ratio is fairly average for Canada as a whole and is, if anything, slightly better than average. Every other large province is doing worse on that metric, Ontario especially.

 

As much as I would love for provincial governments to start throwing more money and supports at FPs - and I still believe there are good reasons to consider increasing the relative distribution of healthcare resources towards primary care - doing so won't change much to get more patients an available FP. If demand from medical students to be an FP shot through the roof, it wouldn't change the number of FPs coming out because every English-language FP position fills, one way or another. If we want more FPs, we need more training spots for FPs. That's where the main logjam is. Changing anything but that, including fees, allied health support, or hours requirements, won't make too much of a difference.

 

I hate it when they quote ABC percentage of the population doesn't have a family doctor. It assumes absolutely everyone is trying to get one. 

 

For instance I don't have a family doctor. I haven't bothered to get one - I move relatively a lot all over the province and potentially country wide so keeping one is annoying from that aspect, have no current chronic health conditions, and no particular need otherwise for a family doctor.  I am not alone - for similar reasons a not insignificant fraction of the population will never have a family doctor in any given year. 

 

The real question is what fraction wants a family doctor and doesn't have one. Quote that number :)


Our knowledge has made us cynical.
Our cleverness, hard and unkind.
We think too much and feel too little.
More than machinery we need humanity.
More than cleverness we need kindness and gentleness.
Without these qualities, life will be violent and all will be lost.
-
Schulich Medicine 2013, PGY4 - Ottawa for Radiology

 

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#397 mavrik13

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Posted 06 May 2017 - 08:35 PM

http://www.cbc.ca/ne...-fees-1.4100251

 

Great article illustrating the problem 

 

Agree entirely. Family medicine is hugely underappreciated and underpaid. Why do family medicine when you can have just as good hours in many other specialties and punt any issues that aren't yours back to the family doc? IMO, it's a lot easier to have depth of knowledge in single topic versus the breadth of knowledge required for FM.

 

Even if you do family medicine, "regular" family medicine is a slog and difficult to do well and make any money (try squeezing a 73 y/o multiple medical comorbidities with a history of cancer, CHF, diabetes on 15 different medications into a 10-15 minute time slot - the expectation of patients and their GP's is to address multiple issues at one visit, but you barely get premiums for providing good quality care). I had fantastic GP preceptors during my core rotations who were angels for their patients, but nearly totally burnt out in ~15 years of practice. Glad I'm not in family medicine, but I have the utmost respect for them and think we should be placing far more focus (and money) on primary care versus specialists.


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#398 #YOLO

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Posted 07 May 2017 - 01:12 AM

True. It is sad I've worked with various doctors in FHOs and FFS. The FHO docs typically take their time with the complex pts and help deal with them. The FFS see them quickly and refer to GIM typically. Keep in mind the FHO docs are making a killing, the average FHO physician was bringing around 400k, and working less hours. Although fam docs do have to work more hours to reach specialist money, it can be argued the work is a lot easier and not as complex. 



#399 rmorelan

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Posted 07 May 2017 - 01:39 AM

True. It is sad I've worked with various doctors in FHOs and FFS. The FHO docs typically take their time with the complex pts and help deal with them. The FFS see them quickly and refer to GIM typically. Keep in mind the FHO docs are making a killing, the average FHO physician was bringing around 400k, and working less hours. Although fam docs do have to work more hours to reach specialist money, it can be argued the work is a lot easier and not as complex. 

 

although as I understand it that is not an accident at least in Ontario - the government wanted to push people to do a particular model - they do that by forcing fee changes on people. 


Our knowledge has made us cynical.
Our cleverness, hard and unkind.
We think too much and feel too little.
More than machinery we need humanity.
More than cleverness we need kindness and gentleness.
Without these qualities, life will be violent and all will be lost.
-
Schulich Medicine 2013, PGY4 - Ottawa for Radiology

 

yoda.jpg





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