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kinemed

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  1. You would qualify for EI - your hours worked as a resident count even though it's a different job than your staff employment. Max is about $500/week through EI only. I only have experience in BC - Doctors of BC has a program that I think bumps it up to $1000/wk, but I'm still a resident and don't know the details. Things to think about: difficult 1st and 2nd trimester (especially 1st) may make it ++ difficult to study (I experienced this prior to LMCC2), risk of preterm delivery (low risk but there), complicated pregnancy preventing you from flying for RC exam, etc. Not sure where you are in training, but I'm currently on my 2nd mat leave (5yr program) and happy to chat. ETA: I'm at UBC
  2. Re: technical skills. You don't need very small/fine motor skills, but you need to be dextrous and good with your hands. I'm going to go ahead and toot my own horn here - the technical skills in anesthesia have always come easily to me and I've repeatedly been told so as an MS and an R1. I worked with a young staff who said that she had been told the same thing during training, but didn't realize how significant it was until she became a staff and started working with MS/residents to whom it doesn't come naturally. You can learn, but it does makes things much easier if it comes naturally. Common stuff like difficult IVs, spinals, epidurals, central lines, regional procedures, and intubation (especially nasal) can be particular and require skill. Anesthesia is increasingly competitive. In the past, they had to active recruit people. You can look at the data in lots of ways (and drive yourself mad in the process), but spots per 1st choice applicant is helpful. Last year (2014), there were 1.29 people who ranked anesthesia as first choice specialty for every available spot. 2013 - 1.27, 2012 - 1.27, 2011 - 1.22. Consistently less competitive than plastics, derm, ophtho, emerg. More competitive than usually all the other ones. ENT, urology, vascular are sometimes more competitive. I think people are increasingly seeing it as a lifestyle specialty. There are jobs, but you may need to be flexible in where you live. As far as big markets go, Vancouver apparently has lots of jobs.
  3. Everyone has given some good tips, but I thought I'd throw in my $0.02. I'm an R1 in anesthesia and still learning, so I've learnt a lot in the last 10 months! Anatomy: knowing what you're looking for (the cords, duh) is key, but also being able to identify where the hell you are when you don't get a grade I view right away. This will come with volume (which you won't get in a 1-2 week clerkship rotation) and know the textbook anatomy. Positioning: I try to position all patients with the airway between my hips and epigastrium, and their head close to the top of the bed. Make sure the patient is where you want them to be when they first move on to the OR table, so you don't have to move them later when they have monitors on and maybe a bit of pre-med in them. Obese patients or patients with large necks may need two pillows (or a pillow on top of the donut) to bring them closer to the sniffing position. Get the head into extension when you're bagging - it'll make BMV easier and they'll be in a good spot for intubation. Equipment: use the smallest blade you think is reasonable, i.e. almost always start with a Mac 3. You have better leverage and more control. Some people always stylet their tubes, some never do. My preferred way now, which I've only seen one staff do, is to flex the tube like you're trying to make a circle and then stick both ends in the package. You only need to do this for a few minutes and you get an exaggerated bend in the tube that gives some of advantage of styleting without dealing with a stylet. I don't know if I would do this as an MS since it's not common, but I do it now as a resident. Technique: go in slow and make sure you scoop the tongue right to left. Watch as you go in so you can see the epiglottis and not go too far. Never crank on the teeth, always pull the handle towards the opposite corner of the room. You're trying to align the 3 axes - this both gives you a good view and a straighter shot with the tube. I often have my right hand on the back of the patients head so I can adjust their position, and then often apply my own BURP before having the nurse apply it for me if needed. Don't take your eyes off the cords when you ask for the tube. Troubleshooting: if all you see is tissue and no identifiable anatomy, you may be in too far - pull back slowly to try to slip into the valecula. Make sure your blade is midline. If you have a good view but the tube is catching on the cords, rotating the tube a bit can shift an edge that is catching. It'll take time, and a staff that will let you troubleshoot a bit before taking over. If you need to pull out and bag the patient, always give a bit more propofol or something...awareness is more common than we think! In the end, intubating is a skill only very few specialties use regularly, and not being able to intubate someone never killed them (...unless you can't also BMV them).
  4. If you're a PGY-1, salary is around $51,000 in Ontario - you can find this information on every provincial site for the resident organization (e.g. PARO). I know they just signed a new retroactive contract, I'm not sure what the new salary will be. One-bedrooms near the downtown hospitals will run you $1400-$1900 depending on what you are looking for and what's including, etc.
  5. kinemed

    Ccfp(Em) Training Over 2 Years?

    In addition to all these great points - the CCFP-EM program is super competitive, and you would be hard-pressed to make yourself look like a good candidate if you brought this up during the application process, and I think find yourself out of luck if you sprung it on them after you had matched.
  6. kinemed

    Question For Residents To Ease My Nervousness

    Like everyone has said - you can't know how your interview went. That said, yes, I expect that people have matched to programs where they either feel they had a bad interview, or did have a bad interview - it just might not have been their first choice program. The best lesson of CaRMS - especially now that it's all over and your rank list is in anyway - is to move on to the next thing, you can't go back and do anything to change it (easier said than done)
  7. I think it's a bit difficult to answer this questions without knowing what specialties you're interested in, as it will depend on how compatible they are. It sounds like maybe GenSx vs different surgical specialty? If you're okay sharing what the two specialities are, you might get some more advice.
  8. Thanks, everyone. I'm still a bit confused about the logistics of it (e.g. a resident in my program has taken 2 x 4-month mat leaves...what does that mean for her?) but I think I'd have to ask residents who has personally dealt with it or just address it with my program when it becomes a more pressing issue.
  9. I know I can get this information from my PD, admin, or provincial residency union, but I'd rather keep these thoughts quiet for now since it's nothing that going to be a reality any time soon, and don't need to alarm anyone in my program yet haha. When you take maternity or paternity leave in residency, how does it affect your PGY? I know you have to make up the time you take off, but do you get moved through as if you had completed that time? E.g. female resident has baby mid-way through PGY-3 and takes 6 months mat leave. When she returns to work in July, she would be a PGY-4 if she had taken no time off. Does she come back as a PGY-4 or continue to be a PGY-3 for 6 months, and transition to PGY-4 in January. I have a feeling these forums are not rife with residents who have children, but maybe someone out there knows, since I can't seem to find this info anywhere.
  10. I worked during my MS2 at a waitressing job for 8-20 hours/week, usually Saturday night and Sunday day shifts with an occasional evening during the week. I had worked 40-70 hours a week at the same job during the summer between MS1 and MS2. I went to a school where we had most afternoons off, so it made it easier to balance my time during the school year as my days were flexible to accommodating study, gym, social, etc. time. I loved my job and my co-workers, and still sometimes miss working in that environment. Having a social circle and employment outside of medicine was really healthy for me, and the service industry can be a blast to work in. I was making about $11/hour base, but taking in anywhere from $100-$400 cash per shift. I continued to work during the summer between MS2 and MS3 while doing research as well. I quit before MS3 started, though honestly there were some blocks when I could have worked a couple shifts a week and stayed sane. I made a lot of money in the 16 months I worked there, and wish I had been working during MS1 as well. As some PP have mentioned, it either needs to be good $$ or something you like to do or both. Some people seem to think it'll inhibit your career prospects - I disagree. You have to have good time management skills, but you can do a lot of things with the time you have in MS1 and MS2, including work part-time. I agree MS3 and MS4 should be more dedicated to figuring out what you want to do and matching well. I ended up at my 1st choice in a desirable location in a competitive specialty, so I guess it turned out well for me TLDR; I worked 8-20 hours/week in MS2, loved it, 10/10 would again
  11. Do you think you need more time in ortho to figure out if that's what you want to do? My goal in 3rd year was solidifying which specialty I wanted by Christmas, so I could set up appropriate electives for pre-CaRMS in 4th year. Can you do an elective at your home school in ortho in 3rd and 4th year? It would allow you to make some more connections, and aim to have a reference letter from the 4th year elective.
  12. kinemed

    Length of Electives

    Booking 2 week electives won't hinder you're ability to develop skills or gain an appreciation for a given specialty - you can still do the same total number of weeks. In psych and peds, 5 2-week electives will allow you to explore more subspecialities within each, as well. I think 2 weeks is a perfect length for getting a feel for a program, and for them to get a feel for you. In the end it'll likely have very little impact on your result in CaRMS
  13. All of the above! Everyone is stretched thin and not typically too pumped to be working over the holidays. Take a break and decompress before the interview tour. Depending on what you're applying to, you'll most likely know about all your interviews by then, and this elective will have near zero impact on anything. That said, if you still want to, I'm no help and have no idea. Sorry
  14. kinemed

    Anesthesia

    I can only comment on Ottawa. Downsides: rotate through multiple preceptors during your two weeks (basically a different one every day) so difficult to get letter, rumour that program director doesn't meet with elective students (I didn't make contact with her), difficult to set up elective if you are not an Ottawa student Upsides: schedule you for a good variety of rooms during the 2 weeks, most staff great teachers and like to teach, staff open to you doing call with them, free coffee in lounge (ha), residents happy for you to do call with them if no other students, good trauma centre at the Civic, new facilities at the General If you are interested in doing an elective in Ottawa, I would suggest contacting the Heart Institute and seeing if they take visiting elective students. Great experience - smaller number of staff, more flexible so you can try to work with staff more than once, my first exposure to cardiac anesthesia, +++ procedures and hands-on work if you show you're willing (and able!), awesome teaching all around.
  15. I'm not sure how it was in previous years or if this may change for 2015, but for this year the application closed Nov 22-25, everything but reference letters opened to programs on Nov 25, we had until Dec 3 to assign letters of reference, and then letters were opened to programs Dec 3. https://www.carms.ca/en/first-iteration-timetable
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