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About Alastriss

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  1. Alastriss

    Life of a General Surgeon?

    I really have to second this one. The most important piece of advise I have for medical students is to pick a career not a specialty, and you may think that's one and the same but it's not. For example, you may really like surgery and your job may make you really happy, but you may not like the fact that you won't have personal time, you may be on call every so often, or have to work in specific locations. Alternatively, you may find a career that you don't enjoy as much as general surgery, but say it may enable you to work in a city of your choosing, allow you to work without being attached to a hospital (a big big bonus), and you may never carry a pager ever again. Overall, you may be happier with your life despite picking a specialty you enjoy less. Think about what you want your life to be not when you are in your 20s and doing 26 hour call non-stop, but how you want your life to be 30-40 years down the road. As an aside, community centres in my personal experience can have better call than academic centres. Yes, you don't have residents, but most often Surgeons round between cases, and you don't always come in for an apply at 3 AM unless it is really urgent. Often times ER staff are adept at starting IV fluids and Abx with pain control and call the surgeon at 6-7 AM for that apply that came in earlier in the night.
  2. Alastriss

    Interventional Cardiology

    Go to the contact section on that site and realize it's in the USA. I definitely don't want my mom or dad of anyone I know for that matter getting stents put in outside of a hospital. Diagnostic caths are a finnicky thing. What do you do if you find a 70% lesion? Not stent it and refer it to an interventionalist only to have them redo the cath for stenting?
  3. Alastriss

    5 year vs 4 year GIM program

    Ya but some of us want to do GIM just not primarily, I have another subspecialty in mind that would permit you to keep up your general skills but would still like to do GIM on the side as well.
  4. You are 100% right, but that's where locums come into place to keep those skills up and it can be hard to get the job you want even after 15 years of working hard, but we generally know the prospects of the job market for whatever field we go into. Cardiac surgery residents now know the job market is poor but still make that choice anyways. They aren't owed anything just because they put in ridiculous hours, but they accept the fact that they would rather do this one specialty and risk unemployment than do anything else.
  5. Hey all, I had a question regarding what you guys have been hearing about the 5 year vs 4 year GIM business and how it will affect those of us in residency now. Say after your 3 core IM years you apply to a fellowship like GI, ICU, Cardio, Resp etc, and in your 4th year you write your Royal college IM board, and in your 5th year your subspecialty board. As a subspecialist, and with the 4 year GIM equivalent, what are some things that will limit you from what a 5 year GIM other than say working at an academic center? 1) What's to stop you from opening up a GIM office practice anywhere other than GPs referring to you? 2) typically what geographic locations would actually hire you on as a GIM? I know that towns around the size of 50k would have no problems hiring you on as a GIM if you are a sub-specialist but wondering whether how big of a hospital you can go before you're likely to get beat out by a 5 year GIM 3) any difference in terms of billing? 4) Reading around it looks like you can challenge the exam after 5 years of practice will this functionally elevate you to the status of a 5 year GIM subspecialist with regards to job prospects even at academic centers?
  6. I read this, and I'll say +1. People keep saying things like no jobs in Nephro, for example. If you open a nephro office practice in even a downtown Center and send your letters out to GPs seeing you will see their CKD patients fast, you will fill up. Again, you'll have a job. It might not be the job you really want, and by that I mean affiliated with a hospital and have dialysis time, but then again you can still make a living. The catch is that your nephro patients who eventually need dialysis will need to be followed by another nephrologist if they get to that point but again, saying there are "no jobs" is a bit more dramatic than people lead it out to be.
  7. Alastriss

    Respirology and ICU

    Thanks for clarifying this. This was what my thinking was but in speaking to a few residents here I heard that there was a possibility and it actually got my hopes up. out of curiousity, how does the college view those who did the combined 3 year program in the states (which I believe still exists), and moved back to canada?
  8. Alastriss

    Respirology and ICU

    So I've heard the opposite here, than in fact it may be possible if you can get the two programs t help you out. The reasoning being that there is a considerable amount of elective time in ICU that can be out towards resp but you are still expected to write both board if you want to practice each specialty. Can someone reconcile this for me?
  9. Alastriss

    PARO negotiations?

    So when do we find out about our salaries? And Rmorelan, do you mean that if we get a pay raise as it is expected, it will be retroactive as in we can expect a nice bonus? Just sounds too good!
  10. I can't speak as much for other programs, but I'd have to respectfully disagree about western's assessment. The best strength about this place is that it is the most collegial I have experienced through my electives across the country. Staff really look out for you, are always there for you, and you never feel like you are alone or unsupported. I've had staff hold 30 minute phone conversations doing teaching when I was reviewing a case overnight and senior residents who would message me to check up on how things were going. I even had a senior who wasn't even on the service help me out with something when I was on call. I don't know why you thought UWO was very depersonalized, but in my experience here, it couldn't be further from the truth. I think this will become clear when you guys come to our social this year. my advice, to everyone who has yet to do electives, is go out and find what programs work for you. If you are on the interview trail, you'll go ahead and see for yourself what the facilities are like, what the residents are like, and feel free to ask all the questions you want, even if it puts them in a tough spot. You are interviewing them as much as they are interviewing you.
  11. Western Resident R2s are seniors. Not for your sake, but so everyone else gets accurate information. We've had recent staff grads from Toronto GIM who have said that seniors have almost too much autonomy at Western.
  12. All I have to add is: don't listen to the aforementioned rubbish.
  13. A note about research. I don't know if you have any idea how you want to practice, but this is coming from a guy who wants an academic, research focused career. Re: compared to western not being comparable to research at Toronto and Mac. Forgetting that I'm at Western for a second, please remember that as a single resident you really don't need eleventh billion PIs. You will likely only get involved in a few research projects. The variety that exists and even the smaller institutions in Canada will be more than enough to satisfy your needs. You don't need the ridiculous diversity that exists in cities like Toronto or UBC. To pick a school like Toronto over a school like Mac because it has more research opportunities is frankly naive. Secondly, you have to be a bit more astute when you REALLY want to get the low-down about research. For one, if you are serious about research, then you need to ask about grants/funding options that you can apply to. Having applications/grants accepted is something that goes on your CV and builds your research portfolio. Secondly, the more important thing, is ask what kind of supports are there for Research. Are there dedicated staff that ensure a good pair-up with a mentor or facilitate that? do they help ensure you are getting a good experience? Finally, the most important thing, ask what you will be doing. Will you help from the get-go by submitting an REB, helping with the project design, synthesizing/generating the hypothesis, or will you be just a data miner? Based on that, McGill was by far the most impressive school in my opinion and I interviewed across the country. I have to put Toronto towards the bottom in that regard. My interviewer at McGill was personally responsible for matching residents with mentors who fit their needs/interests/and career goals, and made sure that residents who wanted to be in the 'driver seat' for projects could have that role if they wanted to, and they strived really hard to get residents first authorships so that they can start building their research portfolio. I ended up ranking them pretty high even with a 10k pay cut and being in a french school. Toronto, on the other hand, nicely said that they had a lot of big-shot doctors who wouldn't be letting any resident come near to the driver-seat and I almost felt like an idiot for even asking such a question from the answers I got. It might have been the interviewer who wasn't as informed and maybe there are great opportunities, but you do what you can with the information you have. So just a note, for all you guys serious about research, ask the right questions and you'll get the answer you want. Remember that having a first author publication in a low impact journal is more significant than being 15th author in the NEJM for building your research career. You'll also gain valuable skills on the way if you are taking more of a 'driver-seat' role. If you just want to do research casually and just want to remotely affiliate yourself with a research powerhouse, well, then the 'here-say' provided here is adequate advice.
  14. Alastriss

    Internal medicine and FM rotations

    I was also on call July 1st. The learning curve is steep. No ease in period. You'll feel uncomfortable but that's part of learning. Welcome to residency.
  15. I trained at western for medicine and am at western for residency but judging from my colleagues I think many of these stereotypes are not true. It is one of the best for training and it is hardcore but I can't say that the rumours are infact true. Best to do an elective there or contact a resident with these questions.