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ArchEnemy

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ArchEnemy last won the day on August 19 2018

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About ArchEnemy

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  1. I believe that most supervisors start a project with the intention to publish, so you will be fine to express your interest in doing so. Research publications are always helpful, especially for the more popular schools like UofT or Mac.
  2. A study comparing the two would be very difficult and will be highly politicized. By way of your argument though, the quality of care provided by NP, GP-A and GP-OB must be equivalent (or non-inferior) to GP, Anesthetists and OBGYN respectively right? Since litigation lawyers / colleges / CMPA has not shut down any of these pathways either.
  3. I have to disagree: longer training will always lead to better training due to increased exposure and opportunities to apply skills in various scenarios. Sure a significant portion of that extra work may be repetitive, it is through repeated exposure and application that one is able to hone its craft. I think it would also be very delusional to equate the first 2 years of FM training to the first 2 years of EM training. The extra 4 years of training is significant, and difference between a fresh CCFP(EM) and FRCPC(EM) graduate is stark (anecdotally). Once both have been in practice for a few years, then the difference is less noticeable. Otherwise, we should start equating NP to GP, GP-A to Anesthesia, GP-OB to OBGYN, GP-Sports Med to PMR right?
  4. This is a very important question that is often overlooked when discussing billings. 300k-400k may seem "average" in terms of physician OHIP billing, but because their overhead is so low (<5%), their pre-tax income is similar to physicians who are billing 420-570k but have 30% overhead.
  5. I have tried Bose QC35 II, Sony WH1000XM3 and Airpods Pro. AirPods Pro dominates hands down in terms of noise canceling and portability. Plus, being in-ear earbuds they do not weigh down on your ears / neck much even after prolonged use. Only caveat is that your ear anatomy may not fit well with the Airpods. Personally, my helicis crus began to hurt after 1h of use, but my partner did not experience any discomfort with prolonged use. YMMV.
  6. Better training and preparedness. Better hiring prospects in large cities.
  7. Most fellowships dont even require USMLEs...
  8. I will respond to the points that I have bolded & underlined above. According to the Alberta Medical Associations' report, the average Ophthalmology's overhead is around 45%. From speaking to Staff Ophthalmologists, the "60-70%" overhead that is often thrown around is for those running private ORs for LASIK or Blephs, not the average Medical or Surgical Ophthalmologist. The tight job market and difficulty securing OR time is a complex problem that plagues all surgical specialties, not unique to Ophthalmology. Arguably, Ophthalmology is one of the fortunate specialties where the practitioner can choose to lean towards the Medical side if OR time is unavailable. Even without OR time, Medical Ophthalmologists make a very decent living with their intravitreal injections. Can't say the same for Neurosurgeons or Orthopedic surgeons who do not share the same alternative without inevitably crossing into Neurology or Physiatry/Rheumatology's turf. Your last point on Canadian Govt spending hundreds of thousands training specialists only to lose them to the US is a frequently brought up argument. However, it vastly underestimates the cost savings from a senior resident. Many senior residents are quite capable of functioning almost independently by PGY-4, so the Govt is actually benefiting from 2 years of decreased labour cost (70k vs 400k), and potentially more if they choose pursue a fellowship. Back to my original point, Dr. Rocha claimed that fee cuts will hurt recruitment and retention of Ophthalmologists. He is right in that any fee cuts in general will hurt any recruitment or retention efforts. However, I stand by my point that the 10-25% cut will not be a significant factor in driving Ophthalmologists to emigrate South, since Canadian Ophthalmologists vastly outearn their American counterparts. On the other hand, Neurosurgeons & Orthopedic surgeons in Canada are under-compensated compared to their American counterparts, so this will be another impetus for them to emigrate South. I have to admit that a bigger problem in our system seems to be that older physicians are delaying retirement and hanging onto the better paid procedures, which may require OR time, while leaving the lower paid procedures to the newer graduates.
  9. Where are these FHOs located? I have a couple of classmates who are in FHO but no where close to those numbers despite working more.
  10. Yes. My response was more directed towards Dr. Rocha in the CMAJ article, who claimed that fee cuts will hurt recruitment and retention of "physicians". He is right in that fee cuts in that 10-25% range will hurt recruitment or retention of overall "physicians", but Canadian Ophthalmologists still vastly outperform their US counterparts that despite those cuts, none are lining up to move to the US.
  11. I can assure you that none of my Ophthalmology colleagues are lining up to move to the US . The ones that are considering the move, are willing to take the financial hit.
  12. Americans have been quite successful at realigning physician compensation, but Canadians have not. I think it is very interesting to analyze the differences in remuneration of various specialties in US compared to Canada, but also physician migration pattern. There's a reason why Canadian Ophthalmologists, Radiologists & Cardiologists are not moving to the US in big numbers, whereas Canadian Neurosurgeons & Orthopedic surgeons are. Argubly, the prospects of finding a job in bigger Canadian cities are similarly bleak in these specialties.
  13. I disagree. I think at some point the applicant needs to understand that they are not competitive or suitable for that specialty and move on with life. There are so many niches within family medicine (e.g. ER, Palliative, Anesthesia, Women's Health, OB, Chronic Pain, Surgical Assistant, Endoscopy etc) that one should be able to find something that they enjoy. And if one still cannot find something that they enjoy, then maybe they should consider careers beyond clinical medicine (e.g. administrative, start-ups, consulting etc).
  14. Great analysis. I think however, many "investors" would consider that 10 years is the short term, 15 years is the moderate term and ≥25 years is the long term. Would love to see this analysis using a 10-15 year horizon instead.
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