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PilotMD

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PilotMD last won the day on December 19 2017

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  1. Going to completely agree here. At your level, the MOST I would expect of a student intern is that they are hardworking with a good attitude and a willingness to learn. You check those boxes, you pass the rotation. Everything else is gravy....these physicians obviously take themselves way too seriously (and honestly, most physicians in general are absolutely terrible at presentations themselves). Touch base with the UME people as others have suggested - and try to move past it. Don't let these a$$holes ruin the rest of your clerkship experience. PMD
  2. The topic is an interesting one - at the risk of offending 'snowflakes' who may be perusing the forum, I will give my two cents. First - I do not think women make better physicians or surgeons. That is, I do not believe there is some inherent advantage conferred by a double X chromosome that results in improved clinical outcomes. I believe that anyone is capable of being a great physician (or firefighter, or nurse, or teacher, or....) regardless of gender (or sexual orientation, religious belief, political leanings, etc). However, there is good data to suggest that women have better outcomes (large internal medicine study, recent BMJ article looking at female surgeons, etc). The question is why? If we focus on gender, we aren't going to get anywhere. We have to look past gender and focus on things that truly matter. For example, in the surgeon study, one of the hypothesis from the lead author is that perhaps women surgeons fair better due in part to surgery self selecting for the best female applicants (that is, due to the nature of surgery - aka: old boys club - women work harder to gain access to these specialties, as such, they are on average a more elite cohort then their male counterparts). Another reason could be communication - perhaps women spend more time with their patients, communicate better expectation and outcomes then their male colleagues and this translates into better care. I have one partner who calls all his patient 1 day after they have been discharged to 'check in' - his readmission rates are the lowest amongst our group and he personal attributes this as one factor (he is able to reassure patients that certain things are normal, etc). The bottom line is - we need to figure out why we are seeing these findings so that we can generalize these practice patterns to improve on patient outcomes (whether it be better communication, more time spent with patients, more empathy, etc). As to why their are more females in medical school then men - who cares. Equality is not about outcome, it is about opportunity. Choosing an individual for a particular job (or program of study, or whatever) should be based on that individuals abilities, skills, potential, etc. and not on irrelevant aspects such as gender, sexual orientation, religious belief, marital status, etc. Pick the best person for the job, period. So if we believe that medical school selection is not biased to these irrelevant characteristics (which I do), then if 60% of the top applicants are female (or male), then so be it. Now, it's definitely worth studying why this is being observed (as mentioned already, women may perform better in MMI interviews - aka communication, problem solving, etc. - and there may be a larger cohort of women in university to begin with). Again, it is not gender, but some other characteristics that are driving these observed differences - focus on those and leave irrelevant factors out of it. My thoughts
  3. This is very saddening for the medical community at large - no one wins here. The government and her colleagues invested time and money into her training and the population was to reap the benefits of that investment. That skill set/talent is now wasted. Let me clearly define my position before going further - her punishment is absolutely warranted. It is clear (from the facts available for us to review) that she is not fit to practice medicine. It does nothing but strengthen our relationship with patients when they know harsh punishments are handed out by our governing bodies for inappropriate conduct. My personal feeling (having read the facts available to me - however, as a disclaimer, I do not know this person) is that she has deeper issues (personality disorder, lack of insight, sexual addiction, etc). The reason I feel this way is the manner in which she conducted herself - 1) Giving out her instagram contact early in the relationship (you should NEVER do this btw - IF I give any contact information to my patients, it is my work email that can serve as medico-legal documentation if required) 2) Continuing to treat the patient despite engaging in a sexual relationship (this is wrong on so many levels that I wont go into it - here's a general rule for those in training (and practice): IF YOU HAVE EVER OR ARE TREATING A PATIENT, DO NOT ENGAGE IN SEXUAL RELATIONSHIP WITH THAT INDIVIDUAL, EVER) 3) Engaging in sexual acts while the patient is in hospital receiving active treatment (......WTF) 4) Breaking up with said patient because you are committed to a relationship with a colleague (which was also an affair - again, highlighting poor decision making). This demonstrates to me that there is some other issue at play here (again whether it be a personality disorder, sexual addiction, lack of insight, etc). While some of these decisions may not be rare or 'illegal' with regards to practicing as a physician (engaging in an affair, connecting with patients via social media) engaging in a sexual relationship with a patient and the constellation of these poor decisions points to a deeper issue. Ultimately, she is not fit to practice medicine (nor be in any position where there is a 'power dynamic'). I am glad that the CPSO has handed out harsh justice - it is a reminder to all of us that we sit in a very privileged and powerful position and that with our patients our decisions should always be guided by the notion to 'First do no harm'. My thoughts
  4. As a urologist, I would warn you that urology, as NLengr has stated, is not a lifestyle specialty. If you want lifestyle (again, as NLengr stated - notice a trend amongst surgeons?), do not go into a surgical discipline. PMD
  5. Way back in the day I looked into the military as an option (I must confess, I have inquired as to whether my services could be of some use to the military more recently - alas, my specialty is not required at this time). This really is a great deal for the right individuals - think of it as a sort of return of service if you will. You get a fully funded residency position and the opportunity to practice medicine with no overhead. As well, if you want to further sub-specialize down the road, there are opportunities for this as well (ranging from dive medicine/flight surgeon qualification to full residencies in orthopaedic surgery, general surgery, emergency medicine, etc). There are of course drawbacks to military medicine that have been discussed before - but in the end, for those that are facing the possibility of not being able to practice medicine, this is a nice avenue to get back into the game - win-win for the military and the 'unemployed' physician. When I last checked (best to discuss with a recruiter), the time 'owed' to the military was roughly 2 months for every 1 month of training (so you owe 4 years for your two year residency). As edict stated, you will attend basic officer training at the Canadian Forces Leadership School (learn how to be an officer and a soldier) which I believe lasts 14 weeks. You then attend Canadian Forces Medical Services school to learn about military medicine. Second language training and other smaller courses may be thrown in as well. Cheers PMD
  6. Come on...... There are many reasons not to become a surgeon - this one should be positioned right at the bottom of the list. What next - don't drive because you have an increased chance of dying in a car accident if you drive versus if you don't? Don't fly because your chances of dying from a plane crash increase if you fly versus if you don't? Yes - a surgeon can loose his/her privileges if he/she contracts a blood borne illness. The statistically likelihood of this is extremely low. Couple that with PEP for HIV and the cure rates for HIV C, and I think you have very little to worry about. There are a million 'what if's' that could impact on your ability to do surgery.... what if you loose a limb/an eye etc in a terrible accident? What if you develop severe arthritis or a neurological condition that impacts on your ability to operate? What if you get cancer and die right after residency (seen that)? Should we all be worrying about this as well prior to a decision? There are many future events waiting for us that are beyond our control - why worry about them? Instead, focus on the things you do have control over - like double gloving in surgery (many don't), wearing eye protection (many don't), tying without holding instruments especially when there is a fu$king needle present (many don't). Just like you wear a seatbelt while driving and choose an airline with an excellent safety record, there are things you can do to mitigate risks in your surgical practice. Choosing not to do surgery because you are afraid of what MIGHT happen while in practice is a poor decision at best. There are numerous other factors that will significantly impact on a successful and enjoyable career that should be weighed in your decision - in my opinion, this is not one of them. 2 cents from a surgeon in practice
  7. As none of the posters here are lawyers (I assume), all comments are really based on personal opinion and interpretation of the charters of rights (including yours ABU). I can appreciate your frustration and I don't disagree that the system has serious flaws: you trained many years to be a physician, investing a significant amount of your time and money to do so. Further, you can't practice medicine without residency training. This fact is poorly understood by the general population, including our government. It's a shitty deal when you don't go matched. Do I think it's a violation of the charter of rights - my personal opinion: not a chance. Nothing is owed to you (or anyone for that matter) because you have post-secondary education. There are no guarantees in school nor in life. When you were accepted to medical school, there was no contract signed stating that you would be employed as a physician once completed. There was no guarantee that if matched it would be to the specialty of your choice, or in the city of your choice, or as many medical students feel it owed to them, both. The same goes for all students in university investing time and energy into training - there are no guarantees for them either. Law students are not promised a job at the end of law school, nor are engineers, graduate students, teachers, etc. etc. There are many individuals that spends thousands of dollars and invest significant time into pilot training that never find work. Again, is this a violation of their rights - no - it's reality. I know this sounds harsh - and it is. But this is the truth - many physicians have it in their minds that they somehow deserve 'better' because they trained longer, sacrificed more, etc. etc. The harsh truth of it is - we are not special. We are not owed anything more than the fellow members of our society that did not go to medical school. Physicians can die young, get divorced, commit criminal acts and yes, be unemployed. We are not immune to these things. Many individuals are working in society outside of their 'area of study.' Physicians can (and do) as well. Do I think it's unfair that someone trains so long in medicine and not be employable. Damn right I do (BTW - this can also happen after residency training as well. You think it sucks to finish medical school and not be employable - there are individuals finishing years of residency training with fellowships and graduate degrees that can't find decent work. Again, nothing is owed to you regardless of training/dedication, etc). Do I think its a significant waste of taxpayer money when this happens. Damn right I do. Do I think we need to improve the system for training physicians. Damn right I do. But life is tough and can be unfair - fairness is not guaranteed (nor owed) to any of us. So you have some big decisions to make - you have done so much work to this point. You have been handed a shitty deal. If you want to practice in medicine, you can apply to the second round or improve your application for next year and go for it. This may require self reflection on the type of physician you want (or can) be. It will take a lot of effort - but there are a lot of success stories on this forum for those that applied to second round/re-applied the following year. Or you can talk to a lawyer and push this violation of the charter of rights agenda - personally, I think this will amount to a dead end for you (and possibly the final stake in you medical career). Or you pursue other avenues of employment - there are lots of jobs out there waiting for hard working intelligent individuals like yourself. Again, just my opinion. PMD
  8. Only you can determine if it will be an issue. Surgery requires working with your hands 'most' of the time - over a 30+ year career. It's a very difficult job and surgical residency is no joke. What are surgeons (such as myself) going to care about when you are a resident - can you do the job. What are your patients going to care about when you are a staff surgeon - can you do the job. Thats it. Full stop. If the pain limits your ability to do the job (effectively or period) then this is not the place for you. So only you can really answer your own question. Honest advice - surgery is painful (training and somewhat in practice) in general relative to many (most) other specialties in medicine - if you are in a situation that is going to make your training/career more difficult, choose something else - I think you will be happier overall if you do. But if your hand does not limit you (dexterity, pain, etc) then join the club. PMD
  9. They are high numbers. I'll echo what NLengr said - it is program dependant for sure. General surgery/neurosurgery seemed to lose more residents than any of the other programs (when I was in residency, general surgery lost 75% of their residents one year - but this was an anomaly). The other thing is you have to take the number of residents in a given program into consideration when interpreting these high drop out rates. If 1 or 2 residents transfer out of a smaller program (around 10 residents - think urology/plastic surgery/neurosurgery/cardiac surgery), that can be 10-20% of the program. When I went through, a few urology folks transferred out, a few plastic people left, a few cardiac people left and many general/neurosurgery residents left. Don't let these numbers deter you from a surgical specialty. No doubt, surgery is very tough (see prior posts on why). If you want to improve your chances of not transferring out, my advice is to experience a resident life-style as much as you can while on surgical rotations/electives. Again, I believe the trouble is that medical students are getting more of a 'attending-level' experience while on rotation. When they hit residency, life suddenly sucks much more than anticipated and you were not mentally prepared for that. Some argue (and I agree) that unhappiness reflects the distance between expectation and reality - when reality aligns with expectation, life is better. When reality differs greatly from expectation, life sucks. Mimic your residents life (especially the juniors) and see what your life will really be like in a few years (and then you can better judge if its worth it): do lots of call like they do, including weekends, stay post-call if they are (I know - there are 'rules' that you can't stay post call: you will find, however, that many residents do stay post call to maximize their experience while in residency, especially when good learning opportunities are available. Little fun fact for you - attending surgeons do not have post call restrictions), help out with scut work, consults, etc. Get the most realistic experience you can because its a big commitment. PMD
  10. What's your confusion with what I said? I personally know some individuals who were gunning for competitive non-surgical specialties (like emerg) - instead of backing up with family and securing only two years of funding, they also applied to surgical disciplines. Here they get five years of funding (easier to transfer into another five year program). Plus surgical residents often have many desirable quantities (whether they actually possess these qualities or are assumed to have them as surgical residents is another issue topic altogether) for other programs (hard working, motivated, etc). That being said - that was nine years ago - CARMS is a different beast these days. I'm not even sure how one would backup these days. But I suspect the dropout rate in surgery hasn't changed much in these last 9 years. Congrats on the match btw (I'm assuming you matched derm) PMD
  11. Agreed - though there is a balance. Surgical residency (residency in general) often amounts to a 5+ year job interview (especially in surgical disciplines that have few jobs available). So you want to pace yourself, but you also want to impress (typically with work ethic and competence + a willingness to 'fill a role (usually amounting to fellowship training in a less popular area of subspecialty - aka - fill a need; with a graduate degree on top of that)). I agree though - it wasn't the crap residents transferring out of programs (in fact, many of the best residents did); and your sh#t tolerance level better be at maximum capacity coming into a surgical residency. I suspect this relates to job shortages. Though it's actually a fairly tactical move matching to a surgical specialty and then transferring out. Many of the residents who transferred moved to some fairly nice specialties - radiology and emergency medicine were quite common transfers during my time. Plus you have 5 years of funding attached to you. Pretty smart move for the forward thinking student (though if you can't transfer - you F$cked). PMD
  12. Though certainly three accusations increase the chances this physician is guilty, last time I checked, the law stipulates that you are innocent to proven guilty. Lets wait for the decision before burning this physician at the stake. I, as should we all, take accusations of sexual misconduct between a physician and patient very seriously (and any accusation of sexual misconduct/abuse for that matter). However, for you future physicians, you should be terrified by the what appears to be a shift in public mentality from 'you are innocent until proven guilty' to 'you are guilty until proven innocent'. Individuals are loosing their jobs (I'm speaking generally here) and receiving public shaming before the allegations are even proven to be true. There are some individuals out there who would have no problem taking advantage of this fact. It is for this very reason, as a male physician, I NEVER examine a female patient without a female nurse in the room. We should take every allegation seriously, women (and men) who have been sexually abused should feel safe to come forward and the men (and women) found guilty should be punished to the full extent of the law. But an allegation does not warrant punishment - the allegation must be proven to be true. This physician made a number of mistakes that don't have to be proven in court as BoopityBoop has mentioned. The lessons - don't do that. Whether he will be convicted of sexual misconduct (violation of the physician/patient relationship) will be up to the court. As an aside - what is up with all this d$ck showing off that seems rampant in society - d$ck pics, whipping it out for the ladies (men) to see, etc. Guys keep your d$cks in your pants. PMD
  13. When I went through residency (7 year experience), dropout rate across the surgical specialties was about 20%. I could talk for hours as to why I think surgical residents drop out, however, I believe one of the biggest factors is 'expectation' vs 'reality'. I feel that medical students these days are getting a 'softened' exposure on their surgical rotations - reality hits hard when you are a PGY1 (especially when you do all the crap work - taking care of inpatients, consults, etc. without the 'fun' suff - operating). You find out pretty quick whether you truly believe the 'juice is worth the squeeze' in the first 1-2 years. Interestingly, many of the dropouts came in years 2-3 - my belief - this is when you start operating, and I believe that some realize at this point that they actually don't enjoy operating as much as they thought they would. Coupled with all the other sh$t that comes with being a surgical resident (long hours, surgical persona's, etc) and it's not surprising that many head for greener pastures.
  14. - Grab a keychain and some thread - Tie two handed and one handed knots on the keychain - make sure the keychain does not move when you tie the knots - alternate the 'position' of your body relative to the keychain - you have to learn how to tie square knots from various angles relative to your position - Do this 1000x/day until you can tie perfect knots in your sleep Learning to tie perfect knots is critical - most times, if your suturing, your tying (few exceptions - instrument ties, stay sutures, etc). Practice your knots - you would be surprised at how many surgical residents struggle with tying good knots - even in the higher years (R3/R4). PMD
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