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Everything posted by NLengr

  1. Tell them. And explain why based on family AND training reasons.
  2. NLengr

    U of T medical student convicted of rape

    Medicine is by far the worst profession I have ever seen (and I was formerly an engineer who dealt with lots of other professionals and tradespeople). Engineers, accountants, vets, even lawyers, seem to treat each other better and have more empathy for each others problems than physicians do. We talk the talk but it's all BS. As a profession we rarely walk the walk.
  3. NLengr

    U of T medical student convicted of rape

    Welcome to medicine. A huge number of physicians are nacsassistic, empathyless, unprofessional a-holes.
  4. I agree that the loss of freedom with salary is a huge issue. I would never want to be an employee of a health authority. It has all the disadvantages of being an employee of a regular company plus you get the absolute incompetence and unprofessional behaviour of healthcare administration on top of it.
  5. The average person is not who does medicine. People who do medicine would also have good careers in other professions or business and be well (although not as well) compensated financially. But I can tell you 125k a year (what a salaried engineer in my former field makes quite easily) makes you just as happy as making 170k or 250k (roughly the going rate for salaried family docs and specialists in an urban area in my province). Second, define better off. Sure, you are better off financially. But you are much worse off from the point of view of burnout, risk of mental illness, substance abuse, career regret/dissatisfaction , risk of divorice, family life, stress, longevity, workplace bullying, support from co-workers and administration, personal safety, career mobility, ability to live where you want etc. So it's highly dependent on the metrics you chose when you say you are better off. Medicine may be a "great career" for some, but for many physicians, it is far from a "great career" and the data backs this up.
  6. Yup. Given the rate of burnout and depression among physicians, as well as the high percentage that are unhappy with their career, med schools do a total disservice by whitewashing all the unhappiness and issues in the profession. Honestly, I think the best think medical schools could do is have some average physicians come on and talk about their careers, including multiples ones who are unhappy. And tell the students very specifically all the issues in medicine (way too many to list right now) and be up front that there is a very real.chance they will regret it all. Then at least they could say they were warned.
  7. In my professional opinion, don't spend anything on it. Find another profession. Medicine sucks. Maybe consider it if you are independently wealthy and can finance yourself with existing funds that you can walk away from if you decide you hate medicine. Otherwise, stay the hell away. It is very easy to become a life ruining prison.
  8. NLengr

    Radiology as a backup...?

    There is the tech aspect. But airline travel.used to be for only the rich due to cost, so everything associated with it was glamorous in the public eye. Now that airline travel is so cheap and available to the masses, it's essentially similar to bus travel in the public's eye, so the pilot no longer has that aura about him/her.
  9. I switched from engineering to medicine after about a year of working as an engineer. First thing you need to do is look at what schools require what courses so you know what ones you can apply for. As for if you should do it, I'm a community hospital staff in a surgical specialty now. I have advanced fellowship training in a specific area. To be honest, if I had my time back ,i probably would have stayed an engineer. There are a couple reasons for this: 1. Jobs. This is somewhat dependent on your specialty of choice, but certainly there are many specialties with a tight job market. Even in fairly open specialties, it can be hard to get a job in the location you want. I didn't appreciate this enough prior to medicine. Expect that you will not be able to live where you want. You will have to take a job in whatever location is avaliable. That may mean a rural location or thousands of km away from your home. It is extremely hard to leave a job and may take years to find a new one. The hospital you end up with the job in may be a hell hole, but if it's the only job you can get, well sucks to be you. If you want to have a family, being away from your support system is a MAJOR deal (I didnt realize this completely till I had children). You will likely be far away from your friend base and it can be hard to make new friends in a new location. If I could be an engineer again and work in my hometown (which I almost certainly could) I would do it in a heartbeat. 2. Debt. This isn't a massive deal to pay off if you are smart with money but the problem is you will build a debt in med school that will essentially be almost impossible to pay off without working as an MD. That means you are committed to medicine before you ever know what it is like to be a doctor (or even a resident). There is no backing out, even if you realize in residency you hate it 3. The System. You are probably used to private industry and its efficiency, safety focus and rewarding of competency. A system that is goal and outcome focused. Forget all that in healthcare. The system is a total disaster and infinitely frustrating. Administration is frequently completely incompetent at their jobs. Full blown incompetence with zero management skills. Many workers are extremely lazy and suffer no consequences for it due to extreme union protection. Moral is terrible. It takes forever to get anything done, if it gets done at all. You will be extremely overworked and nobody will care. You will be blamed for the failures of the system. Expect to have to fight administration on almost everything you need for your patients. As an MD, bureaucrats and administrators will frequently ignore your opinion, despite the fact you are the one who knows the data and provides frontline care. Admin is only concerned about keeping their little fiefdom intact and the gravy train going. They don't care about the patients. Expect issues of patient safety to be ignored. If you speak up to help your patients, expect administration to treat you as the problem and to publicly try to humiliate you and question your skills as an MD. You will go right under the bus as fast as they can get you there. 4. Other MDs. People always think that engineers have social issues. Completely wrong. Medicine is the worst profession I have ever seen. So many doctors are completely socially incompetent. They backstab and badmouth each other all the time. They have no idea about how to act professionally. They have no empathy for others in the profession. They don't support each other. Bullying is rampant. Lying is rampant. There is zero accountability for this kind of behaviour. It is much more likely to be encouraged, tolerated or covered up than disciplined or addressed. It really is awful. You honestly can't understand the sad state of the profession until you live it. For someone who was another professional in a previous life, it will be shocking. If I had my time back, I never would have done medicine, despite the fact that I love working with my patients and performing surgery. Everything else is just so so so bad it doesn't make the sacrifice and practice of medicine worth it. I would go back to an engineer in a heartbeat if I didnt have my soul crushing debt to pay off. I wish someone had told me the truth of medicine before I applied. My advice: think very very very carefully before you commit to something you will never be able to back out of.
  10. And even if they are understanding initially, there is no reason they couldn't use it against you later on. I have seen health authorities use a history of mental illness to try and silence professionals (docs, nurses. allied health) speaking out against them (because of concerns the professional has about patient safety, equipment, working conditions etc). They will use your history and then try to frame up situations to portray you as currently unstable. It is a lot easier and preferable for the system to screw you over than to actually address the problem. I know a person who used to work for a health organization as an in-house counselor for employees and that person's employer would routinely push the counselor to make inappropriate diagnosis against "troublesome" employees to silence or fire them. The person I know ended up quitting because the organization was so bad to work for.
  11. While you should seek help if you need it, it is advisable to do this in the most private and untraceable way possible. That means not going through your university or a physician health program. Those may claim to be confidential but I have seen confidentiality violated to the benefit of the university or employer. It means seeing counsellors and doctors who work independently from employers, universities and boards. Fiercely protect your medical data. Consult with lawyers before disclosing any health information to a university, employer or board (I'm not saying lie, but you need to be extremely careful to avoid disclosing extra information that could be used against you for any reason in the future). I have seen so many physicians burned because they did what they thought was right and assumed the university/employer/board would treat them fairly and with empathy. Unfortunately, that is frequently not the case. It was much more common that they were targeted, bullied and treated in an unfair or prejudiced manner. Medicine is a terrible profession filled with many terrible people who, quite frankly, have no idea how to behave like professionals or even civilized human beings. A surprising number lack basic social understanding and baseline empathy. The only way to protect yourself is to ensure you look out for yourself. Never assume someone will look out for you because they rarely will. The safest thing is to assume everyone has the worst intentions and act to protect yourself in all ways possible. I wish it wasn't this way but the longer I am in it, the more I see it. Medicine really is the worst profession. Lawyers treat each other better for gods sake. /disheartening but true //if I could afford to leave medicine, i would do so in a heartbeat.
  12. Just don't get pregnancy complications and screw up your ability to study or write the exam. At the very least make sure the period of viability is after the exam. Honestly, I would just wait till it is all over to get pregnant. The delay is a few months but the outcomes if you can't write or fail are catastrophic. We had two premature kids, one after a very complicated pregnancy. Both are fine now, but I can't imagine the disaster if I had to do an RC exam at the same time.
  13. NLengr

    Med school in US then coming to Canada

    You will likely need to pass the Royal College exam (which, at least in my specialty, is harder than th US board) or get some kind if provisional license based on your US board qualifications (which is not easy to get, usually will force you to be in a unwanted job, and can be pulled at any time, leaving you at the mercy of your health board which you do not want).
  14. Yeah can't forget the pointless empire building.
  15. Unfortunately, the government wants them to be considered equivalent. The public sees them as equivalent, or in some cases superior. Never ever think that government or the healthcare authorities care about quality of care. In every experience I have had, they don't care at all. It's all about re-election for politicians or making the jobs of bureaucrats or hospital admin easier. To the point where patient safety, outcomes and privacy takes a back seat. It's very depressing if I actually sit down and think about it
  16. I expect NP numbers will increase more and more in rural areas at least. Very hard to get/keep family docs in those areas. Unfortunately, in my experience, the knowledge base of the average NP seems to be less than the knowledge base of the average family doc, at least for the referrals I get in my specialty.
  17. Ontario was giving physicians the royal screw job for years. It would make me more embarrassed to be a resident on ON.
  18. Community jobs make it pretty easy to work less. I have Wednesday AM off for non work appointments and stuff. I am not working this Monday since my partner doesn't need an OR assist. The difference in community work and academic work comes down to the nature of the job. In the community, you are the only person. You see the consults, you do the OR at 10 PM, you manage your patients on the floor. You do much more clinical medicine. In an academic center, you do less clinical medicine because you have residents and fellows. As a trade off, you have to do more paperwork and research. It may be boring to a degree but nobody has ever died because a research application wasn't filled out at 3 am. Pick your poison.
  19. NLengr

    GP Surgery?

    I have yet to see a GP surgeon in my province. And I am a rural surgical specialist in a rural province.
  20. Maybe you are just a slow learner. Hahaha I wouldnt worry, most surgical specialties don't need super fine dexterity. Honestly doing surgery is 90% about knowing what not to do, not how to do something.
  21. This for pretty much any surgical specialty (except the really bad ones like Ortho, Cardiac, neurosurg etc). Fellowship and then scrounge to find whatever is avaliable. If you are lucky something is open in a place you want to work. If you aren't, you take a job that's usually open for a reason (crappy location, crappy coworkers, crappy lifestyle etc.).
  22. NLengr

    Unhappy in medicine?

    Debt level is key here. Are you too far in to back out? If I could afford it now, I'd consider leaving medicine. Mostly because I will never get back to my home city, family and friends doing what I do. The place I currently live in SUUUUCKS.
  23. Really? Because I am staff and life still sucks. Hahaha I do agree autonomy is awesome. I could never go back to being a resident/fellow. Hell, i don't think I could even be salaried staff at this point.
  24. You need to have more than a 1:1 ratio of students to residency spots. If you don't than a whole lot of people would be forced to do things they hate, are ill suited for or both. You need some flexibility in the system. The flexibility should not come at the cost of ROS's for CMGs. Being forced to work in an undesirable location doesnt sound that bad as a med student because you honestly have no idea what it will be like. I am speaking from personal experience here. Most of the locations are rural, so right away, forget most of the things you enjoy about being in an even medium sized city (restaraunts that are decent, shopping, nightlife, cultural activities etc). You will probably be away from all family support and I can tell you first hand that makes your life very difficult, especially if you have children. You also will be away from your entire social base and it may be hard to build a new one in a smaller center. Smaller centers mean a lot more call for you. Even if you aren't getting called in all night, just being on call limits your life. Also, don't expect to have all the services you are used to at an academic center. This increases your workload and limits the type of practice you have or procedures you may perform. Once you are done your ROS and want to leave, it is still difficult. You'll realize that after a few years in practice it's hard to find new job opportunities in many specialties. Canada doesn't have great mobility for physicians to change jobs. So maybe your 3 year ROS is now a 6 year stay because there is nothing avaliable anywhere else you would be willing to work. Expect the administration of the hospital and the local government to not give a shit about your concerns because you are on ROS so it's not like you can easily threaten to leave. If you do leave at the end of your ROS, who cares, the government will force another ROS new grad in the position. That removes the motivation for anyone to address problems or concerns you have. CMG ROS contracts will reduce our ability to negotiate contracts because it will force people to stay and work in a province. If you can't leave, why would the government care about trying to pay you well and keep you? Even if you do leave at the end of your ROS, they have more ROS's to replace you. Make no mistake, the government sees physicians as an expense before anything else. They would like nothing more than to pay you 60k a year like a standard government without providing you with any of the benefits government workers are given. It is a slippery slope because, again, the politicians you as the enemy. You are an expense item, nothing more. They don't care about you. They care about getting re-elected and getting that pension. They will do whatever it takes to do that. Once they realize they can force.CMGs into ROS's, it's very easy to whip up public support for this. Then they can claim they are using the ROS to: 1. improve staffing (even if it doesn't) 2. reduce costs (no need to pay incentives if you are locked into working for them) 3. Stick it to those fat cat doctors (make no mistake, this plays really well with a segment if the electorate). All three of those help them get re-elected.
  25. If you open the door to making standard cmg's do ROS for a residency spot, the government will push for all CMGs to do an ROS eventually. It gives them more power to force people to work where the government thinks they should (think crappy undesirable locations) and it will reduce physicians ability to negotiate fee schedules (yay pay cuts!) etc. Once you get into practice, you realize the government rarely has any idea what the hell it is doing in the healthcare system. The last thing you want it to hand more control of your life and career over to them.