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StarStrike

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  1. Agree with ya :). If many of my classmates understood and internalized what they know now 4 years ago, I think many of them wouldn't have taken the risk going abroad (and rightly so). The funny thing though is the grass always seems to be greener on the other side - many of my friends (and some people on this forum too) over the years have asked me for my opinion on pursuing medicine abroad....and despite telling them of the risks, the competitiveness, stigma, etc. etc. many of them end up doing it anyway. I mean for me, I switched careers to medicine...and I went into this with the understanding that I might not make it, but perhaps naively so wanted to give myself a chance. I got lucky.
  2. Gotta love the emotionally driven hate that is being shared in this thread (including the quiet ones liking said posts...). I appreciate the respectful chatter from the other members of this thread. Good to see that we can have some constructive discussion.
  3. I think in BC there is the "No Docs Left Behind" initiative (https://www.nodocsleftbehind.com)!
  4. 1) I think we are in agreement here. These are calculated risks for sure, but that doesn't mean it doesn't come with costs. I suppose the situation with our loan system here is no where near as bad as the US. 2) I never said anything about completely outsourcing education outside Canada. This is a straw man argument. I agree with you that we should have CMGs and Canadian medical schools. 3) It is true that the residency is an added barrier compared to most other professions. The addition of residency potentially adds yet another choke point. I see the rationale for wanting to stamp out competition, but I'm not convinced the argument is cohesive. I suppose what makes it more difficult is both of us are coming at this from different angles and understandably with different biases. Do we have any information about the unmatched CMGs from CaRMS RE their choice of discipline? If most of these applicants were aiming for primary care, you could make a case about the allotment of residency spots to IMGs. Though before we do that we would need to determine whether this separation is unconsitutional and/or ethical. 4) Absolutely, I get that. If the purpose of these exams is to see that applicants are at the same standard of CMGs, why have that separation between the CMG/IMG group. If passing/doing well on these exams shows you are on the same playing field, why are we separating these groups still? 5) I'm in agreement with you on that. Nobody has a right to a certain career. Not everyone gets to go to medical school, or pursue a residency, or even have a job waiting for you at the end. What I am disagreeing with is why this is selectively being applied to different groups of Canadians. I could make the same argument about CMGs and say that getting into medical school doesn't entitle you to pursue a residency of your choice. Not everybody becomes a surgeon. As competition is getting more and more intense...not everyone gets to practice clinical medicine (though the upside is that this is not the only thing we can do with our credentials...). 6) I'm glad to hear about that. I know many of our medical schools also have pathways to support our Indigenous population which I think, if it is working well, is fantastic. I'm not so sure I agree with you that we should base our admission just purely on academics. You just end up selecting for people that do well on exams and who focus their energies on the things that provide the highest yield. I know its a fluffy/subjective process the way we have it now, but I think it allows for some degree of diversity in the field and encourages people to build their soft skills and involve themselves in the community. Academics is only one of the many aspects that are important to be a good doc' nowadays (or so what most PDs tell me...).
  5. Yeah, I see your point. Obviously not a straight forward situation, be interesting to see what if anything comes out of the petition. Agreed with the point that some schools are predatory and yes they do use the revenue source to subsidize and improve the training of their own students. Personally, I think these overseas schools also have an ethical responsibility to provide a pathway for their international cohort if they are to continue taking them on. As for stretching family finances, I agree 100%, but that doesn't stop people from taking these risks. I suppose the question is to see what if any obligation we have to our own fellow Canadians.
  6. Think about that first statement here for a moment. The issue here is the ethics of having dedicated spots for one group of Canadians and another group of Canadians. The exact reverse argument is being made in the petition that we're discriminating against other Canadians. Even if we can play mental gymnastics to justify discriminating against groups of Canadians (replace IMG/CMG with anything else and you see the problem - black/white, religious/non-religious, etc) are we even sure that these IMG spots are created at the expense of the CMGs? When the separation was first created in 1993, do we know if IMG spots created through funding from elsewhere or if spots were reallocated from CMGs? My understanding of this was that this was borne in part out of a need to service our underserved areas (hence the RoS on IMG positions) and to fill the gap not met by the CMGs (primary care - which is why most spots are allocated in IM/FM/etc). About your second statement, I'm not so sure the opportunity to apply and get into Canadian medical schools is equal or equitable. Our adcoms are definitely moving in that direction to make it so, but it would be silly to think that certain groups of people are not at an advantage. Many of these same people are those that you dislike so much - the rich, the connected, etc. For my own curiosity, how many CSAs or IMGs do you know well personally? They're not all the "scumbags" you make them out to be. You have a broad range of people going abroad, from those busting their ass from day 1 but unable to get into Canada, those wanting a change in career, those wanting to travel and learn about a new medical system, etc. They're Canadians just like you or me. I don't see what is so unethical about them traveling abroad for their medical education.
  7. That is a totally nonsensical statement. What makes you believe that CSAs are all upper class? Many of these people come from working class families that work themselves to the ground for years trying to make a living and get into Canada and then bravely make the decision to make the jump abroad to pursue their dream. Even still, very few people have a "full ride", we've all mortgaged our future to an extent and many of the ones that didn't match are in dire straits. It really is disheartening to see the bias that is on this forum. Even though we learn things like compassion and empathy, I guess the reality is it all goes out the window when it may (or may not) affect you.
  8. 1) For the most part you are correct about the bank situation. Bad bets do happen and those do burden the banks (and usually the family that has co-signed the student's debts). I've seen it happen with many of my colleagues and some are doubly screwed if they don't match. What about the government loans? 2) I might not understanding your point well, but I'm not sure that is much of an argument. Admission logistics can change "on a whim" anywhere, including Canada. For residency, think about the abolishment of the rotating internship, creation of the IMG stream, creation of CAP, etc. Same thing with medical school admission, many schools no longer require prerequisites, favour non-academics equally, etc. As for the free market question, I guess that is part of the point and what these guys are petitioning. Why is it that it isn't a free market like other professionals (like you mention with law). I'm not necessarily saying a free market is better, but why is medicine so different? Plenty of Canadians train abroad in professions like law, pharmacy, dentistry, etc and many immigrants also successfully make it in to the Canadian system with their education and credentials. I was just looking at the mission statement of CaRMS which is: "Our mission is to serve as an independent, arms-length provider of a client-centred, fair, transparent, and equitable matching service for medical education in Canada" An argument can be made that the current process isn't equitable - by definition IMGs have to jump through the NAC OSCE, MCCEE (next year the QE1), and the CAP for UBC to even compete at the same level as CMGs. You could also argue that it isn't fair, given that it discriminates between Canadians based on their place of training. You could argue that the purpose of the board exams (which CMGs don't have to do until they've matched or are in residency) is to create a level playing field, but then why are Canadian IMGs separated into a different pile? The last point you make about setting up a system where students incur 200k+ debt is an interesting one. Nobody wants that. The reality is, this situation already happens with CSAs and CMGs that don't match. To a degree, you are probably right that the average CSA is better off than the average Canadian, but I'm not so sure you could say that about the average CMG - do we have any statistics on that anywhere? It would be interesting to see what the data is in Canadian medical schools RE their socioeconomic status compared to the average CSA. Although the money usually needed to go abroad is usually a deterrent, I think you might be surprised how many people mortgage their lives to make it happen. Some of my own colleagues in Ireland are in a dire situation financially (though as you may argue and correctly so, at a risk of their own, but also borne by their families and the gov't). Many of these people aren't the stinking rich people that you think they are. It is tempting to believe that because it justifies the resentment and hate the IMGs regularly and constantly receive. Over my last few years in Ireland, I've talked to so many people that are desperate to become doctors, many of whom are working class, strong academically, etc. Their misfortune is they couldn't play the game as well as the CMGs did - and the reality is to a large degree it boils down to luck and "playing the game". And depressingly, it is actually our own medical system in Canada that is unintentionally or intentionally discouraging the socioeconomically disadvantaged from pursuing medicine in Canada - which is precisely why many go abroad.
  9. So is your argument that because tax payer dollars are necessary to train CMGs, residency spots should automatically be reserved for them? Why do you think so? Why is it unethical for residency spots to be available for IMGs or Canadians that studied abroad? Is it unreasonable to think that this practice could potentially be seen as discriminatory? Help me understand your perspective. Remember, many of the IMGs (which to reiterate are Canadian citizens or permanent residents and tax payers) that train abroad either self-fund their education abroad (which funny enough saves the government money - they don't need to fund 3-4 years of medical school) or take out loans which also burden the government and our bank system. If you look at it from this perspective it is a financial burden both ways on the Canadian economy. Once you're at the point of competing for residency, the cost of training a CMG or an IMG is already sunk. So the question is, what is our goal/intention? Is our goal is to prioritize CMGs to ensure they're guaranteed residency spots? Or to train the best future doctors? If the goal is the former, then it is really important to sit down and really think about what is happening with CMGs not matching. Most IMG spots are in primary care - what if it turns out a large proportion of the CMGs that don't match only wanted surgery, ophtho, radiology, etc.? Cutting out the IMGs will not change anything significantly in that circumstance. It is tempting to scapegoat IMGs as being villains (or crooks, cheats, idiots, etc.), but I think it is important we actually try and address the larger systemic issue rather than creating enemies out of each other. If a potential solution is to cut out (which is what many people on this forum seem to be advocating) or restrict (the current case) the IMGs then I think it is our obligation to think about this rationally and from both a legal and ethical perspective. If the goal is to train the best future doctors, a good argument can be made that increasing competition in a level playing field, not decreasing it, is better suited to achieving this (e.g. like the US). Understandably, I think this is in part where a lot of the fear comes from. It is akin to the situation elsewhere in the world where people exclaim "the immigrants are taking our jobs!" except here they aren't immigrants, but Canadians....
  10. Thanks for that. That bottom link is a wealth of information. Quite interesting!
  11. This could end up being an interesting discussion, but if history is any indication it just ends up becoming IMG bashing. You mention the constitution and tax payers - remember that IMGs are Canadian citizens or permanent residents and do also pay taxes. To that effect they're really no different than CMGs beyond where they did their training. What Europe does is essentially create rankings and allocate spots to students that trained in their own country, then the EU, and then everyone else, if there are spots left over. There are problems with this as well, but it allows their own trainees to be guaranteed spots (e.g. the Irish in Ireland). There are relatively few people that do their training outside of the EU so its not a big issue. If we did that in Canada where Canadians were all competing with each other, the reality is it would amp up competition tremendously....which is probably why we're so protectionistic and why we have a separate IMG pool... It is interesting to read a little about the history of the changes in CaRMS and how/why the IMG pool was created in the first place and to do some of my own reading about our Charter of Human Rights. Some of the barriers put forth in medicine in Canada aren't seen any where near the same degree in other professions like pharmacy, dentistry, veterinary, etc. There any way to see where (if anywhere) this thing has gone? Be interesting to see at least from a legal perspective and an ethical perspective as well.
  12. Sorry to hear about that :(. I'm an IMG, but when I did my electives back home this summer, I was lucky that I didn't run into a situation like that. I enjoy spending time with patients... I probably wouldn't have taken it well if I got told off myself! Though I didn't end up matching to IM in the end (matched FM) so maybe its karma hah!
  13. I wonder if there are any statistics on this. In today's climate, I feel like we select for these sorts of people more than in the past. Medical schools, residency programs, etc only take the "top 1% of the top 1%" based on criteria they feel selects for great doctors. I wonder if those selection pressures inadvertently weed out those "soft" traits that are also important to be an effective and compassionate physician - because really those are things you can "fake" for 30 minutes during an interview, so you spend more time developing the things that actually get you to succeed. In the game of medicine, it actually costs you to spend more time than you need to developing yourself or connecting with others because they reduce the amount of time you spend doing things that bring you ahead (and its that fraction of a difference that can determine whether you get into school, get a residency, get that fellowship, etc.). Might explain why so many more people appear to be "unprofessional, vindictive, self-interested" assholes. (Sorry for the rant btw, I can totally relate to what you're describing. From my own peers in medical school, to some of the residents and consultants I've worked with, etc. It is amazing how many people could care less and don't see the suffering they're bringing to others). It would be really interesting to see how doctors compare to people like lawyers, politicians, bankers, CEOs, etc.
  14. I see. Very sad to hear... Best to avoid the headache with the university/hospital/college in having to "prove" your potential mental health issue will not influence your abilities as a doctor for now. I suppose the argument could be made that this comes from a good place (e.g. we can easily see the risk posed in extreme situations if someone is acutely unwell), but it becomes problematic if they paint everyone with the same brush. Have you encountered situations where GPs/psychiatrists/etc have illegally disclosed one of their patient's information to an authority with malicious intent?
  15. In what circumstances can what someone previously disclosed be used against them if you don't mind me asking? Are you talking about disclosures to your own family doctor/counselor/psychiatrist/etc? Or disclosure to the College, your medical school, etc.? I find this very interesting so I want to re-educate myself on the details. My understanding is that the details from your private consultations with your health care provider are confidential except in the most extenuating circumstances. Disclosure to the College is different as their responsibility isn't really to protect us, but to protect the public, so your disclosure could very well be used against you. Same thing with the insurance bit - signing up for disability or health insurance is harder (and more $$) once you have pre-existing diagnoses (mental health or not). Would appreciate any info you guys have. I'm surprised that most of the forum feels so strongly against seeking mental health services. My own anecdotal experiences in Canada when I was in pharmacy school and in Ireland for medical school have been nothing but positive and supportive when seeking out these services.
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