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About ACHQ

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  1. Thanks, is there any way to know which programs have these positions even available?
  2. Curious, does anyone know how this works?
  3. Looks like you went UofT and I'm assuming you did IM rotation there too. I'm very sorry someone told you this. If it was a Junior or Senior resident that said this they should pull their head out of their ass and stop being a D*$K If it was a staff that said this then...they should pull their head out of their ass and stop being a D*$K Maybe THEY should have came prepared for rounds and knew the lab values... cause ultimately THEY are the ones responsible
  4. Yes, it is scary but at the same time what are you going to do? Makes you wonder how they practiced 25-30 years ago when either EMR's didn't exist or were just starting off. That being said it IS much better than when I was a PGY-1 (2.5 years ago). A lot more hospitals are on it before it was just the academic sites.
  5. I'm not a staff (yet), but I have talked to staff community doctors that work in those hospitals (and others in the GTA). One said PARTIME (e.g. 20-21 weeks, so more than 1 week off a month) of work GIM work (mixture of wards, ER consults and clinics) pays $300k gross (but with minimal to no overhead), this was for Trillium. A General Internist at North York General said working 36 weeks (considered "full time") they grossed close to 400k (again minimal to no overhead).
  6. ACHQ

    IM Programs that let you moonlight

    This is via a restricted registration license. You don't bill OHIP and get a stipend (about 1500-2500 per night)
  7. ACHQ

    Stress level

    As someone with their royal college exam this year.... this x 10.
  8. ACHQ

    GP hospitalist job market

    Most of the large GTA hospitals have ER-call/overnight coverage by a GIM/sub-specialists. That's because they are "the doctor" in the hospital and handle admissions to ICU, code blues, seeing deteriorating patients on the floor etc...
  9. ACHQ

    GP hospitalist job market

    technically yes. People who chose to sub-specialize typically don't want to do GIM work, or are too busy with their sub-specialty to take on GIM work. Many will take on ER-call shifts because it pays $$$. Some (but less so) will also do MRP work because it can also pay decently. Most who do this don't do too much because they are busy with a sub-fellowship, or clinical associate positions, or other subspecialty locums etc.... but this helps pay the bills
  10. Hahahahahah sorry I didn’t mean to be so harsh, but it is the reality of the situation. Some of the best medical students will be an asset to a team (an asset as much as a JMR can be). My point was that CTU won’t crumble in their absences. tbh I could care less if med students slow me down, but their job during their IM rotation is NOT to help make me more efficient (which they cannot do anyways), it’s to learn Internal medicine. I WANT my clerks learn something that they can carry with them forward regardless of what they eventually go into, even if it means we have to spend a little bit more time for it. “CTU” is a constructed system to teach medical students and residents internal medicine. As people mentioned if we just wanted to provide patient care and peace out we could (like how weekend rounding works, although we’re on call and there the whole day ahah)
  11. I have been on several teams where we had no medical students (at all), both during the day or on call at night. They are by no means essential to running my CTU team. If I am the on call SMR and I have no medical students, then I cover the ward pages, as well as admit to my own team with no issues (I'll likely be up all night anyways) If I have no medical students during the day then the JMR's might take 2 extra patients each, and/or I will easily pick up the slack and can see 5+ patients myself. No offense but CTU can and has run without medical students (at least I can only comment about UofT, but I'm sure this is similar at other sites). Can clerks save time for the team? of course! but it usually balances out for the most part. Even with medical students (even excellent ones, that function like JMR's) I always know what is going on behind the scenes and implement investigation/management plans, if the medical student doesn't know or missed it etc..., they are their to learn ultimately. I even do this with my JMR's but to a less extent depending on the complexity of the patient, whether they are a medicine resident vs off service etc... and try to give them autonomy without sacrificing patient care. All the SMR's I know do this and we make it seem like we are giving all the power to our JMRs and medical students. Any SMR that says they don't are lieing or are not doing their job Note: I really like having medical students, especially ones that like internal medicine and/or want to do internal. I like being able to teach them and have them learn and eventually grow as clinicians. That doesn't mean they are essential to my team by any means.
  12. This is NOT true. I personally know lots of sub-specialty fellows (PGY-5's and above) that do GIM call at large GTA hospitals (North York, TEGH, St Joes). Alot of the GIM people start to give away their overnight/weekend calls because they can still make 350-375k without having to do too much overnight work
  13. Correction I doubled checked its 7 people
  14. Yeah there's about maybe 4-5 people from Mac that matched to UofT IM in my cohort (PGY-3 class)
  15. When you do your internal medicine rotation they should teach you how to look for the JVP. Also its pretty helpful if its abnormally high (Elevated JVP has a + LR of 5, for CHFe which is pretty decent). For the JVP specifically, no medical student (and some Junior residents) ever actually see it. Even staff have a hard time seeing it at times. Change the position of the bed, press down on the abdomen (HJR), palpate. These things should help... and if not then just move on and say you didn't see it. It'll come with practice. Do I make any clinical decisions based off of JUST my physical exam findings... no. But do I use them to corroborate my history and in my gestalt... yes absolutely. Just like investigations/tests. I don't treat numbers or images (even though sometimes I might be very tempted to), I treat patients. That means History + physical + investigations = A/P There are some specialties/sub specialties that are highly dependent on physical exams, like neurology, rheumatology, Dermatology (skin exam)