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RadCdn

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  1. FM residency is way more humane, but pay in GIM will be significantly higher. If you are one of those people who can work well with little sleep, then you'll do fine in an IM residency. Lifestyle of GIM can be better than FM. In GIM you don't have to see such a high volume of patients for a good income.
  2. I practiced with two others who did their residency in the US, we all passed. There is also an IM Review Course done in Toronto annually and it's definitely worth doing that course. If you do that course, plus have the Canadian study materials, you will be on the same playing field as the Canadian residents. There is nothing in residency training that helps for the exam, it's the study materials that are needed. That's because about 25% of the questions on the written exam are EXACT copies from year to year. Those questions are so ridiculously detailed that they're impossible to get correct if you have not researched the answers beforehand. I will say that it is probably impossible to pass without the study materials.
  3. ABIM is MUCH easier. It's an 8 hour written exam, no oral component. It's also a much better designed exam. After writing all the US and Canadian exams, I found the US exams were far better designed. I know people that have done residency in Canada and then moved to the US due to more job opportunities in the US. However, these are in fields outside of IM. In IM, you'll find work easily. At most places it's been "what can we do to convince you to work for us?" type of thing. You're in the driver's seat. You can work in the US as long as you're "board eligible". Which means eligible to write the boards. But you can work without having passed the test for quite some time. Writing your USMLE's is never a bad idea. It opens so many doors. In my experience, in the US your talent and skill will go far and it will be recognized. In Canada, there are all sorts of obstacles at every level.
  4. There are no restrictions on patient load. You just have to work at the same clinic as your supervisor. This is not difficult as some clinics are groups practices. The main criteria is that you must meet with your supervisor one time per month. The separate pathway is quite simple. Pass the ABIM, then 2 years of supervision, then pass an in-person evaluation (which I've heard is easy).
  5. Having gone through the US route, I know many Canadians that did their residency in the US. Most stay in the US due to the abundant job opportunities and many of them marry Americans. They are certainly not stuck there. From the IM perspective, it is not hard to come back to Canada. The question is, who would want to? The US is an amazing country in so many ways. I came back because I had nothing holding me there in terms of my private life or job. My family is still in Canada so I came back.
  6. Passing the Royal College exams after doing a residency in the US is completely doable, certainly for Internal Medicine. I did my residency in NYC, then passed the Royal College exams. You are correct that without the Canadian study materials it is almost impossible to pass that test. However, one does not need to do their residency in Canada to get these materials. One can get these materials if you know people doing residency in Canada. I studied with two other international grads doing their residencies in the US. We all shared the Canadian study materials with one another. All of us passed the test.
  7. Just to add some details with regards to Ontario. In IM for example, if you have done a 3 year ACGME accredited IM residency in the US and passed your ABIM, then you can practice under a restricted licence right away in Ontario. All you would need is a supervisor. The supervision is very minimal. Generally meeting with your supervisor one time per month to look over a few cases. After supervision for 2 years, you can get your practice evaluated and then have your independent licence. I know people who have done this pathway and it was quite seamless, allows you to start making money quickly without having to wait to pass exams. With the above pathway, you do not need to write any Canadian exams.
  8. I did 3 years IM in the US, did a 1 year fellowship afterwards as well. Then I was eligible to write the Royal College exams which I passed. I know IM doctors in Canada who just did the 3 year IM in the US, then went through a separate pathway to get qualified in Ontario. No need to do the Royal College exams this way. The Royal College exam is a big headache, and very poorly designed. Personally if I did it again, I'd do the 3 year pathway and start practicing sooner. And yes, you can practice in Ontario right away with a 3 year IM residency from the US as long as you have written the ABIM (which is a much easier exam than the Royal College). You would initially be on the restricted licence and then after two years can have your practice evaluated over a weekend and then you'll have your independent licence.
  9. You're in a very good position right now. Keep in mind, the IM route is an 8 year investment (if everything goes according to plan and things rarely do!) and many of those years are not fun years. Residency is quite brutal actually. I started med school in my mid-20's and I was working a minimum wage job after my undergrad. Going to med school made financial sense and it was my passion (and still is). But even though I love it, I'd like to minimize my hours working. With good planning I think I will eventually be able to work 3 days a week. Many of my colleagues do that and they do quite well financially.
  10. You'll easily take 400K (net before tax) working 6 days a week, but who wants to do that?! That's a lot of work. My colleague in general IM did that for part of the year and took in 500 K last year. I wouldn't focus too much on income. We're taxed like crazy at the upper income tax bracket. Of course incorporation helps, but keep in mind you'll be limited in how you can spend incorporated earnings. Personally, I prefer to make less and have some more time for a balanced life. Everyone has their sweet spot. My sweet spot is four days of work per week. I spend very carefully. I don't care for material things which really helps. Things like fancy cars are not tax deductible, so think twice before you buy the BMW. You may look wealthy, but spending like that actually stalls your wealth growth and slows your ability to become financially independent. The majority of doctors do not have good financial sense and they spend their lives on the "treadmill". Keep in mind, as you get older, you won't be able to nor desire to work as much. This is why it's important to have good financial habits early. As a fee-for-service doctor, if you go on vacation, you won't be paid. If money is your goal, get to know other income-focused physicians. Generally you'll earn more as a private practice physician. Only go to academia if you really enjoy it. Otherwise, stick to private practice.
  11. I work entirely outpatient general IM. I set my own hours, which is a late morning start which is what I prefer. 8 am start?? No way!! I knew early on that I could not work in the hospital. It doesn't suit my introverted personality and the noise in the hospital drives me crazy. In my work, 4 days a week, 300 K net is very reasonable, and I'm a relatively slow paced doctor. Definitely stick it out with IM, as the billings are significantly higher than FM. I do no call whatsoever. Life as an IM Attending is very good. Residency was terrible. I did four years of IM. I saw no point in the fifth year. Always keep in mind opportunity cost for the length of your training. The great thing about general IM is that you can easily focus your career on your particular field of interest. I have a colleague who is general IM, but only does Cardiology, stress tests, Echocardiograms every day. Another colleague of mine focuses on diabetes. Your practice will build quickly and you will have no problem receiving consults. It's better to focus on a few diseases as you'll be quicker and of course volume will be higher. I'm still in the phase where I'm focusing on 5-6 different diseases. Eventually I plan to narrow my focus more. IM previously had chronic disease premiums, but unfortunately they were removed in Ontario a couple of years ago.
  12. Hey Everyone, Anyone around the Ottawa area to practice the OSCE IM exam scenarios for the Royal College IM Exam? I'm looking for a partner to practice with. I'm looking forward to hearing from anyone who is available.
  13. Hey Guys, Any of you taking the Royal College IM exam next year? I stumbled across this board review course. I'm wondering if anyone here has taken it or heard anything about it. I'd like to know if it's worth the cost. http://www.internalmedicinereview.ca/
  14. I'm IM trained with a Geriatrics fellowship. All done in the US. I did IM because the choices of fellowship were numerous. Also, I like the consultant role of an IM doc in Canada. The billing is higher, less factory-type work (5 mins per patient which I can't stand in FM), allows me to focus and be really good in a particular niche too.
  15. I considered studying in the US and looked into this and talked to medical student financial advisors about it. Canadian banks are a bit strict, but that was 10 years ago for me. If your Dad has a steady income it's better than the situation I was in. My Dad had no steady income from a salaried job, but lots of assets. It caused problems for me. Banks prefer those that make a regular salary. I was rejected by 3-4 different banks, then approved by NBC (at prime). To this day, I don't know how NBC approved an LOC while all the others didn't. Also, I was only approved for a 150K loan. I went fully acknowledging that 150K would not be enough money. In the end, to my surprise, I spent far less than that. The whole situation may be different now though as all this was 10 years ago for me.
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