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Lactic Folly

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Everything posted by Lactic Folly

  1. Lactic Folly

    ADHD in top 10

    I didn't sense that at all. The delivery may have been blunt, but goleafsgochris is just sharing what they have seen going through medical school and residency. I think most other future applicants reading this thread will appreciate the realism and the fact that their senior colleagues are taking the time to alert them of potential pitfalls that lie ahead.
  2. Agree that you want coaches who will give you as much constructive feedback as possible. It's one thing to provide a confidence boost to someone who needs it, but most everyone starting out this in this process will have room for improvement. Did these coaches have a background in medical admissions? Are you near a university where you can access in-person coaching? Even family/friends may be helpful to pick up on body language cues, as they will be motivated to help you succeed.
  3. Lactic Folly

    Research in Med School & Residency

    Not in itself - it's understandable that people will explore different areas during medical school and may switch focus as their interests evolve. It's about the total impression from your application (including personal letter, electives, and references).
  4. Lactic Folly

    Research in Med School & Residency

    Congrats! For residency applications, research is beneficial in demonstrating interest in a field, and making connections within a department who can provide references and vouch for you at the program selection committee meetings come CaRMS time. As such, you'd want to work with MDs in the field you are applying to. The main consideration for continuing in a basic science lab is if you envisioned pursuing that research into residency (i.e. applying for a clinician investigator stream).
  5. Lactic Folly

    UBC vs U of A

    Congrats! If you can envision yourself attending either school, then you can't go wrong with your decision either way. I suppose the first question that comes to my mind is - where do you want to live for the next 4 years, and where do you want to eventually end up?
  6. Lactic Folly

    Drop out rate?

    Thanks - perhaps we can refine the questions as "what keeps people late in their careers from wanting to retire" versus "what keeps people going for the long term when they start their training and practices". Although enjoyment and fun are similar, I also think of them slightly differently, though I'm not sure whether others make the same distinction. To me, fun is more in-the-moment excitement, while enjoyment includes a sense of satisfaction that will linger on in one's memory after the experience has ended. Sometimes late-career physicians are able to scale down their practice a bit and divest themselves of low-satisfaction admin duties. Even if they don't, their accumulated experience allows them to handle tasks with more ease and efficiency. When I have the space to delve into an interesting case, or teach without other time pressures or distractions (i.e. on one's day off), it can indeed be 'fun'. When these same experiences occur during a busy clinical day, they are often very challenging to juggle and accommodate without (or even with) working around the clock. My experience on such a day has essentially no resemblance to the carefree fun I might experience on a holiday. However, when I look back on the day, I enjoy having spent that time with students, and am glad I made that space for them. It is meaningful and is why I continue to do it for the foreseeable future.
  7. Do you know if you want to do family or specialize?
  8. It's natural to have some of the same feelings as starting at a new high school, which may sound a bit surprising given that most people have completed undergrad +/- some work experience prior to starting medical school, but I'll leave it at that. There are some good reads out there about the difference between fitting in and belonging. By virtue of your acceptance, you now belong in this profession, and hopefully that knowledge will help release some of the anxiety about fitting in. Congratulations! Life may throw curveballs regardless, but the changes that are coming will be an amazing opportunity for growth that you've worked hard to achieve.
  9. Lactic Folly

    UofT vs McGIll

    I think there is a definite advantage in doing postgraduate training where you want to work, especially if it's a more competitive urban area. For example, you could start tailoring your training to a department's anticipated needs if there is opportunity (e.g. upcoming retirement). That being said, there is still the fellowship phase for many specialties, where you could arrive in a city and start to network that way, albeit on a tighter timeline. I think the advantage for matching to the same school for residency is there but less pronounced, and would mostly be due to increased familiarity with the home school candidates, and perhaps the thought that local grads are more interested in staying for residency, plus the logistical factors as Edict mentioned above.
  10. Lactic Folly

    UofT vs McGIll

    http://carms.ca/wp-content/uploads/2017/05/Table_29_Match_Results_by_School_of_Graduation_English.pdf There is a large proportion of students matching to their home school in other provinces as well, so I do wonder how much of that is due to applicant preference vs the preferences of the program. Can't speak to UofT specifically though.
  11. Lactic Folly

    U of T vs. MacMed

    I just wanted to say that I appreciate the frankness of the above post, given that the author identifies as a Mac graduate. Seems that most if not all of the important factors have been covered in this thread.
  12. Different values. McMaster's Faculty of Health Sciences vision is: Within a culture of innovation, exploration and collaboration, we lead by learning from what was, challenging what is and embracing what could be." The vision for University of Alberta Faculty of Medicine & Dentistry (a school which has promoted their students' LMCC results in the past) is: To build an exceptional socially accountable Faculty through leadership in education, research and patient care and to be recognized as graduating highly skilled doctors, researchers, and health care professionals for Canada. (italics mine)
  13. Lactic Folly

    U of Alberta vs. McMaster

    I agree with this. Regarding the enrichment year, doing one essentially negates the main advantage of a 3-year program. In addition, as it does not start until after the pre-clerkship phase is completed, its timing is less advantageous CaRMS-wise than doing research during the summer between 1st and 2nd year in a 4-year school.
  14. Lactic Folly

    U of Alberta vs. McMaster

    There are established linkages between surgery and research in a broad range of fields including machine learning, probably more so than with emergency medicine in Canada if I had to guess, though I could be wrong on that. https://www.ncbi.nlm.nih.gov/pubmed/27119951 A search reveals a scientist at McMaster who is doing research in machine learning and trains surgical residents/fellows in research. https://rhpcs.mcmaster.ca/who-we-are/ranil The McMaster Surgeon Scientist program has biotechnology/innovation as one of its areas of focus. https://fhs.mcmaster.ca/ssp/ I provided links to UofT residency programs since you expressed an interest in returning to Toronto. There are Clinician Investigator Programs at other schools as well, which are designed for residents interested in research careers. Your undergraduate program will primarily serve to get you into the residency program of your choice. Some research during your MD years would help, but I don't know how much time you would have for learning additional subjects like math/comp sci during Mac's program. Your time would likely be better spent learning medicine and working on strengthening your application for highly competitive fields such as the ones you are considering. With summers off in Alberta, you could set up months-long research projects in Toronto if you wish. When I meant that research could be time consuming, I meant in general, not with reference to GIM in particular which should not be longer than pursuing research through other Royal College specialties. Again, it depends if you see yourself building a career as a clinician researcher (PI), or being a clinician who simply participates in some research. You would want support from your department to apply for grants, etc. more than simply going down in clinical hours and pay, although your group scheduling would need to accommodate that as well. Again, it's easier if you're working somewhere that already has dedicated research personnel to support these activities. That's why I am unsure of your emphasis on FM being able to set up shop anywhere, as you will want to be close to a university performing research in machine learning/AI if you are seriously pursuing this path. This will determine your practice location more than needing to work in a hospital ER. I don't have firsthand knowledge of the EM job market, but any hospital with an emergency department needs it to be staffed, and it's flexible for anyone with privileges to pick up ER shifts, as long as the hospital and ER group are willing.
  15. Lactic Folly

    U of Alberta vs. McMaster

    Also, not sure what you mean by funding hinging on a hospital - both hospital-based EM and traditional fee-for-service clinic-based FM bill the government directly for their services. The emergency medicine physician holds hospital privileges, but provides services as an independent contractor, as does the FM physician. It's the surgical specialties which are more constrained by availability of hospital resources (in particular OR time).
  16. Lactic Folly

    U of Alberta vs. McMaster

    I differ on this somewhat. All the surgeons I have seen in academic centres do some research, whether it's medical education research, participating in multicentre trials, etc., and some publish quite a bit with the help of trainees. https://surgery.mcmaster.ca/research/ongoing-areas-of-research Of course, there is a significant difference between doing some research (mostly on one's own time while still maintaining a full clinical practice) and being a clinician researcher with protected time as above. Unless someone already has a strong background in the area of research they wish to pursue (e.g. MD/PhD), I think it is much easier to establish a research program (if someone is that serious about it) if there is some infrastructure. It is invaluable to have access to a training program such as the ones listed above, which would provide access to mentors and research resources, and pave the way to further fellowships and success in obtaining grants. Not impossible without these if one is sufficiently determined of course, but more uphill. FM(EM) is primarily clinical training. You could apply for a research-oriented FM residency, but the coursework may not be entirely relevant to your interests. You could approach computing science and engineering faculty on your own, but will you be able to convince them to devote their limited time and funding to collaborating with you? I am not sure that being a trailblazer in FM is enough of a selling point in itself, unless you are bringing something else to the table (whatever experience and connections you may have from your MSc). I suspect that as far as non-surgical options go, general internal medicine is likely the more hospitable specialty for these kinds of research interests. More common for academic GIM to be doing fellowships in areas such as clinical informatics, and carrying that on into future practice. But developing a successful research program is also a time-consuming endeavour. It depends on how serious you are about this, like choosing surgery as a career. When looking at specialties, I would focus less on the subject matter (because everything makes a difference to patient QoL and becomes more interesting the more you learn about it). Rather, I would focus more on the nature of the work itself. How important is it for you to work with your hands, and specifically in the OR? If you haven't read it, Brian Freeman's Ultimate Guide to Choosing a Medical Specialty is pretty good. I think that if being close to family is more important in the long run, and you can see yourself being satisfied working in family medicine in Toronto (as the +1 EM is also competitive - 60-something percent match rate in recent years), then go for Mac. If you need more time for specialty exploration, the 4 year program may be advantageous for that reason, but certainly students have matched well coming from Mac - you'll just need to hit the ground running. Often reading or talking to people in the field about their careers can be equally or more high-yield than observing, since those further along in their careers are familiar with the range of practices out there and can distill what's most relevant to specialty choice and career satisfaction, whereas although there is also no substitute for firsthand experience as a student, it is only a small slice of a particular practice rather than of the possibilities available in an entire field.
  17. Lactic Folly

    U of Alberta vs. McMaster

    It sounds like research is important to you. Do you hold a PhD, or currently work in AI research? If not, would you pursue a program such as https://surgery.utoronto.ca/surgeon-scientist-training-program or http://www.deptmedicine.utoronto.ca/eliot-phillipson-clinician-scientist-training-program ? Do you envision yourself a clinician scientist with a research program and a collaboration with computing science? The right infrastructure is invaluable for setting up a research career - I found a family medicine-based informatics fellowship in the US but not sure if similar opportunities exist in Canada. https://wexnermedical.osu.edu/departments/family-medicine/education/fellowships/clinical-informatics-fellowship How much time would you spend on research during the school year?
  18. Lactic Folly

    U of Alberta vs. McMaster

    Congrats! It is evident that you have done a fair amount of career exploration and reflection. Given this, the main outstanding question in my mind based on your post is - how far along are you in that decision? For example, if you are 90% for FM-EM, and can see yourself being able to decide on the 3-year program versus a 5-year specialty in fairly short order once commencing the medical program, then sure, it might be a 'waste' of the extra year as you put it. However, if you are more 50/50 at this point, then the extra year may be beneficial, especially as your shortlist essentially consists of the most competitive Royal College specialties. My understanding is that electives for fields such as ophth and derm can be challenging to obtain (they are sought after by FM students too), and deciding on a field early on will make it easier to book them. With regards to your career-related connections in Toronto, do you anticipate you would travel back and see people on weekdays? weekends? It's not clear to me whether the concern about distance is primarily a career or family- related consideration.
  19. What the others said. If there is a specific issue at the interview stage, then trying to skirt this during the admissions process may only mean that you'll run into the same issue again at the residency match stage.. or the job hunting stage... when you've left your previous career behind and the stakes are higher. Better to try to figure out what the problem is and deal with it head-on.
  20. Lactic Folly

    Use Of Extracurricular Activities?

    Everyone has ECs prior to getting into medical school, and can continue to list them on their CV. It seemed that ECs at my school were more of a social vehicle, and those who didn't participate as much were labelled as "doing nothing but study" - not that such comments should, or do, matter after leaving the preclerkship milieu.
  21. Lactic Folly

    Use Of Extracurricular Activities?

    The value will be in the eyes of the beholder - but in general, it is about what you accomplished in the role. Established an initiative making a valuable contribution to the community, which will continue after your graduation? That would be memorable and impressive (and not very common). Spent several hours participating in a club or volunteer effort that most people in the class do? It is nice to be an active citizen in your class, but that's not going to matter as much for residency applications.
  22. Not particularly worried either. This figure from a recent article in CARJ outlines the role of radiologists in patient care. The areas where artificial intelligence are being applied are circled in red - as you can see, there are many areas that require human input to place automated output into the context of a specific patient's situation. https://www.carjonline.org/article/S0846-5371(18)30030-5/fulltext
  23. Lactic Folly

    Drop out rate?

    For longer-term career satisfaction, it's probably more relevant to think in terms of meaning rather than fun. It may or may not be thrilling to do that nth cholecystectomy on call , but it is meaningful and satisfying to use the skills you've trained years for in order to carry out a technically successful procedure for the patient who needs that immediate intervention. Similarly, it was probably not fun to study for the MCAT, but satisfying to receive that medical school acceptance, which made the process meaningful (and it is meaning, not fun, that is the greater contribution to happiness). Desire for change is quite person dependent, and for those who find change/improvements exciting, the medical field offers a limitless stream of new developments and ideas to influence one's practice.
  24. Lactic Folly

    Drop out rate?

    The off-service residents are generally PGY1 and should be backed up by a more senior general surgery resident on call. These are the people who run the teams during the day as well, so short-staffing would increase the number of patients assigned to each of the other teams/residents.
  25. Congrats! I think you've laid out the gist of it already. Which is more important to you, a shorter program or summers off (which can be an advantage for career exploration and planning)? Then add personal factors into it, which are evidently different for everyone.
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