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Lactic Folly

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Everything posted by Lactic Folly

  1. Lactic Folly

    Residency based on University Location?

    It's hard to know how much of the supposed "home school advantage" is due to people preferring to stay in the same place for residency due to personal reasons. There are also students who attempt to match into their home school program but do not end up there. It's most important to be a strong candidate IMO; you can still target your residency program of choice through electives/summer research if you attend another medical school.
  2. Yes, it's very common. I'd also note the maximum number of months that you can miss in residency and still complete on schedule, if that works for your household. Something like 3 months (check program requirements).
  3. CTU by its very name and design is structured around medical education. If I recall correctly, during my internal medicine rotation, there were a few staff in the same hospital who did not have any trainees but carried a similar patient load; I am sure not having to teach, speed rounding, and dictating short focused notes helped greatly with efficiency. The internists here can comment better on this. We're a bit off from the topic of resident pay, but to the question of clerk pay, in my mind it would be the same as paying nursing students, tech students, etc. for their contributions to patient care during their 3rd and 4th year practicums. I'm not sure that they receive any stipend to offset their tuition, but anyone in the know can correct me.
  4. Ok, but writing "discussed with dr. X" still means that someone else is noted as responsible on the chart, and the unit clerks treat it as being from the resident/attending. I meant orders being processed when signed with the student's name alone, without the "discussed with" notation.
  5. Yeah... in that case SMR still assesses the patient, and JMR is needed to cosign all orders, so there's still quite a bit of supervision. I meant clerk solo in house with resident on home call - which I actually did a few times, but has presumably been phased out by now (along with clerk orders being processed without resident cosign).
  6. Lactic Folly


    - Sounds like you're off to a good start, being offered a letter. Do you think it will be a strong letter? Did you work closely with that person during the week? My inclination would be to accept it if it was freely offered. I wouldn't wait until a year has passed - you are correct their memory of relevant details would fade. They can draft a letter now and keep it on their computer until you let them know that CaRMS is ready to receive documents. If you acquire more strong letters during clerkship, great - you can use this as an extra letter for the programs which accept them, or an extra letter for programs at that same school in case your letter writer is better known there. If you run into troubles with absentee referees, you'll be glad to have the additional letter. - I don't know that programs would frown on any strong letter. Might be advantageous if you're applying to a research-track program. Otherwise, you could treat it as an extra letter as above. Just check the specific requirements for each program.
  7. Clerks are students, not employees (unlike residents who have dual status). The work that they do is basically hands-on training, and is supervised by residents and staff, who also see the patient, check the student's work, and are 100% responsible for any errors or omissions. It's just an odd concept since I never really expected pay as a clerk - any stipend was a bonus, as there are other professions where students do unpaid practicums as part of their training. Of course, clerks aren't useless, and often they can spend the most time talking to patients which is very valuable. I was just curious what services wouldn't function properly without clerks (except perhaps when extra retractors are needed in the OR). Are there still many services where clerks do solo call without resident backup? Ref. House of God Law #11.
  8. I can appreciate the argument for residents, but under what circumstances do clerks contribute more work than the supervision and teaching that is devoted to them (much of which is provided by residents)??
  9. Lactic Folly

    Income and Lifestyle

    The CMA profiles do give different income stats for each specialty as well, but I agree it's not data to hang your hat on without a better understanding of the context re: overhead, hours. I don't have the knowledge to comment on how conditions vary across the nation. It is my understanding that the Toronto Star has filed a FOI request for *all* physician billings and names, not just the top billing names or likely more accurately groups (although those obviously make for the best headlines). The OMA is attempting to appeal this on behalf of all physicians in Ontario.
  10. Lactic Folly

    Income and Lifestyle

    Yes, that was the point of my response in the context of OP's post - there is always a tradeoff. If you prioritize location, as to be closer to family and friends which is understandable, then your options with regard to specialty choice narrow. High billings don't come without high workload, period. Expecting a career that fits all of our criteria perfectly is a setup for disappointment. If we're looking at the same CMA specialty data - they don't really support your assertions about relativity in income, so how reliable do you feel the data would be overall for other things like overhead and hours? Individual outliers are just that, outliers, and mashing together data from different practice settings/styles doesn't really give someone a full picture of what someone can expect in terms of lifestyle/workload, as evidenced by OP's unmet expectations. Many differences between urban FM working office hours, versus rural GP available around the clock, but everything gets lumped together under those aggregate profiles.
  11. Lactic Folly

    Income and Lifestyle

    Exactly, grass is always greener, a very human and common feeling. As long as one's expectations do not meet reality, it's difficult to be content no matter what your situation. Sure, one could compare specialist billings to FM. But how easy would it be for a new specialist grad to land that coveted position in a downtown metropolis, compared to FM which actually lets you choose where to work to a much greater extent? And if lifestyle is a concern, how would you feel about spending much of your free time (including "vacation") to prepare talks, write papers, etc. to meet the expectations of such a position? Everything has a tradeoff, which may not be apparent until you are in the other position. As above, pathology has regular hours and pension/benefits etc., but suffers lack of autonomy which leads to dissatisfaction. I know friends who worked in family medicine and then entered radiology found that the workload and hours were not what they expected. (The data in the CMA specialty profile almost certainly are averaged with many 65+ part-timers; obviously no full-time person works 30-something hours/week in patient care, can be as much as 2-3x that for rads starting out). Not a problem if you have intrinsic interest in the work, but would be disillusioning for anyone who expected a "deal". In the end, happiness comes from adjusting one's own expectations. I entered medicine with the expectation of meaningful work and a stable income, and I have not been disappointed. Never had a wish for "lifestyle" in terms of house/car etc. If contentment is not found in one's current situation (presumably young, healthy, with stable family situation and career), I doubt any changes in one's external situation will solve the matter, as it is primarily internal. There can always be an upward comparison to be made - how about someone lucky enough not to need to work at all... but perhaps they might look at you and envy your accomplishments and sense of purpose in getting to this point.
  12. Lactic Folly

    Income and Lifestyle

    Yes, students who have worked in other careers prior to medicine often express a greater appreciation for the security and privilege it provides, compared to many other people who also work difficult hours in less desirable occupations for much less pay and job security.
  13. Lactic Folly

    Finding a job

    Most specialty societies should have a job board of some sort. WowJobs also works.
  14. Did they indicate they thought the deadline would be an issue? Some people work close to the deadline, so it doesn't matter in that case if they haven't started it yet. If you're worried, give them a deadline that is somewhat in advance of the real deadline, to allow for a buffer.
  15. Lactic Folly

    Income and Lifestyle

    Are you using a corporate tax rate? A spouse who doesn't work outside the home?
  16. Only if they request your help with pointers on content. If they're a medical person and they haven't asked you to draft a letter, I wouldn't offer. Don't want to imply that they don't know how to write a good letter of reference. You want one that's personalized, anyhow. Do provide your CV, official instructions from the school, envelopes, etc. of course.
  17. You know what, when I was moving for residency, I came across my study notes from undergrad and realized I had pretty much forgotten all of that material. To echo everyone else, residency is learning on the job. You learn by doing, and then reading around what you're doing, so no worries.
  18. Lactic Folly

    Speciality Closest to Derm

    How about dermatopathology?
  19. Not much way around if it, if this is going to be one of your strongest letters. If it helps, most of the time and effort lies in writing the initial draft. It should take much less work afterwards if all they need to do is change the date and print out a new copy in subsequent years.
  20. Half the members in my prior department did (which is why I have my own set). Also saw them frequently throughout medical school and residency on other docs in the hospital. It depends where you are.
  21. Not at UofT, but am in medicine, and willing to take a look this weekend gratis if you're looking for another opinion.
  22. The buttoned-up long white coat also lets one get away with wearing the same outfit underneath much more frequently. It dresses up more casual garments, and always looks professional. If you wear the hospital-issued lab coats, no need to worry about cleaning them yourself. Nice to have as an outer layer between one's own clothes and the hospital environment, if not on a scrub-wearing rotation. That being said, despite these advantages, no one in my current department ever wears a lab coat, so I have decided to conform, and my personal set of lab coats hangs in my closet at home
  23. Check the CaRMS program descriptions. The instructions for each program should state if undergraduate transcripts are requested as an extra document.
  24. Lactic Folly

    Questions About Reference Letters

    It's not the standard in North America that good reference letters need to include a weakness in order to sound 'objective.' I have heard this could be the norm in other parts of the world (UK?), but can't speak to it personally.
  25. Lactic Folly

    Papers that are not yet published?

    You would specify that they have been accepted, in press (or submitted to xx Journal if there is no official manuscript decision yet).