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Birdy

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Birdy last won the day on January 30

Birdy had the most liked content!

About Birdy

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    Kinda Bossy
  • Birthday 03/15/1987

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    Female
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    Hamilton, ON for now

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  1. Birdy

    Pregnant in Med school

    I had my third child right at the end of preclerkship, took a week off, then returned to class. It wasn’t too bad, but I had a few factors going for me; my husband was taking parental leave, I’d done the whole baby thing before, and I was starting out clerkship with some electives that allowed me to work from home until my younger daughter was two months old. Plus I had basically the easiest delivery ever I graduated on time, which was my goal. But when I had my next baby right after I started residency, I took seven months off and holy cow am I glad I did because there is absolutely no way I’d have been able to work right away this time around. I had a spinal headache for two months (failed blood patching) and then I got knocked on my arse by an autoimmune disease - which tends to flare postpartum - and I’m struggling to make it through the days right now. So life can go in unexpected ways after having a baby and you may need more time than you think you will. It is possible to do it without deferring. That said, especially for a first baby (if this is your first, you didn’t say) when you don’t know how you’ll handle pregnancy and postpartum, allowing for the possibility of needing more time off is a good thing. You could start school, see how it goes, and then take a year off (most schools will allow that) but you can run into issues with financial aid/LOC in doing that, so tread cautiously.
  2. Birdy

    Family Medicine Salary

    (Whoops, replies to a super old thread sorry for the zombie thread, everyone!) There’s a lot of work that needs doing that isn’t directly remunerated, so that’s worth remembering. No one’s paying you for charting, reading labs, yelling at your computer, or otherwise doing all the things that seeing patients involves. There are other provinces besides Ontario, too. In New Brunswick, a code 1 (similar to an A007) is $47, and you can bill for emails and phone calls with rostered patients under their new model. Family docs on average spend a lot less time in traditional clinic (it’s just over 2 days per week on average) in NB because so many of them are doing emerg/LTC/walk-in, etc. There’s a lot of variation. Most doctors are not straight FFS or straight salary if you look up the breakdowns.
  3. I got this too, but I’m very happy with my choice to go into family medicine. The OR is awesome and all, but so is having a day that starts at 8:45 and ends at 4:30, after having had a full nights sleep.
  4. I’d be very interested to hear your update. It’s a bit annoying that so few people talk frankly about remuneration. I didn’t go into medicine for the money but dammit I’ve got six figure debt and six mouths to feed; it’s nice to be able to set some decent projections.
  5. Seek what help you need, but as others have said be cautious what you disclose. I have personally run into difficulty because I ended up in a position where I had to disclose a mental health diagnosis (postpartum depression.) What happened was that my entire history - including things like my phobia of wasps - was disclosed to the College by my psychiatrist who treated me for the postpartum depression and had no concerns about my ability to practice. None of the historical items had ever impacted my ability to work, nor would they as I am attentive to my mental health and pro-active about management I ended up getting a letter that they had reason to believe I wasn’t mentally competent to practice medicine, and I was put through the review process and am now required to be monitored. Because I had postpartum depression from which I completely recovered (which everyone agrees on; there’s no concern whatsoever that I have any ongoing issues.) The fact that I’ve been required to be monitored for mental health reasons will come up every time I seek to be licensed anywhere, so this will follow me for the remainder of my career. I don’t mind sharing the story with people because I’m angry, but in no way ashamed of my history. It’s a super common issue, I took appropriate steps to manage it, and I got kicked in the arse for it. So seek help, but tread carefully.
  6. I was at work getting absolutely nothing done because I was obsessively refreshing my email. I was also watching the admissions results start to roll out on PM101. Around 9:30 (I was on the east coast at the time) I saw that email subject line “Offer of Admission, McMaster MD Program - Hamilton Campus.” I whooped and shouted “I got into medical school!” as I ran over to my coworker’s desk. I was so excited I forgot I’d just sprained my ankle earlier that day and it gave out as I got to her cubicle and I slammed into the wall. Didn’t even care, I was so happy. My coworkers were congratulating me and my boss was so proud of me she couldn’t stop grinning. I called my husband at his work and told him. My hands were shaking I was so happy as I told him. He was just beside himself with excitement; he told his coworkers and they were thrilled for us. I posted on PM101 and my blog and Facebook and it was just amazing. Quite honestly right up there with my wedding and the births of my kids as one of the happiest days of my life.
  7. Birdy

    Mcmaster Family Sites

    Great question. A major difference is that I didn’t work in a big team. No JMR/SMR, usually no medical students or other residents at all unless there was someone on elective. It was me one on one with my staff. The patients overall did tend to be in hospital for more ‘bread and butter’ stuff since that hospital also has IM, but I did have some more complex cases sprinkled in as well. Honestly I feel like the mix I had at my site was about the same with respect to breadth and acuity as what the family residents on my CTU team in med school were being assigned from the list. We also work with the internists when doing call (no overnight call, but evening/weekend) so you do get some internal medicine exposure, so more complex consults, and I often got to follow these patients if they stepped down to hospitalist. I got to pick and choose my own cases and go where the learning was best since there was no one ahead of me. Plus the staff docs I worked with loved teaching and it was a heck of a lot of fun to work with them. One of the staff docs I worked with was IM-hospitalist (the others were FM) and so his list included both IM and hospitalist patients. My understanding was I could only be required to care for the hospitalist patients on the list, but I was allowed to be part of internal cases as well as there were some interesting ones.
  8. I know of at least one small hospital that pairs FM docs interested in emerg who plan to challenge the exam with experienced emerg docs as a sort of mentoring relationship for more acutely ill patients to ensure adequate skill-building. As someone with an interest in doing some emerg work in addition to family practice, I’ve been looking at places where FM docs can do emerg work without the +1 and there are several areas I’ve been able to find in my region of interest (Maritimes.)
  9. I honestly don’t have any sympathy for her. Her behaviour was unacceptable and she is receiving professional consequences, as she should. This is not unprofessional in the manner of stressed out doctor snapping back at some rude patient. I could feel bad for that sort of conduct. This is big-U Unprofessional, the consequences of which are clearly laid out and explained to us in med school. There was an inherent inequality in the professional relationship which made true consent impossible. This is one of the really big no-nos in medicine.
  10. Birdy

    Mcmaster Family Sites

    I’d like to plug one of the smallest Mac sites - Grand Erie Six Nations in Brantford - because quite honestly the learning is fantastic. I feel like it’s a bit of a hidden gem of a program. There are bimonthly sim sessions with the emerg docs, POCUS training, really fantastic staff who work 1:1 with residents for the most part so you end up with quite a bit of independence. Admin staff are responsive. Oh, plus overnight call is only on one rotation, otherwise you’re done at 11pm. And no CTU; it’s two blocks hospitalist.
  11. Mac has eight weeks of clinical electives at the end of first year (well, an eight week block. There’s one week of vacation.)
  12. https://www.carms.ca/data-reports/ Pick a year, go to town analyzing the data. Looks like last year there were 9 CMG spots and 8 people ranked it first.
  13. Birdy

    What do you think about this blog?

    Honestly I don’t know the averages off the top of my head. I don’t imagine they’d represent more than 30% or so of their overall revenue, but that’s just a very rough estimate. We’re talking $5-ish for the majority of visits (intermediate visit) with a few additions like smoking cessation, psych work, or diabetes visits thrown in there. But I’m estimating based only on a very incomplete understanding myself. Back home, as a contrast, family docs have the option of being straight FFS or having a salary plus 31% of shadow billings. To be eligible for a salary, you have to shadow bill at least 85% of your salary’s equivalent, so the minimum earnings for a salaried doc is actually 1.26x the salary (most make more. They don’t pay overhead when they’re salaried, and there is paid vacation and defined benefit retirement, so it’s equivalent to a lot more than it looks at first glance.) NS offers a straight salary option (no one has been able to actually clarify for me whether they have shadow billings on top of that) which they call their “alternative payment plan” since it’s an alternative to FFS. There are a couple setups for academic docs too that are slightly different. Making heads or tails of FM income is... not a straightforward proposition.
  14. Birdy

    What do you think about this blog?

    Capitation models (there are several different kinds) are common in Ontario but not so much elsewhere. Average per patient annual rostering fee is $144 last I recall. But they still bill per visit. There are “in-basket” services - things that are expected to be part of the basic services a family doc should offer - for which they receive usually 15% of the standard fee on top of the rostering fee, and then they have “out of basket” services that they receive the full fee for. Those are usually things that are being incentivized or are specialized FM services. And that’s just touching on the basics of it in Ontario. A straight up salary from the province isn’t an option here for community practice but it is elsewhere. Family docs often have multiple revenue streams; it’s not just their capitation payments or just FFS.
  15. Birdy

    What do you think about this blog?

    I would expect he’s talking after-tax and after overhead take home, assuming no tax-saving measures are used.
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