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Valentine

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Everything posted by Valentine

  1. Questions 1. Does a doc need to complete a residency to open a private cosmetic clinic? 2. How does a doc get the training necessary to practice cosmetic medicine safely? Stuff like botox, injections, etc 3. Can any doc from any residency do cosmetic medicine?
  2. Mac ortho has been having accreditation difficulties. They were under "intent to withdraw" status. I do not know if this has been rectified.
  3. How to prevent ****ty useless parents: Mandatory vasectomies at birth. Think of it as a vaccination against bratty children. Should you be deemed suitable to raise one or more youngsters, your vasectomy will be reversed.
  4. The most important thing when it comes to any application process for anything, is connections. You could be the brightest, most handsome, most ambitious and accomplished applicant in the pool, and it wouldn't matter because the son or daughter of Dr.X, who is friends with Dr.Y on the interview committee, is also applying.
  5. My advice is to avoid FM if you want to work in a larger urban center. In large cities, FPs generally do the maintenance work and well baby visits only. Any interesting or vital illnesses that arise become the domain of the pediatric specialist. The only way to do FP interestingly is to do it in a small area where YOU are THE doc. So, my advice is to do pediatrics.
  6. Where does everyone think the spots will go?
  7. NPs are one more reason to avoid going into FP. I've been saying this for a long time: family medicine is in a dire position right now, and its only going to get worse. If any premed or med student asks me what I think about family medicine, I tell them to avoid it unless they were completely enthralled by its philosophy. The field is facing enough problems as it is, and the future looks bleak. Follow the numbers: less students are going into FP every year. Medical students are not fools - they as a whole realize that FP is a total lemon of a career choice right now.(yes, I said it.) If they're unsure of a career choice, I tell them to go into internal since it allows one to explore more options than family med. Honestly, I would not be surprised if family medicine was primarily a nurse's responsibility in the future. An unfortunate, dismal prognosis which is more politically feasible than recruiting more doctors.
  8. You make a good point here. Those who have an aptitude for business would thrive in an FP setting. However, as it stands most medical students are there to do medicine, and medicine is I assume what they expect to be doing for most of their lives. Thus, why put all of that business effort into an FP office that may fail when you can just do ophtho and bill crazy amounts.
  9. Neither does being the president of your local/national/international do-gooder association, or being able to charm and flash a smile at the right times. Currently we have no consistent way to determine who will be good doctors.
  10. From the NOMS website: ""Specialty training delivered through NOSM includes General Surgery, Internal Medicine, Anesthesiology, Pediatrics, Orthopedic Surgery, Obstetrics/Gynecology and Psychiatry which are all accredited by McMaster University and/or the University of Ottawa. Community Medicine is also offered as a NOSM-accredited specialty program."" This residency list is far more succinct than at most, if not all, other schools in Canada, which isn't surprising since its a new school. Thus, if one desires to do a residency in something other than the above listed, then they should go somewhere else. Again, from the NOMS website: ""NOSM, while preparing students for the full range of clinical disciplines in medicine, will focus on training general practitioners of medicine, family doctors and specialists, who remain generalists across their specialties. NOSM will develop physicians able to practice and engage in research anywhere in the world but who have a particular understanding of people in northern and remote settings."" So, although the training of NOMS will be on par with any domestic medical school, the focus will be on training physicians that will be able to work in rural settings. This is where logic sets in: rural, northern communities do not commonly have academic institutions. Thus, if one desires to work academically, they should go elsewhere. I'm not trashing on NOMS. It has a purpose and it is not dancing around its purpose: to train doctors for rural communities. This is essential and its about time there's a medical school that prepares its future graduates for rural medicine. However, not everyone wants to be a rural doctor, so applicants should think long and hard before attending NOMS if they're more attracted to urban environments or a future in academic medicine, or if the career they want isn't on the residency list offered at NOMS. In any case its important that you actually understand what you read.
  11. Yes. Both in a small rural area and in a major center. The small rural area doc basically did everything besides surgery, and referred only when he was truly stumped. The major center doc juggled medications while referring any thought-provoking problems to the specialists, and this was de-rigeur for the area...not very interesting work. Talk to any student about the lack of pay a GP makes compared to basically anything else. For instance, these rural bursaries are minuscule relative to the yearly net of basically anything else AND you have to move rurally, which most students do not want to do. So why not just do opthto? I hate it when med students(or worse yet, clueless pre-meds), laypeople, and doctors pull the argument that we shouldn't be in it for the money. Why is it ok for basically any other profession to be in it for the money except physicians? Physicians sacrifice a lot of their time, financial credit, and energy to provide a crucial service to society. When family physicians are not paid well, it is construed that those physicians are not important, only necessary.
  12. Hi, according to the CaRMS website, NOMS only offers residency positions in FP and community medicine. If one desires to make connections during clerkship in fields other than those listed above, then NOMS will make that far more difficult since no other residency positions are offered at NOMS. NOMS is a school that caters to students who are apt to practice rural family medicine, according to its mission statement. Thus, students who think they'd be open to doing something other than rural FP or com. med. should opt to attend another medical school.
  13. Try to avoid going to Carib/ overseas schools at all costs! Carib schools are notorious for their lack of student support. Also, they are expensive. Furthermore, lets say during your time at a Carib school you discover you have an aptitude for plastic surgery. But you'll never be a plastic surgeon, because you go to a Carib school, and in the US match, Carib schools are considered bottom of the barrel. Stay domestic. All Canadian schools are more or less equal quality. However, some emphasize didactic lectures whereas others emphasize group learning. If you have your pick, go to a school that teaches in methods you prefer. I'd also say pick NOMS as your last choice, since they lack the connections you'd make in clerkship to match there to anything besides FP. If you can't get into a Can school, go to the US. Of course, anyone and their dog can open a college in the states if they have enough money. Thus, many of the med schools in the US are sketchy. Consult Studentdoctornetwork to get opinions on schools you consider.
  14. I see in no way how my opinion that FPs are severely underpaid and how this results in far less people entering that particular field suggests I have a "desire to make a lot of money". Don't be so sanctimonious. This discussion is about why the FP shortage is persisting, and how little is being done to remedy it. As for your reasons that you state...: 1. Lifelong DP relationships: some doctors don't want to have this, and that's fine. Based on the declining interest in FP, students aren't holding this in high priority. 2. Wide range of practice: this is only partially true and is dependent on the number of specialists in an area. If there are a lot of specialists, like in a major city, then FPs don't get to do very much. If it's in a very rural area, then FPs do everything, all of the time. However, based on declining interest in FP, students do not consider this wide range of practice to be enough to warrant entering the field unless they are one of the few students dead-set on practicing rurally. 3. Flexibility of the work: same argument as above. The way I see it, its just a bad deal to go into it at the current time, when there are so many better options out there in medicine, both fiscally and professionally. The numbers say the same thing: students just aren't going into it.
  15. If taxes are subtracted, the true amount one actually nets is revealed. For FPs, its somewhere around the 80-90k range. Now, this isn't a bad yearly income by any means. It's moderately higher compared to most any job. However, most everything else in medicine pays better. So, aside from someone really loving FP and wanting to do it out of pure enjoyment, why should any student want to go into it? I can't really see any tangible upsides compared to any other specialty in this day and age.
  16. I'm aware that there are some FPs who make a lot of money. However, I'm at a loss on how they actually do this. Does it require they practice short-visit, somewhat poor, medicine(one complaint per visit, 2 min per patient, no smokers, no old people with multiple comorbidities)? Does it require they work in an extremely backwoods community? Does it require they don't practice traditional office medicine at all?
  17. Your argument is severely flawed. 1. There's nothing wrong with being motivated by money. If money is what it takes for people to do an exceptional job(and it usually is) then pay them well, regardless of the field. Granted, money should not be one's only motivation for success - they should actually enjoy the job they're doing. 2. This argument is ridiculous. The doctor does not gain money by prescribing an antibiotic for a viral infection. If anything, a doctor who is not paid well will lose motivation to perform medicine to the current standard. It is clear that you are a premed, since you have this naive idealistic view of medicine. If you get into med, then you'll realize the politics of the situation, and the labor required to do a good job. You'll realize that your 20s are worth far more than 80k a year in the future.
  18. Nonetheless, average intelligence isn't something that is valued highly in medicine. The complex nature of disease can only be sufficiently understood by those with high intellectual capacity. The interview process should ideally weed out those who are irresponsible. I disagree. A doctor who does not adhere to the national standard of care, and could not be bothered enough to practice sensible diagnostic medicine, is incompetent and should have his/her license revoked (but this is another story). I totally agree. The problem is that doctors are seen by society as generally altruistic. Thus, the governing bodies and businessmen take advantage of this image(which in the past was true for most docs) and decrease our reimbursements. It is to the point now that only the most lucrative fields are desired, and the least lucrative, but apparently most important, fail to attract the interest of most medical graduates. Regardless of the bleeding heart attitude that some very vocal pro-primary care people/premeds have, the numbers show that prestige and income are extremely influential in the career decisions of graduating medical students. Ergo, the only truly effective way of recruiting more domestically-trained primary care physicians is to drastically increase the salary. The opportunity cost of learning and practicing medicine is very high. One must fork over six-figures, and sacrifice their twenties, to be able to competently practice medicine by a Canadian standard. If all I were earning post-tax for all this was 80 grand, I'd be a high school teacher instead: more pay-per-hour, less stress, and a sweet two month vacation every year.
  19. I like your idea. Heck, I think the interview should be abolished completely. I'm surprised that medicine, with its erection for Evidence Based Medicine, still uses interviews for the admissions process. Where is the objective evidence that interviews are useful in recruiting the best people for the job? Objective assessments are the only way to be certain of measurements.
  20. Your attitude is kind of blindingly optimistic. The responsibilities of a doctor are great: health and wellness of individuals is not a task that can be doled out to just anyone. It should be given to our best and brightest. In the past, doctors were highly respected members of society. Their knowledge of the human body was immense, and special, and therefore they were paid handsomely and rightfully so. Due to this mix of prestige and income, the medical field attracted the best and brightest of society. Now, doctors are little more than pawns in a political football game. Their pay is going down while society still expects them to sacrifice their 20s to learn medicine and apply it. Residents are paid next to nothing. The best and brightest know this and thus avoid medicine, instead opting for law and business- fields where their aptitudes will be rightfully rewarded. What you say about doctors who are in it for the money giving horrible patient care and selecting other specialties besides FP is false(on a personal note, the worst care I've received has been from FPs. I have more than one permanent injury due to the incompetence of FPs I've encountered). Everyone who works is in it for the money to an extent. Doctors should be paid well for their efforts and the importance of their jobs. The medical student who is factoring in reimbursement when he chooses a field during the match is a smart student. One who doesn't is foolish. You did make a good point above, stating that the government doesn't really mind not having to pay as many physicians during this shortage. The most powerful, rich members of society will all receive medical care, so who cares about everyone else?; they're not influential enough, even in large numbers, to have any substantial effect on the political system. So why accommodate for their needs?
  21. Why don't they bump up their pay? As it stands, FP isn't very popular. Less and less grads are going into it. Clearly it is primarily because of the lack of prestige and relatively low pay this field offers . Sure, FPs are crucial to the healthcare system. Sure, FPs are scarce and depleting yearly. Sure, thousands are living without access to a primary care physician who knows them. But really, none of this can be very important in the grand scheme of things, since FPs are still paid pittance for their efforts. This is precisely why I didn't choose FP. It can't be as important as everyone says it is, since very little is being done to effectively recruit new ones.
  22. It's a combo of money and exclusivity. Money = MDs get paid more than PhDs, thus they are revered more. Exclusivity = every university has grad school programs. Only certain ones have med school programs. Thus, med school, due to scarcity, is more competitive. Just having one is not enough: I know guys working on the oil sands in Alberta who make as much if not more than some FPs. But its not an exclusive job, thus it doesn't hold much prestige. Some art colleges are more exclusive than med school. But since most artists get paid nothing compared to a doctor, they are not held in as high regard. Buffy pool is right too. Within medicine, the hardest-to-obtain fields are the ones with the highest pay-per-hour ratio: dermatology, ER, plastics, ENT, uro, radiology, eye. On the other end of the scale, any med grad with a pulse and reactive pupils can land an FP residency because FPs get paid FAR too little. Hypothetically, how competitive do you think FP would become if they pay was increased to radiology levels? hmmmmm
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