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Arztin

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  1. Yeah this is important guys. One of the last worry-free summers ever. Enjoy it. Don't think about the material, courses etc... You'll have to think about it often enough when the school year starts.
  2. 1- It depends where you work. Areas where there aren't enough family docs will more often have this problem. To name a few, people do show up for prescription refills, chronic things for which the ED isn't the place, for severe undertreated hypertension, and really benign stuff sometimes like a wart on their foot. Yes people do show up with chronic pain, including chronic back pain. Yes there are healthy 20 year old adults who go to the ED when they have a common cold. Variety-wise I totally disagree. There isn't a place where you will see presentations as varied as in the ED. You never know what will happen during the shift. There isn't a place where you can see a paeds status epilepticus, then a STEMI, then a shoulder dislocation, then a major trauma, then a septic patient, then a diverticulitis, then a schizophrenic patient, all that in one single shift. On the fast track side, in one shift you can see a big hand laceration for which do a ultrasound guided nerve block, a retinal detachment, a corneal foreign body, a fishing hook stuck, and a patient who had a shoulder patient who was actually having a STEMI all in one shift. Acuity-wise, it depends on the days and where you work. If you work in a low volume center, you will see less high-acuity patients. But in a high volume center, if you are covering the high-acuity area and resusc, you will pretty much always see at least one very sick patient during your shift. 2- It depends where you work. In many large academic hospitals, with all the consultants and the residents available, emerg will often ask the initial labs and consult right away. When you are outside these hospitals, consultants typically only see patients during the day, unless if they need an immediate intervention. From 4 pm to the 8 AM next day, you are actively managing patients. It's up to you if you want to ask for urine lytes if you want to figure out why your patient is in hyponatremia and why they have metabolic alkalosis before consulting the admitting service (although emerg physicians typically don't do this). Obviously, emerg is the place to stabilize and to initiate the treatment - It is not a hospital ward for patients to stay. Eventually if a patient needs to go to the OR, then surgery will need to take over anyways. If a patient needs to be admitted by a medical service, then that will happen. For example, finding brain mets on a guy who seized in the ED means this patient will need to see a consultant regardless. However, a patient who comes with an asthma exacerbation that doesn't need to be admitted ? Emerg will treat it and let the patient go. A shoulder or a wrist got dislocated? They will reduce it and have the patient seen shortly by ortho on an outpatient basis. A patient comes with hypertention undiagnosed but not in hypertensive crisis? The emerg will start a PO medication and have them seen by their family doctor after. (although this should have been managed by their family doctor) As you can see it all depends. I would suggest you to go shadow when it's possible. Hope it helps.
  3. Non tu ne peux pas. Le curriculum est fait tel que tel. Les stages ne peuvent pas être raccourcis.
  4. Family doctors are doing all sort of things right now. Many do ER. Many manage patients in nursing homes. Telehealth is actually very important. Many anxious patients are decompensating. Also, being able to talk to your patients will prevent ED visits. Then, there are the hospitalists doing COVID units as well. Some do COVID clinics / COVID screening clinics. There are also people doing public health.
  5. Good luck everyone! Also, stay home!!!!
  6. Yeah. Fair enough. It's just that working a few months and having to restudy is kind of a bummer. Some guidelines will have changed. Some people will be in a different environment. The annoying part is mainly this: you went from exam knowledge learning mode to practical knowledge learning mode, and now re switch to exam learning mode, and have to cram a bunch of things that will probably be useless in your practice, especially because the fact that we will be thrown in an unfamiliar environment, and having to learn on the spot new practical knowledge. e.g. being thrown in the ICU, or the ED for people not familiar with those. The CFPC said they want to hold the exams in October. Nothing is certain for now. We don't know yet how bad things can get. The worst case scenario would be a terrible one. But quite frankly, timing of RC or CCFP exams, and having to restudy, and having problems with licensing are truly first world problems. There will be many people who will have lost their jobs, with many small business owners going bankrupt.
  7. wouldn't be surprised. There are more important things than med students showing their face at their dream schools' dream residency programs right now unfortunately. Edit: not meant to be sarcastic. Every hospital network, residency program, hospital administration, department chief etc... is overwhelmed right now in the entire country. Anything not COVID related will probably have to wait unfortunately.
  8. Spring exams probably won't happen. The Quebec government wrote a letter to the RCPSC today saying it doesn't agree with their decision to hold exams while the priority is to have as much manpower as possible as soon as possible with the Covid situation.
  9. postponed. There are talks about trying to make the local physicians assess their trainees. Hmmm. conflict of interest? I don't any program would want to fail their own residents though. Maybe orals will be cancelled for some programs with the written components taking place somehow. Also, in Quebec, we will likely have a temporary restrictive license for those who graduate so that people can work as staff physicians. I guess similar measures will take place in the other provinces.
  10. Yes this is very important indeed! Most people staff off just fishing for symptoms. At some point, when someone has a chief complaint, you should take your OPQRST, and then be disease specific according to your DDx. For the person reviewing with you afterwards, it's much easier to follow you also. It also probably means that you have a higher level of clinical skills than the one just fishing for symptoms left and right.
  11. University of Montreal pulled out all med students apparently. For residents, royal college, mccqe2, and CFPC exams all postponed. What's funny is that we keep working in hospitals, but an exam apparently is too dangerous, while 500 ppl can be at Costco at the same time.
  12. To be the student that make people think ''who the hell is this person and why is this person even here?'' Basically absent or minimal presence, wants to leave as early as possible, doesn't want to calls, doesn't want to work, not interested, doesn't read about topics you suggest, doesn't take your feedback, and doesn't seem fit to be in the environment.
  13. Hey, I'm sorry about that. It sure sounds terrible. There are many people going away from residency. For sure you will make new friends during residency! Also, you did get your specialty of choice after all! Regretting, and overthinking at this point probably won't help. What's important is what you do with the match. Take it one day at a time. A few of my close friends had a ''disastrous'' match and now are very happy residents actually. I also made some really close friends during residency. Job-wise, it's kind of early to think about... But many people switch provinces after residency. I'm sure you will find mentors who will help you out regarding this during residency. Stay strong and enjoy your summer! Hmmm.... I'm not sure this kind of message helps...
  14. A lot depends on where you do your residency, how motivated you are, and how you are actively getting the exposure. E.G. you can be a FM resident based at the JGH in Montreal (a gigantic academic teaching hospital). There is no trauma there at all. Furtheremore, they send CCFP-EM and FRCP emerg residents + a bunch of other specialty residents there. As a FM resident, getting hands on exposure would be a bit hard. Also, you typically don't see as medically and or surgically complex in the average community hospital. Also, you don't see paeds patients at that hospital's ED typically. So no paeds EM exposure. Another resident can be at a super rural site, where the local ED sees 20k patients per year. They will sure get their hands dirty, but how many big traumas will go through their doors? Not too many. They will be basically doing walk-in clinics there. I'm not sure you will have the skills to function in a big emerg after this type of residency. In my opinion, for FM residents who want to work in the ED after residency, getting the most emerg exposure would be to be based at a site in between those two extremes. You'd see more cases, sicker patients, including trauma patients and paeds patients, and you can get more hands on experience when it comes to curriculum flexibility, and experience with procedures. There won't be as much of a hierarchy so the procedures are yours. Obviously, if you do a 5 year program, you would see many traumas as a junior, be actively participating in many as a senior, so you should be fully ready after 5 years.
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