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Everything posted by Edict

  1. If this job is 1-2 years away and is a guarantee or near guarantee, I would strongly consider that option. Burnout is one thing and its true that studying 60-70 hrs a week won't last forever, but what I'm more concerned about is that you seem to be worried about the responsibilities that a family doctor has to have. A lot of it is true, it gets harder and harder and clerkship will be harder than pre-clerkship and residency will be harder than clerkship. Even staff life is not easy as having that responsibility is a huge task. On the one hand, the studying will get easier because you just simply realize that you don't need to know every thing. 99% of the time its the same things that show up and in the 1% you don't know, you can ask others for help. But what doesn't get easier is the sense of responsibility and the work. It isn't easy money for sure. I urge you to think things through some more, when do you need to make a decision? Try to spend less time studying and see how you feel. If it is simply just a work hour issue, that should be manageable, but what you should really consider is this part: I don't think this anxiety will slow down because clerkship hasn't even started, and the thought that I will be responsible for people's lives is terrifying me. I thought I had the strength to uphold that responsibility, but honestly, I'd rather not deal with it. Sacrificing my happiness isn't worth the job, especially when I read that patients are extremely demanding of their family doctors. I don't think I could handle the short appointments and constant need to be perfect. Given that I have no passion, I don't even think it would be fair to patients. My gut is telling me that I'll be miserable as a family doctor. I am also overwhelmed by the amount of information you have to know as a family doctor. For instance, I am having a lot of trouble remembering the names of medications, their indications, contraindications, etc. I review concepts every day but remembering the details never works. And like I said above, this issue is exacerbated because I have no interest in the material. So I'm constantly dragging myself to learn more. Don't worry about taking a spot from someone, focus on yourself and what makes you happy. You earned your spot in medical school and you fully deserve to be here. I know the imposter syndrome and the feelings of guilt, but the question is whether you want to be there or not, not whether you deserve it or what others will think.
  2. It is also possible, if they are doing "medians" not mean's it could decrease the influence of some high billing outliers. Derm is a bit different because they also do bill private. The other thing if you look at the Torstar, you'll be surprised at the number of doctors who bill 50-150k. There are a lot of doctors nearing retirement as well who scale back but still work. They may be working part time. Again, no one talks about the part-time doctors but they are at least as common as the high billers and that is influencing the numbers.
  3. Okay, so yeah GTA its possible particularly in some centers. Many GTA centers are very busy with high volumes. But I would not say these numbers are generalizable. ER at Trillium or William Osler is just not going to pay the same as ER in most other cities. But that is an important caveat. Sure, some ER docs who are willing to work hard at the right center can make a lot, but that still means that only a few select people are making those numbers and leaves a lot of room for the "average" ER doc across Canada to make closer to 300k.
  4. It wasn't easy for myself as well, still debating this now. I think unfortunately, we all have to choose. I chose the interest/passion path and am faced with the same decision again, but the sacrifice is going to be even greater. At the end of the day though, it is your life, so you should always choose what makes you happy.
  5. I would only expect those numbers at certain busy centers, can you share your sources?
  6. Don't let it, because crazy numbers spread faster than normal numbers. If I told you that I knew of a surgeon making 2 million a year, you are much more likely to tell others than if i told you i knew of a surgeon who made 300-400k. But that one surgeon making 2 million a year may be also lucky, working 70 hrs a week and taking so much clients that no other surgeon in the area can now make an average salary or that some of the younger surgeons are now forced to find a job elsewhere etc. I have never heard that Peds ER makes much for instance, so is that really true or is that just one guy who has a great set up? The only thing i wonder is will this intense surgical specialty offer you lifestyle? I always believe that salary numbers are pretty inaccurate and really shouldn't be used to make a decision on your specialty. It is similar to lifestyle as well as you will be surprised at what kind of specialties can also have a set up with lifestyle if they so chose. There are broad ranges sure, but these salary ranges between specialties overlap so heavily that in most cases it doesn't matter. Generally speaking, there is no free lunch and as a doctor working a standard 40-50 hrs a week I would not expect more than 400k income in most cases. If you want to make more than 400k expect to put in more training and/or at least 50 or 60+ hrs a week. If you want to make more than 1 mil you'll need to be lucky, good, in the right specialty at the right time in the right location and you will still have to put in 60+ hrs a week.
  7. You can if you take on more than the average number of shifts. I heard the typical ER doc working 16 shifts a month (8 hrs a shift) or so with a mix of days and nights made around 300k but no overhead. So that is actually a really sweet gig, since you can easily scale up when you are younger if you want. Also, as a general rule, don't read too much into salary numbers, the more you hear about the numbers bandied around by folks the more you realize consistency between numbers is often lacking and the more you realize that in many specialties you can find a way to bill at least 400k and in most specialties you can find a way to bill 150-200k and have more flexibility in your life. There are exceptions to this of course, surgical specialties tend to have little control over their hours.
  8. If you look at the toronto star database however, you see a lot of people are not billing those high numbers. While it is probably true you can bill those numbers if you choose to work a full time+ equivalent like around 60 hrs a week, a lot of doctors don't choose to do that which drags those numbers down significantly.
  9. Not in Alberta but my two cents is that, when Albertans are struggling with the double whammy of coronavirus and a downturn in oil prices/inability to build pipelines it seems inevitable to me that the government cannot afford to continue to pay their doctors the same high salaries that they got when times were good. Alberta has always been a boom bust province and honestly this really doesn't come as a surprise to me.. As physicians, I appreciate and support those that fight for our rights but I'm not sure this is the right battlefield to fight and die on.
  10. One school of thought is just to do whatever you need to get to where you want. If doing something you don't love is actually an important component to getting ur subspec of choice, it is probably worth it if its not too unbearable for you, since getting your subspec will change the rest of your life. If chiefing is only a slight boost to your application and may not even make a difference, don't bother doing things that take time that you don't enjoy. It all depends on your individual situation but i think you'll be able to figure it out.
  11. Even some cardiologists don't carry a stethoscope. Honestly, the stethoscope is becoming a relic of the past. It will doesn't matter but i'd imagine most med students get the Cardio IV so if you just want to fit in get the Cardio IV. Like toxicmegacolon said, I wouldn't sweat the few extra hundred bucks.
  12. I think if residents/staff compliment you on your knowledge/work ethic etc, then you know you are doing well. I know if I run into a medical student that I've felt was doing well, i try to let them know because I remember how hard it is to be at the bottom of the totem pole and not sure if you are doing well. Although, if residents/staff aren't doing that, it doesn't mean you aren't doing well, just ask and they will give you honest feedback. I think if you have good patient care, patient's will compliment you, sometimes in front of the team.
  13. I would argue that for OP's situation, medicine is probably the best way of making a 150k+ income. With that being said however, it is a road with a lot of sacrifices and I actually don't think the benefits of medicine will pay off for OP for at least 15 years compared to if she stayed at her current job and during at least 10 of those years your life will be more challenging.
  14. It puts you in a tough spot, but it really depends on how you feel about it. The only thing I wouldn't recommend doing is outright refusing to work with them. You can find an excuse not to work with them, you can just say that you're actually starting the project and you don't need any help right now for example. If you do think they could actually be of help and make it so that you can have time to work on another project lets say, then it may be worth collaborating. Depending on how small this specialty is, it could still be a win win situation, but if we are talking about a specialty with less than 20 spots across the country, then you may truly be in direct competition.
  15. It isn't that rosy, partly because Albertan doctors are the best paid in Canada and other provinces namely Ontario do not pay that high. This also is changing as oil prices drop and Alberta's finances take a hit. The second thing is people tend to focus on the outliers, news of a derm making 1mil+ spreads way farther and faster than the derm making 170k a yr because they decided to work part time. Admittedly those CMA numbers are surveys so take that with a grain of salt, but do understand that even in the fields above, those numbers are really only for the doctors who work in subsets of those fields and often work long hours as well.
  16. But can they guarantee they will have that income (350k+) for the rest of their careers? I tend to see big tech as similar to big oil. Right now, its the hottest thing so compensation/hoursworked ratio is the best out there, but just like IBM was the hottest thing of the 80s and now those same 20 something hot shots are now 55 and finding themselves pushed out of their 150k a yr jobs (there was a news article about this), this could happen to the software engineers of today.
  17. Agree with this, everyone has moments where they question why they went into medicine even if briefly, but everyone has moments where they feel they made the right choice and feel on top of the world. Overall, I think medicine is a good career for a lot of people. I think for the nice, more academic, slightly less assertive types, this is probably one of the few ways they'll land a high paying stable upper middle class job. For those who could truly succeed in business, law, medicine it really depends on your values. The one thing i've learned through residency and friends in other jobs is, in the majority of cases, there is no free lunch. Everyone who has money, prestige, power, income/freetime ratio, all had to work hard to get there. You really just need to pick your poison and just run with it. Medicine is rough, and yes residents work hard. In a surgical residency (when on surgical rotations) your days will start at 5:45 and end between 7-9pm with call on at least half your weekends and 1 in 3 home call. As a junior resident you may start slightly earlier and end closer to 6pm but will have to do in house call 1 in 4. The difference between resident hours and hours in a corporate world is that surgical resident hours are often physically demanding and non-stop busy. This can be exhausting at times. In the corporate world you may be at work on your desk waiting for emails and it is nowhere near as mentally taxing as being in the OR trying to do 10 things at once. In fact, many attendings brag about never seeing the sun going to and from work for their entire career. Some intense fellowships (transplant) can be 1 in 1 call or 1 in 2 call and this can even be the case as a junior staff. On your off days you are trying to catch up on emails and research and you barely have time for your IADLs when things are rough. The good things though, job security (you don't recognize it until a recession, but job security is huge, plus the little income you earn you know is going to keep coming, whereas for high paid unstable professions they don't know if they will even have a job in a year or two so they are forced to save and invest a huge part of it), feeling like you are doing good (what we do is so tangible, helping patients get through their rough times, despite all the jadedness there is still something to be said about this, few other professions get to feel it) and a unique skill set (knowing your medicine is just something that would be useful today and in an apocalypse, this is similar to job security but you are useful in every corner of the world at any time in any place and that is a good feeling).
  18. With the 3 specialties you are thinking of, you are already diversified enough. I wouldn't do IM or emerg if you aren't interested because it could be misconstrued as not being as sure what you want to do. Every specialty you listed will want to see some dedication and maxing out is the best way to show it. Not only that, but if you want 3 letters for each specialty, keep in mind that you may not get letters from every elective. Sometimes, the electives aren't set up well, your preceptor is away, not interested, or you are bounced around and so keep that in mind as well.
  19. It also depends on what your goals are. If your goal going into medicine is to become a subspecialist, I would think carefully about applying. Training can be anywhere from 6 up to a dozen years post-medical school for some surgical specialties and grueling, something i think can only feed on the wild imaginations of naive 20 year olds. But if your interest is in family medicine or in some form of primary care in the community, then it is definitely a reasonable and sound financial and lifestyle decision.
  20. It does get better. As a resident, you will get less feedback and less criticisms and the hours while worse will also be more efficient as you aren't repeating what others have already done. Also, you will be making money. In the community, once you are staff, you make money for every consult you do, and i've seen their notes, a few scribbles and a dictated consult note, it can take you less than 20 minutes to make 190 dollars or so. No one in the community pushes back on consults because they bill. You can choose your hours, sleep in, travel the world, locum wherever you want etc. Right now, you are seeing the worst of it, but it gets better and eventually you reap what you sow. While you probably don't love CTU, IM is much broader than just CTU, you just have to get used to it until you can finally do what you want. When you take a step back, you'll realize that its so easy to get complacent in medicine and see the negatives rather than the positives. Our jobs are stable, well paying and in some cases very flexible. You can't get that in any other industry.
  21. Juggling 3 specialties is hard, but it does depend on how competitive you are for the other two and what kind of program you want. If you want a competitive location, it would be challenging, but if lets say your dream location isn't something many others want and you are competitive for im and fm already, i don't see any problem with applying for these 3 specialties.
  22. They definitely don't care but some people put it others don't it doesn't matter. Surprisingly enough it does come up at some points, even in residency, i guess people are just curious.
  23. I think you'll find happy and unhappy residents just like you'll find happy and unhappy medical students. People also have good and bad days, good and back weeks/months and so it really is hard to generalize. Residents work long hours yes, but at the same time, residents get to do the widest variety of things they will ever get to do in their careers and they also don't have that ultimate responsibility like staff do. Ultimately, there is no substitute for time put in, you'll notice that in many european countries, training is less split into residency and staff, and more split into a pyramid. Work hours may be mandated to be less, but training is often longer or progression isn't guaranteed and there are still places where the "contract" is broken regularly. While I don't know which system is better, I do think that we should accept our privilege to be working a profession with a stable career, stable pay which is well respected and helps people. Especially with coronavirus, it made me think about how lucky we all are to have a stable career.
  24. In order to best help, can you explain why did you just realize you like derm?
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