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UoC-CCFP-07

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  1. Montreal is a fantastic city, but everything I've read and heard suggests the PQ hates doctors and takes them for granted. Nobody seems to be looking at how doctors are treated as a factor as to where they want to work. That bodes poorly for the CMA/OMA/AMA/BCMA/etc argument that pay/lifestyle/fair treatment would help/hurt physician recruitment. . .
  2. When I was deciding where to practice in 2005, I thought the answer as to best province to practice in was fairly straightforward: - Highest physician salaries - REASONABLE REAL ESTATE PRICES (about 2/3 that of Toronto) - reasonable cost of living - two solid ~ 1 million person cities to live in - lots of good sports teams (NHL, CFL, WHL) - Access to some kickass skiing (I can't consider collingwood 'skiing') - MUCH quicker access to certain services: CT, MRI, primary PCI for STEMI, - a provincial budget that isn't doomed to collapse within 10-15 years based on healthcare expenses (ie Ontario) Of course, since 2005 real estate prices have gone through the roof and many physicians' overheads have increased to the point they'd make more in other provinces. I don't think it's so clear-cut now. But Ontario?!!?? - physician remuneration is historically mediocre - historically poor physician-government relations - the constant fear of an audit - GTA: traffic - GTA: Despite the real estate boom in Alberta, a house in Toronto is still about the same as a house in Calgary. You're unlikely to make as much money on it. And you're stuck living in Toronto. - a healthcare budget that's increasing at such a rate that collapse is pretty much guaranteed within 15 years - ridiculously humid summers and ++++ smog - you breathe air from coal and auto plants in michigan, illinois, ohio - the topography of southern ontario is essentially the same as ohio. - You have to put up with all those Leaf fans It's pretty obvious you're better off in Newfoundland. . . at least you have the ocean, and Marble mountain blows Collingwood away.
  3. UoC-CCFP-07

    Does it (med school) get better?

    I though 5th and 6th year were pretty good. But then again I did transfer schools. And got a raise.
  4. UoC-CCFP-07

    Match list @ Calgary

    I went to Western for med school. I've been a resident for 2 years and had the chance to talk to ex-med students from across the country. I also paid a lot of attention to the matches while I was in med school, from 2001-2005. With one to two caveats (see next paragraph,) there is little correlation between medical school attended and success in the CaRMS match. I've seen people from everywhere match to everything and back again. I've seen schools have no unmatched people one year and 12 unmatched the next (the exception seems to be UWO, which very oddly always seems to unmatch 6-7 people every year - meaning they ALWAYS perform in the middle of the pack for the match.) Most schools have had both good and bad matches while I've been around. And you can never tell how aggressive any one class from a particular school was in the match. . . ie if 12 people went unmatched was that because 25 people from that class only ranked Dermatology as a specialty? The first caveat is that I have seen a trend for the uber-competitive specialties (ie plastics, ophthalmology, Emerg, ENT, Urology) to have a slight preference for selecting students from that site (ie UWO plastics usually took at least one plastics resident from the UWO med students, and the other would go to UWO or somewhere else.) This makes sense as UWO students had 4 years to get to know the UWO plastics staff. As well, theoretically the UWO med student is more of a known quantity. Of course, I had tons of classmates who matched to competitive residencies outside UWO. . . but it was often less predictable where they matched. This MIGHT be a consideration when selecting medical school. If you absolutely hate the city of Toronto and desperately want to be in Calgary for residency or long term, and know that you are 100% going to be shooting for a competitive program (ie plastics, derm, etc) it might not be a good idea to go to Toronto for medical school. . . as you might end up there 9-10 years, rather than just 4. The second caveat is that not all programs are offered at all sites. If you are pretty sure you're going to want to be dermatologist, there is a THEORETICAL benefit to being at a school with a dermatology program, so you can work with the academic dermatologists. This caveat is even weaker than the one above as I've known at least a few UWO grads to match to derm (there's no derm program at UWO) and even more so because we matched tons of people to physiatry in 2002 and 2005 (more than any other school in the country), and yet didn't have a physiatry program until after the 2005 match. Go figure. Success in the match isn't a great criteria to pick medical schools on.
  5. UoC-CCFP-07

    Does it (med school) get better?

    This is kind of funny - I just posted the following (see below) in the thread about depression in med school. I think it should be apropos. I think most (but not at all) of my fellow med students who were realistic, not in denial, or not trying to put a brave face on things agreed that the preclerkship years of med school really sucked. I make no bones about it: 2nd year was the worst, 1st yr was pretty bad too. I loved clerkship. There are some downsides (no sleep, some minor abuse, disorganization sometimes, guess what I'm thinking questions and preceptors not up to date on EBM and guidelines, being bottom of the totem pole) but on the whole I would assume you applied to medical school wanting to be in the clinic, OR and hospital. . . rather than in a lecture hall for 35 hrs/week. I've actually really enjoyed residency as well, with the exception of a few supervisors. Hang in there, it's totally worth it. (BTW - I'm completely done in 2 months) ------------------------- Depression is ridiculously common in medical school - particularly the first few years. I knew several classmates open about being on anti-depressants, a few others in the closet, would guess there were others I didn't know about, and am sure there were a bunch in denial. The first few years of med school pretty much suck. Some people enjoy because they love the fact they're in medical school, but there's lots to be not happy about. (depending on the med school) you're usually stuck in a classroom for 35-40 hrs a week. We almost never saw daylight oct-mar in first and second year --> the perfect setup for SADS. Unless you've got extensive credit at the bank of mom and pop, you see yourself accumulate ridiculous amounts of debt (I surpassed most people's undergrad debt after my first year.) Med school is full of grunt work - memorizing lots of stuff for tests you'll never use later, unless you do that specialty. Most of us were the top students in high school or undergrad, and now you may find yourself middle of the pack. Considering middle of the pack wouldn't have gotten you IN to med school in the first place, lots of med students freak out over this. You're still not sure what you're going to do for the rest of your life, and rumours still fly around that if you're middle of the pack (which you likely are as most med students are by definition going to be middle of the pack of medical school) you'll end up in your least favourite specialty choice in your least favourite city (which for me would have been neurosurgery in Toronto.) It never seems like you can study enough. Many med students are used to getting high 90s on tests that were fair. . . some of docs setting tests in med school have never set tests before and throw in "guess what I'm thinking" questions or ones on topics never covered in lectures. Many of the curriculum in the country are ridiculously disorganized (I say this from talking to residents who were med students at places across the country) and what sounded great on paper (PBL, PCL, COPS, self-directed learning) turns out to be some buzzword attached to a poorly organized course. You don't have a whole lot of time for a social life and many med students find themselves in cities where they know nobody but their classmates, as they went wherever they could get in, even if it's half the country away. If you're a medical student, there's a good chance you're Obsessive-Compulsive Personality Disorder (Not OCD) and all of this probably isn't sitting too well with your disorder. When you do get to clerkship, you find an archaic system where medical students are often expected to "pay their dues" by proving they can continue working for 36 hrs without sleep or food (it does happen!,) conditions no labour legislation would ever approve. What's to get depressed about in medical school? My vague memory of mental health issues was that the prevalence of psychiatric issues was similar between doctors/residents/medical students and the general public. . . but doctors have a lower prevalence of psychotic disorders, and a higher prevalence of mood disorders. But seriously, seeing as I'm now less than 2 months away from being done residency, I can honestly say it's all worth it. You just have to keep perspective.
  6. UoC-CCFP-07

    Depression and Med School

    Depression is ridiculously common in medical school - particularly the first few years. I knew several classmates open about being on anti-depressants, a few others in the closet, would guess there were others I didn't know about, and am sure there were a bunch in denial. The first few years of med school pretty much suck. Some people enjoy because they love the fact they're in medical school, but there's lots to be not happy about. (depending on the med school) you're usually stuck in a classroom for 35-40 hrs a week. We almost never saw daylight oct-mar in first and second year --> the perfect setup for SADS. Unless you've got extensive credit at the bank of mom and pop, you see yourself accumulate ridiculous amounts of debt (I surpassed most people's undergrad debt after my first year.) Med school is full of grunt work - memorizing lots of stuff for tests you'll never use later, unless you do that specialty. Most of us were the top students in high school or undergrad, and now you may find yourself middle of the pack. Considering middle of the pack wouldn't have gotten you IN to med school in the first place, lots of med students freak out over this. You're still not sure what you're going to do for the rest of your life, and rumours still fly around that if you're middle of the pack (which you likely are as most med students are by definition going to be middle of the pack of medical school) you'll end up in your least favourite specialty choice in your least favourite city (which for me would have been neurosurgery in Toronto.) It never seems like you can study enough. Many med students are used to getting high 90s on tests that were fair. . . some of docs setting tests in med school have never set tests before and throw in "guess what I'm thinking" questions or ones on topics never covered in lectures. Many of the curriculum in the country are ridiculously disorganized (I say this from talking to residents who were med students at places across the country) and what sounded great on paper (PBL, PCL, COPS, self-directed learning) turns out to be some buzzword attached to a poorly organized course. You don't have a whole lot of time for a social life and many med students find themselves in cities where they know nobody but their classmates, as they went wherever they could get in, even if it's half the country away. If you're a medical student, there's a good chance you're Obsessive-Compulsive Personality Disorder (Not OCD) and all of this probably isn't sitting too well with your disorder. When you do get to clerkship, you find an archaic system where medical students are often expected to "pay their dues" by proving they can continue working for 36 hrs without sleep or food (it does happen!,) conditions no labour legislation would ever approve. What's to get depressed about in medical school? My vague memory of mental health issues was that the prevalence of psychiatric issues was similar between doctors/residents/medical students and the general public. . . but doctors have a lower prevalence of psychotic disorders, and a higher prevalence of mood disorders. But seriously, seeing as I'm now less than 2 months away from being done residency, I can honestly say it's all worth it. You just have to keep perspective.
  7. UoC-CCFP-07

    FP Salaries...

    One more point about GP salaries. . . overhead has a ridiculous say in what you make. I was at a recent job fair in Calgary where I was quoted $8000-$8500/month for overhead in most offices in Calgary. That's NOT including CMPA fees, college fees, disability, CMA fees, etc. Just office expenses (but admittedly these usually are the majority of your overhead.) I had an offer from a doc in a rural center just outside of Calgary asking for $4000/month in overhead. Some family medicine in opportunities in Calgary involve almost NO office overhead - hospitalists, urgent care centers, long-term care centers, hospice care, etc. Anyone wondering why traditional family medicine is in such trouble in Canada just got their answer. From a business perspective, I'd be an idiot to enter traditional family practice over some of the other options. Too bad (I'm saying this 100% tongue in cheek) I like family medicine. But once again - in the end you can do well doing family medicine (in alberta) if you are smart about how you do things.
  8. UoC-CCFP-07

    Primary care salaries Can. vs USA

    Those net figures are post-overhead ONLY. You also have to subtract: - income tax (like everybody else) - RRSP contributions because you don't have a pension (I'm going to need to afford $1500/month) - Other benefits, ie medical/dental, that paid employees might not have to pay - Your student debts: my student debt is going to cost approx $2500-$3000/month to service. And since it's a bank LOC, and not gov't student loans - none of that is eligible for tax benefits. AS WELL. . . depending on how overhead is being reported it may or may not include things like CMPA dues, CPSA dues, CMA dues. The numbers for physician salaries appear big, but it gets whittled down might quick. The $5-10,000 a GP makes per month (after tax) is not really $5-10k in the pocket.
  9. UoC-CCFP-07

    FP Salaries...

    As far as I know, Quickdraw McGraw is correct: incorporation only reduces taxes on money you keep in the corporation. It's a good way of accumulating equity in the corporation for long term growth. . . but only good really when you're at the stage of your career that you have a whole lot of extra cash lying around that you don't know what to do with. It's not really useful when you're paying off debt. BTW - $200k is totally doable as a GP in Alberta, especially if you're a rural doc. The average in the province for ?2004? was $200k, after overhead, but included rural docs. I do know a few city docs that bill that much. . . but it's tougher do as a GP. When I was in ontario, it was essentially impossible to make $200k as a city doc. . . but things may have changed.
  10. UoC-CCFP-07

    student loans as residents

    Nuts - I couldn't get interest free status when I called the OSAP offices. What gives?
  11. UoC-CCFP-07

    student loans as residents

    You can moonlight in Alberta after 18 mos of training, if you pass the LMCC. I think you get $130/hr to cover ICU. Obs/gyne is $86/hr. Psych is $70/hr or so, but you get to sleep overnight.
  12. UoC-CCFP-07

    Pcl

    The impression those of us back in class of 2005 had of PCL was that it was UWO's attempt to modernize the curriculum and add buzzwords from other curriculum into what was essentially a 35-40 hr/wk didactic lecture curricullum: ie "Patient centredness," "case based learning," "small group learning," "problem based learning," "self directed learning." Because UWO is where the buzzword "Patient Centred medicine" was coined, they chose that as a title. What those of us who went through the course found was a unfocussed mess. There would be a case of the week very few people would attend and would only in some weeks be tied to what we learned. Objectives were brought up out of the blue. We were supposed to go to the library (back in the days when not everything was an e-journal) and spend several hours finding original articles (in reality most of us googled answers.) The small group sessions were supposed to be focussed learning sessions, but would usually disintegrate into random discussions on everything from ethics to billing practices. How the sessions were run varied widely depending on who the preceptor was. I never saw one patient in all my "patient centred learning." I can't comment at all about this new variant. One thing UWO is horrible for is trying to stick buzzwords into their curriculum and then stick them into flashy brochures. The best thing about my UWO training was getting stuck with 36 hr calls with more responsibility than I maybe should have - writing my own orders, working up new onset A. Fib on a vascular patient on my own. Many other medical schools coddle their clerks. Not UWO! It can be hellish while you're a medical student, but you'll appreciate it once you are a resident.
  13. UoC-CCFP-07

    class of 2010 demographics

    I think having more of a, for lack of a better term, "blue collar background" (ie worked at walmart while struggling to get through undergrad, never had the money or chance to volunteer overseas at your parent's expense, etc) WILL NOT HURT YOU at UWO's interviews. My previous comments reflected the composition of my class. . . which I feel was the result of selection bias due to high tuition fees and an inability to survive without a car, vs. any bias during the interview process. It's possible things have changed with the Schulich scholarships.
  14. House has the worst medicine I have ever seen. But them main character is so entertaining. I often tell my patients I learned my bedside manner from him. It's usually worth a laugh.
  15. UoC-CCFP-07

    class of 2010 demographics

    Racial diversity was never a problem at UWO. Economic diversity was a huge problem. It's too bad demographics aren't included in that report that reflect that fact - though I also think admin would prefer not to advertise that fact. A survey of my class (2005) showed the average family income for a UWO med student to be well in excess of $100,000 (~$130,000 I believe.) Personally, I found sometimes reflected in comments and opinions voiced by classmates - both in regards to fellow classmates and patients. I found there was often a naiivety about how life is for the average joe Canadian trying to make ends meet. As well, being a resident and being able to compare my situation to other residents in my program, I honestly haven't found any with quite as much debt as I accrued while at UWO. The report may suggest UWO's tuition now isn't out of line with other Ontario med schools, but it's still a) a heck of a lot higher than many other Canadian provinces a school where not owning and maintaing a vehicle is 100% impossible for years 3 and 4, and improbable for years 1 and 2 and c) a 4 yr program as opposed to MacMaster (with which the report compares UWO.)\
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