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coastalslacker

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  1. I followed my gut in the spur of the moment away from a planned chill life as a small town family doc doing some ER into a surgical sub-speciality with an exhausting residency and terrible job prospects. My wife was thrilled.. I regretted it at times during residency, especially when friends were done training and out in practice as FM docs. But residency was also pretty great at times. Job satisfaction is important, and for me, doing surgery was and is very satisfying. Three years out of residency things have worked out better than I could have imagined, moving from a good first job in a location most people only dream of living, to an amazing second job in a busy academic center that is almost as nice. In retrospect I am so happy that I followed my gut.
  2. - Remember that you're there to learn, not to get into medicine. - Get good grades. Treat school like a job. If you can't get good grades, medicine isn't for you. If you change your mind about what you want to do, good grades will likely help. - If you have paid employment, don't over-do it (unless you need to). Took me a semester to realize 20 hours/week at the grocery store wasn't leaving me enough time for fun things, and then cut back abit - Have fun - Take up one new hobby you've always wanted to try - Volunteer with one organization where you feel like you can make a difference, or, where you think what they do is important. Service is important. This might not be a hospital - I always felt useless volunteering at the hospital (as an MD now, I realize I probably was!), but I did feel like I made a difference when I was teaching ESL to a recent immigrant (although that was harder).
  3. Went to less and less with each semester of medical school. The variability in lecture quality plus the time it took were what got to me. None of our lectures were recorded. That actually would have been worse, I think, listening to bad lectures without social interaction. I would read the slides, which were posted in advance, and then spend some time reading around each topic. Once I figured out my routine, I would rarely have to think about medicine after lunch, except around tests. You don't need to get 100% on tests, so you don't need the lecturers hint that "this will be on the test". You'll miss some things on exams, but you'll learn all sorts of other important things by reading broadly around your daily topics.
  4. Cool, find a source for that statement and you're good! Far as I know it's just fine. I'm in my second year of practice so relatively recent migrant.
  5. It is over-saturated in Canada but not in the United States (it's really nice sending money back to Canada right now!). Who knows where things will be in 10 years.
  6. It will help, without question. However, orthopedics is not particularly competitive in Canada - most people who are serious about it match. If you have a year between undergrad and med school, great, sounds like a cool idea. If you are putting off medical school for a year to do a Masters, that makes less sense to me. Don't let the job prospects put you off if you love the field (ortho) and aren't tied to working in Canada. There are lots of jobs in the US where, once you move there, you will all of a sudden find yourself in one of the highest paid specialities in the US.
  7. It really depends on the numbers. Canadians at the US medical school I am affiliated with pay $60 or 70,000 per year. Assume an average Canadian tuition of 20k per year. 60,000 US at current exchange rates is 72k Canadian, so the difference is 50,000 per year. 50,000 x 3 years (cause you're going south for one year in this scenario) minus one extra year in Canada (20k tuition, 20k living?) - so it costs you $110,000 more to stay in the States. Then you have to factor in the interest you pay on that extra amount. Some people pay down LOC in residency, but many don't. Assume you do Internal and are a resident for 5 years and interest is 3-4% (hopefully!). My rough calculations put you $150,000 (major "ish" factor here) more in the hole by staying in the US. That would be $150,000 after tax, so if you pay 40% tax (assuming you work in Canada, less Stateside), it ends up a wash as long as you make $250,000 in that first extra year of work you would benefit from by staying in the US and getting done faster. Doing first year medicine a second time would suck. Boring boring boring. Good luck!
  8. Age is sort of irrelevant, it is more a matter of how old your kids are. I didn't have kids in medical school. First two years, pre-clerkship, you would have lots of time to see them - potentially more than many people with full-time jobs see their kids. Classes can end early, or, in many places are not mandatory, you get home for the afternoon. You can study at night while they are asleep. It's a non-issue. Clerkship is different, you have less freedom. Busy rotations you won't see your family for a stretch. Other rotations like family medicine and psychiatry it will be like a regular job. I had kids throughout all of residency, except for the first few months of R1 year. I had a very busy residency program and it certainly impacted my life. My rule was you could have two of three - work, family, social life, so I did work and family, which was fine for my wife and I. If you choose something very busy, residency will have a cost for your family life. My wife and I were okay with how busy residency was because, a) I loved what I was going to do, and, we rationalized that our kids wouldn't remember those years. A year and a half post-residency, my 6 year old already has so many new memories that the busy times of PGY4/5 are starting to get blurred out. If my kids had been older, I wouldn't have felt so confident about that. My wife stayed home during residency - that allowed us to feel better about things. If you choose a different path, it would have no more impact on your family life than many other moderately busy jobs. My months on physiatry and Emerg were blissful - I didn't know what to do with all the time! I kept wishing I liked those fields more! My friends in Family Medicine had a pretty good life for the most part, with the odd bad rotation here and there. There are many residencies that are very livable. As an attending, life is great, even in a non-lifestyle specialty. Lots of time for family and other things. Financially, going from sonographer to physician will be worth it. If you steer yourself towards a career with better lifestyle it will not impact your kids and family too much. Being a physician is a pretty great job. Go for it.
  9. Went into a bad lifestyle speciality with poor job prospects (ortho) after initially thinking mostly about lifestyle. Had the opposite crisis of faith when utterly exhausted as a PGY2 and friends were almost done their family medicine residencies, but stuck it out. Have a great job now, which I love (in the US), and the lifestyle is much better as an attending. It is difficult with the job prospects in certain specialities, but what I asked myself when I was thinking of switching was whether the other speciality was going to challenge me and interest me for more than a few years (the answer was a resounding no). Easy for me to,say when things have worked out, but do what you love.
  10. Well that's what we need, isn't it? We just need it to be easier to get into medical school! Good solution. What other world problems can we solve?
  11. Older, (I don't know how to quote) It's not that I'm missing the point, I just don't agree. Life is inherently unfair. Some people are born smarter/prettier/insert adjective of choice/harder-working than others. Some people can do very little work and do well in university - well enough to get into medicine. Some people have to work extremely hard, to the exclusion of all else, in order to achieve the grades and CV to get into medicine. If an individual falls into the latter group then it comes down to a choice - are they willing to work that hard, or, should they pursue one of the myriad other careers that are available. Unfortunately, for those in the latter group, this is often perceived as "failure" instead of an honest assessment of one's abilities. The culture of 10,000 hours, in which enough work will get anyone to their goal, encourages people to keep at it - study all night for their exams, forgo enjoyable life experiences because it will take time away from studying, or, fluffing up their med school CV. Someone said above: "It is not that a high GPA is not achievable - it is. But for many it comes at a very high price." Well.....duh. Not everyone is smart enough to be a doctor. Some people (lots of people) are just barely smart enough....that's a hard position to be in - do you want to always be panting to keep up, or, do something different? One girl in my medical school class remembered everything she read after reading it once. We all envied her incredibly. Some people read the same thing over and over again and never remembered it. We all wondered how exactly they had gotten in and hoped none of our loved ones were their patients. I don't want to put medicine on a pedestal, but not everyone is cut out for this business. In the same vein, and more to the point of my previous comment, not everyone can manage stress adequately to get through medical training and become a physician. Failing to deal with stress in undergrad (a fraction of what one will encounter in residency and beyond) might be a sign. Man....I'm sure I've offended lots of people. I don't see how direct entry from high school improves things. You just transfer the stress from one part of life to another. High school is great because you don't have to worry about grades. Some people do, I respect that. The two years you "save" is negligible in the grand scheme of things and many people (myself included) value the time they got to spend in undergrad before medical school. I got to read hundreds of books totally unrelated to medicine, take some years off between undergrad years to travel the world, have fun and learn and wouldn't trade those experiences for getting to be a doctor two years sooner. Who cares, you only live once - do other stuff besides medicine. Study something that interests you in case you don't get into medicine. I think the "maturity" card is overplayed as I would agree there are vast differences in the maturity levels between different individuals. The benefit of using university GPA versus high school performance is the heterogeneity of high school education in Canada, without common tests such as in the UK. Until there is a way to compare apples to apples, direct high school entry will not happen in Canada. Undergrad is also not apples to apples, but it is better, and MCAT smooths things out abit. Yes, I know Queen's is admitting a few kids out of high school, but it seems like a publicity stunt more than an honest reappraisal of how they choose doctors. I truly wish the best of luck to all those applying to medical school. It's a great career. Most people who are up to snuff do make it in. Be honest about yourself and your abilities. Don't beat your head against a wall. If you find the process of getting in so terrible, you won't hack it when things actually get stressful.
  12. Don't think of it as "burning out", think of it as "weeding out". The stress doesn't magically end when you finish your training and become an attending. All of a sudden the buck stops with you. Even consenting a patient for surgery is an entirely different process - something you do a thousand times as a trainee - because now it's your name at the end of the chart. Thankfully, you've progressed through a rigorous training program and stress, while still unpleasant, is something you are equipped to deal with. My 4 hour case turned into a 6 hour case yesterday through a somewhat predictable but entirely unpreventable event....drop a quick f-bomb, tell anaesthesia you need 2 more hours, and then fix it. Thank you to all the stressful situations I've had before. I think there are, and, always will be, improvements that can be made in the process of selecting who gets to become a physician and then training those people. However, at the end of the day the job is the same, so trying to smooth out the process may actually be counterproductive. An aside - people should stop complaining about how hard their degree is. Nobody thinks you're smarter because of it, you just sound like a whiner. Put on your big-boy pants if you want to go into medicine.
  13. It is easy to be enthusiastic about medicine when you are early in the game, or, just trying to get in. Comments like "I would live in a tent to do what I love" are ver characteristic of a certain phase of the training process - I've been there! Just started as an attending and I pretty much have one of the best jobs you could ever imagine. I make a very good living, treat interesting patients, pretty much never pick up the phone at night or on weekends and get paid to travel internationally several times per year. That said, I started my training at 24, 10 years ago, and still feel like much of that training is a chunk of life I will never get back. Pre-clerkship was a joke, but clerkship was steadily busy, and residency precluded all hobbies. That is 7 years of the 10 that were pretty bad. I had fun throughout (sort of), and you trick yourself in residency into thinking you enjoy working that hard, it inhindsight it was quite awful. I didn't see my kids much. Much depends on the field you end up in.....my wife made a point of not commiserating at all with the wives of my friends in family medicine when they were complaining about their husbands' call and hours because it was so incredibly good compared to a surgical residency. She just endured. Now life is great, but we have a 6 figure med school debt to payoff and are essentially financially starting out at 34.... I could not imagine being in a similar position 10 years from now-kids are a bit of a game changer for how you think about finances. I love my job and couldn't imagine doing something else. However, I'm not the most imaginative, and the years it took to get here took a bite out of my life.
  14. Cool. I'm sure you've already done this, but it is worth talking to an immigration lawyer and mapping out your 10 year plan. A colleague was waiting around for a full year after completing a very prestigious fellowship on the US because she was on a J1. She had a great job offer in he US, a top notch immigration lawyer, but the J1 in that instance screwed her over. H1B's are only renewable for 7 years (ie less time than med school and residency). It is worth understanding the process just so you are not surprised at some point. I know people who have gone through it without incident, but also those who have had issues. As an aside, I did med school and residency in Canada and went stateside for fellowship and now for work. Doing some of your training where you want to end up is helpful, but fellowship and residency have more of an impact than medical school. Congrats again-I don't want to rain on your parade!
  15. Just a thought - it's not a terrible idea to see what happens with Canadian schools as well. The only reason I say this is that there may be a significant cost difference. I work in the US and was talking to a Canadian medical student who is paying $70,000 per year tuition....that's a lot of dough. Depends on where you got in, I suppose, and I'm sure a host of other factors. Good luck and congrats!
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