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Everything posted by medisforme

  1. medisforme

    Working during CCFP-EM fellowship

    If you give even a small modicum of effort, it's pretty much impossible to fail the PIP/research project. It's much more likely the person in question failed their licensing exam. I was told around 7 BC FM residents fail per year, not sure the pass rate in other provinces.
  2. I am a BC resident, did all my FM electives in BC and received OOP interviews everywhere I applied (Alberta (Calgary and Edmonton), Sask, Manitoba).
  3. Hi, I am a 2016 UBC MD grad. There were at least 6 people in our class (myself included) who attended University of the Fraser Valley for undergrad. I definitely don't think you are at a disadvantage by attending a smaller school. In many ways it is an advantage (easier to get reference letters from profs for example). There are just so few applicants relatively speaking who apply from these schools, it seems to a lot of people they are at a disadvantage (most high school medicine gunners are aiming for UBC/SFU/maybe UVic right off the bat for whatever reason).
  4. It doesn't matter which site you do pre-clerkship in, you are eligible to apply to any ICC site. I was SMP and did ICC 3rd year in Chilliwack.
  5. medisforme

    Addictions med: family or psych?

    I plan on doing a moderate amount of addictions work now that I am graduated. The key I have found is to get hired on by health authorities to do sessionals (usually they are 3.5 hours) for both OAT and withdrawal management/detox assessments (I think it works out to $133/hr). This way you get paid per hour and so it doesn't matter if a patient shows up or not. There are also mixed models where you are guaranteed a sessional payment but if you manage to bill above that for the time, you keep the difference. I did some training with docs who were in the midst of trying to build up a methadone/suboxone practice from scratch. This is a massive money loser, as you are paying 1-2 staff as well as office space to often just sit around until the practice builds up (which takes a decent amount of time). Some clinics charge patients a monthly fee ($50 or so) as part of the care they provide. The field of addictions from a family medicine standpoint is not very lucrative to begin with. The only way you would make a good living is to build up a large practice of stable patients (200-300+). The family medicine addiction billing fees just got updated, I assume to attract more docs to this area. You now get paid an initial evaluation fee as well as a suboxone induction fee on top of the regular 00039 weekly fee. Typical OAT clinic/community detox assessments don't take an R3 level of training IMO. I worked with several family docs who learned as they went. Addictions fellowships are more important if you want to do in-patient hospital consults or work in medical in-patient detox facilities (ie. Creekside, St. Paul's)
  6. Might depend on what type of residency you are doing. I had some friends in neurology, peds etc.. who benefited from some extra prep as the exam is heavily skewed towards primary care (and a lesser extent emergency medicine) and they had not covered a lot of the material since med school (obs history etc...). If you are in family medicine, your prep should be minimal. Outside of our program dedicating one AHD to a mock LMCC2, I didn't practice a single physical exam (though did review important points in OSCE style physical exams). Review your general histories (obs, peds, cardiac, psych etc...), have a general approach to critical care (ABCOMIP), have a general sense of time and you will be fine.
  7. I am just finishing residency and had a question for other graduating residents, recent grads, or established family docs. I have agreed to stay on at my preceptors clinic (2 of the 3 docs at the clinic recently retired and there are many patient that need to be seen) for a period of 6 months and am leaning heavily towards staying on at the clinic and starting a practice with a certain percentage of the leftover patients who are left without a family doc (due to the recent retirements), many of whom I am already familiar with from residency. Since there would only be 2 docs there, I have been told I would need to see around 30 patients/day for 3.5 days a week to make the clinic financially viable (my current preceptor owns the clinic). They would expect 30% of payments to go to overhead. It is great EMR and I am familiar with the local community. I would also have access if I wanted, to a lot of residential care patients to supplement my income. I have also been told I would have a lot of input into how the clinic is run. I will note, I have an interest in addictions and have applied and been hired tentatively for 2 separate positions, each a half day a week which pays sessional unless I bill more than the sessional, then I can keep the difference (I assume I would be able to keep all this money, not have to pay it into the clinic). From reading around it seems like 30% is on the lower end of competitive (though still typical). My concern is that he would like to retain the majority of MOA's and office manager. I personally don't see the need for an office manager with a two person clinic (I could be mistaken) and don't see why two physicians would require >2 MOA's. Is it at all typical to have more MOA's than physicians in a practice? Also, is the 30% overhead typically fixed based on your billings or are practices open to charging a fixed amount to sustain the practice (ie. so the more you bill the less your overhead percentage is). If anyone has any thoughts on what I have shared please feel free to post. Thanks in advance.
  8. From personal experience, I know that UBC only considers your graded courses in their AQ pre-interview assessment, but considers all courses (including pass/fail) when assessing whether or not you have taken a full course load. This may be somewhat dated as I started medical school in 2012.
  9. medisforme

    2018 CCFP exam

    I would apply this exact description to the SOO's. 15 minutes to take an extensive medical and social history without doing even a cursory physical exam is not indicative of real life. Every candidate memorized the formula for a SOO (problem 1, FIFE, plan, problem 2, FIFE, plan, random social history = pass). I would argue the SOO stations are much less reflective of real life than the LMCC. Also, if you can't FIFE by the time you are done medical school, i don't have much hope for you as a physician. That is something that should be tested before someone starts residency.
  10. medisforme

    2018 CCFP exam

    I have now written and passed my CCFP, so no one can accuse me of having any particular axe to grind. Does anyone else think the exam is full of fluff? The SAMP portion was challenging at times, but had several what am I thinking questions in regards to mental health scenarios. I also found it heavily guideline based vs assessing other forms of clinical knowledge. The way that the SOO portion is set up is also somewhat strange; purely history based with the candidate tasked with finding "the second issue" as well as taking a comprehensive social history. Completely unrelated to the realities of everyday clinical family medicine. In my opinion, the LMCC part II is much more related to common primary care issues (despite the fact all specialities must do this exam) and a better test of family medicine skills than the CCFP SOO. Any other FM residents have any thoughts on this?
  11. I was a distributed site student as well. I connected with a finishing second year student who was moving to a different city for clerkship and just extended the rent off of his contract for 4 months. The landlord was happy for another individual to move in without too much hassle. The facebook site is probably the best place to start this search.
  12. medisforme

    Attrition rates for each medical school?

    One student in first year failed in my cohort. They were given 2 chances to rewrite one particular exam and failed it both times. From a distance, it did not look like they tried particularly hard (showed up unprepared for workshops, rarely spoke during PBL etc...). Person was allowed to repeat the year and didn't have any further issues as far as I am aware.
  13. After l was accepted by UCD I looked into it, and the process was overwhelming and confusing to say the least. I consequently decided against going overseas and continued to apply in Canada. I applied more times than you and eventually got in, and considering the current difficulty of CSA's matching back to Canada, I would advise you to consider applying to med schools Canada for at least another couple of years. You are essentially uprooting your entire family for at least 10 years if you decide to study in Ireland.
  14. Hey all, Just wanted to put this out there on behalf of one of my colleagues who was inquiring. What type of employment could a foreign trained physician with a public health and preventive medicine residency along with a masters of public health expect to obtain in Canada? The person is realistic about not obtaining a residency spot in Canada but was inquiring about realistic job prospects Anyone have any ideas? Would it still be possible to obtain a position as a medical health officer?
  15. medisforme

    Pediatric neurology

    Why is it a stand alone specialty for residency compared to other peds specialities which are all fellowships?
  16. medisforme

    Filing taxes question

    Once any big tax company hear's you are a doctor, they will do your taxes for free until you are done residency (with the hope you will stick with them once you are done). I have had MNP do my taxes for free for the past 6 years. They do everything to maximize your return and I am positive any reputable company will know what to do with your provincial residency status.
  17. medisforme

    Which Site and Why

    SMP grad here. I would agree with all the positive attributes other members have posted here. One negative that hasn't been brought up that affected me a lot as my wife and son did not live in Kelowna with me is the difficulty travelling back to the lower mainland in the winter (ie. on weekends). The connector and coquihalla can be precarious. I witnessed several accidents on the highway over three years, and was involved in one myself (the driver of the vehicle I was in IMO was going too fast for the conditions but I digress). Also, at least twice I was stuck in the lower mainland past the weekend as the highway was closed or conditions were treacherous. I tended to be white knuckled the entire drive. Finally, I unexpectedly missed out on a couple of events I had signed up for due to the conditions (ICC visits, conferences etc...). Of course, you can bypass this by flying all the time (though this is more expensive and only practical if you live in Vancouver, which I didn't) or just not going home. Anyways, just something to be aware of.
  18. I I interviewed on the same day as IMG candidates for UBC psych. There were apparently about 50-60 interviews for 2 spots. I can't imagine how many people applied. Your odds are not good in Canada to say the least. I know in US getting into psych as an IMG is much, much easier due to the sheer number of spots. It seems to be a less popular specialty in US compared to Canada.
  19. Anyone attended the CCFP review course put on by Dr. Simon Moore in the past and have a review course manual they would like to sell. You can post here or PM me. Thanks.
  20. medisforme

    MCCQE Part 2 Preparation

    1. Ask senior residents for the MCC "resource sheets/practice questions" they used 2. Use whatever resources you used to practice for MS4 OSCE 3. Podcast- Dr. Mike Kirlew LMCC prep is helpful but he goes into way too much detail IMO and its overly focused on critical care stations which only make up about 15-20% of the actual exam. I just listened whenever I was driving for the month before the exam. 4. Others on here (including Dr. Kirlew on the podcast) will tell you to practice with partners over and over again. If you are confident in your clinical skills this really isn't necessary. I spent about one hour in total doing a few histories with a partner and nothing more. The only benefit of it is to practice your timing. The tricky stations are the ones where you have to do a hx and px, so you have to time the stations carefully (quite a few stations required a hx and px during my testing day).
  21. The only thing I would add to the OP is that you don't lose marks if you talk for seven minutes and don't reach the prompt questions. A lot of great candidates already address these questions in their initial response. The marking scheme is actually very simple and based on your overall response. It has nothing to do with leaving time for the prompt questions. Having said that, a lot of candidates tend to blabber and repeat themselves in their answers, the prompt questions help steer the candidates in the right direction. As an aside, I also used a professional company which I found helpful. It gave me some new approaches to questions and a good strategy for tackling answers. Yes, they are a complete rip off.
  22. medisforme

    What to do?

    I am surprised this has not been brought up yet, but why have you waited until now to even think about doing any interview prep? You really should have been working on it since your first application. I had to apply to med school 4x as well (and I was older than you when I started). Each year I did a variety of prep (1:1, group interviews, mock MMI, did some counselling/mock MMI with a professional company etc...). If you really want to get into medicine, you need to constantly be trying to improve your game. It is just so cut throat these days with hundreds of very qualified applicants.
  23. If you are a reasonable applicant, I don't think you need that many interviews to match to family. I only applied to four FM programs (I applied to psych as well), and many of my friends only applied to 2 or 3 programs (I actually only had one friend who did not match to one of their top 2 provinces/schools for FM and none of us were star applicants). None of us were ever that worried about not matching. One thing I did, was ask one of my psychiatry preceptors to write reference letters to both FM programs (specifically an FM focused letter) as well as psych programs in order to make my FM application stronger and not look like I was all in on psych. Of course, you have to test the waters first before you ask a preceptor this as some might not be so open.
  24. A lot of people are ranting about LMCC 2, though I do personally see some of the utility of it for family medicine residents. Our CCFP oral exams are basically testing our ability to carry out a glorified social history so I think there is some utility for family practice residents for doing the LMCC to show we have a good approach to common primary care scenarios and can take a proper history and physical. What I don't get is why other specialties are required to do this exam when they are going to be put through the ringer with their own Royal College Exams. MCC has some statement on their website about ensuring high quality, generalist physicians. Is't that what a family doctor is? Why does a vascular surgeon or pathologist need to be a good generalist physician? I would think some specialties would have powerful enough lobbies to get the exam waived or something. Finally, as it is now, family medicine residents (and to a much lesser extent emergency medicine residents) have a massive advantage on the exam. The majority of the scenarios are straight out of a primary care office. How many specialty residencies rotate through obs/gyne? Less than half? How about peds? It seems like a lot of the candidates are doing stations they may not have done since third year med school. It seems quit unfair, I am surprised there hasn't been a major backlash or uproar to have exam cancelled for Royal College programs (aside from premed101 rants).
  25. To echo some of the above discussion, I definitely think regional centres are the best combination of volume and acuity. The majority of them only train FM residents so there is no one else to take procedures. I am at a regional centre and have no interest in EM, but just walking through the ER on a different rotation I have been invited to do intubations, assist with codes, casting etc... I know there are a few regional hospitals in BC that have very good +1 match rates for FM residents because of the experiences they get in residency. Regarding the preference for Rural FM residents. I could be wrong, but my understanding is that the +1 program was (is?) originally intended for FM docs to practice emergency medicine in a rural setting. Not sure if that belief still predominates the selection committee's thinking.