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guy30

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  1. Not a dentist but isn't this a problem with the assessment/licensing system for dentists in the end? If dentists are passing the exam, obtaining their license, but still providing subpar work, it seems like the NDEB hasn't assessed them properly and the concern or advocacy should be with them in raising their standards and not with the dentists who follow their 2 year assessment process successfully to ultimately become licensed in Canada?
  2. I would honestly say that Australia is an amazing place to live if you're comparing it to the USA... especially nowadays with their mass shooting epidemic. But both countries and Canada obviously have their pro's and cons though Canada and Aus are fairly similar as I mentioned before, kind of like cousins in different hemispheres. In terms of medical training, I think the average standard in Aus is going to be higher than in the USA as there is a lot of variability in the quality of residency programs. There are obviously going to be some really top notch training programs in the USA at your high end Ivy league schools but also some terrible programs at private hospitals not affiliated with major universities or teaching centers. Healthcare system as a whole is definitely going to be better in Aus compared to the USA from an access point of view and just in general with how the system is run. The USA doesn't really have a system per se but more like a ton of hospitals run as corporations doing their own thing. The Aus health system is also much more similar to the Canadian health system than the American health system as I mentioned before. Yup feel free to PM me, can't promise super prompt responses but I can try! haha
  3. There are certainly regional differences in terms of how easily and how much of an urban academic teaching hospital you are likely to get for internship. As you probably know, some states will even prioritize their own Aus graduates who are international students over inter-state domestic students. However, for the vast majority of Australian medical graduates that want an internship, those that want one will get an offer somewhere, even if it's a super rural area or with some of the newer private hospital internships attached to a one year return of service contract offered now as part of the Aus governments expansion in internship positions. The internship stats show it (you might need to google it or obtain it through the Australian Medical Students Association). Main caveat being major red flags in their application and an individual's willingness to go anywhere and actually commit to the training for their contract period. If it gets to the point where they're super desperate even after applying to hospitals across the country, job positions do even pop up in the middle of the year as people go on leave etc. They treat the process much more as a job in the application process than how things are done with CaRMS. You can even get paid overtime at work! The nice thing about doing internship in a super rural area is that it is often an interesting and challenging learning experience, and after one year you have the ability to apply back into more urban areas just like everyone else since you'll have your general registration (essentially kind of like your LMCC but it allows you to work across the country). I'm certainly happy to chat with some of your colleagues if they're having issues? Did they all get internships in the end? Still looking to apply to Canada? Feel free to PM me if they need advice.
  4. Unfortunately I don't think the rates of Canadian students who are Australian Medical School grads staying in Aus is really tracked publicly but the community of international students isn't huge so who is staying in Aus and who is applying to the USA or Canada for residency is generally known within the community, at least definitely within each medical school especially since people need to prep for the LMCC exams or USMLE exams ahead of time. The CaRMS data for just under half of Aus grads matching to a Canadian residency each year is just based on those who actually apply back to Canada obviously and not those who stay with no intention of applying to CaRMS. I would say at my school roughly 80% of the Canadian students stayed in Aus and just continued on with their internship and postgraduate training without applying to CaRMS. Of the remaining people who did apply to CaRMS, in my year everyone who applied matched in the first iteration but on average for other years, I would say roughly 50-75% matched in their first application and the other 25-50% just continued working in Aus and the re-applied in a subsequent year and matched. I think that would be consistent with the CaRMS stats in general. I would also say that all of the people I know who applied to the USA matched in their first application. I think that those are pretty decent match rates for IMG's though anecdotal in the end. The other thing with Aus applicants is that they generally have the option to just continue working in Aus so they may be more selective with which programs they apply to since the training opportunities may end up being better in Aus if there are quite limited residency positions in Canada for a particular field of medicine. Also the risk of not matching to Canada is not as high since there's usually a job that they can continue with in Aus.
  5. Australia in general is a great place to work if you're interested! Similar to Canada but different in some quirks, and also warmer haha. Getting PR and eventually citizenship is generally not an issue once you start working as a doctor after medical school. There's usually ways around financing including personal savings, government student loans, and bank line of credits that get most people through. It certainly isn't cheap for international students but probably similar in tuition to what American medical schools charge.
  6. The majority of Canadians who study in Australia actually don't come back because they end up liking it there, get in to the training system, and end up staying there either long term or finishing up their postgrad training and moving back to Canada on reciprocity agreements between the two countries eventually. Australian grads that do apply to the USA or Canada for residency generally have fairly good match rates. Aus grads generally do quite well in the Canadian postgrad training system and the Australian healthcare system is significantly more similar to the Canadian health care system than the US health system is to the Canadian health system so the transition is actually smoother for an Aus grad from what I've seen compared to American grads. A lot of misperceptions about obtaining postgraduate training for Aus grads but for an international student who is an Australian medical school graduate, the match rate for an internship is roughly similar to the match rate for CMG's in CaRMS over the last several years (as noted, there may be different pathways that need to be undertaken if not successful in the initial round of job applications, similar to going through the 2nd iteration in CaRMS, but pretty much almost everyone that wants a job is able to eventually get one somewhere). The match rate for Australian domestic students is basically 100% unless there are some major red flags. They call it such an 'internship crisis' in Aus because the Australian Medical Students' Association advocates for all Australian graduates, whether domestic or international students, and have been successful in the 'internship crisis' campaign over the last decade in getting the Aus government to further expand internship training positions so that as close to all Aus grads have an internship after medical school. For post-graduate training in Aus, once you do your internship, you're basically on the same footing as any Australian student in apply for post-graduate training positions. Everyone is essentially treated the same based on merit for post-graduate training. Whether you were an international student or domestic student in medical school essentially doesn't matter anymore. In the Aus system, most people work as a Resident Medical Officer/House Officer (think kind of similar to an extender or an off-service resident) for different services to gain more experience and beef up their applications or figure out what they want to do in life before applying to post-grad programs but there are some programs where people can apply to right after internship (the most obvious being GP/Family Medicine training). Hope that helps!
  7. I would agree with this. I think from what I've seen in general, community hospital FM hospitalist teams tend to take on more acuity with an average patient load of roughly 25 patients (some ALC/rehab type patients may be in the mix too). Large academic centers on the other hand tend to use their FM hospitalist service for lower acuity patients probably owing to the huge GIM teams staffed by tons of residents able to take on higher acuity cases. These are of course generalizations and as staff, you can often dictate the type of acuity you are willing to accept as well. Things will also be quite different province to province depending on how FM docs are utilized in a province. There are not many enhanced skills (+1) hospitalist programs in the country and all the FM hospitalists I've seen have not had additional training but pretty much all practice full scope FM (some are even doing deliveries in the same hospital while on hospitalist service, in an urban center!) or hospitalist full time at multiple centers.
  8. I don't know much about dentistry but don't people who go into Maxillofacial surgery do this all the time? As in complete Dent, then Med, and then a Maxillofacial surgery residency?
  9. This would be similar to the timing of the USMLE for US med students where they do their step 2 CK and step 2 CS exams during the first half of MS4 between Aug-Dec of 4th year.
  10. I've seen some +1 EM docs hold faculty positions and do EM research through the Department of Family Medicine at my school. Not sure how common this is though.
  11. I don't think it's that unusual to have CCFP-EM docs work in Level 1 trauma centers. In fact, I think at the very least a large minority of the docs in the departments I've worked in have their CCFP-EM. I also don't think they did a trauma fellowship year either. Usually when you're working with a staff you won't know anyways unless you ask around cause it doesn't really matter from a practical or clinical standpoint in the end. The situation might be a bit different in terms of hiring nowadays though. Not sure how many new jobs are available at Level 1 centers and when there are, not sure what the hiring patterns are. I would imagine these jobs are more limited now and FRCPC docs would usually get first pick at hiring though things like experience etc. can play a role too.
  12. Yeah I've heard of the LMCC being considered equivalent in some states too but I couldn't find anything specific to back that up in my quick search so maybe someone else has more info on that? In terms of doing ER in the US, I think it's important to differentiate between being able to do it and actually getting hired to do it. As a CCFP(EM), you'd be able to become board certified in family medicine which has a scope that allows you to practice emergency medicine. However, to be hired in any major center (and to have insurance companies be willing to pay you) it will be difficult and just like in Canada as a family doc, you'd be more likely to be hired in a peripheral community or rural center.
  13. I believe the answer is generally yes, you need to have all 3 steps of the USMLE done in order to have a license to practice medicine in the US. In addition, each state puts requirements on the minimum amount of post-graduate residency training an individual must have obtained in order to obtain licensure. I think it needs to be ACGME accredited training but they don't always explicitly say that. I'm also pretty sure all Canadian residency is considered equivalent to ACGME so both the FRCP and CCFP(EM) training should count this should count. The minimum number of years for residency required may differ between US grads and IMG's with IMG's often requiring more. I would think CMG would be considered in the US grad category here but they only state that for one state (Maine). Generally the US grad requirement is at least 1-2 years and IMG requirement is about 3 years. Again, both FRCP and CCFP(EM) fit the bill here. This table outlines it pretty nicely: https://www.fsmb.org/licensure/usmle-step-3/state_specific
  14. Yeah agreed that a fractured collarbone alone would not merit urgent attention. Apparently the label of being the worst hospital in the western world was based on a host of other factors though. "A report on the hospital by Quebec's health watchdog unrelated to the coroner's report said it underperforms compared to other Quebec hospitals, which that same watchdog ranks as the worst in Canada and the western world. The health watchdog report gave the Gatineau Hospital a D- for emergency care. And since no other hospital in Quebec has ever received a D- score before, "we are forced to conclude that the statistics indicate that this hospital is among the worst in the western world for health care possible," the watchdog's report concludes in French. That comment was then echoed in the coroner's report into Gauthier's death."
  15. Just read this article and thought it was quite shocking for a Quebec hospital to get this label from both the coroner and Quebec's health watchdog. Anyone ever rotate through Gatineau hospital? I wonder if it's a manning issue in their emergency department. "Gatineau Hospital among worst in western world for ER care, report finds Man with ALS waited more than 10 hours to see a doctor for fractured collar bone" http://www.cbc.ca/news/canada/ottawa/gatineau-hospital-coroners-report-1.3736927 (edit to fix link)
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