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tere

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tere last won the day on December 15 2018

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  1. A lot of different factors - ortho was cut from 21 spots in 2011 to 6 in 2019 in QC. If roughly the same number of people apply each year to far fewer spots, then it would make it much more competitive. I've informally heard that it's possible to get ortho jobs in QC without a fellowship - so cutting the numbers down may have really helped the job market and also made it more competitive. Pediatrics is better paid in QC which could explain part of the differences. To me Peds is the big surprise for CaRMs 2019 - it was roughly the same competitiveness as ENT, NeurSurg and only slightly behind Ophthal - despite being a way larger specialty (slides 47-48 here)
  2. Agree - having demonstrated interest in research could be part of a fit for some programs/specialties. But, like others have said it's not at all necessary, nor close to the highest priority when applying to CaRMs. Plus it's more like a domain that may be looked for rather than being hired on the basis of research skills - so diminishing returns on having some research vs PhD.
  3. tere

    CaRMS 2019 Prelim Data

    There's mobility before (sometimes during) and after residency, but less when you have a staff job. Coming back to Canada after the US isn't so easy for many specialties. US has many undesirable locations - so no location guarantee there either. It really depends what you're looking for as shakeshake suggests.
  4. tere

    CaRMS 2019 Prelim Data

    Haha - for sure:). Vasc surg from this summary year data was actually non-competitive. OTOH peds and neurosurg were more competitive than anesth & ENT! (slide 47-8). I know other forum members also usually crunch the numbers differently - odd year!
  5. tere

    CaRMS 2019 Prelim Data

    Logical, but politics is about getting votes - cutting med school spots doesn't really have that ring. After all, IMG residency positions are partly justified politically by talking about the "doctor shortage". Can't see cutting being a winner for any politician that wants to stay in power, unless there's some back up plan - more IMGs? (might cost less for the government).
  6. tere

    CaRMS 2019 Prelim Data

    Lots of research demands in very competitive US specialties - a research year is much more common. Spending all spare time on the USMLE Step 1 would mean having less of a foot in CaRMs (in terms of networking, researching..) - and then as a non-US citizen, at every level, one would be behind any equivalent American citizen. Maybe if pre-clerkship at the school is both similar to the US curriculum and not very time demanding, then it would be possible - neither of those conditions was fulfilled at my faculty. Very competitive US specialties are filled with USMGs - one would have to have a more competitive application in terms of scores, research, etc in order to get a residency position and be preferred over a US citizen. Plus American electives would be preferred for US PDs vs Canadian electives. So there would definitely need to be sacrifice. USMG gun for Step 1 from day 1 - it's not a past-time for them, and they are learning that material in their med school. It's an even more extreme form of IP vs OOP - sure some people are accepted as OOP, but most are accepted as IP.
  7. tere

    CaRMS 2019 Prelim Data

    Trying too hard to match to very competitive US specialties from Canada and potentially decreasing CaRMs matching opportunities, makes even less sense. I think it's better to have an informed opinion of the US after having spent time there, as a non-US citizen.
  8. re: graphs, it refers to electives taken in Derm - which means there were only 5 who matched to a program without a prior elective there. Included in the data are the 8 French-speaking spots which traditionally have had incoming residents with fewer electives in the discipline, generally speaking (both by rules and availability). there are definitely electives related to derm - it used to be part of IM years ago. This could be more of a factor in future matches when # electives will be limited for all applicants.
  9. tere

    Unique Situation

    I really think these kinds of generalizations are unfair and not accurate. I would never stereotype Canadian-born IMGs as wealthy and entitled but it's easy to see that some may live in a different financial reality than many CMGs (from Atlantic Bridge testimonials link): "For anyone who was in the same situation as me, I would definitely recommend studying abroad in Ireland. Ireland definitely has a unique charm and culture, and anyone who studies there will definitely grow from the life experiences that those staying home will just simply never get. Where else can you spend your week studying medicine and your weekends touring La Sagrada Familia in Barcelona, carving up some serious powder on one of the many slopes of Oslo, or experiencing the culture of Paris? Certainly not in Canada or the United States!" Personally, by your measure, I would say I've already paid the piper several times over, partly in an other language, without any trips to Paris:(.
  10. https://www.theglobeandmail.com/canada/article-supreme-court-ruling-may-pave-way-to-identification-of-ontarios-top/ The Ontario doctors who previously charged the most to the province’s health system may soon have their names released to the public, a Supreme Court decision suggested Thursday. Canada’s top judicial body issued a brief ruling declining to hear an appeal from the Ontario Medical Association and two groups of physicians who have spent years fighting to keep the names of – and amounts charged – by some of Ontario’s top-billing doctors out of the hands of a major newspaper. The Supreme Court, in keeping with custom, did not release reasons for its refusal to hear the case. But its decision means a 2018 ruling from the Ontario Court of Appeal still stands. Toronto Star reporter Theresa Boyle had previously made a Freedom-of-Information request to the province’s health ministry for the names of the top 100 physician billers to the Ontario Health Insurance Insurance Plan between 2008 and 2012. The Ministry of Health made only a partial disclosure and did not include the names or some specializations of the doctors in question. Boyle successfully appealed to the provincial information and privacy commissioner, who ordered full disclosure of the records on the grounds that the details she sought did not constitute personal information. The doctors groups then took their fight to court, where subsequent decisions were handed down in Boyle’s favour. The most recent of those came last August when the Court of Appeal – Ontario’s top court – dismissed the challenge from the doctors. The three-judge panel that heard the case agreed previous decisions had correctly ruled that information such as names and financial details disclosed in connection with professional activities did not count as personal information, since they were distinct from a person’s private life. “In our view, where, as here, an individual’s gross professional or business income is not a reliable indicator of the individual’s actual personal finances or income, it is reasonable to conclude not only that the billing information is not personal information … but also that it does not describe ‘an individual’s finances 1/8 or 3/8 income,“’ the decision read. A spokesperson for the Ontario Ministry of health declined to offer specific comment on the Supreme Court’s decision to uphold the Court of Appeal’s ruling, but said the issue of billing disclosure is on its radar. “The ministry is working with the Ontario Medical Association to look at how physician billings might be disclosed in the future, but those are very early discussions,” said a statement from the ministry. The Ontario medical Association declined to comment specifically on the Supreme Court decision, but said amounts billed to OHIP demonstrate doctors are performing their duties. “Every billing represents a distinct health care service delivered to patients in Ontario,” the Association said in a statement. “ … Every billing submitted means one more Ontario resident treated, and one fewer patient waiting for a needed service.” Toronto Star Editor Irene Gentle cast the Supreme Court’s decision as a victory for government transparency and accountability to the public. “The Star fought for five years (with several previous rulings in our, so your, favour) for your right to know how your health dollars are spent,” she wrote in a tweet. “The public interest question is settled.”
  11. I think it's really important that would-be CSAs are fully informed of the risks and likely downsides to going abroad. IMG schools are going to give a very positive spin, since many earn revenue from CSAs. Similarly, the CSAs who match back to Canada represent a biased sample - so it's really important to see the whole picture, from the outset. So ethically speaking, talking openly about the situation as it is today with potential CSAs before they decided to go anywhere is probably a good idea. Unlike some others, I simply see CSAs as pursuing whatever advantages/opportunities they may have, but without full awareness of a certain ethical murkiness of their path nor of the impracticality wrt to matching to Canada, nor of the financial risk, nor of the resentment towards them. As others have mentioned, CMGs are going unmatched with only little concrete action - a few more spots, and some minor streaming adjustments, even though CMGs are clearly the highest profile and priority group. Immigrant IMGs I think are probably now aware that generally speaking, that a medical training will favour entry to Canada, but not further practice as a physician. I've noted before that I find it disturbing if the federal government is recruiting immigrants based on misleading promises of working as doctor in Canada when in the current system that's generally not probable (vs the past). Immigrant IMGs may still choose to come to Canada for other reasons, often sacrificing career and migration for children's futures. It's important to note that immigrant IMGs are also Canadians - with equal rights as CSAs. And CSAs - well it's unfair to stereotype them, like it is with any group, but given the tightness of the match situation in Canada, they are going to be scapegoated to some extent. Even if they won their petition (highly unlikely in my view), there's still way too many CSAs versus residency spots. So in a sense we'd be back to square one.
  12. (from last Thread)Health lawyer Lisa Feldstein noted discrimination in law can be permitted in some instances, but discrimination that violates the Charter or human rights codes is not allowed. “There are examples where making decisions to treat groups differently may be lawful,” she said. “One thing I would note is the College of Physicians and Surgeons, in our model of self-regulated health professions, [is] actually there for the benefit of the public, not the physicians. Their duty is to solely protect the public interest — I think the college may fall back on its duty to the public.” Feldstein said, if the petitioners are successful, she would expect the decision to be appealed, but added that CSAs in other provinces would likely follow suit.https://www.thelawyersdaily.ca/articles/7468/discrimination-claimed-in-british-columbia-medical-residency-placements- Fine you might say, but Aus/Irl are very similar to Canadian training (setting aside the cost question for a moment) and so this shouldn't apply to them (i.e. college shouldn't have any safety concerns). Here's where it gets a little tricky: at one point (before CSAs existed), Canada did treat IMGs differently (in a formal sense) depending on where they trained (e.g. UK vs Asia...). Some immigrant-IMGs appealed this, even went on hunger strikes, and the IMG quota was born in Manitoba. My take-home from this is that all IMGs must be treated equally from a procedural point of view: in fact even separating CSAs from immigrant IMGs seems to me unconstitutional. Moving ahead - legally speaking, CSAs then piggybacked off the quota created for immigrant IMGs and their numbers went up dramatically (200 in 2008 vs 1000 in 2014 vs ? in 2019). And they even now dominate the IMG match vs immigrant IMGs for probably basic reasons like language, culture, etc. And yes - effectively speaking CSAs from certain regions Aus/Irl are preferred over other CSA/IMGs despite the formal non-discrimination. So back to cost.. Canadian schools are set-up for the benefit of the Canadian public incl non-discrimination and pay lip-service at least to accessibility. No IMG school has the same mandate, and the cost of attending some of these schools is staggering - an earlier forum post states that Aus is ~300K+ and Irl is ~260K+ in tuition alone (link). Which means 4 years is going to be 400-500K+, a colossal sum for almost all Canadians which bank (if cosigner available)+government loans don't come to close to covering and thus require major personal/family income/savings. Ironically, these schools are using this `revenue source' of Canadian students to subsidize training of their own students. And then what's the payoff for would-be CSA? The best odds are 1:1 from Aus. That's a staggering half-million dollar gamble, that not many can or would take. So unless one is able/prepared to write-off the money completely (i.e. very expensive international adventure), able/allowed/prepared to work in the location of training (or nearby area), or prepared to match to the US, then it doesn't make a lot of sense. So for some, this may still be worthwhile route even if they may treated with vitriol if they come back. But for others, esp who would be stretching family finances to the max on a risky proposition, then it's probably best to think twice.
  13. The previous thread had more discussion along legal, ethical lines... I also skimmed this link a long time ago for IMG history - https://mspace.lib.umanitoba.ca/bitstream/handle/1993/30375/Cavett_Teresa.pdf?sequence=3&isAllowed=y
  14. Don't think it's too late - a major association with derm matching seems to be the number of electives. If you can line up electives, then you probably have a decent shot.
  15. I've moved around a lot which makes it difficult to stay close to people. Med school fits in the pattern, and where I am now for sure hasn't been the best place for me socially or on other levels. I too get along with people and enjoy transient friendships while they're there - I have fewer expectations from people as I get older, which makes things easier - i.e. I get bothered less. My friends from my youth are established and many have families, which is when people become more home-life focused anyways. It's always great to stay open minded, and people can be surprising. I have activity friends (i.e. shared sport interest, etc..), maybe more of a male-bonding type of friendship. I also have some friends from med school, at different levels of closeness, but usually based on shared interests or experiences. Clichéd, but a little goes a long way - I'm not sure I'll be where I am in the future, but that's the part of being where I am that I'll miss the most. I don't really think I have any kind of home town at the moment and not sure I would have one in the future either. For me that represents opportunity on some level, but it's true that being in a place for a longer period of time does give a lot more chances to build social circles,... supposing it's a place where one actually would like to be. In the OP's situation, pre-clinical will be over next year and then clerkship. Like others have stated, clerkship is a whole new game and with away electives, there won't be much of the pre-clinical atmosphere left. I would have enjoyed having more close friendships from med school, but at the end of the day, the whole situation is transient.
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