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insomnias

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insomnias last won the day on February 14 2018

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  1. insomnias

    1st year resident take home pay

    Those of us who move from OOP or started studying after 2017 will still end up paying provincial taxes, however, since Ontario abolished the provincial tuition tax credit in 2017 and doesn't provide credit for provincial tuition tax credits from other provinces
  2. I have a friend from France who's thinking of moving to QC after an FM residency, but he asked me what the PREM is... and while I read a bit about it, the system didn't really make sense to me. Is it sort of like a return-of-service (aside: anyone know if French MDs who come to QC via the ARM have to do a ROS?)? Does it last forever or just for your first x years before you can practice wherever you want? Does it basically preclude Canadians who did a residency outside of Quebec from practising in Quebec? (Vous pouvez répondre également en français ou anglais, même si lire trop de français me faire mal au tête . Je dois améliorer mon français!)
  3. insomnias

    Alberta vs Ontario for FP billing

    I'm not sure if that figure is true, but I rotated with an FM who saw maybe 2-3 patients/hr from 9-12 and then 1-2/h from 1-4 only working Mon-Thu in a PCN (the AB equivalent of an FHO?) with no outside work, and he told me he billed $240k the previous year, with a similar setup and 30% overhead. Extrapolating that to someone who sees twice as many patients, it's not hard to imagine netting $300k in FM. Doctors in AB do have a more favourable fee structure than elsewhere (https://edmontonjournal.com/news/local-news/alberta-physicians-remain-nations-highest-paid-statistics-show). I'm told that FM in Edmonton and Calgary is now saturated though.
  4. insomnias

    2019 CaRMS unfilled spots

    I don't understand why no government/licensing body has considered this: require all medical schools to give their medical students an R1 spot if they can't match. At the end of that R1 year, they can receive a restricted license (permanently restricted unless they complete a CFPC/RCPSC/ACGME-certified residency) to practice as generalists in rural/underserved areas (+/- lower the amount they can bill) but retain access to the second round of the match as current physicians (who've completed a full residency) do. Yes, there's the argument that rural areas will then not be receiving proper care, but if it's a slightly less trained doctor vs no doctor, I'd say that's a no-brainer... especially when you're willing to bring in NPs, who get substantially less clinical training, to those same areas. In that way, you make the CFPC happy (family med retains whatever prestige they got when the rotating internship went away), you make the rural areas/voters happy (they get Drs), you make the people who'd otherwise go unmatched... well, less sad (earning $$ with the potential to enter the second round >> accruing debt with the potential to enter the second round). It's basically a compromise between bringing back the rotating internship (which the CFPC would be heavily against) and doing nothing (which results in unmatched grads). There is, of course, the argument that doing so would make the R1 year a de facto requirement as programs might elect not to fill seats in the first round to see what they can get in the second, but I haven't seen that being a problem in the US, where you can get an unrestricted license after an R1.
  5. insomnias

    CBD = shorter residency?

    Yeah, discussed here http://forums.premed101.com/topic/88075-competency-based-residency/?do=findComment&comment=972076
  6. If you wanted to estimate training costs, you would look at what training an NP has to do to get licensed. Presumably there's a clinical component. Figure out how many hours an NP spends in a class vs clinic and what kind of rotations they are. If they're comparable to the rotations residents do, you can just calculate the $/hr on training an FM resident and use that same figure
  7. Honestly, as long as you have PR or citizenship, nobody cares where you grew up (exception: you're basically ineligible for any spots reserved for rural applicants/in-province @ schools outside your province of residence). If you don't have PR or citizenship, you're basically limited to those schools which accept non-Canadians. Iirc, that's Queen's, McGill and Toronto, at something like $100k/yr CAD.
  8. Here's what I've wondered: why not just go to the US, where they're in demand? Certainly, there's a decent number who are stuck in Canada for personal reasons; however, I don't see why the unattached wouldn't just move south. Ortho here is PGY5; to qualify for the US boards it's 5 years, so...
  9. I know that it's happened that doctors get licenses here/in the US despite having been sanctioned in another jurisdiction. I just don't understand how. The Colleges here seem to ask for certificates of good standing from everywhere you've worked, so...?
  10. insomnias

    Cap in number of Electives

    What does that mean exactly? That you're only allowed 8 weeks of research, that if you do research in any field it counts towards 8 weeks in that field, or that research is a way to circumvent the 8-week cap...?
  11. Wouldn't they ask for a certificate of good standing..?
  12. Back when I applied MD/PhD to Toronto, I got an email inviting me to an MD interview, but no info on the MD/PhD. I emailed them back, and they told me I'd also been offered an MD/PhD interview, so they rescheduled my MD one so I could do them both in the same weekend. Consider emailing them?
  13. It seems like to work in an ER without a +1 or FRCP-EM, you need to be somewhere pretty rural -- as in, 2 hours away from the nearest place with a population > 50k rural. To qualify for the practice-eligible route to EM, you need to spend 400h/yr over 5 consecutive years and then pass the CCFP-EM exam. The CFPC and ABFM have reciprocal agreements, and you can take the CFPC exam after your ACGME-approved FM residency provided you meet the requirements listed in https://www.cfpc.ca/Application_and_Requirements_for_Residency_Eligibility/ . You should then be eligible to apply for a +1.
  14. I don't know a lot about how much surgery makes/if they have to pay overhead/how long their residency is, so I'll assume they make 400k pre-tax/overhead, 30% overhead, and the person is a superstar and gets a job right out of PGY5. Their LOC is $124.9k, and they have $280k pretax => after-tax of 158.8k - 184.7k (QC - NU). Obviously they could pay that off in a year, but assuming they pay it off in two, that's roughly $65k in payments each year, leaving them with ~93 - 119k/yr to spend otherwise. If we assume that a doctor in QC works for 35 years after medical school (including residency) before retiring, requires 35k/yr to survive wherever they're living (big if; I know we'd want more) and invests the rest at 6% in some index fund, then at the end of a 35-year career, a FM will have saved/made $5.3M, whereas a surgeon will have made $9M. The surgeon surpasses the family doctor pretty quickly since they hit their peak income early on. You'll lose a lot of this to taxes, and a lot of these assumptions fall through (I think it would take until PGY9-10 to get a job as a surgeon; I think most would accumulate debt during residency; I don't think living on 35k/yr for the rest of your life is unrealistic), but that's why I've attached a spreadsheet so those interested can model this with their own numbers. For those who dare to dream, here's a graph: Note that I redid the numbers in my earlier post and found that a FM would have to pay more like 60k/yr to pay off their loans in two years (hence I assumed the person needs 35k/yr to survive). Modeling physician salary and debt.xlsx
  15. Let's say you take out 25k/yr over 4 years of med school and take out nothing during residency. You put all the interest (3%) on your LOC. You end up with ~107k in debt at the end of med school, and 114k at the end of your 2-yr FM residency. Now you're a staff FM, earning ~220k/yr. You lose 30% to overhead = you have 154k left. Your after-tax income is between $98k (QC) and 112k (Nunavut -- but this probably comes with higher COL lol), assuming you don't deduct anything. That's less than your actual debt. If you want to pay it off over two years, well, you'd make a total of 196k - 224k over two years, but that leaves you with 89k - 114k over two years (44.5k/57k per year), ignoring the amount that your debt would grow over that additional year. It's certainly doable, but it's not a lot of money left over to live + save with -- don't forget you fund your own retirement and health insurance now. Furthermore, that calculation didn't factor in the cost of CMPA fees, licensing fees, disability insurance,...
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