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ZBL

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ZBL last won the day on November 14 2018

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About ZBL

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  1. I agree that a PhD is not necessary to match, but it’s certainly not detrimental to have one. Matching is 100% NOT a reason to do a PhD though. I have noticed that some specialties/programs seem to have more PhDs but whether that’s the program selecting them, or the PhDs wanting that program I don’t know. Check with your specialty/local program I guess to see if/how many of the residents have done grad degrees. Either way, people match to every specialty without grad degrees so I wouldn’t worry about that aspect as much as I would impressing on electives and interviews. CaRMS will happen the way it’s supposed to happen.
  2. Agree with this actually. Or do research on the topic. You don’t need to be a doctor to know what makes someone attractive or how humans perceive beauty. 1. Have some decency. You’re not even in med school yet. IF you get into med school, I urge you to actually spend time shadowing a variety of specialties to see what you like and don’t like before deciding. Chances are you haven’t a clue what a plastic surgeons life as actually like. 2. If your primary goal out of med school is aesthetics, you will severely, greatly, absolutely, and regrettably HATE going through absolute hell of med school, residency, fellowships and getting practice started in cosmetics. I don’t care why people go into medicine, or what specialty they choose - everyone has their own reason, but for your sake I hope it’s more than just cosmetics. Everyone thinks cosmetics is la-dee-da hang a sign and now you’re Beverly Hills chillin’, but it’s seriously an absolute grind. The money involved in setting up a fancy private clinic, the time it takes to get a decent patient load, and the hours involved in clinic, surgery and managing your business is no joke. That’s to say nothing about being able to carve out a niche in already saturated big cities 3. Chill. Plastics chooses you, you don’t choose platics. If they want you, it will work out that way.
  3. And that's a perfectly good reason to pursue ENT. But why are so many interested in it before they even know what it is, like on day 1 of med school? Derm and plastics everyone knows in the public realm, but ENT is not really "known" outside of the medical community.
  4. That’s a specialty I never understood. Super random discipline, not glamorous/publically known, decent hours for a surgical specialty but it’s still a surgical specialty, very good pay but not crazy high, yet tons of med students are 100% ENT gunners from day one. I think it’s a good specialty, but it’s competitiveness confuses me.
  5. While this is a fair anecdote to bring up to show that things can work out well with multiple competitive application disciplines, to be equally fair it should also be noted that this occurrence is not particularly common - lightning strike as you said. CaRMS data indicate that not a single person matched to ophtho or derm as their second choice discipline in 2017 or 2018, and that generally applicants matching to ophtho or derm have at least 3 electives in that specialty. I think it’s more likely that you’d go unmatched than end up in a different competitive specialty as your backup, but obviously as Bambi has described there can be exceptions to the rule.
  6. I think you already know what adcoms will think. Splitting your application between derm and ophtho is risky to say the least, especially if you will have electives in both and research in both. If you’re set on ophtho, go all out: do the research, do the 8 weeks electives. But do the remaining electives in something else to distance yourself from derm. Something like ENT to show your surgical commitment, rheum for the interesting inflammatory stuff, ID etc that generally relate to ophtho. Elective caps may be for the better, but unfortunately splitting your application between 2 of the top 3 competitive programs is really unwise in today’s CaRMS environment.
  7. No, for full-time university academic staff they usually have an alternate payment plan with the university/health authority. So, there is no billing per patient but rather a true annual pre-determined salary that includes a mixture of clinical time and research time. This is partially why you will often see academic physicians seeing more complex cases or taking longer per patient - because their income is not dependent on an extra procedure here or there, or taking 10 min vs 15 min per patient. In terms of dollar figure, it’s highly dependent on specialty. These types of positions are extremely rare in surgical specialties since doing 70% research in a surgical discipline is not likely, which doesn’t give an incentive to the university to pay them through that model. The exception is neurosurgery and cardiac surgery where an academic centre is basically required for their work, but I’m not sure if that’s a university thing or health authority thing. In medical specialties it’s in accordance with typical billing, as in a interventional cardiologist will get paid more than an intensivist who will get paid more than an endocrinologist. Usually, the salary is lower than what billing’s would be for that specialty outside of academics, but it does usually have some perks: no or little overhead, admin staff provided for you, paid vacation, and pension - not to mention getting paid very well to do research as your primary job. Over a career, these things may help balance out somewhat with an average biller in the same specialty outside of academics but of course the ceiling for what you can possibly earn is higher outside of academics as well. The downside is that most clinician-scientist jobs now expect a PhD and a fellowship or two. That’s a lot of years of accumulating debt and lost/delayed potential clinical income. Estimates I have seen have been about a $2 million opportunity cost for clinician-scientists.
  8. If a competitive specialty is on the radar, then I’d suggest a 4 year school. Since you mentioned no surgery, this essentially means derm and EM since the next most competitive non-FRCSC programs are Anesthesia and Pediatrics which you can match from anywhere. Same for EM and derm and other competitive surgical things, but for sure in the case of derm/plastics/ophtho more time gives you more time to build a stronger application and connections which is critical. In terms of research/technology, don’t put so much stake in Toronto and UBC. No doubt they are good in general and even have some world-class things going on, but so do every other Canadian University and Toronto/UBC are far from the leaders in R&D for every specialty in medicine let alone domains of science. An MD does not train you to be a world class scientist anyway, so don’t worry about it. Having a few research opportunities is really all you need. Tuition is also an important consideration, as is location as you already know.
  9. ZBL

    Going unmatched

    I meant more in the sense that it is statistically unlikely that most Canadians taking the USMLE will do well enough to be given a second look for most competitive specialties in the US. Therefore, when planning to write the USMLE, it’s unreasonable to do so with the expectation that you will automatically be able to apply to any specialty you want in the US, other than lesser competitive things as backups. This comes back to my point further down: anyone who can match something competitive in the US can absolutely match something competitive in Canada, not the other way around. Derm, plastics, neuroSx, ortho are infinitely more competitive in the US by nature of the extreme USMLE scores needed, emphasis on coming from a good school, and way higher research expectations. The US is NEVER a backup option for those things - it’s not just another flip of the coin.
  10. ZBL

    Going unmatched

    My philosophy on the USMLE during med school is dependent on specialty of interest and reason for applying to the US. Reasons to do the USMLE: - If the US is your first choice place to match - if you are worried about going unmatched in Canada and wanting some backup FM/IM options in the US (may be less important if you are aiming for something less competitive in Canada to begin with) - if you are interested in a specialty with poor job prospects in Canada - you want to work in the US one day but not sure what state or the rules note the above all require diffetent levels levels of success on the USMLE Reasons to not do the USMLE - you are using US applications to a competitive specialty as s back up - anyone who can match something competitive in US should easily be able to do so in Canada (I.e. plastics, derm etc in the USA ARE NEVER a reasonable backup plan). - you have no intention of ever working in the US or figure you’ll cross that bridge if/when it comes up - you are confident in your Canadian match chances or just don’t give a damn
  11. I agree. There is a balance to be made for sure, which is very individualized to each person and their situation. I just discourage living in misery lol. Beyond that, make a spreadsheet!
  12. Another devils advocate comment here. Frugality can be good at times, and yes you shouldn’t let your spending get out of control. But don’t forget that you are spending the prime years of your life in a classroom, ER, or some crappy call-room while you work a stupid amount of hours each week and miss out on friends, family and your own youth, the thought of which would make most normal people vomit. That trade off should be rewarded - not deferred to 30 years later. The one thing most med students do have going for them is their health. 30 years later, who knows what your situation will be. Spend money to eat properly, buy things that make you happy now, do fun things with what little free time you have. Saving everything for the future is risky just as well in my opinion. If it’s a difference of even 80K at the end of residency, my personal opinion is who cares? 6 months more to pay it off is meaningless when you’ve been in school for 10+ years with a (hopefully) 30 year career ahead of you. There’s a difference between living, living well and living extravagantly, and there’s no reason a med student/resident should be forced into just getting by on the bare minimum cost. PS I also think reasonable mortgages CAN be a good idea in the right circumstance. Not a clear cut yes or no though.
  13. Now you’re thinking like a Toronto/McGill resident!
  14. To play devils advocate (and in actuality I’m not suggesting one way or another as only you know your financial situation), but even if you did spend more each year on a nicer living arrangement, car, clothes, vacation, a nice bag or whatever etc - your LOC might be 30-60K higher at the end. That sounds like a lot, but as a staff physician that extra 30-60K probably won’t make a huge difference. It all comes down to balancing what you are comfortable with and capable of in terms of expenses vs what you need to be happy, de-stressed and the convenience factor. None of us here can tell you where that sweet spot will be for you. But it if you really want to save money... - downsize your apartment/house and get roommates or live with parents - ditch the car and bike or take public transit or Uber - map out what restaurants have chicken wing deals for dinner - only go for coffee when residents or staff are going too - staycation on time off
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