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1D7

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1D7 last won the day on October 16 2019

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About 1D7

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  1. It's a realistic take on things given how things are moving. For family medicine residency education has moved away from that (and is moving further). Many programs no longer have any surgical exposure during residency, and a part of that is because most FM residents and attendings don't feel there is commensurate value in learning how to mostly do surgical floor work/consults in exchange for an exceptionally bad lifestyle for 1-2 months. I believe this is in part due to the personality various specialties attract and also because modern medicine has reduced the autonomy of residents. E.g. In the old days a pathology resident rotating through OB for whatever reason was expected to catch babies. Nowadays the nurses won't even bother calling you even when you leave your pager # up on the board. If you want to be first assist, or deliver babies, or put in chest tubes, you have to be highly self-directed because there are plenty of other people who are eager to learn and are easier to teach.
  2. I agree! But the 'option' of being a bit less pleasant or more assertive is generally more accepted coming from a surgeon than family doctor for example, just how it is.
  3. Sounds reasonable. I don't really know how stable being a vet is, but with the current down turn everyone was hit hard. Though I agree typical outpatient FM is one of the most stable jobs, it's hard to beat it in that respect. Sure in some specialties maybe you can take on a more assertive demeanor, but not in family medicine. Aside from the ER (which are often manned by family docs), family medicine probably has the highest proportion of people who treat you like you're serving a burger. There is no end to overly demanding patients with inappropriate expectations. Plus in general while you don't have to be nice to survive, you need to develop a therapeutic alliance with the patient to do your job. Medicine is very competitive. I know veterinary school is competitive, but there's some self-selection at play. You may not be able to enter into the medical schools close to you unless you're already an exceptional candidate (in terms of grades/MCAT/other entrance reqs).
  4. Schools that still use(d) grades have a competitive environment. In my time I believe the only schools that use grades instead of P/F were Quebec schools. I would say a hypercompetitive environment is rare in P/F schools, though a few people here and there may have some issues in clerkship.
  5. Research is definitely advantageous for IM. Sure you probably will match without it, but most people care a lot about where they end up, whereas in the most competitive specialties some people are happy just to match at all. It may sound melodramatic to you now, but the difference between matching to your #1 vs #3 program or #2 vs #5 program will feel vast (other than for program/ego reasons, you may live much further from your family/SO than expected). Spending a bit of time working in your summer can mean the difference between getting an extra interview or not, which ultimately may affect where you end up. For FM it definitely matters less. Though as a M1, maybe you'll end up wanting to do a specialty where research is traditionally considered a part of the application or even if you don't want to do the most competitive specialties, it definitely helps for the specialties in the 'mid' competitiveness range. I've gone through CaRMS (the above 2 posters are still medical students) and have seen my old classmates go through it. IMO it's worth working a bit harder to maximize your chances to match where you want.
  6. Talk with your school's faculty (the people who usually meet with students and give advice) and upper years. Usually they will give you advice on establishing a working relationship with someone, or put you in contact with someone that does.
  7. It's only important if you plan to work in the States or if you pursue a few certain surgical subspecialties which have exceedingly poor Canadian job prospects. The vast majority of specialties do not have any need to do USMLEs for the purpose of finding a job. For fellowship, a few fellowships require the USMLEs but most do not. If you want to keep every possible option open, then you should write it. There are many good/prestigious ones that do not require it though.
  8. Depends on the school. At my medical school and residency (different institutions) students help round & do consults. Someone late or missing for a while would definitely be noticed and it would affect their evaluation... enough absences would definitely affect someone's ability to pass the rotation.
  9. IMO it's personality dependent. I would lean towards not doing medicine because of the heavy upfront investment needed (aside from financials, you need 4 years of medical school and 2 years of residency training, during which you may have to relocate and may want to relocate again as an attending). Plus it sounds like you want to avoid stress, death, and responsibility, which are to some extent unavoidable with medicine. You hear very split opinions on family medicine because there are very varied experiences. Some people get hired right away in a good practice where they did residency and are able to be efficient, making good money as others are alluding to here. Most move around, locum for a while, or maybe even take a bit of time off for kids (reducing their income). A few have horrible experiences where got sued in residency/as a junior attending or just hate their job. There was a recent poster who seemed to really dislike it (quoted below). While I don't think the quote below is representative of the average family physician (or even a good argument against doing FM since other specialties have higher rates of being sued), it does show that some people end up disliking what they do because of the anxiety/stress that comes with working with patients.
  10. I wouldn't bother changing floors/specialties for the sake of medicine. Interviews: I doubt nursing experience in one area vs another will be more valuable than another for medical school adcoms unless there was some personal/deep underlying reason to it. It might help a tiny bit for residency interviews if you can talk up your nursing experiences... but that 3-5 minute spiel is probably the extent that it could be useful for residency interviews. Networking: It's unlikely you're going to meet with the PD of the residency program. Even if you make it a goal to do so, in the time you meet anyone and interview for residency, that's going to be ~4 years. The PD may have changed by then and most residents you've met have graduated. Even some of the nurses you work alongside may be gone by then. It's a longshot that it would be helpful here. Clinical: It might be a bit useful in terms of knowing common medications in that specialty while you are in clerkship or shared procedures between medicine & nursing. I know sometimes pharmacy->medicine students look pretty sharp when they know everything about the medications we want to give. I doubt it will be helpful for residency and beyond. In all the situations where it could be a bit helpful, that assumes you end up pursuing the specialty you work in.
  11. For in-house call, it will be 24-26 hours (i.e. start of your day, which is around usually 7-8 to the next day around 7-8 plus handover taking 1-2 hours). On some services you will work a few more hours handling busywork, typically until noon, meaning ~28 hours. If you are doing home call like I said you may just continue to work, or you may get a post-call day depending on how much you worked overnight and the culture. Rarely there may be some sort of special evening shift for some services which is also referred to as call but does not last nearly as long as a typical 24+ hr shift. If you are doing nightfloat usually you get blocks of X hour shifts overnight.
  12. I made a math mistake in my post above in terms of how many call shifts/month (1 in 4 looks like 7 or 8 call shifts per full block). Friday+Sunday is a combination that happens frequently, but other than that it's fairly random, meaning it may be spaced out or may be grouped together. In terms of scheduling, you're at the mercy of whoever is making it (usually the chief residents or designated staff). Usually call switches are arranged between residents, though sometimes they will send out preliminary drafts for you to request for a switch from the scheduler directly.
  13. 1 in 4 = 1 in 4 days for residents. Usually this is an average of number of call shifts/month, so you may be doing something like 4 call shifts in a span of 8 days but because it's looked at over a month, that's considered ~1 in 7. For staff it's a bit different since they are often referring to weeks, e.g. 1 in 4 weeks. Home call vs in-house call will determine the stipend you receive for each (it's marginally more with the in-house call), how many call shifts you can receive in a block (1 in 4 for in-house vs 1 in 3 for home), and the rules governing your post-call day (you not supposed to work post-call for in-house call). The numbers I posted may be different for provinces other than ON. For some specialties you are expected to be able to go home during home call, while for others it's in name only so you can consistently work post-call.
  14. Terrible news. Not much anyone can do against someone who's bent on murdering you, which this guy sounded like he was. If someone gets close to you with a big knife, you're basically done. Best you can do is position yourself so you can readily attempt escape from bad encounters.
  15. For the medical students out there, you are only opened up to being taken to court if there are 'damages', AKA a bad outcome of some sort. That is the basis for why most inpatient physicians, including obstetricians, emergency physicians, radiologists, neurologists, and surgeons are sued at higher rates. These sort of specialists see sicker patients and are much more likely to be involved in bad outcomes, even if they didn't do anything wrong. On top of that, inpatient physicians are the ones performing more invasive procedures. A surgeon will have bad wound infections and dehiscences. A radiologist will have pneumos post-lung biopsy. And it's pretty easy to see why OB is the most litigious field in medicine. For many specialists these sort of things don't happen '5 times in a life time', many procedural complications happen weekly/monthly/yearly. This is a lot of 'the grass is greener on the other side' sort of thinking.
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