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About 1D7

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  1. 1D7

    McMaster or Western?

    There are some people who have known what they wanted early and stuck with it all 4 years, but there are just as many who switched in M2 or M3 (in my 4 year med school). This wouldn't have been possible or would have been much harder in a 3 year program. You're picking a specialty you'll be working in for the next 30-50+ years. If you're 100% sure you know what you want to do, then sure shaving off a year is awesome. For me, coming from a non-med family, the extra time was very important in deciding my specialty of choice.
  2. 1D7

    Applying to Radiology Q!

    In general I'd advise someone to spend essentially the maximum number of weeks in their specialty of preference if it's truly your top choice. Programs across the country can be very different and doing more electives helps the applicant decide how to rank programs. Anyway, to match FM I advise at least 1 elective. With 1 elective you should be able to obtain 1 interview at your home school and maybe a few in sites that are traditionally less competitive.
  3. As far as I know there are only a few cases of hospitals replacing their anesthesiologists/emerg docs with CNRAs/PAs. It's a few cases too many and it does appears to be on the rise, but outright displacement still isn't too common yet. In America most hospitalists, anesthesiologists, and emerg docs have allowed themselves to become employees of large hospital systems and corporations so they have no real control over anything anyway. With increasing healthcare costs, there is also increasing pressure to increase efficiency and midlevels are a great way to do that. On the floor, there are plenty of patients with chronic dispo issues that residents/attendings don't really want to deal with. In clinic, having more warm bodies always helps. Basically having someone who can function at the level of a resident long-term is beneficial and makes teams more efficient. On a financial level, seeing more patients = more money for the attending. Anyway it's not really an issue physicians can oppose; doctors are rarely a united group (see OMA). If hospitals want midlevels and there's a school churning them out, then they will eventually come. To oppose it would need docs to unite, take back hospital leadership/admin, lobby effectively... essentially things that are unlikely to happen, especially since the problem of displacement may never even happen in Canada.
  4. Well mid-levels proliferated in the first place because physicians in America realized they could make more money supervising PAs/NPs (see anesthesia, primary care) or delegating tasks to them (see surgery), rather than seeing patients themselves. They do make the services more efficient, so a mid-level functioning at the 'mid-level' is actually good for everyone. It's mainly a negative when they push for autonomous practice, which frequently seems to be the case because their own schools/programs tell them that they receive equivalent or better training to doctors lol.
  5. 1D7


    1. Interest: Sure not many people know of ENT before medical school, but since it's competitive many people hear of it early on. 'Sexy' ENT procedures make a huge impression on M1s and M2s; watching a laproscopic cholecystectomy usually isn't as exciting. Things sometimes change during clinical years, when students realize the day-to-day isn't that exciting, but by then there's already a lot of time, effort, and 'identity' investment into the specialty. 2. Perceived prestige: It's highly competitive so it becomes even more attractive to this subset of students. Students who prioritize lifestyle more have already self-selected themselves out. 3. Job availability: Students applying to competitive specialties in the first place generally value #1 and 2 more. Plus, this is hard for students to gauge. Basically everyone basically tells you it's getting better. Even orthopedics fellows doing their 2nd fellowship told me the job outlook in their specialty was improving. 4. Pay: Separated from perceived prestige, not a deciding factor in and of itself for most students.
  6. 1D7


    In my experience students choose specialties based on factors in this order: 1. Interest 2. Perceived prestige (and/or lifestyle, depending on the type of student) 3. Perceived job availability 4. Pay Interest is driven by the day-to-day work (patient population, procedures, work culture, etc.), prior exposure, and strong mentors. Perceived prestige is influenced by the CaRMS competitiveness and correlates with pay. The students who don't care about prestige generally value lifestyle instead. Job availability is self-explanatory. Money itself, separated from prestige, is usually not a deciding factor. To answer your question, with regards to CaRMS statistics you have to first understand that there is a lot of variability because of how small many of these fields are: 10 more people applying one year can almost double competitiveness in ophthal for example. There are 1000+ students applying to FM each year; it only takes a small trickle to rock the boat. IMO plastic surgery's competitiveness is driven largely by the first 2 factors I listed. There is a lot of potential interest in it from day 1 since it's a well-known specialty and procedural. Its competitiveness has reached a point where it draws in more students than pushes away since it adds to its exposure and perceived prestige. Students applying to competitive specialties put less emphasis on job availability in the first place (unless it's known to be exceedingly horrible for some reason, like cardiac surg). With regards to pay, most students categorize it into something like "really good, good, not great" and both specialties you mentioned fall into the "really good" range. Reported specific numbers often do not capture many important details, like differences between practice location & setting, patient population, private billings, etc.
  7. 1D7

    Whats the point ?

    You're catastrophizing. Mostly it sounds like you shouldn't apply to medicine if you can't handle uncertainty, risk, and hard work. For everyone else out there, AI isn't going to replace any doctors. The tech field tends to over promise and under deliver when it comes to the field of medicine. EMRs are mostly terrible. Breast cancer detection algorithms in mammography have a negative impact on patient care. IBM Watson has been a complete failure. If physicians in any field could be replaced, most of society would already look drastically different. Don't buy into the hype.
  8. Well something that has changed in the recent decade is the reduction of clinical experience students actually get during their M3 and M4. There's more medico-legal and administrative oversight so students for the most part are writing fewer and fewer orders/Rx's. There is a lot less hands-on experience nowadays too—younger attendings routinely mentioned they had completed 20-50 deliveries by the end of their OBGYN rotation, while most of us in M3 had 1-10. And from the student side, there is a lot more anxiety surrounding finding a residency position today, leading to strategies/behaviours from students that maximize matching sometimes at the expense of clinical learning. I wasn't around back in the day, but my gut feeling is that someone coming out of their rotating internship/R1 back then had a lot more clinical experience than someone finishing R1 now.
  9. Don't really know, but there's 4 spots for it from IM across Canada (2 anglophone).
  10. Mostly more people backing up and a reduction in back-log of applicants thanks to the "3rd iteration" last year from the military. Increase in tendency to back up is due to the large cohorts of growing unmatched students, plus schools doing their best to scare students.
  11. I don't think anyone can truly give you a good answer. When you go through clerkship you'll have plenty of chances to see how your personality plays into your performance.
  12. OP what you feel is completely normal. I grew up in a lower-middle class family and most of my friends are not in medicine. Over my 4 years in school, I didn't meet many people I liked—I had no desire to have any interaction beyond work with 90%+ of the class. Most are not bad people, but as you mentioned, fundamentally their social interactions are different because of their socioeconomic background. Typically, you will not enjoy their company much, and they will not enjoy yours. My personal recommendation is to avoid them altogether and find friends outside of medicine (see suggestions made by other posters).
  13. In my experience, the variables least affected by socioeconomic factors are GPA and MCAT. ECs heavily favour those who come from well-connected backgrounds—this is self-explanatory. Interviews also favour those from well-connected backgrounds. Aside from the fact that they have more impressive ECs, those who are well-connected have often already internalized language that conveys professionalism and maturity. Overall while I think ECs and interviews correlate with socioeconomic factors, I still think they are good discriminators for dedication and communication. This isn't just medicine. Back in the day, my friends who were applying to careers in finance and law had the very same issues, though much worse due to an increased emphasis on resumes, interviews, and connections. It's just a fact that life favours the well-to-do both in unfair ways (e.g. nepotism) and fairer ways (e.g. knowledge of important skills and traits conducive to making them a better physician).
  14. 1D7

    Unique Situation

    Might not even be high reward. Someone from high school might end up hating medicine even if they found a spot.
  15. That's surprising. Just browsing around medical microbiology program descriptions, most seem to have only 2 years of clinical training (1 year general, 1 year ID).