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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. Healthcare workers are superspreaders. We work with populations most likely to die from the disease. This isn't time for some hero-martyrdom complex bullshit; that's how vulnerable patients die. If a patient is suspected to have coronavirus on a service where the patient has to be seen relatively closely by an attending, and the patient isn't immediately dying in front of you, I would argue residents have a duty to request staff see the patient instead.
  2. Curious, was your program supportive of your leave for 2-3+ years? I understand you are a ED physician, which is a field that is supposed to have plentiful jobs everywhere (or at least relative compared to many medical/surgical specialties). Did you feel like it has added much value to your work or finding a job?
  3. Quota & # 1st choice specialty rank still probably makes the most sense for assessing competitiveness. # Unique applicants is a pointless measurement. If I wanted IM, I would want to know how competitive it is amongst 'serious' applicants, i.e. those who rank IM first. I don't want to look at data that includes the guy who ranked 7 different specialties in Toronto, or someone who backed up with IM.
  4. You need to check if there have been any applicants who have matched to plastic surgery at all after 1 attempt before attempting to pursue it anymore. I suspect for plastics that doesn't happen much or ever. I would recommend family medicine.
  5. Unless the program explicitly said "OP you are our #1 candidate" or something along those lines then I don't see it as a lie. It's just social etiquette that we all have to play along with; no different than how we talked to our 'back up programs' during interviews. Of course I don't think this behaviour should be encouraged, but frankly applicants should realize that there is no reason to change their rank decisions based on someone telling you they like you. Programs objectives: #1 Fill all spots with adequate candidates #2 Avoid all potential trouble residents Every program has had or has heard of a horror story of a resident and will do their best to avoid such a situation. For extremely small specialties (e.g.1 residents/year) this becomes exponentially more important since the loss of 1 resident in a year is a loss of 1/5th of all your residents & call pool. Programs do not have much to go on for applicants outside of direct interaction during electives, thus even the potential for a significant deficiency/red flag may lead to a program not ranking you (e.g. going through CaRMS a 2nd time, failure on MSPR, terrible interview, unprofessional interactions during socials, poor elective performance, likely desire to switch out, etc.).
  6. It could be that the program wanted those from other schools. Tbh there's no real way to know unless you were a part of the ranking process or it is extremely obvious somehow.
  7. Hahahaha why??? Them liking you should have no effect on how you rank the programs. In my experience a lot of applicants misinterpret nice emails and phrases. "You are a strong/great/top/wonderful/excellent/exceptional applicant" = you could be anywhere between 0-100th percentile of ranked applicants on their list. Yes but I didn't let it affect my rank decision one bit. If I received something like that, the only assumption I made was that I was at least probably ranked somewhere on the list. An an applicant I was used to saying how every program was a great choice, wonderful place to live, etc. It wasn't completely untrue, since on my entire rank list even the most middle-of-nowhere programs in my specialty I ranked higher than the dozen of FM programs I had ranked as well. Thus when I would read/hear programs telling me those sort of things, I could tell they were just being nice. But let's say that they were being genuine. Why would that at all change how you rank them? The system favours the applicant, so programs will do their best to try and make sure they don't have unmatched spots.
  8. I'm doubtful on making less per hours worked unless you're talking exclusively about cardiology/gastroenterology/ICU. None of the other factors you've mentioned are recent. If anything the last few years were abnormally competitive for surgical specialties; in the past there were often spots left open here and there even in competitive surgical subspecialties. This one year may just be a return to past trends, or just an anomaly. 2015: 2 gen sx, 3 ortho, 1 ENT, 3 urology, 3 neurosurgery, 1 cardiac sx open after 1st iteration 2014: 5 gen sx, 7 ortho, 2 ENT, 1 ophthal, 4 neurosurgery, 2 cardiac sx spots open after 1st iteration 2013: 5 ortho, 1 ENT, 1 uro, 6 cardiac sx open after 1st iteration etc.
  9. Surgery: You can pick almost anything. Most useful are general surgery and orthopaedics but most programs already have default blocks in those areas (or significant medical school exposure). After that neurosurgery, vascular surgery, thoracic surgery, and urology are probably best to pick from. Medical: Respirology, neurology, radiation oncology.
  10. For small/moderate differences in residency lifestyle I agree it's not worth basing your decision of residency off of. For absolutely massive differences like pathology/psychiatry vs general surgery, then it's worth thinking about. The difference is putting your life on hold x5 years vs being able to live some of it freely (e.g. being able to start a family vs putting it on hold).
  11. Vascular has had 1-2 spots unfilled in the previous years, this isn't out of the ordinary. General surgery has typically had a few spots open prior to 2017 so this is just a return to the norm. Mainly it was orthopaedics that was abnormal this year. It could just be a statistical blip, or maybe the reputation for a poor job market is catching up to them. UofC FM is unfilled because of unfavourable legislation towards doctors trying to limit where you can practice.
  12. Surgical: 3 General surgery spots, 1 vascular, 2 urology, 5 ortho spots. Some are in reasonable locations (UBC, Western, Alberta). Medical: 8 IM, 1 neurology, 3 PMR. Mostly less desirable locations or have ROS attached. Lots of FM/pathology & lab specialty spots. Orthopaedics seemed quite uncompetitive this year compared to previous. I wonder how many people will choose orthopaedics in the 2nd round given that it is a completely different world compared to most other surgical specialties and has a reputation for a difficult residency and poor job prospects. Vascular is about the same as before. Unsurprising. It is an excellent specialty when considering lifestyle and freedom to find a job, and can be a high earning specialty doing certain kinds of inpatient work.
  13. Hours/call: For IM residency 9 hour work days starting at 8am. During call you often work most or all of the night but will always take a post-call day. For general surgery residency 12 hour days starting between 6am-7am. Call shifts more variable in that some nights you'll get more rest. Post-call days are variable as well: there is a culture (worse at some places) of not taking post-call days if the night was light or if there's a significant lack of manpower/assists the day after. Stress: Worse in general surgery. It stems from the culture, the fact that you work in close proximity to your attendings, and the fact that for ORs overnight, you will have to call them in. Lifestyle flexibility: Variable across institutions but in general it is not very flexible in general surgery because it is a smaller program than IM. For IM there are usually more residents around and the culture is usually a bit more amenable to lifestyle flexibility/starting a family. Overall it's worse in general surgery residencies. Hard to comment about the call and stress in surgical subspecialties, but the hours and lifestyle flexibility are worse across the board due to the nature of when ORs start/finish and how small the programs are.
  14. It counts but I would imagine if it counted that much it would have got them in the 1st round. Being the PD's nephew is different than being the R2's thrice removed cousin.
  15. We will be shielded somewhat since our system focuses more on cost savings rather than profit. In the American system someone ordering unnecessary tests and consults is encouraged because it generates more billings for the hospital. Administrators realize this which is why midlevel expansion has been much slower here. My worry is that public opinion and politicians will be the ones who make the end decision, not the administrators who can see/understand the numbers. The general public doesn't care if a doctor works 80 hours/week after 8 years of training at 80-100 hours/week—all they see is that the doctor has a bigger dollar/year figure. The fact that a midlevel is less efficient is actually perceived positively by patients since they get more time with their medical provider. And because nurses actually collaborate/unite instead of ripping each other up like doctors do, they can maintain a good PR machine while doctors are picked apart villified by the media.
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