bentobox1234 reacted to rmorelan in Controversial Topic: Physician Misconduct Regulation
yeah me neither - if I had to guess probably not very. Not to mention the sheer humiliation factor (ok least say you do get back your licence and that would the only reason I could see anyone trying to do this. Would anyone actually refer to you? Would any hospital actually want to go near you? Even if in family medicine it would be hard to get away from things. Plus I am sure the college would be "aggressive" in monitoring you forever - they don't like to lose)
bentobox1234 reacted to ellorie in Controversial Topic: Physician Misconduct Regulation
He has a restricted license according to the CPSO - some sort of supervised practice arrangement. Unclear if that's related to this, or for another reason.
I'd see us in psychiatry as high risk - we work with really vulnerable people in very intimate, long-term psychotherapeutic relationships. If you haven't worked through your own "stuff" in one way or another, you tend to start acting it out with your patients, especially when your own life gets stressful.
bentobox1234 got a reaction from asthecrowflies in Controversial Topic: Physician Misconduct Regulation
Ok so. Sexual misconduct (such as this psychiatrist) vs sexual abuse.
In the context of psychiatry what's the fine line here?
And once no case could be made in front of the tribunal, what happened afterwards? I couldn't find anything about this Queen's professor on the CPSO website.
He seems to have gotten full tenureship though. Opinions on this?
bentobox1234 reacted to ralk in Most "competitive" Ontario Fam Med Programs
Queen's takes far more than 20 CMGs per year, they've got 56 CMG spots. Many of these are open to the military stream, but that's more a matter of classification, most will be filled by regular CMGs. Also, if you're trying to do an elective for Queen's FM, apply early or not at all. They have very few elective spots, if any, for non-Queen's students. Doesn't matter much for matching there, they don't put much emphasis on doing an elective there, if they care at all.
The most competitive FM program is Toronto, no question.
bentobox1234 reacted to hkmedic in Most "competitive" Ontario Fam Med Programs
Toronto is the most competitive program to get into. Toronto always fills up in first iteration because it's Toronto (many people with attachments to the city or wanting to live in the city). Ottawa has had left-over spots going into second iteration.
bentobox1234 reacted to asthecrowflies in Controversial Topic: Physician Misconduct Regulation
Definitely agree with the majority of your comments about bill 87 and the situation in Ontario.
For this case--I do think with regards to allegations and complaints, if it's a severe and substantial enough allegation that a physician has a restriction placed on license for sexual abuse (e.g. cannot care for patients of a specific gender/sex without supervision), the public deserves to know.
bentobox1234 reacted to ellorie in Controversial Topic: Physician Misconduct Regulation
I mean, it seems like the other alternative in that case was to compel the patient who brought the complaint to testify - and I would suspect (though there is no way to know) that trauma is grounds upon which her physician recommended that the College excuse her. If the College had sought a warrant to compel her to testify, the PR on that wouldn't have looked great either, nor would it be in the patient's best interest, so I'm not sure I'd qualify that as dismissing the case on a technicality. If there was no other way to investigate the case, their hands were kind of tied, and it would be the same in a criminal court.
It's a horrific breach of trust - I support mandatory license revocation, which is in place. The CPSO also often publishes the information from the disciplinary hearing in the medical register, so it's openly available when you look up that physician.
bentobox1234 got a reaction from Edict in Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?
I'm finishing a 4 year program. I'm a lot more cynical about some things:
1) the med school's administration, and how much they care about you as a person versus accreditation, or versus statistics (eg match rate)
2) whenever a study comes out about a new drug, or a new application of an existing drug, and it's in anything less than Phase II OR the study is sponsored by Big Pharma, I just tune out and go digging for the flaws.
I think 2) is a good thing and 1) a sad reality of life.
I'm still idealistic about the following:
1) advocating passionately for your patients will help them get that extra care in an overstretched healthcare system
2) the stories and the struggles of my patients who are so much more resilient than I ever thought a human being could be. I see them everyday while I'm on service.
bentobox1234 reacted to ellorie in Tips/tricks To Succeed In Residency?
I did a bit of both - I did far more teaching as a PGY2 because I was on service and also the only resident on the team. As a PGY1, most times on team, the senior would do most of the teaching.
I think what's useful is helping clerks with the mechanics of how to get stuff done in a hospital, as well as giving advice on things like CaRMS, how to book electives, how to look good on electives, things like that. As a PGY1 you're the closest to that and so have good insights to share.
When I am on-service now and I have medical students that are mine, I generally try to find out their learning goals/specialty of choice so that I can pick topics that will be relevant to them. I let them know that I want to teach them well, and that I want them to give me feedback about if my teaching style is working or what they would like to be different. I also try to make time to sit down with them every day, even if it's only 10-15 minutes. I have some topics that I have prepared that I can teach (mostly "approach to [bread and butter topic]" but I also teach around cases. If I see a patient with a particular finding, I'll make time to take the medical students and show them how to do that examination.
I also send clerks home early when there's nothing to do, and while I do get them to help with paperwork and scut (because as a resident, you need to know how to do that stuff), if it's the end of the day and there's nothing left but scut, I'll often send them home and just tell them to pay it forward when they're residents.
And, if they're good clerks (which most of them are) I'll make sure to highlight the good stuff they do to staff and make sure they get credit for helping out.
Just think about what you wanted from your residents when you were a clerk. For me, I wanted time/attention, positive regard, the sense that I was valued, and teaching that was appropriate to my level and career goals. And sometimes to go home a bit early. So those are the things I try to give my clerks.
bentobox1234 reacted to ontariostudent in What was your strategy when studying for the LMCC?
I just wanted to share my strategy for the LMCC since I ended up doing really well with what I consider to be very minimal effort.
First of all, doing well on the LMCC is about playing the game. The exam is not made to pick out the experts from those who aren't. Rather, it's about figuring out who is minimally competent. It's scored out of 900, with an average around 500 (the average reported with my score was actually 496) and a standard deviation of 100. A pass is usually 390. If you do the math the pass rate should be about 85% (lowest 25% fail), but if you look at the stats you will know that only about 2% of Canadian grads fail per year while 40-50% of IMGs fail per year (http://www.medicine.uottawa.ca/sim/data/MCC_Pass_Rates_e.htm). That means the bar is set REALLY low. It has been speculated many times that most of the people who fail are people who struggle with English.
With all that in mind, the first step in studying for the LMCC is to NOT freak out. Stay calm and don't overwork yourself because it won't be worth it. The second step is to keep in mind that they really aren't expecting you to know that much so if you find yourself analyzing what a question is trying to get at, you're overthinking it. Just take everything at face value and think of the question in the most basic terms. If they tell you a patient has lung cancer, don't try to analyze which type it is. Just take it for what they say it is and don't try to apply all that specialized knowledge you got in your 3 week Respirology elective.
Now, as for how I actually studied: First, I attended all of our (U of T) review lectures and I paid attention. For many of the topics (surgery and medicine) I knew that it would be my ONLY time going through the material so I made sure to listen and take notes. Second, I read each of these sections of Toronto Notes exactly twice each: OB, GYNE, Peds, Psych, Ethics, Pub Health. I also read ER and FM once each. I did NOT touch any of the surgical chapters (except if they were cross-referenced from Peds) or any of the medicine chapters. I highlighted and took some notes in the margins while I was reading. One other thing that I haven't mentioned is that I made sure to get at LEAST 7 hours of sleep a night for the 2 weeks before the exam and I never sacrificed sleep for studying. I realized that it wasn't worthwhile to choose studying over sleep, since I decided studying was so low yield anyway.
What I did not do: I did not take any notes outside of the Toronto Notes margins. I also didn't use any resources other than Toronto Notes. I did not pay for or use any question banks. Lastly, I didn't overstudy. I took my exam in the first few days that it was offered.
How long I studied: U of T has 2 weeks worth of review lectures. I would say that I read through the 6 TN chapters (the chapters listed above) once before the lectures began (let's say in the couple weeks before) and once in the 2 weeks of review time. Those 2 weeks are also when I looked at the FM and ER chapters. I never had time to read through the notes I took in the review classes. In the couple days before the exam I finished reading the chapters I mentioned above and I did some old exams that I was able to get my hands on for free. I also did the free LMCC on their website but that was weeks before I actually started studying.
In summary, I feel that I took a pretty relaxed approach to studying for the LMCC. I basically did the few free exams that I could get my hands on and I read a total of 6 TNotes chapters (4 of them I read twice, and 2 of them I read once). I also attended review lectures and I wrote the exam in the first few days that it was offered. During the exam I made sure to just take the questions at face value and I didn't overanalyze anything. I also didn't try to read into whether the questions were getting harder or easier. The most important thing is to take it easy and keep calm, because the pass rate is about 98% for CMGs. As I mentioned at the beginning I ended up doing really well on the exam and I think it was because of the things I mentioned above. Like everyone else, I thought it was a ridiculous exam and it was brutal to take. I'm sure the fact that I did well had little to do with my medical knowledge and was mostly a result of the fact that I am a good test taker and optimized my conditions as much as I could leading up to and on the day of the test.
bentobox1234 reacted to westcoastgirl in My Experiences Being Unmatched
I matched to my top choice family program this year! I'm very excited and happy about it! I decided that I didn't want to be identifiable by my blog so I'm just going to say that last year I applied to two very competitive specialties (but broadly, to all the English programs for both).
I got interviews last year, but not a ton. Over this year and after lots of reflection, I decided not to apply to one of the specialties (and this is actually one of the big reasons I am happy I didn't match last year! I don't think I would have been happy in that field). I did apply to the other one and got one interview, but it was actually a bit of a toss up as to whether I wanted that or family more by the end.
This year I did a masters program (I think a lot of medical schools also have one year masters available), worked clinically with family docs and specialists (like part-time rotations), and worked on a research project I'm now getting ready to submit for publication. There's TONS you can do with the year off! I know people who found a doc to work with and pretty much worked with them full time, another who started an MBA (I think that's a 2 year program so I don't think they finished it) or did other cool online master's, people who went on big trips, and people who got really involved in research. My advice is to figure out what you want in your career and how you can use this year to strengthen it. I enjoy clinical research and want to stay involved in it, which is why I picked the masters program I did.
I'm more than happy to point people in the direction of resources if they like! Or answer any questions. I have a contact page on my blog.
bentobox1234 reacted to ellorie in Matching To Psych
I'd say that the fact that U of T has by far the most spots, and still consistently fills in the first round every year, speaks to some degree of competitiveness. Really I guess you'd need to know what % of people who ranked it first got it, as well as how far down their rank list they had to go to fill the program.
In my year we had I think 5 people who ranked U of T first, and 4 got it.
bentobox1234 reacted to FrenchToast in Matching To Psych
Hmm I find the word "competitive" to be tricky when it comes to CaRMS. Because the CaRMS algorithm is a relatively complex process, it's hard to even define what "competitive" means. I know one person who ranked Toronto psych around #5 or so (below other psych programs), and matched to Toronto... which would make it seem not very competitive. In my class, of the people I know well, there were 4 of us who ranked Toronto first. 3/4 of us matched to Toronto, and the one who didn't match to Toronto unfortunately didn't match at all. Meanwhile, I know a few people from other schools who ranked Toronto #1 and didn't get it. One of these people actually matched to a school that *she* ranked as #5... which is the school that the aforementioned applicant who ranked Toronto #5 actually ranked as #1. Soooo: it's hard to say, especially because people can be inconsistent with interviews and Toronto does have so many spots.
I would say that overall psychiatry seemed more competitive than in the past. Anecdotally, there were far more applicants than in the past. Ottawa had 12 serious psych gunners, whereas normally there are 3-6 or so. Speaking from people from other schools, they also had about double the applicants. But there were still some spots left over (in the prairies - where most people didn't apply - as well as NOSM and Ottawa), so it's hard to say.
Also, elective-planning advice: I'd agree that psych emerg electives are a good idea. I did a bunch of inpatient electives, and I was very happy with them. I got to do a lot and worked closely with staff, and I believe I ended up with good letters as a result. I'd probably try to stay away from any outpatient electives where you'd probably just be observing - at least pre-CaRMS. (Child psychiatry clinic comes to mind.)
I hope this helps!
bentobox1234 reacted to asthecrowflies in Obgyn Lifestyle
Med student matched to OB/GYN for whatever that's worth.
Lots of good things I agree with said above.
Since you didn't mention surgery I thought I'd say just be aware that OB/GYN is very much a surgical subspecialty, and much of residency is focused on time spent obtaining surgical skills, completing the principles of surgery course and exam, etc.
In obstetrics--operative vaginal deliveries, C-sections, complex obstetrical repairs
In gyne--laparoscopic, vaginal, and open surgery, with a trend towards more technological minimally-invasive options
As a staff though you do spend relatively more time in clinic as a generalist.
If you are primarily interested in clinic, deliveries, and office gyne procedures it's worthwhile to consider family medicine + a women's health year. (not looking down on this option, and of course being a family doctor doing deliveries there's another set of challenges in terms of managing time and practice)
bentobox1234 reacted to collegedude22 in Applying To Dermatology And Backing Up With Im
Yes, it is possible. Dermatology is first or second in terms of competitiveness each year, and programs expect that applicants will also be applying to an alternate specialty. Most people whose preferred discipline is dermatology end up matching to something else. I have even heard of dermatology programs negatively viewing applicants who clearly aren't applying to another specialty, as it shows poor judgment.
The other consideration is what you choose to back up with. As you have probably heard, internal medicine is becoming increasingly competitive for those who are "all in", let alone those who are backing up. You would need to do at least one internal medicine elective (3 weeks would be best) and get a very strong letter from it. That way you have at least 2 internal letters. I think most internal programs are open to a strong general letter from another specialty to round out the 3 required by most programs. Then you would need to apply VERY broadly. Most applicants this year didn't get at least 2-3 interviews they were expecting. Keep in mind that some internal programs prefer candidates who are clearly more "all in" (Toronto/UBC/Mac/Calgary/others), whereas some programs value applicants who have done electives in different specialties (Dal/Queen's/Manitoba/Saskatchewan/Alberta). You'll likely have better luck with the latter programs.
Another consideration is the fact that if you don't match to dermatology in Canada, you could do a year of internal medicine then apply for the PGY2-entry dermatology programs in the US. You would obviously have to take (and annihilate) steps 1 and 2CK/CS.
bentobox1234 reacted to Let'sGo1990 in Information On Competency Based Medical Education (Cbme) At Queen's
If a preceptor or staff doesn't like a resident, is it possible for them to hold them back under the pretense of inadequate performance?
Who is assessing the competencies of the residents? I imagine it's the staff/attendings at the specific institution - would this not introduce bias depending on how well a resident is liked or disliked?
bentobox1234 reacted to Talon01 in Where Can A Doctor Get Anonymous Psychiatry/psychotherapy
You can see a psych and be honest about what your concerns are. As you know, the psych only will break your confidentiality if you're a harm to yourself, others, or children are involved. When you do your college application, it's ultimately up to you to answer the college applications honestly. However, the college isn't going to have access to your personal health record.
Edit - if you feel you need to talk to someone then do it. If you do decide to disclose a mental health diagnosis to the college, as long as it's properly managed, it won't hinder your ability to get/renew a license.
bentobox1234 reacted to medicallyinclined in Where Can A Doctor Get Anonymous Psychiatry/psychotherapy
You have to disclose your Psychiatric Illnesses to colleges to obtain a license?
This seems like a violation of confidentiality, especially since some Psych disorders are very stigmatized. I would definitely not want my diagnosis out in the open.