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magneto

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  1. Yes but only a few schools accept applications from practicing physicians. Look at the CaRMS website as majority of programs only accept applications from FM PGY2s. There is also a possibility of obtaining CCFP-EM certification by working in ED without CCFP-EM and accumulating a certain amount of ED hours and then challenging the exam. It requires a lot of work and dedication. And the pass rate is lower than physicians who did a dedicated PGY3 EM program.
  2. I think IM will bill more. They will have different billing codes, which will pay higher. Also their salaries will be higher if the hospital is not FFS. This is all a guess because I am not familiar with IM billings.
  3. I think GIM doctors will bill more (due to billing codes) or have a higher salary. This is a guess.
  4. Rural is usually defined by the province that you are working in. But I would say 20,000 population would be considered rural.
  5. Both programs are very competitive. Most medical students who want to do EM will apply to the 5 year program first. CCFP-EM is very competitive so if anyone who does not want to do family medicine should not apply to FM.
  6. 3 year program: - Finish CCFP (family medicine training - 2 years) - Apply for PGY-3 CCFP-EM (emergency medicine training - 1 years) Total number of years = 3 Dalhousie (I believe) has a dedicated CCFP-EM program that is 3 years long and is direct entry from medical school so you only have to apply to CaRMS once but spots are very limited.
  7. It is disheartening to see that current group of physicians, residents, medical students and pre-meds have started creating a divide in medicine. Sometimes I feel that new incoming medical students have lost sight of becoming a doctor first but instead are focused on specialty-of-choice from day 1. This has led to us vs them situation. And that is not helpful for anyone. I think instead of arguing which program is better or worst, we should talk about how to work together to provide great care to our patients and service to our society. This debate does not only apply only to CCFP (EM) vs FRCPC (EM). There are other examples out there such as whether pediatric emergency medicine training should be through emergency medicine residency training or pediatrics training. A few years ago, it was vascular surgery direct entry vs vascular surgery fellowship post general surgery. I am happy to answer any questions about the two program.
  8. FRCPC (EM) program Advantages: - Cannot apply to Royal College accredited fellowships (e.g., critical care, pediatrics emergency medicine) - Credentials recognized internationally - Only need to apply to CaRMS once - Extra 2 years of training helps with networking, job prospects, finishing research projects etc. Disadvantages: - Longer residency (5 years at least) Potential disadvantages: - Can potentially only practice as emergency medicine physician (or within the sub-specialty niche)
  9. CCFP (EM) program Advantages: - Shorter residency (3 years) - Can work as family physician and emergency physician - Can diversify practice if you want (OB etc.) Disadvantages: - Not recognized by some international countries (e.g., USA) - Cannot apply to Royal College accredited fellowships (e.g., critical care, pediatrics emergency medicine) - Need to apply to CaRMS twice Potential disadvantages: - Hiring prospect. In theory, when both CCFP-EM and FRCPC-EM graduate apply to only one spot at their home program, there is a greater likelihood that FRCPC-EM will get hire. This is for 2 reasons: (1) home program knows FRCPC-EM resident for 5 years vs CCFP-EM resident for 1 year; (2) FRCPC-EM resident had 2 additional years to become a more competitive candidate (e.g., PGY4 fellowship, more time to get research papers published, more time to present at conferences, more time to network etc.)
  10. Here are some common myths regarding CCFP-EM and FRCPC-EM: - CCFP-EM is inferior training. This is false. Graduates of both programs have the same scope of practice. There is no limitation to scope of practice of CCFP-EM residents. - CCFP-EM graduates only work in rural areas and the purpose of CCFP-EM is to train emergency physicians for rural areas. This is false. Majority of CCFP-EM graduates in large urban areas and work along FRCPC-EMs. There are also many FRCPC-EMs who have decided to work in smaller towns due to their preference. - CCFP-EM graduates are not eligible to do fellowship training. This is false. Many fellowships, such as ultrasound fellowship are open to CCFP-EM graduates. Fellowships that are accredited by Royal College are not open to CCFP-EM graduates (this includes critical care fellowship and pediatrics emergency medicine fellowship). - CCFP-EM are like GP-A, GP-OB etc. This is false. There is clear distinction in scope of practice between other PGY3 enhanced skills program and their royal college colleagues. For example, GP-OBs do not routinely train to do C-sections. This does not apply in emergency medicine and graduates of both CCFP-EM and FRCPC-EM have same scope of practice. - CCFP-EM graduates do not work in tertiary centers. This is false. There are CCFP-EM graduates working at tertiary care across the country. - CCFP-EM graduates only do part-time emergency medicine. This is false. The majority of CCFP-EM graduates do 100% emergency medicine. - CCFP-EM graduates make more mistakes. This is false. There is no objective data to make up for this claim. And malpractice insurance is the same for all emergency physicians. - CCFP-EM graduates do not engage in research. This is false. Many CCFP-EM graduates are leaders in research. Many have extra training (Phd, MPH etc.). - CCFP-EM graduates do not engage in administration. This is false. Many department and hospital chiefs across the country are CCFP-EM graduates.
  11. Before emergency medicine developed as a specialty, emergency departments were run by general practitioners and interns/residents of specialists (e.g., internal medicine, pediatrics, trauma etc.). Slowly emergency medicine started emerging as its own specialty and countries across the Globe started developing training pathways to train future emergency physicians. In Canada, there was a long discussion and debate between the College of Family Physician and the Royal College of Physicians and Surgeons of Canada. In College of Family Physician view, emergency medicine was a sub-specialty of family medicine and they proposed a training pathway where family physicians can get extra training to become emergency physicians. The Royal College of Physicians and Surgeons of Canada proposed that emergency medicine is its own specialty and the training should be under the guidance of royal college. The two colleges were not able to come with a common solution. So each of them came up with their own training pathway around the same time, and started accreditation process for residency programs around the same time, and developed board exams for their graduates around the same time. The scope of practice is same for emergency physicians regardless of whether they trained through CCFP-EM pathway or FRCPC (EM) pathway. This is reflected in two things: (1) almost every tertiary care center in Canada employs both CCFP-EM and FRCPC-EM graduates (except for very few and the reason is political/bureaucracy) and (2) both CCFP-EM and FRCPC-EM graduates use the same billing codes and are paid the same (except a few places, I believe Quebec is one of them).
  12. I wanted to make a post to explain the two training pathways to emergency medicine in Canada (5 year FRCPC and 2+1 CCFP-EM program). There is a lot of great information on the two programs on this forum but there is also not-so-great information and sometimes plain wrong information based on opinions and anectodes. I believe this false information is not helpful for anyone. If you want to read more about history of emergency medicine in Canada, and history of how CCFP-EM and FRCPC (EM) program started, please search the following on your favourite search engine: 1. The birth of a new specialty: the history of emergency medicine in Canada by Remon Elyas 2. Emergency Medicine Training & Practice in Canada: Celebrating the Past & Evolving for the Future by Collaborative Working Group on the Future of Emergency Medicine in Canada. 3. Past, present, and future of emergency medicine by CAEP 4. The Multiple Paths to a Career in Emergency Medicine by Andrei Karpov and Maurice Agha 5. Practice patterns of graduates of a CCFP(EM) residency program by Catherine Varner, Howard Ovens, Eric Letovsky, Bjug Borgundvaag 6. Emergency medicine training in Canada: learning from the past to prepare for the future by Tim Rutledge 7. Emergency medicine certification in Canada: the years march on but the questions remain the same by Riyad B. Abu-Laban Some of the articles might be behind a paywall but can be easily accessed through your university library. I will summarize these in my next post.
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