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rmorelan last won the day on July 2

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About rmorelan

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    Was a computer programmer/project manager. Now a resident.

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  1. I think the primary drawback you maybe the loss of OSAP funding so I would do that math there - in my case the free money (in my case grant plus no interest payment was higher than the expected return on any investment. However again at the time RRSPs were not considered assets so could have filled that etc). Objective smallish amounts won't make or break anyone - I can see the temptation with the low rate, and tax free status. We have to be careful not to be blinded by how low the rates are (usually any of this would be relatively silly as the interest rates are still way below historical norms). TFSA's as tax free investments also wipes out some things. I always remind people that they are investing quite heavily right now anyway - in themselves basically. Whatever you do don't have that threatened. Also ha on a pure investment approach point - what is the point of having bonds at all right now? At what point would you do anything with the money you are investing? At your stage, and with a mix like you are proposing, I would probably just do a simply all in one rather than wealthsimple (which will hit you with a 0.5% fee for really in your case no reason). Just like BigM is suggesting. Also if you are going down this route - take the time now to read some basically financial planning books if you haven't already That sort of them pays off hugely in the end.
  2. I predict in advance that if it is yellow that class will be known as the "lemons"
  3. Been there, done that - it isn't easy. Particularly with the expense of training. I am not sure there is a good way - you can explain the situation, and for their sake give lots of notice. I ended up still working for them for a few months to help with any transitions etc. I had two groups I was working with that both were shocked by my departure. One of the weird things about getting into medical school seems to be all the breaks you have to with various organizations.
  4. because we just happen to like doing another field more - and enough so that you go a different route (and I have said over and over again on the forum how annoyed I am with myself that I didn't really like family medicine on a day to day basis - yet for many of the reasons you mention, plus the small fact that you can have a profoundly fulfilling career helping a lot of people that is sure an annoying fact. and yes it would have saved 5 years of time in my case).
  5. when we lose residents (transfer to another program/school, long term illness, mat/pat leave...........) the remaining call shifts are just redistributed yeah. For most people they are not actually doing the max allowed call (which is insane and quite often only there for most to handle extremely busy rotations on a shorter term interval), which means things can be increased at least by the rules. When you have full resident roaster the increase can be evenly distributed, and ideally there is already some buffer can in some programs you cannot expect everyone to always complete things - things happen etc. Still it can be a bit draining when you are already in the mud as it were, and someone leaves for whatever reason and now there is a bit more to do.
  6. as a rad resident I was by myself reading as a sole radiologist for about 8 hours every call shift Those hours were all through the night when you are max tired, and having read already for 16+ hours and much more likely to make a mistake. I would joke that you must study until you can do it in your sleep - because well you basically will be doing in your sleep - but that would hit too close to home. Now at many centres that isn't the case for some things - some have gone 24/7 staff in areas and in particular for rads at big centres. Others (most) are still as residents by themselves for at least a long part of the night. Ottawa was pretty good and had staff until 11 for many things. If you ever get into extreme trouble you can call staff but that is a very rare thing to do - in my case done exactly 2 twice and both times because a surg staff insisted on it (didn't trust any residents reads prior to the OR for complex things - fair enough). I should say that in many places where the staff are there 24/7 it is also quite busy - and that staff may not always be there to help with the full range of imaging you are reading for instance in rads (like they only do the ER cases, and you have in patients to read as well). This is rad specific but most residents are operating for long periods of time with only other residents or just themselves (but at least with another resident you still have someone to discuss things with). This isn't all doom or gloom but I think you do have to have these open conversations about what residency is like and how we can collectively get through it.
  7. the only way to reschedule call is to have someone else do it - but that doesn't work because then you just owe them a call shift. It isn't that a particular shift is annoyingly in the wrong place - it is just that the shear number of them didn't allow for recovery (for me personally - I should point out that the issue in part is that as a particular individual late nights are not much of an issue but early mornings are. The flipping around from days to nights to days constantly was the issue. with a different call structure - say a week of night float - I could have been just fine). You have vacation time - and you can use that to recover (and should) but often that seems to result in call shifts pushed closer together in many cases, you only have 4 weeks a year, and often you use that time to study for important milestones. So it isn't really penalized directly at all - the system just doesn't let you really escape things. even if you could you would have the wonderful knowledge you are just dumping onto your friends basically. Each call shift must be covered - it is a zero sum game.
  8. I will just mention why the last part in particular is a problem - if you are going to human anatomy rooms taught in the traditional manner you don't want to be walking around trying to find a place to change after (before I suppose it is possible ignoring for the moment that it shouldn't be set up so that is necessary). Some things can be messy no matter how careful you are. So yeah this is an area where a school should have a good solution setup.
  9. yeah it really is. For me personally I can say the residency experience particularly early on when the call shifts were near their maximum levels was simply so destructive that I barely got through that part. I like to think I am relatively hard working and smart but the depths of sleep deprivation, with the physical and mental burnout was crushing me to pieces. It was very hard to bring that up while in the middle of a program - particularly when anything done to reduce one persons call shifts just resulted in them being added to someone else. We lost people along the way in residency in various programs that just couldn't handle it (people that would have no problem doing this as staff under more normal shift situations). Good people, and I could have been one of them. Sounds stupid but I think it was really a relatively small number of call shifts over a personal limit that wiped me out. Once that fell down from 5-6 a month to 3-4 I got my brain back. I remember one day I could do math again - that was a good day. There was a year and a half or so there were I was in a complete mental fog - extremely frustrating.
  10. Ha I mean you are right - the "required service" I mentioned wasn't to imply that service was required to learn the skills etc. It was "required" by the system to operate the way it currently operates. I was stating the philosophy we seem to operate under, not whether it is great system. We can in fact change that - it will have consequences of course- something some where would give (I mean even Switzerland for Radiology just as an example is not 5 years - it is 6. So 20% longer. In Europe a lot of the rad programs are 6 years. I am not as familiar with all the other fields - maybe they align with ours. I hope I am remembering this correctly but I think the salary in Switzerland is actually pretty good although some one would argue their tax rate is higher ha. also again I am stuck on rads - that isn't one of the fields we do consider equivalent for the exam although absolutely there are a solid bunch that are ). There are a lot of ways to change medical residency to be more educational - our current system is seems to be based on if you do enough things eventually you will learn enough stuff and see all the strange things so you will be able to practise independently. If you think about that from an educational point of view that is kind of stupid for many fields. Not to focus just on mine but there is nothing stopping you from creating a list of imaging studies all residents have to dictate that actually IS all the pathology you need to know, instead of hoping you eventually might see something (because you won't see somethings that way). I think in many fields there are ways if we wanted to either speed it up reduce the number of hours required in total. and someone mentioned this - the idea of academic days post call is nuts. There is a lot of back pressure against changing it still - yes it will cost the system more (but not actually the hospital more - I always found that strange actually but I suppose it is just directly the government). There is alway a ton of staff pushing against it - perhaps because they would have to deal with things the residents do now if they weren't there, but many also because it just delays reaching staff level longer which is expensive in many ways.
  11. Residency unfortunately I think - despite all the talk about it - is not about work life balance. It is about maximum training in minimal time coupled with required service etc. Making it more balanced would increase the training time (which is an option we could put it - they do that in Europe) FM is better - because for parts of it you work with family doctors that have a set schedule. Many places still have off service rotations that are more intense usually. It is also shorter - which I think is actually most important factor. It was for me at least about 2 full years into contact call shifts and sleep deprivation that I really crashed. No matter what you do people only have so much reserve. FM isn't the only lighter one either. Still as intrepid says above it is temporary. you have to be very careful taking to residents about what they like or if they are happy etc if you are making a long term decision based on it. Talk to staff as they are the ones past all that. Residents are often tired, overworked, overstressed, and pushing them to the limit - and accidentally going past that point quite often.
  12. you know I like to think I am pretty good at keeping up with all the changes but this year they are making me work at it!
  13. Possibly true - although trying to juggle 3 specialities is always a hard. You probably shouldn't try to attempt more than two.
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