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rmorelan last won the day on January 4

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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 can say the definitely don't do that there is no meaningful pattern really. Additionally the various people reading the applications are also not all doing so at the same rate further randomizing.
  2. I mean every doctor is going to face impacts of attempts to reduce costs, and the PA/NPs also aren't all that interested in removing doctors completely either (their argument for increased pay is simply relative to FD. Remove family doctors - and that is HUGE assumption that they can do the same role - just removes the very reason they are entering the system). Of course you can expect a long drawn out fight about truly opening independent practices (family medicine is a complete and challenging job - there is a reason people go to medical school for it ha).
  3. exactly they just have a big stack of apps to go through. If you hit the level required you go to interview. It just takes time to go through it. If they waited until it was all done then there would be no interviews until far too late in the year. The last thing you should do is go into the interview thinking you are already behind the curve. That can mess with you. Thinking you are inferior on any level can make you inferior. So again don't do that - trust the system is running as it is stated and there is no disadvantage to going later (other than being stuck with a more painful wait time ha - which I suppose should be used for more prep time in a perfect world).
  4. interesting - I wonder it is a case of the grass is greener on the other side. I would love to hear everyone's thoughts.
  5. hey - no one replied? They may under conditional acceptance rules (like all of western's rules you have be careful to make sure you line things up properly).
  6. True but I would say there is enough general evidence from mining that stats to draw some conclusions.
  7. gah I hate skype interviews ha - I hope it went well.
  8. most likely a verbal question I am assuming? I think it was that way prior.
  9. Hey I missed this I want to really make sure it is clear that this is NOT unique to the centre but perhaps this one had it a bit worse because it is a harder program or maybe just bad luck - it lost a resident give or take once a year for a while there. There were 5 or 6 actually ( an update due to it now being 2020) that I know of that for a variety of reasons left the program. Most switched to other programs (going either to family medicine one way, or to other highly competitive ones the other way - it was funny like that). That was my residency program - and I would not say it is an easy program. The program is tough, the 2 hours of teaching daily is tough, and man the call is tough. They have worked to find solutions to that and done a good job - no one likes to lose a resident. However on the flip side the residents there were trained extremely well (I am biased here of course but there is objective evidence for it) . The residents come out and match to top fellowships without issue, there is a perfect pass rate for well over a decade on the boards (so long that no one seems to remember the last failure) .....the residency program is respected is what I am getting at, and that helps with the hiring down the line. The school is hard but if you get through it you are well trained - which in the end is a good thing. Now on this side of things - almost done my fellowships and entering the staff phase I can be glad for the pressure applied. 4 years ago doing a lot of radiology call and getting the squeeze probably not so much. Point is to reinforce the idea that radiology is no longer a walk in the park - not during training, and not after. You will work and work hard but if you do there are rewards in the end.
  10. that is true - and although I think the solution is probably better that the respective subspecialities should "get off their asses and do their job" if I may be blunt, there should be some way of dealing with the cases you are mentioning. I think the issue is that while you may look at the imaging from a stroke perspective you cannot by desire, training, or agreement to take on the risk of reading the entire study (miss that 2-3mm PComm aneurysm while you are worried about the M1 clot in the middle of a busy stroke code and when it burst after growing for 10 years you are in big trouble). The government doesn't seem to like to be charged twice for the same thing - a prelim and a final read in this case. and thanks ha - it is growing as a field because it has to. Both of the major trauma centres in TO as of this year now have full emerg radiology groups, and soon both will operate 24/7 with full staff coverage.
  11. At Ottawa and in where I have worked in the US the stroke team and the on call radiologist are all at the scanner when a code stroke is performed (same with trauma studies except the trauma team is there rather than neuro). The study is read by the radiologist but also of course the stroke team are all there too. That is how I also will run my practise for stoke codes as well when I start in the summer. part of that is for pure technicality - the neurologist cannot order contrast technically for a study - only the radiologist can so we are there to actually allow the CTA to proceed. That is a fine point that is often overlooked in the heat of the moment - sometimes although very rarely to bad effect ha. It is also a very good idea for two people to read a critical study anyway - I have caught serious errors by the reading neurology team, and there is the chance they can do the same the other way and we can learn from each other. At the time of the study I also get the full history from the neuro team as well which helps me a lot reading the study. I view any centre NOT doing something similar in the year 2020 to be one that isn't living up to modern practise standards (now that is of course my opinion as an emergency radiologist). Once the study is read at the scanner we were required at ottawa to review it with the on call neuroradiology fellow or staff (depending on who is on). We also have neuroradiology coverage in house by staff from 7am to midnight. In the US we have emergency radiology coverage by staff 24/7 and provide nighthawk services for hospitals that cannot provide those staffing. In many places in the US those sort of read structures are required by guideline, and also by law actually. None of this "hours later" crap ha. We literally count minutes from ER arrival team and are punished it we don't hit targets. The point is that if radiology provides the appropriate service then the entire problem mostly goes away. Not just for stroke codes, but for any critical imaging study (of which there are many). Reading stroke studies is clearly in the realm of general radiology as well - the vast majority of them read country wide would not be read by subspecalist neuroradiology after all. They aren't that complex of a study to interrupt by a properly trained radiologist doing them regularly. The issue in academic centres not set up to manage these you either have a resident with variable experience level, on call neuroradiology which is hard to do 24/7 or another radiologist who in a subspecialist land of academia doesn't read neuro studies regularly. That why emergency radiology as a field is now a pretty hot field (when I started this it was a big risk - I am glad it seems to be working out ha). We can serve as both the on call "everything else" as well as neuroradiology emergencies.
  12. Truth is we never know - radiology constantly changes. Has for 50+ years to where if you take any point in time and compare to 15 years prior there are shocking differences. 15 years from now we are going to have very different imaging technologies (including possibly the death of the standard chest X Ray ha, imagine that - replaced with tomo). Multi-phasic CT, synthetic MRI, 3D ultrasound, contrast enhanced US, further merging with nucs for molecular imaging, interventional radiology just doing more and more....... We have CTs doing what MRI does, and MRI doing what CT can ha. AI is going to be in there somewhere. If you want to be on the cutting edge you have to accept you might get cut. Fun times
  13. I think it is the other way around - it is competitive because of the salary ha - and when something comes up that makes that look like it is going away there is a drop in applicants (threat of AI being really talked about, or cuts in fees etc). One factor in the salary unfortunately is the sheer volume - lots of fields work hard but haven't had the amount of work increase that much in the past say decade. Radiology objectively has had its work volume dramatically go up over the last 10 years forcing rads to read faster and faster, and longer and longer (we track the number of studies over time required). It really is just non stop - community rads particularly when new are just destroyed (6 day work weeks, 12 hours each is what they are telling us + call). Residency doesn't prepare you for the extreme volume basically and you need more time to learn to read fast. We are just flat out told to expect it to be much worse than residency in the beginning - the staff position is not the end of the rainbow for us ha. Eventually you can get the hang of it and it goes down but still it isn't the old days of relaxation ha.
  14. although a stroke study should never be read "hours later" ha - let alone days. That is flat our improper care. I am part of the "new generation" of radiology, and things are changing. Fields get stuck in their history in a sense and radiology definitely did - there are a ton of staff that are currently working that predate the technology that allows anyone to read a study fast (20 years ago is not that long ago in medical terms ha). No PACS, no electronic reports, reports were mailed out or at best faxed - took days to get results. Nothing could happen fast ha. People went into the field with expectations as a result - no different than many other fields that also had to painfully adjust (I remember the major complaints when family medicine had to as their practise teams work evenings and weekends for the first time - many people went into that field because they didn't have to work evenings and weekends ha) We don't live in that world now and radiology is changing - faster in the US than here but change regardless. It's a good thing too because old ways don't work, and hurt our patients. Radiology is becoming a 24/7 service - I for instance read the stroke studies at the scanner so as fast as they can possibly be read. That is a good thing because we are the best trained to read them (it is literally our jobs ha and we have the training to look at all possible pathology that may be present) and we have to step up to do that. We just have to. If your centre cannot provide that level of service then nighthawk services are becoming more common to cover the difference (makes sense as small radiology teams cannot go 24/7 - you end up with teams of 4-5 radiologies doing worse call than junior residents forever - it destroys people - particularly as they get older, and already are getting reduced sleep with young families).
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