Super Moderators
  • Content count

  • Joined

  • Last visited

  • Days Won


rmorelan last won the day on March 11

rmorelan had the most liked content!


About rmorelan

  • Rank
    Super Moderator

Profile Information

  • Gender
    Not Telling
  • Occupation
    Was a computer programmer/project manager. Now a resident.

Recent Profile Visitors

5,123 profile views
  1. That is true - they know the risk, and more over that the SGU school (or equivalent) are designed to get you into the US system not Canada. That is the target group after all. Now route is without barriers - and doing residency in the US might be the result (well a better result than can happen). Part of the reason that if you are going outside of Canada, an US school seems to be in my mind a better option. Man we have gone way off of the track on this thread - I am going to have moderating to do at some point and move all this to another thread. To those going through this - seriously good luck. Hoping for some good outcomes when the dust clears.
  2. Sure they paid for them - and what is the outcome? A resident. Say it costs them X dollars to get that person ready to be a resident. They do that, get the resident who goes off to be a doctor ultimately. Awesome! Now least say the get an IMG - who take that canadian medical student's spot. The government just wasted X dollars if that student never becomes a doctor. Except the IMG costs nothing to train. In either scenario the government pays X dollars and get a resident. It is actually cost neutral - it is doesn't matter from a cost point of view what way it goes. In fact since the IMG will have ROS the there is a small advantage as the government can control the placement of that resident, which might fulfill a political need, and boost their government (but they will have to deal with a complaining medical student instead). Now least say the do remove all IMGs from the first round match and assume the government is nice enough to boost the CMG pool exactly with the replacement (they might not actually - governments are like that). That might be a good policy choice for a variety of reasons (even if the math is even it still feels "wrong" even if it is irrational to train someone and not use them, a lot of bad press right now with people not matching, doesn't cost much to do that and the downside is a bunch of complaints from CSA and the fed government on their immigration front). Politics will occur - ha, politics always occurs. Some of those spots will be in a variety of things (rad spots at Ottawa and TO for instance and so on). Good chance can med student will go after those spots - they are competitive now after all. That will in general skew the selection away from less popular fields (exactly what happened when the match was 1.1 to 1 or higher). Means that in the second round there will be more of the traditional less popular fields left for IMG which would include family medicine mostly among other fields. The result is more family doctors and so on will be IMGs by proportion than now - that may not be good or bad but I am sure some groups may not like it. Not rational but again it might "feel" to them that they are always stuck with leftovers. There will be some nosy CSA's in that case as well to deal with - as you will never have a IMG (still hate that term) becoming certain types of doctors not matter how good they are.
  3. ha - exactly how many medical students are really "taxpayers" as the term is intended? I really hate that term (it somehow implies the amount of tax you pay equals your worth - and since tax is basically on everything one way or the other, even if it is just sales tax, it is a bit meaningless if applied overall or not so subtly insulting in other ways.) Medical students' parents might be tax payers. Statistically speaking pay more than most as they have on average higher incomes. But medical students? With our huge tuition benefits, highly subsidized medical education (and prior education), numerous bursaries/grants....... not so much So why would a Canadian taxpayer have any obligation towards a medical student on a tax basis? Those students aren't taxpayers - not yet and either an IMG or them will be equal taxpayers in the long run. If the Canadian taxpayer has obligations towards Canadian citizens - which I think is a much better argument - then the issue is IMGs one way or there are either citizens or will be soon enough re immigration and the argument doesn't quite work that way either. In the traditional political sense a "taxpayer" should be happy about IMGs - that is great value for the taxpayer as someone else has paid at least a major part of the roughly 25 years of education it takes to be a doctor. Each one saves roughly 300K in direct education costs.
  4. a lot of programs swear by the interview - and yeah having gone through a few of these there can be a ton of movement based on an interview. This is a 5 year job contract - can you imagine any other employer in any other field that would accept someone for 5 year professional level job with high stakes without even bothering to interview that person? plus on a purely cost level - who is paying for the interviews? How much does it cost a program to run an interview day really?
  5. Yeah I am not sure - I am also not sure if there is much they can do about it if somehow they want IMG and CSA groups to separate out even if they have good reason to do so - any dedicated spots for IMGs as a whole cannot exclude CSA. That is why I don't really like the term IMG - they aren't all immigrants, and not all "CMG" were trained in Canada. It is really graduates accredited by the Committee on Accreditation of Canadian Medical Schools or by the Liaison Committee on Medical Education in the US, or those that didn't. Those are the two divisions - it really would be better if we have more accurate terms ha as that is pretty wordy. Ultimately give an advantage to either IMG non CSA and CSA gropus, and the other one will push back legally - both would have the motivation and resources to do so.
  6. ha reading through everything here is becoming a challenge I am not an expert on constructional law but as I understand it legally we cannot treat in our process what most people are calling CSA and IMGs any differently as we aren't allowed to discriminate on the bases of country of origin - even if that country of origin is actually Canada. From the Charter: Every person has a right to full and equal recognition and exercise of his human rights and freedoms, without distinction, exclusion or preference based on race, colour, sex, gender identity or expression, pregnancy, sexual orientation, civil status, age except as provided by law, religion, political convictions, language, ethnic or national origin, social condition, a handicap or the use of any means to palliate a handicap. When we preferentially accept CMGs into our CARMS process we base that on a difference in education - the Canadian and American schools are accredited by the same oversight organization which is why we can apply for residency there and they can apply for residency here. The wording gets weird because any Canadian graduating from an American medical school is basically a CMG for all purposes, and not a CSA. There have been efforts by CSAs to gain the same advantages as CMGs and this was not successful because of the differences in education. It is that protection that has creates the difference as I understand it. For application purposes (not political ones, or philosophical ones etc ) CSA is just a subset of IMG which doesn't have any special advantage formally and couldn't develop one. I have a feeling that even if you did "whatever" with IMG spots that relatively quickly you would be back in the same position. The current situation gives the government a measure of control that they want - the reduction was done on purpose after all
  7. Yeah that is a bit trickier than just a normal day at an academic centre - first off the the fellows/residents are doing most of the work because it is important training and the stuff already know everything. Next trainees are often tricky as we already have one, you don't have radiation clearance/badges etc, and in an academic hospital often just a subset does the majority of the procedures (faster, more efficient, some really like/hate them.....). At our centre for instance 6 staff do US biopsies in the abdomen and they do one full week at a time.
  8. I wonder how much is actually in the reserve at this point.
  9. Minor point - but diagnostic radiology is actually the field that does all the biopsies (prostate, lung, abdominal, breast, thyroid...., thoracentesis, paracentesis, LP drains/aspirate/chemotherapy, nephro/biliary/abscess tubes. GI tube placement, RF ablations, spine injections, joint injections and aspirations........... NOT IR radiology. It is a part of the job I actually really enjoy and I get to routinely stab people ha. IR radiology does all of the angio-interventional work - anything that has to access a blood vessel. Now because a IR rad is also a general rad they can do the above as well and it may be structured that way but often it is well any rad. 20-30% of the job is often doing procedures. People often don't realize that. We have been doing procedures a lot longer than IR even existed.
  10. Part of the problem is we have basically a do nothing or fail someone system. That is kind of nuts really. Punishment and remediation are made to be the same thing.
  11. I agree - with the point was that "problematic people" probably shouldn't even get through medical school at all. There is a lot of "someone will deal with it later" approach to things - and yeah it is quite hard of course, but right now there isn't a lot of pressure to get it right. I am sure both of us have see some medical students/residents and though wow someone should have fixed this way back when it was easier to fix (not specifically by failing them -there is a whole range of other things to do). If you aren't good enough to match to a spot why are you good enough to be moved along at all (adding more debit only to hit a brick wall at the end)? Instead someone should fix the problem. This only applies to small minority of course so not worth obsessing over - but if people are thinking somehow about a 100% match for everyone then that means that somehow the medical schools would have to make sure everyone is actually worth matching.
  12. I know of two similar sounding cases - and yeah there was some delays, mostly because again yeah the don't meet all that often and they are slow getting anything down (risk vs reward for them - benefit of getting someone approved is one less paperwork task which can be put off until another day, risk of letting the wrong person in could be something rather bad. Remember the college is not your friend ha).
  13. no it isn't - and not that I want to restrict people but it just seems like they basically aren't checking anything. That is very dangerous as they could spring at some point (at least in theory) the punishments of the contracts (which are huge) against people.
  14. just to add - objectively mostly will but by most we are talking as per the carms data about 60-70% in the following year. That means the possibility of not matching is real, and those people roll over and the process continues. and people fall of the tracks as well of course - every resident knows people like that. I know people that are in their 3rd and 4th attempts - small numbers but there none the less.
  15. Logical yes but two different government groups with different objectives. Universities really want high med school numbers - people want to go to medical school (hence the forum), and they bring in money is so very many ways. It is politically challenging to drop enrollment that sounds like a something that will cause wait times etc (which just got out of all the press on that from the 2000-2010 period). The governments never seem to come up with a perfect overall pattern - you cannot boost one part of the system without reinforcing the rest - the trouble is that costs money. Plus for the most part the public has very little idea how residency actually fits into to things. So much politics - some people think no IMG should get a shot at any spot until every CMG has a shot at all the spots and either not applied to one or rejected from it (basically add a 3rd round of CARMS. Some think each med school HAS to give a family medicine spot to any resident in their home school as a last stop measure (even if that means they are pulling funding from other unmatched 2nd round spots from other programs or other parts of the province - which would encourage the schools as well to make sure their spots are filled in the first round, as you may not even have funding for that spot in the second round. It also means that if that student is so bad that they shouldn't be a family doctor then the school should have dealt with that during their training (we still do graduate people who are well bad students and so red flagged they cannot match - very small minority and it is important to remember that when dealing with unmatched people as most often they are actually solid students.) And as hard as it is for people on the forum some people in the system simply don't care about unmatched students - even think that having some people fail is useful as it makes everyone else work that much harder (you can imagine the sort of conversations you would have with that sort of person ha).