rmorelan

ha side note, but it seems some forum upgrade has added new badges. I am proud to be "rookie" now based on that. Ha, endless tracking for everything.

They did! they are learning Don't think that general trend down for family medicine is going to win any favours for anyone.

there are many lawyers that work in law where they run into medical reports etc. It helps them to have someone with medical training to interpret the various reports so they can prepare their arguments.

yeah there usually isn't much - and your variable schedule does get in the way of somethings as well. Plus let's face it - you will have limited energy/attention, and you don't want any distractions from preventing you from getting the target end goal. Some of my classmates reviewed legal cases for a bit - help explain to lawyers what is going on medically.

Just to add - that is probably a less than average level of debit to start with. Debit sucks but you will come out on the other side. Be careful with the Ontario loan forgiveness program - it truly is hard to be 100% sure that you will be staying in Ontario unless you happen to be a family doctor (yeah for flexibility!). Also hopefully as a side impact of the rising interest rates there will be greater push back on the just constantly increasing the medical school tuition. Some people with the higher end levels of debit - say around 200K which is also not unusual - could be soon dropping 10K post tax income on to those loans. It will start to get much more painful. Can you pay off 60K in residency? It is possible - but there are factors like where you are going (TO for instance is expensive if you happen to be there, and how long is your residency?) You have to balance the desire to pay it off with not letting the effort restrict your ability to be a good resident.

If you don't want to go insane looking at the small number (ha!) it is probably best to not think of the stipend to do with the actual time spent working - you are on a salary for the year which includes the requirement you do call. That salary includes the full income for doing all aspects of the job. The stipend's original goal was not to provide extra income for working more but rather to pay for cost related to having to do the shift - for instance the stipend would cover the cost of food on shift, transportation there by cab and back etc. For that purpose it does actually equate to a reasonable amount. If anyone put it as an actual income amount for doing up to 24-30 hours of work in some cases it is beyond insulting ha. I made the mistake of calculating it once and noticed the the tea I just bought to keep me awake for the next 2 hours required me to work those two hours to earn enough post tax to buy said tea. I think I was actually 7 cents short. While the rates have gone since then I still think that way madness lies

First good luck! Usually by email on that day - since the system can evolve over time it is best to not put too much faith in any form of order of them being sent out, plus they usually try to have things all pretty close to each other.

If those were the only options of course But likely there are desirable people that just matched somewhere else or perhaps not at all. Having unfilled spots truly is a royal pain in the ass - you have a round 2 process to go though with people that may not otherwise be interested in your problem, and if end up with unfilled spots in the end you are stuck with issues with staffing (call has to be filled no matter what so empty spots hurt residents and hurt residents make a PDs life worse). Messy - point I guess is you can be overly selective and that isn't a good thing.

you know I asked specifically if you could graduate early with competency by design approaches - let's say for instance you are IMG who is actually a fully practising doctor in your home country - we had that in radiology in fact in my residency program. They automatically know almost everything already (they were super annoying in rounds ha as they always made you feel like a moron for about 4 years until you at last caught up to them) - and unlike some other fields where there may be different approaches, in my case radiology is still mostly the same everywhere - it isn't like X rays, US, or CTs are somehow different - although we may have additional access to some modalities over some other places. They could in theory demonstrate competency very quickly - easily a year or two and then boom be gone. Many fields in medicine would be similar. But no ha - I was told by the college that they won't let that happen - and it was a real concern of the programs originally that it would work that way. They still NEED that person for clinical service as these are never just training programs, they are also a job - so you cannot have the chaos of people leaving at random points. Imagine the response of a program director if you could leave early- as directly you would likely end up NOT accepting super high level people into the program in many cases as you are afraid they will finish quickly and leave making it hellish on the remaining people stuck doing all the extra call and in turn your life more annoying. It would be an insane situation of the likely best candidates not be accepted - as if CARMS wasn't complex enough as it is. Programs will let you spend what would amount to as a fellowship within your training period if you show mastery of the required competencies, which can be quite useful but not as good as just letting the person immediately go off to fellowships and so on. We still don't really have a good way of recording that something like that actually happened - and if we did it would still be dangerous - imagine surgery fields with a tight job market - you give another way for someone to say they are so good they finished early and did fellowship level work after and things just got even more stressful. This is particular a problem as the very core concept of competency by design is that equally good people learn at different rates and it is stupid to think someone is better or worse just because they reach the end point faster or later - the real question is whether they can reach the end point at all, and if so they are all effectively equal. This is still a radical thought in medicine but is a core pillar of these newer curriculum designs. Only point I will add about the fellowship - if you are credentialed but you cannot actually work without a fellowship then it is as if you are not credentialed at all. Same situation like graduating medical school. Congrats you are a doctor! - you still cannot do anything with that clinically without the residency so for most how useful is that in isolation. Wasn't always like the current situation in the past when there was a very rapid route to be a GP post med school. Point is the college could have figured out potentially ways that people wouldn't need a fellowship to say actually work - but they didn't or perhaps even couldn't. Just because they didn't directly increase the training time doesn't mean they are blameless in the overall process that requires a fellowship to be hired (for instance there is a lot of arguments that the majority of the first year in many programs is kind of pointless from a training point of view and the college could have worked towards revising it. There are endless arguments that the older LMCC exams were completely pointless as well but they also took up time that could be spent on other things, and they didn't directly do anything about that either. They could have worked at being more efficient during the training, and when fields get too bloated to be covered consider breaking them up - like say in radiology where interventional radiology and diagnostic radiology are separating in many places into different residencies) and there has to be some kind of a balance here - residents need some actual input into the system but by the same time it seems unlikely that med student graduating would truly know what is actually involved training wise to be an effective doctor in a particular area (I mean I sure as hell didn't when I started radiology - for me to say it should take 4 or 5 or 6 years would be a best a pure guess - building curriculums is really really hard work). They real question is over time is if a field is getting progressively more complex and harder and harder to cover properly in a set period of time then what do you do?

yeah - I mean the Western interview panels have been variable - it really is just up to who ever is interviewing that day. As others have said it doesn't matter in terms of scoring though - I have seen the friendliest interviews completely downvote someone, and a stone cold appearing one give the highest possible marks. The only way this impacts you negatively would be your reaction - some people can get flustered with a colder panel, and may not have on a warmer one. It does work in reverse too though - some point get a bit "too loose" with a warmer panel and go off the rails as well ha. Bottom line points - all schools are aware of this sort of thing and take steps to manage it, and you need to practice for interviews with both cold or warm seeming groups. Then you get what you get and go from there

If you believe that active managers are useful - which is generally against the literature on the subject - then you likely by extension believe that past performance would be a guide to future success. If so then it would be logical to look at MD Financial's track record on their actively managed funds and see how they do relatively to a standardized benchmark. Spoiler alert - they sub performed and did so for decades and that was BEFORE you subtracted their very high fees. They did that as well with no lack of resources to construct something superior. Neither has scotia's investment line either for that matter net of fees. You are left with : You believe active management with costs will do worse than doing low cost index investing on your own, so just do it yourself or Active management works but MD Financial has not demonstrated with plenty of chances to do so that they are superior in that space. Why would you invest with under performers? Either way........

honestly no. Further that is even with the in person ones which are easier to do this sort of thing

well not just travel is my point I suppose - just well life.....and that means in particular the grading schemes for these things are set up to avoid introducing a confound etc. Socials are unstructured as well so it just isn't a good way to evaluate people. There is also a general principle here - socials are designed to let people learn something about a program more than the program learning something about you (which is what the interview is for). Unless you do something obviously stupid at them they just don't matter for evaluation.

programs understand people cannot always make those as there are travel considerations etc. The places I was at specifically took efforts to avoid having people not going to those from having any negative impact on things.

ha good grief - that is someone that cannot make up their mind Has to be incredibly rare for that to happen - although with 1000s of people going into it a year you are going to get these strange events. I wonder why they moved so much, and what they ended up with.

highly unlikely - one case of it I saw was someone returning to their old specialty. There is a lot of work involved in moving people around, and you start to reduce you funding amounts.

Done!

basically - so it doesn't really mean anything specific at all. and they will "get around to things" in their usual someone lengthy process (although to be fair in the end the wait time is always exactly the same as the results all come out on the same day in May I suppose). breaking my own rules here ha, I will have to go back and clean out this thread again at some point

does happen - people do attempt to transfer all the time, and success is variable really (best odds are within your current school, which depends then on if there is room for you. Some places have more capacity, and in some years someone may have left which frees up a spot!). I am not sure about Quebec but in Ontario the only other real issue is the funding for the residency - radiology needs 5 for instance same as internal of course and family medicine comes with two. That means someone some where has to drop down into family medicine to free up the funding for other to move. In practise this seems to happen from time to time as well as people move around - as much as CARMS is this big thing and so much prep goes into it, people are people and do change their mind. You won't have much time though I suspect - usually around now is when the options to apply for moving occur - if you wait until next year it is well another year of what you are doing (and at that point you probably should just finish anyway as you are right at the end). First step usually is learning your local school's policies and then reaching out to both internal and radiology in your case for any options - you will also have make sure you all your ducks in a row as well - your performance on your prior rotations is fair game for evaluating you in terms of a transfer.

Ha, well done by them! To add there really is a bit of hero worship in general at time regarding the US top schools - not surprising I suppose as one of the major points of those sorts of schools is to promote their image and hopefully for them create a self-reinforcing pattern - we are amazing so amazing people want to come here. So they do, and thus it is amazing..... Along in the circle the most important point is the "amazing people". There is not insignificant education research showing if the people of the same caliber end up in other places, they still achieve amazing things, and in fact sometimes going to an ivy league school is a bad idea from a career point of view. All Canadian med schools have very high admission requirements, and thus ultimately get high achieving students - as measured and measured constantly by high quality assessments.

Perhaps not a perfect analogy as you picked two top US schools vs Canadian schools you are grading I suspect as of lower quality than other Canadian ones. Exceeding few people relatively speaking are getting training at MGH or Hopkins. How would the average American resident fair against the average Canadian one? I truly don't have any real objective evidence on that either way - if I had to guess probably fairly close I will say having personally trained medical students a several Canadian schools, vs Harvard there is really no difference I could find in quality. I found that kind of surprising initially but when you look at the admissions data the required GPA and MCAT scores at least it makes sense. We just truly have very high admission requirements.

FYI - Just cleaning up the thread - we try to keep things just to the pure posts of what shows up, so it is easy to see where we are at. Please keep to the standard format but discussion is of course welcome in other threads.

haven't read that article yet - ha, that is next - but if true that is just Canadian healthcare as per normal. Most of it is done in private businesses that directly bill the government.

Probably the same with most of us and fellowships - sure we learn some specific stuff in a particular area but overall it is just getting faster and more accurate in the area you already know with some areas of refinement.

Still have the paradox going on there - where a generalist is most useful - more rural practice which population wise is still relatively smaller population pool is also for many are less desirably areas. Adding a year of training people will make that worse as well - there are other factors in play here - they longer your you are working in urban areas the more likely you are going to stay there (for one thing people often find a partner there who has their own career already going in that city). You can never separate out these staffing issues from the broader context of things. Doing more training without access to any additional income down the line isn't exactly a great sell either - there is a real cost to doing extra years of training. Medicine is generally riff with mismatch of skill training to the actual job - medical school is always trying to train "generalists" but the majority of us simply aren't and use only a fraction of the training (time consuming and expensive training). Objectively it really is highly inefficient in places (you could argue the entire model is outdated - and there are fields that could be separated out and trained better separately. A major argument against this is you would have to know what field you wanted to do prior to starting medical school which is not true for most but medical school is often poorly designed to let you do that either (for instance not at all uncommon to have to pick 4th year electives for CARMS prep prior to even doing your clerkship rotations in those areas, and your clerkship order is not designed in most places to let you select from a list of fields you narrowed down. We really don't make a major focus on helping people pick a specialty and get it either - it comes up but is not woven into most medical school curriculums as a core function).