This is a throwaway account. I am a well-known member here so I made an alt account for stuff like this, just for the sake of cautiousness.
First of all, why should you listen to me? I don't know that you should, or whether or not you want to, it's purely up to you. But I will say that having overcome many self-esteem, confidence and anxiety issues, I think of myself as attractive, self-directed, athletic, charming, confident, and I have the capability of being vulnerable and empathic. I have never really had 'trouble' with women in the sense of not ever having kissed or been intimate with, formed a serious relationship with, had multiple casual sexual partners, etc. I've done all of that many times over. However, I did still struggle with a lot of issues that I believe you struggle with. Deeper, more fundamental concerns. However, it was a long journey from zero to here.
Anyways, here goes.
Buckle in for a long ride, Schulich2019. This journey will not be short. The issue you have, largely, is not one of "I have no experience with women" and your goal, in fact, should not be "I want to be in a relationship." Your goal rather, should be, "I want to be a confident, self-assured person who knows myself, my principles, my boundaries, my strengths and weaknesses, and has the sense of self and courage to learn, to grow, and to change myself at my will."
Your journey should be one of self-development and the study of yourself, not one of how to relate to the opposite sex in order to have sex, have relationships, or settle down. This may seem like a curious and ill-guided aside, a distraction from what you believe will make you happy, fulfilled, or a whole person. But the entire reason why your focus should be on yourself, rather than others, is because it behoves you to be focused on the process, rather than the result.
Overthinking the result, which in this case is a desire to becoming intimate with the opposite sex, is precisely what causes irrationality, desperation, an inability to see the truth clearly, and the escapism that prevents you from addressing true root causes. Why have you never had sex? Why have you never kissed someone? Why do you feel awkward when you approach a stranger? Despite their initial superficiality, or the misguided idea that these questions are easy to answer, they in act are NOT surface level questions with answers like "I never had time," "I am too shy," or "I don't want to bother people." No. The true answers are much, much deeper and more profound. They revolve around things like "I don't believe I'm worthy of other people's attention," "I don't think of myself as a competent individual," and "I don't love myself."
In order to really get to the bottom of this you have to do a few things, all simultaneously, none of which are any less or more important than the other.
1. Know yourself.
Can you answer me a question? Who are you? What do you value? What are you passionate about? What do you look for in order people? Who do you want to be? What are your strengths? What are your weaknesses? Where do your boundaries lie? What are your principles? These aren't talking points or interview questions. These questions, despite their apparent commonality, are not things for you to blabber on about on dates (although you can). On the contrary, these are questions to ask oneself that aid in building a foundation of "Who I Am". Truly pondering these ideas requires being vulnerable and open to the answers you have for yourself, many of which, at the end of it, you may not like at all. They allow you to formulate an idea of what it is you want in life. You may be surprised to learn that the things you thought you wanted were in fact a story you told yourself, perpetuated by friends, family, society, social media, popular media, and any number of other influences, into an internalized dreamscape of expectation that you willingly incorporated into your own mind. In fact, perhaps they aren't things you actually care about or value, but rather, you find yourself being quite remiss at the idea of following what others are doing, living your life the way that everyone else seems to do for themselves. Indeed, upon deciding what you want in life, or at least beginning to formulate an idea in the present, then in a self-loving manner, principles & boundaries begin to form. Principles and boundaries help dictate the way you behave, what relationships you value and don't value, when to say yes, and when to say no (and most importantly, your confidence in definitively saying yes or no), and they give you the fundamental courage you have to go after things that you want, and avoid things you do not. It may be shocking to realize at some point in your life and in your journey of self-study that a large a lot of people think they know what they want, and they will tell themselves and others this, but have not introspected to the point of truly knowing themselves. Mindfulness & meditation are some primary key tools you can use to boil down who you are, to get back to your roots, before you unlearned yourself, and put on a mask to show for the world.
2. Build confidence
There are 3 layers of confidence. The first layer is surface confidence. This is the way you present yourself to the world. It's the way you act and speak. This can be faked. Most people do fake it, on a regular basis. That means physicians. That means used car salesmen. That means the barista making you your coffee. Everybody fakes it. That's fine. This doesn't mean it's bad, it can be good, as the top layer of confidence can bleed into the lower two. However, it's important to remember that the first layer of confidence is completely insufficient. It's also important to remember that a lot of people you will meet or hear about will APPEAR confident from the outside, but don't mistake this for an unshakable sense of self. Their lower two layers may be crumbling, and they only have the top layer to rely on. The second layer is lifestyle confidence. This means any external factor in your life that you can garner confidence, self-worth, self-esteem from. This could be your career, your car, your apartment, the friends you have, the dog you have, the Rolex you just bought, the vacation you just went on, how many Instagram followers you have, your talents, your six-pack abs, your 400-lb deadlift. It doesn't particularly matter. The key thing to remember about this second layer is that a) it's all external and b) it's like a mosaic grid of squares that make up a big assembly of confidence that you can pull from when you need to. The issue is two-fold: 1. many people have far, far too few squares and 2. even those who have many, often have 1 or 2 squares or aspects of their life that they derive far, far too much confidence & self-worth from. They're over-leveraged, over-invested in a couple of things. They're one or two track people. There are a LOT of these types in professional fields. Folks who derive all of their self-worth from their academic, professional or financial position. Why do you think finance folks jump off of buildings during market crashes? Why do you think you hear stories of people who fall into the deepest of darkest of depressions after a break-up or divorce? It's because they derived far, far too much of their confidence, self-esteem, and sense of identity & purpose from one or two things that ultimately, they did not really have the control over its robustness or stability. Be cautious about being the master of one. The third level of confidence is core confidence. This is what remains once nothing in the second layer remains. You lose your job. You lose your friends. Your girlfriend breaks up with you. You fall into financial ruin. You get sick with cancer. You lose your body because you can't work out anymore. Etc. What do you have left? Can you keep going? No one says you can't be upset, distraught, dissapointed, but you cannot be at a loss. Core confidence is the self-assuredness of knowing that whatever happens, you will be okay. You will find a way to make the best of the situation, and continue on. You must work at building all 3 layers of confidence simultaneously. This means knowing yourself (building core confidence), developing hobbies, interests and investing your time in productive things (building lifestyle confidence), and learning how to present yourself the way that you want to present yourself (surface confidence). Do not be a house of cards that relies too much on one level. Build a castle.
3. Cultivate your mindset, attitude, and perspective.
People go to the gym to exercise their physical body. They do this to remain physically active and healthy. You must, absolutely must, do the same for your mental health and wellbeing. You must cultivate an expansive and positive atittude toward yourself and toward the world. People more than ever focus on their specific problems--their depression, their lack of motivation, their social inadequacies, their boredom. But what governs all of these seemingly separate problems is our attitude, how we view the world on a daily basis. It is how we see and interpret events. Improve the overall attitude and everything else will elevate as well, including our relationships with people. A negative, constricted attitude is designed to narrow down the richness of life in such a way that it only becomes a self-fulfilling prophecy, and eliminates our potential, our sense of fulfillment, and our lust for life. Instead, in the words of Robert Greene, "see yourself as an explorer. With the gift of consciousness, you stand before a vast and unknown universe that we humans have just begun to investigate... as an explorer you leave all... certainty behind you." This is the attitude that views adversity as an opportunity, that views failure as a success, and that views optimism as essential. I assure you that these values will carry you far in terms of your ability to take steps and make changes in your life, regardless of what avenue it's in.
4. Fuck around. Have fun. Get rejected.
Let's focus more on the issue at hand now. Earlier I mentioned not being concerned with the result, but rather being in love with the process (of becoming a self-assured & self-realized, confident & capable, empathetic & sensitive human being). This means that you will fuck up. You will have your heart broken. You will break hearts. You will be rejected, and reject. You will fumble, foil, fail, fall foolishly in the mess that is human relationships, dating, sex, whatever. That's okay. That's the point. No one was born instantly able to attract, charm, connect, build with people. The people who do this the best are the people who did it the worst previously. Don't hold yourself to an unreasonable standard so early in your journey.
5. Don't get tied up in time.
It will always, inevitably, be temping to rush yourself, to think that you're behind, and to think that everyone else seems to have it wholly together, being successful in their relationships and their lives and any number of other things you have not yet acquired. It may seem that you're late, as everyone else speeds ahead, and in your frustration you fall into the trap of insisting that you should get what you want NOW, or at least very soon, if only because it seems quite unfair that seemingly everyone else should be enjoying the spoils of life while you waste your time merely trying to achieve them.
This is an illusion. Aside from the fact that it is ludicrous to think, without any doubt, that everyone else has everything we don't and has not gone through the struggles we possess, but even if that were to be true, we must be strong and assured in the idea that our toils are not governed by time, but rather only by progress. It is essential only that we take it one day at a time, and simply try to be better tomorrow. Despite slow progress, despite bumps in the road, despite the surface confidence and surface appearance of others discouraging us, we stay in our own lane, at our own pace, with the knowledge and solace that our journey is our own. If we know ourselves, and if we treat ourselves with the self-love and self-respect we so truly deserve, time is no issue. Do not live in, and regret, the past, and do not live in, and expect too much from, the future. Everything you have and are is in the here and the now, and though at first this may seem like a frightening thought, it may be in fact, the single truism of life that grants us the courage, power, and ability to know ourselves, become who we would like to be, and treat both ourselves and the world with love, kindness, and gratitude.
I did not want this post to be just about women, sex, and relationships. However, if you'd like to discuss that in anymore detail with me, please feel free to PM me.
Ahhh the star......if it was up to them, there would be no physicians in the country and health outcomes would be perfect as a result. They sell papers by doctor bashing.
No citation on that data, so as far as we know, someone made it up. And those patients the NP is seeing are low acuity, uncomplicated patients. People are gonna be happy when you give them a birth control refill or treat an uncomplicated UTI. They are gonna be less happy when they are a poorly controlled T2DM and you are telling them they have to lose weight and exercise, while at the same timing starting insulin and piling extra BP meds on them to try and prevent an MI. On top of that, there are good studies out of the US that shows patient satisfaction (at least during hospitalization) is inversely related to outcomes. Satisfaction is a terrible metric to use to judge performance. It has nothing to do with actual outcomes that matter (survival, glucose control, time till recurrence etc).
The Star is anti-doctor. Everyone knows it. Unfortunately, the OMA has done a crap job with public relations in Ontario and now they are paying the price.
I don’t know what’s with all the obsession to have something objective. The way I see it, there are three factors that get you an interview to a program: 1) demonstration of interest, which will mean different things to different specialties regardless of whether we have grades or a standardized exam, and 2) some sort of accomplishment related to that specialty (i.e. it is not sufficient to simply do electives and get an interview), again this will be independent of grades or standardized exams and 3) absence of red flags and a few colleagues from your specialty highlighting some positive attributes in your reference letters, again this won’t change even with grades or a standardized exam. None of these three things are really subjective - you either demonstrated interest or you didn’t, you either took on research or other projects or you didn’t, and either you were half decent on electives or you weren’t. Maybe it’s subjective to the applicant because they don’t know the criteria, but frankly that’s the liberty the employer has - they can evaluate on and prioritize whatever they want.
Once you you have an interview, it is absolutely subjective and I don’t see why it shouldn’t be. Pre-interview screens for applicant quality on paper (your CV), the interview screens for people the program wants to have around for 5 years, and this will differ from one program to the next. Every job on Earth uses this model - impress with a CV to get the interview, then demonstrate your fit with the team and job needed at the interview to secure the position. No google exec is looking at the applicants grades. To me, a program director saying they need grades to discriminate applicants is lazy. There’s probably something they can discern between two people on paper, and if not just interview both.
Relying on grades and and exam scores alone would not, and should not change this - it’s a crutch for people who don’t have anything else going on and thinking that if you get good grades and a good exam score then you deserve a match is wrong. It will show what students are at the top of the class, but how does that translate into someone who is going to be a good resident? Anyone who uses every hour of the day to focus on med school grades is doing it wrong - at one point there are diminishing returns of how useful that extra 5% knowledge is in your daily practice, so you are better off using that extra time to get to know the faculty and residents and do other things that will help your career for the better.
That is a valid point I think - McMaster has always claimed their program is equivalent and this would be another way to show that in practice. It would actually be a powerful recruiting tool as well in a sense. In the US for instance the average USMLE score of the students is used to help attract people to the school.
As you point out it would also partially remove some of the pressure of selecting a specialty so early - a standard test would be a universal currency in the matching process. You change your mind and at least you have that to stand on. Now you can spend a lot of time before you ready doing things that may not have any positive impact on your application in the end. It also means you won't be constantly trying to figure out as much about what a particular school's program in X is actually interested in - which honestly no one can clearly give you an answer to as it everyone just has a piece of the puzzle, and it changes quite frequently (PD for instance have a lifespan of about 5 years give or take on average and there are often shake ups when the change).
I'm using the Scotia LOC and from what I've researched there are no downsides that i can think of (I actually will be using my LOC though).
There are some conditions you have to meet to get all the perks, but other than that I don't see why not. You don't have to actually use the LOC to meet any of the conditions.
We have quite a few different threads going on relating to this, so just wanted to put things in one place. With the CBC article out today and the CMAJ editorial out this week on the topic of CaRMS and what to do, the media, the public and physicians are looking for possible solutions - the UofT Dean tweeted today as well about looking for solutions. So, I figured, a dedicated thread with proposals to share ideas could be useful.
My own opinions on guiding principles of CaRMS/the Match:
- Every graduating CMG deserves a fair opportunity to a residency position, and should be given priority over candidates trying to re-enter, IMGs, or last year's unmatched. Basically it should be such that if the student wants a spot, there will be a spot available in their graduating year, and they only become fully unmatched needing to go again the next year if they decline the available spot on their own terms. This would mean that (a) programs are not legally allowed to leave spots unfilled, and (b) there should be options to default into FM at your home school if nothing else is available.
- For those that do go unmatched, there should be enough residency spots left over for a "round 3" of CaRMS. This would basically be a gamble to see if a spot is available in some other specialty, and if not then they should still have the option of defaulting to FM at their home program. Ideally, there would be very few people in this category based on point #1 above. These people would take priority over IMGs, with IMGs being able to pick up whatever is leftover - Canadian taxpayers have no obligations to take IMGs.
- All MDs who have passed LMCC part 1 should be able to work as a physician extender/moonlight in certain clinical settings. This will allow students who do go unmatched the opportunity to pick up a shift or two and help cover costs of the unmatched year.
- No student is or should be guaranteed the residency specialty of their desire. No, not everyone who wants to be a plastic surgeon will or should be a plastic surgeon. This should be made extremely clear even when starting med school, and setting people up to have backup careers in mind. In med school, it's often thought that it's an "even playing field" on day 1, but that is 100% not true. There are people in my class who were destined to be pediatricians before med school even started that no late comer to the specialty would have any chance of displacing from a position in peds. Same for plastics, derm, ophtho etc - the entry CV of people in med school is incredibly broad and it can't be expected that your chances on day one of matching into a certain specialty is just as good as anyone elses. At the end of the day, while medicine is our job, we are doing it to provide a service to the community and so there needs to be a proper distribution of students going into specialties in need rather than the specialty the absolutely want (and I'm sure most people day before med school acceptance offers came out would have been happy to do anything so long as they got accepted).
- The subjective aspect of CaRMS is a good thing and should remain as such. In basically every other job, selection of the right candidate comes down to a combination between on paper performance, and who the person actually is. There is probably no rigidly defined weighting to each of those, and that weighting could change year to year depending on the needs of the company. Moreover, this weighting probably differs company to company as they have different needs. Same for residency - the needs of a rural FM program are different from an academic neurosurgery program, which may be different even within themselves across the country. So instituting standardized exam scores, publication counts, grades etc as standardized measures to form rank lists of candidates would not be appropriate - it should be the individual program's discretion to decide what their priority is for their program and the community they serve, and then accept candidates accordingly. This is just how employment works. Within this freedom, however, refer to my first point that they still should not be allowed to leave a position unfilled if there are candidates interested in taking the spot.
- There should be an adjustment to med school admissions, residency positions (mostly FM) or both.
This grade business is scaring me hahaha, at what point should I not worry about my undergrad grades, 4.0,3.9,3.8, etc. If they're gonna pull up my past like that they might as well pull up my grade school report cards as well lol
Honestly all the fuss here about UG transcripts is too much and I think this is going to perpetuate some wrong ideas. It’s honestly such a small piece of the application, I can only see it being used as a flag to capture any past professionalism issues. I don’t know about rads, but I can guarantee you that in ultra competitive specialties like derm it will be your lack of publications/PhD, lack of stellar ECs, lack of outstanding elective and general clerkship performance (both medically and professionally), lack of “knowing” and being liked by the residents and staff that spoils your application loooooooong before that C/D/F grade in first year undergrad comes back to haunt you.
EDIT: just to add, rmorelan above mentioned that on paper 20% of applicants look amazing and stand out, 20% look terrible and 80% look good but the same. In derm, plastics etc, if you’re outside of that top 20% your chances are already very slim since not much more than that gets accepted every year. Which is why I say that for these programs, your UG grades won’t matter since the top 20% are not being differentiated from the rest on the basis of their undergrad grades.