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CGreens

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  1. Most doctors who work at hospitals would not be considered employees. I think it would also be important to note that "employee" has a legal meaning where the employer is required to provide benefits and is subject to employee/employer labour legislation. Most doctors work essentially as independent contractors. If a doctor is working in a hospital they generally have "privileges" to work in the hospital. Basically they exchange call coverage for the ability to provide care (and the associated OHIP billings) in the hospital. Now correct me if I am wrong, but within the organizational structure of a hospital, physicians don't report to the CEO. Rather they report to a physician chief of staff, but they are not treated as employees within the structure of thee hospital. Now some doctors are provided with a salary. Some of these physicians will be true employees (I think laboratory medicine physicians such as pathologists are employees of hospitals in Ontario. They receive benefits, pensions through HOOPP, etc), but other physicians receiving a salary or hourly pay will still be classified as independent contractors and not entitled to the benefits of employment such as benefits (e.g., many family doctors will provide ER coverage in rural locations for an hourly rate, but they're not getting benefits). Note there are also differences between academic professorships vs community practice. I think these are really good questions to ask. As a medical student from a non physician parent background, its something I am really trying to educate myself on. People often have a rosey picture of what practicing as a physician is like (and that they can neglect the business side!) and I think it is important to realize many specialties operate essentially as small businesses and that it is okay to want to be interested in entrepreneurship while still optimizing patient care. RE: incomes, many physicians might not think in terms of income. For example, many in Ontario will be incorporated as a tax strategy and provide themselves with a salary to meet the max RRSP contribution (~150,000 I think) and pay dividends from their corp to meet any additional costs of living if needed. Extra money will be invested in the tax sheltered corp to save for retirement, so you might think more in terms of gross billings and overhead costs. Note also that there are pros and cons to being an employee. For example, you may have a pension and benefits in some positions. However, as a business owner you could perhaps beat the pension fund's return over your lifetime (and pension may also not be indexed to inflation!). Additionally, as an employee you give up a certain degree of autonomy, which is a key pillar of professionalization. You could also look into other forms of physician payment. Fee for service is one model, but you can also look into capitation where you are paid per patient in your roster, and various other alternative physician payment plans. EDIT: I'm only a medical student so all this could also be completely wrong
  2. Actually depends on where you are in Canada (for access to different provincial programs) and your residency. For example, family medicine residents and physician can have up to $8,000 per year of student loans forgiven up to $40,000 if they complete up to 400 hours or 50 days a year in a rural location (https://www.canada.ca/content/dam/canada/employment-social-development/migration/documents/assets/portfolio/docs/en/student_loans/forms/forgiveness.pdf). If you pay off your student loans on your LOC you would not have access to this forgiveness program. Make sure you consider your unique situation prior to making any financial decisions.
  3. That is a good outlook to have for now. Shadowing in the Winter was definitely more useful compared to the fall as you definitely had more clinical knowledge under your belt to make sense of what was going on (ITM in the fall is useful for background info and introducing you to medical school and how physicians think, but it isn't until you get to CPC that the really useful clinical information starts being taught in class/clinical skill/CBL). In the past we have been able to shadow at non-UofT affiliated hospitals. During the fall, you'll get a lecture that goes over all the procedures for how to approach shadowing. Basically with any UofT hospital (including Mississauga hospitals, and any of the academy sites - they don't have to be just the academic ones) you can set up an observership basically just by emailing the physician and logging the experience prior to shadowing. You have to log it for it to count as a "curricular experience" so that appropriate legal/liability mechanisms are in place to cover you. With outside hospitals you have to give at least 3-weeks notice for approval of your observership. I believe the rationale is so that they can arrange appropriate legal/liability coverage (though I could be wrong/misremembering what was said). One caveat is I'm not sure how it would work if the outside hospital or site is associated with another medical school.
  4. While true that that is what they communicated for shadowing, I think its important to read between the lines a bit and not let your hopes get too high (and maybe be pleasantly surprised if they allow it). Note that I'm not trying to be argumentative or contrarian, just trying to share what I know, which is formed partly from my experiences at UofT last school year. What I "know" could be wrong, dated, or misinformed. My understanding through previous communications is that UofT is prioritizing the current clerkship students in clinical settings. Due to the pause in clinical activities related to COVID, there will be a period of time with a double cohort of clerkship students as the now 4th years finish up their core while the 3rd years enter clerkship. Once this period passes, then there would be an opportunity perhaps for us to shadow (with that being said, shadowing for first years only starts in October generally. On MedSIS click the CAP tab to see previous students shadowing opportunities btw if you want to look ahead). I am personally only expecting to be able to shadow again starting in the Winter, with perhaps some opportunity for virtual shadowing in the fall (though I am not sure how this will be set up re: in person with the physician or connecting remotely). At the same time, this is also still all flexible to the COVID situation as I also expect numbers to rise again in the Fall, especially within Toronto (e.g., returning students, elementary/secondary schools, etc).
  5. Anatomy labs at UofT are not truly in person. The usual modules that we’d do in person with prosections and dissection are online. There are optional guided prosections with a TA that you can sign up for in addition to the online content to do in person. Basically, you don’t need to be in Toronto for the Fall, it’s possible to do it all online and they’re even polling us to understand our time zones for test start times. Shadowing for the time being is still not allowed (not up in the air, wouldn’t expect it to be allowed until the winter either). Edit: from the second year (2T3) perspective, could be different from first years
  6. Someone feel free to correct this as I am not a PHPM specialist, I am just speaking from my research and what I have been told by PHPM specialists during tutorials. The general format of most PHPM residencies that you can find by viewing CARMS descriptions follows something like this: PGY1: Family medicine year PGY2: Family medicine year At this point you'd be able to write the CFPC exams I think and register as a family doctor. PGY3: Graduate degree year (seems to generally be a MPH and I believe you can also make extra money working as a family doctor if you have time) PGY4: PHPM rotations including electives and selectives (environmental health, health promotions/chronic disease prevention, health planning/policy, communicable disease control, senior management and administration) PGY5: PHPM rotations including electives and selectives (environmental health, health promotions/chronic disease prevention, health planning/policy, communicable disease control, senior management and administration) See this link for an example royal college exam for some of the questions that PHPM residents would be asked (click "sample SAQ exam"): http://www.royalcollege.ca/rcsite/documents/ibd/public_health_and_preventive_medicine_examformat_e The vast majority of training positions in PHPM also certify you in family medicine, but there are a select few that do not (e.g., four positions across English speaking medical schools in 2020 match). I think one reality individuals have to face is that generally (there are exceptions) PHPM programs train you to work as a medical officer of health at a public health unit. This entails a significant amount of "politicking" within your local community where you will work (e.g., interacting with elected municipal council and media appearances), which may not be for everyone. I do know that some PHPM graduates will continue to work occasionally as a family doctor in a limited capacity or will hold clinics within their interest areas (e.g., tropical diseases, sexual health, STI clinic, etc.). Definitely a great option for someone who is interested in health policy and maintaining a clinical practice. However, it also possible to be involved in advocacy work which can influence policy as any other type of doctor or become involved in physician association groups (e.g., family doctor advocating for rural health, OBGYN advocating for progressive reproductive policies, etc.). You can also take a jump and transition into an elected provincial or federal MP role during your career if you want direct legislative experience...
  7. Hi mavrik13, thank you for offering to answer some questions. I am a current M2 with some exposure to rad onc through shadowing and am interested in the field, but I have some questions I hope you can address. 1. On the Student Doctor Network, there is an alarmingly pessimistic attitude towards rad onc primarily directed towards the job outlook in the US context. As it is on SDN I want to take it with a grain of salt, but the concerns relate to the over training of the number of rad onc residents (and to some extent with profit-driven healthcare and radiation oncologists being the down stream receiver of referrals). Some posts even suggest that they'd need to shut down all residencies for five years for their job market to recover. My questions for this is -> will the Canadian rad onc job market be protected from a potential over supply in the US (e.g., hiring practices of community vs. academic centres and preference for CDN vs USA training)? This is important as the Canadian market still doesn't seem fantastic despite what was sold to you and I wonder if rad onc will go the way of pathology, with IMGs making up an increasing number of the specialty. In addition, how is the job market for those who don't want to work in the major, major centres like Toronto and Vancouver (and maybe even have a preference for community)? 2. As the field of rad onc evolves in the future, I know that is it unlikely for rad onc to become obsolete in my lifetime. With that being said, there seems to be a general push for hypo fractionated treatment regimens, SBRT, SRS, etc. These are fascinating technologies that look really cool to use and learn with the potential for great patient outcomes. A potential side effect I wonder though is there are less on treatment checkups, and potentially less ownership or shared decision making with the patient. If you are not seeing the patient as often, I see it as becoming more difficult to build the relationships that rad onc is known for/make that difference in their life through managing cancer and treatment related side effects. My questions here essentially boils down to, in the future with new technologies how will the rad onc role change, and will it become more technical/"procedural" (or one-off? maybe more similar to interventional radiology)? What will define a rad onc as a physician oncologist vs. a technician who uses radiation? As targeted therapies become more prevalent and have fewer toxicities as compared to chemotherapies that med oncs use, will rad oncs in Canada become more involved in their prescribing? 3. Earlier in this thread it was mentioned that rad onc evolved out of radiology rather than IM. While IM is a gruelling residency, at my naive point in training, I see IM as containing much potentially useful knowledge and experiences. Do you ever feel your medical knowledge is "lacking" or wish you had more of that general IM training when seeing patients (or if you are in a rad onc residency that sees inpatients?). Will this present problems related to my question 2 in the future and prevent rad oncs from being the MRP. With that being said, obviously rad onc is its own specialty for a reason and needs the time to develop expertise within its own competencies. I appreciate your time providing feedback on any of these questions! I'm sure if I'm thinking of these questions, that there are at least a few others also thinking some variation of them!
  8. UofT mentioned during a webinar to 2T3s that the fall would be mostly online. It was unclear at the time if it was entirely online, or with “optional” in person experiences for things like anatomy. UofT seems concerned about a second wave and mentioned winter likely having online components as well. They mentioned that they’d give students ample warning to arrange living if they require us to be in person in Toronto.
  9. Thanks for this write up, makes me excited to work in the North in the near future! As NOSM continues to supply new graduates to the North year after year, do you foresee this practice style to be sustainable for new family medicine grads (I.E., mix of inpatient, clinic, walk-in, for others ER/OB/etc)? That is, do you predict that there will be plenty of practice opportunities for new grads in rural (or northern urban) locations in the coming years, perhaps with new grads being offset by retirements of older physicians and physicians moving away? Or is there a possibility that we see the non-specialist physician job market it Northern Ontario tighten up in the future as additional classes from NOSM graduate?
  10. This was for last year. Unsure if the 125 will screen you out. Considering Queens doesn't have supplementary essays, it doesn't hurt to try applying.
  11. I got an interview with a 125 in chem/phys and 128 in everything else.
  12. Anyone get their academy assignment yet?
  13. I was accepted to UofT, but our admissions officer emailed us directing us to submit to OMSAS.
  14. Result: Accepted - St. George cGPA: 3.95 wGPA: 3.99 MCAT: 509 (125/128/128/128) ECs: Lots of research (2 first author, 2 coauthors pubs, NSERC, posters, invited speaker, etc.), and a good balance of other activities with leadership, employment, etc. I also felt like I had 2 very strong LoR and one average to strong LoR. Essays: I wrote them during an all nighter the day before applications were due so I wasn't expecting much. However, I did go back and reread them, and maybe due to the time crunch, I can tell I answered the questions while being true to myself, so perhaps that helped. I didn't have anyone review them. Interview: My favourite interview by far! I felt like I was able to be myself and made some genuine connections with 3 of the interviewers. I felt 3 stations went great and 1 was average. Year: 4th Geography: IP I will be accepting my offer and am looking forwarded to meeting everyone! Good luck and don't give up if things don't go your way this year!
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